Aortic pathologies such as coarctation, dissection, and aneurysm represent a

particularly emergent class of cardiovascular diseases and account for significant cardiovascular morbidity and mortality worldwide. Computational simulations of aortic flows are growing increasingly important as tools for gaining understanding of these pathologies and for planning their surgical repair. In vitro experiments are required to validate these simulations against real world data, and a pulsatile flow pump system can provide physiologic flow conditions characteristic of the aorta.

This dissertation presents improved experimental techniques for in vitro aortic blood flow and the increasingly larger parts of the human cardiovascular system. Specifically, this work develops new flow management and measurement techniques for cardiovascular flow experiments with the aim to improve clinical evaluation and treatment planning of aortic diseases.

The hypothesis of this research is that transient flow driven by a step change in volume flux in a piston-based pulsatile flow pump system behaves differently from transient flow driven by a step change in pressure gradient, the development time being substantially reduced in the former. Due to this difference in behavior, the response to a piston-driven pump can be predicted in order to establish inlet velocity and flow waveforms at a downstream phantom model.

The main objectives of this dissertation were: 1) to design, construct, and validate a piston-based flow pump system for aortic flow experiments, 2) to characterize temporal and spatial development of start-up flows driven by a piston pump that produces a step change from zero flow to a constant volume flux in realistic (finite) tube geometries for physiologic Reynolds numbers, and 3) to develop a method to predict downstream velocity and flow waveforms at the inlet of an aortic phantom model and determine the input waveform needed to achieve the intended waveform at the test section. Application of these newly improved flow management tools and measurement techniques were then demonstrated through in vitro experiments in patient-specific coarctation of aorta flow phantom models manufactured in-house and compared to computational simulations to inform and execute future experiments and simulations.

Image segmentation is of great importance and value in many applications. In computer vision, image segmentation is the tool and process of locating objects and boundaries within images. The segmentation result may provide more meaningful image data. Generally, there are two fundamental image segmentation algorithms: discontinuity and similarity. The idea behind discontinuity is locating the abrupt changes in intensity of images, as are often seen in edges or boundaries. Similarity subdivides an image into regions that fit the pre-defined criteria. The algorithm utilized in this thesis is the second category.

This study addresses the problem of particle image segmentation by measuring the similarity between a sampled region and an adjacent region, based on Bhattacharyya distance and an image feature extraction technique that uses distribution of local binary patterns and pattern contrasts. A boundary smoothing process is developed to improve the accuracy of the segmentation. The novel particle image segmentation algorithm is tested using four different cases of particle image velocimetry (PIV) images. The obtained experimental results of segmentations provide partitioning of the objects within 10 percent error rate. Ground-truth segmentation data, which are manually segmented image from each case, are used to calculate the error rate of the segmentations.

The application of novel visualization and modeling methods to the study of cardiovascular disease is vital to the development of innovative diagnostic techniques, including those that may aid in the early detection and prevention of cardiovascular disorders. This dissertation focuses on the application of particle image velocimetry (PIV) to the study of intracardiac hemodynamics. This is accomplished primarily though the use of ultrasound based PIV, which allows for in vivo visualization of intracardiac flow without the requirement for optical access, as is required with traditional camera-based PIV methods.

The fundamentals of ultrasound PIV are introduced, including experimental methods for its implementation as well as a discussion on estimating and mitigating measurement error. Ultrasound PIV is then compared to optical PIV; this is a highly developed technique with proven accuracy; through rigorous examination it has become the “gold standard” of two-dimensional flow visualization. Results show good agreement between the two methods.

Using a mechanical left heart model, a multi-plane ultrasound PIV technique is introduced and applied to quantify a complex, three-dimensional flow that is analogous to the left intraventricular flow. Changes in ventricular flow dynamics due to the rotational orientation of mechanical heart valves are studied; the results demonstrate the importance of multi-plane imaging techniques when trying to assess the strongly three-dimensional intraventricular flow.

The potential use of ultrasound PIV as an early diagnosis technique is demonstrated through the development of a novel elasticity estimation technique. A finite element analysis routine is couple with an ensemble Kalman filter to allow for the estimation of material elasticity using forcing and displacement data derived from PIV. Results demonstrate that it is possible to estimate elasticity using forcing data derived from a PIV vector field, provided vector density is sufficient.

The advent of medical imaging has enabled significant advances in pre-procedural planning, allowing cardiovascular anatomy to be visualized noninvasively before a procedure. However, absolute scale and tactile information are not conveyed in traditional pre-procedural planning based on images alone. This information deficit fails to completely prepare clinicians for complex heart repair, where surgeons must consider the varied presentations of cardiac morphology and malformations. Three-dimensional (3D) visualization and 3D printing provide a mechanism to construct patient-specific, scale models of cardiovascular anatomy that surgeons and interventionalists can examine prior to a procedure. In addition, the same patient-specific models provide a valuable resource for educating future medical professionals. Instead of looking at idealized images on a computer screen or pages from medical textbooks, medical students can review a life-like model of patient anatomy.



In cases where surgical repair is insufficient to return the heart to normal function, a patient may proceed to advanced heart failure, and a heart transplant may be required. Unfortunately, a finite number of available donor hearts are available. A mechanical circulatory support (MCS) device can be used to bridge the time between heart failure and reception of a donor heart. These MCS devices are typically constructed for the adult population. Accordingly, the size associated to the device is a limiting factor for small adults or pediatric patients who often have smaller thoracic measurements. While current eligibility criteria are based on correlative measurements, the aforementioned 3D visualization capabilities can be leveraged to accomplish patient-specific fit analysis.

The main objectives of the work presented in this dissertation were 1) to develop and evaluate an optimized process for 3D printing cardiovascular anatomy for surgical planning and medical education and 2) to develop and evaluate computational tools to assess MCS device fit in specific patients. The evaluations for objectives 1 and 2 were completed with a collection of qualitative and quantitative validations. These validations include case studies to illustrate meaningful, qualitative results as well as quantitative results from surgical outcomes. The latter results present the first quantitative supporting evidence, beyond anecdotal case studies, regarding the efficacy of 3D printing for pre-procedural planning; this data is suitable as pilot data for clinical trials. The products of this work were used to plan 200 cardiovascular procedures (including 79 cardiothoracic surgeries at Phoenix Children's Hospital), via 3D printed heart models and assess MCS device fit in 29 patients across 6 countries.

Three dimensional (3-D) ultrasound is safe, inexpensive, and has been shown to drastically improve system ease-of-use, diagnostic efficiency, and patient throughput. However, its high computational complexity and resulting high power consumption has precluded its use in hand-held applications.

In this dissertation, algorithm-architecture co-design techniques that aim to make hand-held 3-D ultrasound a reality are presented. First, image enhancement methods to improve signal-to-noise ratio (SNR) are proposed. These include virtual source firing techniques and a low overhead digital front-end architecture using orthogonal chirps and orthogonal Golay codes.

Second, algorithm-architecture co-design techniques to reduce the power consumption of 3-D SAU imaging systems is presented. These include (i) a subaperture multiplexing strategy and the corresponding apodization method to alleviate the signal bandwidth bottleneck, and (ii) a highly efficient iterative delay calculation method to eliminate complex operations such as multiplications, divisions and square-root in delay calculation during beamforming. These techniques were used to define Sonic Millip3De, a 3-D die stacked architecture for digital beamforming in SAU systems. Sonic Millip3De produces 3-D high resolution images at 2 frames per second with system power consumption of 15W in 45nm technology.

Third, a new beamforming method based on separable delay decomposition is proposed to reduce the computational complexity of the beamforming unit in an SAU system. The method is based on minimizing the root-mean-square error (RMSE) due to delay decomposition. It reduces the beamforming complexity of a SAU system by 19x while providing high image fidelity that is comparable to non-separable beamforming. The resulting modified Sonic Millip3De architecture supports a frame rate of 32 volumes per second while maintaining power consumption of 15W in 45nm technology.

Next a 3-D plane-wave imaging system that utilizes both separable beamforming and coherent compounding is presented. The resulting system has computational complexity comparable to that of a non-separable non-compounding baseline system while significantly improving contrast-to-noise ratio and SNR. The modified Sonic Millip3De architecture is now capable of generating high resolution images at 1000 volumes per second with 9-fire-angle compounding.

Cigarette smoking remains a major global public health issue. This is partially due to the chronic and relapsing nature of tobacco use, which contributes to the approximately 90% quit attempt failure rate. The recent rise in mobile technologies has led to an increased ability to frequently measure smoking behaviors and related constructs over time, i.e., obtain intensive longitudinal data (ILD). Dynamical systems modeling and system identification methods from engineering offer a means to leverage ILD in order to better model dynamic smoking behaviors. In this dissertation, two sets of dynamical systems models are estimated using ILD from a smoking cessation clinical trial: one set describes cessation as a craving-mediated process; a second set was reverse-engineered and describes a psychological self-regulation process in which smoking activity regulates craving levels. The estimated expressions suggest that self-regulation more accurately describes cessation behavior change, and that the psychological self-regulator resembles a proportional-with-filter controller. In contrast to current clinical practice, adaptive smoking cessation interventions seek to personalize cessation treatment over time. An intervention of this nature generally reflects a control system with feedback and feedforward components, suggesting its design could benefit from a control systems engineering perspective. An adaptive intervention is designed in this dissertation in the form of a Hybrid Model Predictive Control (HMPC) decision algorithm. This algorithm assigns counseling, bupropion, and nicotine lozenges each day to promote tracking of target smoking and craving levels. Demonstrated through a diverse series of simulations, this HMPC-based intervention can aid a successful cessation attempt. Objective function weights and three-degree-of-freedom tuning parameters can be sensibly selected to achieve intervention performance goals despite strict clinical and operational constraints. Such tuning largely affects the rate at which peak bupropion and lozenge dosages are assigned; total post-quit smoking levels, craving offset, and other performance metrics are consequently affected. Overall, the interconnected nature of the smoking and craving controlled variables facilitate the controller's robust decision-making capabilities, even despite the presence of noise or plant-model mismatch. Altogether, this dissertation lays the conceptual and computational groundwork for future efforts to utilize engineering concepts to further study smoking behaviors and to optimize smoking cessation interventions.

Objective: Examine cardiovascular response to OMT via central and peripheral measurements. Methods: Central and peripheral cardiovascular signals of asymptomatic human subjects were monitored during a procedure with alternating rest and active phases. Active phases included systemic perturbations and application of controlled vertebral pressure (OMT) by an experienced osteopathic physician. Pulse plethysmograph and laser Doppler flow sensors measured peripheral flow from index and middle fingers bilaterally. A three-lead EKG monitored cardiac activity. The biosignals were recorded continuously, in real time, and analyzed in time and frequency domains. Results from the control group (n=11), without OMT, and active group (n=16), with OMT, were compared. Peripheral (n=5) and central responders (n=6), subsets of the active group showing stronger peripheral or central response, were examined. In an additional effort, a modified clinical device recorded spectral Doppler ultrasound signals of the radial and dorsalis pedis arteries of clinically asymptomatic human subjects. Controlled physiologic provocations (limb occlusion and elevation), were performed. Time domain and spectral analyses were completed. Results: In the human subject study, the time wave characteristics and spectral analysis resulted in similar trends. Peripheral blood flow attenuated in the control group over time, while it was maintained in the active group, and increased specifically during OMT in the responder groups. Heart rate remained around 65 BPM in the control group, fluctuated between 64-68 BPM in the active group, and dropped 4 and 3 BPM in the peripheral and central responder groups, respectively. The effect in the OMT group was statistically significant compared to no-OMT, however, was not statistically significant within-groups. For the preliminary spectral ultrasound Doppler study, segmental flow was successfully monitored. A prototype "Quick Assessment" tool was developed, providing instant post-processing results for clinical use. Conclusions: OMT along the vertebral column may influence autonomic processes that regulate heart rate and peripheral vascular flow.

Stereolithography files (STL) are widely used in diverse fields as a means of describing complex geometries through surface triangulations. The resulting stereolithography output is a result of either experimental measurements, or computer-aided design. Often times stereolithography outputs from experimental means are prone to noise, surface irregularities and holes in an otherwise closed surface.

A general method for denoising and adaptively smoothing these dirty stereolithography files is proposed. Unlike existing means, this approach aims to smoothen the dirty surface representation by utilizing the well established levelset method. The level of smoothing and denoising can be set depending on a per-requirement basis by means of input parameters. Once the surface representation is smoothened as desired, it can be extracted as a standard levelset scalar isosurface.

The approach presented in this thesis is also coupled to a fully unstructured Cartesian mesh generation library with built-in localized adaptive mesh refinement (AMR) capabilities, thereby ensuring lower computational cost while also providing sufficient resolution. Future work will focus on implementing tetrahedral cuts to the base hexahedral mesh structure in order to extract a fully unstructured hexahedra-dominant mesh describing the STL geometry, which can be used for fluid flow simulations.

The ability to monitor electrophysiological signals from the sentient brain is requisite to decipher its enormously complex workings and initiate remedial solutions for the vast amount of neurologically-based disorders. Despite immense advancements in creating a variety of instruments to record signals from the brain, the translation of such neurorecording instrumentation to real clinical domains places heavy demands on their safety and reliability, both of which are not entirely portrayed by presently existing implantable recording solutions. In an attempt to lower these barriers, alternative wireless radar backscattering techniques are proposed to render the technical burdens of the implant chip to entirely passive neurorecording processes that transpire in the absence of formal integrated power sources or powering schemes along with any active circuitry. These radar-like wireless backscattering mechanisms are used to conceive of fully passive neurorecording operations of an implantable microsystem. The fully passive device potentially manifests inherent advantages over current wireless implantable and wired recording systems: negligible heat dissipation to reduce risks of brain tissue damage and minimal circuitry for long term reliability as a chronic implant. Fully passive neurorecording operations are realized via intrinsic nonlinear mixing properties of the varactor diode. These mixing and recording operations are directly activated by wirelessly interrogating the fully passive device with a microwave carrier signal. This fundamental carrier signal, acquired by the implant antenna, mixes through the varactor diode along with the internal targeted neuropotential brain signals to produce higher frequency harmonics containing the targeted neuropotential signals. These harmonics are backscattered wirelessly to the external interrogator that retrieves and recovers the original neuropotential brain signal. The passive approach removes the need for internal power sources and may alleviate heat trauma and reliability issues that limit practical implementation of existing implantable neurorecorders.

Advancements in mobile technologies have significantly enhanced the capabilities of mobile devices to serve as powerful platforms for sensing, processing, and visualization. Surges in the sensing technology and the abundance of data have enabled the use of these portable devices for real-time data analysis and decision-making in digital signal processing (DSP) applications. Most of the current efforts in DSP education focus on building tools to facilitate understanding of the mathematical principles. However, there is a disconnect between real-world data processing problems and the material presented in a DSP course. Sophisticated mobile interfaces and apps can potentially play a crucial role in providing a hands-on-experience with modern DSP applications to students. In this work, a new paradigm of DSP learning is explored by building an interactive easy-to-use health monitoring application for use in DSP courses. This is motivated by the increasing commercial interest in employing mobile phones for real-time health monitoring tasks. The idea is to exploit the computational abilities of the Android platform to build m-Health modules with sensor interfaces. In particular, appropriate sensing modalities have been identified, and a suite of software functionalities have been developed. Within the existing framework of the AJDSP app, a graphical programming environment, interfaces to on-board and external sensor hardware have also been developed to acquire and process physiological data. The set of sensor signals that can be monitored include electrocardiogram (ECG), photoplethysmogram (PPG), accelerometer signal, and galvanic skin response (GSR). The proposed m-Health modules can be used to estimate parameters such as heart rate, oxygen saturation, step count, and heart rate variability. A set of laboratory exercises have been designed to demonstrate the use of these modules in DSP courses. The app was evaluated through several workshops involving graduate and undergraduate students in signal processing majors at Arizona State University. The usefulness of the software modules in enhancing student understanding of signals, sensors and DSP systems were analyzed. Student opinions about the app and the proposed m-health modules evidenced the merits of integrating tools for mobile sensing and processing in a DSP curriculum, and familiarizing students with challenges in modern data-driven applications.