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Point-of-care technologies

Overview

Shieak Tzeng thumbAssociate Professor Shieak Tzeng.

We are dedicated to improving patient outcomes through innovation at the point of care. Optimised monitoring and objective, informed decision-making can revolutionise patient care and save lives.

Using our translational expertise, we marry medical engineering and statistical modelling with the aim of empowering clinicians to make better informed decisions at the bedside.

Our extensive team includes clinicians, neonatologists, physicists, neuroscientists, data scientists, and animal technicians.

Contact

Associate Professor Shieak Tzeng
Tel +64 4 918 5229
Email shieak.tzeng@otago.ac.nz

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Research

Decision-making software

The Precision Health in Surgical and Intensive Care (PHySIC) group, is combining active clinical research, novel clinical databases, and machine learning, to determine patient status and needs in critical care.

PHySIC is an open source, anonymous archive database holding continuous wave-form data alongside the usual clinical information sourced from ICU’s and intraoperative spaces across New Zealand’s District Health Boards.

Through relationships with Wellington Regional Hospital, Capital Coast DHB, and clinical collaborators, our team are actively working towards the creation of a novel, New Zealand-specific medical database based on MIT’s MIMIC (Multi-parameter Intelligent Monitoring in Intensive Care).

Data scientists and machine learning experts at the University of Otago, Wellington, and Victoria University Wellington are using the PHySIC database to create predictive models for the likes of sepsis and cardiac surgery risk, the potential for innovating treatment with predictive models extends to every corner of New Zealand critical care.

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Medical engineering

Translational and clinical researchers at the University of Otago Wellington campus have partnered with physicists and engineers at Victoria University Wellington with the aim to innovate bedside brain-health detection.

Through this collaboration, they hope to validate brain diagnoses and monitoring in an accessible paradigm. Making these capabilities more available will empower more clinicians in their decision making and lead to better care of critical neurological disorders.

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Research facilities

The Centre for Translational Physiology at the University of Otago can offer unique research facilities such as:

  • GENESIS environmental chamber able to simulate a variety of extreme environmental conditions by altering temperature, humidity and altitude.
  • Whole body room calorimeter
  • DXA scanner
  • Ultrasound (transcranial, vascular, cardiac)
  • Near-infrared spectroscopy
  • Cardiopulmonary bypass
  • Wireless physiological monitoring

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Our people

The team, led from University of Otago Wellington campus, includes physiologists, surgeons, neonatologists, and engineers.

Point-of-care research leader

Associate Professor Shieak Tzeng, systems physiology and biomedical signal processing

Investigators

External collaborators

Publications

Fan, J.-L., O'Donnell, T., Lanford, J., Croft, K., Watson, E., Smyth, D., … Tzeng, Y.-C. (2020). Dietary nitrate reduces blood pressure and cerebral artery velocity fluctuations and improve cerebral autoregulation in transient ischemic attack patients. Journal of Applied Physiology. Advance online publication. doi: 10.1152/japplphysiol.00160.2020

Fan, J.-L., O'Donnell, T., Gray, C. L., Croft, K., Noakes, A. K., Koch, H., & Tzeng, Y.-C. (2019). Dietary nitrate supplementation enhances cerebrovascular CO2 reactivity in a sex-specific manner. Journal of Applied Physiology, 127, 760-769. doi: 10.1152/japplphysiol.01116.2018

Saito-Benz, M., Gray, C., Tzeng, Y.-C., Atkinson, G., & Berry, M. J. (2019). Cerebral oxygenation and cardiorespiratory stability following liberal transfusion in preterm neonates [Brief report]. Acta Paediatrica, 108, 559-561. doi: 10.1111/apa.14631

Saleem, S., Sarafis, Z. K., Lee, A. H. X., Squair, J. W., Barak, O. F., Sober-Williams, E., … Tzeng, Y.-C., & Phillips, A. A. (2019). Spinal cord disruption is associated with a loss of Cushing-like blood pressure interactions [Short communication]. Journal of Neurotrauma, 36, 1487-1490. doi: 10.1089/neu.2018.5931

Allan, P. D., Saleem, S., O'Donnell, T., Fan, J.-L., Larsen, P. D., Berry, M. J., & Tzeng, Y.-C. (2019, September). New approaches to assessing and optimising cerebral perfusion. Verbal presentation at the Medical Sciences Congress (MedSci), Queenstown, New Zealand.

Journal - Research Article

Fan, J.-L., O'Donnell, T., Lanford, J., Croft, K., Watson, E., Smyth, D., … Tzeng, Y.-C. (2020). Dietary nitrate reduces blood pressure and cerebral artery velocity fluctuations and improve cerebral autoregulation in transient ischemic attack patients. Journal of Applied Physiology. Advance online publication. doi: 10.1152/japplphysiol.00160.2020

Fan, J.-L., O'Donnell, T., Gray, C. L., Croft, K., Noakes, A. K., Koch, H., & Tzeng, Y.-C. (2019). Dietary nitrate supplementation enhances cerebrovascular CO2 reactivity in a sex-specific manner. Journal of Applied Physiology, 127, 760-769. doi: 10.1152/japplphysiol.01116.2018

Allan, P. D., O'Donnell, T., & Tzeng, Y.-C. (2018). Agreement between finger plethysmography- and brachial oscillometry-derived blood pressure measurements. Clinical Physiology & Functional Imaging, 38(3), 439-446. doi: 10.1111/cpf.12435

Allan, P. D., Tzeng, Y.-C., Gowing, E. K., Clarkson, A. N., & Fan, J.-L. (2018). Dietary nitrate supplementation reduces low frequency blood pressure fluctuations in rats following distal middle cerebral artery occlusion. Journal of Applied Physiology, 125(3), 862-869. doi: 10.1152/japplphysiol.01081.2017

Saleem, S., Vucina, D., Sarafis, Z., Lee, A. H. X., Squair, J. W., Barak, O. F., … Tzeng, Y.-C., & Phillips, A. A. (2018). Wavelet decomposition analysis is a clinically relevant strategy to evaluate cerebrovascular buffering of blood pressure after spinal cord injury. American Journal of Physiology: Heart & Circulatory Physiology, 314(5), H1108-H1114. doi: 10.1152/ajpheart.00152.2017

Saleem, S., Teal, P. D., Howe, C. A., Tymko, M. M., Ainslie, P. N., & Tzeng, Y.-C. (2018). Is Cushing mechanism a dynamic blood pressure stabilizing system? Insights from Granger causality analysis of spontaneous blood pressure and cerebral blood flow. American Journal of Physiology: Regulatory, Integrative & Comparative Physiology, 315(3), R484-R495. doi: 10.1152/ajpregu.00032.2018

Faulkner, J., Tzeng, Y.-C., Lambrick, D., Woolley, B., Allan, P. D., O'Donnell, T., Lanford, J., Wong, L., & Stoner, L. (2017). A randomized controlled trial to assess the central hemodynamic response to exercise in patients with transient ischaemic attack and minor stroke. Journal of Human Hypertension, 31, 172-177. doi: 10.1038/jhh.2016.72

Malenfant, S., Brassard, P., Paquette, M., Le Blanc, O., Chouinard, A., Nadeau, V., Allan, P. D., Tzeng, Y.-C., … Provencher, S. (2017). Compromised cerebrovascular regulation and cerebral oxygenation in pulmonary arterial hypertension. Journal of the American Heart Association, 6(10), e006126. doi: 10.1161/jaha.117.006126

Phillips, A. A., Squair, J., Currie, K., Tzeng, Y.-C., Ainslie, P., & Krassioukov, A. V. (2017). 2015 ParaPan American Games: Autonomic function, but not physical activity, is associated with vascular-cognitive impairment in spinal cord injury. Journal of Neurotrauma, 34(6), 1283-1288. doi: 10.1089/neu.2016.4751

Saleem, S., Tzeng, Y.-C., Kleijn, W. B., & Teal, P. D. (2017). Detection of impaired sympathetic cerebrovascular control using functional biomarkers based on principal dynamic mode analysis. Frontiers in Physiology, 7, 685. doi: 10.3389/fphys.2016.00685

Witter, T., Tzeng, Y.-C., O'Donnell, T., Kusel, J., Walker, B., Berry, M., & Taylor, C. E. (2017). Inter-individual relationships between sympathetic arterial baroreflex function and cerebral perfusion control in healthy males. Frontiers in Neuroscience, 11, 457. doi: 10.3389/fnins.2017.00457

Saleem, S., Teal, P. D., Kleijn, W. B., Ainslie, P. N., & Tzeng, Y.-C. (2016). Identification of human sympathetic neurovascular control using multivariate wavelet decomposition analysis. American Journal of Physiology: Heart & Circulatory Physiology, 311(3), H837-H848. doi: 10.1152/ajpheart.00254.2016

Smirl, J. D., Hoffman, K., Tzeng, Y.-C., Hansen, A., & Ainslie, P. N. (2016). The relationship between blood pressure and cerebral blood flow during supine cycling: Influence of aging. Journal of Applied Physiology, 120(5), 552-563. doi: 10.1152/japplphysiol.00667.2015

Saleem, S., Teal, P. D., Kleijn, W. B., O'Donnell, T., Witter, T., & Tzeng, Y.-C. (2015). Non-linear characterisation of cerebral pressure-flow dynamics in humans. PLoS ONE, 10(9), e0139470. doi: 10.1371/journal.pone.0139470

Horsman, H. M., Peebles, K. C., & Tzeng, Y. C. (2015). Interactions between breathing rate and low-frequency fluctuations in blood pressure and cardiac intervals. Journal of Applied Physiology, 119, 793-798. doi: 10.1152/japplphysiol.00525.2015

Rickards, C. A., Sprick, J. D., Colby, H. B., Kay, V., & Tzeng, Y.-C. (2015). Coupling between arterial pressure, cerebral blood velocity, and cerebral tissue oxygenation with spontaneous and forced oscillations. Physiological Measurement, 36(4), 785-801. doi: 10.1088/0967-3334/36/4/785

Smirl, J. D., Hoffman, K., Tzeng, Y.-C., Hansen, A., & Ainslie, P. N. (2015). Methodological comparison of active- and passive-driven oscillations in blood pressure: Implications for the assessment of cerebral pressure-flow relationships. Journal of Applied Physiology, 119(5), 487-501. doi: 10.1152/japplphysiol.00264.2015

Allan, P. D., Faulkner, J., O'Donnell, T., Lanford, J., Wong, L., Saleem, S., … Tzeng, Y.-C. (2015). Hemodynamic variability and cerebrovascular control after transient cerebral ischemia. Physiological Reports, 3(11), e12602. doi: 10.14814/phy2.12602

Rickards, C. A., & Tzeng, Y.-C. (2014). Arterial pressure and cerebral blood flow variability: Friend or foe? A review. Frontiers in Physiology, 5, 120. doi: 10.3389/fphys.2014.00120

Meel-van den Abeelen, A. S. S., Simpson, D. M., Wang, L. J. Y., Slump, C. H., Zhang, R., Tarumi, T., … Tzeng, Y.-C., … Claassen, J. A. H. R. (2014). Between-centre variability in transfer function analysis, a widely used method for linear quantification of the dynamic pressure-flow relation: The CARNet study. Medical Engineering & Physics, 36(5), 620-627. doi: 10.1016/j.medengphy.2014.02.002

Horsman, H. M., Tzeng, Y. C., Galletly, D. C., & Peebles, K. C. (2014). The repeated sit-to-stand manoeuvre is a superior method for cardiac baroreflex assessment: A comparison with the modified Oxford method and Valsalva manoeuvre. American Journal of Physiology: Regulatory, Integrative & Comparative Physiology, 307(11), R1345-R1352. doi: 10.1152/ajpregu.00376.2014

Smirl, J. D., Tzeng, Y. C., Monteleone, B. J., & Ainslie, P. N. (2014). Influence of cerebrovascular resistance on the dynamic relationship between blood pressure and cerebral blood flow in humans. Journal of Applied Physiology, 116(12), 1614-1622. doi: 10.1152/japplphysiol.01266.2013

Berry, M., Tzeng, Y., & Marsland, C. (2014). Percutaneous transtracheal ventilation in an obstructed airway model in post-apnoeic sheep. British Journal of Anaesthesia, 113(6), 1039-1045. doi: 10.1093/bja/aeu188

Tzeng, Y.-C., & Ainslie, P. N. (2014). Blood pressure regulation IX: Cerebral autoregulation under blood pressure challenges. European Journal of Applied Physiology, 114(3), 545-559. doi: 10.1007/s00421-013-2667-y

Smirl, J. D., Haykowsky, M. J., Nelson, M. D., Tzeng, Y.-C., Marsden, K. R., Jones, H., & Ainslie, P. N. (2014). Relationship between cerebral blood flow and blood pressure in long-term heart transplant recipients. Hypertension, 64, 1314-1320. doi: 10.1161/hypertensionaha.114.04236

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