KUDDLER

By
EVAN LEWIS

Submitted in partial fulfillment of the requirements

For the degree of Master of Science

Thesis Adviser: Dr. Kenneth Loparo

Department of Electrical Engineering and Computer Science

CASE WESTERN RESERVE UNIVERSITY

August, 2010

CASE WESTERN RESERVE UNIVERSITY

SCHOOL OF GRADUATE STUDIES

We hereby approve the thesis/dissertation of

Evan Lewis
______________________________________________________
M.S.
candidate for the ________________________________degree
*.

Kenneth Loparo
(signed)_______________________________________________
(chair of the committee)
Susan Ludington
________________________________________________
Mark Scher
________________________________________________

________________________________________________

________________________________________________

________________________________________________

6/2/10
(date) _______________________

*We also certify that written approval has been obtained for any
proprietary material contained therein.

Copyright 2010 by Evan Lewis

All rights reserved

TABLE OF CONTENTS
Table of Contents..1
List of Figures2
Abstract.5
Chapter 1: Purpose and Background.6
Chapter 2: Design and Method.8
2.1: Equipment and Software....9
2.2: Hardware Setup12
2.3: Recording Process.....22
2.4: LabView Program.23
2.5: MATLAB Program...50
2.6: User Instructions for Operating the KUDDLER device......54
Chapter 3: Evaluation..63
Chapter 4: Conclusions and Future Work...70
References...73

List of Figures
Figure 2.1 Block diagram of KUDDLER components and connections9
Figure 2.2 Computer and computer connections...12
Figure 2.3 Schematic of DAQ connections..13
Figure 2.4 DAQ with connections14
Figure 2.5 Littmann stethoscope factory design16
Figure 2.6 Littmann stethoscope final design full.17
Figure 2.7 Littmann stethoscope final design connections...17
Figure 2.8 Motor controller card18
Figure 2.9 24VDC power supply.19
Figure 2.10 Audio input to audio amplifier20
Figure 2.11 Audio output to speakers.20
Figure 2.12 KUDDLER bed top..21
Figure 2.13 KUDDLER bed speaker..21
Figure 2.14 KUDDLER bed motor.22
Figure 2.15 Pre-GUI loop initialization..24
Figure 2.16 KUDDLER block diagram for initial screen25
Figure 2.17 KUDDLER initial screen26
Figure 2.18 Block diagram for Record screen 1...27
Figure 2.19 Record screen 127
Figure 2.20 Record screen 2 block diagram..28
Figure 2.21 Record screen 228
Figure 2.22 Record screen 3 block diagram..29

Figure 2.23 Record screen 3..30

Figure 2.24 Recording initial setup block diagram.31
Figure 2.25 Recording screen32
Figure 2.26 Data acquisition loop block diagram32
Figure 2.27 DAQ Assistant window for Read Signals.33
Figure 2.28 Compression VI window for thoracic band signal..34
Figure 2.29 Recording timer loop block diagram...35
Figure 2.30 Recording final sequence structure block diagram37
Figure 2.31 Playback screen 1 block diagram.38
Figure 2.32 Playback screen 1...38
Figure 2.33 Playback screen 2 block diagram.39
Figure 2.34 Playback screen 2...40
Figure 2.35 Playback initial setup block diagram...41
Figure 2.36 Playback screen..42
Figure 2.37 Motor control loop block diagram...43
Figure 2.38 DAQ Assistant window for motor signal generation..44
Figure 2.39 Playback audio loop block diagram.45
Figure 2.40 Delete names screen 1 block diagram..46
Figure 2.41 Delete names screen 146
Figure 2.42 Delete names screen 2 block diagram..47
Figure 2.43 Delete names screen 247
Figure 2.44 Backup data screen block diagram..48
Figure 2.45 Backup data screen....49

Figure 2.46 Recover data screen block diagram50

Figure 3.1 Heartbeat raw signal..63
Figure 3.2 Heartbeat filtered signal64
Figure 3.3 Heartbeat local peaks64
Figure 3.4 Heartbeat beats determined..65
Figure 3.5 Heartbeat full beat lineup cut...65
Figure 3.6 Heartbeat full beat lineup cut wrap-around...66
Figure 3.7 Heartbeat amplitude and slope match cut..66
Figure 3.8 Heartbeat amplitude and slope match cut wrap-around...67
Figure 3.9 Respiration raw signal...67
Figure 3.10 Respiration filtered signal...68
Figure 3.11 Respiration approximate derivative...68
Figure 3.12 Respiration speed and direction signals....69
Figure 3.13 Respiration signals cut for continuous loop..69

KUDDLER

Abstract
by
EVAN LEWIS

This thesis discusses the design, development and, construction of a device to be

deployed in the Neonatal Intensive Care Unit (NICU) to provide health and
developmental benefits to premature infants in an incubator setting. The device, hereafter
referred to as KUDDLER, provides customized access to Kangaroo Care for premature
infants in the NICU when they cannot be with their mothers. One of the important
features of KUDDLER is that it can be customized to the unique respiratory and
heartbeat patterns of the mother. During setup of the unit, the mothers heartbeat and
respiration signals are recorded and stored in a computer for future use. The KUDDLER
is then placed in an incubator and the infant is placed on top on the device. The
KUDDLER is operated from a computer that is located on a cart and oscillates up and
down with the same respiratory rhythm that would be experienced in direct contact with
the mother and a speaker on the back of the device provides the mothers heartbeat
sounds. The KUDDLER also retains the heat of the surrounding incubator to provide
proper warmth for the neonate.

Chapter 1: Purpose and Background

Each year in the United States, 43,750 babies are born premature. These premature
infants are at a higher risk for death, poor growth, poor sleep, and prolonged
hospitalization15 than their full-term counterparts.

Beginning in the 1970s, a program called Kangaroo Care was begun as a response to
these risks and problems. During Kangaroo Care the premature infants are held upright
in skin-to-skin contact against their mothers chest and underneath a blanket, similar to a
kangaroos pouch. This contact has been found to improve the infants heath by reducing
mortality 18, 36, stabilizing heart and respiratory rates 1, 9, 14, maintaining 2, 20 or improving
blood oxygenation 8, 22, increasing body warmth 3, 4, 22, 27, preventing body heat loss 27, 28,
minimizing stress 21, 30, reducing pain 5, 16, 19, 23, improving feeding 25, 26, increasing weight
gain 7, organizing sleep 12, 24, maturing the brain 17, 34, and improving neurobehavioral
development 10-13, 15, 29, 31, 32, 35.

All of these improvements lead to a decrease in the amount of time spent in the hospital
and NICU 33. The average discharge from the hospital for a premature infant regularly in
Kangaroo Care versus an infant without any Kangaroo Care is 10-14 days sooner6.
Given that the cost of care for a premature infant in the NICU is $1,823.60 per day, for
the 43,750 premature infants a year, that 10-14 day early discharge is a savings of $800
million - $1.1 billion a year.

Unfortunately the infants mothers arent always available to administer Kangaroo Care.
Due to financial responsibility, health problems, or other reasons, the mother may not be
able to give their infant the sufficient amount of care they need. On the other hand, the
infant may not be in stable enough condition to be removed from their incubator for
prolonged periods of time to be held by their mother.

Thus there is a need for a device that emulates the sensation that the infant receives from
lying on their mothers chest. This device should fit inside the incubator, for the infant to
lie on, and reproduce the feel, sound, and look of their specific mothers chest.

There is a United States patent37 that describes a similar device, simulating a mothers
temperature, heartbeat, and breathing. However, what makes the KUDDLER device
developed in this thesis different is that it is customizable: a mothers heartbeat and
breathing patterns are recorded and nearly instantly those signals are used to drive the
device to perform in a manner that is very similar to what the neonate would experience
while on the mothers chest. It is predicted that the sound and feel of an infants own
mother will be more beneficial to the baby, and a clinical study is ongoing to gather the
data necessary to validate this hypothesis.

This thesis describes the design, development, and creation of the hardware and software
of the KUDDLER. The thesis is split up into the hardware and software components of
the device. The hardware is listed in its entirety and then the setup, modification, and
connections of the hardware are described. Next, the LabView program that controls the

recording and operation of the KUDDLER is detailed. The MATLAB code that
processes the recordings is then described. After this, the software is evaluated and
shown to work properly. Finally, the thesis is concluded with future work to be done,
should the live trials be completed successfully.

Chapter 2: Design and Method

This section describes the KUDDLER in its entirety, from hardware to software. First,
the hardware of the KUDDLER and listed in its entirety, and then it is explained exactly
how the hardware is setup. The LabView and MATLAB programs are then described in
great detail. Finally, the actual recording process and operation of the KUDDLER is
explained in the user instructions.

2.1: Equipment and Software

Figure 2.1 Block diagram of KUDDLER components and connections

ASUS 1005HA-PU1X-BK EeePC Seashell Netbook Computer Base computer where

all data collection, processing and storage takes place. Chosen for its small size and ease
of use.

National Instruments LabView 8.6 Computer program that runs the device during data
acquisition and operation of the device. Also initiates the Matlab program that processes
the acquired data signals. Chosen for the initial run of the device because of its
availability and ease of use.

MATLAB Computer program used to analyze recorded heartbeat and respiration data,
and manipulate data into a usable driving signal for the device.

National Instruments USB-6215 Data Acquisition (DAQ) Card Analog-to-digital data

converter for recording and collection of audio heartbeat signal and respiratory effort
signal.

3M Littmann Electronic Stethescope 4100WS Used to record heartbeat of the mother.

Chosen for its electrical signal output, frequency bandpass filters, and noise filters
integrated into the stethoscope, despite drawbacks from necessary hacking of the device
and complicated use.

Sleemate RIPmate Inductive Respiratory Effort Thoracic Band Used to record rise and
fall of mothers chest.

10

Samson Servo 120a Audio Amplifier Used to amplify the computer audio signal for the
speaker.

Orientalmotor BLHM015K-100 Brushless DC Motor and Driver Package Used to

move bed of device up and down to playback the motion of the mothers chest. Has a
circular cam on the rotor designed with a profile for breathing motion. Chosen to be
relatively quiet, yet strong and reliable.

Potrans FS-04024-1M ITE Power Supply 24VDC @ 1.8A Powers the electric motor.

Innovox SL-1.1 US Speaker Bolted to the underside of the bed of the device to
playback the heartbeat of the mother. Not only gives the sound, but the feel of the
heartbeat as well. Chosen for its slim profile, frequency response, and power.

Tripp-Lite Isobar ISOBAR4ULTRA Diagnostic Surge Suppressor All devices are

powered through the surge suppressor to simplify use of the device and to protect the
device and anyone connected to the device from a power surge.

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2.2: Hardware Setup

The EeePC netbook computer is the heart of the device, where all the data collection,
data processing, data storage, and signals that drive the device originate. The computer
boots up straight to the LabView program that operates the device, ready for use without
any additional setup. The computer is connected to the National Instruments DAQ
device through a standard USB port. A mouse, connected to another USB port provides
ease of use with the GUI interface of the KUDDLER program. The computer is
connected to the Samson audio amplifier using a standard 1/8-inch RCA cable to the
audio output jack of the computer. The computer and computer connections can be seen
in Figure 2.2.

Figure 2.2 Computer and computer connections

The National Instruments USB-6215 DAQ card is used to record both the heartbeat audio
signal and the respiratory signal from the mother, as well as operate the drive motor that

12

moves the bed of the device. All DAQ connections can be seen in Figure 2.3 and Figure
2.4.

Figure 2.3 Schematic of DAQ connections

13

Figure 2.4 DAQ with connections

The analog input ports on the DAQ card are used to record the differential voltage of the
stethoscope measuring heartbeats and the thoracic band outputs measuring respiration.
The outputs of the Littmann stethoscope are connected to ports 19 and 20 (differential
analog input 2) of the DAQ and the shielded ground wire is connected to port 28 (analog
input ground) of the DAQ. The Sleepmate thoracic band output cables are connected to
ports 15 and 16 (differential analog input 0) of the DAQ.

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The speed and direction of the motor are controlled from 2 analog output ports on the
DAQ. The green (5) motor wire controls the speed of the motor and is connected to port
12 (analog output 0) of the DAQ. The input voltage varies linearly from 0V, where the
motor is stopped, to 5V where the motor rotates at 32 rpm. The gray wire controls the
direction of the motor and is connected to port 13 (analog output 1) of the DAQ. Here,
0V provides clockwise rotation and 5V provides counterclockwise rotation. The orange
(3), yellow (4), white (10), and black (11) motor control wires are connected to port 11
(digital ground) of the DAQ card. The orange wire is the reference ground for all the
other motor control wires. The yellow wire is the differential ground, paired with the
green wire, to control motor speed. The white wire is the RUN/BRAKE wire, which is
always set to RUN. The black wire is the START/STOP wire, which is always set to
START. The brown (8) control wire is connected port 10 (digital +5V), which allows the
motor to operate under an external voltage input to control the motor speed rather than
the internal potentiometer. The brown (1), red (2), blue (6), and purple (7) wires were not
connected as they have no effect on the operation of the motor in the current setup. The
brown wire is the alarm output for the motor. The red wire is the speed output for the
motor. The blue wire is the high voltage input for an external potentiometer. The purple
wire is the alarm reset input for the motor.

The 3M Littmann 4100 is a battery powered stethoscope with functions for noise
reduction, volume control, frequency filtering, and clip recording. Unfortunately, the
built in recording can only record up to 8 seconds per track on 6 tracks. The stethoscope

15

had no provisions for continuous recording of the heartbeat signal. The stethoscope as
purchased can be seen in Figure 2.5.

Figure 2.5 Littmann stethoscope

In order to make continuous recording possible, the stethoscope was modified. The
battery casing was taken apart to remove the speaker and earpiece. The speaker wires
were cut and the speaker and earpiece were discarded. Longer wires were spliced into
the output wires of the stethoscope where the speaker was connected. The other ends of
these wires were connected to the DAQ input ports to record the output of the
stethoscope. Finally, the battery casing was reassembled. The modifications to the
stethoscope can be seen in Figure 2.6 and Figure 2.7.

16

Figure 2.6 Modified Littmann stethoscope

Figure 2.7 Modified Littmann stethoscope connections

17

The Sleepmate RIPmate Respiratory Effort System consists of a belt and a sensor that
measures the inductance changes in the belt and provides a differential voltage that
linearly coincides with the expansion of the patients chest. A detachable cable connects
the belt and sensors and the sensor is not energized until it is connected to the belt. The
sensor output wires were modified to facilitate connection to the DAQ input ports.

The motor control lines are connected to the motor controller card with a 12 wire
connector. The card is also connected to a 24VDC power supply with a 2 wire connector,
to power the motor. The controller card is then connected to the motor itself, which is
mounted on the device, through an 8-wire connector cable. The motor controller card is
shown with all connections in Figure 2.8.

Figure 2.8 Motor controller card

The Portrans 24VDC Power Supply provides power to the motor. Using a three pronged
grounded power cable, the red wire was connected to the live (L) input, the white wire
18

was connected to the neutral (N) input, and the green wire was connected to the
functional ground (FG) input. From the controller card the black power wire was
connected to the common (COM) output and the red power wire was connected to the
24VDC (+V) output. The power supply is shown with all connections in Figure 2.9.

Figure 2.9 24VDC power supply

The computers audio output port is connected to the Samson audio amplifier with a 1/8th
inch to RCA connector cable. The output is only a monophonic audio signal. The right
channel of the RCA plug is connected to the right channel port of the amplifier as seen in
Figure 2.10. The amplifier was connected to the Innovox speaker from the amplifiers
right channel output terminals to the speakers input terminals as seen in Figure 2.11.

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Figure 2.10 Audio input to audio amplifier

Figure 2.11 Audio output to speakers

The KUDDLER device consists of a base box that contains the motor and speaker, and a
bedplate that is connected to the base by a hinge and actuated by a motor cam unit at the
other end of the box, lengthwise. The speaker is connected to the underside of the
bedplate to transfer both the sound and vibration of the mothers heartbeat. On the bed is
a custom made Z-Flo pad that will retain heat up to 37C, and two silicone breasts that

20

can be positioned to cradle the baby and allow the baby to see the nipples. The pad and
breasts will be covered with a cloth slip cover that will be replaced with every infant.

Figure 2.12 KUDDLER bed top

Figure 2.13 KUDDLER bed speaker

21

Figure 2.14 KUDDLER bed motor and cam unit

The power cords for the computer, amplifier, and 24VDC power supply power cord are
all connected to the Tripp-Lite Isobar ULTRA Diagnostic Surge Suppressor. The surge
suppressor is connected to a standard wall socket and has its own power switch to power
the entire device.

2.3: Recording Process

To customize the operation of the KUDDLER, heartbeat and respiration from the mother
are obtained through a quick and easy recording process that requires a maximum of 10
minutes and the acquired signals can be used indefinitely. Two 2-minute recordings are
obtained, one of the mothers heartbeat, and one of the mothers respiration. These two
measurements are taken separately. When recording, the program samples the
differential voltage from the stethoscope or thoracic band at 8 kHz. The acquired signals

22

are stored in the files [name]_steth.lvm and [name]_resp.lvm for the heartbeat and
respiration recordings respectively.

To record heartbeat the stethoscope is taped to the mothers chest, slightly left of center;
this is directly over the heart where the heartbeat signal is strongest. The stethoscope is
then turned on. The attendant then uses the computer to select the appropriate recording
settings and runs the program to record the mothers heartbeat for 2 minutes. Then the
stethoscope is removed and the thoracic band is placed around the mothers abdomen
directly beneath the breasts. The wires from the band are connected and the attendant
uses the computer to select the appropriate setting for respiration recording and again
runs the program, which will record the mothers respiration pattern for 2 minutes.

When the second recording session is finished the program opens, runs, and closes
executable MATLAB code that analyzes the recorded signals and process them to be
stored and used later for playback.

2.4: LabView Program

The KUDDLER LabView program is made up of two distinct sections. The first
provides the look and feel of the GUI interface, and the second is for signal recording
during setup and playback during operation. The entire program is executed within a
continuous loop, so that when the recording or playback is done, the program returns to
the first screen of the GUI to start over again.

23

At the beginning of this program, going into the GUI loop, is an address to the base
folder for all the data that is used in the program besides the program itself, a path to the
names.txt file which is a list of names of all the recordings created, and an integer
variable of 0 to begin the case structure inside the loop at case 0. All the GUI objects are
located above the GUI loop for quick reference.

Figure 2.15 Pre-GUI loop initialization

The GUI portion of the program consists of a case structure nested inside a continuous
loop. Each case is the result of a specific button press on the GUI. Within each case is a
sequence structure that has three main blocks: an initialization to set visibility and text for
all buttons and text boxes as well to set all buttons to the off position, a loop to wait for a
button press, and a determination of which button was pressed and which case/screen to
go to next as a result of the button press. Any data or information that needs to be used in
subsequent cases can be carried through to the next iteration of the loop with a shift
register. For instance, the integer variable used to select subsequent cases is initialized to

24

0 going into the loop and on successive iterations the shift register is used to determine
the case used by the case structure.

Figure 2.16 KUDDLER block diagram for initial screen

The initial screen that appears on startup is case 0 of the GUI case structure. The main
options are between Record, to record a mothers heartbeat or respiration, or
Playback, to play back the signals on the KUDDLER device. Other minor options are
Backup Data, to backup recorded signals to a USB flash drive, Recover Data, to
restore lost recordings from a USB flash drive, Delete Names, to delete recordings from
the program, Back, which moves to the previous screen (it has no function on the first
screen), and Shutdown, to shutdown the program and computer. There is also a static
text box on the computer screen to provide instructions and important information to the
user about the operation of the system.

25

Figure 2.17 KUDDLER initial screen

If the Record button is pressed the program moves to case 2 and carries through the
boolean variable to either record or playback. On this screen the user is prompted to type
the patients name into the edit text box and click the Next button to proceed. If the
Back button is pressed, the program returns to the initial screen (case 0). When the
Next button is pressed the program adds the name entered in the text box to the top of a
list of names from a file, names.txt. If the name entered is already in the list, it is
moved to the top of the list to simplify the autonomy of the MATLAB analysis program.
The name is also added to the end of a file address to be used to create a new folder for
all of the patients recorded data. The program then moves to case 4 and carries through
the list and the address as well as the record/playback boolean.

26

Figure 2.18 Block diagram for Record screen 1

Figure 2.19 Record screen 1

On this screen the user has the option to record either the mothers Heartbeat or
Respiration. If the Back button is pressed, the program returns to record screen 1

27

(case 2). In either case the program proceeds to case 5 and carries the boolean option of
either respiration or heartbeat. The record/playback boolean, the name list, and the name
address are also carried through.

Figure 2.20 Record screen 2 block diagram

28

Figure 2.21 Record screen 2

This is the final screen before the program runs the recording part of the program and
serves as a summary and review of all the options chosen on the previous screens. The
operation being performed is listed as record, the patients name is displayed and either
respiration or heartbeat is displayed as the recording type. Finally the user is prompted to
click the Run button the begin recording. If the Back button is pressed the program
returns to record screen 2 (case 4). When the Run button is pressed the loop is stopped
and the recording case of the record/playback case structure is run.

Figure 2.22 Record screen 3 block diagram

29

Figure 2.23 Record screen 3

The record case is the true case of the record/playback case structure. The first things
that happen in this case are saving the names.txt file with the new name, and changing
the GUI interface to display the waveform input signals from the recording devices. The
user also has the option to stop the recording process before the program automatically
stops the recording after 2 minutes.

30

Figure 2.24 Recording initial setup block diagram

31

Figure 2.25 Recording screen

The main part of the recording case is the data acquisition loop.

Figure 2.26 Data acquisition loop block diagram

32

The DAQ Assistant Express VI reads the analog inputs ai0, ai1, and ai2 continuously
from the NI USB-6215 DAQ card at 8kHz with a memory buffer of 8k samples. ai0 and
ai2 correspond to the thoracic band and stethoscope inputs, respectively. ai1 is an artifact
from a previous temperature feature that was removed and does affect the operation of
the current system.

Figure 2.27 DAQ Assistant window for Read Signals

The data output from the DAQ Assistant is then split into separate signals each for
temperature, stethoscope, and thoracic band. The signal from the stethoscope is written
33

directly to the file [name]_steth.lvm in the folder [name] where [name] is the name of
the patient entered in case 2 of the GUI case structure. The thoracic band data is filtered
through a compression VI that takes the mean of the signal for every 800 samples or
10Hz. This eliminates the 60Hz and 120Hz components of the thoracic band output.
This new 10Hz signal is then saved to the file [name]_resp.lvm.

Figure 2.28 Compression VI window for thoracic band signal

No temperature signal is recorded in the current version of the device. Whether the
stethoscope signal or thoracic band signal is saved is determined by the

34

heartbeat/respiration boolean chosen in case 4 of the GUI case structure. An indicator in

the other loop of the recording case stops the DAQ Assistant and loop. When the loop
stops a string is sent to a sequence structure to finish the recording case.

The other loop of the recording case includes a timer for the user to watch on the GUI, all
triggers and buttons to stop the recording process, and a signal generation DAQ Assistant
that is not used in the current version of the device.

Figure 2.29 Recording timer loop block diagram

35

The timer is reset when the loop first starts and is set to trigger a true signal on the Time
has Elapsed boolean when the timer reaches 120 seconds or 2 minutes. The Elapsed
Time output is fed into a circuit to convert the floating number to a string in the form of
[hours]:[minutes]:[seconds] that is put in a static text box to display for the user.

When either the timer reaches 120 seconds or the Stop button is pressed, the stop
check indicator is made true, stopping the data acquisition loop. It also stops the signal
generation DAQ Assistant and stops the loop.

The final sequence structure of the recording case first runs the MATLAB program that
analyzes the respiration and heartbeat signals, and then initializes the GUI objects that
were used in the recording case. The program then loops to the beginning of the program
and returns to case 0 of the GUI interface loop.

36

Figure 2.30 Recording final sequence structure block diagram

From the initial screen (case 0), if the Playback button is pressed the program moves to
case 1 and carries through the boolean variable to either record or playback. On this
screen the user is prompted to select the name of the recording they want to play back
through the KUDDLER device from a drop down menu and then press the Next button
to continue; the program returns to the initial screen (case 0) if the Back button is
pressed. The list of patient names in the drop down menu is loaded from the text file
with the list of names, called names.txt, as an array. When a patients name is selected
that name is selected from the array. When the Next button is pressed the program
37

moves to case 3 and carries through the selected name and the record/playback boolean.

Figure 2.31 Playback screen 1 block diagram

Figure 2.32 Playback screen 1

38

This is the final screen before playback begins and serves as a summary and review of all
the options chosen on the previous screens. The operation is displayed as playback and
the patients name is displayed. Finally, the user is prompted to click the Run button to
begin operation of the KUDDLER device using the patients recorded data; the program
returns to the previous screen (case 1) if the Back button is pressed. When the Run
button is pressed the program creates two path variables in preparation for finding the
necessary recording files needed to run the device. These files are [name]_bpm.lvm and
[name]_steth.wav, located in the [name] folder of the current directory, where [name]
is the selected patients name. The program then stops the loop and runs the playback
case of the recording/playback case structure.

Figure 2.33 Playback screen 2 block diagram

39

Figure 2.34 Playback screen 2

The playback case begins by opening the LabView data file [name]_bpm.lvm, which is
the breaths per minute of the recording and is used to drive the motor, and sets up the
GUI interface. The user has a timer on the screen and a Stop button to stop the
operation of the KUDDLER device.

40

Figure 2.35 Playback initial setup block diagram

41

Figure 2.36 Playback screen

The rest of the playback case is once again made up of two loops and a sequence
structure. The first loop consists of a signal generating DAQ Assistant to drive the motor
on the KUDDLER device, as well as the same timer structure as in the recording case
without the 2-minute time limit. The breaths per minute number is taken from the Read
from Measurement File VI and is multiplied by .16 to scale the number to the voltage
needed to drive the motor at that specific number of rotations per minute.

42

Figure 2.37 Motor control loop block diagram

In this version of the KUDDLER, the output voltage is constant and the DAQ Assistant
needs to only output 1 sample.

43

Figure 2.38 DAQ Assistant window for motor signal generation

When the Stop button is pressed the signal sent to the DAQ Assistant is changed to 0 to
stop the motor as well as the execution of the DAQ Assistant and the loop.

The second loop in the playback case is the heartbeat audio. This loop was copied from
an included example VI, called Sound Player.vi, that came with the LabView program.
The event structure was replaced with a case structure and the case was chosen by the
status of the Stop button. This loop opens the sound file [name]_steth.wav and writes
it to the computers sound card to play it through the computers audio output port. The
audio file loops until it is stopped. This loop is stopped when the Stop button is pressed
44

and allows the final sequence structure to run.

Figure 2.39 Playback audio loop block diagram

The final sequence structure in the playback case simply initializes the GUI objects that
the case used. The program then loops back around to the beginning of the program and
returns to case 0 of the GUI interface loop.

From the initial screen (case 0), if the Delete Names button is clicked, the program
moves to case 6. On this screen the user is prompted to select the name of the patient
data that they want to delete. The mechanics of this case are similar to case 1 of the
playback selection; the program returns to case 0 if the Back button is pressed. When
the Next button is pressed the program moves to case 7 and carries through the selected
name.

45

Figure 2.40 Delete names screen 1 block diagram

Figure 2.41 Delete names screen 1

Case 7 is a summary and review of the users selections, similar to cases 3 and 5; the
program returns to case 6 if the Back button is pressed. When the Delete button is
clicked the program opens the names.txt file, deletes the selected name from the list,
46

and saves the new list to names.txt. The data folder of the same name is also deleted.
The program then returns to case 0.

Figure 2.42 Delete names screen 2 block diagram

Figure 2.43 Delete names screen 2

47

From the initial screen (case 0), if the Backup Data button is pressed the program moves
to case 8. The user is prompted to make sure that a USB flash drive is plugged into the
computer and then press the Confirm button; the program returns to case 0 if the Back
button is pressed. When the Confirm button is pressed the program opens the
names.txt file on both the computer and the flash drive. For every name on the
computer list the program adds and saves that name to the USB drive list and adds the
data folder of the same name to the USB drive. The program then returns to case 0.

Figure 2.44 Backup data screen block diagram

48

Figure 2.45 Backup data screen

From the initial screen (case 0), if the Recover Data button is pressed the program
moves to case 9. The screen is the same as the Backup Data screen. When the
Confirm button is pressed the program opens the names.txt file on both the computer
and the flash drive. For every name on the USB drive list the program adds and saves
that name to the computer list and adds the data folder of the same name to the computer.
The program then returns to case 0.

49

Figure 2.46 Recover data screen block diagram

2.5: MATLAB Program

The MATLAB program makewav.exe analyzes and processes the heartbeat and
respiration signals that were recorded in the LabView KUDDLER.exe program.

First, on lines 6 and 7, the names.txt file is read and the first name on the list, which is
the name that just got recorded, is saved in order to open the necessary files. This allows
the program to be completely autonomous, with no need for user input.

The heartbeat signal is processed first. The heartbeat signal is opened in line 12 using
dlmread. Then the signal is offset to be entirely positive in order to avoid any problem
that may occur from absolute value use while finding the magnitude in the frequency
filtering.

50

The signal is then sent through a lowpass filter in lines 19-26 to remove any unwanted
high frequencies from the recording process. The filter is a windowed finite impulse
response lowpass filter with an order of 50 and a cutoff frequency of 500Hz. The signal
transformed to the Fourier domain, filtered in the Fourier domain, and then is
transformed back to the time domain. The absolute value is taken to get the magnitude of
the filtered signal.

On lines 28-30, the signal is then normalized so that the minimum of the signal is -0.9
and the maximum is 0.9. This allows the signal to have the required amplitude without
any chance of clipping when the signal is saved as a .wav file.

In order to get a continuous signal from the 2 minute recording of the heartbeat, the end
of the recording needs to loop back to the beginning without a noticeable change in the
heartbeat signal. The heartbeat as recorded from the stethoscope has a two beat cycle a
large beat, then a smaller beat. These beats are found throughout the recording. To
locate these beats the absolute value of an approximation to derivative of the signal is
used where peaks in the first derivative are determined by examining an approximation to
the second derivative. This is all done on lines 35-38.

On lines 46-52 all local maxima of the derivate that are above 0.3 throughout the signal
are found and stored in the variable dsmax. Then from lines 55-63 each of those
maxima is compared to their neighbors. For each maximum, if the next maximum is
within 500 samples it is not used as the next beat. Each maximum that is further than 500

51

samples from its previous neighbor is added to a list of beats dspeaks. Also, if a
maximum that is within 500 samples from its previous neighbor is greater than the last
maximum added to dspeaks, it replaces that maximum. Thus all the beats throughout
the recording are found.

Next, at the beginning of the recording the first small beat is found along with the next
large beat. Lines 70-75 determine which beat is the first small one and sets a variable
hbstart exactly halfway between that first small beat and the next large beat. At the end
of the file the last large beat is found along with the preceding small beat. Lines 76-81
determine which beat is the last large one and sets a variable hbend exactly halfway
between that last large beat and the preceding small beat. The original file is then cut
from hbstart to hbend. This creates the effect of a continuous heartbeat when the
audio file loops from the end to the beginning.

Finally the signal is cut again at the end to match up with the amplitude and slope of the
signal at the beginning to avoid a loud pop in the signal when it loops around to the
beginning. This is done in lines 88-101 by finding the last sample that has an amplitude
within .02 of the first sample of the signal and whose slope is within .001 of the first.

Next, the respiratory recording is processed. The recording is read in using dlmread at
line 106. The signal is then filtered through the same filter as the heartbeat signal from
lines 111-118, except the cutoff frequency is now 1Hz.

52

Now, the respiratory signal is the displacement of the chest at any given time, but the
signal needed to drive the motor must be the speed at which the chest is moving at any
given time. Thus, the approximate derivative of the signal is taken on line 121. Then, in
lines 124-126 the signal is split into a directions component and a magnitude component
to control the direction and speed of the motor, respectively.

Next, from lines 128-134 the number of breaths taken throughout the recording is
determined by finding every time the direction of chest motion changes. Also, the
magnitude portion of the signal is zeroed whenever the direction component changes to
allow the motor to operate properly. On line 135 the direction component changed from
a -1/+1 signal to a 0/5 signal compatible with the motor. From lines 137-143 the
beginning of the signal is cut to the beginning of the first full chest rise. From lines 144150 the end of the signal is cut to the end of the last chest fall. This creates the effect of a
continuous breathing motion when the signal loops around from the end to the beginning.

From lines 153-159 the average breaths per minute from the recording is calculated.
However, to keep the motion within reason, if the calculated breaths per minute is greater
than 17 or less than 8, the number is brought to within the range of 8-17.

Finally, all the required signals are written to files in lines 162-165. The heartbeat audio
signal is saved as [name]_steth.wav using the wavwrite function. The rest are saved
using dlmwrite. The respiration magnitude signal is saved as [name]_control.lvm, the
respiration direction signal is saved as [name]_dir.lvm, and the breaths per minute

53

number is saved as [name]_bpm.lvm.

2.6: User Instructions for Operating the KUDDLER device

Instruction for Operating KUDDLER Device

Turn on the KUDDLER Device
1. On the left-hand side of the cart, plug in the power cord for the Main Power and turn on
the Main Power Switch. The switch will light up when it is on.
2. On the right hand-hand side of the cart, turn on the Data Power Switch. The power
switch will light up when it is on.
3. On the front of the cart, make sure the right side volume knob of the SAMSON amplifier
is turned all the way down (counterclockwise) and press the center power button of the
SAMSON amplifier. A blue ring will light up around the power button and a red light
will light up around the speaker button after a few seconds.
4. Pull out the tray with the EeePC Netbook Computer, open the computer, and turn the
computer on with the power button in the top right of the keyboard.
5. The computer will boot up to the Windows login screen. The password is kuddler.
Type in the password and press Enter.
6. Wait 5 minutes until the computer has completely booted up. The KUDDLER interface
will be on the screen.

Record mother's heartbeat

1. Press the Record button.

2. Type name of patient into text box. Then press the Next button.

54

3. Press the Heartbeat button.

(Continue on next page)

4. Stethoscope:

Bell
a) IMPORTANT: Be sure to begin recording within 1 minute of turning on the
stethoscope. Patient must be completely silent while recording.
b) Under the Computer tray, roll out the bottom tray with the stethoscope and the
respiratory band. Take out the stethoscope.
c) Tape the stethoscope to the patients chest, slightly left of center, where the
heartbeat sound will be best picked up.
d) Turn on the stethoscope with power button (On/Off).
e) Make sure the stethoscope is set to bell mode (BELL MODE SELECTOR). This
should be the default setting when the stethoscope is turned on. If it is not, set it
using the FREQUENCY MODE SELECTOR button.

: Correct
Incorrect

OR

f) Make sure the stethoscopes volume is set to 4 bars. This should be the default
setting when the stethoscope is turned on. If it is not, use the Volume
Increase(+)/Decrease(-) buttons to set it.

55

: Correct

: Increase Volume

:Decrease

Volume

5. Make sure all the recording information is correct and press the Run button.

6. The recording will stop automatically after 2 minutes. To stop recording sooner, press
the Stop button.

(Continue on next page)

7. The program will open a new window to analyze the recording. This window will
automatically close when analysis if finished. After this, the program will return to the
Record/Playback screen.

Record mother's respiration

1. Press the Record button.

56

2. Type name of patient into text box. Then press the Next button.

3. Press the Respiration button.

(Continue on next page)

4. Respiratory Band
a) Before putting on the band, adjust band length so that it fits around the
chest, directly beneath the breasts. The band should fit snuggly, so that
when the patient breathes out fully, the band will not slip.

57

b) Place the band around the chest and buckle with the wire inputs facing
down.
c) Connect the wire leads to the band on both sides of the buckle. The wire
with the Left Side tag on it goes on the patients left, and the Right
Side tag on it goes on the patients right.
(Continue on next page)

58

d) IMPORTANT: Wait at least 1 minute while all wires are connected to the
band before beginning recording of respiratory signal.
5. Make sure all the recording information is correct and press the Run button.

6. The recording will stop automatically after 2 minutes. To stop recording sooner, press
the Stop button.

7. The program will open a new window to analyze the recording. This window will
automatically close when analysis if finished. After this, the program will return to the
Record/Playback screen.

59

Run KUDDLER Device

1. Press the Playback button.

2. Select patient name from drop down list. Then press the Next button.

3. Make sure all the playback information is correct and press the Run button. The
KUDDLER device will run indefinitely.

4. Turn the right side volume knob on the SAMSON amplifier up to half power (straight
up).
5. Press the Stop button to stop running the KUDDLER.

6. Turn the right side volume knob on the SAMSON amplifier all the way down again
(counterclockwise).
7. The program will return to the Record/Playback screen. To select another mothers
recording to play back, simply return to step 1 of the Run KUDDLER Device section.

60

Backing Up Patient Data

1. To backup patient recordings and data click the Backup Data button in the upper left
corner of the screen.

2. Unplug the mouse from the computer and insert the File Backup USB stick into the
USB port on the right side of the computer where the mouse was plugged in.
3. Click Confirm to confirm the backup. All patient data will be backed up onto the
Backup Data USB stick. The program will then return to the start screen.

4. Unplug the Backup Data USB stick from the computer and plug the mouse back into
the USB port.

Recovering Backed Up Patient Data

1. To recover patient recordings and data that has been previously backed up, click the
Recover Data button in the top middle of the screen.

2. Unplug the mouse from the computer and insert the File Backup USB stick into the
USB port on the right side of the computer where the mouse was plugged in.
3. Click Confirm to confirm the recovery. All patient data that had been backed up will
be recovered. The program will then return to the start screen.

4. Unplug the Backup Data USB stick from the computer and plug the mouse back into
the USB port.

61

Deleting Patient Data

1. Click on the Delete Names button on the bottom middle of the screen.

2. Click on the Patient drop down menu and select the name of the patient data you want
to delete. Then click Next.

3. Review the information on the left of the screen and then click Delete. The patient data
will be deleted and the program will return to the start screen.

Shutting Down the KUDDLER Device

1. Press the Shutdown button in the lower right corner of the screen. The
program cannot be closed while the program is recording or playing back.

2. Turn off Samson Amplifier, Data Power Switch, and Main Power Switch.

62

Chapter 3: Evaluation

The KUDDLER device works as it was intended to. The device records the mothers
signals through the LabView program and stores them in the desired files. The MATLAB
program processes the signals as intended, which can be seen in the following graphs,
showing the progress through the program. These signals are shortened samples in order
to be able to see the progress easily. Actual recordings are 120 seconds long, rather than
5 and 30 seconds for the heartbeat and respiration signals, respectively.

The heartbeat signal is first processed.

Figure 3.1 Heartbeat raw signal

63

Figure 3.2 Heartbeat filtered signal

The signal after the windowed FIR filter does not show much difference from before the
filter, as the higher pitched noise is small in amplitude and difficult to view. Also the
signal is normalized to avoid clipping.

Figure 3.3 Heartbeat local peaks

64

Figure 3.4 Heartbeat beats determined

The position of the beats is determined, as well as the maximum amplitudes, in order to
find the large beat and the small beat.

Figure 3.5 Heartbeat full beat lineup cut

65

Figure 3.6 Heartbeat full beat lineup cut wrap-around

As you can see, when the heartbeat wraps around it appears to be one continuous
heartbeat, with the wrap falling directly between two full beats. The only issue is the
small spike that occurs at time 0, which will be cleared up in the next step.

Figure 3.7 Heartbeat amplitude and slope match cut

66

Figure 3.8 Heartbeat amplitude and slope match cut wrap-around

The heartbeat signal wraps around from the end to the beginning very smoothly,
eliminating any sort of loud, high frequency pop that might have occurred when the
signal loops from the end to the beginning.

Next, the respiration signal is processed.

Figure 3.9 Respiration raw signal

67

Figure 3.10 Respiration filtered signal

The respiration signal is filtered to reduce noise, giving a smooth rise and fall of the
chest.

Figure 3.11 Respiration approximate derivative

68

Figure 3.12 Respiration speed and direction signals

The derivative of the signal is taken and split into speed and direction of the respiration to
drive the motor.

Figure 3.13 Respiration signals cut for continuous loop

The signals are cut to match the end and beginning of full breaths so that when the signal
loops around from the end to the beginning it appears continuous.

After processing, playback is continuous without any issues and can be run continuously

69

for as long as is necessary without any errors.

The design, programming and implementation of the device was accomplished and the
device has passed biomedical evaluation at the University Hospital Case Medical Center
and is currently undergoing patient testing. The device was designed in an incremental
fashion with new features added as necessary onto the existing base design and code.
Although this is not the most effective from an overall system design perspective, since
this is a prototype device the robustness and functionality took precedent over smooth,
minimal design and the most efficient operation. Once feedback from testing is
complete, the prototype will be transformed to a final design with additional features and
functionality.

Chapter 4: Conclusions and Future

The KUDDLER prototype device was a successful project. Moving forward, the device
will be used in trials with infants in the NICU of University Hospital Case Medical
Center in Cleveland, OH, to determine if the KUDDLER device has a beneficial effect on
the premature infants in the NICU. Assuming the trials successfully conclude that the
KUDDLER is a viable option to supplement the Kangaroo Care program, the device will
need to be redesigned and produced in greater numbers. This redesign would benefit the
device by increasing functionality, streamlining and minimizing the design, and lowering
the cost of the device.

70

In the prototype device there were issues with using the exact recording of the mothers
respiratory pattern, so an average breaths per minute measurement was calculated and
used to drive to motor at a constant speed. The motor used was not compatible with the
desired implementation of using the exact recording and motion. The motor did not have
the necessary positional feedback to be able to reset the device to a starting position upon
stopping playback. Being a circular rotation, if the cam was not started at a 90 position
to the bed it would not have the full range of motion. Also if it was started at a 0
position to the bed, the motion would be very small but twice as fast, as the motor moves
the cam back and forth across its top ridge. A motor with positional feedback would be
preferable to implement a 1-to-1 playback of the mothers respiratory pattern.

Another issue that arose was that the Littmann electronic stethoscope was used in a way
that it was not designed for. The stethoscope was designed for short interval use by
doctors performing exams on their patients. It is battery operated and so, in order to
conserve power, is designed to shut off after no buttons have been pressed for 3 minutes.
The stethoscope also only has internal functionality to record 8-second clips of a patients
heartbeat. For the device redesign it would be beneficial to have a specially made model
of this stethoscope that is powered by the microcontroller card and has a direct line out to
an audio input on the card so recordings can be as long as is desired and free of any
outside interference.

The need for robustness and functionality also resulted in most of the hardware having

71

more options and performance than was necessary for the device to work properly. The
audio amplifier had two 60W channels when all that was needed was a single 45W
channel for the speaker. The National Instruments DAQ had far more functionality than
was necessary. It had more analog input channels than were utilized (the digital channels
were not used at all) and was able to read and write signals at 250kS/s when the
maximum used was 8kS/s. Finally, a full laptop computer running the Windows XP
operating system was used to operate the device. Not only was this more power and
functionality than was necessary, but the possibility of errors in the operating system and
software was greatly increased. All of these devices could likely be implemented on a
single dedicated microcontroller card. This would greatly decrease the cost of the device
and allow for faster and more streamlined design and functionality. There would also be
fewer variables that could negatively affect performance, such as poor compatibility
between hardware or bugs in the operating system and software.

72

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