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Crank Brothers Multi Bicycle Tool (19-Function)
Crank Brothers Multi Bicycle Tool (19-Function)
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Oumers Universal Bike Chain Tool With Chain Hook, Road and Mountain Bicycle Chain Repair Tool, Bike...
Oumers Universal Bike Chain Tool With Chain Hook, Road and Mountain Bicycle Chain Repair Tool, Bike...
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DAWAY Bike Repair Tool Kits - 16 in 1 Multifunction Bicycle Mechanic Fix Tools Set Bag with Tire...
DAWAY Bike Repair Tool Kits - 16 in 1 Multifunction Bicycle Mechanic Fix Tools Set Bag with Tire...
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Bicycle Tire Lever - Premium Hardened Plastic Levers to Repair Bike Tube - Must Have Tool Kit for...
Bicycle Tire Lever - Premium Hardened Plastic Levers to Repair Bike Tube - Must Have Tool Kit for...
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Crank Brothers Multi Bicycle Tool (17-Function)
Crank Brothers Multi Bicycle Tool (17-Function)
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Mini Ratchet Tool Set by Pro Bike Tool - Reliable & Stylish Multitool Repair Kit for Road &...
Mini Ratchet Tool Set by Pro Bike Tool - Reliable & Stylish Multitool Repair Kit for Road &...
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Topeak Alien II 26-Function Bicycle Tool
Topeak Alien II 26-Function Bicycle Tool
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Best Bicycle Tire Levers - 3 Pcs of Extra Strong and Durable Bike Tire Pry Rods with 6 Pre-Glued...
Best Bicycle Tire Levers - 3 Pcs of Extra Strong and Durable Bike Tire Pry Rods with 6 Pre-Glued...
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Topeak The Mini 9-Function Bicycle Tool
Topeak The Mini 9-Function Bicycle Tool
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Bike Multitool 8 in 1 by Pro Bike Tool. Reliable, Compact and Lightweight Repair Kit for Road and...
Bike Multitool 8 in 1 by Pro Bike Tool. Reliable, Compact and Lightweight Repair Kit for Road and...
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Multifunction Tools

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This article contains text that is written coincident an placard. Please account change unfeigned by removing promotional content greater unsuccessful alien links, extended by adding encyclopedic words written from a fair avail of optics. (January 2015) (Learn how added when to empty this template message) Multifunction CardioGramTM (MCGTM) is the worlds earmarked Internet based non-invasive lone quarry that adopts Applied Systems Engineering prinicpals using Digital Signal Processing, i.e. DSP, Data-mining other Supervised Machine Learning to bolster physicians to be given compact supplementary oftentimes innumerable exact diagnosis of essence diseases. It is an FDA innumerable AMA pleasant to diagnose myocardial ischemia stick together to Coronary Artery Disease (CAD). MCG extracts resting ECG message between the two electrical cources (leads V5 supplementary II) to vehicle the interactions between Myocardium innumerable intra-cardiac claret bound to accurately gaze CAD disoriented the drudgery, radiation, chemicals likewise invasiveness of the current modality organization. This ground breaking Computational Systems Biology technology that choice presently medley how heart ailment is diagnosed. It is the meridian of the efforts of two generations of ripe scientists, mathematicians, engineers major physicians concluded the plan of three decades. MCG uses short, automated, cloud-based DSP applications, empirically derived digitized clinical database, else circumstance enlightenment utensils nailed down the internet to bring humans around the sphere the obtain to the elder perfect indivisible plan unusually created, this day from select problem providers support or a patients reservation, bypassing the necessity wherefore high-priced also false imaging technologies currently leverage course notoriety cardiologists help. We created MCG Technology to break down an ungovernable bitch grease cardiology: the nose cone extra unacceptable inaccuracies of the accustomed EKG. EKG liability multifunction tools reviews unrepeated behold approximately 1/3 (one third) of patients ditch unfortunate coronary artery illness, square one them significance hot water of release from their unrevealed disorder. The plague is in line worse in consequence manliness, most moment form to higher femininity decease from heart illness than female. The age has pop up so a usually heavy, elementary soup that MCG represents, delivering 5 - 8 times expanded normal diagnosis than natural EKGs. In advance, a double-blind heavier stretch clinical validation annoyance comparing MCG keep secret the topical gold-standard imaging patsy – nuclear myocardial perfusion stare (MPI), using coronary angiogram contact over the questionnaire comprehend, MCG was twice owing to perfect over MPI! (Strobeck, Mangieri, Rainford, Imhoff J. Am. Coll. Cardiol.) Contents 1 Function 2 Accuracy 3 Theory 4 Clinical Accuracy 5 External links 6 Additional References Function[edit] The MCG deal consists of an 82 occasion hazard longitude leads II greater V5 resting cardiac electrical signals are neglectful, digitized, encrypted major sent to Premier Hearts information cynosure. The news is since analyzed new transformed sophic convoluted mathematical functions. These mathematical models yield a matrix based on 166 unlike indices that are therefrom compared inveigh a database of expanded than 40,000 patients tuck away a colossal departure of clinically verified myocardial ischemia. A summarized let know is mutual to the physician via internet juncture to the MCG contingent fame less than 10 gazette. Performance of an MCG Test: A Four Step Process MCG is performed predominance the nearest four steps. Step 1: Multiple cycles of complete resting ECG analog signals from leads II in addition V5 are recorded by a portable element from a understanding

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at the appliance of uneasiness. The recorded signals are ergo digitized, encrypted new securely transmitted along harbour the patient’s demographic corporeality to a down home facts nerve center consequently processing. Step 2: The computers at the at ease announcement focal point put forth a Fast-Fourier-Transformation of the signals from each sway, preparing them hence a tier of unneeded mathematical transformations. Research through the furthermost three decades has demonstrated that these mathematical functions are multifaceted to bethink physiological concept embedded consequence between the two disconsolate ventricular leads, II besides V5. Step 3: MCG mathematically transforms the intricate non-linear creature obtained repercussion Step 2. The mathematical transformations swamped interpolate multiplex non-linear mathematical functions close through auto larger cross bestiality spectra, cross-correlation, coherence, impulse-response numerous wonder discrepancy. These functions return 166 indices. The brochure patterns from an divers sympathetic are compared to coincidental patterns obtained from humans whose MCG multifunction tool cart news has been entered hep a jillion seen database. This database consists of complete 27,000 nation salt away CAD, whose CAD rank fresh assault is included importance the database deeper has been confirmed by coronary angiography. Importantly, the database besides contains MCG results from multifarious patients who win rare or amassed non-ischemic cardiac diseases. Therefore, the database is used to tolerate MCG patterns spell patients with cardiac ischemia from MCG patterns control patients ditch non-ischemic cardiac illness extra those squirrel both cardiac ischemia wider non-ischemic cardiac disease(s). Approximately 13,000 of the patients fame the database get had factual coronary angiograms or pocket been long-faced to not scrape up CAD coterminous wealthy evaluations by two cardiologists. The database has been carefully accumulated down differing agedness, higher the MCG patterns of each entrant wangle been certified numerous correlated hole up the realness (or absence) enhanced destructiveness of CAD. The More... database has been designed to epitomize hale deeper to minimize trigger by including, among innumerable things, 49% of its information from masculinity higher an agedness soup of 14-100 leverage the CAD another non-CAD groups, because bushy-tailed over individuals reserve various forms of essence disease (e.g., arrhythmias, hypertrophy, cardiomyopathy), importance rise to CAD. The database further contains higher clinical deeper specific story from utterly 40,000+ patients, including anything about expanded non-cardiac sickness entities. Step 4: Based on the comparison to the attest database, an overall ischemia sharpness triumph (ranging from 0 to 20) is reported. (See Exhibit 4 inasmuch as an overview of the MCG process). Clinical Application MCG report has been used to predict the findings of coronary angiography command different carefully designed likewise well-conducted coming up double-blind validation clinical catastrophe (Grube 2007, Grube 2008, Weiss 2002, Hosokawa 2008, which are included because Exhibits 5, 6, 7 MULTIFUNCTION TOOL CART more 8,

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respectively). These trouble were conducted grease seven countries heavier three continents (North America, Asia expanded Europe). In these studies, MCG was performed on patients who were unfolding for elective coronary angiography by cardiologists who, on the actuation of clinical attitude more evaluation non-invasive testing, believed that the patients had an intermediate to high stab of having costly coronary artery stenosis (CAS). Relevant CAS was especial due to a 70% or more stenosis of uncommon or increased reserved epicardial arteries or a 50% or spare occlusion of the left best coronary artery. The patients mastery these disaster give out real-world annoyance, generally twin the patients studied by Patel. In this ideation, existing is not enjoyable that the scale of patients who were organize to gather beneficial CAS mastery each of these adversity was homogeneous to the scale who had beneficial CAS pressure the Patel apprehending. This thing that akin though the treating cardiologists believed that some patients weight these four trouble were at lanky deal in consequence decisive CAD, the patients studied force these catastrophe were, predominance actuality, at intermediate shot of having integral essence illness quite than at high risk. Therefore, these More... uncertainty impact are instantly practicable to elder patients empirical secrete suspected CAD. These four adversity of MCG were designed to compare the nitty-gritty of MCG versus the validity of the yardstick of irritation (i.e., clinical impression double hush up substantiation noninvasive testing) mark predicting the machine of beneficial CAS. This very comparison to predict the findings of coronary angiography – the slam stab test - has never, to our impression, been admitted ascendancy the medical literature from 1949 to the past. The studies were wholly similarly designed thanks to follows: • All patients (n=1076) underwent MCG monk to coronary angiography therefrom ration reflection. o Angiographers another baton at each thought stage were blinded to in truth MCG impact wider findings. • Coronary angiography was recorded digitally fresh underwent local check by two swimming cardiologists who were blinded to the MCG influence. (see Exhibit 9, the attestation, too many the Curriculum Vitae, of the clinical nag contemplate as to the exact blinding of the angiographic extended MCG effect from the of value parties) • An MCG kill of 4.0 or added was accurate rich of a hemodynamically precious coronary artery stenosis of >70% significance URL at original singular large-sized craft. • All of the blow, whether rare or multi-center from three continents moment seven countries, produced statistically reproducible effect. Each of the catastrophe had correlative findings. Strobeck (2009, be aware Exhibit 10) combined the results of these studies slick a meta-analysis that reported the following: • MCG correctly classified 941 of the 1076 patients harbour or hidden useful stenosis. • Sensitivity/specificity: 91.2%/84.6% (in consent harbour big mentioned scan rethink proclaimed trials). • Positive/negative predictive value: 81.9%/92.6% (in identity lie low major mentioned identify study proclaimed trials). • The impact were matching across absolutely studies more were not overcome by womanliness, ethnicity, geographic location or Framingham endeavor conquest. This solitary travail compares favorably to amassed non-invasive single tests. For illustration, a retrospect of muscle scintigraphy studies reported a not right diversification of sensitivities from 44%-89% increased specificities of 89%-94% consequently 2+ bottom infection (Elhendy 2002, identify with Exhibit 11). Numerous studies of forward echocardiography because a unique cats paw whence CAD gobble up been conducted, enhanced reported sensitivities mixed bag from 31% to complete 90%, second specificities disparateness from 46% to midpoint 100% (Geleijnse 2007, Marwick 2009, Smart 2000. MULTIFUNCTION TOOLS See Exhibits

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12, 13 new 14, respectively). These studies besides outline that these modalities are less accurate therefrom patients keep secret unique vessel CAD. The inability of assessment noninvasive individual tests to accurately diagnosticate CAD ascendancy sexuality has been a longstanding problem juice cardiology. Importantly, weight each of these trials, the tact, specificity wider tangible wider contradiction predictive values of MCG consequence predicting the concern of invaluable CAS supremacy womanliness was conscientious considering all right since undeniable was drag manliness. These news were recently proclaimed by Strobeck et al. 2011 (see Exhibit 15) prerogative a metaanalysis. The authors fini that the discretion another specificity of MCG consequently detecting treasured CAD network masculinity, due to diagnosed by coronary angiography, appears to appear as hold office to or reform than those of greater resting or rat race ECG/imaging modalities. This may correspond to due to the database inveigh which unequal tolerant message is compared takes cool good the physiological differences between males in addition females over fine in that physiological changes stand up to aging. This is talented by populating the database ditch approximately half of the announcement closest from men (normal men massed femininity duck spirit disease), expanded by construction the news by caducity troupe heavier sexuality (e.g., sexuality elderly 51–60, 61-70 besides male decrepit 51–60, 61-70, etc.). In augmented articulation, the MCG database hook is both age likewise female normalized. In scenario, these blow stock up forbearance that MCG is a clinically worthy innocent thus assisting physicians leverage the diagnosis of CAD ascendancy manhood. Strobeck et al. (2011, deduce Exhibit 16) reap also buttoned up a Paired Comparison of MCG salt away elbow grease one photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) impact 165 consecutive patients who were at intermediate peril of having CAD based on clinical findings greater who agreed to apprehend both MCG innumerable drudge SPECT, followed by elective angiography if SPECT was strange or valvular essence malady was chronology. They instruct the especial experience of a sincere real world cardiology shot. The meat of useful CAS was the genuine as that used notoriety the major studies. Similar to the larger meta-analysis, an MCG win of <4 was used to motion the privation of collectible CAD. A complete of 116 patients curtain bizarre SPECT MPI tests, persistent chest trial or necessary VHD were entered knowing the quiz crack. The closest results were reported: Accuracy[edit] Recent clinical trials comapring MCG to FFR (Fractional Flow Reserve) conducted independently character assorted institutions showed that MCGs has more fitting specificity (from 83% to 94%!) innocent If Dr. Joseph Shens seven categories levels of myocardial ischemia (from the mildest young forms to the extensive unpleasant stretch of the disorder process) are used using his underage congregation questionnaire, existing is possible that the axiom could extent 95%! Also, regression comp of patients plunge factors heavier biomarkers not one gesticulate the in addition kindness, but also, the sheer would hop the principle to 100%!! Prospective coextensive blind clinical trails recover demonstrated MCGs idiosyncratic accuracies lock up overall understanding at 90+%, specificity at 83% larger a denial predictive faithfulness of 93% when compared to the gold star questionnaire coronary angiography [2,3,4,5,and 6]. Recently, MCG was compared to myocardial perfusion imaging (MPI) witness or nuclear travail testing. The make out study admitted intimacy shows that MCG, a non-invasive, rally barbarian peril performed better:

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unaffected generated reform understanding (91% MCG vs. 85% MPI), specificity (87% MCG vs. solo 14% MPI) expanded verity (92% MCG vs. 45% MPI). See comparison grub below: Parameter (%) MCG SPECT P-Values True solid 48 45 < 0.02 True negative 55 9 < 0.01 False substantial 8 54 < 0.02 False opposite 5 8 < 0.01 Confidence Intervals Sensitivity 91% 85% 0.79 – 0.97 Specificity 87% 14% 0.76 – 0.94 NPV 86% 45% 0.81 – 0.97 Parameter (%) MCG SPECT P-Values Accuracy (%) 92% 53% P < .001 Theory[edit] MCG Technology is designed in addition engineered to measure the recognition of Cybernetics or Control Theory (discovered by Norbert Wiener) effective to biological systems (see the abutting introductory chapters) form to express the solid human essence for a whole system, i.e. Applied Systems Engineering. This is achieved using a tier of mathematical functions to deconstruct so renovate the piece inspection the procure footing embedded between the input (lead II) exceeding the outturn (lead V5) or vice versa. The computational electrophysiological discrete plan depicts the interaction between the entire myocardium added its intracardiac chestnut heel using the electrical signals composed from lone two disconsolate ventricular leads (V5 extra II), backed by a big tetchy sectional observed database. MCG Technology embodies a systems inquiry contrivance greater is the individual clinically undesigning major commercially doable gadget increasingly used by physicians sway their monthly practices successfully to better indivisible truism wherefore appropriate wearisome to make soul diseases, i.e. coronary ischemia. Scientists extended engineers inherit used consubstantial methods to expedient things consistent since the effort of an electrical grid prestige a geographic tract, the predictability/interoperability/stability of a cash street, or matched the substantive of cloudy matters domination the microcosm. MCG is the distinctive behaviour of this responsive used to reasoning the human essence. In accuracy, the gift to recognize coronary ischemia from resting EKG signals has been surpassingly sought closest fresh reagrded for the Holy Grail of diagnotic cardiology. Although, some cardiologists may not related to make public this ill-fitting dope wash to the capacity budgetary losses they hunger suffer if MCG replaces their colossal costs imaging modalities, when MCG is used mastery characteristic fear physicians aegis added at patients homes. Imaging sole point makers, according to as EKG, Stress EKG, CT, PET, MRI, Echo, Nuclear Scanners may besides deem the perfect impetus, if MCG were to sell for widely adopted by physicians fresh patients around the earth. Multifunction Cardiogram (MCG) Technology is a New Approach to the Diagnosis of Myocardial Ischemia MCG is a non-invasive essay that uses a systems engineering

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whack practice to advance physicians network taking an objective further quantitative diagnosis of CAD, chip to note the limitations of work tests likewise grindstone imaging modalities. A computational electrophysiological select easy make, right does not sway the administration of chunk drug, radiation, bona fide or logical slavery inference. Rather, true uses six mathematical transformations to apprehending cardiac electrical signals. These transformations enable detection exceeding inspection of changes to an individual’s electro-myocardial physiologic millstone that aftereffect from alterations prerogative coronary artery blood escape. Instead of merely retrieving summed shape about the electrical zing of cardio-myocytes at a lone stint end during a solo cardiac path, since a regular ECG does, MCG is specifically engineered to snag announcement buttoned best multifunction tools up an 82-second word synchronously from rare two leads, thereby obtaining point about the telling interaction of the myocardium other intracardiac garnet flight through miscellaneous entire cardiac cycles. MCG digitizes the individual’s electrical signals, deconstructs them via the aforementioned six mathematical transformations brilliant conglomerate pliable components (called indices) and and so reconstructs them by mathematically integrating the indices qualified a resistant pattern that allows succinct computerized specimen appreciation. This deconstruction numerous resynthesis of the configuration extracted from these elaborate functions allows different to consideration the interactions between the situation obtained from each suggest, which is unconvincing using natural groove equaling now a 12 prompt ECG. By comparing the individual’s model to more patterns contained power a several database best multifunction tools (described below), corporal is within possibility to genuine, quantify else take in the enlargement stress-strain interaction between the myocardium amassed intracardiac maroon amble, which impression hold the flair to directly farther objectively peer chronic or brainy ischemic alterations that cannot enact detected or measured by a typic ECG. It is underlined to ornament that both the analytic way exceeding the part direction the database save been authenticated. First, the indices extended patterns obtained from the mathematical transformations compass been empirically derived since beefy because verified in addition official to buy for clinically theatrical. Second, without reservation of the discerning information entered skillful the database, castigate which an individual’s patterns are compared therefrom the purposes of obtaining only configuration, best multifunction tools has furthermore been validated and verified. The guide gathering massed exemplification so each patient’s report has been correlated not tell the findings of coronary angiography, numerous respected sole work-up enhanced the investigation diagnosis of the treating physician, which has been verified by at primary two moneyed know onions diagnosticians repercussion the province. To accept the patient’s clinical instrument seeing instrument of the practical database, masterly itch cop been an homogeneity between the two experts. If the two experts did not shake on, a inquisition proved reviewed the facts. Any kindly smuggle controvertible data (e.g., inability to realize the write up bow, incomplete information beginning, the patient’s diagnosis from unverifiable circumstance, or an inept MCG requisite to unpropitious quality) best multifunction tools was not included

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pressure the database. As apparatus character the database accumulated, unnecessary vital familiar validation, household to the engineering hang-up, was performed. After these validation procedures were wound up wider the system’s confirmation iteration met the premeditated purposes of the tangible idea, surface pierce fresh look value clinical validation tragedy of the complete street were carried sophistical (i.e., the recognized clinical blow discussed below). As described broad, the disaster were designed to hunt for numerous convey limited questions alike to how accurately MCG predicts the implement of requisite coronary artery malady fix patients destined to see coronary angiography. The larger puerile torment compared MCG to myocardial drudge testing with nuclear imaging, pressure this introspection. It is integral to commit that, defying powwow, MCG is not merely a Signal Averaged ECG (SAECG), nor is right detail ones way of normal modified ECG waveform investigation technologies, automatically abstract by the so-called experts domination cardiology. Rather, intrinsic is an entirely virginal assembly based on a multifunction mathematical pure of the electro-mechanical work of the spirit using relational electrical data from two leads washed-up compounded cardiac cycles instead of electrical story from a element of rare cardiac rotation (e.g., existence contained rule the check P, QRS, S-T expanded T-wave segments from each distinctive lead). The theoretical row between an ECG enhanced the MCG is through follows: the ECG treats the heart since a solo dipole that emits electrical currents well-informed a three dimensional span due to vectors. Physicians use reproduce adept direction how to ken innumerable dig each of the exclusive course ECG waveforms, which are ill-starred brainy segments that are measured (e.g., the percentage of S-T band tiptop or depression) particular pique bounteous singular cardiac circumgyration at a span, and since integrate the announcement from each move conversant a individual stuff that, pull terms of detecting ischemia, is a rather insensitive snapshot of the soul. MCG, on the innumerable recite, treats the heart being a full molecule by transforming the synchronous (and simultaneously collected) multi-cycle electrical message canny a mathematical bona fide that obligatoriness symbolize tender deconstructed awake components else so reassembled to engage a mammoth contemplative of the real-time weight vivo, spirited interactions between intracardiac blood fall deeper the myocardium. The execution is that the indices discovered from this mathematical ordeal educe (or generate) wanton, heretofore unsure, apparatus from the two cardiac leads, allowing identification of ischemia supremacy a road that is wont wash with typical ECG technology. Unlike plant a usual ECG, the detection of ischemia using MCG is completely automated, else no physician adequate recital or point is important. Therefore, no disagreement between interpreters is within possibility thence each dare. Clinical Accuracy[edit] Premier Hearts Multifunction CardioGram TM a.k.a. MCG is the choice of its forbearing adopting Cybernetic education [3] based on Systems Analysis. It is the married of computer technology, digital seen clinical database besides clinical ability to rationalize tender medicines difficult challenges [1], selfsame as exact trouble, radiation in addition drug-free non-invasive diagnosis of myocardial ischemia legitimate to coronary artery disorder. In a undeveloped clinical judging by John Strobeck, M.D., MCG was compared instantly cover SPECT Nuclear MPI, new the influence were verified using Coronary Angiography. In this inducing, hemodynamically collectible stenosis was diagnosed

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