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Yoshida K, Sawano R, Okamoto M, Murao K, Tsuchida S, Terada T. Physical Noninvasive Attacks on Photoplethysmogram by Computer Controlled Blood Pressure Cuff. SENSORS (BASEL, SWITZERLAND) 2023; 23:9764. [PMID: 38139610 PMCID: PMC10747835 DOI: 10.3390/s23249764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/29/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023]
Abstract
Sensor data has been used in social security and welfare infrastructures such as insurance and medical care to provide personalized products and services; there is a risk that attackers can alter sensor data to obtain unfair benefits. We consider that one of the attack methods to modify sensor data is to attack the wearer's body to modify biometric information. In this study, we propose a noninvasive attack method to modify the sensor value of a photoplethysmogram. The proposed method can disappear pulse wave peaks by pressurizing the upper arm with air pressure to control blood volume. Seven subjects experiencing a rest environment and five subjects experiencing an after-exercise environment wore five different models of smartwatches, and three pressure patterns were performed. It was confirmed in both situations that the displayed heart rate decreased from the true heart rate.
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Affiliation(s)
- Kazuki Yoshida
- Graduate School of Information Science and Engineering, Ritsumeikan University, 1-1-1 Nojihigashi, Shiga, Kusatsu 525-8577, Japan; (K.Y.)
| | - Ryota Sawano
- Graduate School of Information Science and Engineering, Ritsumeikan University, 1-1-1 Nojihigashi, Shiga, Kusatsu 525-8577, Japan; (K.Y.)
| | - Masahiro Okamoto
- Graduate School of Information Science and Engineering, Ritsumeikan University, 1-1-1 Nojihigashi, Shiga, Kusatsu 525-8577, Japan; (K.Y.)
| | - Kazuya Murao
- Graduate School of Information Science and Engineering, Ritsumeikan University, 1-1-1 Nojihigashi, Shiga, Kusatsu 525-8577, Japan; (K.Y.)
| | - Shuhei Tsuchida
- Center for Interdisciplinary AI and Data Science, Ochanomizu University, 2-1-1 Otsuka, Bunkyo-ku, Tokyo 112-8610, Japan;
| | - Tsutomu Terada
- Graduate School of Engineering, Kobe University, 1-1 Rokkodai-cho, Nada-ku, Hyogo, Kobe 657-8501, Japan;
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Alvarado Alvarez M, Padwal R, Hiebert W. Masking of Korotkoff sounds used in blood pressure measurement through auscultation. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2023; 153:1496. [PMID: 37002066 DOI: 10.1121/10.0017354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 02/07/2023] [Indexed: 05/18/2023]
Abstract
Measurement of blood pressure (BP) through manual auscultation and the observation of Korotkoff sounds (KSs) remains the gold standard in BP methodology. Critical to determining BP levels via auscultation is the determination of KS audibility. While absolute sound level audibility is well researched, the problem has not been approached from the point of view of psychoacoustic masking of the sounds. Here, during manual auscultation of BP, a direct comparison is made between what an observer perceives as audible and the electronic analysis of audibility level determined from masking of sound signal levels. KSs are collected during auscultation with an electronic stethoscope, which allows simultaneously observing sound audibility and recording the sound electronically. By time-segmenting the recorded sound around Korotkoff peaks into a test segment and a masking segment, performing Fourier transforms on the segments, and comparing frequency-band sound energy levels, signal-to-noise ratios of a sound to its masking counterpart can be defined. Comparing these ratios to difference limen in the psychoacoustic masking literature, an approximate threshold for sound audibility is obtained. It is anticipated that this approach could have profound effects on future development of automated auscultation BP measurements.
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Affiliation(s)
| | - Raj Padwal
- Department of Medicine, University of Alberta, Edmonton, Alberta T6G 2R7, Canada
| | - Wayne Hiebert
- National Research Council Canada, Edmonton, Alberta T6G 2M9, Canada
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Lin W, Jia S, Chen Y, Shi H, Zhao J, Li Z, Wu Y, Jiang H, Zhang Q, Wang W, Chen Y, Feng C, Xia S. Korotkoff sounds dynamically reflect changes in cardiac function based on deep learning methods. Front Cardiovasc Med 2022; 9:940615. [PMID: 36093170 PMCID: PMC9458936 DOI: 10.3389/fcvm.2022.940615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 07/18/2022] [Indexed: 11/24/2022] Open
Abstract
Korotkoff sounds (K-sounds) have been around for over 100 years and are considered the gold standard for blood pressure (BP) measurement. K-sounds are also unique for the diagnosis and treatment of cardiovascular diseases; however, their efficacy is limited. The incidences of heart failure (HF) are increasing, which necessitate the development of a rapid and convenient pre-hospital screening method. In this review, we propose a deep learning (DL) method and the possibility of using K-methods to predict cardiac function changes for the detection of cardiac dysfunctions.
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Affiliation(s)
- Wenting Lin
- Department of Cardiology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Sixiang Jia
- Department of Cardiology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Yiwen Chen
- Department of Cardiology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Hanning Shi
- Department of Anime and Comics, Hangzhou Normal University, Hangzhou, China
| | - Jianqiang Zhao
- Department of Cardiology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Zhe Li
- Department of Cardiology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Yiteng Wu
- Department of Cardiology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Hangpan Jiang
- Department of Cardiology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Qi Zhang
- Department of Cardiology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Wei Wang
- Department of Cardiology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Yayu Chen
- Department of Cardiology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Chao Feng
- Department of Cardiology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Shudong Xia
- Department of Cardiology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
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4
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Babbs CF. The origin of Korotkoff sounds and the accuracy of auscultatory blood pressure measurements. ACTA ACUST UNITED AC 2015; 9:935-50.e3. [DOI: 10.1016/j.jash.2015.09.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Revised: 08/11/2015] [Accepted: 09/10/2015] [Indexed: 10/23/2022]
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Westhorpe RN, Ball C. Blood Pressure Monitoring – Automated Non-invasive Blood Pressure Monitors. Anaesth Intensive Care 2009; 37:343. [DOI: 10.1177/0310057x0903700321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | - C. Ball
- Geoffrey Kaye Museum of Anaesthetic History
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7
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Affiliation(s)
- J T Lightfoot
- Human Performance Laboratory, Florida Atlantic University, Boca Raton
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8
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Geddes LA, Voelz M, Combs C, Reiner D, Babbs CF. Characterization of the oscillometric method for measuring indirect blood pressure. Ann Biomed Eng 1982; 10:271-80. [PMID: 7171156 DOI: 10.1007/bf02367308] [Citation(s) in RCA: 142] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Abstract
An accurate modified auscultatory technique for the indirect measurement of arterial pressure in the horse is described. Limitations of the method were sensitivity to external motion in nervous, conscious horses, and the failure to detect Korotkoff sounds in shocked, anaesthetized surgical cases. The apparatus required for the method is expensive and is probably impractical for routine monitoring during anaesthesia.
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Golden DP, Wolthuis RA, Hoffler GW, Gowen RJ. Development of a Korotkov sound processor for automatic identification of auscultatory events. I. Specification of preprocessing bandpass filters. IEEE Trans Biomed Eng 1974; 21:114-8. [PMID: 4818796 DOI: 10.1109/tbme.1974.324296] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Tavel ME, Faris J, Nasser WK, Feigebaum H, Fisch C. Korotkoff sounds. Observations on pressure-pulse changes underlying their formation. Circulation 1969; 39:465-74. [PMID: 5778247 DOI: 10.1161/01.cir.39.4.465] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
We have studied Korotkoff sounds in 10 subjects by recording pressures and sounds simultaneously through a brachial arterial needle at locations both beyond and beneath the inflatable cuff. The Korotkoff sounds coincided with a small dip and ensuing steep rise in pressure immediately beyond the distal edge of the cuff. Sound intensity paralleled not only the rate and the acceleration of this steep ascent, but also the total pressure through which it was maintained. Pressures beneath the midportion of the cuff showed a more pronounced sharp initial negative dip, usually followed by a rapid reversal and steep rise, and the sounds were also recorded here in association with these rapid pressure changes. This study supports the hypothesis that the initial Korotkoff sound is produced by rapid changes of pressure both beneath and distal to the compressing cuff, sufficient in rate to impart sonic vibrations to the vessel wall and surrounding tissues. We have attempted to explain how these rapid pressure changes are produced.
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12
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Geddes LA, Moore AG. The efficient detection of Korotkoff sounds. MEDICAL & BIOLOGICAL ENGINEERING 1968; 6:603-9. [PMID: 5713299 DOI: 10.1007/bf02474723] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Vallbona C, Cardus D, Spencer WA, Hoff HE. Patterns of sinus arrhythmia in patients with lesions of the central nervous system. Am J Cardiol 1965; 16:379-89. [PMID: 5828133 DOI: 10.1016/0002-9149(65)90729-0] [Citation(s) in RCA: 53] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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15
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Logic JR, Johnson SA, Smith JJ. Cardiovascular and Hematologic Responses to Phlebotomy in Blood Donors. Transfusion 1963. [DOI: 10.1111/j.1537-2995.1963.tb05905.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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GEDDES LA, HOFF HE, SPENCER WA, MILLAR HD, HICKMAN DM, SEITZ RF, MOORE AG. The center for vital studies--a new laboratory for the study of bodily functions in man. IRE TRANSACTIONS ON BIO-MEDICAL ELECTRONICS 1961; BME-8:33-45. [PMID: 13704145 DOI: 10.1109/tbmel.1961.4322849] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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