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Nagai M, Ewbank H, Po SS, Dasari TW. Cardio-respiratory coupling and myocardial recovery in heart failure with reduced ejection fraction. Respir Physiol Neurobiol 2024; 328:104313. [PMID: 39122159 DOI: 10.1016/j.resp.2024.104313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Revised: 07/23/2024] [Accepted: 08/02/2024] [Indexed: 08/12/2024]
Abstract
INTRODUCTION The interaction between the cardiovascular and respiratory systems in healthy subjects is determined by the autonomic nervous system and reflected in respiratory sinus arrhythmia. Recently, another pattern of cardio-respiratory coupling (CRC) has been proposed linking synchronization of heart and respiratory system. However, CRC has not been studied precisely in heart failure (HF) with reduced ejection fraction (EF) (HFrEF) according to the myocardial recovery. METHODS 10-min resting electrocardiography measurements were performed in persistent HFrEF patients (n=40) who had a subsequent left ventricular EF (LVEF) of ≤ 40 %, HF with recovered EF patients (HFrecEF) (n=41) who had a subsequent LVEF of > 40 % and healthy controls (n=40). Respiratory frequency, respiratory rate, CRC index, time-domain, frequency-domain and nonlinear heart rate variability indices were obtained using standardized software-Kubios™. CRC index was defined as respiratory high-frequency peak minus heart rate variability high-frequency peak. RESULTS Respiratory rate was positively correlated with high-frequency (HF) peak (Hz) in both persistent HFrEF group (p<0.001) and HFrecEF group (p<0.001), while respiratory rate was negatively correlated with HF power (ms2) in the healthy controls (p<0.05). CRC index was lowest in the persistent HFrEF group followed by HFrecEF and was high in healthy controls (0.008 vs 0.012 vs 0.056 Hz, p=0.03). CONCLUSION CRC index was lowest in patients with impaired myocardial recovery, which indicates that cardio-respiratory synchrony is stronger in persistent HFrEF. This may represent a higher HF peak (Hz)/lower HF power (ms2) and abnormal sympathovagal balance in persistent HFrEF group compared to healthy controls. Further work is underway to tests this hypothesis and determine the utility of CRC index in HF phenotypes and its utility as a potential biomarker of response with neuromodulation.
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Affiliation(s)
- Michiaki Nagai
- Cardiovascular section, Department of medicine, University of Oklahoma Health Science Center, OK, USA.
| | - Hallum Ewbank
- Cardiovascular section, Department of medicine, University of Oklahoma Health Science Center, OK, USA
| | - Sunny S Po
- Cardiovascular section, Department of medicine, University of Oklahoma Health Science Center, OK, USA
| | - Tarun W Dasari
- Cardiovascular section, Department of medicine, University of Oklahoma Health Science Center, OK, USA.
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2
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G Ravindran KK, Della Monica C, Atzori G, Lambert D, Hassanin H, Revell V, Dijk DJ. Reliable Contactless Monitoring of Heart Rate, Breathing Rate, and Breathing Disturbance During Sleep in Aging: Digital Health Technology Evaluation Study. JMIR Mhealth Uhealth 2024; 12:e53643. [PMID: 39190477 DOI: 10.2196/53643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 05/13/2024] [Accepted: 06/25/2024] [Indexed: 08/28/2024] Open
Abstract
BACKGROUND Longitudinal monitoring of vital signs provides a method for identifying changes to general health in an individual, particularly in older adults. The nocturnal sleep period provides a convenient opportunity to assess vital signs. Contactless technologies that can be embedded into the bedroom environment are unintrusive and burdenless and have the potential to enable seamless monitoring of vital signs. To realize this potential, these technologies need to be evaluated against gold standard measures and in relevant populations. OBJECTIVE We aimed to evaluate the accuracy of heart rate and breathing rate measurements of 3 contactless technologies (2 undermattress trackers, Withings Sleep Analyzer [WSA] and Emfit QS [Emfit]; and a bedside radar, Somnofy) in a sleep laboratory environment and assess their potential to capture vital signs in a real-world setting. METHODS Data were collected from 35 community-dwelling older adults aged between 65 and 83 (mean 70.8, SD 4.9) years (men: n=21, 60%) during a 1-night clinical polysomnography (PSG) test in a sleep laboratory, preceded by 7 to 14 days of data collection at home. Several of the participants (20/35, 57%) had health conditions, including type 2 diabetes, hypertension, obesity, and arthritis, and 49% (17) had moderate to severe sleep apnea, while 29% (n=10) had periodic leg movement disorder. The undermattress trackers provided estimates of both heart rate and breathing rate, while the bedside radar provided only the breathing rate. The accuracy of the heart rate and breathing rate estimated by the devices was compared with PSG electrocardiogram-derived heart rate (beats per minute) and respiratory inductance plethysmography thorax-derived breathing rate (cycles per minute), respectively. We also evaluated breathing disturbance indexes of snoring and the apnea-hypopnea index, available from the WSA. RESULTS All 3 contactless technologies provided acceptable accuracy in estimating heart rate (mean absolute error <2.12 beats per minute and mean absolute percentage error <5%) and breathing rate (mean absolute error ≤1.6 cycles per minute and mean absolute percentage error <12%) at 1-minute resolution. All 3 contactless technologies were able to capture changes in heart rate and breathing rate across the sleep period. The WSA snoring and breathing disturbance estimates were also accurate compared with PSG estimates (WSA snore: r2=0.76; P<.001; WSA apnea-hypopnea index: r2=0.59; P<.001). CONCLUSIONS Contactless technologies offer an unintrusive alternative to conventional wearable technologies for reliable monitoring of heart rate, breathing rate, and sleep apnea in community-dwelling older adults at scale. They enable the assessment of night-to-night variation in these vital signs, which may allow the identification of acute changes in health, and longitudinal monitoring, which may provide insight into health trajectories. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.3390/clockssleep6010010.
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Affiliation(s)
- Kiran K G Ravindran
- Surrey Sleep Research Centre, Guildford, United Kingdom
- UK Dementia Research Institute, Care Research and Technology Centre at Imperial College, London, United Kingdom, and the University of Surrey, Guildford, London, United Kingdom
| | - Ciro Della Monica
- Surrey Sleep Research Centre, Guildford, United Kingdom
- UK Dementia Research Institute, Care Research and Technology Centre at Imperial College, London, United Kingdom, and the University of Surrey, Guildford, London, United Kingdom
| | - Giuseppe Atzori
- Surrey Sleep Research Centre, Guildford, United Kingdom
- UK Dementia Research Institute, Care Research and Technology Centre at Imperial College, London, United Kingdom, and the University of Surrey, Guildford, London, United Kingdom
| | - Damion Lambert
- Surrey Sleep Research Centre, Guildford, United Kingdom
- UK Dementia Research Institute, Care Research and Technology Centre at Imperial College, London, United Kingdom, and the University of Surrey, Guildford, London, United Kingdom
| | - Hana Hassanin
- UK Dementia Research Institute, Care Research and Technology Centre at Imperial College, London, United Kingdom, and the University of Surrey, Guildford, London, United Kingdom
- Surrey Clinical Research Facility, University of Surrey, Guildford, United Kingdom
- NIHR Royal Surrey Clinical Research Facility, Guildford, United Kingdom
| | - Victoria Revell
- Surrey Sleep Research Centre, Guildford, United Kingdom
- UK Dementia Research Institute, Care Research and Technology Centre at Imperial College, London, United Kingdom, and the University of Surrey, Guildford, London, United Kingdom
| | - Derk-Jan Dijk
- Surrey Sleep Research Centre, Guildford, United Kingdom
- UK Dementia Research Institute, Care Research and Technology Centre at Imperial College, London, United Kingdom, and the University of Surrey, Guildford, London, United Kingdom
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3
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Jha R, Mishra P, Kumar S. Advancements in optical fiber-based wearable sensors for smart health monitoring. Biosens Bioelectron 2024; 254:116232. [PMID: 38520984 DOI: 10.1016/j.bios.2024.116232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 02/26/2024] [Accepted: 03/16/2024] [Indexed: 03/25/2024]
Abstract
Healthcare system is undergoing a significant transformation from a traditional hospital-centered to an individual-centered one, as a result of escalating chronic diseases, ageing populations, and ever-increasing healthcare costs,. Wearable sensors have become widely used in health monitoring systems since the COVID-19 pandemic. They enable continuous measurement of important health indicators like body temperature, wrist pulse, respiration rate, and non-invasive bio fluids like saliva and perspiration. Over the last few decades, the development has mostly concentrated on electrochemical and electrical wearable sensors. However, due to the drawbacks of such sensors, such as electronic waste, electromagnetic interference, non-electrical security, and poor performance, researchers are exhibiting a strong interest in optical principle-based systems. Fiber-based optical wearables are among the most promising healthcare systems because of advancements in high-sensitivity, durable, multiplexed sensing, and simple integration with flexible materials to improve wearability and simplicity. We present an overview of recent developments in optical fiber-based wearable sensors, focusing on two mechanisms: wavelength interrogation and intensity modulation for the detection of body temperature, pulse rate, respiration rate, body movements, and biomedical noninvasive fluids, with a thorough examination of their benefits and drawbacks. This review also focuses on improving working performance and application techniques for healthcare systems, including the integration of nanomaterials and the usage of the Internet of Things (IoT) with signal processing. Finally, the review concludes with a discussion of the future possibilities and problems for optical fiber-based wearables.
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Affiliation(s)
- Rajan Jha
- Nanophotonics and Plasmonics Laboratory, School of Basic Sciences, Indian Institute of Technology Bhubaneswar, Odisha, 752050, India.
| | - Pratik Mishra
- Nanophotonics and Plasmonics Laboratory, School of Basic Sciences, Indian Institute of Technology Bhubaneswar, Odisha, 752050, India
| | - Santosh Kumar
- Department of Electronics and Communication Engineering, Koneru Lakshmaiah Education Foundation, Vaddeswaram, Andhra Pradesh, 522302, India
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Stevens G, Hantson L, Larmuseau M, Heerman JR, Siau V, Verdonck P. A Guide to Measuring Heart and Respiratory Rates Based on Off-the-Shelf Photoplethysmographic Hardware and Open-Source Software. SENSORS (BASEL, SWITZERLAND) 2024; 24:3766. [PMID: 38931550 PMCID: PMC11207213 DOI: 10.3390/s24123766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 05/23/2024] [Accepted: 06/04/2024] [Indexed: 06/28/2024]
Abstract
The remote monitoring of vital signs via wearable devices holds significant potential for alleviating the strain on hospital resources and elder-care facilities. Among the various techniques available, photoplethysmography stands out as particularly promising for assessing vital signs such as heart rate, respiratory rate, oxygen saturation, and blood pressure. Despite the efficacy of this method, many commercially available wearables, bearing Conformité Européenne marks and the approval of the Food and Drug Administration, are often integrated within proprietary, closed data ecosystems and are very expensive. In an effort to democratize access to affordable wearable devices, our research endeavored to develop an open-source photoplethysmographic sensor utilizing off-the-shelf hardware and open-source software components. The primary aim of this investigation was to ascertain whether the combination of off-the-shelf hardware components and open-source software yielded vital-sign measurements (specifically heart rate and respiratory rate) comparable to those obtained from more expensive, commercially endorsed medical devices. Conducted as a prospective, single-center study, the research involved the assessment of fifteen participants for three minutes in four distinct positions, supine, seated, standing, and walking in place. The sensor consisted of four PulseSensors measuring photoplethysmographic signals with green light in reflection mode. Subsequent signal processing utilized various open-source Python packages. The heart rate assessment involved the comparison of three distinct methodologies, while the respiratory rate analysis entailed the evaluation of fifteen different algorithmic combinations. For one-minute average heart rates' determination, the Neurokit process pipeline achieved the best results in a seated position with a Spearman's coefficient of 0.9 and a mean difference of 0.59 BPM. For the respiratory rate, the combined utilization of Neurokit and Charlton algorithms yielded the most favorable outcomes with a Spearman's coefficient of 0.82 and a mean difference of 1.90 BrPM. This research found that off-the-shelf components are able to produce comparable results for heart and respiratory rates to those of commercial and approved medical wearables.
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Affiliation(s)
- Guylian Stevens
- Department of Electronics and Information Systems—IBiTech, Korneel Heymanslaan, Ghent University, 9000 Ghent, Belgium;
| | - Luc Hantson
- H3CareSolutions, Henegouwestraat 41, 9000 Ghent, Belgium;
| | - Michiel Larmuseau
- AZ Maria Middelares Hospital, Buitenring Sint-Denijs 30, 9000 Ghent, Belgium;
| | - Jan R. Heerman
- Partnership of Anesthesia of the AZ Maria Middelares Hospital, Buitenring Sint-Denijs 30, 9000 Ghent, Belgium;
| | | | - Pascal Verdonck
- Department of Electronics and Information Systems—IBiTech, Korneel Heymanslaan, Ghent University, 9000 Ghent, Belgium;
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Sbrollini A, Marcantoni I, Lunghi T, Morettini M, Burattini L. Cardiorespiratory DB: Collection of cardiorespiratory data acquired during normal breathing, deep breathing and breath holding. Data Brief 2024; 54:110406. [PMID: 38660233 PMCID: PMC11039937 DOI: 10.1016/j.dib.2024.110406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 04/02/2024] [Accepted: 04/04/2024] [Indexed: 04/26/2024] Open
Abstract
The database is constituted by 50 datasets containing cardiorespiratory signals acquired from 50 healthy volunteer subjects (one dataset for each subject; 23 males and 27 females; age: 23±5 years) while performing normal breathing, deep breathing, and breath holding, and two spreadsheet files, namely the "SubjectsInfo.xlsx" and "DBInfo.xlsx" containing the metadata of subjects (including demographic data) and of acquired signals, respectively. Cardiorespiratory signals consisted in simultaneously recorded 12-lead electrocardiograms acquired by the clinical M12 Global InstrumentationⓇ digital Holter ECG recorder, and single-lead electrocardiograms and respiration signals acquired by the wearable chest strap BioHarness 3.0 by Zephyr. The database may be useful to: (1) validate the use of wearable sensors in the acquisition of cardiorespiratory data during different respiration kinds, including apnea; (2) investigate the physiological association between cardiovascular and respiratory systems; (3) validate algorithms able to indirectly extract the respiration signal from the electrocardiogram; (4) study the fatigue level induced by a series of controlled respiration patterns; and (5) investigate the effect of COVID-19 infection on the cardiorespiratory system.
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Affiliation(s)
- Agnese Sbrollini
- Cardiovascular Bioengineering Lab, Department of Information Engineering, Università Politecnica delle Marche, Ancona, Italy
| | - Ilaria Marcantoni
- Cardiovascular Bioengineering Lab, Department of Information Engineering, Università Politecnica delle Marche, Ancona, Italy
| | - Tamara Lunghi
- Cardiovascular Bioengineering Lab, Department of Information Engineering, Università Politecnica delle Marche, Ancona, Italy
| | - Micaela Morettini
- Cardiovascular Bioengineering Lab, Department of Information Engineering, Università Politecnica delle Marche, Ancona, Italy
| | - Laura Burattini
- Cardiovascular Bioengineering Lab, Department of Information Engineering, Università Politecnica delle Marche, Ancona, Italy
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Nemati N, Burton T, Fathieh F, Gillins HR, Shadforth I, Ramchandani S, Bridges CR. Pulmonary Hypertension Detection Non-Invasively at Point-of-Care Using a Machine-Learned Algorithm. Diagnostics (Basel) 2024; 14:897. [PMID: 38732312 PMCID: PMC11083349 DOI: 10.3390/diagnostics14090897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/10/2024] [Accepted: 04/22/2024] [Indexed: 05/13/2024] Open
Abstract
Artificial intelligence, particularly machine learning, has gained prominence in medical research due to its potential to develop non-invasive diagnostics. Pulmonary hypertension presents a diagnostic challenge due to its heterogeneous nature and similarity in symptoms to other cardiovascular conditions. Here, we describe the development of a supervised machine learning model using non-invasive signals (orthogonal voltage gradient and photoplethysmographic) and a hand-crafted library of 3298 features. The developed model achieved a sensitivity of 87% and a specificity of 83%, with an overall Area Under the Receiver Operator Characteristic Curve (AUC-ROC) of 0.93. Subgroup analysis showed consistent performance across genders, age groups and classes of PH. Feature importance analysis revealed changes in metrics that measure conduction, repolarization and respiration as significant contributors to the model. The model demonstrates promising performance in identifying pulmonary hypertension, offering potential for early detection and intervention when embedded in a point-of-care diagnostic system.
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Affiliation(s)
- Navid Nemati
- Analytics for Life, Toronto, ON M5X 1C9, Canada; (N.N.); (F.F.)
| | - Timothy Burton
- Analytics for Life, Toronto, ON M5X 1C9, Canada; (N.N.); (F.F.)
| | - Farhad Fathieh
- Analytics for Life, Toronto, ON M5X 1C9, Canada; (N.N.); (F.F.)
| | - Horace R. Gillins
- Analytics for Life, Bethesda, MD 20814, USA; (H.R.G.); (I.S.); (C.R.B.)
| | - Ian Shadforth
- Analytics for Life, Bethesda, MD 20814, USA; (H.R.G.); (I.S.); (C.R.B.)
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McErlean J, Malik J, Lin YT, Talmon R, Wu HT. Unsupervised ensembling of multiple software sensors with phase synchronization: a robust approach for electrocardiogram-derived respiration. Physiol Meas 2024; 45:035008. [PMID: 38350132 DOI: 10.1088/1361-6579/ad290b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 02/13/2024] [Indexed: 02/15/2024]
Abstract
Objective.We aimed to fuse the outputs of different electrocardiogram-derived respiration (EDR) algorithms to create one higher quality EDR signal.Methods.We viewed each EDR algorithm as a software sensor that recorded breathing activity from a different vantage point, identified high-quality software sensors based on the respiratory signal quality index, aligned the highest-quality EDRs with a phase synchronization technique based on the graph connection Laplacian, and finally fused those aligned, high-quality EDRs. We refer to the output as the sync-ensembled EDR signal. The proposed algorithm was evaluated on two large-scale databases of whole-night polysomnograms. We evaluated the performance of the proposed algorithm using three respiratory signals recorded from different hardware sensors, and compared it with other existing EDR algorithms. A sensitivity analysis was carried out for a total of five cases: fusion by taking the mean of EDR signals, and the four cases of EDR signal alignment without and with synchronization and without and with signal quality selection.Results.The sync-ensembled EDR algorithm outperforms existing EDR algorithms when evaluated by the synchronized correlation (γ-score), optimal transport (OT) distance, and estimated average respiratory rate score, all with statistical significance. The sensitivity analysis shows that the signal quality selection and EDR signal alignment are both critical for the performance, both with statistical significance.Conclusion.The sync-ensembled EDR provides robust respiratory information from electrocardiogram.Significance.Phase synchronization is not only theoretically rigorous but also practical to design a robust EDR.
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Affiliation(s)
- Jacob McErlean
- Department of Mathematics, Duke University, Durham, North Carolina, United States of America
| | - John Malik
- Department of Mathematics, Duke University, Durham, North Carolina, United States of America
| | - Yu-Ting Lin
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Anesthesiology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ronen Talmon
- Faculty of Electrical and Computer Engineering, Technion-Israel Institute of Technology, Haifa, Israel
| | - Hau-Tieng Wu
- Department of Mathematics, Duke University, Durham, North Carolina, United States of America
- Department of Statistical Science, Duke University, Durham, North Carolina, United States of America
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De Falco E, Solcà M, Bernasconi F, Babo-Rebelo M, Young N, Sammartino F, Tallon-Baudry C, Navarro V, Rezai AR, Krishna V, Blanke O. Single neurons in the thalamus and subthalamic nucleus process cardiac and respiratory signals in humans. Proc Natl Acad Sci U S A 2024; 121:e2316365121. [PMID: 38451949 PMCID: PMC10945861 DOI: 10.1073/pnas.2316365121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/16/2024] [Indexed: 03/09/2024] Open
Abstract
Visceral signals are constantly processed by our central nervous system, enable homeostatic regulation, and influence perception, emotion, and cognition. While visceral processes at the cortical level have been extensively studied using non-invasive imaging techniques, very few studies have investigated how this information is processed at the single neuron level, both in humans and animals. Subcortical regions, relaying signals from peripheral interoceptors to cortical structures, are particularly understudied and how visceral information is processed in thalamic and subthalamic structures remains largely unknown. Here, we took advantage of intraoperative microelectrode recordings in patients undergoing surgery for deep brain stimulation (DBS) to investigate the activity of single neurons related to cardiac and respiratory functions in three subcortical regions: ventral intermedius nucleus (Vim) and ventral caudalis nucleus (Vc) of the thalamus, and subthalamic nucleus (STN). We report that the activity of a large portion of the recorded neurons (about 70%) was modulated by either the heartbeat, the cardiac inter-beat interval, or the respiration. These cardiac and respiratory response patterns varied largely across neurons both in terms of timing and their kind of modulation. A substantial proportion of these visceral neurons (30%) was responsive to more than one of the tested signals, underlining specialization and integration of cardiac and respiratory signals in STN and thalamic neurons. By extensively describing single unit activity related to cardiorespiratory function in thalamic and subthalamic neurons, our results highlight the major role of these subcortical regions in the processing of visceral signals.
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Affiliation(s)
- Emanuela De Falco
- Laboratory of Cognitive Neuroscience, School of Life Sciences, Neuro-X Institute and Brain Mind Institute, École Polytechnique Fédérale de Lausanne, Lausanne1015, Switzerland
- Department of Neuroscience, Rockefeller Neuroscience Institute–West Virginia University, Morgantown, WV26505
| | - Marco Solcà
- Laboratory of Cognitive Neuroscience, School of Life Sciences, Neuro-X Institute and Brain Mind Institute, École Polytechnique Fédérale de Lausanne, Lausanne1015, Switzerland
- Department of Psychiatry, University Hospital Geneva, Geneva1205, Switzerland
| | - Fosco Bernasconi
- Laboratory of Cognitive Neuroscience, School of Life Sciences, Neuro-X Institute and Brain Mind Institute, École Polytechnique Fédérale de Lausanne, Lausanne1015, Switzerland
| | - Mariana Babo-Rebelo
- Laboratory of Cognitive Neuroscience, School of Life Sciences, Neuro-X Institute and Brain Mind Institute, École Polytechnique Fédérale de Lausanne, Lausanne1015, Switzerland
| | - Nicole Young
- Medical Department, SpecialtyCare, Brentwood, TN37027
| | - Francesco Sammartino
- Department of Physical Medicine and Rehabilitation, The Ohio State University, Columbus, OH43210
| | - Catherine Tallon-Baudry
- Laboratoire de Neurosciences Cognitives et Computationnelles, Département d’Etudes Cognitives, École normale supérieure-Paris Sciences et Lettres University, Inserm, Paris75005, France
| | - Vincent Navarro
- Sorbonne Université, Paris Brain Institute—Institut du Cerveau et de la Moelle épinière, Inserm, CNRS, Assistance Publique - Hôpitaux de Paris, Epilepsy Unit, Hôpital de la Pitié-Salpêtrière, Paris75013, France
| | - Ali R. Rezai
- Department of Neurosurgery, Rockefeller Neuroscience Institute—West Virginia University, Morgantown, WV26505
| | - Vibhor Krishna
- Department of Neurosurgery, University of North Carolina at Chapel Hill, Durham, NC27516
| | - Olaf Blanke
- Laboratory of Cognitive Neuroscience, School of Life Sciences, Neuro-X Institute and Brain Mind Institute, École Polytechnique Fédérale de Lausanne, Lausanne1015, Switzerland
- Department of Clinical Neurosciences, University Hospital Geneva, Geneva1205, Switzerland
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Chin WJ, Kwan BH, Lim WY, Tee YK, Darmaraju S, Liu H, Goh CH. A Novel Respiratory Rate Estimation Algorithm from Photoplethysmogram Using Deep Learning Model. Diagnostics (Basel) 2024; 14:284. [PMID: 38337800 PMCID: PMC10855057 DOI: 10.3390/diagnostics14030284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/29/2023] [Accepted: 01/26/2024] [Indexed: 02/12/2024] Open
Abstract
Respiratory rate (RR) is a critical vital sign that can provide valuable insights into various medical conditions, including pneumonia. Unfortunately, manual RR counting is often unreliable and discontinuous. Current RR estimation algorithms either lack the necessary accuracy or demand extensive window sizes. In response to these challenges, this study introduces a novel method for continuously estimating RR from photoplethysmogram (PPG) with a reduced window size and lower processing requirements. To evaluate and compare classical and deep learning algorithms, this study leverages the BIDMC and CapnoBase datasets, employing the Respiratory Rate Estimation (RRest) toolbox. The optimal classical techniques combination on the BIDMC datasets achieves a mean absolute error (MAE) of 1.9 breaths/min. Additionally, the developed neural network model utilises convolutional and long short-term memory layers to estimate RR effectively. The best-performing model, with a 50% train-test split and a window size of 7 s, achieves an MAE of 2 breaths/min. Furthermore, compared to other deep learning algorithms with window sizes of 16, 32, and 64 s, this study's model demonstrates superior performance with a smaller window size. The study suggests that further research into more precise signal processing techniques may enhance RR estimation from PPG signals.
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Affiliation(s)
- Wee Jian Chin
- Department of Mechatronics and Biomedical Engineering, Lee Kong Chian Faculty of Engineering and Science, Universiti Tunku Abdul Rahman, Kajang 43000, Selangor, Malaysia; (W.J.C.); (B.-H.K.); (Y.K.T.); (S.D.)
- Centre for Healthcare Science and Technology, Universiti Tunku Abdul Rahman, Kajang 43000, Selangor, Malaysia
| | - Ban-Hoe Kwan
- Department of Mechatronics and Biomedical Engineering, Lee Kong Chian Faculty of Engineering and Science, Universiti Tunku Abdul Rahman, Kajang 43000, Selangor, Malaysia; (W.J.C.); (B.-H.K.); (Y.K.T.); (S.D.)
- Centre for Healthcare Science and Technology, Universiti Tunku Abdul Rahman, Kajang 43000, Selangor, Malaysia
| | - Wei Yin Lim
- Electrical and Computer Systems Engineering, School of Engineering and Advanced Engineering Platform, Monash University Malaysia, Bandar Sunway 47500, Selangor, Malaysia;
| | - Yee Kai Tee
- Department of Mechatronics and Biomedical Engineering, Lee Kong Chian Faculty of Engineering and Science, Universiti Tunku Abdul Rahman, Kajang 43000, Selangor, Malaysia; (W.J.C.); (B.-H.K.); (Y.K.T.); (S.D.)
- Centre for Healthcare Science and Technology, Universiti Tunku Abdul Rahman, Kajang 43000, Selangor, Malaysia
| | - Shalini Darmaraju
- Department of Mechatronics and Biomedical Engineering, Lee Kong Chian Faculty of Engineering and Science, Universiti Tunku Abdul Rahman, Kajang 43000, Selangor, Malaysia; (W.J.C.); (B.-H.K.); (Y.K.T.); (S.D.)
| | - Haipeng Liu
- Centre for Intelligent Healthcare, Coventry University, Coventry CV1 5RW, UK;
| | - Choon-Hian Goh
- Department of Mechatronics and Biomedical Engineering, Lee Kong Chian Faculty of Engineering and Science, Universiti Tunku Abdul Rahman, Kajang 43000, Selangor, Malaysia; (W.J.C.); (B.-H.K.); (Y.K.T.); (S.D.)
- Centre for Healthcare Science and Technology, Universiti Tunku Abdul Rahman, Kajang 43000, Selangor, Malaysia
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Roberts JD, Walton RD, Loyer V, Bernus O, Kulkarni K. Open-source software for respiratory rate estimation using single-lead electrocardiograms. Sci Rep 2024; 14:167. [PMID: 38168512 PMCID: PMC10762020 DOI: 10.1038/s41598-023-50470-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 12/20/2023] [Indexed: 01/05/2024] Open
Abstract
Respiratory rate (RR) is a critical vital sign used to assess pulmonary function. Currently, RR estimating instrumentation is specialized and bulky, therefore unsuitable for remote health monitoring. Previously, RR was estimated using proprietary software that extract surface electrocardiogram (ECG) waveform features obtained at several thoracic locations. However, developing a non-proprietary method that uses minimal ECG leads, generally available from mobile cardiac monitors is highly desirable. Here, we introduce an open-source and well-documented Python-based algorithm that estimates RR requiring only single-stream ECG signals. The algorithm was first developed using ECGs from awake, spontaneously breathing adult human subjects. The algorithm-estimated RRs exhibited close linear correlation to the subjects' true RR values demonstrating an R2 of 0.9092 and root mean square error of 2.2 bpm. The algorithm robustness was then tested using ECGs generated by the ischemic hearts of anesthetized, mechanically ventilated sheep. Although the ECG waveforms during ischemia exhibited severe morphologic changes, the algorithm-determined RRs exhibited high fidelity with a resolution of 1 bpm, an absolute error of 0.07 ± 0.07 bpm, and a relative error of 0.67 ± 0.64%. This optimized Python-based RR estimation technique will likely be widely adapted for remote lung function assessment in patients with cardiopulmonary disease.
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Affiliation(s)
- Jesse D Roberts
- Departments of Anesthesia, Pediatrics, and Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Richard D Walton
- IHU-LIRYC, Heart Rhythm Disease Institute, Fondation Bordeaux Université, 33600, Pessac, Bordeaux, France
- INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, University of Bordeaux, 33000, Bordeaux, France
| | - Virginie Loyer
- IHU-LIRYC, Heart Rhythm Disease Institute, Fondation Bordeaux Université, 33600, Pessac, Bordeaux, France
- INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, University of Bordeaux, 33000, Bordeaux, France
| | - Olivier Bernus
- IHU-LIRYC, Heart Rhythm Disease Institute, Fondation Bordeaux Université, 33600, Pessac, Bordeaux, France
- INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, University of Bordeaux, 33000, Bordeaux, France
| | - Kanchan Kulkarni
- IHU-LIRYC, Heart Rhythm Disease Institute, Fondation Bordeaux Université, 33600, Pessac, Bordeaux, France.
- INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, University of Bordeaux, 33000, Bordeaux, France.
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11
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Sbrollini A, Morettini M, Gambi E, Burattini L. Identification of Respiration Types Through Respiratory Signal Derived From Clinical and Wearable Electrocardiograms. IEEE OPEN JOURNAL OF ENGINEERING IN MEDICINE AND BIOLOGY 2023; 4:268-274. [PMID: 38196981 PMCID: PMC10776097 DOI: 10.1109/ojemb.2023.3343557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/30/2023] [Accepted: 12/08/2023] [Indexed: 01/11/2024] Open
Abstract
GOAL To evaluate suitability of respiratory signals derived from clinical 12-lead electrocardiograms (ECGs) and wearable 1-lead ECG to identify different respiration types. METHODS ECGs were simultaneously acquired through the M12R ECG Holter by Global Instrumentation and the chest strap BioHarness 3.0 by Zephyr from 42 healthy subjects alternating normal breathing, breath holding, and deep breathing. Respiration signals were derived from the ECGs through the Segmented-Beat Modulation Method (SBMM)-based algorithm and the algorithms by Van Gent, Charlton, Soni and Sarkar, and characterized in terms of breathing rate and amplitude. Respiration classification was performed through a linear support vector machine and evaluated by F1 score. RESULTS Best F1 scores were 86.59%(lead V2) and 80.57%, when considering 12-lead and 1-lead ECGs, respectively, and using SBMM-based algorithm. CONCLUSION ECG-derived respiratory signals allow reliable identification of different respiration types even when acquired through wearable sensors, if associated to appropriate processing algorithms, such as the SBMM-based algorithm.
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Affiliation(s)
- Agnese Sbrollini
- Department of Information EngineeringUniversità Politecnica delle Marche60121AnconaItaly
| | - Micaela Morettini
- Department of Information EngineeringUniversità Politecnica delle Marche60121AnconaItaly
| | - Ennio Gambi
- Department of Information EngineeringUniversità Politecnica delle Marche60121AnconaItaly
| | - Laura Burattini
- Department of Information EngineeringUniversità Politecnica delle Marche60121AnconaItaly
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12
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Charlton PH, Allen J, Bailón R, Baker S, Behar JA, Chen F, Clifford GD, Clifton DA, Davies HJ, Ding C, Ding X, Dunn J, Elgendi M, Ferdoushi M, Franklin D, Gil E, Hassan MF, Hernesniemi J, Hu X, Ji N, Khan Y, Kontaxis S, Korhonen I, Kyriacou PA, Laguna P, Lázaro J, Lee C, Levy J, Li Y, Liu C, Liu J, Lu L, Mandic DP, Marozas V, Mejía-Mejía E, Mukkamala R, Nitzan M, Pereira T, Poon CCY, Ramella-Roman JC, Saarinen H, Shandhi MMH, Shin H, Stansby G, Tamura T, Vehkaoja A, Wang WK, Zhang YT, Zhao N, Zheng D, Zhu T. The 2023 wearable photoplethysmography roadmap. Physiol Meas 2023; 44:111001. [PMID: 37494945 PMCID: PMC10686289 DOI: 10.1088/1361-6579/acead2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 04/04/2023] [Accepted: 07/26/2023] [Indexed: 07/28/2023]
Abstract
Photoplethysmography is a key sensing technology which is used in wearable devices such as smartwatches and fitness trackers. Currently, photoplethysmography sensors are used to monitor physiological parameters including heart rate and heart rhythm, and to track activities like sleep and exercise. Yet, wearable photoplethysmography has potential to provide much more information on health and wellbeing, which could inform clinical decision making. This Roadmap outlines directions for research and development to realise the full potential of wearable photoplethysmography. Experts discuss key topics within the areas of sensor design, signal processing, clinical applications, and research directions. Their perspectives provide valuable guidance to researchers developing wearable photoplethysmography technology.
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Affiliation(s)
- Peter H Charlton
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB1 8RN, United Kingdom
- Research Centre for Biomedical Engineering, City, University of London, London, EC1V 0HB, United Kingdom
| | - John Allen
- Research Centre for Intelligent Healthcare, Coventry University, Coventry, CV1 5RW, United Kingdom
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, NE2 4HH, United Kingdom
| | - Raquel Bailón
- Biomedical Signal Interpretation and Computational Simulation (BSICoS) Group, Aragon Institute of Engineering Research (I3A), IIS Aragon, University of Zaragoza, E-50018 Zaragoza, Spain
- CIBER-BBN, Instituto de Salud Carlos III, C/Monforte de Lemos 3-5, E-28029 Madrid, Spain
| | - Stephanie Baker
- College of Science and Engineering, James Cook University, Cairns, 4878 Queensland, Australia
| | - Joachim A Behar
- Faculty of Biomedical Engineering, Technion Israel Institute of Technology, Haifa, 3200003, Israel
| | - Fei Chen
- Department of Electrical and Electronic Engineering, Southern University of Science and Technology, Shenzhen, 518055 Guandong, People’s Republic of China
| | - Gari D Clifford
- Department of Biomedical Informatics, Emory University, Atlanta, GA 30322, United States of America
- Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, United States of America
| | - David A Clifton
- Department of Engineering Science, University of Oxford, Oxford, OX3 7DQ, United Kingdom
| | - Harry J Davies
- Department of Electrical and Electronic Engineering, Imperial College London, London, SW7 2AZ, United Kingdom
| | - Cheng Ding
- Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, United States of America
- Department of Biomedical Engineering, Emory University, Atlanta, GA 30322, United States of America
| | - Xiaorong Ding
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 611731, People’s Republic of China
| | - Jessilyn Dunn
- Department of Biomedical Engineering, Duke University, Durham, NC 27708-0187, United States of America
- Department of Biostatistics & Bioinformatics, Duke University, Durham, NC 27708-0187, United States of America
- Duke Clinical Research Institute, Durham, NC 27705-3976, United States of America
| | - Mohamed Elgendi
- Biomedical and Mobile Health Technology Laboratory, Department of Health Sciences and Technology, ETH Zurich, Zurich, 8008, Switzerland
| | - Munia Ferdoushi
- Department of Electrical and Computer Engineering, University of Southern California, 90089, Los Angeles, California, United States of America
- The Institute for Technology and Medical Systems (ITEMS), Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, United States of America
| | - Daniel Franklin
- Institute of Biomedical Engineering, Translational Biology & Engineering Program, Ted Rogers Centre for Heart Research, University of Toronto, Toronto, M5G 1M1, Canada
| | - Eduardo Gil
- Biomedical Signal Interpretation and Computational Simulation (BSICoS) Group, Aragon Institute of Engineering Research (I3A), IIS Aragon, University of Zaragoza, E-50018 Zaragoza, Spain
- CIBER-BBN, Instituto de Salud Carlos III, C/Monforte de Lemos 3-5, E-28029 Madrid, Spain
| | - Md Farhad Hassan
- Department of Electrical and Computer Engineering, University of Southern California, 90089, Los Angeles, California, United States of America
- The Institute for Technology and Medical Systems (ITEMS), Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, United States of America
| | - Jussi Hernesniemi
- Finnish Cardiovascular Research Center Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, 33720, Finland
- Tampere Heart Hospital, Wellbeing Services County of Pirkanmaa, Tampere, 33520, Finland
| | - Xiao Hu
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, 30322, Georgia, United States of America
- Department of Biomedical Informatics, School of Medicine, Emory University, Atlanta, 30322, Georgia, United States of America
- Department of Computer Sciences, College of Arts and Sciences, Emory University, Atlanta, GA 30322, United States of America
| | - Nan Ji
- Hong Kong Center for Cerebrocardiovascular Health Engineering (COCHE), Hong Kong Science and Technology Park, Hong Kong, 999077, People’s Republic of China
| | - Yasser Khan
- Department of Electrical and Computer Engineering, University of Southern California, 90089, Los Angeles, California, United States of America
- The Institute for Technology and Medical Systems (ITEMS), Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, United States of America
| | - Spyridon Kontaxis
- Biomedical Signal Interpretation and Computational Simulation (BSICoS) Group, Aragon Institute of Engineering Research (I3A), IIS Aragon, University of Zaragoza, E-50018 Zaragoza, Spain
- CIBER-BBN, Instituto de Salud Carlos III, C/Monforte de Lemos 3-5, E-28029 Madrid, Spain
| | - Ilkka Korhonen
- Finnish Cardiovascular Research Center Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, 33720, Finland
| | - Panicos A Kyriacou
- Research Centre for Biomedical Engineering, City, University of London, London, EC1V 0HB, United Kingdom
| | - Pablo Laguna
- Biomedical Signal Interpretation and Computational Simulation (BSICoS) Group, Aragon Institute of Engineering Research (I3A), IIS Aragon, University of Zaragoza, E-50018 Zaragoza, Spain
- CIBER-BBN, Instituto de Salud Carlos III, C/Monforte de Lemos 3-5, E-28029 Madrid, Spain
| | - Jesús Lázaro
- Biomedical Signal Interpretation and Computational Simulation (BSICoS) Group, Aragon Institute of Engineering Research (I3A), IIS Aragon, University of Zaragoza, E-50018 Zaragoza, Spain
- CIBER-BBN, Instituto de Salud Carlos III, C/Monforte de Lemos 3-5, E-28029 Madrid, Spain
| | - Chungkeun Lee
- Digital Health Devices Division, Medical Device Evaluation Department, National Institute of Food and Drug Safety Evaluation, Ministry of Food and Drug Safety, Cheongju, 28159, Republic of Korea
| | - Jeremy Levy
- Faculty of Biomedical Engineering, Technion Israel Institute of Technology, Haifa, 3200003, Israel
- Faculty of Electrical and Computer Engineering, Technion Institute of Technology, Haifa, 3200003, Israel
| | - Yumin Li
- State Key Laboratory of Bioelectronics, School of Instrument Science and Engineering, Southeast University, Nanjing 210096, People’s Republic of China
| | - Chengyu Liu
- State Key Laboratory of Bioelectronics, School of Instrument Science and Engineering, Southeast University, Nanjing 210096, People’s Republic of China
| | - Jing Liu
- Analog Devices Inc, San Jose, CA 95124, United States of America
| | - Lei Lu
- Department of Engineering Science, University of Oxford, Oxford, OX3 7DQ, United Kingdom
| | - Danilo P Mandic
- Department of Electrical and Electronic Engineering, Imperial College London, London, SW7 2AZ, United Kingdom
| | - Vaidotas Marozas
- Department of Electronics Engineering, Kaunas University of Technology, 44249 Kaunas, Lithuania
- Biomedical Engineering Institute, Kaunas University of Technology, 44249 Kaunas, Lithuania
| | - Elisa Mejía-Mejía
- Research Centre for Biomedical Engineering, City, University of London, London, EC1V 0HB, United Kingdom
| | - Ramakrishna Mukkamala
- Department of Bioengineering and Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Meir Nitzan
- Department of Physics/Electro-Optic Engineering, Lev Academic Center, 91160 Jerusalem, Israel
| | - Tania Pereira
- INESC TEC—Institute for Systems and Computer Engineering, Technology and Science, Porto, 4200-465, Portugal
- Faculty of Engineering, University of Porto, Porto, 4200-465, Portugal
| | | | - Jessica C Ramella-Roman
- Department of Biomedical Engineering and Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33174, United States of America
| | - Harri Saarinen
- Tampere Heart Hospital, Wellbeing Services County of Pirkanmaa, Tampere, 33520, Finland
| | - Md Mobashir Hasan Shandhi
- Department of Biomedical Engineering, Duke University, Durham, NC 27708-0187, United States of America
| | - Hangsik Shin
- Department of Digital Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea
| | - Gerard Stansby
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, NE2 4HH, United Kingdom
- Northern Vascular Centre, Freeman Hospital, Newcastle upon Tyne, NE7 7DN, United Kingdom
| | - Toshiyo Tamura
- Future Robotics Organization, Waseda University, Tokyo, 1698050, Japan
| | - Antti Vehkaoja
- Finnish Cardiovascular Research Center Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, 33720, Finland
- PulseOn Ltd, Espoo, 02150, Finland
| | - Will Ke Wang
- Department of Biomedical Engineering, Duke University, Durham, NC 27708-0187, United States of America
| | - Yuan-Ting Zhang
- Hong Kong Center for Cerebrocardiovascular Health Engineering (COCHE), Hong Kong Science and Technology Park, Hong Kong, 999077, People’s Republic of China
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, 999077, People’s Republic of China
| | - Ni Zhao
- Department of Electronic Engineering, The Chinese University of Hong Kong, Hong Kong
| | - Dingchang Zheng
- Research Centre for Intelligent Healthcare, Coventry University, Coventry, CV1 5RW, United Kingdom
| | - Tingting Zhu
- Department of Engineering Science, University of Oxford, Oxford, OX3 7DQ, United Kingdom
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13
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Mehmood A, Sarouji A, Rahman MMU, Al-Naffouri TY. Your smartphone could act as a pulse-oximeter and as a single-lead ECG. Sci Rep 2023; 13:19277. [PMID: 37935806 PMCID: PMC10630323 DOI: 10.1038/s41598-023-45933-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 10/25/2023] [Indexed: 11/09/2023] Open
Abstract
In the post-covid19 era, every new wave of the pandemic causes an increased concern/interest among the masses to learn more about their state of well-being. Therefore, it is the need of the hour to come up with ubiquitous, low-cost, non-invasive tools for rapid and continuous monitoring of body vitals that reflect the status of one's overall health. In this backdrop, this work proposes a deep learning approach to turn a smartphone-the popular hand-held personal gadget-into a diagnostic tool to measure/monitor the three most important body vitals, i.e., pulse rate (PR), blood oxygen saturation level (aka SpO2), and respiratory rate (RR). Furthermore, we propose another method that could extract a single-lead electrocardiograph (ECG) of the subject. The proposed methods include the following core steps: subject records a small video of his/her fingertip by placing his/her finger on the rear camera of the smartphone, and the recorded video is pre-processed to extract the filtered and/or detrended video-photoplethysmography (vPPG) signal, which is then fed to custom-built convolutional neural networks (CNN), which eventually spit-out the vitals (PR, SpO2, and RR) as well as a single-lead ECG of the subject. To be precise, the contribution of this paper is twofold: (1) estimation of the three body vitals (PR, SpO2, RR) from the vPPG data using custom-built CNNs, vision transformer, and most importantly by CLIP model (a popular image-caption-generator model); (2) a novel discrete cosine transform+feedforward neural network-based method that translates the recorded video-PPG signal to a single-lead ECG signal. The significance of this work is twofold: (i) it allows rapid self-testing of body vitals (e.g., self-monitoring for covid19 symptoms), (ii) it enables rapid self-acquisition of a single-lead ECG, and thus allows early detection of atrial fibrillation (abormal heart beat or arrhythmia), which in turn could enable early intervention in response to a range of cardiovascular diseases, and could help save many precious lives. Our work could help reduce the burden on healthcare facilities and could lead to reduction in health insurance costs.
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Affiliation(s)
- Ahsan Mehmood
- Department of Electrical Engineering, KAUST, Thuwal, Kingdom of Saudi Arabia
| | - Asma Sarouji
- Department of Electrical Engineering, KAUST, Thuwal, Kingdom of Saudi Arabia
| | - M Mahboob Ur Rahman
- Department of Electrical Engineering, KAUST, Thuwal, Kingdom of Saudi Arabia.
| | - Tareq Y Al-Naffouri
- Department of Electrical Engineering, KAUST, Thuwal, Kingdom of Saudi Arabia
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14
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Zanelli S, Eveilleau K, Charlton PH, Ammi M, Hallab M, El Yacoubi MA. Clustered photoplethysmogram pulse wave shapes and their associations with clinical data. Front Physiol 2023; 14:1176753. [PMID: 37954447 PMCID: PMC10637540 DOI: 10.3389/fphys.2023.1176753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 09/05/2023] [Indexed: 11/14/2023] Open
Abstract
Photopletysmography (PPG) is a non-invasive and well known technology that enables the recording of the digital volume pulse (DVP). Although PPG is largely employed in research, several aspects remain unknown. One of these is represented by the lack of information about how many waveform classes best express the variability in shape. In the literature, it is common to classify DVPs into four classes based on the dicrotic notch position. However, when working with real data, labelling waveforms with one of these four classes is no longer straightforward and may be challenging. The correct identification of the DVP shape could enhance the precision and the reliability of the extracted bio markers. In this work we proposed unsupervised machine learning and deep learning approaches to overcome the data labelling limitations. Concretely we performed a K-medoids based clustering that takes as input 1) DVP handcrafted features, 2) similarity matrix computed with the Derivative Dynamic Time Warping and 3) DVP features extracted from a CNN AutoEncoder. All the cited methods have been tested first by imposing four medoids representative of the Dawber classes, and after by automatically searching four clusters. We then searched the optimal number of clusters for each method using silhouette score, the prediction strength and inertia. To validate the proposed approaches we analyse the dissimilarities in the clinical data related to obtained clusters.
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Affiliation(s)
- Serena Zanelli
- Laboratoire Analyse, Géométrie et Applications, University Sorbonne Nord, Villetaneuse, France
| | | | - Peter H. Charlton
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Mehdi Ammi
- Laboratoire Analyse, Géométrie et Applications, University of Sorbonne Nord, Saint-Denis, France
| | - Magid Hallab
- Axelife, Saint-Nicolas-de-Redon, France
- Clinique Bizet, Paris, France
| | - Mounim A. El Yacoubi
- SAMOVAR Telecom SudParis, CNRS, Institut Polytechnique de Paris, Palaiseau, France
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15
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Geangu E, Smith WAP, Mason HT, Martinez-Cedillo AP, Hunter D, Knight MI, Liang H, del Carmen Garcia de Soria Bazan M, Tse ZTH, Rowland T, Corpuz D, Hunter J, Singh N, Vuong QC, Abdelgayed MRS, Mullineaux DR, Smith S, Muller BR. EgoActive: Integrated Wireless Wearable Sensors for Capturing Infant Egocentric Auditory-Visual Statistics and Autonomic Nervous System Function 'in the Wild'. SENSORS (BASEL, SWITZERLAND) 2023; 23:7930. [PMID: 37765987 PMCID: PMC10534696 DOI: 10.3390/s23187930] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/25/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023]
Abstract
There have been sustained efforts toward using naturalistic methods in developmental science to measure infant behaviors in the real world from an egocentric perspective because statistical regularities in the environment can shape and be shaped by the developing infant. However, there is no user-friendly and unobtrusive technology to densely and reliably sample life in the wild. To address this gap, we present the design, implementation and validation of the EgoActive platform, which addresses limitations of existing wearable technologies for developmental research. EgoActive records the active infants' egocentric perspective of the world via a miniature wireless head-mounted camera concurrently with their physiological responses to this input via a lightweight, wireless ECG/acceleration sensor. We also provide software tools to facilitate data analyses. Our validation studies showed that the cameras and body sensors performed well. Families also reported that the platform was comfortable, easy to use and operate, and did not interfere with daily activities. The synchronized multimodal data from the EgoActive platform can help tease apart complex processes that are important for child development to further our understanding of areas ranging from executive function to emotion processing and social learning.
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Affiliation(s)
- Elena Geangu
- Psychology Department, University of York, York YO10 5DD, UK; (A.P.M.-C.); (M.d.C.G.d.S.B.)
| | - William A. P. Smith
- Department of Computer Science, University of York, York YO10 5DD, UK; (W.A.P.S.); (J.H.); (M.R.S.A.); (B.R.M.)
| | - Harry T. Mason
- School of Physics, Engineering and Technology, University of York, York YO10 5DD, UK; (H.T.M.); (D.H.); (N.S.); (S.S.)
| | | | - David Hunter
- School of Physics, Engineering and Technology, University of York, York YO10 5DD, UK; (H.T.M.); (D.H.); (N.S.); (S.S.)
| | - Marina I. Knight
- Department of Mathematics, University of York, York YO10 5DD, UK; (M.I.K.); (D.R.M.)
| | - Haipeng Liang
- School of Engineering and Materials Science, Queen Mary University of London, London E1 2AT, UK; (H.L.); (Z.T.H.T.)
| | | | - Zion Tsz Ho Tse
- School of Engineering and Materials Science, Queen Mary University of London, London E1 2AT, UK; (H.L.); (Z.T.H.T.)
| | - Thomas Rowland
- Protolabs, Halesfield 8, Telford TF7 4QN, UK; (T.R.); (D.C.)
| | - Dom Corpuz
- Protolabs, Halesfield 8, Telford TF7 4QN, UK; (T.R.); (D.C.)
| | - Josh Hunter
- Department of Computer Science, University of York, York YO10 5DD, UK; (W.A.P.S.); (J.H.); (M.R.S.A.); (B.R.M.)
| | - Nishant Singh
- School of Physics, Engineering and Technology, University of York, York YO10 5DD, UK; (H.T.M.); (D.H.); (N.S.); (S.S.)
| | - Quoc C. Vuong
- Biosciences Institute, Newcastle University, Newcastle upon Tyne NE1 7RU, UK;
| | - Mona Ragab Sayed Abdelgayed
- Department of Computer Science, University of York, York YO10 5DD, UK; (W.A.P.S.); (J.H.); (M.R.S.A.); (B.R.M.)
| | - David R. Mullineaux
- Department of Mathematics, University of York, York YO10 5DD, UK; (M.I.K.); (D.R.M.)
| | - Stephen Smith
- School of Physics, Engineering and Technology, University of York, York YO10 5DD, UK; (H.T.M.); (D.H.); (N.S.); (S.S.)
| | - Bruce R. Muller
- Department of Computer Science, University of York, York YO10 5DD, UK; (W.A.P.S.); (J.H.); (M.R.S.A.); (B.R.M.)
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16
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Zhao Q, Liu F, Song Y, Fan X, Wang Y, Yao Y, Mao Q, Zhao Z. Predicting Respiratory Rate from Electrocardiogram and Photoplethysmogram Using a Transformer-Based Model. Bioengineering (Basel) 2023; 10:1024. [PMID: 37760126 PMCID: PMC10525435 DOI: 10.3390/bioengineering10091024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 08/27/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
The respiratory rate (RR) serves as a critical physiological parameter in the context of both diagnostic and prognostic evaluations. Due to the challenges of direct measurement, RR is still predominantly measured through the traditional manual counting-breaths method in clinic practice. Numerous algorithms and machine learning models have been developed to predict RR using physiological signals, such as electrocardiogram (ECG) or/and photoplethysmogram (PPG) signals. Yet, the accuracy of these existing methods on available datasets remains limited, and their prediction on new data is also unsatisfactory for actual clinical applications. In this paper, we proposed an enhanced Transformer model with inception blocks for predicting RR based on both ECG and PPG signals. To evaluate the generalization capability on new data, our model was trained and tested using subject-level ten-fold cross-validation using data from both BIDMC and CapnoBase datasets. On the test set, our model achieved superior performance over five popular deep-learning-based methods with mean absolute error (1.2) decreased by 36.5% and correlation coefficient (0.85) increased by 84.8% compared to the best results of these models. In addition, we also proposed a new pipeline to preprocess ECG and PPG signals to improve model performance. We believe that the development of the TransRR model is expected to further expedite the clinical implementation of automatic RR estimation.
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Affiliation(s)
- Qi Zhao
- School of Medicine and Biological Information Engineering, Northeastern University, Shenyang 110819, China; (Q.Z.); (Y.W.)
| | - Fang Liu
- School of Information Technology, Dalian Maritime University, Dalian 116026, China; (F.L.); (Y.S.)
| | - Yide Song
- School of Information Technology, Dalian Maritime University, Dalian 116026, China; (F.L.); (Y.S.)
| | - Xiaoya Fan
- School of Software, Key Laboratory for Ubiquitous Network and Service Software, Dalian University of Technology, Dalian 116024, China;
| | - Yu Wang
- School of Medicine and Biological Information Engineering, Northeastern University, Shenyang 110819, China; (Q.Z.); (Y.W.)
| | - Yudong Yao
- Department of Electrical and Computer Engineering, Stevens Institute of Technology, Hoboken, NJ 07030, USA;
| | - Qian Mao
- School of Light Industry, Liaoning University, Shenyang 110136, China
| | - Zheng Zhao
- School of Artificial Intelligence, Dalian Maritime University, Dalian 116026, China
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17
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Brandwood BM, Naik GR, Gunawardana U, Gargiulo GD. Combined Cardiac and Respiratory Monitoring from a Single Signal: A Case Study Employing the Fantasia Database. SENSORS (BASEL, SWITZERLAND) 2023; 23:7401. [PMID: 37687857 PMCID: PMC10490584 DOI: 10.3390/s23177401] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/16/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023]
Abstract
This study proposes a novel method for obtaining the electrocardiogram (ECG) derived respiration (EDR) from a single lead ECG and respiration-derived cardiogram (RDC) from a respiratory stretch sensor. The research aims to reconstruct the respiration waveform, determine the respiration rate from ECG QRS heartbeat complexes data, locate heartbeats, and calculate a heart rate (HR) using the respiration signal. The accuracy of both methods will be evaluated by comparing located QRS complexes and inspiration maxima to reference positions. The findings of this study will ultimately contribute to the development of new, more accurate, and efficient methods for identifying heartbeats in respiratory signals, leading to better diagnosis and management of cardiovascular diseases, particularly during sleep where respiration monitoring is paramount to detect apnoea and other respiratory dysfunctions linked to a decreased life quality and known cause of cardiovascular diseases. Additionally, this work could potentially assist in determining the feasibility of using simple, no-contact wearable devices for obtaining simultaneous cardiology and respiratory data from a single device.
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Affiliation(s)
- Benjamin M. Brandwood
- School of Engineering, Design and Built Environment, Western Sydney University, Penrith, NSW 2751, Australia;
| | - Ganesh R. Naik
- Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, SA 5042, Australia;
| | - Upul Gunawardana
- School of Engineering, Design and Built Environment, Western Sydney University, Penrith, NSW 2751, Australia;
| | - Gaetano D. Gargiulo
- School of Engineering, Design and Built Environment, Western Sydney University, Penrith, NSW 2751, Australia;
- The MARCS Institute, Westmead, NSW 2145, Australia
- Translational Research Health Institute, Westmead, NSW 2145, Australia
- The Ingam Institute for Medical Research, Liverpool, NSW 2170, Australia
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18
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Moon KS, Lee SQ. A Wearable Multimodal Wireless Sensing System for Respiratory Monitoring and Analysis. SENSORS (BASEL, SWITZERLAND) 2023; 23:6790. [PMID: 37571572 PMCID: PMC10422350 DOI: 10.3390/s23156790] [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: 06/13/2023] [Revised: 07/15/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023]
Abstract
Wireless sensing systems are required for continuous health monitoring and data collection. It allows for patient data collection in real time rather than through time-consuming and expensive hospital or lab visits. This technology employs wearable sensors, signal processing, and wireless data transfer to remotely monitor patients' health. The research offers a novel approach to providing primary diagnostics remotely with a digital health system for monitoring pulmonary health status using a multimodal wireless sensor device. The technology uses a compact wearable with new integration of acoustics and biopotentials sensors to monitor cardiovascular and respiratory activity to provide comprehensive and fast health status monitoring. Furthermore, the small wearable sensor size may stick to human skin and record heart and lung activities to monitor respiratory health. This paper proposes a sensor data fusion method of lung sounds and cardiograms for potential real-time respiration pattern diagnostics, including respiratory episodes like low tidal volume and coughing. With a p-value of 0.003 for sound signals and 0.004 for electrocardiogram (ECG), preliminary tests demonstrated that it was possible to detect shallow breathing and coughing at a meaningful level.
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Affiliation(s)
- Kee S. Moon
- Department of Mechanical Engineering, San Diego State University, San Diego, CA 92182, USA
| | - Sung Q Lee
- Electronics and Telecommunications Research Institute, Daejeon 34129, Republic of Korea
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19
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van Melzen R, Haveman ME, Schuurmann RCL, Struys MMRF, de Vries JPPM. Implementing Wearable Sensors for Clinical Application at a Surgical Ward: Points to Consider before Starting. SENSORS (BASEL, SWITZERLAND) 2023; 23:6736. [PMID: 37571519 PMCID: PMC10422413 DOI: 10.3390/s23156736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023]
Abstract
Incorporating technology into healthcare processes is necessary to ensure the availability of high-quality care in the future. Wearable sensors are an example of such technology that could decrease workload, enable early detection of patient deterioration, and support clinical decision making by healthcare professionals. These sensors unlock continuous monitoring of vital signs, such as heart rate, respiration rate, blood oxygen saturation, temperature, and physical activity. However, broad and successful application of wearable sensors on the surgical ward is currently lacking. This may be related to the complexity, especially when it comes to replacing manual measurements by healthcare professionals. This report provides practical guidance to support peers before starting with the clinical application of wearable sensors in the surgical ward. For this purpose, the Non-Adoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework of technology adoption and innovations in healthcare organizations is used, combining existing literature and our own experience in this field over the past years. Specifically, the relevant topics are discussed per domain, and key lessons are subsequently summarized.
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Affiliation(s)
- Rianne van Melzen
- Division of Vascular Surgery, Department of Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (R.C.L.S.); (J.-P.P.M.d.V.)
| | - Marjolein E. Haveman
- Department of Anesthesiology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (M.E.H.); (M.M.R.F.S.)
| | - Richte C. L. Schuurmann
- Division of Vascular Surgery, Department of Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (R.C.L.S.); (J.-P.P.M.d.V.)
| | - Michel M. R. F. Struys
- Department of Anesthesiology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (M.E.H.); (M.M.R.F.S.)
| | - Jean-Paul P. M. de Vries
- Division of Vascular Surgery, Department of Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (R.C.L.S.); (J.-P.P.M.d.V.)
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20
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Breuer L, Mösch L, Kunczik J, Buchecker V, Potschka H, Czaplik M, Pereira CB. Camera-Based Respiration Monitoring of Unconstrained Rodents. Animals (Basel) 2023; 13:1901. [PMID: 37370412 DOI: 10.3390/ani13121901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/03/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
Animal research has always been crucial for various medical and scientific breakthroughs, providing information on disease mechanisms, genetic predisposition to diseases, and pharmacological treatment. However, the use of animals in medical research is a source of great controversy and ongoing debate in modern science. To ensure a high level of bioethics, new guidelines have been adopted by the EU, implementing the 3R principles to replace animal testing wherever possible, reduce the number of animals per experiment, and refine procedures to minimize stress and pain. Supporting these guidelines, this article proposes an improved approach for unobtrusive, continuous, and automated monitoring of the respiratory rate of laboratory rats. It uses the cyclical expansion and contraction of the rats' thorax/abdominal region to determine this physiological parameter. In contrast to previous work, the focus is on unconstrained animals, which requires the algorithms to be especially robust to motion artifacts. To test the feasibility of the proposed approach, video material of multiple rats was recorded and evaluated. High agreement was obtained between RGB imaging and the reference method (respiratory rate derived from electrocardiography), which was reflected in a relative error of 5.46%. The current work shows that camera-based technologies are promising and relevant alternatives for monitoring the respiratory rate of unconstrained rats, contributing to the development of new alternatives for a continuous and objective assessment of animal welfare, and hereby guiding the way to modern and bioethical research.
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Affiliation(s)
- Lukas Breuer
- Department of Anesthesiology, Faculty of Medicine, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Lucas Mösch
- Department of Anesthesiology, Faculty of Medicine, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Janosch Kunczik
- Department of Anesthesiology, Faculty of Medicine, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Verena Buchecker
- Institute of Pharmacology, Toxicology, and Pharmacy, Ludwig-Maximilians-University of Munich, Königinstraße 16, 80539 München, Germany
| | - Heidrun Potschka
- Institute of Pharmacology, Toxicology, and Pharmacy, Ludwig-Maximilians-University of Munich, Königinstraße 16, 80539 München, Germany
| | - Michael Czaplik
- Department of Anesthesiology, Faculty of Medicine, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Carina Barbosa Pereira
- Department of Anesthesiology, Faculty of Medicine, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany
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21
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Garland EL, Gullapalli BT, Prince KC, Hanley AW, Sanyer M, Tuomenoksa M, Rahman T. Zoom-Based Mindfulness-Oriented Recovery Enhancement Plus Just-in-Time Mindfulness Practice Triggered by Wearable Sensors for Opioid Craving and Chronic Pain. Mindfulness (N Y) 2023; 14:1-17. [PMID: 37362184 PMCID: PMC10205566 DOI: 10.1007/s12671-023-02137-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/15/2023] [Indexed: 06/28/2023]
Abstract
Objective The opioid crisis in the USA remains severe during the COVID-19 pandemic, which has reduced access to evidence-based interventions. This Stage 1 randomized controlled trial (RCT) assessed the preliminary efficacy of Zoom-based Mindfulness-Oriented Recovery Enhancement (MORE) plus Just-in-Time Adaptive Intervention (JITAI) prompts to practice mindfulness triggered by wearable sensors (MORE + JITAI). Method Opioid-treated chronic pain patients (n = 63) were randomized to MORE + JITAI or a Zoom-based supportive group (SG) psychotherapy control. Participants completed ecological momentary assessments (EMA) of craving and pain (co-primary outcomes), as well as positive affect, and stress at one random probe per day for 90 days. EMA probes were also triggered when a wearable sensor detected the presence of physiological stress, as indicated by changes in heart rate variability (HRV), at which time participants in MORE + JITAI were prompted by an app to engage in audio-guided mindfulness practice. Results EMA showed significantly greater reductions in craving, pain, and stress, and increased positive affect over time for participants in MORE + JITAI than for participants in SG. JITAI-initiated mindfulness practice was associated with significant improvements in these variables, as well as increases in HRV. Machine learning predicted JITAI-initiated mindfulness practice effectiveness with reasonable sensitivity and specificity. Conclusions In this pilot trial, MORE + JITAI demonstrated preliminary efficacy for reducing opioid craving and pain, two factors implicated in opioid misuse. MORE + JITAI is a promising intervention that warrants investigation in a fully powered RCT. Preregistration This study is registered on ClinicalTrials.gov (NCT04567043).
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Affiliation(s)
- Eric L. Garland
- University of Utah, 395 South, 1500 East, Salt Lake City, UT 84112 USA
- Salt Lake VA Medical Center, Salt Lake City, USA
| | | | - Kort C. Prince
- University of Utah, 395 South, 1500 East, Salt Lake City, UT 84112 USA
| | - Adam W. Hanley
- University of Utah, 395 South, 1500 East, Salt Lake City, UT 84112 USA
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22
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Zhong W, Mao L, Du W. A signal quality assessment method for fetal QRS complexes detection. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2023; 20:7943-7956. [PMID: 37161180 DOI: 10.3934/mbe.2023344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
OBJECTIVE Non-invasive fetal ECG (NI-FECG) provides a non-invasive method to monitor the health of the fetus. However, the NI-FECG is easily interfered by noise, which makes the signal quality decline, leading to the fetal heart rate (FHR) monitoring becoming a challenging task. METHODS In this work, an algorithm for dynamic evaluation of signal quality is proposed to improve the multi-channel FHR monitoring. The innovation of the method is to assess the signal quality in the process of multi-channel fetal QRS (FQRS) complexes detection. Specifically, the detected FQRS is used as quality unit. Each quality unit can be a true R peak (TR) or a false R peak (FR). It is the basic quality information in this work. The signal quality of each channel is estimated by estimating the correctness of the detection results. Further, the TRs of all channels can be fused to obtain more reliable fetal heart rate monitoring. MAIN RESULTS Analysis results demonstrate that the proposed algorithm is capable of selecting the good quality signal for FQRS detection achieving 97.40% PPV, 98.33% SE and 97.86% F1. SIGNIFICANCE This work sheds light on the quality assessment of fetal monitoring signal.
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Affiliation(s)
- Wei Zhong
- Guangdong Police College, Guangzhou 510000, China
| | - Li Mao
- Guangdong Police College, Guangzhou 510000, China
| | - Wei Du
- Guangdong Police College, Guangzhou 510000, China
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23
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Shuzan MNI, Chowdhury MH, Chowdhury MEH, Murugappan M, Hoque Bhuiyan E, Arslane Ayari M, Khandakar A. Machine Learning-Based Respiration Rate and Blood Oxygen Saturation Estimation Using Photoplethysmogram Signals. Bioengineering (Basel) 2023; 10:bioengineering10020167. [PMID: 36829661 PMCID: PMC9952751 DOI: 10.3390/bioengineering10020167] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/22/2023] [Accepted: 01/23/2023] [Indexed: 02/03/2023] Open
Abstract
The continuous monitoring of respiratory rate (RR) and oxygen saturation (SpO2) is crucial for patients with cardiac, pulmonary, and surgical conditions. RR and SpO2 are used to assess the effectiveness of lung medications and ventilator support. In recent studies, the use of a photoplethysmogram (PPG) has been recommended for evaluating RR and SpO2. This research presents a novel method of estimating RR and SpO2 using machine learning models that incorporate PPG signal features. A number of established methods are used to extract meaningful features from PPG. A feature selection approach was used to reduce the computational complexity and the possibility of overfitting. There were 19 models trained for both RR and SpO2 separately, from which the most appropriate regression model was selected. The Gaussian process regression model outperformed all the other models for both RR and SpO2 estimation. The mean absolute error (MAE) for RR was 0.89, while the root-mean-squared error (RMSE) was 1.41. For SpO2, the model had an RMSE of 0.98 and an MAE of 0.57. The proposed system is a state-of-the-art approach for estimating RR and SpO2 reliably from PPG. If RR and SpO2 can be consistently and effectively derived from the PPG signal, patients can monitor their RR and SpO2 at a cheaper cost and with less hassle.
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Affiliation(s)
- Md Nazmul Islam Shuzan
- Department of Electrical, Electronic and System Engineering, Universiti Kebangsaan Malaysia, Bangi 43600, Malaysia
| | - Moajjem Hossain Chowdhury
- Department of Electrical, Electronic and System Engineering, Universiti Kebangsaan Malaysia, Bangi 43600, Malaysia
| | - Muhammad E. H. Chowdhury
- Department of Electrical Engineering, Qatar University, Doha 2713, Qatar
- Correspondence: (M.E.H.C.); or (M.M.)
| | - Murugappan Murugappan
- Intelligent Signal Processing (ISP) Research Lab, Department of Electronics and Communication Engineering, Kuwait College of Science and Technology, Block 4, Doha 13133, Kuwait
- Department of Electronics and Communication Engineering, School of Engineering, Vels Institute of Sciences, Technology and Advanced Studies, Chennai 600117, Tamil Nadu, India
- Center for Excellence for Unmanned Aerial Systems, Universiti Malaysia Perlis, Perlis 02600, Malaysia
- Correspondence: (M.E.H.C.); or (M.M.)
| | - Enamul Hoque Bhuiyan
- BioMedical Engineering and Imaging Institute (BMEII), Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Mohamed Arslane Ayari
- Department of Civil and Architectural Engineering, Qatar University, Doha 2713, Qatar
| | - Amith Khandakar
- Department of Electrical Engineering, Qatar University, Doha 2713, Qatar
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24
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Ryals S, Chiang A, Schutte-Rodin S, Chandrakantan A, Verma N, Holfinger S, Abbasi-Feinberg F, Bandyopadhyay A, Baron K, Bhargava S, He K, Kern J, Miller J, Patel R, Ratnasoma D, Deak MC. Photoplethysmography-new applications for an old technology: a sleep technology review. J Clin Sleep Med 2023; 19:189-195. [PMID: 36123954 PMCID: PMC9806792 DOI: 10.5664/jcsm.10300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 09/14/2022] [Accepted: 09/15/2022] [Indexed: 01/07/2023]
Abstract
Education is integral to the American Academy of Sleep Medicine (AASM) mission. The AASM Emerging Technology Committee identified an important and evolving piece of technology that is present in many of the consumer and clinical technologies that we review on the AASM #SleepTechnology (https://aasm.org/consumer-clinical-sleep-technology/) resource-photoplethysmography. As more patients with sleep tracking devices ask clinicians to view their data, it is important for sleep providers to have a general understanding of the technology, its sensors, how it works, targeted users, evidence for the claimed uses, and its strengths and weaknesses. The focus in this review is photoplethysmography-a sensor type used in the familiar pulse oximeter that is being developed for additional utilities and data outputs in both consumer and clinical sleep technologies. CITATION Ryals S, Chang A, Schutte-Rodin S, et al. Photoplethysmography-new applications for an old technology: a sleep technology review. J Clin Sleep Med. 2023;19(1):189-195.
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Affiliation(s)
- Scott Ryals
- Atrium Health Sleep Medicine, Charlotte, North Carolina
| | - Ambrose Chiang
- Louis Stokes Cleveland VA Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Sharon Schutte-Rodin
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | | | | | | | | | - Anuja Bandyopadhyay
- Section of Pediatric Pulmonology, Allergy, and Sleep Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
| | - Kelly Baron
- University of Utah Sleep-Wake Center, Salt Lake City, Utah
| | - Sumit Bhargava
- Lucille Packard Children’s Hospital at Stanford, Palo Alto, California
| | - Ken He
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington, Seattle, Washington
| | - Joseph Kern
- New Mexico VA Health Care System, Albuquerque, New Mexico
| | | | - Ruchir Patel
- The Insomnia and Sleep Institute of Arizona, Scottsdale, Arizona
| | - Dulip Ratnasoma
- Sleep Medicine, Sentara Martha Jefferson Medical & Surgical Associates, Charlottesville, Virginia
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25
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Khan AM, Ahmed S, Chowdhury NH, Islam MS, McCollum ED, King C, Shi T, Nahar K, Simpson R, Ahmed A, Rahman MM, Baqui AH, Cunningham S, Campbell H. Developing a video expert panel as a reference standard to evaluate respiratory rate counting in paediatric pneumonia diagnosis: protocol for a cross-sectional study. BMJ Open 2022; 12:e067389. [PMID: 36379660 PMCID: PMC9668034 DOI: 10.1136/bmjopen-2022-067389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Manual counting of respiratory rate (RR) in children is challenging for health workers and can result in misdiagnosis of pneumonia. Some novel RR counting devices automate the counting of RR and classification of fast breathing. The absence of an appropriate reference standard to evaluate the performance of these devices is a challenge. If good quality videos could be captured, with RR interpretation from these videos systematically conducted by an expert panel, it could act as a reference standard. This study is designed to develop a video expert panel (VEP) as a reference standard to evaluate RR counting for identifying pneumonia in children. METHODS AND ANALYSIS Using a cross-sectional design, we will enrol children aged 0-59 months presenting with suspected pneumonia at different levels of health facilities in Dhaka and Sylhet, Bangladesh. We will videorecord a physician/health worker counting RR manually and also using an automated RR counter (Children's Automated Respiration Monitor) from each child. We will establish a standard operating procedure for capturing quality videos, make a set of reference videos, and train and standardise the VEP members using the reference videos. After that, we will assess the performance of the VEP as a reference standard to evaluate RR counting. We will calculate the mean difference and proportions of agreement within±2 breaths per minute and create Bland-Altman plots with limits of agreement between VEP members. ETHICS AND DISSEMINATION The study protocol was approved by the National Research Ethics Committee of Bangladesh Medical Research Council, Bangladesh (registration number: 39315022021) and Edinburgh Medical School Research Ethics Committee (EMREC), Edinburgh, UK (REC Reference: 21-EMREC-040). Dissemination of the study findings will be through conference presentations and publications in peer-reviewed scientific journals.
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Affiliation(s)
- Ahad Mahmud Khan
- Usher Institute, The University of Edinburgh, Edinburgh, UK
- Projahnmo Research Foundation, Dhaka, Bangladesh
| | - Salahuddin Ahmed
- Usher Institute, The University of Edinburgh, Edinburgh, UK
- Projahnmo Research Foundation, Dhaka, Bangladesh
| | | | | | - Eric D McCollum
- Department of Paediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Carina King
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Ting Shi
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Kamrun Nahar
- Department of Paediatrics, Shaheed Suhrawardi Medical College Hospital, Dhaka, Bangladesh
| | | | - Ayaz Ahmed
- Royal Hospital for Children, Glasgow, UK
| | - Md Mozibur Rahman
- Department of Neonatology, Institute of Child and Mother Health, Dhaka, Bangladesh
| | - Abdullah H Baqui
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Steve Cunningham
- Department of Paediatric Respiratory Medicine, The University of Edinburgh Centre for Inflammation Research, Edinburgh, UK
| | - Harry Campbell
- Usher Institute, The University of Edinburgh, Edinburgh, UK
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26
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Lee S, Moon H, Al-antari MA, Lee G. Dual-Sensor Signals Based Exact Gaussian Process-Assisted Hybrid Feature Extraction and Weighted Feature Fusion for Respiratory Rate and Uncertainty Estimations. SENSORS (BASEL, SWITZERLAND) 2022; 22:8386. [PMID: 36366083 PMCID: PMC9654728 DOI: 10.3390/s22218386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/22/2022] [Accepted: 10/23/2022] [Indexed: 06/16/2023]
Abstract
Accurately estimating respiratory rate (RR) has become essential for patients and the elderly. Hence, we propose a novel method that uses exact Gaussian process regression (EGPR)-assisted hybrid feature extraction and feature fusion based on photoplethysmography and electrocardiogram signals to improve the reliability of accurate RR and uncertainty estimations. First, we obtain the power spectral features and use the multi-phase feature model to compensate for insufficient input data. Then, we combine four different feature sets and choose features with high weights using a robust neighbor component analysis. The proposed EGPR algorithm provides a confidence interval representing the uncertainty. Therefore, the proposed EGPR algorithm, including hybrid feature extraction and weighted feature fusion, is an excellent model with improved reliability for accurate RR estimation. Furthermore, the proposed EGPR methodology is likely the only one currently available that provides highly stable variation and confidence intervals. The proposed EGPR-MF, 0.993 breath per minute (bpm), and EGPR-feature fusion, 1.064 (bpm), show the lowest mean absolute error compared to the other models.
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Affiliation(s)
- Soojeong Lee
- Department of Computer Engineering, Sejong University, 209 Neungdong-ro, Gwangjin-gu, Seoul 05006, Korea
| | - Hyeonjoon Moon
- Department of Computer Engineering, Sejong University, 209 Neungdong-ro, Gwangjin-gu, Seoul 05006, Korea
| | - Mugahed A. Al-antari
- Department of Artificial intelligence, Sejong University, 209 Neungdong-ro, Gwangjin-gu, Seoul 05006, Korea
| | - Gangseong Lee
- Ingenium College, Kwangwoon University, 20 Kwangwoon-ro, Nowon-gu, Seoul 01897, Korea
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27
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Sharma P, Zhang Z, Conroy TB, Hui X, Kan EC. Attention Detection by Heartbeat and Respiratory Features from Radio-Frequency Sensor. SENSORS (BASEL, SWITZERLAND) 2022; 22:8047. [PMID: 36298396 PMCID: PMC9610852 DOI: 10.3390/s22208047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/13/2022] [Accepted: 10/17/2022] [Indexed: 06/16/2023]
Abstract
This work presents a study on users' attention detection with reference to a relaxed inattentive state using an over-the-clothes radio-frequency (RF) sensor. This sensor couples strongly to the internal heart, lung, and diaphragm motion based on the RF near-field coherent sensing principle, without requiring a tension chest belt or skin-contact electrocardiogram. We use cardiac and respiratory features to distinguish attention-engaging vigilance tasks from a relaxed, inattentive baseline state. We demonstrate high-quality vitals from the RF sensor compared to the reference electrocardiogram and respiratory tension belts, as well as similar performance for attention detection, while improving user comfort. Furthermore, we observed a higher vigilance-attention detection accuracy using respiratory features rather than heartbeat features. A high influence of the user's baseline emotional and arousal levels on the learning model was noted; thus, individual models with personalized prediction were designed for the 20 participants, leading to an average accuracy of 83.2% over unseen test data with a high sensitivity and specificity of 85.0% and 79.8%, respectively.
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28
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Chowdhury MH, Shuzan MNI, Chowdhury MEH, Reaz MBI, Mahmud S, Al Emadi N, Ayari MA, Ali SHM, Bakar AAA, Rahman SM, Khandakar A. Lightweight End-to-End Deep Learning Solution for Estimating the Respiration Rate from Photoplethysmogram Signal. BIOENGINEERING (BASEL, SWITZERLAND) 2022; 9:bioengineering9100558. [PMID: 36290527 PMCID: PMC9598342 DOI: 10.3390/bioengineering9100558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 11/05/2022]
Abstract
Respiratory ailments are a very serious health issue and can be life-threatening, especially for patients with COVID. Respiration rate (RR) is a very important vital health indicator for patients. Any abnormality in this metric indicates a deterioration in health. Hence, continuous monitoring of RR can act as an early indicator. Despite that, RR monitoring equipment is generally provided only to intensive care unit (ICU) patients. Recent studies have established the feasibility of using photoplethysmogram (PPG) signals to estimate RR. This paper proposes a deep-learning-based end-to-end solution for estimating RR directly from the PPG signal. The system was evaluated on two popular public datasets: VORTAL and BIDMC. A lightweight model, ConvMixer, outperformed all of the other deep neural networks. The model provided a root mean squared error (RMSE), mean absolute error (MAE), and correlation coefficient (R) of 1.75 breaths per minute (bpm), 1.27 bpm, and 0.92, respectively, for VORTAL, while these metrics were 1.20 bpm, 0.77 bpm, and 0.92, respectively, for BIDMC. The authors also showed how fine-tuning a small subset could increase the performance of the model in the case of an out-of-distribution dataset. In the fine-tuning experiments, the models produced an average R of 0.81. Hence, this lightweight model can be deployed to mobile devices for real-time monitoring of patients.
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Affiliation(s)
- Moajjem Hossain Chowdhury
- Department of Electrical, Electronic and System Engineering, Universiti Kebangsaan Malaysia, Bangi 43600, Malaysia
| | - Md Nazmul Islam Shuzan
- Department of Electrical, Electronic and System Engineering, Universiti Kebangsaan Malaysia, Bangi 43600, Malaysia
| | - Muhammad E. H. Chowdhury
- Department of Electrical Engineering, Qatar University, Doha 2713, Qatar
- Correspondence: (M.E.H.C.); (M.B.I.R.); (M.A.A.)
| | - Mamun Bin Ibne Reaz
- Department of Electrical, Electronic and System Engineering, Universiti Kebangsaan Malaysia, Bangi 43600, Malaysia
- Correspondence: (M.E.H.C.); (M.B.I.R.); (M.A.A.)
| | - Sakib Mahmud
- Department of Electrical Engineering, Qatar University, Doha 2713, Qatar
| | - Nasser Al Emadi
- Department of Electrical Engineering, Qatar University, Doha 2713, Qatar
| | - Mohamed Arselene Ayari
- Department of Civil and Architectural Engineering, Qatar University, Doha 2713, Qatar
- Technology Innovation and Engineering Education Unit (TIEE), Qatar University, Doha 2713, Qatar
- Correspondence: (M.E.H.C.); (M.B.I.R.); (M.A.A.)
| | - Sawal Hamid Md Ali
- Department of Electrical, Electronic and System Engineering, Universiti Kebangsaan Malaysia, Bangi 43600, Malaysia
| | - Ahmad Ashrif A. Bakar
- Department of Electrical, Electronic and System Engineering, Universiti Kebangsaan Malaysia, Bangi 43600, Malaysia
| | - Syed Mahfuzur Rahman
- Department of Biomedical Engineering, Military Institute of Science and Technology, Mirpur Cantonment, Dhaka 1216, Bangladesh
| | - Amith Khandakar
- Department of Electrical Engineering, Qatar University, Doha 2713, Qatar
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Soliman MM, Ganti VG, Inan OT. Towards Wearable Estimation of Tidal Volume via Electrocardiogram and Seismocardiogram Signals. IEEE SENSORS JOURNAL 2022; 22:18093-18103. [PMID: 37091042 PMCID: PMC10120872 DOI: 10.1109/jsen.2022.3196601] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
The current COVID-19 pandemic highlights the critical importance of ubiquitous respiratory health monitoring. The two fundamental elements of monitoring respiration are respiration rate (the frequency of breathing) and tidal volume (TV, the volume of air breathed by the lungs in each breath). Wearable sensing systems have been demonstrated to provide accurate measurement of respiration rate, but TV remains challenging to measure accurately with wearable and unobtrusive technology. In this work, we leveraged electrocardiogram (ECG) and seismocardiogram (SCG) measurements obtained with a custom wearable sensing patch to derive an estimate of TV from healthy human participants. Specifically, we fused both ECG-derived and SCG-derived respiratory signals (EDR and SDR) and trained a machine learning model with gas rebreathing as the ground truth to estimate TV. The respiration cycle modulates ECG and SCG signals in multiple different ways that are synergistic. Thus, here we extract EDRs and SDRs using a multitude of different demodulation techniques. The extracted features are used to train a subject independent machine learning model to accurately estimate TV. By fusing the extracted EDRs and SDRs, we were able to estimate the TV with a root-mean-square error (RMSE) of 181.45 mL and Pearson correlation coefficient (r) of 0.61, with a global subject-independent model. We further show that SDRs are better TV estimators than EDRs. Among SDRs, amplitude modulated (AM) SCG features are the most correlated to TV. We demonstrated that fusing EDRs and SDRs can result in moderately accurate estimation of TV using a subject-independent model. Additionally, we highlight the most informative features for estimating TV. This work presents a significant step towards achieving continuous, calibration free, and unobtrusive TV estimation, which could advance the state of the art in wearable respiratory monitoring.
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Affiliation(s)
- Moamen M Soliman
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA 30332
| | - Venu G Ganti
- Bioengineering Graduate Program, Georgia Institute of Technology, Atlanta, GA 30332
| | - Omer T Inan
- School of Electrical and Computer Engineering and, by courtesy, the Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA 30332
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MonEco: a Novel Health Monitoring Ecosystem to Predict Respiratory and Cardiovascular Disorders. Ing Rech Biomed 2022. [DOI: 10.1016/j.irbm.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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31
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A computationally efficient CNN-LSTM neural network for estimation of blood pressure from features of electrocardiogram and photoplethysmogram waveforms. Knowl Based Syst 2022. [DOI: 10.1016/j.knosys.2022.109151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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32
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Lampier LC, Valadão CT, Silva LA, Delisle-Rodriguez D, Caldeira EMDO, Bastos Filho TF. A deep learning approach to estimate pulse rate by remote photoplethysmography. Physiol Meas 2022; 43. [PMID: 35728793 DOI: 10.1088/1361-6579/ac7b0b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 06/21/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE This study proposes an U-net shaped Deep Neural Network (DNN) model to extract remote photoplethysmography (rPPG) signals from skin color signals to estimate Pulse Rate (PR). APPROACH Three input window sizes are used into the DNN: 256 samples (5.12 s), 512 samples (10.24 s), and 1024 (20.48 s). A data argumentation algorithm based on interpolation is also used here to artificially increase the number of training samples. MAIN RESULTS The proposed model outperformed a prior-knowledge rPPG method by using input signals with window of 256 and 512 samples. Also, it was found that the data augmentation procedure only increased the performance for window of 1024 samples. The trained model achieved a Mean Absolute Error (MAE) of 3.97 Beats per Minute (BPM) and Root Mean Squared Error (RMSE) of 6.47 BPM, for the 256 samples window, and MAE of 3.00 BPM and RMSE of 5.45 BPM for the window of 512 samples. On the other hand, the prior-knowledge rPPG method got a MAE of 8.04 BPM and RMSE of 16.63 BPM for the window of 256 samples, and MAE of 3.49 BPM and RMSE of 7.92 BPM for the window of 512. For the longest window (1024 samples), the concordance of the predicted PRs from the DNNs and the true PRs was higher when applying the data augmentation procedure. SIGNIFICANCE These results demonstrate a big potential of this technique for PR estimation, showing that the DNN proposed here may generate reliable rPPG signals even with short window lengths (5.12 s and 10.24 s), suggesting that it needs less data for a faster rPPG measurement and PR estimation.
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Affiliation(s)
- Lucas Côgo Lampier
- Universidade Federal do Espirito Santo, Av. Fernando Ferrari, 514, Vitoria, 29075-910, BRAZIL
| | | | - Leticia Araújo Silva
- Universidade Federal do Espirito Santo, Av. Fernando Ferrari, 514, Vitoria, 29075-910, BRAZIL
| | - Denis Delisle-Rodriguez
- Universidade Federal do Espirito Santo, Av. Fernando Ferrari, 514, Vitoria, Espirito Santo, 29075-910, BRAZIL
| | | | - Teodiano Freire Bastos Filho
- Postgraduate Program in Electrical Engineering, Universidade Federal do Espirito Santo, Av. Fernando Ferrari, 514, Vitoria, ES, 29075-910, BRAZIL
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Chalupsky MR, Craddock KM, Schivo M, Kuhn BT. Remote patient monitoring in the management of chronic obstructive pulmonary disease. J Investig Med 2022; 70:1681-1689. [PMID: 35710143 DOI: 10.1136/jim-2022-002430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2022] [Indexed: 11/03/2022]
Abstract
Remote patient monitoring allows monitoring high-risk patients through implementation of an expanding number of technologies in coordination with a healthcare team to augment care, with the potential to provide early detection of exacerbation, prompt access to therapy and clinical services, and ultimately improved patient outcomes and decreased healthcare utilization.In this review, we describe the application of remote patient monitoring in chronic obstructive pulmonary disease including the potential benefits and possible barriers to implementation both for the individual and the healthcare system.
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Affiliation(s)
- Megan R Chalupsky
- Division of Pulmonary and Critical Care Medicine, University of California Davis School of Medicine, Sacramento, California, USA.,VA Northern California Health Care System, Mather, California, USA
| | - Krystal M Craddock
- Department of Respiratory Care, University of California Davis Health System, Sacramento, California, USA
| | - Michael Schivo
- Division of Pulmonary and Critical Care Medicine, University of California Davis School of Medicine, Sacramento, California, USA.,VA Northern California Health Care System, Mather, California, USA
| | - Brooks T Kuhn
- Division of Pulmonary and Critical Care Medicine, University of California Davis School of Medicine, Sacramento, California, USA .,VA Northern California Health Care System, Mather, California, USA
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Chan M, Ganti VG, Inan OT. Respiratory Rate Estimation Using U-Net-Based Cascaded Framework From Electrocardiogram and Seismocardiogram Signals. IEEE J Biomed Health Inform 2022; 26:2481-2492. [PMID: 35077375 PMCID: PMC9248781 DOI: 10.1109/jbhi.2022.3144990] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/14/2023]
Abstract
OBJECTIVE At-home monitoring of respiration is of critical urgency especially in the era of the global pandemic due to COVID-19. Electrocardiogram (ECG) and seismocardiogram (SCG) signals-measured in less cumbersome contact form factors than the conventional sealed mask that measures respiratory air flow-are promising solutions for respiratory monitoring. In particular, respiratory rates (RR) can be estimated from ECG-derived respiratory (EDR) and SCG-derived respiratory (SDR) signals. Yet, non-respiratory artifacts might still be present in these surrogates of respiratory signals, hindering the accuracy of the RRs estimated. METHODS In this paper, we propose a novel U-Net-based cascaded framework to address this problem. The EDR and SDR signals were transformed to the spectro-temporal domain and subsequently denoised by a 2D U-Net to reduce the non-respiratory artifacts. MAJOR RESULTS We have shown that the U-Net that fused an EDR input and an SDR input achieved a low mean absolute error of 0.82 breaths per minute (bpm) and a coefficient of determination (R2) of 0.89 using data collected from our chest-worn wearable patch. We also qualitatively provided insights on the complementariness between EDR and SDR signals and demonstrated the generalizability of the proposed framework. CONCLUSION ECG and SCG collected from a chest-worn wearable patch can complement each other and yield reliable RR estimation using the proposed cascaded framework. SIGNIFICANCE We anticipate that convenient and comfortable ECG and SCG measurement systems can be augmented with this framework to facilitate pervasive and accurate RR measurement.
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Sinaki FY, Ward R, Abbott D, Allen J, Fletcher RR, Menon C, Elgendi M. Ethnic disparities in publicly-available pulse oximetry databases. COMMUNICATIONS MEDICINE 2022; 2:59. [PMID: 35637660 PMCID: PMC9142514 DOI: 10.1038/s43856-022-00121-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 05/03/2022] [Indexed: 11/25/2022] Open
Abstract
Sinaki et al. highlight ethnic disparities in the populations of 12 publicly-available pulse oximetry databases. The authors outline the potential consequences of such disparities on pulse oximetry device and algorithm development.
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36
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Charlton PH, Pilt K, Kyriacou PA. Establishing best practices in photoplethysmography signal acquisition and processing. Physiol Meas 2022; 43. [PMID: 35508148 PMCID: PMC9136485 DOI: 10.1088/1361-6579/ac6cc4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 05/04/2022] [Indexed: 11/19/2022]
Abstract
Photoplethysmography is now widely utilised by clinical devices such as pulse oximeters, and wearable devices such as smartwatches. It holds great promise for health monitoring in daily life. This editorial considers whether it would be possible and beneficial to establish best practices for photoplethysmography signal acquisition and processing. It reports progress made towards this, balanced with the challenges of working with a diverse range of photoplethysmography device designs and intended applications, each of which could benefit from different approaches to signal acquisition and processing. It concludes that there are several potential benefits to establishing best practices. However, it is not yet clear whether it is possible to establish best practices which hold across the range of photoplethysmography device designs and applications.
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Affiliation(s)
- Peter H Charlton
- Department of Public Health and Primary Care, Cambridge University, Strangeways Research Laboratory, 2 Worts' Causeway, Cambridge, CB1 8RN, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Kristjan Pilt
- Department of Health Technologies, Tallinn University of Technology, Ehitajate tee 5, Tallinn, Harjumaa, 19086, ESTONIA
| | - Panayiotis A Kyriacou
- School of Mathematics Computer Science and Engineering, City University of London, Northampton Square, London, EC1V 0HB, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
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37
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Deep learning for predicting respiratory rate from biosignals. Comput Biol Med 2022; 144:105338. [DOI: 10.1016/j.compbiomed.2022.105338] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/27/2022] [Accepted: 02/10/2022] [Indexed: 12/23/2022]
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Contactless Vital Sign Monitoring System for In-Vehicle Driver Monitoring Using a Near-Infrared Time-of-Flight Camera. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12094416] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
We demonstrate a Contactless Vital Sign Monitoring (CVSM) system and road-test the system for in-cabin driver monitoring using a near-infrared indirect Time-of-Flight (ToF) camera. The CVSM measures both heart rate (HR) and respiration rate (RR) by leveraging the simultaneously measured grayscale and depth information from a ToF camera. For a camera-based driver monitoring system (DMS), key challenges from varying background illumination and motion-induced artifacts need to be addressed. In this study, active illumination and depth-based motion compensation are used to mitigate these two challenges. For HR measurements, active illumination allows the system to work under various lighting conditions, while our depth-based motion compensation has the advantage of directly measuring the motion of the driver without making prior assumptions about the motion artifacts. In addition, we can extract RR directly from the chest wall motion, circumventing the challenge of acquiring RR from the near-infrared photoplethysmography (PPG) signal of low signal quality. We investigate the system’s performance in various scenarios, including monitoring both drivers and passengers while driving on highways and local roads. Our results show that our CVSM system is ambient light agnostic, and the success rates of HR measurements on the highway are 82% and 71.9% for the passenger and driver, respectively. At the same time, we show that the system can measure RR on users driving on a highway with a mean deviation of −1.4 breaths per minute (BPM). With reliable HR and RR measurement in the vehicle, the CVSM system could one day be a key enabler to sudden sickness or drowsiness detection in DMS.
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Almarshad MA, Islam MS, Al-Ahmadi S, BaHammam AS. Diagnostic Features and Potential Applications of PPG Signal in Healthcare: A Systematic Review. Healthcare (Basel) 2022; 10:547. [PMID: 35327025 PMCID: PMC8950880 DOI: 10.3390/healthcare10030547] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/03/2022] [Accepted: 03/11/2022] [Indexed: 02/04/2023] Open
Abstract
Recent research indicates that Photoplethysmography (PPG) signals carry more information than oxygen saturation level (SpO2) and can be utilized for affordable, fast, and noninvasive healthcare applications. All these encourage the researchers to estimate its feasibility as an alternative to many expansive, time-wasting, and invasive methods. This systematic review discusses the current literature on diagnostic features of PPG signal and their applications that might present a potential venue to be adapted into many health and fitness aspects of human life. The research methodology is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines 2020. To this aim, papers from 1981 to date are reviewed and categorized in terms of the healthcare application domain. Along with consolidated research areas, recent topics that are growing in popularity are also discovered. We also highlight the potential impact of using PPG signals on an individual's quality of life and public health. The state-of-the-art studies suggest that in the years to come PPG wearables will become pervasive in many fields of medical practices, and the main domains include cardiology, respiratory, neurology, and fitness. Main operation challenges, including performance and robustness obstacles, are identified.
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Affiliation(s)
- Malak Abdullah Almarshad
- Computer Science Department, College of Computer and Information Sciences, King Saud University, Riyadh 11543, Saudi Arabia; (M.S.I.); (S.A.-A.)
- Computer Science Department, College of Computer and Information Sciences, Al-Imam Mohammad Ibn Saud Islamic University, Riyadh 11432, Saudi Arabia
| | - Md Saiful Islam
- Computer Science Department, College of Computer and Information Sciences, King Saud University, Riyadh 11543, Saudi Arabia; (M.S.I.); (S.A.-A.)
| | - Saad Al-Ahmadi
- Computer Science Department, College of Computer and Information Sciences, King Saud University, Riyadh 11543, Saudi Arabia; (M.S.I.); (S.A.-A.)
| | - Ahmed S. BaHammam
- The University Sleep Disorders Center, Department of Medicine, College of Medicine, King Saud University, Riyadh 11324, Saudi Arabia;
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Charlton PH, Kyriacou PA, Mant J, Marozas V, Chowienczyk P, Alastruey J. Wearable Photoplethysmography for Cardiovascular Monitoring. PROCEEDINGS OF THE IEEE. INSTITUTE OF ELECTRICAL AND ELECTRONICS ENGINEERS 2022; 110:355-381. [PMID: 35356509 PMCID: PMC7612541 DOI: 10.1109/jproc.2022.3149785] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 01/06/2022] [Accepted: 01/27/2022] [Indexed: 05/29/2023]
Abstract
Smart wearables provide an opportunity to monitor health in daily life and are emerging as potential tools for detecting cardiovascular disease (CVD). Wearables such as fitness bands and smartwatches routinely monitor the photoplethysmogram signal, an optical measure of the arterial pulse wave that is strongly influenced by the heart and blood vessels. In this survey, we summarize the fundamentals of wearable photoplethysmography and its analysis, identify its potential clinical applications, and outline pressing directions for future research in order to realize its full potential for tackling CVD.
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Affiliation(s)
- Peter H. Charlton
- Department of Biomedical EngineeringSchool of Biomedical Engineering and Imaging SciencesKing’s College London, King’s Health PartnersLondonSE1 7EUU.K.
- Research Centre for Biomedical Engineering, CityUniversity of LondonLondonEC1V 0HBU.K.
- Department of Public Health and Primary CareUniversity of CambridgeCambridgeCB1 8RNU.K.
| | - Panicos A. Kyriacou
- Research Centre for Biomedical Engineering, CityUniversity of LondonLondonEC1V 0HBU.K.
| | - Jonathan Mant
- Department of Public Health and Primary CareUniversity of CambridgeCambridgeCB1 8RNU.K.
| | - Vaidotas Marozas
- Department of Electronics Engineering and the Biomedical Engineering Institute, Kaunas University of Technology44249KaunasLithuania
| | - Phil Chowienczyk
- Department of Clinical PharmacologyKing’s College LondonLondonSE1 7EHU.K.
| | - Jordi Alastruey
- Department of Biomedical EngineeringSchool of Biomedical Engineering and Imaging SciencesKing’s College London, King’s Health PartnersLondonSE1 7EUU.K.
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Gazi AH, Wittbrodt MT, Harrison AB, Sundararaj S, Gurel NZ, Nye JA, Shah AJ, Vaccarino V, Bremner JD, Inan OT. Robust Estimation of Respiratory Variability Uncovers Correlates of Limbic Brain Activity and Transcutaneous Cervical Vagus Nerve Stimulation in the Context of Traumatic Stress. IEEE Trans Biomed Eng 2022; 69:849-859. [PMID: 34449355 PMCID: PMC8853700 DOI: 10.1109/tbme.2021.3108135] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Variations in respiration patterns are a characteristic response to distress due to underlying neurorespiratory couplings. Yet, no work to date has quantified respiration pattern variability (RPV) in the context of traumatic stress and studied its functional neural correlates - this analysis aims to address this gap. METHODS Fifty human subjects with prior traumatic experiences (24 with posttraumatic stress disorder (PTSD)) completed a ∼3-hr protocol involving personalized traumatic scripts and active/sham (double-blind) transcutaneous cervical vagus nerve stimulation (tcVNS). High-resolution positron emission tomography functional neuroimages, electrocardiogram (ECG), and respiratory effort (RSP) data were collected during the protocol. Supplementing the RSP signal with ECG-derived respiration for quality assessment and timing extraction, RPV metrics were quantified and analyzed. Specifically, correlation analyses were performed using neuroactivity in selected limbic regions, and responses to active and sham tcVNS were compared. RESULTS The single-lag unscaled autocorrelation of respiration rate correlated negatively with left amygdala activity and positively with right rostromedial prefrontal cortex (rmPFC) activity for non-PTSD; it also correlated negatively with left and right insulae activity and positively with right rmPFC activity for PTSD. The single-lag unscaled autocorrelation of expiration time was greater following active stimulation for non-PTSD. CONCLUSION Quantifying RPV is of demonstrable importance to assessing trauma-induced changes in neural function and tcVNS effects on respiratory physiology. SIGNIFICANCE This is the first demonstration of RPV's pertinence to traumatic stress- and tcVNS-induced neurorespiratory responses. The open-source processing pipeline elucidated herein uniquely includes both RSP and ECG-derived respiration signals for quality assessment, timing estimation, and RPV extraction.
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Shintomi A, Izumi S, Yoshimoto M, Kawaguchi H. Effectiveness of the heartbeat interval error and compensation method on heart rate variability analysis. Healthc Technol Lett 2022; 9:9-15. [PMID: 35340403 PMCID: PMC8927864 DOI: 10.1049/htl2.12023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 01/29/2022] [Accepted: 02/22/2022] [Indexed: 01/22/2023] Open
Abstract
The purpose of this study is to evaluate the effectiveness of heartbeat error and compensation methods on heart rate variability (HRV) with mobile and wearable sensor devices. The HRV analysis extracts multiple indices related to the heart and autonomic nervous system from beat-to-beat intervals. These HRV analysis indices are affected by the heartbeat interval mismatch, which is caused by sampling error from measurement hardware and inherent errors from the state of human body. Although the sampling rate reduction is a common method to reduce power consumption on wearable devices, it degrades the accuracy of the heartbeat interval. Furthermore, wearable devices often use photoplethysmography (PPG) instead of electrocardiogram (ECG) to measure heart rate. However, there are inherent errors between PPG and ECG, because the PPG is affected by blood pressure fluctuations, vascular stiffness, and body movements. This paper evaluates the impact of these errors on HRV analysis using dataset including both ECG and PPG from 28 subjects. The evaluation results showed that the error compensation method improved the accuracy of HRV analysis in time domain, frequency domain and non-linear analysis. Furthermore, the error compensation by the algorithm was found to be effective for both PPG and ECG.
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Affiliation(s)
- Ayaka Shintomi
- Graduate School of System InformaticsKobe University1‐1 Rokkodai‐choNada‐kuKobeHyogoJapan
| | - Shintaro Izumi
- Graduate School of System InformaticsKobe University1‐1 Rokkodai‐choNada‐kuKobeHyogoJapan
| | - Masahiko Yoshimoto
- Graduate School of System InformaticsKobe University1‐1 Rokkodai‐choNada‐kuKobeHyogoJapan
| | - Hiroshi Kawaguchi
- Graduate School of System InformaticsKobe University1‐1 Rokkodai‐choNada‐kuKobeHyogoJapan
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Jung H, Kimball JP, Receveur T, Gazi AH, Agdeppa ED, Inan OT. Estimation of Tidal Volume Using Load Cells on a Hospital Bed. IEEE J Biomed Health Inform 2022; 26:3330-3341. [PMID: 34995200 DOI: 10.1109/jbhi.2022.3141209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Although respiratory failure is one of the primary causes of admission to intensive care, the importance placed on measurement of respiratory parameters is commonly overshadowed compared to cardiac parameters. With the increased demand for unobtrusive yet quantifi- able respiratory monitoring, many technologies have been proposed recently. However, there are challenges to be addressed for such technologies to enable widespread use. In this work, we explore the feasibility of using load cell sensors embedded on a hospital bed for monitoring respi- ratory rate (RR) and tidal volume (TV). We propose a globalized machine learning (ML)-based algorithm for estimating TV without the requirement of subject-specific calibration or training. In a study of 15 healthy subjects performing respiratory tasks in four different postures, the outputs from four load cell channels and the reference spirometer were recorded simultaneously. A signal processing pipeline was implemented to extract features that capture respira- tory movement and the respiratory effects on the cardiac (i.e., ballistocardiogram, BCG) signals. The proposed RR estimation algorithm achieved a root mean square error (RMSE) of 0.6 breaths per minute (brpm) against the ground truth RR from the spirometer. The TV estimation results demonstrated that combining all three axes of the low- frequency force signals and the BCG heartbeat features best quantifies the respiratory effects of TV. The model resulted in a correlation and RMSE between the estimated and true TV values of 0.85 and 0.23 L, respectively, in the posture independent model without electrocardiogram (ECG) signals. This study suggests that load cell sensors already existing in certain hospital beds can be used for convenient and continuous respiratory monitoring in general care settings.
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Haveman ME, van Rossum MC, Vaseur RME, van der Riet C, Schuurmann RCL, Hermens HJ, de Vries JPPM, Tabak M. Continuous Monitoring of Vital Signs With Wearable Sensors During Daily Life Activities: Validation Study. JMIR Form Res 2022; 6:e30863. [PMID: 34994703 PMCID: PMC8783291 DOI: 10.2196/30863] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 09/17/2021] [Accepted: 10/05/2021] [Indexed: 01/19/2023] Open
Abstract
Background Continuous telemonitoring of vital signs in a clinical or home setting may lead to improved knowledge of patients’ baseline vital signs and earlier detection of patient deterioration, and it may also facilitate the migration of care toward home. Little is known about the performance of available wearable sensors, especially during daily life activities, although accurate technology is critical for clinical decision-making. Objective The aim of this study is to assess the data availability, accuracy, and concurrent validity of vital sign data measured with wearable sensors in volunteers during various daily life activities in a simulated free-living environment. Methods Volunteers were equipped with 4 wearable sensors (Everion placed on the left and right arms, VitalPatch, and Fitbit Charge 3) and 2 reference devices (Oxycon Mobile and iButton) to obtain continuous measurements of heart rate (HR), respiratory rate (RR), oxygen saturation (SpO2), and temperature. Participants performed standardized activities, including resting, walking, metronome breathing, chores, stationary cycling, and recovery afterward. Data availability was measured as the percentage of missing data. Accuracy was evaluated by the median absolute percentage error (MAPE) and concurrent validity using the Bland-Altman plot with mean difference and 95% limits of agreement (LoA). Results A total of 20 volunteers (median age 64 years, range 20-74 years) were included. Data availability was high for all vital signs measured by VitalPatch and for HR and temperature measured by Everion. Data availability for HR was the lowest for Fitbit (4807/13,680, 35.14% missing data points). For SpO2 measured by Everion, median percentages of missing data of up to 100% were noted. The overall accuracy of HR was high for all wearable sensors, except during walking. For RR, an overall MAPE of 8.6% was noted for VitalPatch and that of 18.9% for Everion, with a higher MAPE noted during physical activity (up to 27.1%) for both sensors. The accuracy of temperature was high for VitalPatch (MAPE up to 1.7%), and it decreased for Everion (MAPE from 6.3% to 9%). Bland-Altman analyses showed small mean differences of VitalPatch for HR (0.1 beats/min [bpm]), RR (−0.1 breaths/min), and temperature (0.5 °C). Everion and Fitbit underestimated HR up to 5.3 (LoA of −39.0 to 28.3) bpm and 11.4 (LoA of −53.8 to 30.9) bpm, respectively. Everion had a small mean difference with large LoA (−10.8 to 10.4 breaths/min) for RR, underestimated SpO2 (>1%), and overestimated temperature up to 2.9 °C. Conclusions Data availability, accuracy, and concurrent validity of the studied wearable sensors varied and differed according to activity. In this study, the accuracy of all sensors decreased with physical activity. Of the tested sensors, VitalPatch was found to be the most accurate and valid for vital signs monitoring.
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Affiliation(s)
- Marjolein E Haveman
- Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Mathilde C van Rossum
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands.,Department of Cardiovascular and Respiratory Physiology, University of Twente, Enschede, Netherlands
| | - Roswita M E Vaseur
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
| | - Claire van der Riet
- Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Richte C L Schuurmann
- Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Hermie J Hermens
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands.,eHealth group, Roessingh Research and Development, Enschede, Netherlands
| | - Jean-Paul P M de Vries
- Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Monique Tabak
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands.,eHealth group, Roessingh Research and Development, Enschede, Netherlands
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Yang Q, Zou L, Wei K, Liu G. Obstructive sleep apnea detection from single-lead electrocardiogram signals using one-dimensional squeeze-and-excitation residual group network. Comput Biol Med 2022; 140:105124. [PMID: 34896885 DOI: 10.1016/j.compbiomed.2021.105124] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 12/04/2021] [Accepted: 12/04/2021] [Indexed: 11/17/2022]
Abstract
Obstructive sleep apnea (OSA), which has high morbidity and complications, is diagnosed via polysomnography (PSG). However, this method is expensive, time-consuming, and causes discomfort to the patient. Single-lead electrocardiogram (ECG) is a potential alternative to PSG for OSA diagnosis. Recent studies have successfully applied deep learning methods to OSA detection using ECG and obtained great success. However, most of these methods only focus on heart rate variability (HRV), ignoring the importance of ECG-derived respiration (EDR). In addition, they used relatively simple networks, and cannot extract more complex features. In this study, we proposed a one-dimensional squeeze-and-excitation (SE) residual group network to thoroughly extract the complementary information between HRV and EDR. We used the released and withheld sets in the Apnea-ECG dataset to develop and test the proposed method, respectively. In the withheld set, the method has an accuracy of 90.3%, a sensitivity of 87.6%, and a specificity of 91.9% for per-segment detection, indicating an improvement over existing methods for the same dataset. The proposed method can be integrated with wearable devices to realize inexpensive, convenient, and highly efficient OSA detectors.
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Affiliation(s)
- Quanan Yang
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen, 518107, China
| | - Lang Zou
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen, 518107, China
| | - Keming Wei
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen, 518107, China
| | - Guanzheng Liu
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen, 518107, China.
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Bawua LK, Miaskowski C, Suba S, Badilini F, Mortara D, Hu X, Rodway GW, Hoffmann TJ, Pelter MM. Agreement between respiratory rate measurement using a combined electrocardiographic derived method versus impedance from pneumography. J Electrocardiol 2021; 71:16-24. [PMID: 35007832 DOI: 10.1016/j.jelectrocard.2021.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 12/15/2021] [Accepted: 12/20/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Impedance pneumography (IP) is the current device-driven method used to measure respiratory rate (RR) in hospitalized patients. However, RR alarms are common and contribute to alarm fatigue. While RR derived from electrocardiographic (ECG) waveforms hold promise, they have not been compared to the IP method. PURPOSE Study examined the agreement between the IP and combined-ECG derived (EDR) for normal RR (≥12 or ≤20 breaths/minute [bpm]); low RR (≤5 bpm); and high RR (≥30 bpm). METHODOLOGY One-hundred intensive care unit patients were included by RR group: (1) normal RR (n = 50; 25 low RR and 25 high RR); (2) low RR (n = 50); and (3) high RR (n = 50). Bland-Altman analysis was used to evaluate agreement. RESULTS For normal RR, a significant bias difference of -1.00 + 2.11 (95% CI -1.60 to -0.40) and 95% limit of agreement (LOA) of -5.13 to 3.13 was found. For low RR, a significant bias difference of -16.54 + 6.02 (95% CI: -18.25 to -14.83) and a 95% LOA of -28.33 to - 4.75 was found. For high RR, a significant bias difference of 17.94 + 12.01 (95% CI: 14.53 to 21.35) and 95% LOA of -5.60 to 41.48 was found. CONCLUSION Combined-EDR method had good agreement with the IP method for normal RR. However, for the low RR, combined-EDR was consistently higher than the IP method and almost always lower for the high RR, which could reduce the number of RR alarms. However, replication in a larger sample including confirmation with visual assessment is warranted.
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Affiliation(s)
- Linda K Bawua
- School of Nursing, University of California, San Francisco, CA, USA.
| | | | - Sukardi Suba
- School of Nursing, University of Rochester, NY, USA.
| | - Fabio Badilini
- School of Nursing, University of California, San Francisco, CA, USA.
| | - David Mortara
- School of Nursing, University of California, San Francisco, CA, USA.
| | - Xiao Hu
- School of Nursing, Duke University Durham, NC, USA.
| | | | - Thomas J Hoffmann
- School of Nursing, University of California, San Francisco, CA, USA.
| | - Michele M Pelter
- School of Nursing, University of California, San Francisco, CA, USA.
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Haveman ME, van Melzen R, Schuurmann RCL, El Moumni M, Hermens HJ, Tabak M, de Vries JPPM. Continuous monitoring of vital signs with the Everion biosensor on the surgical ward: a clinical validation study. Expert Rev Med Devices 2021; 18:145-152. [PMID: 34937478 DOI: 10.1080/17434440.2021.2019014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Wearable sensors enable continuous vital sign monitoring, although information about their performance on nursing wards is scarce. Vital signs measured by telemonitoring and nurse measurements on a surgical ward were compared to assess validity and reliability. METHODS In a prospective observational study, surgical patients wore a wearable sensor (Everion, Biovotion AG, Zürich, Switzerland) that continuously measured heart rate (HR), respiratory rate (RR), oxygen saturation (SpO2), and temperature during their admittance on the ward. Validity was evaluated using repeated-measures correlation and reliability using Bland-Altman plots, mean difference, and 95% limits of agreement (LoA). RESULTS Validity analyses of 19 patients (median age, 68; interquartile range, 62.5-72.5 years) showed a moderate relationship between telemonitoring and nurse measurements for HR (r = 0.53; 95% confidence interval, 0.44-0.61) and a poor relationship for RR, SpO2, and temperature. Reliability analyses showed that Everion measured HR close to nurse measurements (mean difference, 1 bpm; LoA, -16.7 to 18.7 bpm). Everion overestimated RR at higher values, whereas SpO2 and temperature were underestimated. CONCLUSIONS A moderate relationship was determined between Everion and nurse measurements at a surgical ward in this study. Validity and reliability of telemonitoring should also be assessed with gold standard devices in future clinical trials.
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Affiliation(s)
- Marjolein E Haveman
- Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Rianne van Melzen
- Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Surgery, Division of Trauma Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Richte C L Schuurmann
- Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Mostafa El Moumni
- Department of Surgery, Division of Trauma Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Hermie J Hermens
- Department of Biomedical Signals and Systems, University of Twente, Enschede, The Netherlands.,eHealth Group, Roessingh Research and Development, Enschede, The Netherlands
| | - Monique Tabak
- Department of Biomedical Signals and Systems, University of Twente, Enschede, The Netherlands.,eHealth Group, Roessingh Research and Development, Enschede, The Netherlands
| | - Jean-Paul P M de Vries
- Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Elgendi M, Fletcher RR, Tomar H, Allen J, Ward R, Menon C. The Striking Need for Age Diverse Pulse Oximeter Databases. Front Med (Lausanne) 2021; 8:782422. [PMID: 34926525 PMCID: PMC8671450 DOI: 10.3389/fmed.2021.782422] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 11/08/2021] [Indexed: 12/03/2022] Open
Affiliation(s)
- Mohamed Elgendi
- Biomedical and Mobile Health Technology Laboratory, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.,Menrva Research Group, School of Mechatronic Systems Engineering, Simon Fraser University, Vancouver, BC, Canada.,Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.,Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Richard Ribon Fletcher
- Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, United States.,Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, United States
| | - Harshit Tomar
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - John Allen
- Research Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom
| | - Rabab Ward
- Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Carlo Menon
- Biomedical and Mobile Health Technology Laboratory, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.,Menrva Research Group, School of Mechatronic Systems Engineering, Simon Fraser University, Vancouver, BC, Canada
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Lazazzera R, Laguna P, Gil E, Carrault G. Proposal for a Home Sleep Monitoring Platform Employing a Smart Glove. SENSORS 2021; 21:s21237976. [PMID: 34883979 PMCID: PMC8659764 DOI: 10.3390/s21237976] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 11/21/2021] [Accepted: 11/23/2021] [Indexed: 11/16/2022]
Abstract
The present paper proposes the design of a sleep monitoring platform. It consists of an entire sleep monitoring system based on a smart glove sensor called UpNEA worn during the night for signals acquisition, a mobile application, and a remote server called AeneA for cloud computing. UpNEA acquires a 3-axis accelerometer signal, a photoplethysmography (PPG), and a peripheral oxygen saturation (SpO2) signal from the index finger. Overnight recordings are sent from the hardware to a mobile application and then transferred to AeneA. After cloud computing, the results are shown in a web application, accessible for the user and the clinician. The AeneA sleep monitoring activity performs different tasks: sleep stages classification and oxygen desaturation assessment; heart rate and respiration rate estimation; tachycardia, bradycardia, atrial fibrillation, and premature ventricular contraction detection; and apnea and hypopnea identification and classification. The PPG breathing rate estimation algorithm showed an absolute median error of 0.5 breaths per minute for the 32 s window and 0.2 for the 64 s window. The apnea and hypopnea detection algorithm showed an accuracy (Acc) of 75.1%, by windowing the PPG in one-minute segments. The classification task revealed 92.6% Acc in separating central from obstructive apnea, 83.7% in separating central apnea from central hypopnea and 82.7% in separating obstructive apnea from obstructive hypopnea. The novelty of the integrated algorithms and the top-notch cloud computing products deployed, encourage the production of the proposed solution for home sleep monitoring.
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Affiliation(s)
- Remo Lazazzera
- Laboratoire Traitement du Signal et de l’Image (LTSI-Inserm UMR 1099), Université de Rennes 1, 35000 Rennes, France;
| | - Pablo Laguna
- Biomedical Signal Interpretation and Computational Simulation (BSICoS) Group, I3A, IIS Aragón, University of Zaragoza, and with the CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), 50018 Zaragoza, Spain; (P.L.); (E.G.)
| | - Eduardo Gil
- Biomedical Signal Interpretation and Computational Simulation (BSICoS) Group, I3A, IIS Aragón, University of Zaragoza, and with the CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), 50018 Zaragoza, Spain; (P.L.); (E.G.)
| | - Guy Carrault
- Laboratoire Traitement du Signal et de l’Image (LTSI-Inserm UMR 1099), Université de Rennes 1, 35000 Rennes, France;
- Correspondence:
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Contactless Vital Sign Monitoring System for Heart and Respiratory Rate Measurements with Motion Compensation Using a Near-Infrared Time-of-Flight Camera. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app112210913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study describes a contactless vital sign monitoring (CVSM) system capable of measuring heart rate (HR) and respiration rate (RR) using a low-power, indirect time-of-flight (ToF) camera. The system takes advantage of both the active infrared illumination as well as the additional depth information from the ToF camera to compensate for the motion-induced artifacts during the HR measurements. The depth information captures how the user is moving with respect to the camera and, therefore, can be used to differentiate where the intensity change in the raw signal is from the underlying heartbeat or motion. Moreover, from the depth information, the system can acquire respiration rate by directly measuring the motion of the chest wall during breathing. We also conducted a pilot human study using this system with 29 participants of different demographics such as age, gender, and skin color. Our study shows that with depth-based motion compensation, the success rate (system measurement within 10% of reference) of HR measurements increases to 75%, as compared to 35% when motion compensation is not used. The mean HR deviation from the reference also drops from 21 BPM to −6.25 BPM when we apply the depth-based motion compensation. In terms of the RR measurement, our system shows a mean deviation of 1.7 BPM from the reference measurement. The pilot human study shows the system performance is independent of skin color but weakly dependent on gender and age.
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