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Kashchenko VA, Kamshilin AA, Zaitsev VV, Pavlov RV, Bogatikov AA, Lodigin AV, Guschina OB, Boyko NA. [Possibilities of tissue perfusion assessment in abdominal surgery: integration into the intraoperative system of safety control points]. Khirurgiia (Mosk) 2023:33-42. [PMID: 37682545 DOI: 10.17116/hirurgia202309233] [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] [Indexed: 09/09/2023]
Abstract
OBJECTIVE To evaluate the possibility of integrating tissue perfusion assessment techniques (ICG perfusion and imaging photoplethysmography - iPPG) into the system of intraoperative control points of laparoscopic interventions with a reconstructive component. MATERIALS AND METHODS Quantitative assessment of ICG fluorescence and iPPG were used during 8 laparoscopically assisted interventions: gastrectomy for gastric cancer (total - 2 and distal - 1) and colorectal resections (left-sided colorectal resections - 4 and right hemicolectomy - 1). RESULTS Four stages are presented for the assessment of tissue perfusion: initial assessment, before intestine transection, before anastomosis formation, and evaluation of anastomosis. From the point of view of the significance of clinical decision-making, the «before intestine transection» stage is of great importance, due to the ease of transferring the resection level to the optimal tissue perfusion zone. CONCLUSION Integration of tissue perfusion assessment techniques into the system of intraoperative checkpoints is possible and promising.
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Affiliation(s)
- V A Kashchenko
- North-Western District Scientific and Clinical Center named after L.G. Sokolov of the Federal Medical and Biological Agency, St. Petersburg, Russia
- St. Petersburg State University, St. Petersburg, Russia
| | - A A Kamshilin
- North-Western District Scientific and Clinical Center named after L.G. Sokolov of the Federal Medical and Biological Agency, St. Petersburg, Russia
- Institute of Automation and Control Processes, Far Eastern Branch of the Russian Academy of Sciences, Vladivostok, Russia
| | - V V Zaitsev
- North-Western District Scientific and Clinical Center named after L.G. Sokolov of the Federal Medical and Biological Agency, St. Petersburg, Russia
- Institute of Automation and Control Processes, Far Eastern Branch of the Russian Academy of Sciences, Vladivostok, Russia
| | - R V Pavlov
- North-Western District Scientific and Clinical Center named after L.G. Sokolov of the Federal Medical and Biological Agency, St. Petersburg, Russia
- St. Petersburg State University, St. Petersburg, Russia
| | - A A Bogatikov
- North-Western District Scientific and Clinical Center named after L.G. Sokolov of the Federal Medical and Biological Agency, St. Petersburg, Russia
- St. Petersburg State University, St. Petersburg, Russia
| | - A V Lodigin
- North-Western District Scientific and Clinical Center named after L.G. Sokolov of the Federal Medical and Biological Agency, St. Petersburg, Russia
- St. Petersburg State University, St. Petersburg, Russia
| | - O B Guschina
- North-Western District Scientific and Clinical Center named after L.G. Sokolov of the Federal Medical and Biological Agency, St. Petersburg, Russia
- St. Petersburg State University, St. Petersburg, Russia
| | - N A Boyko
- North-Western District Scientific and Clinical Center named after L.G. Sokolov of the Federal Medical and Biological Agency, St. Petersburg, Russia
- St. Petersburg State University, St. Petersburg, Russia
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Harford M, Villarroel M, Jorge J, Redfern O, Finnegan E, Davidson S, Young JD, Tarassenko L, Watkinson P. Contactless skin perfusion monitoring with video cameras: tracking pharmacological vasoconstriction and vasodilation using photoplethysmographic changes. Physiol Meas 2022; 43. [PMID: 36270506 DOI: 10.1088/1361-6579/ac9c82] [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: 06/15/2022] [Accepted: 10/21/2022] [Indexed: 02/07/2023]
Abstract
Objectives.Clinical assessment of skin perfusion informs prognosis in critically ill patients. Video camera monitoring could provide an objective, continuous method to monitor skin perfusion. In this prospective, interventional study of healthy volunteers, we tested whether video camera-derived photoplethysmography imaging and colour measurements could detect drug-induced skin perfusion changes.Approach.We monitored the lower limbs of 30 volunteers using video cameras while administering phenylephrine (a vasoconstrictor) and glyceryl trinitrate (a vasodilator). We report relative pixel intensity changes from baseline, as absolute values are sensitive to environmental factors. The primary outcome was the pre- to peak- infusion green channel amplitude change in the pulsatile PPGi waveform component. Secondary outcomes were pre-to-peak changes in the photoplethysmographic imaging waveform baseline, skin colour hue and skin colour saturation.Main results.The 30 participants had a median age of 29 years (IQR 25-34), sixteen (53%) were male. A 34.7% (p= 0.0001) mean decrease in the amplitude of the pulsatile photoplethysmographic imaging waveform occurred following phenylephrine infusion. A 30.7% (p= 0.000004) mean increase occurred following glyceryl trinitrate infusion. The photoplethysmographic imaging baseline decreased with phenylephrine by 2.1% (p= 0.000 02) and increased with glyceryl trinitrate by 0.5% (p= 0.026). Skin colour hue changed in opposite direction with phenylephrine (-0.0013,p= 0.0002) and glyceryl trinitrate (+0.0006,p= 0.019). Skin colour saturation decreased with phenylephrine by 0.0022 (p= 0.0002), with no significant change observed with glyceryl trinitrate (+0.0005,p= 0.21).Significance.Drug-induced vasoconstriction and vasodilation are associated with detectable changes in photoplethysmographic imaging waveform parameters and skin hue. Our findings suggest video cameras have great potential for continuous, contactless skin perfusion monitoring.
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Affiliation(s)
- M Harford
- Critical Care Research Group, Kadoorie Centre for Critical Care Research and Education, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom.,Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, United Kingdom.,Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - M Villarroel
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, United Kingdom
| | - J Jorge
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, United Kingdom
| | - O Redfern
- Critical Care Research Group, Kadoorie Centre for Critical Care Research and Education, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom
| | - E Finnegan
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, United Kingdom
| | - S Davidson
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, United Kingdom
| | - J D Young
- Critical Care Research Group, Kadoorie Centre for Critical Care Research and Education, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom
| | - L Tarassenko
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, United Kingdom
| | - P Watkinson
- Critical Care Research Group, Kadoorie Centre for Critical Care Research and Education, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom.,Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
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Kashchenko VA, Zaytsev VV, Ratnikov VA, Kamshilin AA. Intraoperative visualization and quantitative assessment of tissue perfusion by imaging photoplethysmography: comparison with ICG fluorescence angiography. BIOMEDICAL OPTICS EXPRESS 2022; 13:3954-3966. [PMID: 35991934 PMCID: PMC9352280 DOI: 10.1364/boe.462694] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/09/2022] [Accepted: 06/09/2022] [Indexed: 05/02/2023]
Abstract
Intraoperative monitoring of tissue perfusion is of great importance for optimizing surgery and reducing postoperative complications. To date, there is no standard procedure for assessing blood circulation in routine clinical practice. Over the past decade, indocyanine green (ICG) fluorescence angiography is most commonly used for intraoperative perfusion evaluation. Imaging photoplethysmography (iPPG) potentially enables contactless assessment of the blood supply to organs. However, no strong evidence of this potential has been provided so far. Here we report results of a comparative assessment of tissue perfusion obtained using custom-made iPPG and commercial ICG-fluorescence systems during eight different gastrointestinal surgeries. Both systems allow mapping the blood-supply distribution over organs. It was demonstrated for the first time that the quantitative assessment of blood perfusion by iPPG is in good agreement with that obtained by ICG-fluorescence imaging in all surgical cases under study. iPPG can become an objective quantitative monitoring system for tissue perfusion in the operating room due to its simplicity, low cost and no need for any agent injections.
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Affiliation(s)
- Victor A. Kashchenko
- First Surgical Department, North-Western District Scientific and Clinical Center named after L.G. Sokolov of the Federal Medical and Biological Agency, 4 Kultury Pr., St. Petersburg 194291, Russia
- Department of Faculty Surgery, Saint Petersburg State University, 8A 21st Vasilyevskogo Ostrova Line, Saint-Petersburg 199106, Russia
| | - Valeriy V. Zaytsev
- Laboratory of New Functional Materials for Photonics, Institute of Automation and Control Processes of the Far-Eastern Branch of the Russian Academy of Sciences, 5 Radio str., Vladivostok 690041, Russia
| | - Vyacheslav A. Ratnikov
- Department of Radiology, North-Western District Scientific and Clinical Center named after L.G. Sokolov of the Federal Medical and Biological Agency, 4 Kultury Pr., St. Petersburg 194291, Russia
- Institute of Advanced Medical Technologies, Saint Petersburg State University, 8A 21st Vasilyevskogo Ostrova Line, Saint-Petersburg 199106, Russia
| | - Alexei A. Kamshilin
- Laboratory of New Functional Materials for Photonics, Institute of Automation and Control Processes of the Far-Eastern Branch of the Russian Academy of Sciences, 5 Radio str., Vladivostok 690041, Russia
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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:healthcare10030547. [PMID: 35327025 PMCID: PMC8950880 DOI: 10.3390/healthcare10030547] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [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
- Correspondence:
| | - 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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Kasprzyk-Kucewicz T, Cholewka A, Englisz-Jurgielewicz B, Mucha R, Relich M, Kawecki M, Sieroń K, Onak P, Stanek A. Thermal Effects of Topical Hyperbaric Oxygen Therapy in Hard-to-Heal Wounds-A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136737. [PMID: 34201483 PMCID: PMC8268767 DOI: 10.3390/ijerph18136737] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 06/12/2021] [Accepted: 06/14/2021] [Indexed: 01/22/2023]
Abstract
Clinical studies have been performed to evaluate the thermal response of topical hyperbaric oxygen therapy (THBOT) in patients suffering from hard-to-heal wounds diagnosed as venous leg ulcers located on their lower extremities. It was found that this therapy leads to a temperature decrease in areas around the wound. Moreover, a minor temperature differentiation between all areas was seen in the third period of topical hyperbaric oxygen therapy (THBOT) that may suggest that microcirculation and thermoregulation improvement start the healing process. On the other hand, the results of the conducted studies seem to prove that thermal imaging may provide a safe and effective method of analyzing wound healing of hard-to-heal wounds being treated with THBOT. This is the first study that tries to show the possibilities of a very new method by evaluating treatment of hard-to-heal wounds using thermal imaging, similar to the hyperbaric oxygen therapy effects evaluated by thermal imaging and described previously. However, the first clinical results showed a decrease in temperature due to the THBOT session and some qualitative similarities in the decrease in temperature differentiation between the studied areas and the temperature effects obtained due to hyperbaric oxygen therapy.
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Affiliation(s)
- Teresa Kasprzyk-Kucewicz
- Faculty of Science and Technology, University of Silesia, 40-007 Katowice, Poland; (A.C.); (B.E.-J.); (M.R.)
- Correspondence:
| | - Armand Cholewka
- Faculty of Science and Technology, University of Silesia, 40-007 Katowice, Poland; (A.C.); (B.E.-J.); (M.R.)
| | - Beata Englisz-Jurgielewicz
- Faculty of Science and Technology, University of Silesia, 40-007 Katowice, Poland; (A.C.); (B.E.-J.); (M.R.)
| | - Romualda Mucha
- Department and Clinic of Internal Medicine, Angiology and Physical Medicine, Specialistic Hospital No. 2 in Bytom, Batorego 15 St., 41-902 Bytom, Poland;
| | - Michał Relich
- Faculty of Science and Technology, University of Silesia, 40-007 Katowice, Poland; (A.C.); (B.E.-J.); (M.R.)
| | - Marek Kawecki
- Department of Health Sciences, Technical-Humanistic Academy, 43-300 Bielsko-Biała, Poland;
| | - Karolina Sieroń
- Department of Physical Medicine, School of Health Sciences in Katowice, Medical University of Silesia, Medyków Street 12, 40-752 Katowice, Poland;
| | - Patrycja Onak
- Med Holding S.A. Specialist Hospital Named after prof. E. Michałowski, Strzelecka 9 St., 40-073 Katowice, Poland;
| | - Agata Stanek
- Department and Clinic of Internal Medicine, Angiology and Physical Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Batorego 15 St., 41-902 Bytom, Poland;
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Marcinkevics Z, Aglinska A, Rubins U, Grabovskis A. Remote Photoplethysmography for Evaluation of Cutaneous Sensory Nerve Fiber Function. SENSORS 2021; 21:s21041272. [PMID: 33670087 PMCID: PMC7916836 DOI: 10.3390/s21041272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/06/2021] [Accepted: 02/08/2021] [Indexed: 11/23/2022]
Abstract
About 2% of the world’s population suffers from small nerve fiber dysfunction, neuropathy, which can result in severe pain. This condition is caused by damage to the small nerve fibers and its assessment is challenging, due to the lack of simple and objective diagnostic techniques. The present study aimed to develop a contactless photoplethysmography system using simple instrumentation, for objective and non-invasive assessment of small cutaneous sensory nerve fiber function. The approach is based on the use of contactless photoplethysmography for the characterization of skin flowmotions and topical heating evoked vasomotor responses. The feasibility of the technique was evaluated on volunteers (n = 14) using skin topical anesthesia, which is able to produce temporary alterations of cutaneous nerve fibers function. In the treated skin region in comparison to intact skin: neurogenic and endothelial component of flowmotions decreased by ~61% and 41%, the local heating evoked flare area decreased by ~44%, vasomotor response trend peak and nadir were substantially reduced. The results indicate for the potential of the remote photoplethysmography in the assessment of the cutaneous nerve fiber function. It is believed that in the future this technique could be used in the clinics as an affordable alternative to laser Doppler imaging technique.
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Affiliation(s)
- Zbignevs Marcinkevics
- Department of Human and Animal Physiology, Faculty of Biology, University of Latvia, Jelgavas St.1, LV-1004 Riga, Latvia
- Biophotonics Laboratory, Institute of Atomic Physics and Spectroscopy, University of Latvia, Jelgavas St. 3, LV-1004 Riga, Latvia; (A.A.); (U.R.); (A.G.)
- Correspondence:
| | - Alise Aglinska
- Biophotonics Laboratory, Institute of Atomic Physics and Spectroscopy, University of Latvia, Jelgavas St. 3, LV-1004 Riga, Latvia; (A.A.); (U.R.); (A.G.)
| | - Uldis Rubins
- Biophotonics Laboratory, Institute of Atomic Physics and Spectroscopy, University of Latvia, Jelgavas St. 3, LV-1004 Riga, Latvia; (A.A.); (U.R.); (A.G.)
| | - Andris Grabovskis
- Biophotonics Laboratory, Institute of Atomic Physics and Spectroscopy, University of Latvia, Jelgavas St. 3, LV-1004 Riga, Latvia; (A.A.); (U.R.); (A.G.)
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Luo J, Zhen J, Zhou P, Chen W, Guo Y. An iPPG-Based Device for Pervasive Monitoring of Multi-Dimensional Cardiovascular Hemodynamics. SENSORS 2021; 21:s21030872. [PMID: 33525472 PMCID: PMC7865369 DOI: 10.3390/s21030872] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/18/2020] [Accepted: 12/22/2020] [Indexed: 11/16/2022]
Abstract
Hemodynamic activities, as an essential measure of physiological and psychological characteristics, can be used for cardiovascular and cerebrovascular disease detection. Photoplethysmography imaging (iPPG) can be applied for such purposes with non-contact advances, however, most cardiovascular hemodynamics of iPPG systems are developed for laboratory research, which limits the application in pervasive healthcare. In this study, a video-based facial iPPG detecting equipment was devised to provide multi-dimensional spatiotemporal hemodynamic pulsations for applications with high portability and self-monitoring requirements. A series of algorithms have also been developed for physiological indices such as heart rate and breath rate extraction, facial region analysis, and visualization of hemodynamic pulsation distribution. Results showed that the new device can provide a reliable measurement of a rich range of cardiovascular hemodynamics. Combined with the advanced computing techniques, the new non-contact iPPG system provides a promising solution for user-friendly pervasive healthcare.
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Affiliation(s)
- Jingjing Luo
- Institute of AI and Robotics, Academy for Engineering and Technology, Fudan University, Shanghai 200433, China;
- Jihua Laboratory, Guangdong 528000, China;
| | - Junjie Zhen
- School of Precision Instruments and Opto-Electronics Engineering, Tianjin University, Tianjin 300072, China;
| | - Peng Zhou
- Jihua Laboratory, Guangdong 528000, China;
- School of Precision Instruments and Opto-Electronics Engineering, Tianjin University, Tianjin 300072, China;
| | - Wei Chen
- Center for Intelligent Medical Electronics, School of Information Science and Technology, Fudan University, Shanghai 200433, China;
- Human Phenome Institute, Fudan University, Shanghai 200433, China
| | - Yuzhu Guo
- School of Automation Science and Electrical Engineering, Beihang University, Beijing 100191, China
- Correspondence:
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Association of remote imaging photoplethysmography and cutaneous perfusion in volunteers. Sci Rep 2020; 10:16464. [PMID: 33020579 PMCID: PMC7536393 DOI: 10.1038/s41598-020-73531-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 09/11/2020] [Indexed: 01/09/2023] Open
Abstract
Remote imaging photoplethysmography (iPPG) senses the cardiac pulse in outer skin layers and is responsive to mean arterial pressure and pulse pressure in critically ill patients. Whether iPPG is sufficiently sensitive to monitor cutaneous perfusion is not known. This study aimed at determining the response of iPPG to changes in cutaneous perfusion measured by Laser speckle imaging (LSI). Thirty-seven volunteers were engaged in a cognitive test known to evoke autonomic nervous activity and a Heat test. Simultaneous measurements of iPPG and LSI were taken at baseline and during cutaneous perfusion challenges. A perfusion index (PI) was calculated to assess iPPG signal strength. The response of iPPG to the challenges and its relation to LSI were determined. PI of iPPG significantly increased in response to autonomic nervous stimuli and to the Heat test by 5.8% (p = 0.005) and 11.1% (p < 0.001), respectively. PI was associated with LSI measures of cutaneous perfusion throughout experiments (p < 0.001). iPPG responses to study task correlated with those of LSI (r = 0.62, p < 0.001) and were comparable among subjects. iPPG is sensitive to autonomic nervous activity in volunteers and is closely associated with cutaneous perfusion.
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