A Video-Based Technique for Heart Rate and Eye Blinks Rate Estimation: A Potential Solution for Telemonitoring and Remote Healthcare

Reducing flight upset risk and startle response: A study of the wake vortex alert with licensed commercial pilots

The study aimed at investigating the impact of an innovative Wake Vortex Alert (WVA) avionics on pilots' operation and mental states, intending to improve aviation safety by mitigating the risks associated with wake vortex encounters (WVEs). Wake vortices, generated by jet aircraft, pose a significant hazard to trailing or crossing aircrafts. Despite existing separation rules, incidents involving WVEs continue to occur, especially affecting smaller aircrafts like business jets, resulting in aircraft upsets and occasional cabin injuries. To address these challenges, the study focused on developing and validating an alert system that can be presented to air traffic controllers, enabling them to warn flight crews. This empowers the flight crews to either avoid the wake vortex or secure the cabin to prevent injuries. The research employed a multidimensional approach including an analysis of human performance and human factors (HF) issues to determine the potential impact of the alert on pilots' roles, tasks, and mental states. It also utilizes Human Assurance Levels (HALs) to evaluate the necessary human factors support based on the safety criticality of the new system. Realistic flight simulations were conducted to collect data of pilots' behavioural, subjective and neurophysiological responses during WVEs. The data allowed for an objective evaluation of the WVA impact on pilots' operation, behaviour and mental states (mental workload, stress levels and arousal). In particular, the results highlighted the effectiveness of the alert system in facilitating pilots' preparation, awareness and crew resource management (CRM). The results also highlighted the importance of avionics able to enhance aviation safety and reducing risks associated with wake vortex encounters. In particular, we demonstrated how providing timely information and improving situational awareness, the WVA will minimize the occurrence of WVEs and contribute to safer aviation operations.

Neurophysiological Assessment of An Innovative Maritime Safety System in Terms of Ship Operators' Mental Workload, Stress, and Attention in the Full Mission Bridge Simulator

The current industrial environment relies heavily on maritime transportation. Despite the continuous technological advances for the development of innovative safety software and hardware systems, there is a consistent gap in the scientific literature regarding the objective evaluation of the performance of maritime operators. The human factor is profoundly affected by changes in human performance or psychological state. The difficulty lies in the fact that the technology, tools, and protocols for investigating human performance are not fully mature or suitable for experimental investigation. The present research aims to integrate these two concepts by (i) objectively characterizing the psychological state of mariners, i.e., mental workload, stress, and attention, through their electroencephalographic (EEG) signal analysis, and (ii) validating an innovative safety framework countermeasure, defined as Human Risk-Informed Design (HURID), through the aforementioned neurophysiological approach. The proposed study involved 26 mariners within a high-fidelity bridge simulator while encountering collision risk in congested waters with and without the HURID. Subjective, behavioral, and neurophysiological data, i.e., EEG, were collected throughout the experimental activities. The results showed that the participants experienced a statistically significant higher mental workload and stress while performing the maritime activities without the HURID, while their attention level was statistically lower compared to the condition in which they performed the experiments with the HURID (all p < 0.05). Therefore, the presented study confirmed the effectiveness of the HURID during maritime operations in critical scenarios and led the way to extend the neurophysiological evaluation of the HFs of maritime operators during the performance of critical and/or standard shipboard tasks.

Wearable Technologies for Electrodermal and Cardiac Activity Measurements: A Comparison between Fitbit Sense, Empatica E4 and Shimmer GSR3

The capability of measuring specific neurophysiological and autonomic parameters plays a crucial role in the objective evaluation of a human's mental and emotional states. These human aspects are commonly known in the scientific literature to be involved in a wide range of processes, such as stress and arousal. These aspects represent a relevant factor especially in real and operational environments. Neurophysiological autonomic parameters, such as Electrodermal Activity (EDA) and Photoplethysmographic data (PPG), have been usually investigated through research-graded devices, therefore resulting in a high degree of invasiveness, which could negatively interfere with the monitored user's activity. For such a reason, in the last decade, recent consumer-grade wearable devices, usually designed for fitness-tracking purposes, are receiving increasing attention from the scientific community, and are characterized by a higher comfort, ease of use and, therefore, by a higher compatibility with daily-life environments. The present preliminary study was aimed at assessing the reliability of a consumer wearable device, i.e., the Fitbit Sense, with respect to a research-graded wearable, i.e., the Empatica E4 wristband, and a laboratory device, i.e., the Shimmer GSR3+. EDA and PPG data were collected among 12 participants while they performed multiple resting conditions. The results demonstrated that the EDA- and PPG-derived features computed through the wearable and research devices were positively and significantly correlated, while the reliability of the consumer device was significantly lower.

Non-Invasive Data Acquisition and IoT Solution for Human Vital Signs Monitoring: Applications, Limitations and Future Prospects

The rapid development of technology has brought about a revolution in healthcare stimulating a wide range of smart and autonomous applications in homes, clinics, surgeries and hospitals. Smart healthcare opens the opportunity for a qualitative advance in the relations between healthcare providers and end-users for the provision of healthcare such as enabling doctors to diagnose remotely while optimizing the accuracy of the diagnosis and maximizing the benefits of treatment by enabling close patient monitoring. This paper presents a comprehensive review of non-invasive vital data acquisition and the Internet of Things in healthcare informatics and thus reports the challenges in healthcare informatics and suggests future work that would lead to solutions to address the open challenges in IoT and non-invasive vital data acquisition. In particular, the conducted review has revealed that there has been a daunting challenge in the development of multi-frequency vital IoT systems, and addressing this issue will help enable the vital IoT node to be reachable by the broker in multiple area ranges. Furthermore, the utilization of multi-camera systems has proven its high potential to increase the accuracy of vital data acquisition, but the implementation of such systems has not been fully developed with unfilled gaps to be bridged. Moreover, the application of deep learning to the real-time analysis of vital data on the node/edge side will enable optimal, instant offline decision making. Finally, the synergistic integration of reliable power management and energy harvesting systems into non-invasive data acquisition has been omitted so far, and the successful implementation of such systems will lead to a smart, robust, sustainable and self-powered healthcare system.

Continuous Monitoring of Vital Signs Using Cameras: A Systematic Review

In recent years, noncontact measurements of vital signs using cameras received a great amount of interest. However, some questions are unanswered: (i) Which vital sign is monitored using what type of camera? (ii) What is the performance and which factors affect it? (iii) Which health issues are addressed by camera-based techniques? Following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement, we conduct a systematic review of continuous camera-based vital sign monitoring using Scopus, PubMed, and the Association for Computing Machinery (ACM) databases. We consider articles that were published between January 2018 and April 2021 in the English language. We include five vital signs: heart rate (HR), respiratory rate (RR), blood pressure (BP), body skin temperature (BST), and oxygen saturation (SpO2). In total, we retrieve 905 articles and screened them regarding title, abstract, and full text. One hundred and four articles remained: 60, 20, 6, 2, and 1 of the articles focus on HR, RR, BP, BST, and SpO2, respectively, and 15 on multiple vital signs. HR and RR can be measured using red, green, and blue (RGB) and near-infrared (NIR) as well as far-infrared (FIR) cameras. So far, BP and SpO2 are monitored with RGB cameras only, whereas BST is derived from FIR cameras only. Under ideal conditions, the root mean squared error is around 2.60 bpm, 2.22 cpm, 6.91 mm Hg, 4.88 mm Hg, and 0.86 °C for HR, RR, systolic BP, diastolic BP, and BST, respectively. The estimated error for SpO2 is less than 1%, but it increases with movements of the subject and the camera-subject distance. Camera-based remote monitoring mainly explores intensive care, post-anaesthesia care, and sleep monitoring, but also explores special diseases such as heart failure. The monitored targets are newborn and pediatric patients, geriatric patients, athletes (e.g., exercising, cycling), and vehicle drivers. Camera-based techniques monitor HR, RR, and BST in static conditions within acceptable ranges for certain applications. The research gaps are large and heterogeneous populations, real-time scenarios, moving subjects, and accuracy of BP and SpO2 monitoring.

Air Force Pilot Expertise Assessment with Regard to Mental Effort Requested during Unusual Attitude Recovery Flight Training Simulations

Pilot training and expertise are key aspects in aviation. A traditional way of evaluating pilot expertise is to measure performance output. However, this approach provides a narrow view of the pilot’s capacity, especially with regard to mental and emotional profile. The aim of this study is hence to investigate whether neurophysiological data can be employed as an additional objective measure to assess the expertise of pilots. In this regard, it has been demonstrated that mental effort can be used as an indirect measure of operator expertise and capacity. An increase in mental effort, for instance, can automatically result in a decrease in the remaining capacity of the operator. To better investigate this aspect, we ask two groups of Italian Air Force pilots, experienced (Experts) and unexperienced (Novices), to undergo unusual attitude recovery flight training simulations. Their behavioral (unusual attitude recovery time), subjective (mental effort demand perception) and neurophysiological data (Electroencephalogram, EEG; Electrocardiogram, ECG) are collected during the entire flight simulations. Although the two groups do not exhibit differences in terms of unusual attitude recovery time and mental effort demand perception, the EEG-based mental effort index shows how Novices request significantly higher mental effort during unusual conditions.

Association between mental illness and blood pressure variability: a systematic review

Background

Mental illness represents a major global burden of disease worldwide. It has been hypothesised that individuals with mental illness have greater blood pressure fluctuations that lead to increased cardiovascular risk and target organ damage. This systematic review aims to (i) investigate the association between mental illness and blood pressure variability (BPV) and (ii) describe methods of BPV measurements and analysis which may affect pattern and degree of variability.

Methods

Four electronic databases were searched from inception until 2020. The quality assessment was performed using STROBE criteria. Studies were included if they investigated BPV (including either frequency or time domain analysis) in individuals with mental illness (particularly anxiety/generalised anxiety disorder, depression/major depressive disorder, panic disorder and hostility) and without hypertension. Two authors independently screened titles, abstracts and full texts. A third author resolved any disagreements.

Results

Twelve studies met the inclusion criteria. Three studies measured short-term BPV, two measured long-term BPV and seven measured ultra-short-term BPV. All studies related to short-term BPV using ambulatory and home blood pressure monitoring found a higher BPV in individuals with depression or panic disorder. The two studies measuring long-term BPV were limited to the older population and found mixed results. Mental illness is significantly associated with an increased BPV in younger and middle-aged adults. All studies of ultra-short-term BPV using standard cardiac autonomic assessment; non-invasive continuous finger blood pressure and heart rate signals found significant association between BPV and mental illness. A mixed result related to degree of tilt during tilt assessment and between controlled and spontaneous breathing were observed in patients with psychological state.

Conclusions

Current review found that people with mental illness is significantly associated with an increased BPV regardless of age. Since mental illness can contribute to the deterioration of autonomic function (HRV, BPV), early therapeutic intervention in mental illness may prevent diseases associated with autonomic dysregulation and reduce the likelihood of negative cardiac outcomes. Therefore, these findings may have important implications for patients' future physical health and well-being, highlighting the need for comprehensive cardiovascular risk reduction.

Correlation Evaluation of Pilots' Situation Awareness in Bridge Simulations via Eye-Tracking Technology

To maintain situation awareness (SA) when exposed to emergencies during pilotage, a pilot needs to selectively allocate attentional resources to perceive critical status information about ships and environments. Although it is important to continuously monitor a pilot's SA, its relationship with attention is still not fully understood in ship pilotage. This study performs bridge simulation experiments that include vessel departure, navigation in the fairway, encounters, poor visibility, and anchoring scenes with 13 pilots (mean = 11.3 and standard deviation = 1.4 of experience). Individuals were divided into two SA group levels based on the Situation Awareness Rating Technology (SART-2) score (mean = 20.13 and standard deviation = 5.83) after the experiments. The visual patterns using different SA groups were examined using heat maps and scan paths based on pilots' fixations and saccade data. The preliminary visual analyses of the heat maps and scan paths indicate that the pilots' attentional distribution is modulated by the SA level. That is, the most concerning areas of interest (AOIs) for pilots in the high and low SA groups are outside the window (AOI-2) and electronic charts (AOI-1), respectively. Subsequently, permutation simulations were utilized to identify statistical differences between the pilots' eye-tracking metrics and SA. The results of the statistical analyses show that the fixation and saccade metrics are affected by the SA level in different AOIs across the five scenes, which confirms the findings of previous studies. In encounter scenes, the pilots' SA level is correlated with the fixation and saccade metrics: fixation count (p = 0.034 < 0.05 in AOI-1 and p = 0.032 < 0.05 in AOI-2), fixation duration (p = 0.043 < 0.05 in AOI-1 and p = 0.014 < 0.05 in AOI-2), and saccade count (p = 0.086 < 0.1 in AOI-1 and p = 0.054 < 0.1 in AOI-2). This was determined by the fixation count (p = 0.024 < 0.05 in AOI-1 and p = 0.034 < 0.05 in AOI-2), fixation duration (p = 0.036 < 0.05 in AOI-1 and p = 0.047 < 0.05 in AOI-2), and saccade duration (p = 0.05 ≤ 0.05 in AOI-1 and p = 0.042 < 0.05 in AOI-2) in poor-visibility scenes. In the remaining scenes, the SA could not be measured using eye movements alone. This study lays a foundation for the cognitive mechanism recognition of pilots based on SA via eye-tracking technology, which provides a reference to establish cognitive competency standards in preliminary pilot screenings.