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Nardelli M, Bailón R. Advances in Wearable Photoplethysmography Applications in Health Monitoring. SENSORS (BASEL, SWITZERLAND) 2023; 23:7064. [PMID: 37631601 PMCID: PMC10459612 DOI: 10.3390/s23167064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023]
Abstract
In the last few years, interest in wearable technology for physiological signal monitoring is rapidly growing, especially during and after the COVID-19 pandemic [...].
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Affiliation(s)
- Mimma Nardelli
- Bioengineering and Robotics Research Centre “E. Piaggio” and Dipartimento di Ingegneria dell’Informazione, University of Pisa, Largo Lucio Lazzarino 1, 56122 Pisa, Italy
| | - Raquel Bailón
- BSICoS Group, Aragón Institute of Engineering Research (I3A), IISAragon, University of Zaragoza, 50015 Zaragoza, Spain;
- Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), 28029 Madrid, Spain
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Miklós Z, Horváth I. The Role of Oxidative Stress and Antioxidants in Cardiovascular Comorbidities in COPD. Antioxidants (Basel) 2023; 12:1196. [PMID: 37371927 DOI: 10.3390/antiox12061196] [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: 04/30/2023] [Revised: 05/28/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023] Open
Abstract
Oxidative stress driven by several environmental and local airway factors associated with chronic obstructive bronchiolitis, a hallmark feature of COPD, plays a crucial role in disease pathomechanisms. Unbalance between oxidants and antioxidant defense mechanisms amplifies the local inflammatory processes, worsens cardiovascular health, and contributes to COPD-related cardiovascular dysfunctions and mortality. The current review summarizes recent developments in our understanding of different mechanisms contributing to oxidative stress and its countermeasures, with special attention to those that link local and systemic processes. Major regulatory mechanisms orchestrating these pathways are also introduced, with some suggestions for further research in the field.
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Affiliation(s)
- Zsuzsanna Miklós
- National Korányi Institute for Pulmonology, Korányi F. Street 1, H-1121 Budapest, Hungary
| | - Ildikó Horváth
- National Korányi Institute for Pulmonology, Korányi F. Street 1, H-1121 Budapest, Hungary
- Department of Pulmonology, University of Debrecen, Nagyerdei krt 98, H-4032 Debrecen, Hungary
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Todorov A, Torah R, Ardern-Jones MR, Beeby SP. Electromagnetic Sensing Techniques for Monitoring Atopic Dermatitis-Current Practices and Possible Advancements: A Review. SENSORS (BASEL, SWITZERLAND) 2023; 23:3935. [PMID: 37112275 PMCID: PMC10144024 DOI: 10.3390/s23083935] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 03/29/2023] [Accepted: 04/04/2023] [Indexed: 06/19/2023]
Abstract
Atopic dermatitis (AD) is one of the most common skin disorders, affecting nearly one-fifth of children and adolescents worldwide, and currently, the only method of monitoring the condition is through an in-person visual examination by a clinician. This method of assessment poses an inherent risk of subjectivity and can be restrictive to patients who do not have access to or cannot visit hospitals. Advances in digital sensing technologies can serve as a foundation for the development of a new generation of e-health devices that provide accurate and empirical evaluation of the condition to patients worldwide. The goal of this review is to study the past, present, and future of AD monitoring. First, current medical practices such as biopsy, tape stripping and blood serum are discussed with their merits and demerits. Then, alternative digital methods of medical evaluation are highlighted with the focus on non-invasive monitoring using biomarkers of AD-TEWL, skin permittivity, elasticity, and pruritus. Finally, possible future technologies are showcased such as radio frequency reflectometry and optical spectroscopy along with a short discussion to provoke research into improving the current techniques and employing the new ones to develop an AD monitoring device, which could eventually facilitate medical diagnosis.
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Affiliation(s)
- Alexandar Todorov
- Centre of Flexible Electronics and E-Textiles, School of Electronics and Computer Science, University of Southampton, Southampton SO17 1BJ, UK
| | - Russel Torah
- Centre of Flexible Electronics and E-Textiles, School of Electronics and Computer Science, University of Southampton, Southampton SO17 1BJ, UK
| | - Michael R. Ardern-Jones
- Clinical Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 1DU, UK
| | - Steve P. Beeby
- Centre of Flexible Electronics and E-Textiles, School of Electronics and Computer Science, University of Southampton, Southampton SO17 1BJ, UK
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Aboye GT, Vande Walle M, Simegn GL, Aerts JM. mHealth in sub-Saharan Africa and Europe: A systematic review comparing the use and availability of mHealth approaches in sub-Saharan Africa and Europe. Digit Health 2023; 9:20552076231180972. [PMID: 37377558 PMCID: PMC10291558 DOI: 10.1177/20552076231180972] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 05/23/2023] [Indexed: 06/29/2023] Open
Abstract
Background mHealth can help with healthcare service delivery for various health issues, but there's a significant gap in the availability and use of mHealth systems between sub-Saharan Africa and Europe, despite the ongoing digitalization of the global healthcare system. Objective This work aims to compare and investigate the use and availability of mHealth systems in sub-Saharan Africa and Europe, and identify gaps in current mHealth development and implementation in both regions. Methods The study adhered to the PRISMA 2020 guidelines for article search and selection to ensure an unbiased comparison between sub-Saharan Africa and Europe. Four databases (Scopus, Web of Science, IEEE Xplore, and PubMed) were used, and articles were evaluated based on predetermined criteria. Details on the mHealth system type, goal, patient type, health concern, and development stage were collected and recorded in a Microsoft Excel worksheet. Results The search query produced 1020 articles for sub-Saharan Africa and 2477 articles for Europe. After screening for eligibility, 86 articles for sub-Saharan Africa and 297 articles for Europe were included. To minimize bias, two reviewers conducted the article screening and data retrieval. Sub-Saharan Africa used SMS and call-based mHealth methods for consultation and diagnosis, mainly for young patients such as children and mothers, and for issues such as HIV, pregnancy, childbirth, and child care. Europe relied more on apps, sensors, and wearables for monitoring, with the elderly as the most common patient group, and the most common health issues being cardiovascular disease and heart failure. Conclusion Wearable technology and external sensors are heavily used in Europe, whereas they are seldom used in sub-Saharan Africa. More efforts should be made to use the mHealth system to improve health outcomes in both regions, incorporating more cutting-edge technologies like wearables internal and external sensors. Undertaking context-based studies, identifying determinants of mHealth systems use, and considering these determinants during mHealth system design could enhance mHealth availability and utilization.
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Affiliation(s)
- Genet Tadese Aboye
- M3-BIORES (Measure, Model & Manage Bioreponses), Division of Animal and Human Health Engineering, Department of Biosystems, KU Leuven, Leuven, Belgium
- School of Biomedical Engineering, Jimma University, Jimma, Ethiopia
| | - Martijn Vande Walle
- M3-BIORES (Measure, Model & Manage Bioreponses), Division of Animal and Human Health Engineering, Department of Biosystems, KU Leuven, Leuven, Belgium
| | | | - Jean-Marie Aerts
- M3-BIORES (Measure, Model & Manage Bioreponses), Division of Animal and Human Health Engineering, Department of Biosystems, KU Leuven, Leuven, Belgium
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Shin DA, Kim J, Choi SW, Lee JC. DNN based reliability evaluation for telemedicine data. Biomed Eng Lett 2022; 13:11-19. [PMID: 36249572 PMCID: PMC9553077 DOI: 10.1007/s13534-022-00248-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 09/18/2022] [Accepted: 09/24/2022] [Indexed: 01/29/2023] Open
Abstract
Telemedicine data are measured directly by untrained patients, which may cause problems in data reliability. Many deep learning-based studies have been conducted to improve the quality of measurement data. However, they could not provide an accurate basis for judgment. Therefore, this study proposed a deep neural network filter-based reliability evaluation system that could present an accurate basis for judgment and verified its reliability by evaluating photoplethysmography signal and change in data quality according to judgment criteria through clinical trials. In the results, the deviation of 3% or more when the oxygen saturation was judged as normal according to each criterion was 0.3% and 0.82% for criteria 1 and 2, respectively, which was very low compared to the abnormal judgment (3.86%). The deviation of diastolic blood pressure (≥ 10 mmHg) according to criterion 3 was reduced by about 4% in the normal judgment compared to the abnormal. In addition, when multiple judgment conditions were satisfied, abnormal data were better discriminated than when only one criterion was satisfied. Therefore, the basis for judging abnormal data can be presented with the system proposed in this study, and the quality of telemedicine data can be improved according to the judgment result.
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Affiliation(s)
- Dong Ah Shin
- grid.31501.360000 0004 0470 5905Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, Seoul, 03080 Republic of Korea
| | - Jiwoon Kim
- grid.412010.60000 0001 0707 9039Interdisciplinary Program in Biohealth-Machinery Convergence Engineering, Kangwon National University, Chuncheon-si, 24341 Republic of Korea
| | - Seong-Wook Choi
- grid.412010.60000 0001 0707 9039Interdisciplinary Program in Biohealth-Machinery Convergence Engineering, Kangwon National University, Chuncheon-si, 24341 Republic of Korea ,Program of Mechanical and Biomedical Engineering, College of Engineering, Chuncheon-si, 24341 Republic of Korea
| | - Jung Chan Lee
- grid.31501.360000 0004 0470 5905Department of Biomedical Engineering, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, 03080 Republic of Korea
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Hilty M, Oldrati P, Barrios L, Müller T, Blumer C, Foege M, consortium PHRT, Holz C, Lutterotti A. Continuous monitoring with wearables in multiple sclerosis reveals an association of cardiac autonomic dysfunction with disease severity. Mult Scler J Exp Transl Clin 2022; 8:20552173221103436. [PMID: 35677598 PMCID: PMC9168869 DOI: 10.1177/20552173221103436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 03/03/2021] [Indexed: 11/17/2022] Open
Abstract
Background Dysfunction of the autonomic nervous system is common in multiple sclerosis
patients, and probably present years before diagnosis, but its role in the
disease is poorly understood. Objectives To study the autonomic nervous system in patients with multiple sclerosis
using cardiac autonomic regulation measured with a wearable. Methods In a two-week study, we present a method to standardize the measurement of
heart rate variability using a wearable sensor that allows the investigation
of circadian trends. Using this method, we investigate the relationship of
cardiac autonomic dysfunction with clinical hallmarks and subjective burden
of fatigue and autonomic symptoms. Results In 55 patients with multiple sclerosis and 24 healthy age- and gender-matched
controls, we assessed the cumulative circadian heart-rate variability trend
of two weeks. The trend analysis revealed an effect of inflammation
(P = 0.0490, SMD = -0.5466) and progressive
neurodegeneration (P = 0.0016, SMD = 1.1491) on cardiac
autonomic function. No association with subjective symptoms could be
found. Conclusions Trend-based heart rate variability measured with a wearable provides the
opportunity for unobtrusive long-term assessment of autonomic functions in
patients with multiple sclerosis. It revealed a general dysregulation in
patients with multiple sclerosis.
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Affiliation(s)
- Marc Hilty
- University and University Hospital of Zürich, Department of Neurology, Zürich, 8091, Switzerland
| | - Pietro Oldrati
- University and University Hospital of Zürich, Department of Neurology, Zürich, 8091, Switzerland
- University and University Hospital of Zürich, Department of Neurology, Zürich, 8091, Switzerland
| | - Liliana Barrios
- ETH Zürich, Department of Computer Science, Zürich, 8092, Switzerland
- University and University Hospital of Zürich, Department of Neurology, Zürich, 8091, Switzerland
| | - Tamara Müller
- University and University Hospital of Zürich, Department of Neurology, Zürich, 8091, Switzerland
| | - Claudia Blumer
- University and University Hospital of Zürich, Department of Neurology, Zürich, 8091, Switzerland
| | - Magdalena Foege
- University and University Hospital of Zürich, Department of Neurology, Zürich, 8091, Switzerland
| | | | - Christian Holz
- ETH Zürich, Department of Computer Science, Zürich, 8092, Switzerland
| | - Andreas Lutterotti
- University and University Hospital of Zürich, Department of Neurology, Zürich, 8091, Switzerland
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Heart Rate Variability from Wearable Photoplethysmography Systems: Implications in Sleep Studies at High Altitude. SENSORS 2022; 22:s22082891. [PMID: 35458875 PMCID: PMC9028181 DOI: 10.3390/s22082891] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/28/2022] [Accepted: 04/05/2022] [Indexed: 02/04/2023]
Abstract
The interest in photoplethysmography (PPG) for sleep monitoring is increasing because PPG may allow assessing heart rate variability (HRV), which is particularly important in breathing disorders. Thus, we aimed to evaluate how PPG wearable systems measure HRV during sleep at high altitudes, where hypobaric hypoxia induces respiratory disturbances. We considered PPG and electrocardiographic recordings in 21 volunteers sleeping at 4554 m a.s.l. (as a model of sleep breathing disorder), and five alpine guides sleeping at sea level, 6000 m and 6800 m a.s.l. Power spectra, multiscale entropy, and self-similarity were calculated for PPG tachograms and electrocardiography R–R intervals (RRI). Results demonstrated that wearable PPG devices provide HRV measures even at extremely high altitudes. However, the comparison between PPG tachograms and RRI showed discrepancies in the faster spectral components and at the shorter scales of self-similarity and entropy. Furthermore, the changes in sleep HRV from sea level to extremely high altitudes quantified by RRI and PPG tachograms in the five alpine guides tended to be different at the faster frequencies and shorter scales. Discrepancies may be explained by modulations of pulse wave velocity and should be considered to interpret correctly autonomic alterations during sleep from HRV analysis.
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Georgieva-Tsaneva G, Gospodinova E, Cheshmedzhiev K. Cardiodiagnostics Based on Photoplethysmographic Signals. Diagnostics (Basel) 2022; 12:diagnostics12020412. [PMID: 35204503 PMCID: PMC8871237 DOI: 10.3390/diagnostics12020412] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/02/2022] [Accepted: 02/03/2022] [Indexed: 11/16/2022] Open
Abstract
The article presents a methodology to support the process of correct cardiodiagnostics based on cardio signals recorded with modern optical photoplethysmographic (PPG) sensor devices. An algorithm for preprocessing registered PPG signals and the formation of a time series for the analysis of heart rate variability is presented, which is an important information indicator in the diagnosis of cardiovascular diseases. In order to validate the proposed algorithm, an experimental scheme for synchronous recordings of PPG and electrocardiographic (ECG) signals and the study of the accuracy of the registered signals was created. The obtained results show high accuracy of the studied signals in terms of the following parameters: number of QRS complexes/pulse waves and mean RR intervals/PP intervals and the finding that the proposed algorithm is suitable for preprocessing PPG signals, as well as the possibility of interchangeable use of PPG and ECG. The results of the mathematical analysis of heart rate variability by applying linear methods (Time-Domain and Frequency-Domain) to two groups of people are presented: healthy controls and patients with cardiovascular disease (syncope). After determining the values of the parameters of the methods used, in order to distinguish healthy subjects from sick ones, statistical analysis was applied using t-test and Receiver Operating Characteristics (ROC) analysis. The obtained results show that the linear methods used are suitable for analysing the dynamics of PP interval series and for distinguishing healthy subjects from those with pathological diseases. The presented research and analyses can find applications in guaranteeing correctness and accuracy of conducting cardiodiagnostics in clinical practice.
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Estimating Resting HRV during fMRI: A Comparison between Laboratory and Scanner Environment. SENSORS 2021; 21:s21227663. [PMID: 34833744 PMCID: PMC8619981 DOI: 10.3390/s21227663] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/02/2021] [Accepted: 11/15/2021] [Indexed: 12/31/2022]
Abstract
Heart rate variability (HRV) is regularly assessed in neuroimaging studies as an indicator of autonomic, emotional or cognitive processes. In this study, we investigated the influence of a loud and cramped environment during magnetic resonance imaging (MRI) on resting HRV measures. We compared recordings during functional MRI sessions with recordings in our autonomic laboratory (LAB) in 101 healthy subjects. In the LAB, we recorded an electrocardiogram (ECG) and a photoplethysmogram (PPG) over 15 min. During resting state functional MRI, we acquired a PPG for 15 min. We assessed anxiety levels before the scanning in each subject. In 27 participants, we performed follow-up sessions to investigate a possible effect of habituation. We found a high intra-class correlation ranging between 0.775 and 0.996, indicating high consistency across conditions. We observed no systematic influence of the MRI environment on any HRV index when PPG signals were analyzed. However, SDNN and RMSSD were significantly higher when extracted from the PPG compared to the ECG. Although we found a significant correlation of anxiety and the decrease in HRV from LAB to MRI, a familiarization session did not change the HRV outcome. Our results suggest that psychological factors are less influential on the HRV outcome during MRI than the methodological choice of the cardiac signal to analyze.
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