Effects of slow and regular breathing exercise on cardiopulmonary coupling and blood pressure

Investigation of the interaction between cardiovascular variables and respiration provides a quantitative and noninvasive approach to assess the autonomic control of cardiovascular function. The aim of this paper is to investigate the changes of cardiopulmonary coupling (CPC), blood pressure (BP) and pulse transit time (PTT) during a stepwise-paced breathing (SPB) procedure (spontaneous breathing followed by paced breathing at 14, 12.5, 11, 9.5, 8 and 7 breaths per minute, 3 min each) and gain insights into the characteristics of slow breathing exercises. RR interval, respiration, BP and PTT are collected during the SPB procedure (48 healthy subjects, 27 ± 6 years). CPC is assessed through investigating both the phase and amplitude dynamics between the respiration-induced components from RR interval and respiration by the approach of ensemble empirical mode decomposition. It was found that even though the phase synchronization and amplitude oscillation of CPC were both enhanced by the SPB procedure, phase coupling does not increase monotonically along with the amplitude oscillation during the whole procedure. Meanwhile, BP was reduced significantly by the SPB procedure (SBP: from 122.0 ± 13.4 to 114.2 ± 14.9 mmHg, p < 0.001, DBP: from 82.2 ± 8.6 to 77.0 ± 9.8 mmHg, p < 0.001, PTT: from 172.8 ± 20.1 to 176.8 ± 19.2 ms, p < 0.001). Our results demonstrate that the SPB procedure can reduce BP and lengthen PTT significantly. Compared with amplitude dynamics, phase dynamics is a different marker for CPC analysis in reflecting cardiorespiratory coherence during slow breathing exercise. Our study provides a methodology to practice slow breathing exercise, including the setting of target breathing rate, change of CPC and the importance of regular breathing. The applications and usability of the study results have also been discussed.National Natural Science Foundation (China) (Grant Number: 61471398)Beijing Natural Science Foundation (Grant Number: 3122034)General Logistics Science Foundation (Grant Number: CWS11C108)National Key Technology Research and Development Program (Grant Numbers: 2013BAI03B04, 2013BAI03B05

Characterization, Classification, and Genesis of Seismocardiographic Signals

Seismocardiographic (SCG) signals are the acoustic and vibration induced by cardiac activity measured non-invasively at the chest surface. These signals may offer a method for diagnosing and monitoring heart function. Successful classification of SCG signals in health and disease depends on accurate signal characterization and feature extraction. In this study, SCG signal features were extracted in the time, frequency, and time-frequency domains. Different methods for estimating time-frequency features of SCG were investigated. Results suggested that the polynomial chirplet transform outperformed wavelet and short time Fourier transforms. Many factors may contribute to increasing intrasubject SCG variability including subject posture and respiratory phase. In this study, the effect of respiration on SCG signal variability was investigated. Results suggested that SCG waveforms can vary with lung volume, respiratory flow direction, or a combination of these criteria. SCG events were classified into groups belonging to these different respiration phases using classifiers, including artificial neural networks, support vector machines, and random forest. Categorizing SCG events into different groups containing similar events allows more accurate estimation of SCG features. SCG feature points were also identified from simultaneous measurements of SCG and other well-known physiologic signals including electrocardiography, phonocardiography, and echocardiography. Future work may use this information to get more insights into the genesis of SCG

Data-driven methods for analyzing ballistocardiograms in longitudinal cardiovascular monitoring

Cardiovascular disease (CVD) is the leading cause of death in the US; about 48% of American adults have one or more types of CVD. The importance of continuous monitoring of the older population, for early detection of changes in health conditions, has been shown in the literature, as the key to a successful clinical intervention. We have been investigating environmentally-embedded in-home networks of non-invasive sensing modalities. This dissertation concentrates on the signal processing techniques required for the robust extraction of morphological features from the ballistocardiographs (BCG), and machine learning approaches to utilize these features in non-invasive monitoring of cardiovascular conditions. At first, enhancements in the time domain detection of the cardiac cycle are addressed due to its importance in the estimation of heart rate variability (HRV) and sleep stages. The proposed enhancements in the energy-based algorithm for BCG beat detection have shown at least 50% improvement in the root mean square error (RMSE) of the beat to beat heart rate estimations compared to the reference estimations from the electrocardiogram (ECG) R to R intervals. These results are still subject to some errors, primarily due to the contamination of noise and motion artifacts caused by floor vibration, unconstrained subject movements, or even the respiratory activities. Aging, diseases, breathing, and sleep disorders can also affect the quality of estimation as they slightly modify the morphology of the BCG waveform.Includes bibliographical reference

Photonic Biosensors: Detection, Analysis and Medical Diagnostics

The role of nanotechnologies in personalized medicine is rising remarkably in the last decade because of the ability of these new sensing systems to diagnose diseases from early stages and the availability of continuous screenings to characterize the efficiency of drugs and therapies for each single patient. Recent technological advancements are allowing the development of biosensors in low-cost and user-friendly platforms, thereby overcoming the last obstacle for these systems, represented by limiting costs and low yield, until now. In this context, photonic biosensors represent one of the main emerging sensing modalities because of their ability to combine high sensitivity and selectivity together with real-time operation, integrability, and compatibility with microfluidics and electric circuitry for the readout, which is fundamental for the realization of lab-on-chip systems. This book, “Photonic Biosensors: Detection, Analysis and Medical Diagnostics”, has been published thanks to the contributions of the authors and collects research articles, the content of which is expected to assume an important role in the outbreak of biosensors in the biomedical field, considering the variety of the topics that it covers, from the improvement of sensors’ performance to new, emerging applications and strategies for on-chip integrability, aiming at providing a general overview for readers on the current advancements in the biosensing field

Motion Artifact Processing Techniques for Physiological Signals

The combination of reducing birth rate and increasing life expectancy continues to drive the demographic shift toward an ageing population and this is placing an ever-increasing burden on our healthcare systems. The urgent need to address this so called healthcare \time bomb" has led to a rapid growth in research into ubiquitous, pervasive and distributed healthcare technologies where recent advances in signal acquisition, data storage and communication are helping such systems become a reality. However, similar to recordings performed in the hospital environment, artifacts continue to be a major issue for these systems. The magnitude and frequency of artifacts can vary signicantly depending on the recording environment with one of the major contributions due to the motion of the subject or the recording transducer. As such, this thesis addresses the challenges of the removal of this motion artifact removal from various physiological signals. The preliminary investigations focus on artifact identication and the tagging of physiological signals streams with measures of signal quality. A new method for quantifying signal quality is developed based on the use of inexpensive accelerometers which facilitates the appropriate use of artifact processing methods as needed. These artifact processing methods are thoroughly examined as part of a comprehensive review of the most commonly applicable methods. This review forms the basis for the comparative studies subsequently presented. Then, a simple but novel experimental methodology for the comparison of artifact processing techniques is proposed, designed and tested for algorithm evaluation. The method is demonstrated to be highly eective for the type of artifact challenges common in a connected health setting, particularly those concerned with brain activity monitoring. This research primarily focuses on applying the techniques to functional near infrared spectroscopy (fNIRS) and electroencephalography (EEG) data due to their high susceptibility to contamination by subject motion related artifact. Using the novel experimental methodology, complemented with simulated data, a comprehensive comparison of a range of artifact processing methods is conducted, allowing the identication of the set of the best performing methods. A novel artifact removal technique is also developed, namely ensemble empirical mode decomposition with canonical correlation analysis (EEMD-CCA), which provides the best results when applied on fNIRS data under particular conditions. Four of the best performing techniques were then tested on real ambulatory EEG data contaminated with movement artifacts comparable to those observed during in-home monitoring. It was determined that when analysing EEG data, the Wiener lter is consistently the best performing artifact removal technique. However, when employing the fNIRS data, the best technique depends on a number of factors including: 1) the availability of a reference signal and 2) whether or not the form of the artifact is known. It is envisaged that the use of physiological signal monitoring for patient healthcare will grow signicantly over the next number of decades and it is hoped that this thesis will aid in the progression and development of artifact removal techniques capable of supporting this growth

Advanced Signal Processing in Wearable Sensors for Health Monitoring

Smart, wearables devices on a miniature scale are becoming increasingly widely available, typically in the form of smart watches and other connected devices. Consequently, devices to assist in measurements such as electroencephalography (EEG), electrocardiogram (ECG), electromyography (EMG), blood pressure (BP), photoplethysmography (PPG), heart rhythm, respiration rate, apnoea, and motion detection are becoming more available, and play a significant role in healthcare monitoring. The industry is placing great emphasis on making these devices and technologies available on smart devices such as phones and watches. Such measurements are clinically and scientifically useful for real-time monitoring, long-term care, and diagnosis and therapeutic techniques. However, a pertaining issue is that recorded data are usually noisy, contain many artefacts, and are affected by external factors such as movements and physical conditions. In order to obtain accurate and meaningful indicators, the signal has to be processed and conditioned such that the measurements are accurate and free from noise and disturbances. In this context, many researchers have utilized recent technological advances in wearable sensors and signal processing to develop smart and accurate wearable devices for clinical applications. The processing and analysis of physiological signals is a key issue for these smart wearable devices. Consequently, ongoing work in this field of study includes research on filtration, quality checking, signal transformation and decomposition, feature extraction and, most recently, machine learning-based methods

Characterizing the Noise Associated with Sensor Placement and Motion Artifacts and Overcoming its Effects for Body-worn Physiological Sensors

Wearable sensors for continuous physiological monitoring have the potential to change the paradigm for healthcare by providing information in scenarios not covered by the existing clinical model. One key challenge for wearable physiological sensors is that their signal-to-noise ratios are low compared to those of their medical grade counterparts in hospitals. Two primary sources of noise are the sensor-skin contact interface and motion artifacts due to the user’s daily activities. These are challenging problems because the initial sensor placement by the user may not be ideal, the skin conditions can change over time, and the nature of motion artifacts is not predictable. The objective of this research is twofold. The first is to design sensors with reconfigurable contact to mitigate the effects of misplaced sensors or changing skin conditions. The second is to leverage signal processing techniques for accurate physiological parameter estimation despite the presence of motion artifacts. In this research, the sensor contact problem was specifically addressed for dry-contact electroencephalography (EEG). The proposed novel extension to a popular existing EEG electrode design enabled reconfigurable contact to adjust to variations in sensor placement and skin conditions over time. Experimental results on human subjects showed that reconfiguration of contact can reduce the noise in collected EEG signals without the need for manual intervention. To address the motion artifact problem, a particle filter based approach was employed to track the heart rate in cardiac signals affected by the movements of the user. The algorithm was tested on cardiac signals from human subjects running on a treadmill and showed good performance in accurately tracking heart rate. Moreover, the proposed algorithm enables fusion of multiple modalities and is also computationally more efficient compared to other contemporary approaches

Sparse Time-Frequency Data Analysis: A Multi-Scale Approach

In this work, we further extend the recently developed adaptive data analysis method, the Sparse Time-Frequency Representation (STFR) method. This method is based on the assumption that many physical signals inherently contain AM-FM representations. We propose a sparse optimization method to extract the AM-FM representations of such signals. We prove the convergence of the method for periodic signals under certain assumptions and provide practical algorithms specifically for the non-periodic STFR, which extends the method to tackle problems that former STFR methods could not handle, including stability to noise and non-periodic data analysis. This is a significant improvement since many adaptive and non-adaptive signal processing methods are not fully capable of handling non-periodic signals. Moreover, we propose a new STFR algorithm to study intrawave signals with strong frequency modulation and analyze the convergence of this new algorithm for periodic signals. Such signals have previously remained a bottleneck for all signal processing methods. Furthermore, we propose a modified version of STFR that facilitates the extraction of intrawaves that have overlaping frequency content. We show that the STFR methods can be applied to the realm of dynamical systems and cardiovascular signals. In particular, we present a simplified and modified version of the STFR algorithm that is potentially useful for the diagnosis of some cardiovascular diseases. We further explain some preliminary work on the nature of Intrinsic Mode Functions (IMFs) and how they can have different representations in different phase coordinates. This analysis shows that the uncertainty principle is fundamental to all oscillating signals

Reconstructing time-dependent dynamics

The usefulness of the information extracted from biomedical data relies heavily on the underlying theory of the methods used in its extraction. The assumptions of stationarity and autonomicity traditionally applied to dynamical systems break down when considering living systems, due to their inherent time-variability. Living systems are thermodynamically open, and thus constantly interacting with their environment. This results in highly nonlinear, time-dependent dynamics. The aim of signal analysis is to gain insight into the behaviour of the system from which the signal originated. Here, various analysis methods for the characterization of signals and their underlying non-autonomous dynamics are presented, incorporating time-frequency analysis, time-domain decomposition of nonlinear modes, and methods to study mutual interactions and couplings using dynamical Bayesian inference, wavelet-bispectral and time-localised coherence, and entropy and information-based analysis. The recent introduction of chronotaxic systems provides a theoretical framework in which dynamical systems can have amplitudes and frequencies which are time-varying, yet stable, matching well the characteristics of living systems. We demonstrate that considering this theory of chronotaxic systems whilst applying the presented methods results in an approach for the reconstruction of the dynamics of living systems across many scales