Development of a Signal Processing Library for Extraction of SpO2, HR, HRV, and RR from Photoplethysmographic Waveforms

Non-invasive remote physiological monitoring of soldiers on the battlefield has the potential to provide fast, accurate status assessments that are key to improving the survivability of critical injuries. The development of WPI’s wearable wireless pulse oximeter, designed for field-based applications, has allowed for the optimization of important hardware features such as physical size and power management. However, software-based digital signal processing (DSP) methods are still required to perform physiological assessments. This research evaluated DSP methods that were capable of providing arterial oxygen saturation (SpO2), heart rate (HR), heart rate variability (HRV), and respiration rate (RR) measurements derived from data acquired using a single optical sensor. In vivo experiments were conducted to evaluate the accuracies of the processing methods across ranges of physiological conditions. Of the algorithms assessed, 13 SpO2 methods, 1 HR method, 6 HRV indices, and 4 RR methods were identified that provided clinically acceptable measurement accuracies and could potentially be employed in a wearable pulse oximeter

Novel Methods for Weak Physiological Parameters Monitoring.

M.S. Thesis. University of Hawaiʻi at Mānoa 2017

A contribution to unobtrusive video-based measurement of respiratory signals

Due to the growing popularity of video-based methods for physiological signal measurement, and taking into account the technological advancements of these type of devices, this work proposes a series of new novel methods to obtain the respiratory signal from a distance, based on video analysis. This thesis aims to improve the state of the art video methods for respiratory measurement, more specifically, by presenting methods that can be used to obtain respiratory variability or perform respiratory rhythm measurements. Moreover, this thesis also aims to present a new implementation of a time-frequency signal processing technique, to improve its computational efficiency when applied to the respiratory signals. In this document a first approach to video-based methods for respiratory signal measurement is performed, to assert the feasibility of using a consumer-grade camera, not only to measure the mean respiratory rate or frequency, but to assert if this hardware could be used to acquire the raw respiratory signal and the respiratory rhythm as well. In this regard a new video-based method was introduced that measures the respiratory signal of a subject at a distance, with the aid of a custom pattern placed on the thorax of the subject. Given the results from the first video-based method, a more broad approach was taken by comparing three different types of video hardware, with the aim to characterise if they could be used for respiratory signal acquisition and respiratory variability measurements. The comparative analysis was performed in terms of instantaneous frequency, as it allowed to characterise the methods in terms of respiratory variability and to compare them in the same terms with the reference method. Subsequently, and due to the previous obtained results, a new method was proposed using a stereo depth camera with the aim to tackle the limitations of the previous study. The proposed method uses an hybrid architecture were the synchronized infrared frame and depth point-cloud from the same camera are acquired. The infrared frame is used to detect the movements of the subject inside the scene, and to recompute on demand a region of interest to obtain the respiratory signal from the depth point-cloud. Furthermore, in this study an opportunistic approach is taken in order to process all the obtained data, as it is also the aim of this study to verify if using a more realistic approach to respiratory signal analysis in real-life conditions, would influence the respiratory rhythm measurement. Even though the depth camera method proved reliable in terms of respiratory rhythm measurement, the opportunistic approach relied on visual inspection of the obtained respiratory signal to properly define each piece. For this reason, a quality indicator had to be proposed that could objectively identify whenever a respiratory signal contained errors. Furthermore, from the idea to characterise the movements of a subject, and by changing the measuring point from a frontal to a lateral perspective to avoid most of the occlusions, a new method based on obtaining the movement of the thoraco-abdominal region using dense optical flow was proposed. This method makes us of the phase of the optical flow to obtain the respiratory signal of the subject, while using the modulus to compute a quality index. Finally, regarding the different signal processing methods used in this thesis to obtain the instantaneous frequency, there were none that could perform in real-time, making the analysis of the respiratory variability not possible in real-life systems where the signals have to be processed in a sample by sample basis. For this reason, as a final chapter a new implementation of the synchrosqueezing transform for time-frequency analysis in real-time is proposed, with the aim to provide a new tool for non-contact methods to obtain the variability of the respiratory signal in real-time.A causa de la creixent popularitat en la mesura de senyals fisiològics amb mètodes de vídeo, i tenint en compte els avenços tecnològics d'aquests dispositius, aquesta tesi proposa una sèrie de nous mètodes per tal d'obtenir la respiració a distància mitjançant l'anàlisi de vídeo. Aquesta tesi té com a objectiu millorar l'estat de l'art referent a la mesura de senyal respiratòria mitjançant els mètodes que en ella es descriuen, així com presentar mètodes que puguin ser usats per obtenir la variabilitat o el ritme respiratori. A més, aquesta tesi té com a objectiu presentar una nova implementació d'un mètode de processat de senyal temps-freqüencial, per tal de millorar-ne l'eficiència computacional quant s’aplica a senyals respiratoris. En aquest document, es realitza una primera aproximació a la mesura de senyal respiratòria mitjançant mètodes de vídeo per tal de verificar si és factible utilitzar una càmera de consum, no només per mesurar el senyal respiratori, sinó verificar si aquest tipus de hardware també pot ser emprat per obtenir el ritme respiratori. En aquest sentit, es presenta en aquest document un nou mètode d'adquisició de senyal respiratòria a distància basat en vídeo, el qual fa ús d'un patró ubicat al tòrax del subjecte per tal d'obtenir-ne la respiració. Un cop obtinguts els resultats del primers resultats, s'han analitzat tres tipus diferents de càmeres, amb la finalitat de caracteritzar-ne la viabilitat d'obtenir el senyal respiratori i la seva variabilitat. L'estudi comparatiu s'ha realitzat en termes de freqüència instantània, donat que permet caracteritzar els mètodes en termes de variabilitat respiratòria i comparar-los, en les mateixes condicions, amb el mètode de referencia. A continuació, s'ha presentat un nou mètode basat en una càmera de profunditat estèreo amb la finalitat de millorar i corregir les limitacions anteriors. El nou mètode proposat es basa en una arquitectura hibrida la qual utilitza els canals de vídeo infraroig i de profunditat de forma sincronitzada. El canal infraroig s'utilitza per detectar els moviments del subjecte dins l'escena i calcular, sota demanda, una regió d'interès que s'utilitza posteriorment en el canal de profunditat per extreure el senyal respiratori. A més a més, en aquest estudi s'ha utilitzat una aproximació oportunista en el processat del senyal respiratori, donat que també és un dels objectius d'aquest estudi, verificar si el fet d'utilitzar una aproximació més realista en l'adquisició de senyal, pot influir en la mesura del ritme respiratori. Tot i que el mètode anterior es mostra fiable en termes de mesura del ritme respiratori, la selecció oportunista del senyal necessita d’inspecció visual per tal de definir correctament cada fragment. Per aquest motiu, era necessari definir un índex de qualitat el qual permetés identificar de forma objectiva cada tram de senyal, així com detectar si el senyal conté errors. Partint de la idea de caracteritzar el moviment del subjecte de l'estudi anterior, i modificant el punt de mesura frontal cap a un de lateral per tal d'evitar oclusions, es proposa un nou mètode basat en l'obtenció del moviment toràcic-abdominal a partir del flux òptic del senyal de vídeo. Aquest mètode recupera el senyal respiratori del subjecte a partir de la fase del flux òptic, tot calculant un índex de qualitat a partir del mòdul. Finalment, i tenint en compte els diferents mètodes de processat utilitzats en aquesta tesi per tal de obtenir la freqüència instantània, es pot apreciar que cap d'ells és capaç de funcionar en temps real, fent inviable l'anàlisi de la variabilitat respiratòria en sistemes reals amb processat mostra a mostra. Per aquest motiu, en el capítol final d'aquesta tesi, s'ha proposat una nova implementació de la transformació "synchrosqueezing" per tal de realitzar l’anàlisi temporal-freqüencial en temps real, i proveir d'una nova eina per tal d'obtenir la variabilitat respiratòria en temps real, amb mètodes sense contacte

Remote Assessment of the Cardiovascular Function Using Camera-Based Photoplethysmography

Camera-based photoplethysmography (cbPPG) is a novel measurement technique that allows the continuous monitoring of vital signs by using common video cameras. In the last decade, the technology has attracted a lot of attention as it is easy to set up, operates remotely, and offers new diagnostic opportunities. Despite the growing interest, cbPPG is not completely established yet and is still primarily the object of research. There are a variety of reasons for this lack of development including that reliable and autonomous hardware setups are missing, that robust processing algorithms are needed, that application fields are still limited, and that it is not completely understood which physiological factors impact the captured signal. In this thesis, these issues will be addressed. A new and innovative measuring system for cbPPG was developed. In the course of three large studies conducted in clinical and non-clinical environments, the system’s great flexibility, autonomy, user-friendliness, and integrability could be successfully proven. Furthermore, it was investigated what value optical polarization filtration adds to cbPPG. The results show that a perpendicular filter setting can significantly enhance the signal quality. In addition, the performed analyses were used to draw conclusions about the origin of cbPPG signals: Blood volume changes are most likely the defining element for the signal's modulation. Besides the hardware-related topics, the software topic was addressed. A new method for the selection of regions of interest (ROIs) in cbPPG videos was developed. Choosing valid ROIs is one of the most important steps in the processing chain of cbPPG software. The new method has the advantage of being fully automated, more independent, and universally applicable. Moreover, it suppresses ballistocardiographic artifacts by utilizing a level-set-based approach. The suitability of the ROI selection method was demonstrated on a large and challenging data set. In the last part of the work, a potentially new application field for cbPPG was explored. It was investigated how cbPPG can be used to assess autonomic reactions of the nervous system at the cutaneous vasculature. The results show that changes in the vasomotor tone, i.e. vasodilation and vasoconstriction, reflect in the pulsation strength of cbPPG signals. These characteristics also shed more light on the origin problem. Similar to the polarization analyses, they support the classic blood volume theory. In conclusion, this thesis tackles relevant issues regarding the application of cbPPG. The proposed solutions pave the way for cbPPG to become an established and widely accepted technology

Imaging photoplethysmography: towards effective physiological measurements

Since its conception decades ago, Photoplethysmography (PPG) the non-invasive opto-electronic technique that measures arterial pulsations in-vivo has proven its worth by achieving and maintaining its rank as a compulsory standard of patient monitoring. However successful, conventional contact monitoring mode is not suitable in certain clinical and biomedical situations, e.g., in the case of skin damage, or when unconstrained movement is required. With the advance of computer and photonics technologies, there has been a resurgence of interest in PPG and one potential route to overcome the abovementioned issues has been increasingly explored, i.e., imaging photoplethysmography (iPPG). The emerging field of iPPG offers some nascent opportunities in effective and comprehensive interpretation of the physiological phenomena, indicating a promising alternative to conventional PPG. Heart and respiration rate, perfusion mapping, and pulse rate variability have been accessed using iPPG. To effectively and remotely access physiological information through this emerging technique, a number of key issues are still to be addressed. The engineering issues of iPPG, particularly the influence of motion artefacts on signal quality, are addressed in this thesis, where an engineering model based on the revised Beer-Lambert law was developed and used to describe opto-physiological phenomena relevant to iPPG. An iPPG setup consisting of both hardware and software elements was developed to investigate its reliability and reproducibility in the context of effective remote physiological assessment. Specifically, a first study was conducted for the acquisition of vital physiological signs under various exercise conditions, i.e. resting, light and heavy cardiovascular exercise, in ten healthy subjects. The physiological parameters derived from the images captured by the iPPG system exhibited functional characteristics comparable to conventional contact PPG, i.e., maximum heart rate difference was <3 bpm and a significant (p < 0.05) correlation between both measurements were also revealed. Using a method for attenuation of motion artefacts, the heart rate and respiration rate information was successfully assessed from different anatomical locations even in high-intensity physical exercise situations. This study thereby leads to a new avenue for noncontact sensing of vital signs and remote physiological assessment, showing clear and promising applications in clinical triage and sports training. A second study was conducted to remotely assess pulse rate variability (PRV), which has been considered a valuable indicator of autonomic nervous system (ANS) status. The PRV information was obtained using the iPPG setup to appraise the ANS in ten normal subjects. The performance of the iPPG system in accessing PRV was evaluated via comparison with the readings from a contact PPG sensor. Strong correlation and good agreement between these two techniques verify the effectiveness of iPPG in the remote monitoring of PRV, thereby promoting iPPG as a potential alternative to the interpretation of physiological dynamics related to the ANS. The outcomes revealed in the thesis could present the trend of a robust non-contact technique for cardiovascular monitoring and evaluation

Depressed Mood, Rumination, and Heart Rate Variability in At-Risk University Students

openBackground: Substantial evidence supports the association between rumination and depressive symptoms. Furthermore, autonomic dysregulation, as indexed by low levels of heart rate variability (HRV) is related to both maladaptive emotional regulation (e.g., rumination) and depressive symptoms. Aim of the study: The purpose of this study was to investigate the interplay between heart rate variability, rumination, and depressive symptoms. Specifically, this study focused on the possible moderating role of heart rate variability in the association between rumination and depression. Methods: 31 individuals took part in the study (10 males, 21 females). Self-report questionnaires were used to assess rumination and depressive symptoms (Ruminative Response Scale and Beck Depression Inventory-II, respectively). A time-domain measure of vagally mediated heart rate variability (rMSSD) was computed from short electrocardiogram recordings obtained through a smartphone-based photoelectric volumetric pulse wave assay. Results and conclusions: The findings of this study indicate that both rumination and vagally mediated HRV (as measured by rMSSD) are significantly associated with depressive symptoms. Specifically, those with greater rumination and those with lower heart rate variability exhibited higher levels of depressive symptoms. Additionally, the results demonstrate that the association between rumination and depression is moderated by heart rate variability: among individuals with greater rumination, those with reduced HRV had higher levels of depression. These findings highlight the complex interplay between autonomic dysregulation and cognitive dysfunctions involved in depressive symptoms. The study suggests the importance of considering both cognitive-affective (i.e., rumination) and autonomic (HRV) factors to improve the understanding of depression and develop targeted interventions for its management. Limitations of this study include its cross-sectional design, which restricts causal inferences and the assessment of predictive relationships, and the potential limitations introduced by conducting the study remotely, suggesting the need for future longitudinal research and replication in controlled laboratory settings

Morphological Variability Analysis of Physiologic Waveform for Prediction and Detection of Diseases

For many years it has been known that variability of the morphology of high-resolution (∼30-1000 Hz) physiological time series data provides additional prognostic value over lower resolution (≤ 1Hz) derived averages such as heart rate (HR), breathing rate (BR) and blood pressure (BP). However, the field has remained rather ad hoc, based on hand-crafted features. Using a model-based approach we explore the nature of these features and their sensitivity to variabilities introduced by changes in both the sampling period (HR) and observational reference frame (through breathing). HR and BR are determined as having a statistically significant confounding effect on the morphological variability (MV) evaluated in high-resolution physiological time series data, thus an important gap is identified in previous studies that ignored the effects of HR and BR when measuring MV. We build a best-in-class open-source toolbox for exploring MV that accounts for the confounding factors of HR and BR. We demonstrate the toolbox’s utility in three domains on three different signals: arterial BP in sepsis; photoplethysmogram in coarctation of the aorta; and electrocardiogram (ECG) in post-traumatic stress disorder (PTSD). In each of the three case studies, incorporating features that capture MV while controlling for BR and/or HR improved disease classification performance compared to previously established methods that used features from lower resolution time series data. Using the PTSD example, we then introduce a deep learning approach that significantly improves our ability to identify the effects of PTSD on ECG morphology. In particular, we show that pre-training the algorithm on a database of over 70,000 ECGs containing a set of 25 rhythms, allowed us to boost performance from an area under the receiver operating characteristic curve (AUROC) of 0.61 to 0.85. This novel approach to identifying morphology indicates that there is much more to morphological variability during stressful PTSD-related events than the simple periodic modulation of the T-wave amplitude. This research indicates that future work should focus on identifying the etiology of the dynamic features in the ECG that provided such a large boost in performance, since this may reveal novel underlying mechanisms of the influence of PTSD on the myocardium.Ph.D

Balancing the active power of a railway traction power substation with an sp-RPC

The railway system is one of the safest, most efficient, and environmentally friendly means of land transport for people and goods. However, as the demand for mobility has increased, the current railway system has shown some weaknesses, requiring an increase in catenary power in order to be able to supply power to longer trains and faster locomotives, as well as to increase rail traffic. This paper proposes a control algorithm to be implemented in a sectioning post-Rail Power Conditioner (sp-RPC). The sp-RPC is connected to the neutral section between two traction power substations (TPS). With the control algorithm, it is possible to minimize the existing unbalance of the active powers of each TPS. In a regenerative braking condition, this surplus energy can be used to assist the traction of another locomotive on the existing overhead line. In this way, it is possible to increase the capacity of the overhead line. The analysis was performed with computer models using a modular multilevel converter (MMC) topology for the sp-RPC. Quantitative results for different consumption events of the locomotives and the analysis of the response to these variations are presented.This work has been supported by FCT—Fundação para a Ciência e Tecnologia, within the R&D Units Project Scope UIDB/00319/2020. Luis A. M. Barros is supported by the doctoral scholarship PD/BD/143006/2018, granted by the Portuguese FCT foundation