A review of biophysiological and biochemical indicators of stress for connected and preventive healthcare

Stress is a known contributor to several life-threatening medical conditions and a risk factor for triggering acute cardiovascular events, as well as a root cause of several social problems. The burden of stress is increasing globally and, with that, is the interest in developing effective stress-monitoring solutions for preventive and connected health, particularly with the help of wearable sensing technologies. The recent development of miniaturized and flexible biosensors has enabled the development of connected wearable solutions to monitor stress and intervene in time to prevent the progression of stress-induced medical conditions. This paper presents a review of the literature on different physiological and chemical indicators of stress, which are commonly used for quantitative assessment of stress, and the associated sensing technologies

Recent Trends in Computational Research on Diseases

Recent advances in information technology have brought forth a paradigm shift in science, especially in the biology and medical fields. Statistical methodologies based on high-performance computing and big data analysis are now indispensable for the qualitative and quantitative understanding of experimental results. In fact, the last few decades have witnessed drastic improvements in high-throughput experiments in health science, for example, mass spectrometry, DNA microarray, next generation sequencing, etc. Those methods have been providing massive data involving four major branches of omics (genomics, transcriptomics, proteomics, and metabolomics). Information about amino acid sequences, protein structures, and molecular structures are fundamental data for the prediction of bioactivity of chemical compounds when screening drugs. On the other hand, cell imaging, clinical imaging, and personal healthcare devices are also providing important data concerning the human body and disease. In parallel, various methods of mathematical modelling such as machine learning have developed rapidly. All of these types of data can be utilized in computational approaches to understand disease mechanisms, diagnosis, prognosis, drug discovery, drug repositioning, disease biomarkers, driver mutations, copy number variations, disease pathways, and much more. In this Special Issue, we have published 8 excellent papers dedicated to a variety of computational problems in the biomedical field from the genomic level to the whole-person physiological level

Novel Approaches to Pervasive and Remote Sensing in Cardiovascular Disease Assessment

Cardiovascular diseases (CVDs) are the leading cause of death worldwide, responsible for 45% of all deaths. Nevertheless, their mortality is decreasing in the last decade due to better prevention, diagnosis, and treatment resources. An important medical instrument for the latter processes is the Electrocardiogram (ECG). The ECG is a versatile technique used worldwide for its ease of use, low cost, and accessibility, having evolved from devices that filled up a room, to small patches or wrist- worn devices. Such evolution allowed for more pervasive and near-continuous recordings. The analysis of an ECG allows for studying the functioning of other physiological systems of the body. One such is the Autonomic Nervous System (ANS), responsible for controlling key bodily functions. The ANS can be studied by analyzing the characteristic inter-beat variations, known as Heart Rate Variability (HRV). Leveraging this relation, a pilot study was developed, where HRV was used to quantify the contribution of the ANS in modulating cardioprotection offered by an experimental medical procedure called Remote Ischemic Conditioning (RIC), offering a more objective perspective. To record an ECG, electrodes are responsible for converting the ion-propagated action potential to electrons, needed to record it. They are produced from different materials, including metal, carbon-based, or polymers. Also, they can be divided into wet (if an elec- trolyte gel is used) or dry (if no added electrolyte is used). Electrodes can be positioned either inside the body (in-the-person), attached to the skin (on-the-body), or embedded in daily life objects (off-the-person), with the latter allowing for more pervasive recordings. To this effect, a novel mobile acquisition device for recording ECG rhythm strips was developed, where polymer-based embedded electrodes are used to record ECG signals similar to a medical-grade device. One drawback of off-the-person solutions is the increased noise, mainly caused by the intermittent contact with the recording surfaces. A new signal quality metric was developed based on delayed phase mapping, a technique that maps time series to a two-dimensional space, which is then used to classify a segment into good or noisy. Two different approaches were developed, one using a popular image descriptor, the Hu image moments; and the other using a Convolutional Neural Network, both with promising results for their usage as signal quality index classifiers.As doenças cardiovasculares (DCVs) são a principal causa de morte no mundo, res- ponsáveis por 45% de todas estas. No entanto, a sua mortalidade tem vindo a diminuir na última década, devido a melhores recursos na prevenção, diagnóstico e tratamento. Um instrumento médico importante para estes recursos é o Eletrocardiograma (ECG). O ECG é uma técnica versátil utilizada em todo o mundo pela sua facilidade de uso, baixo custo e acessibilidade, tendo evoluído de dispositivos que ocupavam uma sala inteira para pequenos adesivos ou dispositivos de pulso. Tal evolução permitiu aquisições mais pervasivas e quase contínuas. A análise de um ECG permite estudar o funcionamento de outros sistemas fisiológi- cos do corpo. Um deles é o Sistema Nervoso Autônomo (SNA), responsável por controlar as principais funções corporais. O SNA pode ser estudado analisando as variações inter- batidas, conhecidas como Variabilidade da Frequência Cardíaca (VFC). Aproveitando essa relação, foi desenvolvido um estudo piloto, onde a VFC foi utilizada para quantificar a contribuição do SNA na modulação da cardioproteção oferecida por um procedimento mé- dico experimental, denominado Condicionamento Isquêmico Remoto (CIR), oferecendo uma perspectiva mais objetiva. Na aquisição de um ECG, os elétrodos são os responsáveis por converter o potencial de ação propagado por iões em eletrões, necessários para a sua recolha. Estes podem ser produzidos a partir de diferentes materiais, incluindo metal, à base de carbono ou polímeros. Além disso, os elétrodos podem ser classificados em húmidos (se for usado um gel eletrolítico) ou secos (se não for usado um eletrólito adicional). Os elétrodos podem ser posicionados dentro do corpo (dentro-da-pessoa), colocados em contacto com a pele (na-pessoa) ou embutidos em objetos da vida quotidiana (fora-da-pessoa), sendo que este último permite gravações mais pervasivas . Para este efeito, foi desenvolvido um novo dispositivo de aquisição móvel para gravar sinal de ECG, onde elétrodos embutidos à base de polímeros são usados para recolher sinais de ECG semelhantes a um dispositivo de grau médico. Uma desvantagem das soluções onde os elétrodos estão embutidos é o aumento do ruído, causado principalmente pelo contato intermitente com as superfícies de aquisição. Uma nova métrica de qualidade de sinal foi desenvolvida com base no mapeamento de fase atrasada, uma técnica que mapeia séries temporais para um espaço bidimensional, que é então usado para classificar um segmento em bom ou ruidoso. Duas abordagens diferentes foram desenvolvidas, uma usando um popular descritor de imagem, e outra utilizando uma Rede Neural Convolucional, com resultados promissores para o seu uso como classificadores de qualidade de sinal

A practical bedsheet system for the non-contact and continuous monitoring of heart electric activities.

Wu, Kin Fai.Thesis (M.Phil.)--Chinese University of Hong Kong, 2008.Includes bibliographical references (leaves 88-91).Abstracts in English and Chinese.Abstract --- p.i槪要 --- p.iiAcknowledgements --- p.iiiTable of Contents --- p.ivList of Figures --- p.viList of Tables --- p.xChapter Chapter 1 --- Introduction --- p.1Chapter 1.1 --- Motivation --- p.1Chapter 1.2 --- Outline of the Proposed Design --- p.2Chapter 1.3 --- Purposes of the Present Study --- p.2Chapter Chapter 2 --- Background and Literature Review --- p.4Chapter 2.1 --- Electrocardiogram --- p.4Chapter 2.2 --- Conventional ECG Measurement --- p.7Chapter 2.3 --- Heart Rate --- p.8Chapter 2.4 --- Heart Rate Variability --- p.9Chapter 2.5 --- Capacitive Sensing --- p.11Chapter 2.6 --- Review of ECG Monitoring System by Capacitive Sensing On a Sleeping Bed --- p.14Chapter Chapter 3 --- System Design and Implementation --- p.17Chapter 3.1 --- Hardware --- p.17Chapter 3.1.1 --- Bedsheet Sensor --- p.17Chapter 3.1.2 --- Pre-amplifier --- p.21Chapter 3.1.3 --- Measuring Device --- p.30Chapter 3.1.4 --- Power Supply & PCB Layout --- p.49Chapter 3.2 --- Software --- p.52Chapter 3.2.1 --- Detection of R Waves --- p.52Chapter 3.2.2 --- Tracking of HR & Mean RR Intervals --- p.55Chapter 3.2.3 --- Estimation of Signal-to-Noise Ratios --- p.56Chapter Chapter 4 --- Preliminary Tests on the Functionality of the Proposed System --- p.57Chapter 4.1 --- Test I - Test on the Arrangement of Electrodes --- p.57Chapter 4.1.1 --- Methods --- p.57Chapter 4.1.2 --- Results --- p.60Chapter 4.2 --- Test II - Test on the ECG Measurement of Subjects in Different Sleeping Postures --- p.64Chapter 4.2.1 --- Methods --- p.64Chapter 4.2.2 --- Results --- p.65Chapter Chapter 5 --- Experiments on the Performance of Continuous Monitoring of ECG and HR --- p.69Chapter 5.1 --- Experiment I - Experiment on the Reliability of the Proposed System for Continuous Monitoring of ECG and HR on Thirty Subjects --- p.69Chapter 5.1.1 --- Methods --- p.70Chapter 5.1.2 --- Results --- p.70Chapter 5.2 --- Experiment II - Experiment on the Feasibility of the Proposed System for Continuous Monitoring of ECG and HR on a Subject During an Eight-hour Sleep --- p.75Chapter 5.2.1 --- Materials --- p.76Chapter 5.2.2 --- Methods --- p.76Chapter 5.2.3 --- Results --- p.77Chapter Chapter 6 --- Discussions --- p.81Chapter 6.1 --- Selection of the Passband of the Proposed Circuit --- p.81Chapter 6.2 --- Arrangement of Electrodes on the Bedsheet --- p.82Chapter 6.3 --- Practical Design of Electrodes --- p.83Chapter 6.4 --- Performance of Continuous Monitoring of HR by Using the Proposed System --- p.84Chapter Chapter 7 --- Conclusion --- p.86References --- p.8

Modeling Cardiovascular Patient Pathways in an Accident and Emergency Department from a System Dynamic Perspective Using a Patient Oriented Modeling Approach

This thesis provides a detailed overview of a system dynamics model that focuses on the accident and emergency department and the clinical pathways of cardiovascular patients at Haukeland University hospital. A patient-oriented approach was chosen and sub-models representing patient attributes and accident and emergency resources were developed based on this approach. The simulation model illustrates accident and emergency processes and patient attributes in a disaggregated system. In addition to System Dynamics, other modeling concepts facilitated the modeling process. This included object-based and discrete event modeling concepts where object-based modeling concepts were used to create interactive objects, and stock and flow structures were constructed to be discrete in time and space. As such, the model is considered a hybrid model. The model serves as a network of resources aiding the patient in the most appropriate direction in order to place him or her in the right location at the right time. The patient-oriented modeling approach has proven useful, as it has enabled a systematic observation on the emergence of various cardiovascular pathways based on patient attributes incorporated in the model. The use of objects to represent attributes and AED processes make this model a unique take on System Dynamics. The attributes arising from the model were built on predetermined values in the form of graphical functions, enabling scenario testing to capture the resources the patient claimed in the AED. To this end, a successful simulation model has been created that permits a detailed observation of clinical pathways for cardiovascular patients.Masteroppgave i systemdynamikkGEO-SD350MASV-SYSD

A Basic Study on the Development of Ear-type Smart Monitor for Healthcare

13301甲第4039号博士（工学）金沢大学博士論文本文Ful

Multimodal assessment of emotional responses by physiological monitoring: novel auditory and visual elicitation strategies in traditional and virtual reality environments

This doctoral thesis explores novel strategies to quantify emotions and listening effort through monitoring of physiological signals. Emotions are a complex aspect of the human experience, playing a crucial role in our survival and adaptation to the environment. The study of emotions fosters important applications, such as Human-Computer and Human-Robot interaction or clinical assessment and treatment of mental health conditions such as depression, anxiety, stress, chronic anger, and mood disorders. Listening effort is also an important area of study, as it provides insight into the listeners’ challenges that are usually not identified by traditional audiometric measures. The research is divided into three lines of work, each with a unique emphasis on the methods of emotion elicitation and the stimuli that are most effective in producing emotional responses, with a specific focus on auditory stimuli. The research fostered the creation of three experimental protocols, as well as the use of an available online protocol for studying emotional responses including monitoring of both peripheral and central physiological signals, such as skin conductance, respiration, pupil dilation, electrocardiogram, blood volume pulse, and electroencephalography. An emotional protocol was created for the study of listening effort using a speech-in-noise test designed to be short and not induce fatigue. The results revealed that the listening effort is a complex problem that cannot be studied with a univariate approach, thus necessitating the use of multiple physiological markers to study different physiological dimensions. Specifically, the findings demonstrate a strong association between the level of auditory exertion, the amount of attention and involvement directed towards stimuli that are readily comprehensible compared to those that demand greater exertion. Continuing with the auditory domain, peripheral physiological signals were studied in order to discriminate four emotions elicited in a subject who listened to music for 21 days, using a previously designed and publicly available protocol. Surprisingly, the processed physiological signals were able to clearly separate the four emotions at the physiological level, demonstrating that music, which is not typically studied extensively in the literature, can be an effective stimulus for eliciting emotions. Following these results, a flat-screen protocol was created to compare physiological responses to purely visual, purely auditory, and combined audiovisual emotional stimuli. The results show that auditory stimuli are more effective in separating emotions at the physiological level. The subjects were found to be much more attentive during the audio-only phase. In order to overcome the limitations of emotional protocols carried out in a laboratory environment, which may elicit fewer emotions due to being an unnatural setting for the subjects under study, a final emotional elicitation protocol was created using virtual reality. Scenes similar to reality were created to elicit four distinct emotions. At the physiological level, it was noted that this environment is more effective in eliciting emotions. To our knowledge, this is the first protocol specifically designed for virtual reality that elicits diverse emotions. Furthermore, even in terms of classification, the use of virtual reality has been shown to be superior to traditional flat-screen protocols, opening the doors to virtual reality for the study of conditions related to emotional control