Physics-Based Model-Guided Machine Learning Analysis of Wrist Ballistocardiography for Cuff-Less Blood Pressure Monitoring

Cuff-less blood pressure (BP) monitoring technology is being widely pursued today. In this research we investigated the wrist ballistocardiogram (BCG) as a limb BCG, to develop a scientific basis to use the limb BCG to for cuff-less BP monitoring. In our study, we pursue two alternative approaches to the use of wrist BCG signal for BP monitoring: (1) use of the wrist BCG as proximal timing in pulse transit time (PTT) based methods; (2) use of wrist BCG wave features for BP monitoring. In this regard, the physics-based model is developed to elucidate the mechanism responsible for the generation of the BCG signal at the body’s extremity limb locations. The developed and experimentally validated mathematical model can predict the limb BCG in responses to the arterial BP waves in the aorta. The model suggests that the limb BCG waveform reveals the timings and amplitudes associated with the aortic BP waves and it exhibits meaningful morphological changes in response to the alterations in the CV risk predictors. Such understanding combined with machine learning techniques has helped us to extract viable features, and construct predictive models that can estimate BP. The findings of this study show that limb BCG has the potential to realize convenient cuff-less BP monitoring. First, it is a strong candidate to extract the proximal timing for PTT based methods. Second, BCG wave features are associated with BP and it could be used for BP monitoring. Third, we can combine the PTT with BCG wave features to achieve more comprehensive prediction models with superior performance

Development of a bed-based nighttime monitoring toolset

Doctor of PhilosophyDepartment of Electrical and Computer EngineeringSteven WarrenA movement is occurring within the healthcare field towards evidence-based or preventative care-based medicine, which requires personalized monitoring solutions. For medical technologies to fit within this framework, they need to adapt. Reduced cost of operation, ease-of-use, durability, and acceptance will be critical design considerations that will determine their success. Wearable technologies have shown the capability to monitor physiological signals at a reduced cost, but they require consistent effort from the user. Innovative unobtrusive and autonomous monitoring technologies will be needed to make personalized healthcare a reality. Ballistocardiography, a nearly forgotten field, has reemerged as a promising alternative for unobtrusive physiological monitoring. Heart rate, heart rate variability, respiration rate, movement, and additional hemodynamic features can be estimated from the ballistocardiogram (BCG). This dissertation presents a bed-based nighttime monitoring toolset designed to monitor BCG, respiration, and movement data motivated by the need to quantify the sleep of children with severe disabilities and autism – a capability currently unmet by commercial systems. A review of ballistocardiography instrumentation techniques (Chapter 2) is presented to 1) build an understanding of how the forces generated by the heart are coupled to the measurement apparatus and 2) provide a background of the field. The choice of sensing modalities and acquisition hardware and software for developing the unobtrusive bed-based nighttime monitoring platform is outlined in Chapters 3 and 4. Preliminary results illustrating the system’s ability to track physiological signals are presented in Chapter 5. Analyses were conducted on overnight data acquired from three lower-functioning children with autism (Chapters 6 and 9) who reside at Heartspring, Wichita, KS, where results justified the platform’s multi-sensor architecture and demonstrated the system’s ability to track physiological signals from this sensitive population over many months. Further, this dissertation presents novel BCG signal processing techniques – a signal quality index (Chapter 7) and a preprocessing inverse filter (Chapter 8) that are applicable to any ballistocardiograph. The bed-based nighttime monitoring toolset outlined in this dissertation presents an unobtrusive, autonomous, robust physiological monitoring system that could be used in hospital-based or personalized, home-based medical applications that consist of short or long-term monitoring scenarios

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

Implementación y caracterización de un sistema inalámbrico para la medida de parámetros fisiológicos de manera no invasiva

We want to design a wireless system for measuring physiological parameters non-invasively. The system parameters will be obtained from the measurement of electrical (electrocardiogram (ECG)), and mechanical signals (ballistocardiogram (BCG)) of the body, acquired using a domestic scale and also through a node with an accelerometer sensor. The data acquired with a low-power microcontroller will be sent to a radiofrequency (RF) receiver connected to a PC, in which the measured signals will be observed. The project will study the effect of different mechanical interfaces in the measured signals and the feasibility of the integration of the different sensors in a wireless sensor network

Wearable and Nearable Biosensors and Systems for Healthcare

Biosensors and systems in the form of wearables and “nearables” (i.e., everyday sensorized objects with transmitting capabilities such as smartphones) are rapidly evolving for use in healthcare. Unlike conventional approaches, these technologies can enable seamless or on-demand physiological monitoring, anytime and anywhere. Such monitoring can help transform healthcare from the current reactive, one-size-fits-all, hospital-centered approach into a future proactive, personalized, decentralized structure. Wearable and nearable biosensors and systems have been made possible through integrated innovations in sensor design, electronics, data transmission, power management, and signal processing. Although much progress has been made in this field, many open challenges for the scientific community remain, especially for those applications requiring high accuracy. This book contains the 12 papers that constituted a recent Special Issue of Sensors sharing the same title. The aim of the initiative was to provide a collection of state-of-the-art investigations on wearables and nearables, in order to stimulate technological advances and the use of the technology to benefit healthcare. The topics covered by the book offer both depth and breadth pertaining to wearable and nearable technology. They include new biosensors and data transmission techniques, studies on accelerometers, signal processing, and cardiovascular monitoring, clinical applications, and validation of commercial devices

A multimodal imaging approach for quantitative assessment of epilepsy

Le tecniche di coregistrazione elettroencefalogramma-risonanza magnetica funzionale (EEG-fMRI) ed EEG ad alta densità (hdEEG) consentono di mappare attivazioni cerebrali anomale evocate da processi epilettici. L’EEG-fMRI è una tecnica di imaging non invasivo che permette la localizzazione delle variazioni del livello di ossigenazione nel sangue presente nelle regioni irritative (segnale BOLD). Diversamente, l’analisi di sorgente stima, a partire da un potenziale elettrico misurato sullo scalpo (EEG), la densità di corrente della sorgente elettrica a livello corticale producendo una plausibile localizzazione del dipolo nelle regioni irritative. Lo scopo di questa tesi è quello di sviluppare un approccio multimodale attraverso l’uso di dati di coregistrazione EEG-fMRI e hdEEG al fine di localizzare l’attività epilettica e verificare l’affidabilità sia dell’attivazione BOLD che della localizzazione della sorgente. Nel Capitolo I si introduce il concetto di approccio multimodale. Il capitolo è suddiviso principalmente in due parti: la prima descrive la tecnica di coregistrazione EEG-fMRI e la seconda la tecnica di localizzazione della sorgente in epilessia. La prima parte consiste in una breve analisi delle basi fisiologiche del dato di coregistrazione EEG-fMRI, nella descrizione di tecniche di registrazione simultanea e nell’introduzione del metodo convenzionale di analisi dei dati. Sono inoltre descritti problemi tecnici, problemi di sicurezza, modalità di scansione e strategie di rimozione degli artefatti EEG. È quindi presentata una panoramica sullo stato dell’arte delle coregistrazioni EEG-fMRI con discussione dei problemi aperti riguardanti l’analisi convenzionale. La seconda parte introduce i principi di base della stima delle sorgenti da dati hdEEG ed i loro limiti. Il primo capitolo fornisce un quadro generale, mentre i due capitoli successivi sono dedicati ad introdurre approcci di tipo diverso. Nell’analisi convenzionale di dati EEG-fMRI, l’apparizione di eventi interictali (IED) guida l’analisi dei dati fMRI. Il neurologo identifica gli intervalli degli eventi IED, che sono rappresentati da un’onda quadra, e successivamente questo protocollo viene convoluto con una risposta emodinamica (HRF) canonica per la costruzione di un modello o regressore da impiegare nell’analisi con modelli lineari generalizzati (GLM). I problemi principali dell’analisi convenzionale consistono nel fatto che essa non è automatica, ossia soffre di soggettività nella classificazione degli IED, e che, se la scelta dell’HRF non è ottimale, l’attivazione può essere sovra o sotto stimata. Il nuovo metodo proposto integra nell’analisi GLM convenzionale due nuove funzioni: il regressore basato sul segnale EEG (Capitolo II), e l’individuazione di una risposta emodinamica individual-based (ibHRF) (Capitolo III). Nel Capitolo IV le prestazioni del nuovo metodo per l’analisi di dati EEG-fMRI sono validate su dati in silico. A questo scopo sono stati creati dati fMRI simulati per testare la scelta dell’HRF ottima tra cinque modelli: quattro standard ed un modello HRF individual-based. Le prestazioni del metodo sono state valutate utilizzando come selezione il criterio di Akaike. Le simulazioni dimostrano la superiorità del nuovo metodo rispetto a quelli convenzionali e mostrano come la variazione del modello HRF influisce sui risultati dell’analisi statistica. Il Capitolo V introduce un criterio automatico volto a separare le componenti del segnale fMRI relative a network interni dal rumore. Dopo il processo di decomposizione probabilistico delle componenti indipendenti (PICA), si seleziona il numero ottimale di componenti applicando un nuovo algoritmo che tiene conto, per ciascuna componente, dei valori medi delle mappe spaziali di attivazione seguito da passaggi di clustering, segmentazione ed analisi spettrale. Confrontando i risultati dell’identificazione visiva dei network neuronali con i risultati di quella automatica, l’algoritmo mostra elevata accuratezza e precisione. In questo modo, il metodo di selezione automatica permette di separare ed individuare i network in stato di riposo, riducendo la soggettività nella valutazione delle componenti indipendenti. Nel Capitolo VI sono descritti il design sperimentale e l’analisi dei dati reali. Il capitolo illustra i risultati di dodici pazienti epilettici, concentrandosi sull’attività BOLD, sulla localizzazione della sorgente e sulla concordanza con il quadro clinico del paziente. Lo scopo è quello di applicare un approccio multimodale che combini tecniche non invasive di acquisizione ed analisi. Sequenze di EEG standard e fMRI sono acquisite nel corso della stessa sessione di scansione. L’analisi dei dati EEG-fMRI è eseguita utilizzando l’approccio GLM tradizionale, il nuovo approccio e l’analisi PICA. La sorgente dell’attività epilettica è stimata a partire da tracciati EEG a 256-canali. L’attivazione BOLD è confrontata con la ricostruzione della sorgente EEG. Questi risultati sono infine confrontati con l’attività epilettica definita da EEG standard ed esiti clinici. La combinazione di tecniche multimodali ed i loro rispettivi metodi di analisi sono strumenti utili per creare un workup prechirurgico completo dell’epilessia, fornendo diversi metodi di localizzazione dello stesso focolaio epilettico. L’approccio non invasivo di integrazione multimodale di dati EEG-fMRI e hdEEG sembra essere uno strumento molto promettente per lo studio delle scariche epilettiche.Electroencephalography-functional magnetic resonance imaging (EEG-fMRI) coregistration and high density EEG (hdEEG) can be combined to noninvasively map abnormal brain activation elicited by epileptic processes. EEG-fMRI can provide information on the pathophysiological processes underlying interictal activity, since the hemodynamic changes are a consequence of the abnormal neural activity generating interictal epileptiform discharges (IEDs). The source analysis estimates the current density of the source that generates a measured electric potential and it yields a plausible dipole localization of irritative regions. The aim of this thesis is to develop a multimodal approach with hdEEG and EEG-fMRI coregistration in order to localize the epileptic activity and to verify the reliability of source localization and BOLD activation. In Chapter I the multimodal approach is introduced. The chapter is divided in two main parts: the first is based on EEG-fMRI coregistration and the second on the source localization in epilepsy. The first part consists of a brief review of the physiologic basis of EEG and fMRI and the technical basics of simultaneous recording, examining the conventional method for EEG-fMRI data. Technical challenges, safety issues, scanning modalities and EEG artifact removal strategies are also described. An overview of the state of EEG-fMRI is presented and the open problems of conventional analysis are discussed. The second part introduces the basic principles of the source estimation from EEG data in epilepsy and their limitations. The first chapter provides a general framework. The next two are devoted to introduce different approaches. Conventional analysis of EEG-fMRI data relies on spike-timing of epileptic activity: the neurologist identifies the intervals of the IEDs events, as represented by a square wave; this protocol is then convolved with a canonical hemodynamic response function (HRF) to construct a model for the general linear model (GLM) analysis. There are limitations to the technique, however. The conventional analysis is not automatic, suffers of subjectivity in IEDs classification, and using a suboptimal HRF to model the BOLD response the activation map may result over or under estimated. The novel method purposed integrates in the conventional GLM two new features: the regressor based on the EEG signal (Chapter II) and the individual-based hemodynamic response function (ibHRF) (Chapter III). In Chapter IV the performance of the novel method of EEG-fMRI data was tested on in silico data. Simulated fMRI datasets were created and used for the choice of the optimal HRF among five models: four standard and an individual-based HRF models. The performance of the method was evaluated using the Akaike information criterion as selection. Simulations would demonstrate the superiority of the novel method compared with the conventional ones and assess how the variations in HRF model affect the results of the statistical analysis. Chapter V introduces an automatic criterion aiming to separate in fMRI data the signal related to an internal network from the noise. After the decomposition process (probabilistic independent component analysis [PICA]), the optimal number of components was selected by applying a novel algorithm which takes into account, for each component, the mean values of the spatial activation maps followed by clustering, segmentation and spectral analysis steps. Comparing visual and automatic identification of the neuronal networks, the algorithm demonstrated high accuracy and precision. Thus, the automatic selection method allows to separate and detect the resting state networks reducing the subjectivity of the independent component assessment. In Chapter VI experimental design and analysis on real data are described. The chapter focuses on BOLD activity, source localization and agreement with the clinical history of twelve epileptic patients. The scope is to apply a multimodal approach combining noninvasive techniques of acquisition and analysis. Standard EEG and fMRI data were acquired during a single scanning session. The analysis of EEG-fMRI data was performed by using both the conventional GLM, the new GLM and the PICA. Source localization of IEDs was performed using 256-channels hdEEG. BOLD localizations were then compared to the EEG source reconstruction and to the expected epileptic activity defined by standard EEG and clinical outcome. The combination of multimodal techniques and their respectively methods of analysis are useful tools in the presurgical workup of epilepsy providing different methods of localization of the same epileptic foci. Furthermore, the combined use of EEG-fMRI and hdEEG offers a new and more complete approach to the study of epilepsy and may play an increasingly important role in the evaluation of patients with refractory focal epilepsy

Wearable and BAN Sensors for Physical Rehabilitation and eHealth Architectures

The demographic shift of the population towards an increase in the number of elderly citizens, together with the sedentary lifestyle we are adopting, is reflected in the increasingly debilitated physical health of the population. The resulting physical impairments require rehabilitation therapies which may be assisted by the use of wearable sensors or body area network sensors (BANs). The use of novel technology for medical therapies can also contribute to reducing the costs in healthcare systems and decrease patient overflow in medical centers. Sensors are the primary enablers of any wearable medical device, with a central role in eHealth architectures. The accuracy of the acquired data depends on the sensors; hence, when considering wearable and BAN sensing integration, they must be proven to be accurate and reliable solutions. This book is a collection of works focusing on the current state-of-the-art of BANs and wearable sensing devices for physical rehabilitation of impaired or debilitated citizens. The manuscripts that compose this book report on the advances in the research related to different sensing technologies (optical or electronic) and body area network sensors (BANs), their design and implementation, advanced signal processing techniques, and the application of these technologies in areas such as physical rehabilitation, robotics, medical diagnostics, and therapy

Smart Sensors for Healthcare and Medical Applications

This book focuses on new sensing technologies, measurement techniques, and their applications in medicine and healthcare. Specifically, the book briefly describes the potential of smart sensors in the aforementioned applications, collecting 24 articles selected and published in the Special Issue “Smart Sensors for Healthcare and Medical Applications”. We proposed this topic, being aware of the pivotal role that smart sensors can play in the improvement of healthcare services in both acute and chronic conditions as well as in prevention for a healthy life and active aging. The articles selected in this book cover a variety of topics related to the design, validation, and application of smart sensors to healthcare

Functional MRI of focal and generalised interictal epileptiform discharges.

Localizing the source of epileptic discharges is important in gaining a greater understanding of the disease, classifying epilepsy, and identifying areas suitable for potentially curable surgical resection. Functional imaging measures haemodynamic, metabolic or neurochemical correlates to localise neural activity. Combining EEG with functional MRI (EEG-fMRI) allows the localisation of haemodynamic correlates of neuronal events recorded on surface EEG. The work in this thesis aims to identify the spatial haemodynamic correlates of interictal epileptiform discharges (IED) in patients with epilepsy using EEG-fMRI. Five studies form the main body of this thesis. In the first study, 46 patients with frequent generalised spike wave activity (GSW) were studied with EEG-fMRI on a 1.5 Tesla scanner. The main finding was of a characteristic pattern of fMRI signal decrease in frontal, parietal and posterior cingulate cortex, areas of association cortex, during GSW. In the second study, 4 patients from this first series were re-studied with a 3 Tesla scanner. A high degree of reproducibility was seen in the spatial distribution of fMRI changes. Perfusion MRI with an arterial spin label sequence was used that showed a decrease in blood flow to these areas during GSW. In the third study, a novel method for the analysis of fMRI data in epilepsy, temporal clustering analysis (TCA) was assessed. The technique was confounded by subject motion, and we were unable to reliably detect correlates of IED. The fourth study moves away from correlating visually identified IEDs on the EEG, and correlates power fluctuations in the delta frequency band with simultaneously acquired fMRI. Finally a combination of EEG-fMRI and MR tractography were used to study a patient with temporal lobe epilepsy. The issues surrounding potential use of EEG-fMRI as a clinical tool are discussed

Aerospace medicine and biology, an annotated bibliography. volume xi- 1962-1963 literature

Aerospace medicine and biology - annotated bibliography for 1962 and 196