Fast and Robust Real-Time Estimation of Respiratory Rate from Photoplethysmography

Respiratory rate (RR) is a useful vital sign that can not only provide auxiliary information on physiological changes within the human body, but also indicate early symptoms of various diseases. Recently, methods for the estimation of RR from photoplethysmography (PPG) have attracted increased interest, because PPG can be readily recorded using wearable sensors such as smart watches and smart bands. In the present study, we propose a new method for the fast and robust real-time estimation of RR using an adaptive infinite impulse response (IIR) notch filter, which has not yet been applied to the PPG-based estimation of RR. In our offline simulation study, the performance of the proposed method was compared to that of recently developed RR estimation methods called an adaptive lattice-type RR estimator and a Smart Fusion. The results of the simulation study show that the proposed method could not only estimate RR more quickly and more accurately than the conventional methods, but also is most suitable for online RR monitoring systems, as it does not use any overlapping moving windows that require increased computational costs. In order to demonstrate the practical applicability of the proposed method, an online RR estimation system was implemented.This research was supported by the National Research Foundation of Korea (NRF) grants funded by the Ministry of Science, ICT & Future Planning (MSIP) (NRF-2015M3C7A1065052 and 2015R1A2A1A15054662)

Research progress on wearable devices for daily human health management

As the public’s demand for portable access to personal health information continues to expand, wearable devices are not only widely used in clinical practice, but also gradually applied to the daily health management of ordinary families due to their intelligence, miniaturization, and portability. This paper searches the literature of wearable devices through PubMed and CNKI databases, classifies them according to the different functions realized by wearable devices, and briefly describes the algorithms and specific analysis methods of their applications and made a prospect of its development trend in the field of human health

A pervasive system for real-time blood pressure monitoring

Tese de Mestrado Integrado. Engenharia Electrotécnica e de Computadores. Faculdade de Engenharia. Universidade do Porto. 201

Data science for health-care: Patient condition recognition

>Magister Scientiae - MScThe emergence of the Internet of Things (IoT) and Artificial Intelligence (AI) have elicited increased interest in many areas of our daily lives. These include health, agriculture, aviation, manufacturing, cities management and many others. In the health sector, portable vital sign monitoring devices are being developed using the IoT technology to collect patients’ vital signs in real-time. The vital sign data acquired by wearable devices is quantitative and machine learning techniques can be applied to find hidden patterns in the dataset and help the medical practitioner with decision making. There are about 30000 diseases known to man and no human being can possibly remember all of them, their relations to other diseases, their symptoms and whether the symptoms exhibited by the patients are early warnings of a fatal disease. In light of this, Medical Decision Support Systems (MDSS) can provide assistance in making these crucial assessments. In most decision support systems factors a ect each other; they can be contradictory, competitive, and complementary. All these factors contribute to the overall decision and have di erent degrees of influence [85]. However, while there is more need for automated processes to improve the health-care sector, most of MDSS and the associated devices are still under clinical trials. This thesis revisits cyber physical health systems (CPHS) with the objective of designing and implementing a data analytics platform that provides patient condition monitoring services in terms of patient prioritisation and disease identification [1]. Di erent machine learning algorithms are investigated by the platform as potential candidate for achieving patient prioritisation. These include multiple linear regression, multiple logistic regression, classification and regression decision trees, single hidden layer neural networks and deep neural networks. Graph theory concepts are used to design and implement disease identification. The data analytics platform analyses data from biomedical sensors and other descriptive data provided by the patients (this can be recent data or historical data) stored in a cloud which can be private local health Information organisation (LHIO) or belonging to a regional health information organisation (RHIO). Users of the data analytics platform consisting of medical practitioners and patients are assumed to interact with the platform through cities’ pharmacies , rural E-Health kiosks end user applications

Methods for monitoring the human circadian rhythm in free-living

Our internal clock, the circadian clock, determines at which time we have our best cognitive abilities, are physically strongest, and when we are tired. Circadian clock phase is influenced primarily through exposure to light. A direct pathway from the eyes to the suprachiasmatic nucleus, where the circadian clock resides, is used to synchronise the circadian clock to external light-dark cycles. In modern society, with the ability to work anywhere at anytime and a full social agenda, many struggle to keep internal and external clocks synchronised. Living against our circadian clock makes us less efficient and poses serious health impact, especially when exercised over a long period of time, e.g. in shift workers. Assessing circadian clock phase is a cumbersome and uncomfortable task. A common method, dim light melatonin onset testing, requires a series of eight saliva samples taken in hourly intervals while the subject stays in dim light condition from 5 hours before until 2 hours past their habitual bedtime. At the same time, sensor-rich smartphones have become widely available and wearable computing is on the rise. The hypothesis of this thesis is that smartphones and wearables can be used to record sensor data to monitor human circadian rhythms in free-living. To test this hypothesis, we conducted research on specialised wearable hardware and smartphones to record relevant data, and developed algorithms to monitor circadian clock phase in free-living. We first introduce our smart eyeglasses concept, which can be personalised to the wearers head and 3D-printed. Furthermore, hardware was integrated into the eyewear to recognise typical activities of daily living (ADLs). A light sensor integrated into the eyeglasses bridge was used to detect screen use. In addition to wearables, we also investigate if sleep-wake patterns can be revealed from smartphone context information. We introduce novel methods to detect sleep opportunity, which incorporate expert knowledge to filter and fuse classifier outputs. Furthermore, we estimate light exposure from smartphone sensor and weather in- formation. We applied the Kronauer model to compare the phase shift resulting from head light measurements, wrist measurements, and smartphone estimations. We found it was possible to monitor circadian phase shift from light estimation based on smartphone sensor and weather information with a weekly error of 32±17min, which outperformed wrist measurements in 11 out of 12 participants. Sleep could be detected from smartphone use with an onset error of 40±48 min and wake error of 42±57 min. Screen use could be detected smart eyeglasses with 0.9 ROC AUC for ambient light intensities below 200lux. Nine clusters of ADLs were distinguished using Gaussian mixture models with an average accuracy of 77%. In conclusion, a combination of the proposed smartphones and smart eyeglasses applications could support users in synchronising their circadian clock to the external clocks, thus living a healthier lifestyle

Efficient fetal-maternal ECG signal separation from two channel maternal abdominal ECG via diffusion-based channel selection

There is a need for affordable, widely deployable maternal-fetal ECG monitors to improve maternal and fetal health during pregnancy and delivery. Based on the diffusion-based channel selection, here we present the mathematical formalism and clinical validation of an algorithm capable of accurate separation of maternal and fetal ECG from a two channel signal acquired over maternal abdomen

Monitoring Fetal Heart Rate during Pregnancy: Contributions from Advanced Signal Processing and Wearable Technology

Monitoring procedures are the basis to evaluate the clinical state of patients and to assess changes in their conditions, thus providing necessary interventions in time. Both these two objectives can be achieved by integrating technological development with methodological tools, thus allowing accurate classification and extraction of useful diagnostic information. The paper is focused on monitoring procedures applied to fetal heart rate variability (FHRV) signals, collected during pregnancy, in order to assess fetal well-being. The use of linear time and frequency techniques as well as the computation of non linear indices can contribute to enhancing the diagnostic power and reliability of fetal monitoring. The paper shows how advanced signal processing approaches can contribute to developing new diagnostic and classification indices. Their usefulness is evaluated by comparing two selected populations: normal fetuses and intra uterine growth restricted (IUGR) fetuses. Results show that the computation of different indices on FHRV signals, either linear and nonlinear, gives helpful indications to describe pathophysiological mechanisms involved in the cardiovascular and neural system controlling the fetal heart. As a further contribution, the paper briefly describes how the introduction of wearable systems for fetal ECG recording could provide new technological solutions improving the quality and usability of prenatal monitoring. © 2014 Maria G. Signorini et al

A Novel Electrocardiogram Segmentation Algorithm Using a Multiple Model Adaptive Estimator

This thesis presents a novel electrocardiogram (ECG) processing algorithm design based on a Multiple Model Adaptive Estimator (MMAE) for a physiological monitoring system. Twenty ECG signals from the MIT ECG database were used to develop system models for the MMAE. The P-wave, QRS complex, and T-wave segments from the characteristic ECG waveform were used to develop hypothesis filter banks. By adding a threshold filter-switching algorithm to the conventional MMAE implementation, the device mimics the way a human analyzer searches the complex ECG signal for a useable temporal landmark and then branches out to find the other key wave components and their timing. The twenty signals and an additional signal from an animal exsanuinaiton experiment were then used to test the algorithm. Using a conditional hypothesis-testing algorithm, the MMAE correctly identified the ECG signal segments corresponding to the hypothesis models with a 96.8% accuracy-rate for the 11539 possible segments tested. The robust MMAE algorithm also detected any misalignments in the filter hypotheses and automatically restarted filters within the MMAE to synchronize the hypotheses with the incoming signal. Finally, the MMAE selects the optimal filter bank based on incoming ECG measurements. The algorithm also provides critical heart-related information such as heart rate, QT, and PR intervals from the ECG signal. This analyzer could be easily added as a software update to the standard physiological monitors universally used in emergency vehicles and treatment facilities and potentially saving thousands of lives and reducing the pain and suffering of the injured

Security and privacy services based on biosignals for implantable and wearable device

Mención Internacional en el título de doctorThe proliferation of wearable and implantable medical devices has given rise to an interest in developing security schemes suitable for these devices and the environment in which they operate. One area that has received much attention lately is the use of (human) biological signals as the basis for biometric authentication, identification and the generation of cryptographic keys. More concretely, in this dissertation we use the Electrocardiogram (ECG) to extract some fiducial points which are later used on crytographic protocols. The fiducial points are used to describe the points of interest which can be extracted from biological signals. Some examples of fiducials points of the ECG are P-wave, QRS complex,T-wave, R peaks or the RR-time-interval. In particular, we focus on the time difference between two consecutive heartbeats (R-peaks). These time intervals are referred to as Inter-Pulse Intervals (IPIs) and have been proven to contain entropy after applying some signal processing algorithms. This process is known as quantization algorithm. Theentropy that the heart signal has makes the ECG values an ideal candidate to generate tokens to be used on security protocols. Most of the proposed solutions in the literature rely on some questionable assumptions. For instance, it is commonly assumed that it possible to generate the same cryptographic token in at least two different devices that are sensing the same signal using the IPI of each cardiac signal without applying any synchronization algorithm; authors typically only measure the entropy of the LSB to determine whether the generated cryptographic values are random or not; authors usually pick the four LSBs assuming they are the best ones to create the best cryptographic tokens; the datasets used in these works are rather small and, therefore, possibly not significant enough, or; in general it is impossible to reproduce the experiments carried out by other researchers because the source code of such experiments is not usually available. In this Thesis, we overcome these weaknesses trying to systematically address most of the open research questions. That is why, in all the experiments carried out during this research we used a public database called PhysioNet which is available on Internet and stores a huge heart database named PhysioBank. This repository is constantly being up dated by medical researchers who share the sensitive information about patients and it also offers an open source software named PhysioToolkit which can be used to read and display these signals. All datasets we used contain ECG records obtained from a variety of real subjects with different heart-related pathologies as well as healthy people. The first chapter of this dissertation (Chapter 1) is entirely dedicated to present the research questions, introduce the main concepts used all along this document as well as settle down some medical and cryptographic definitions. Finally, the objectives that this dissertation tackles down are described together with the main motivations for this Thesis. In Chapter 2 we report the results of a large-scale statistical study to determine if heart signal is a good source of entropy. For this, we analyze 19 public datasets of heart signals from the Physionet repository, spanning electrocardiograms from multiple subjects sampled at different frequencies and lengths. We then apply both ENT and NIST STS standard battery of randomness tests to the extracted IPIs. The results we obtain through the analysis, clearly show that a short burst of bits derived from an ECG record may seem random, but large files derived from long ECG records should not be used for security purposes. In Chapter3, we carry out an análisis to check whether it is reasonable or not the assumption that two different sensors can generate the same cryptographic token. We systematically check if two sensors can agree on the same token without sharing any type of information. Similarly to other proposals, we include ECC algorithms like BCH to the token generation. We conclude that a fuzzy extractor (or another error correction technique) is not enough to correct the synchronization errors between the IPI values derived from two ECG signals captured via two sensors placed on different positions. We demonstrate that a pre-processing of the heart signal must be performed before the fuzzy extractor is applied. Going one step forward and, in order to generate the same token on different sensors, we propose a synchronization algorithm. To do so, we include a runtimemonitoralgorithm. Afterapplyingourproposedsolution,werun again the experiments with 19 public databases from the PhysioNet repository. The only constraint to pick those databases was that they need at least two measurements of heart signals (ECG1 and ECG2). As a conclusion, running the experiments, the same token can be dexix rived on different sensors in most of the tested databases if and only if a pre-processing of the heart signal is performed before extracting the tokens. In Chapter 4, we analyze the entropy of the tokens extracted from a heart signal according to the NISTSTS recommendation (i.e.,SP80090B Recommendation for the Entropy Sources Used for Random Bit Generation). We downloaded 19 databases from the Physionet public repository and analyze, in terms of min-entropy, more than 160,000 files. Finally, we propose other combinations for extracting tokens by taking 2, 3, 4 and 5 bits different than the usual four LSBs. Also, we demonstrate that the four LSB are not the best bits to be used in cryptographic applications. We offer other alternative combinations for two (e.g., 87), three (e.g., 638), four (e.g., 2638) and five (e.g., 23758) bits which are, in general, much better than taking the four LSBs from the entropy point of view. Finally, the last Chapter of this dissertation (Chapter 5) summarizes the main conclusions arisen from this PhD Thesis and introduces some open questions.Programa de Doctorado en Ciencia y Tecnología Informática por la Universidad Carlos III de MadridPresidente: Arturo Ribagorda Garnacho.- Secretario: Jorge Blasco Alis.- Vocal: Jesús García López de la Call

Artifact Rejection Methodology Enables Continuous, Noninvasive Measurement of Gastric Myoelectric Activity in Ambulatory Subjects.

The increasing prevalence of functional and motility gastrointestinal (GI) disorders is at odds with bottlenecks in their diagnosis, treatment, and follow-up. Lack of noninvasive approaches means that only specialized centers can perform objective assessment procedures. Abnormal GI muscular activity, which is coordinated by electrical slow-waves, may play a key role in symptoms. As such, the electrogastrogram (EGG), a noninvasive means to continuously monitor gastric electrical activity, can be used to inform diagnoses over broader populations. However, it is seldom used due to technical issues: inconsistent results from single-channel measurements and signal artifacts that make interpretation difficult and limit prolonged monitoring. Here, we overcome these limitations with a wearable multi-channel system and artifact removal signal processing methods. Our approach yields an increase of 0.56 in the mean correlation coefficient between EGG and the clinical "gold standard", gastric manometry, across 11 subjects (p < 0.001). We also demonstrate this system's usage for ambulatory monitoring, which reveals myoelectric dynamics in response to meals akin to gastric emptying patterns and circadian-related oscillations. Our approach is noninvasive, easy to administer, and has promise to widen the scope of populations with GI disorders for which clinicians can screen patients, diagnose disorders, and refine treatments objectively