Computational depth of anesthesia via multiple vital signs based on artificial neural networks

This study evaluated the depth of anesthesia (DoA) index using artificial neural networks (ANN) which is performed as the modeling technique. Totally 63-patient data is addressed, for both modeling and testing of 17 and 46 patients, respectively. The empirical mode decomposition (EMD) is utilized to purify between the electroencephalography (EEG) signal and the noise. The filtered EEG signal is subsequently extracted to achieve a sample entropy index by every 5-second signal. Then, it is combined with other mean values of vital signs, that is, electromyography (EMG), heart rate (HR), pulse, systolic blood pressure (SBP), diastolic blood pressure (DBP), and signal quality index (SQI) to evaluate the DoA index as the input. The 5 doctor scores are averaged to obtain an output index. The mean absolute error (MAE) is utilized as the performance evaluation. 10-fold cross-validation is performed in order to generalize the model. The ANN model is compared with the bispectral index (BIS). The results show that the ANN is able to produce lower MAE than BIS. For the correlation coefficient, ANN also has higher value than BIS tested on the 46-patient testing data. Sensitivity analysis and cross-validation method are applied in advance. The results state that EMG has the most effecting parameter, significantly.This research is financially supported by the Ministry of Science and Technology (MOST) of Taiwan. This research is also supported by the Centre for Dynamical Biomarkers and Translational Medicine, National Central University, Taiwan, which is also sponsored by MOST (MOST103-2911-I-008-001). Also, it is supported by National Chung-Shan Institute of Science & Technology in Taiwan (Grant nos. CSIST-095-V301 and CSIST-095-V302)

EEG signals analysis using multiscale entropy for depth of anesthesia monitoring during surgery through artificial neural networks

In order to build a reliable index to monitor the depth of anesthesia (DOA), many algorithms have been proposed in recent years, one of which is sample entropy (SampEn), a commonly used and important tool to measure the regularity of data series. However, SampEn only estimates the complexity of signals on one time scale. In this study, a new approach is introduced using multiscale entropy (MSE) considering the structure information over different time scales. The entropy values over different time scales calculated through MSE are applied as the input data to train an artificial neural network (ANN) model using bispectral index (BIS) or expert assessment of conscious level (EACL) as the target. To test the performance of the new index's sensitivity to artifacts, we compared the results before and after filtration by multivariate empirical mode decomposition (MEMD). The new approach via ANN is utilized in real EEG signals collected from 26 patients before and after filtering by MEMD, respectively; the results show that is a higher correlation between index from the proposed approach and the gold standard compared with SampEn. Moreover, the proposed approach is more structurally robust to noise and artifacts which indicates that it can be used for monitoring the DOA more accurately.This research was financially supported by the Center for Dynamical Biomarkers and Translational Medicine, National Central University, Taiwan, which is sponsored by Ministry of Science and Technology (Grant no. MOST103-2911-I-008-001). Also, it was supported by National Chung-Shan Institute of Science & Technology in Taiwan (Grant nos. CSIST-095-V301 and CSIST-095-V302) and National Natural Science Foundation of China (Grant no. 51475342)

Measuring and analysing vibration motors in insoles via accelerometers

Purpose: Falling is a major public health concern among elderly people, and they often cause serious injuries1,2. They most frequently occur during walking and are associated with the chronic deterioration in the neuromuscular and sensory systems, as well as with ankle muscle weakness and lower endurance of these muscles to fatigue1,3. Vibrating insoles, providing a subsensory mechanical noise signal to the plantar side of the feet, may improve balance in healthy young and older people and in patients with stroke or diabetic neuropathy4. The object of this study is to find the most suitable vibrator to put into the insole which can effectively improve the balance control of the elderlies. Method: We choose three different vibration actuators (micro vibration motor, brushless motor and eccentric motor) with two different weights on the insole. First, we put three same motors and two accelerometers on the insole, as shown in Figure1, then attach another layer on both side of the insole. Second, connect the motors to the power supply and the accelerometer to NI PXI-1033 spectrum analyzer which is used to collect the accelerometers' data. At last, using Fast Fourier Transform (FFT) to analyze and compare the results to see which motor is the most stable and suitable to put into the insole. Results & Discussion: The results showed that the most stable one is the brushless motor. The reason why the frequency is stable is that the relationship between voltage and frequency is linear, and the error is small through continuous measurements. On the other hand, when a person weight 55 kg stands on the insole, the frequency isn't affected by the weight. These two results appear very similar to each other, as shown in Figure 2. According to the result, we use the brushless motor to be our vibrator in the insole, and hope this will help the elderlies improve their balance control ability more efficiency

Investigating properties of the cardiovascular system using innovative analysis algorithms based on ensemble empirical mode decomposition

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited - Copyright @ 2012 Jia-Rong Yeh et al.Cardiovascular system is known to be nonlinear and nonstationary. Traditional linear assessments algorithms of arterial stiffness and systemic resistance of cardiac system accompany the problem of nonstationary or inconvenience in practical applications. In this pilot study, two new assessment methods were developed: the first is ensemble empirical mode decomposition based reflection index (EEMD-RI) while the second is based on the phase shift between ECG and BP on cardiac oscillation. Both methods utilise the EEMD algorithm which is suitable for nonlinear and nonstationary systems. These methods were used to investigate the properties of arterial stiffness and systemic resistance for a pig's cardiovascular system via ECG and blood pressure (BP). This experiment simulated a sequence of continuous changes of blood pressure arising from steady condition to high blood pressure by clamping the artery and an inverse by relaxing the artery. As a hypothesis, the arterial stiffness and systemic resistance should vary with the blood pressure due to clamping and relaxing the artery. The results show statistically significant correlations between BP, EEMD-based RI, and the phase shift between ECG and BP on cardiac oscillation. The two assessments results demonstrate the merits of the EEMD for signal analysis.This work is supported by the National Science Council (NSC) of Taiwan (Grant number NSC 99-2221-E-155-046-MY3), Centre for Dynamical Biomarkers and Translational Medicine, National Central University, Taiwan which is sponsored by National Science Council (Grant number: NSC 100–2911-I-008-001) and the Chung-Shan Institute of Science & Technology in Taiwan (Grant numbers: CSIST-095-V101 and CSIST-095-V102)

Special Issue “Advanced Signal Processing in Wearable Sensors for Health Monitoring”

Copyright: © 2021 by the authors. Wearable sensors are becoming very popular recently due to their ease of use and flexibility in recording data from home..

Predicting the Percentage of Atrial Fibrillation using Sample Entropy

Atrial fibrillation is the most commonly confronted cardiac arrhythmia in humans. This paper is written to use sample entropy and percentage of atrial fibrillation as a measure of regularity to measure AF. To assume the percentage of AF, 25 long term ECG recordings of human subjects with atrial fibrillation containing a total of 299 AF episodes were processed. The mean and SD of percentage breaking point in all the subjects from the MIT-BIH Atrial Fibrillation database was 0.6057±0.0863, and its sample entropy is 0.3522±0.1509. The mean and SD for sample entropy at 100% AF is 1.0669±0.4521. This data is used to predict the percentage of AF at a given sample entropy value. Our study concludes that the early detection of AF can be initiated by the AF already happened for 60%

Sample entropy analysis of EEG signals via artificial neural networks to model patients' consciousness level based on anesthesiologists experience.

Electroencephalogram (EEG) signals, as it can express the human brain's activities and reflect awareness, have been widely used in many research and medical equipment to build a noninvasive monitoring index to the depth of anesthesia (DOA). Bispectral (BIS) index monitor is one of the famous and important indicators for anesthesiologists primarily using EEG signals when assessing the DOA. In this study, an attempt is made to build a new indicator using EEG signals to provide a more valuable reference to the DOA for clinical researchers. The EEG signals are collected from patients under anesthetic surgery which are filtered using multivariate empirical mode decomposition (MEMD) method and analyzed using sample entropy (SampEn) analysis. The calculated signals from SampEn are utilized to train an artificial neural network (ANN) model through using expert assessment of consciousness level (EACL) which is assessed by experienced anesthesiologists as the target to train, validate, and test the ANN. The results that are achieved using the proposed system are compared to BIS index. The proposed system results show that it is not only having similar characteristic to BIS index but also more close to experienced anesthesiologists which illustrates the consciousness level and reflects the DOA successfully.This research is supported by the Center forDynamical Biomarkers and Translational Medicine, National Central University, Taiwan, which is sponsored by Ministry of Science and Technology (Grant no. MOST103-2911-I-008-001). Also, it is supported by National Chung-Shan Institute of Science & Technology in Taiwan (Grant nos. CSIST-095-V301 and CSIST-095-V302)

Sample entropy analysis for the estimating depth of anaesthesia through human EEG signal at different levels of unconsciousness during surgeries

Estimating the depth of anaesthesia (DoA) in operations has always been a challenging issue due to the underlying complexity of the brain mechanisms. Electroencephalogram (EEG) signals are undoubtedly the most widely used signals for measuring DoA. In this paper, a novel EEG-based index is proposed to evaluate DoA for 24 patients receiving general anaesthesia with different levels of unconsciousness. Sample Entropy (SampEn) algorithm was utilised in order to acquire the chaotic features of the signals. After calculating the SampEn from the EEG signals, Random Forest was utilised for developing learning regression models with Bispectral index (BIS) as the target. Correlation coefficient, mean absolute error, and area under the curve (AUC) were used to verify the perioperative performance of the p roposed method. Validation comparisons with typical nonstationary signal analysis methods (i.e., recurrence analysis and permutation entropy) and regression methods (i.e., neural network and support vector machine) were conducted. To further verify the accuracy and validity of the proposed methodology, the data is divided into four unconsciousness-level groups on the basis of BIS levels. Subsequently, analysis of variance (ANOVA) was applied to the corresponding index (i.e., regression output). Results indicate that the correlation coefficient improved to 0.72 ± 0.09 after filtering and to 0.90 ± 0.05 after regression from the initial values of 0.51 ± 0.17. Similarly, the final mean absolute error dramatically declined to 5.22 ± 2.12. In addition, the ultimate AUC increased to 0.98 ± 0.02, and the ANOVA analysis indicates that each of the four groups of different anaesthetic levels demonstrated significant difference from the nearest levels. Furthermore, the Random Forest output was extensively linear in relation to BIS, thus with better DoA prediction accuracy. In conclusion, the proposed method provides a concrete basis for monitoring patients' anaesthetic level during surgeries.variou

ECG Recurrence Plot-Based Arrhythmia Classification Using Two-Dimensional Deep Residual CNN Features

Data Availability Statement: This study utilizes the publicly available dataset, from https:// physionet.org, accessed on 22 June 2020.Copyright: © 2022 by the authors. In this paper, an effective electrocardiogram (ECG) recurrence plot (RP)-based arrhythmia classification algorithm that can be implemented in portable devices is presented. Public databases from PhysioNet were used to conduct this study including the MIT-BIH Atrial Fibrillation Database, the MIT-BIH Arrhythmia Database, the MIT-BIH Malignant Ventricular Ectopy Database, and the Creighton University Ventricular Tachyarrhythmia Database. ECG time series were segmented and converted using an RP, and two-dimensional images were used as inputs to the CNN classifiers. In this study, two-stage classification is proposed to improve the accuracy. The ResNet-18 architecture was applied to detect ventricular fibrillation (VF) and noise during the first stage, whereas normal, atrial fibrillation, premature atrial contraction, and premature ventricular contractions were de-tected using ResNet-50 in the second stage. The method was evaluated using 5-fold cross-validation which improved the results when compared to previous studies, achieving first and second stage average accuracies of 97.21% and 98.36%, sensitivities of 96.49% and 97.92%, positive predictive values of 95.54% and 98.20%, and F1-scores of 95.96% and 98.05%, respectively. Furthermore, a 5-fold improvement in the memory requirement was achieved when compared with a previous study, making this classifier feasible for use in resource-constricted environments such as portable devices. Even though the method is successful, first stage training requires combining four different arrhyth-mia types into one label (other), which generates more data for the other category than for VF and noise, thus creating a data imbalance that affects the first stage performance.Ministry of Science and Technology, Taiwan (grant number: MOST 110-2221-E-155-004-MY2)

Non-Invasive Hemodynamics Monitoring System Based on Electrocardiography via Deep Convolutional Autoencoder

Data Availability Statement: This study utilizes the publicly available dataset, from https://physionet.org, accessed on 14 January 2021.Copyright: © 2021 by the authors. This study evaluates cardiovascular and cerebral hemodynamics systems by only using non-invasive electrocardiography (ECG) signals. The Massachusetts General Hospital/Marquette Foundation (MGH/MF) and Cerebral Hemodynamic Autoregulatory Information System Database (CHARIS DB) from the PhysioNet database are used for cardiovascular and cerebral hemodynamics, respectively. For cardiovascular hemodynamics, the ECG is used for generating the arterial blood pressure (ABP), central venous pressure (CVP), and pulmonary arterial pressure (PAP). Meanwhile, for cerebral hemodynamics, the ECG is utilized for the intracranial pressure (ICP) generator. A deep convolutional autoencoder system is applied for this study. The cross-validation method with Pearson's linear correlation (R), root mean squared error (RMSE), and mean absolute error (MAE) are measured for the evaluations. Initially, the ECG is used to generate the cardiovascular waveform. For the ABP system-the systolic blood pressure (SBP) and diastolic blood pressures (DBP)-the R evaluations are 0.894 ± 0.004 and 0.881 ± 0.005, respectively. The MAE evaluations for SBP and DBP are, respectively, 6.645 ± 0.353 mmHg and 3.210 ± 0.104 mmHg. Furthermore, for the PAP system-the systolic and diastolic pressures-the R evaluations are 0.864 ± 0.003 mmHg and 0.817 ± 0.006 mmHg, respectively. The MAE evaluations for systolic and diastolic pressures are, respectively, 3.847 ± 0.136 mmHg and 2.964 ± 0.181 mmHg. Meanwhile, the mean CVP evaluations are 0.916 ± 0.001, 2.220 ± 0.039 mmHg, and 1.329 ± 0.036 mmHg, respectively, for R, RMSE, and MAE. For the mean ICP evaluation in cerebral hemodynamics, the R and MAE evaluations are 0.914 ± 0.003 and 2.404 ± 0.043 mmHg, respectively. This study, as a proof of concept, concludes that the non-invasive cardiovascular and cerebral hemodynamics systems can be potentially investigated by only using the ECG signal.Funding: This research received no external funding