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A novel type of application for the exploration of enclosed or otherwise difficult to access environments requires large quantities of miniaturized sensor nodes to perform measurements while they traverse the environment in a “go with the flow” approach. Examples of these are the exploration of underground cavities and the inspection of industrial pipelines or mixing tanks, all of which have in common that the environments are difficult to access and do not allow position determination using e.g. GPS or similar techniques. The sensor nodes need to be scaled down towards the millimetre range in order to physically fit through the narrowest of parts in the environments and should measure distances between each other in order to enable the reconstruction of their positions relative to each other in offline analysis. Reaching those levels of miniaturization and enabling reconstruction functionality requires: 1) novel reconstruction algorithms that can deal with the specific measurement limitations and imperfections of millimetre-sized nodes, and 2) improved understanding of the relation between the highly constraint hardware design space of the sensor nodes and the reconstruction algorithms. To this end, this work provides a novel and highly robust sensor swarm reconstruction algorithm and studies the effect of hardware design trade-offs on its performance. Our findings based on extensive simulations, which push the reconstruction algorithm to its breaking point, provide important guidelines for the future development of millimetre-sized sensor nodes.

Contains fulltext : 200282.pdf (publisher's version ) (Closed access), Obstructive sleep apnea syndrome (OSAS) is a sleep disorder that affects a large part of the population and the development of algorithms using cardiovascular features for OSAS monitoring has been an extensively researched topic in the last two decades. Several studies regarding automatic apneic event classification using ECG derived features are based on the public Apnea-ECG database available on PhysioNet. Although this database is an excellent starting point for apnea topic investigations, in our study we show that algorithms for apneic-epochs classification that are successfully trained on this database (sensitivity < 85%, false detection rate <20%) perform poorly (sensitivity\textit<55%, false detection rate < 40%) in other databases which include patients with a broader spectrum of apneic events and sleep disorders. The reduced performance can be related to the complexity of breathing events, the increased number of non-breathing related sleep events, and the presence of non-OSAS sleep pathologies.

Item does not contain fulltext, OBJECTIVE: Monitoring of the fetal condition during labor is currently performed by cardiotocograpy (CTG). Despite the use of CTG in clinical practice, CTG interpretation suffers from a high inter- and intra-observer variability and a low specificity. In addition to CTG, analysis of fetal heart rate variability (HRV) has been shown to provide information on fetal distress. However, fetal HRV can be strongly influenced by uterine contractions, particularly during the second stage of labor. Therefore, the aim of this study is to examine if distinguishing contractions from rest periods can improve the detection rate of HRV features for fetal distress during the second stage of labor. APPROACH: We used a dataset of 100 recordings, containing 20 cases of fetuses with adverse outcome. The most informative HRV features were selected by a genetic algorithm and classification performance was evaluated using support vector machines. MAIN RESULTS: Classification performance of fetal heart rate segments closest to birth improved from a geometric mean of 70% to 79%. If the classifier was used to indicate fetal distress over time, the geometric mean at 15 minutes before birth improved from 60% to 72%. SIGNIFICANCE: Our results show that combining contraction-dependent HRV features with HRV features calculated over the entire fetal heart rate signal improves the detection rate of fetal distress.

Obstructive sleep apnea syndrome (OSAS) is a sleep disorder that affects a large part of the population and the development of algorithms using cardiovascular features for OSAS monitoring has been an extensively researched topic in the last two decades. Several studies regarding automatic apneic event classification using ECG derived features are based on the public Apnea-ECG database available on PhysioNet. Although this database is an excellent starting point for apnea topic investigations, in our study we show that algorithms for apneic-epochs classification that are successfully trained on this database (sensitivity < 85%, false detection rate <20%) perform poorly (sensitivity\textit<55%, false detection rate < 40%) in other databases which include patients with a broader spectrum of apneic events and sleep disorders. The reduced performance can be related to the complexity of breathing events, the increased number of non-breathing related sleep events, and the presence of non-OSAS sleep pathologies.

Contains fulltext : 182367.pdf (publisher's version ) (Closed access), Photoplethysmography (PPG) is one of the key technologies for unobtrusive physiological monitoring, with ongoing attempts to use it in several medical fields, ranging from night to night sleep analysis to continuous cardiac arrhythmia monitoring. However, the PPG signals are susceptible to be corrupted by noise and artifacts, caused, e.g., by limb or sensor movement. These artifacts affect the morphology of PPG waves and prevent the accurate detection and localization of beats and subsequent cardiovascular feature extraction. In this paper a new algorithm for beat detection and pulse quality assessment is described. The algorithm segments the PPG signal in pulses, localizes each beat and grades each segment with a quality index. The obtained index results from a comparison between each pulse and a template derived from the surrounding pulses, by mean of dynamic time warping barycenter averaging. The quality index is used to discard corrupted pulse beats. The algorithm is evaluated by comparing the detected beats with annotated PPG signals and the results are published over the same data. The described method achieves an improved sensitivity and a higher predictive value.

OBJECTIVE: Doppler ultrasound (US) is the most commonly applied method to measure the fetal heart rate (fHR). When the fetal heart is not properly located within the ultrasonic beam, fHR measurements often fail. As a consequence, clinical staff need to reposition the US transducer on the maternal abdomen, which can be a time consuming and tedious task.APPROACH: In this article, a method is presented to aid clinicians with the positioning of the US transducer to produce robust fHR measurements. A maximum likelihood estimation (MLE) algorithm is developed, which provides information on fetal heart location using the power of the Doppler signals received in the individual elements of a standard US transducer for fHR recordings. The performance of the algorithm is evaluated with simulations and in vitro experiments performed on a beating-heart setup.MAIN RESULTS: Both the experiments and the simulations show that the heart location can be accurately determined with an error of less than 7 mm within the measurement volume of the employed US transducer.SIGNIFICANCE: The results show that the developed algorithm can be used to provide accurate feedback on fetal heart location for improved positioning of the US transducer, which may lead to improved measurements of the fHR.

In the last decades, photoplethysmography (PPG) has been employed in a wide spectrum of applications, ranging from consumer devices to medical equipment. The pulsatile PPG signal recorded contains valuable information on the cardio-vascular and -respiratory system. Several features can be derived from the PPG and these can be used to infer physiological states of the human system, for instance to estimate the sleep structure or the fitness level of a subject [1]. As every sensing technology, the PPG can be corrupted by artifacts so it needs to be enhanced and, sometimes, parts of it have to be rejected. The rejection becomes fundamental especially when features are based on the shape of the signal. In literature, several methods are available to determine a quality index (QI) of parts of the PPG and use this QI as criterion for segment rejection. However, these methods exclude entire segments of the signal rather than single pulses, or they calculate a QI susceptible to the physiological PPG variation. In this study, a new algorithm for single PPG pulse QI calculation is proposed. This QI ranges between 0 and 1 and it is assessed by comparing each pulse with a template. The template is derived from PPG by using dynamic time warping (DTW) barycenter averaging [2]. Each pulse is warped, using DTW, to maximize the match with the template and the QI is calculated as a normalized root mean square error of the remaining mismatch. The QI is resilient to physiological pulse deformations, but still able to quantify the pulse morphology corruption and to recognize artifacts. The algorithm is validated on the Complex System Laboratory database [3], according to the ANSI/AAMI standards. For each pulse the beat location is calculated and it is rejected if QI is lower than 0.5. The positive predictive value and sensitivity (PPV, SEN) are calculated with respect to human beat annotations, with a true positive detection criterion of 30 ms distance from the annotated beat. T

Objective: Filtering power line interference (PLI) from electrocardiogram (ECG) recordings can lead to significant distortions of the ECG and mask clinically relevant features in ECG waveform morphology. The objective of this study is to filter PLI from ECG recordings with minimal distortion of the ECG waveform. Methods: In this paper, we propose a fixed-lag Kalman smoother with adaptive noise estimation. The performance of this Kalman smoother in filtering PLI is compared to that of a fixed-bandwidth notch filter and several adaptive PLI filters that have been proposed in the literature. To evaluate the performance, we corrupted clean neonatal ECG recordings with various simulated PLI. Furthermore, examples are shown of filtering real PLI from an adult and a fetal ECG recording. Results: The fixed-lag Kalman smoother outperforms other PLI filters in terms of step response settling time (improvements that range from 0.1 to 1 s) and signal-to-noise ratio (improvements that range from 17 to 23 dB). Our fixed-lag Kalman smoother can be used for semi real-time applications with a limited delay of 0.4 s. Conclusion and Significance: The fixed-lag Kalman smoother presented in this study outperforms other methods for filtering PLI and leads to minimal distortion of the ECG waveform.

During labor, uterine contractions can cause temporary oxygen deficiency for the fetus. In case of severe and prolonged oxygen deficiency this can lead to asphyxia. The currently used technique for detection of asphyxia, cardiotocography (CTG), suffers from a low specificity. Recent studies suggest that analysis of fetal heart rate variability (HRV) in addition to CTG can provide information on fetal distress. However, interpretation of fetal HRV during labor is difficult due to the influence of uterine contractions on fetal HRV. The aim of this study is therefore to investigate whether HRV features differ during contraction and rest periods, and whether these differences can improve the detection of asphyxia. To this end, a case-control study was performed, using 14 cases with asphyxia that were matched with 14 healthy fetuses. We did not find significant differences for individual HRV features when calculated over the fetal heart rate without separating contractions and rest periods (p > 0.30 for all HRV features). Separating contractions from rest periods did result in a significant difference. In particular the ratio between HRV features calculated during and outside contractions can improve discrimination between fetuses with and without asphyxia (p < 0.04 for three out of four ratio HRV features that were studied in this paper).

Fetal heart rate (fHR) monitoring is usually performed by Doppler ultrasound (US) techniques. For reliable fHR measurements it is required that the fetal heart is located within the US beam. In clinical practice, clinicians palpate the maternal abdomen to identify the fetal presentation and then the US transducer is fixated on the maternal abdomen where the best fHR signal can be obtained. Finding the optimal transducer position is done by listening to the strength of the Doppler audio output and relying on a signal quality indicator of the cardiotocographic (CTG) measurement system. Due to displacement of the US transducer or displacement of the fetal heart out of the US beam, the fHR signal may be lost. Therefore, it is often necessary that the obstetrician repeats the tedious procedure of US transducer positioning to avoid long periods of fHR signal loss. An intuitive US transducer positioning aid would be highly desirable to increase the work flow for the clinical staff. In this paper, the possibility to determine the fetal heart location with respect to the transducer by exploiting the received signal power in the transducer elements is shown. A commercially available US transducer used for fHR monitoring is connected to an US open platform, which allows individual driving of the elements and raw US data acquisition. Based on the power of the received Doppler signals in the transducer elements, the fetal heart location can be estimated. A beating fetal heart setup was designed and realized for validation. The experimental results show the feasibility of estimating the fetal heart location with the proposed method. This can be used to support clinicians in finding the optimal transducer position for fHR monitoring more easily.

Capacitive electrodes are a promising alternative to the conventional adhesive electrodes for ECG measurements. They provide more comfort to the patient when integrated in everyday objects (e.g., beds or seats) for long-term monitoring. However, the application of capacitive sensors is limited by their high sensitivity to motion artifacts. For example, motion at the body–electrode interface causes variations of the coupling capacitance which, in the presence of a dc voltage across the coupling capacitor, create strong artifacts in the measurements. The origin, relevance, and reduction of this specific and important type of artifacts are studied here. An injection signal is exploited to track the variations of the coupling capacitance in real time. This information is then used by an identification scheme to estimate the artifacts and subtract them from the measurements. The method was evaluated in simulations, lab environments, and in a real-life recording on an adult's chest. For the type of artifact under study, a strong artifact reduction ranging from 40 dB for simulated data to 9 dB for a given real-life recording was achieved. The proposed method is automated, does not require any knowledge about the measurement system parameters, and provides an online estimate for the dc voltage across the coupling capacitor.