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Background: Heart rate (HR) is a critical biomarker that provides insights into overall health, stress levels, and the autonomic nervous system. Pulse wave signals contain valuable information about the cardiovascular system and heart status. However, signal acquisition in wearables poses challenges, particularly when using electrical sensors, due to factors like the distance from the heart, body movement, and suboptimal electrode placement. Methods: Electrical bioimpedance (EBI) measurements using bipolar and tetrapolar electrode systems were employed for pulse wave signal acquisition from the wrist in both perpendicular and distal configurations. Signal preprocessing techniques, including baseline removal via Hankel matrix methods, normalization, cross-correlation, and peak detection, were applied to improve signal quality. This study describes the combination of sensor-level signal acquisition and processing for accurate wearable HR estimation. Results: The bipolar system was shown to produce larger Δ Z (t) , while the tetrapolar system demonstrated higher sensitivity. Distal placement of the electrodes yielded greater Δ Z (t) (up to 0.231 Ω) when targeting both wrist arteries. Bandpass filtering resulted in a better signal-to-noise ratio (SNR), achieving 3.6 dB for the best bipolar setup and 4.8 dB for the tetrapolar setup, compared to 2.6 and 3.3 dB SNR, respectively, with the Savitzky–Golay filter. The custom HR estimation algorithm presented in this paper demonstrated improved accuracy over a reference method, achieving an average error of 1.8 beats per minute for the best bipolar setup, with a mean absolute percentage error (MAPE) of 8%. Conclusions: The analysis supports the feasibility of using bipolar electrode setups on the wrist and highlights the importance of electrode positioning relative to the arteries. The proposed signal processing method, featuring a preprocessing pipeline and HR estimation algorithm, provides a proof-of-concept demonstration for HR estimation from EBI signals acquired at the wrist. [ABSTRACT FROM AUTHOR]

The Focused Impedance Method (FIM) is a new technique of electrical bioimpedance measurements in the human body. The idea originated in Bangladesh and provides an opportunity for localized measurement of bioimpedance down to reasonable depths from the body surface using skin surface electrodes. This has potential applications for physiological studies of targeted organs in the body and in detecting or diagnosing diseases and disorders. FIM is based on the age-old Tetra-Polar Impedance Measurement (TPIM) but provides a few significant improvements.

To evaluate the association of standardized phase angle (SPA) with nutritional status, functional parameters, and postoperative outcomes in surgical cancer patients. This prospective study includes 59 cancer patients from Pelotas (Brazil) admitted for elective cancer surgery. We obtained the phase angle through Bioelectrical Impedance Analysis (BIA) and standardized it according to the population's reference values. We estimated the muscle mass using BIA for later calculation of the Skeletal Muscle Index (SMI) and performed handgrip strength (HGS) and gait speed (GS) tests. We used the Patient-Generated Subjective Global Assessment (PG-SGA) to assess the nutritional status. Postoperative complications and duration of hospital stay were evaluated as the outcomes. The prevalence of malnutrition in the sample was 28.8%, according to ASG-PPP. SPA was statistically lower in patients with malnutrition, with lower HGS and reduced GS. For postoperative outcomes, patients with severe complications and those with prolonged hospitalization also had lower SPA values. The greater the number of functional alterations in patients, the lower the SPA value, mainly when associated with reduced muscle mass assessed by BIA, suggesting that muscle mass reduction plays an important role in the association between functional alterations and phase angle in patients with cancer. According to the parameters used in this study, low SPA value was associated with impaired nutritional and functional status and negative outcomes in the analyzed sample. [ABSTRACT FROM AUTHOR]

Introduction: Bioelectrical impedance (BIA) is one of the most widely used indirect methods for assessing human body composition. The phase angle (PhA) as its derivative is considered an indicator of cellular health and monitoring of nutritional status. Due to its safety and reproducibility, it can be used as a prognostic indicator in disease, the assessment of mortality risk, and the effectiveness of nutritional interventions, as reflected in an increasing number of scientific studies. The aim of the study was to assess nutritional status using the PhA indicator in the course of treatment in two patients with pressure injuries. Material and methods: Two patients with pressure injuries were selected to have three consecutive BIA tests, from which the PhA indicator was calculated. In the subsequent three measurements, it was assessed, correlating this with the local wound condition on the day of the measurements taken. Results: After the initial assessment, nutritional intervention was implemented simultaneously with medical and nursing interventions resulting from the wound care plan, observing a systematic increase in PhA parameters starting from the values: Patient I - 3.2; Patient II - 3.3 during the first examination. Subsequently, after 4 and 16 months in the final measurements, the PhA was 5.3° in Patient I and 4.5° in Patient II, which equated to full wound healing, as well as a significant improvement in the nutritional status of the patients compared to the baseline prior to implementing professional care. Conclusions: The assessment of nutritional status should be one of the pillars of a comprehensive examination of a patient with a chronic wound, while also being a determinant of the recovery process. In the cases presented, the correlation between wound condition and the importance played by the PhA can be seen without any doubt. Its increase influences and enhances the regenerative processes within the wound as well as the patient's overall pro-health status. Further studies with a larger group of patients are needed to demonstrate and confirm the multifaceted impact of the use of the above-mentioned indicator in the treatment of chronic wounds. [ABSTRACT FROM AUTHOR]

Background: Heart rate (HR) is a critical biomarker that provides insights into overall health, stress levels, and the autonomic nervous system. Pulse wave signals contain valuable information about the cardiovascular system and heart status. However, signal acquisition in wearables poses challenges, particularly when using electrical sensors, due to factors like the distance from the heart, body movement, and suboptimal electrode placement. Methods: Electrical bioimpedance (EBI) measurements using bipolar and tetrapolar electrode systems were employed for pulse wave signal acquisition from the wrist in both perpendicular and distal configurations. Signal preprocessing techniques, including baseline removal via Hankel matrix methods, normalization, cross-correlation, and peak detection, were applied to improve signal quality. This study describes the combination of sensor-level signal acquisition and processing for accurate wearable HR estimation. Results: The bipolar system was shown to produce larger ΔZ(t), while the tetrapolar system demonstrated higher sensitivity. Distal placement of the electrodes yielded greater ΔZ(t) (up to 0.231 Ω) when targeting both wrist arteries. Bandpass filtering resulted in a better signal-to-noise ratio (SNR), achieving 3.6 dB for the best bipolar setup and 4.8 dB for the tetrapolar setup, compared to 2.6 and 3.3 dB SNR, respectively, with the Savitzky–Golay filter. The custom HR estimation algorithm presented in this paper demonstrated improved accuracy over a reference method, achieving an average error of 1.8 beats per minute for the best bipolar setup, with a mean absolute percentage error (MAPE) of 8%. Conclusions: The analysis supports the feasibility of using bipolar electrode setups on the wrist and highlights the importance of electrode positioning relative to the arteries. The proposed signal processing method, featuring a preprocessing pipeline and HR estimation algorithm, provides a proof-of-concept demonstration for HR estimation from EBI signals acquired at the wrist.

Background: Cardiovascular diseases (CVDs), being the culprit for one-third of deaths globally, constitute a challenge for biomedical instrumentation development, especially for early disease detection. Pulsating arterial blood flow, providing access to cardiac-related parameters, involves the whole body. Unobtrusive and continuous acquisition of electrical bioimpedance (EBI) and photoplethysmography (PPG) constitute important techniques for monitoring the peripheral arteries, requiring novel approaches and clever means. Methods: In this work, five peripheral arteries were selected for EBI and PPG signal acquisition. The acquisition sites were evaluated based on the signal morphological parameters. A small-data-based deep learning model, which increases the data by dividing them into cardiac periods, was proposed to evaluate the continuity of the signals. Results: The highest sensitivity of EBI was gained for the carotid artery (0.86%), three times higher than that for the next best, the posterior tibial artery (0.27%). The excitation signal parameters affect the measured EBI, confirming the suitability of classical 100 kHz frequency (average probability of 52.35%). The continuity evaluation of the EBI signals confirmed the advantage of the carotid artery (59.4%), while the posterior tibial artery (49.26%) surpasses the radial artery (48.17%). The PPG signal, conversely, commends the location of the posterior tibial artery (97.87%). Conclusions: The peripheral arteries are highly suitable for non-invasive EBI and PPG signal acquisition. The posterior tibial artery constitutes a candidate for the joint acquisition of EBI and PPG signals in sensor-fusion-based wearable devices—an important finding of this research. [ABSTRACT FROM AUTHOR]

In general, the electrical property of soft tissues is sensitive to the force applied to their surface. To further study the relationship between the force and the electrical property of soft tissues, this paper attempts to investigate the effect of static and higher-order stresses on electrical properties. Overall, a practical experimental platform is designed to acquire the force information and the electrical property of soft tissues during a contact procedure, which is featured different compression stimuli, such as constant pressing force, constant pressing speed, and step-force compression, etc. Furthermore, the piezoresistive characteristic is innovatively introduced to model the mechanical-electrical properties of soft tissue. Finite Element Modeling (FEM) is adopted to fit the static piezoresistivity of the soft tissue. Finally, experimental studies were performed to demonstrate the effect of stress on the electrical properties and the feasibility of the proposed piezoresistive model to describe soft tissues' mechanical and electrical properties. [ABSTRACT FROM AUTHOR]

The early detection of head and neck squamous cell carcinoma (HNSCC) is essential to improve patient prognosis and enable organ and function preservation treatments. The objective of this study is to assess the feasibility of using electrical bioimpedance (EBI) sensing technology to detect HNSCC tissue. A prospective study was carried out analyzing tissue from 46 patients undergoing surgery for HNSCC. The goal was the correct identification of pathologic tissue using a novel needle-based EBI sensing device and AI-based classifiers. Considering the data from the overall patient cohort, the system achieved accuracies between 0.67 and 0.93 when tested on tissues from the mucosa, skin, muscle, lymph node, and cartilage. Furthermore, when considering a patient-specific setting, the accuracy range increased to values between 0.82 and 0.95. This indicates that more reliable results may be achieved when considering a tissue-specific and patient-specific tissue assessment approach. Overall, this study shows that EBI sensing may be a reliable technology to distinguish pathologic from healthy tissue in the head and neck region. This observation supports the continuation of this research on the clinical use of EBI-based devices for early detection and margin assessment of HNSCC. [ABSTRACT FROM AUTHOR]

Background: To investigate the clinical significance of the disturbance coefficient (DC) and regional cerebral oxygen saturation (rSO2) as obtained through the use of electrical bioimpedance and near-infrared spectroscopy (NIRS) in pediatric neurocritical care. Participants and methods: We enrolled 45 pediatric patients as the injury group and 70 healthy children as the control group. DC was derived from impedance analysis of 0.1 mA-50 kHz current via temporal electrodes. rSO2 was the percentage of oxyhemoglobin measured from reflected NIR light on the forehead. DC and rSO2 were obtained at 6, 12, 24, 48 and 72 h after surgery for the injury group and during the health screening clinic visit for the control group. We compared DC and rSO2 between the groups, their changes over time within the injury group and their correlation with intracranial pressure (ICP), cerebral perfusion pressure (CPP), Glasgow coma scale (GCS) score, Glasgow outcome scale (GOS) score, and their ability to diagnose postoperative cerebral edema and predict poor prognosis. Results: DC and rSO2 were significantly lower in the injury group than in the control group. In the injury group, ICP increased over the monitoring period, while DC, CPP and rSO2 decreased. DC was negatively correlated with ICP and positively correlated with GCS score and GOS score. Additionally, lower DC values were observed in patients with signs of cerebral edema, with a DC value of 86.5 or below suggesting the presence of brain edema in patients aged 6-16 years. On the other hand, rSO2 was positively correlated with CPP, GCS score, and GOS score, with a value of 64.4% or below indicating a poor prognosis. Decreased CPP is an independent risk factor for decreased rSO2. Conclusion: DC and rSO2 monitoring based on electrical bioimpedance and near-infrared spectroscopy not only reflect the degree of brain edema and oxygenation, but also reflect the severity of the disease and predict the prognosis of the patients. This approach offers a real-time, bedside, and accurate method for assessing brain function and detecting postoperative cerebral edema and poor prognosis. [ABSTRACT FROM AUTHOR]

Copyright of Cultura, Ciencia y Deporte is the property of Cultura, Ciencia y Deporte and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Pelotherapy is the traditional procedure of applying curative muds on the skin's surface—shown to have a positive effect on the human body and cure illnesses. The effect of pelotherapy is complex, functioning through several mechanisms, and depends on the skin's functional condition. The current research objective was to develop a methodology and electrodes to assess the passage of the chemical and biologically active compounds of curative mud through human skin by performing electrical bioimpedance (EBI) analysis. Methods: The methodology included local area mud pack and simultaneous tap water compress application on the forearms with the comparison to the measurements of the dry skin. A custom-designed small-area gold-plated electrode on a rigid printed circuit board, in a tetrapolar configuration, was designed. A pilot study experiment with ten volunteers was performed. Results: Our results indicated the presence of an effect of pelotherapy, manifested by the varying electrical properties of the skin. Distinguishable difference in the measured real part of impedance (R) emerged, showing a very strong correlation between the dry and tap-water-treated skin (r = 0.941), while a poor correlation between the dry and mud-pack-treated skin (r = 0.166) appeared. The findings emerged exclusively in the frequency interval of 10 kHz ...1 MHz and only for R. Conclusions: EBI provides a promising tool for monitoring the variations in the electrical properties of the skin, including the skin barrier. We foresee developing smart devices for promoting the exploitation of spa therapies. [ABSTRACT FROM AUTHOR]

Bladder monitoring, including urinary incontinence management and bladder urinary volume monitoring, is a vital part of urological care. Urinary incontinence is a common medical condition affecting the quality of life of more than 420 million people worldwide, and bladder urinary volume is an important indicator to evaluate the function and health of the bladder. Previous studies on non-invasive techniques for urinary incontinence management technology, bladder activity and bladder urine volume monitoring have been conducted. This scoping review outlines the prevalence of bladder monitoring with a focus on recent developments in smart incontinence care wearable devices and the latest technologies for non-invasive bladder urine volume monitoring using ultrasound, optical and electrical bioimpedance techniques. The results found are promising and their application will improve the well-being of the population suffering from neurogenic dysfunction of the bladder and the management of urinary incontinence. The latest research advances in bladder urinary volume monitoring and urinary incontinence management have significantly improved existing market products and solutions and will enable the development of more effective future solutions. [ABSTRACT FROM AUTHOR]

Copyright of Revista Habanera de Ciencias Médicas is the property of Universidad de Ciencias Medicas de La Habana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Rheumatoid arthritis (RA) is a chronic inflammatory syndrome that features painful and destructive joint disease. Aggressive disease-modifying treatment can result in reduced symptoms and protection from irreversible joint damage; however, assessment of treatment efficacy is currently based largely on subjective measures of patient and physician impressions. In this work, we address this compelling need to provide an accurate and quantitative capability for monitoring joint health in patients with RA. Methods: Joint acoustic emissions (JAEs), electrical bioimpedance (EBI), and kinematics were measured noninvasively from 11 patients with RA over the course of three weeks using a custom multimodal sensing brace, resulting in 49 visits with JAE recordings and 43 with EBI recordings. Features derived from all sensing modalities were fed into a linear discriminant analysis (LDA) model to predict disease activity according to the validated disease activity index (the DAS28-ESR). Erythrocyte sedimentation rate (ESR) was predicted using ridge regression and classified into a high or low class using LDA. Results: DAS28-ESR level was predicted with an area under the receiver operating characteristic curve (AUC) of 0.82. With JAEs alone, we were able to track intrasubject differences in the disease activity score as well as classify ESR level with an AUC of 0.93. The majority of patients reported both an interest and ability to use the brace at home for longitudinal monitoring. Conclusion: This work demonstrates the ability to detect RA disease activity using noninvasive sensing. Significance: This system has the potential to improve RA disease activity monitoring by giving treating clinicians objective data that can be acquired independent of a face-to-face clinic visit. [ABSTRACT FROM AUTHOR]

Purpose: Detrusor pressure–volume relationship evaluation by urodynamics provides useful clinical information; however, it is invasive, and requires specific installations. An alternative technique proposed by our research group is the electrical bioimpedance (BI) which is an easily performed and non-invasive method. In this work, we assess the relationship between BI and detrusor bladder pressure in adults with neurogenic lower urinary tract dysfunction. Methods: A prospective observational study was conducted. 20 patients (11 females and 9 male) previously diagnosed with neurogenic bladder were included. All participants underwent simultaneously a urodynamic evaluation (UDS) and BI determination, and both examination signals were recorded and subjected to Shapiro–Wilks statistical test. A correlational statistical test was used to compare the pressure parameters (detrusor, vesical and abdominal) with their respective BI determinations. Subsequently, a linear regression test was performed to evaluate the concordance between BI and their respective pressure values. Results: From the 20 correlations, between detrusor bladder pressure (PDET) and abdominal bioimpedance determinations (ZABD), obtained for all participants, 16 evidenced significant results over 90% (p < 0.05). Conclusions: A significantly high correlation between abdominal bioimpedance determinations and the detrusor bladder pressures was evidenced. These results should be confirmed in a larger group of participants. [ABSTRACT FROM AUTHOR]

Parasitic capacitance represents the main error source in measurement systems based on electrical impedance spectroscopy. The capacitive nature of electrodes' impedance in tetrapolar configuration can give origin to phase errors when electrodes are coupled to parasitic capacitances. Nevertheless, reactive charges in tissue excitation systems are susceptible to instability. Based on such a scenario, mitigating capacitive effects associated with the electrode is a requirement in order to reduce errors in the measurement system. A literature review about the main compensation techniques for parasitic capacitance was carried out. The selected studies were categorized into three groups: (i) compensation in electronic instrumentation; (ii) compensation in measurement processing, and (iii) compensation by negative impedance converters. The three analyzed methods emerged as effective against fixed capacitance. No method seemed capable of mitigating the effects of electrodes' capacitance, that changes in the frequency spectrum. The analysis has revealed the need for a method to compensate varying capacitances, since electrodes' impedance is unknown. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular diseases (CVDs), being the culprit for one-third of deaths globally, constitute a challenge for biomedical instrumentation development, especially for early disease detection. Pulsating arterial blood flow, providing access to cardiac-related parameters, involves the whole body. Unobtrusive and continuous acquisition of electrical bioimpedance (EBI) and photoplethysmography (PPG) constitute important techniques for monitoring the peripheral arteries, requiring novel approaches and clever means. Methods: In this work, five peripheral arteries were selected for EBI and PPG signal acquisition. The acquisition sites were evaluated based on the signal morphological parameters. A small-data-based deep learning model, which increases the data by dividing them into cardiac periods, was proposed to evaluate the continuity of the signals. Results: The highest sensitivity of EBI was gained for the carotid artery (0.86%), three times higher than that for the next best, the posterior tibial artery (0.27%). The excitation signal parameters affect the measured EBI, confirming the suitability of classical 100 kHz frequency (average probability of 52.35%). The continuity evaluation of the EBI signals confirmed the advantage of the carotid artery (59.4%), while the posterior tibial artery (49.26%) surpasses the radial artery (48.17%). The PPG signal, conversely, commends the location of the posterior tibial artery (97.87%). Conclusions: The peripheral arteries are highly suitable for non-invasive EBI and PPG signal acquisition. The posterior tibial artery constitutes a candidate for the joint acquisition of EBI and PPG signals in sensor-fusion-based wearable devices—an important finding of this research.

The early detection of head and neck squamous cell carcinoma (HNSCC) is essential to improve patient prognosis and enable organ and function preservation treatments. The objective of this study is to assess the feasibility of using electrical bioimpedance (EBI) sensing technology to detect HNSCC tissue. A prospective study was carried out analyzing tissue from 46 patients undergoing surgery for HNSCC. The goal was the correct identification of pathologic tissue using a novel needle-based EBI sensing device and AI-based classifiers. Considering the data from the overall patient cohort, the system achieved accuracies between 0.67 and 0.93 when tested on tissues from the mucosa, skin, muscle, lymph node, and cartilage. Furthermore, when considering a patient-specific setting, the accuracy range increased to values between 0.82 and 0.95. This indicates that more reliable results may be achieved when considering a tissue-specific and patient-specific tissue assessment approach. Overall, this study shows that EBI sensing may be a reliable technology to distinguish pathologic from healthy tissue in the head and neck region. This observation supports the continuation of this research on the clinical use of EBI-based devices for early detection and margin assessment of HNSCC.

BackgroundOverhydration (OH) is common in peritoneal dialysis (PD) and increases the cardiovascular risk. Multifrequency bioimpedance spectroscopy (BIS) has been proposed to estimate the hydration in dialysis. Our objective was to evaluate if BIS is superior than control based on clinical assessment plus single-frequency bioimpedance (SF-BIA) on the fluid control and intermediate cardiovascular outcomes.MethodsRandomized controlled study in adult PD patients, with a 9-month follow-up, allocated into two groups: control and BIS. Data were collected from medical records. SF-BIA and BIS, laboratory exams, ambulatory blood pressure monitoring, echocardiography (ECHO), and pulse wave velocity (PWV) were evaluated. The BIS data were available to the medical team only in BIS group.Results34 patients completed the study, 17 in each group. At the endpoint the BIS group had a significant (p < 0.05) greater proportion of patients with OH/extracellular water (OH/ECW%) ≤ 15% than the control (94.1% vs. 52.9%), and a lower OH mean (2.1 ± 1.6 vs. 0.9 ± 1.1 L). The control group has a significant increase in the tumor necrosis factor alpha median concentration from baseline to six [11.9 (6.0–24.1) vs. 44.7 (9.4–70.6) pg/ml] and 9 months [11.9 (6.0–24.1) vs. 39.4 (27.9–62.6) pg/ml], and in the N-terminal fragment of pro-B-type natriuretic peptide median [239 (171.5–360.5) vs. 356 (219–1,555) pg/ml]. For cardiovascular parameters, BIS group presented a significant reduction in radial PWV [7.7 (6.9–9.2) vs. 6.5 (5.5–8.4) m/s] at 9 month, while in the control presented a significant increase in mean central systolic blood pressure (BP) (106.8 ± 11.2 vs. 117.6 ± 16.5 mmHg) and in central diastolic BP (90.4 ± 9.8 vs. 103.3 ± 12.5 mmHg) at 9 months. The left ventricular mass (LVM)/body surface presented a significant reduction in the control (109.6 ± 30.8 vs. 101.2 ± 28.9 g/m2) and BIS group (107.7 ± 24.9 vs. 96.1 ± 27.0 g/m2) at 9 months.ConclusionThe results suggest BIS is superior than the clinical evaluation plus SF-BIA for the fluid control of PD patients.Clinical trial registration[https://www.ClinicalTrials.gov], identifier [RBR-10k8j3bx].

Background: Pelotherapy is the traditional procedure of applying curative muds on the skin’s surface—shown to have a positive effect on the human body and cure illnesses. The effect of pelotherapy is complex, functioning through several mechanisms, and depends on the skin’s functional condition. The current research objective was to develop a methodology and electrodes to assess the passage of the chemical and biologically active compounds of curative mud through human skin by performing electrical bioimpedance (EBI) analysis. Methods: The methodology included local area mud pack and simultaneous tap water compress application on the forearms with the comparison to the measurements of the dry skin. A custom-designed small-area gold-plated electrode on a rigid printed circuit board, in a tetrapolar configuration, was designed. A pilot study experiment with ten volunteers was performed. Results: Our results indicated the presence of an effect of pelotherapy, manifested by the varying electrical properties of the skin. Distinguishable difference in the measured real part of impedance (R) emerged, showing a very strong correlation between the dry and tap-water-treated skin (r = 0.941), while a poor correlation between the dry and mud-pack-treated skin (r = 0.166) appeared. The findings emerged exclusively in the frequency interval of 10 kHz …1 MHz and only for R. Conclusions: EBI provides a promising tool for monitoring the variations in the electrical properties of the skin, including the skin barrier. We foresee developing smart devices for promoting the exploitation of spa therapies.

This study proposes a low-cost, portable, eight-channel electrical impedance tomograph based on the AD5933 impedance converter. The patterns for current injection and voltage measurement are managed by an Arduino Mega 2560 board and four 74HC4067 Texas Instruments multiplexers. Regarding the experimental results, the errors in the impedance estimates of an electrical circuit that represents a Cole model were less than 1.14% for the magnitude and 4.15% for the phase. Furthermore, the signal-to-noise ratio measured in a resistive phantom was 55.23 dB. Additional experiments consisted of placing five spheres of different size and conductivity in a saline tank, measuring their impedance through eight electrodes, and then generating impedance maps using the Electrical Impedance Tomography and Diffuse Optical Tomography Reconstruction Software (EIDORS). These maps were different for each sphere, suggesting the proposed prototype as a promising alternative for medical applications.

With the evolving demands of surgical intervention, there is a strong need for smaller and functionally augmented instruments to improve surgical outcomes, operational convenience, and diagnostic safety. Owing to the narrow and complicated anatomy, the probe head of the medical instrument is required to possess both good maneuverability and compact size. In addition, the development of medical instrument is moving toward patient-specialized, of which the articulation positions can be customized to reach the target position. To fulfill these requirements, this study presents the design of a smart handheld device which equips with a low cost, easy control, disposable flexible wrist, and an electrical bioimpedance sensor for medical diagnosis. Prototype of the device is made and tested. The experimental results demonstrate that the proposed device can provide accurate manipulation and effective tissue detection, showing a great potential in various medical applications. [ABSTRACT FROM AUTHOR]

Robot assisted Minimally Invasive Surgery (RMIS) is widely used for a variety of medical treatments nowadays. In RMIS, tissue recognition is a critical step but few technology is available for assistance. To address this challenge, we develop the Robot Assisted Electrical Impedance Scanning (RAEIS) system. The RAEIS system can be directly implemented on most existing RMIS robotic system without introducing external instruments to the surgical site. In this paper, we present the concept of the RAEIS system and the achievements in three research directions by early 2022. [ABSTRACT FROM AUTHOR]

Sofiene Mansouri,1,2 Tareq Alhadidi,1 Marwa Ben Azouz2 1College of Applied Medical Sciences, Department of Biomedical Technology, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia; 2University of Tunis El Manar, Higher Institute of Medical Technologies of Tunis, Laboratory of Biophysics and Medical Technologies, Tunis 1009, TunisiaCorrespondence: Sofiene MansouriCollege of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi ArabiaTel +966533791123Email s.mansouri@psau.edu.saIntroduction: Early detection of breast cancer saves lives. Existing detecting techniques are invasive. Electrical bioimpedance is a noninvasive technique and has a high diagnostic potential.Methods: An impedance value different from the normal can predict a physiological abnormality. The idea is to use a designed bioimpedance device to early detect breast cancer. A low-frequency current (1 kHz, 0.9 mA) is injected to each breast to measure the extracellular resistances. The resistances of the two breasts are then measured, and if there is a significant difference, warning is displayed. The performance was tested on a set of reference resistors, and the validation was done in vitro on (Na+Cl-) solutions and in vivo on a group of forty volunteer women.Results: The results confirm that the electrical conductivity of an ionic solution is proportional to its concentration. The concentration and the resistance are strongly correlated (correlation coefficient of 0.97). The accuracy and the repeatability of the measures were satisfactory. Early detection means that we can detect small extracellular concentration variations into the breast (from 0.6 g/l). In vivo measurements made it possible to set the threshold at 50 ohm. If the difference between the two measured breast resistances is greater than this threshold, we advise the patient to consult a doctor promptly.Conclusion: The difference between measured resistances of the right and left breast is a pertinent parameter to early detect the presence of a cancer. The lowest resistance value (RR or RL) can provide information on the breast affected by the cancer (right or left). Various improvements in the system are possible but already the results are encouraging. In the future, this system could be integrated into a bra.Keywords: biomedical engineering, breast cancer detection, electrical bioimpedance, FPGA Virtex-5 LX30, LabVIEW FPGA, NI PXI-7841R

Background: Bioimpedance spectroscopy (BIS) is a device used to measure electrical impedance at frequencies from 0 Hz to 1 MHz. Many clinical diagnosis and fundamental researches, especially in the field of physiology and pathology, rely on this device. The device can be used to estimate human body composition, through the information of total body water, extracellular fluid and intracellular fluid, fat-free mass, and fat mass from its impedance. BIS analysis can provide physiological statuses such as ischemia, pulmonary edema, skin cancer, and intramuscular tumors. BIS is expected to be used even more widely, both for hospital or home-based use, particularly because BIS handy, compact, inexpensive, and less power-consuming with adequately accurate real-time. In previous research, the BIS design was based on the magnitude-ratio and phase-difference detection using the AD8302 gain-phase detector method which resulted in an operating range between 20 kHz and 1 MHz. However, the impedance was obtained from the logarithmic ratio magnitude which caused the device to have limited accuracy at frequencies

The aim of this study was to examine whether electrical impedance tomography (EIT) could determine the presence of ventilation inhomogeneity in patients with chronic obstructive lung disease (COPD) from measurements carried out not only during conventional forced full expiration maneuvers but also from forced inspiration maneuvers and quiet tidal breathing and whether the inhomogeneity levels were comparable among the phases and higher than in healthy subjects. EIT data were acquired in 52 patients with exacerbated COPD (11 women, 41 men, 68 ± 11 years) and 14 healthy subjects (6 women, 8 men, 38 ± 8 years). Regional lung function parameters of forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), forced inspiratory vital capacity (FIVC), forced inspiratory volume in 1 s (FIV1), and tidal volume (V T ) were determined in 912 image pixels. The spatial inhomogeneity of the pixel parameters was characterized by the coefficients of variation (CV) and the global inhomogeneity (GI) index. CV and GI values of pixel FVC, FEV1, FIVC, FIV1, and VT were significantly higher in patients than in healthy subjects (p ≤ 0.0001). The ventilation distribution was affected by the analyzed lung function parameter in patients (CV: p = 0.0024, GI: p = 0.006) but not in healthy subjects. Receiver operating characteristic curves showed that CV and GI discriminated patients from healthy subjects with an area under the curve (AUC) of 0.835 and 0.852 (FVC), 0.845 and 0.867 (FEV1), 0.903 and 0.903 (FIVC), 0.891 and 0.882 (FIV1), and 0.821 and 0.843 (VT), respectively. These findings confirm the ability of EIT to identify increased ventilation inhomogeneity in patients with COPD. [ABSTRACT FROM AUTHOR]

Electrical bioimpedance entails the measurement of the electrical properties of tissues as a function of frequency. It is thus a spectroscopic technique. It has been applied in a plethora of biomedical applications for diagnostic and monitoring purposes. In this tutorial, the basics of electrical bioimpedance sensor design will be discussed. The electrode/electrolyte interface is thoroughly described, as well as methods for its modelling with equivalent circuits and computational tools. The design optimization and modelling of bipolar and tetrapolar bioimpedance sensors is presented in detail, based on the sensitivity theorem. Analytical and numerical modelling approaches for electric field simulations based on conformal mapping, point electrode approximations and the finite element method (FEM) are also elaborated. Finally, current trends on bioimpedance sensors are discussed followed by an overview of instrumentation methods for bioimpedance measurements, covering aspects of voltage signal excitations, current sources, voltage measurement front-end topologies and methods for computing the electrical impedance. [ABSTRACT FROM AUTHOR]

Monitoring of anatomical structures and physiological processes by electrical impedance has attracted scientists as it is noninvasive, nonionizing and the instrumentation is relatively simple. Focused Impedance Method (FIM) is attractive in this context, as it has enhanced sensitivity at the central region directly beneath the electrode configuration minimizing contribution from neighboring regions. FIM essentially adds or averages two concentric and orthogonal combinations of conventional Tetrapolar Impedance Measurements (TPIM) and has three versions with 4, 6, and 8 electrodes. This paper describes the design and testing of a multi-frequency FIM (MFFIM) system capable of measuring all three versions of FIM at 8 frequencies in the range 10 kHz—1 MHz. A microcontroller based multi-frequency signal generator and a balanced Howland current source with high output impedance (476 kΩ at 10 kHz and 58.3 kΩ at 1 MHz) were implemented for driving currents into biological tissues with an error 45 frames per second which was deemed adequate for noninvasive real-time impedance measurements on biological tissues.

Parasitic capacitance represents the main error source in measurement systems based on electrical impedance spectroscopy. The capacitive nature of electrodes’ impedance in tetrapolar configuration can give origin to phase errors when electrodes are coupled to parasitic capacitances. Nevertheless, reactive charges in tissue excitation systems are susceptible to instability. Based on such a scenario, mitigating capacitive effects associated with the electrode is a requirement in order to reduce errors in the measurement system. A literature review about the main compensation techniques for parasitic capacitance was carried out. The selected studies were categorized into three groups: (i) compensation in electronic instrumentation; (ii) compensation in measurement processing, and (iii) compensation by negative impedance converters. The three analyzed methods emerged as effective against fixed capacitance. No method seemed capable of mitigating the effects of electrodes’ capacitance, that changes in the frequency spectrum. The analysis has revealed the need for a method to compensate varying capacitances, since electrodes’ impedance is unknown.

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Introduction Ischemic stroke is caused by artery blockage, resulting in damage to brain tissue. A significant factor in the further treatment of a patient is not only the time to reach a specialist centre, but also the state of hydration of the organism. Clinical situations involving the excess or deficiency of water can have extremely serious consequences for the functioning of the body and subsequent stroke-related disorders. One of the increasingly common methods of evaluating the composition of the human body is by electrical bioimpedance. Objective The aim of the study was to assess the state of human body hydration measured by bioimpedance in patients with an early stage of ischemic stroke. Material and methods The examination involved 81 patients with ischemic stroke in the Neurology Department, Subdivision of Stroke Treatment at the Province Specialist Hospital in Lublin, Poland, in 2015. Measurement of the composition and outer and intracellular space of the human body by the Whole Body Bioimpedance (WBIA) method was performed using the Body Composition Monitor (BCM) (Fresenius Medical Care GmbH, Bad Homburg, Germany). Results A group of patients were been examined with the use of the BIA apparatus three times: on the first, seventh, and tenth day of hospital stay, to determine the level of body hydration. Comparative analysis of data showed that on the first day of hospitalization all the measurements of electrical bioimpedance parameters in the patients were significantly different from those of the control group. In the case of TBW, ECW, ICW, the patients’ scores were significantly higher than those of the control group. Only with respect to the over-hydration index, the patients achieved a significantly lower score than the control group. Conclusions Assessment of hydration status in patients with a diagnosed stroke indicates a slight dehydration in relation to the control group, but falling within the scope of normovolaemia, according to bioimpedance measurement standards.

Abstract Background The provision of guidance in ventilator therapy by continuous monitoring of regional lung ventilation, aeration and respiratory system mechanics is the main clinical benefit of electrical impedance tomography (EIT). A new application was recently described in critically ill patients undergoing diagnostic bronchoalveolar lavage (BAL) with the intention of using EIT to identify the region where sampling was performed. Increased electrical bioimpedance was reported after fluid instillation. To verify the accuracy of these findings, contradicting the current EIT knowledge, we have systematically analysed chest EIT data acquired under controlled experimental conditions in animals undergoing a large number of BAL procedures. Methods One hundred thirteen BAL procedures were performed in 13 newborn piglets positioned both supine and prone. EIT data was obtained at 13 images before, during and after each BAL. The data was analysed at three time points: (1) after disconnection from the ventilator before the fluid instillation and by the ends of fluid (2) instillation and (3) recovery by suction and compared with the baseline measurements before the procedure. Functional EIT images were generated, and changes in pixel electrical bioimpedance were calculated relative to baseline. The data was examined in the whole image and in three (ventral, middle, dorsal) regions-of-interest per lung. Results Compared with the baseline phase, chest electrical bioimpedance fell after the disconnection from the ventilator in all animals in both postures during all procedures. The fluid instillation further decreased electrical bioimpedance. During fluid recovery, electrical bioimpedance increased, but not to baseline values. All effects were highly significant (p

Background: Protein-energy wasting is related to impairment of quality of life and lower survival of end-stage kidney disease (ESKD) patients. The evaluation of body composition, especially fat free mass (FFM) and fat mass (FM), is important for the prediction of outcomes in these individuals. The aim of this study was to compare the FFM and FM measurements obtained by single-frequency bioimpedance (SF-BIA) and by a multiple frequency bioimpedance (MF-BIA) device, using dual energy X-ray absorptiometry (DXA) peritoneal dialysis (PD) patients.Methods: This was a cross-sectional study involving adult patients undergoing regular PD, in which we performed SF-BIA, MF-BIA, and DXA at the same visit. To compare the bioimpedance values with DXA, we used: Person correlation (r), intraclass correlation coefficient (ICC), and Bland-Altman concordance analysis.Results: The sample consisted of 50 patients in the PD, with mean age of 55.1 ± 16.3 years. Both bioimpedance methods showed a strong correlation (r > 0.7) and excellent reproducibility (ICC > 0.75) compared to DXA. According to the Bland-Altman diagram, SF-BIA showed agreement in body compartment measurements, with no proportionality bias (p > 0.05), without systematic bias for FFM (−0.5 ± 4.9, 95% CI −1.8 to 0.9, p = 0.506), and for FM (0.3 ± 4.6, p = 0.543). MF-BIA did not present a proportionality bias for the FFM, but it underestimated this body compartment by 2.5 ± 5.4 kg (p = 0.002). In addition, MF-BIA presented proportionality bias for FM.Conclusion: SF-BIA was a more accurate assessing method than MBIA for FFM and FM measurements in PD patients. Because it is a low-cost, non-evaluator-dependent measurement and has less systematic bias, it can also be recommended for fat mass and free-fat mass evaluation in PD patients.

Objective: To present a robust methodology for evaluating ankle health during ambulation using a wearable device. Methods: We developed a novel data capture system that leverages changes within the ankle during ambulation for real-time tracking of bioimpedance. The novel analysis compares the range of reactance at 5 kHz to the range of reactance at 100 kHz; which removes the technique's previous reliance on a known baseline. To aid in interpretation of the measurements, we developed a quantitative simulation model based on a literature review of the effects on joint bioimpedance of variations in edematous fluid volume, muscle fiber tears, and blood flow changes. Results: The results of the simulation predicted a significant difference in the ratio of the range of the reactance from 5 kHz to 100 kHz between the healthy and injured ankles. These results were validated in 15 subjects - with 11 healthy ankles and 7 injured ankles measured. The injured subjects had lateral ankle sprains 2-4 weeks prior to the measurement. The analysis technique differentiated between the healthy and the injured population (p<<0.01), and a correlation (R = 0.8) with a static protocol previously validated for its sensitivity to edema. Conclusion: The technology presented can detect variations in ankle edema and structural integrity of ankles, and thus could provide valuable feedback to clinicians and patients during the rehabilitation of an ankle injury. Significance: This technology could lead to better-informed decision making regarding a patient's readiness to return to activity and / or tailoring rehabilitation activities to an individual's changing needs. [ABSTRACT FROM AUTHOR]

Background and Aims: Obesity is a risk factor for diabetes and cardiovascular disease. Clinical studies have identified two subtypes of obesity: metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUHO), the latter being associated with an increased risk of mortality from any cause or cardiovascular (CV) events. Therefore, for better phenotyping, several atherogenic indices such as atherogenic index and lipid accumulation product have been used that can be calculated at the routine control in order to detect people at high cardiovascular risk. Materials and Methods: This was a retrospective study. A total of 163 obese participants (n = 118 metabolically unhealthy subjects with a mean ± SD body mass index (BMI) of 37.8 ± 5.7 kg/m²) took part in this study. Body composition was assessed by electrical bioimpedance; fasting blood glucose, lipid profile, creatinine, transaminases and serum insulin were obtained using standard protocols. Results: The frequency of metabolic syndrome was 72.8%. Patients with MUHO were significantly older, with a higher weight, BMI, waist circumference and waist-hip ratio compared to MHO. All atherogenic indices were statistically significantly higher in patients with MUHO. Conclusions: We described several clinical parameters that are accessible in medical offices, which can help the clinician in better phenotyping and identifying MUHO, in order to implement preventive measures to reduce cardiovascular risk. [ABSTRACT FROM AUTHOR]

Hypoxia poses a serious threat to pilots. The aim of this study was to examine the efficacy of electrical bioimpedance (EBI) in detecting the onset of hypoxia in real time in a rabbit hypoxia model. Thirty-two New Zealand rabbits were divided equally into four groups (control group and three hypoxia groups, i.e., mild, moderate, and severe). Hypoxia was induced by simulating various altitudes in the hypobaric oxygen chamber (3,000m, 5,000m, and 8,000m). Both cerebral impedance and blood oxygen (SpO2) were monitored continuously. Results showed that the cerebral impedance increased immediately during the period of increasing altitude and decreased quickly to the initial baseline at the phase of descending altitude. Moreover, the change of cerebral impedance in the mild hypoxia group (3,000m) was significantly smaller than those in the other two groups (5,000m and 8,000m, P < 0.05). The changes in cerebral impedance and SpO2 were significantly correlated based on the total of measurement data (r² = 0.628, P < 0.001). Furthermore, the agreement analysis performed with Bland-Altman and standardized residual plots exhibited high concordance between cerebral impedance and SpO2. Receiver operator characteristic analysis manifested that the sensitivity, specificity, and area under the curve using cerebral impedance for changes in SpO2 >10% were 0.735, 0.826, and 0.845, respectively. These findings demonstrated that EBI could sensitively and accurately monitor changes of cerebral impedance induced by hypoxia, which might provide a potential tool for the real-time and noninvasive monitoring of hypoxic condition of pilots in flight for early identification of hypoxia. [ABSTRACT FROM AUTHOR]

Objective . Blood C-reactive protein (CRP) and the electrical bioimpedance spectroscopy (EBIS) variables phase angle (PhA) and impedance ratio (IR) have been proposed as biomarkers of metainflammation in overweight/obesity. CRP involves taking blood samples, while PhA and IR imply a less-than-2-minute-non-invasive procedure. In this study, values for these variables and percent body fat mass (PBFM) were obtained and compared before and immediately after a colon cleansing protocol (CCP), aimed at modulating intestinal microbiota and reducing metainflammation, as dysbiosis and the latter are intrinsically related, as well as along a period of 8 weeks after it. Approach . 20 female volunteers (20.9-24.9 years old) participated: 12 in an overweight group ( OG ), and 8 in a lean group ( LG ). The OG was divided in two subgroups ( n = 6, each): control ( CSG ) and experimental ( ESG ). The ESG underwent a 6-day CCP at week 2, while 5 volunteers in the CSG underwent it at week 9. Main results. Pre/post-CCP mean values for the variables in the OG were: PBFM (34.3/31.3%), CRP (3.7/0.6 mg dl -1 ), PhA (6.9/7.5°) and IR*10 (0.78/0.77). Calculated R 2 correlation factors among these variables are all above 0.89. The favourable changes first seen in the ESG were still present 8 weeks after the CCP. Significance. (a) the CCP drastically lowers meta-inflammation, (b) EBIS can be used to measure metainflammation, before and after treatment, (c) for microbiota modulation, CCP could be a good alternative to more drastic procedures like faecal microbiota transplantation; (d) reestablishing eubiosis by CCP could be an effective coadjutant in the treatment of overweight young adult women., (© 2024 Institute of Physics and Engineering in Medicine.)

In this work, we investigate the possibility of employing sparse reconstruction framework for the separation of cardiac and respiratory signal components from the bioimpedance measurements. The signal decomposition is complicated by the nonstationarity of the signal and overlapping of their spectra. The signal has a harmonic structure, which is sparse in the spectral domain. We approach the problem by considering a dictionary with integrated wideband elements describing spectral components of the considered signal. The parameter estimation task is solved by the means of sparse reconstruction where solving the optimization problem returns a sparse vector of relevant dictionary atoms. DOI: http://dx.doi.org/10.5755/j01.eie.24.5.21844