New Aging Index Using Signal Features of Both Photoplethysmograms and Acceleration Plethysmograms / 대한의료정보학회지

OBJECTIVES: Acceleration plethysmograms (APGs) are obtained by taking the second derivative of photoplethysmograms (PPGs) and are noninvasive circulatory signals related to risk factors for atherosclerosis with age. There has been growing interest in the development of mobile devices to collect and analyze PPG single features for ambulatory health monitoring. The present study aimed to extract a new feature from the morphologies of APG and PPG signals to classify the dominant indices related to the pulsatile volume of blood in tissue according to age. METHODS: Ten APG and 14 PPG indices were simultaneously extracted. All indices were compared via Pearson correlation coefficients (r) and a regression analysis. We introduced a combined index extracted from both the PPG and APG indices defined as the inflection point area plus the d_peak (IPAD). The participants included 93 healthy adults aged 36–86 years with a mean ± standard deviation age of 57.43 ± 11.99 years. RESULTS: The d_peak and age index for the APG indices were significantly correlated with age (r = −0.408, p < 0.0001 and r = 0.296, p = 0.0039, respectively). Only the A1 time for PPG indices was moderately correlated with age (r = −0.247, p = 0.017). The stiffness index, including individual height information, was not related to age (r = −0.031, p = 0.7713). However, the combined IPAD index was significantly more correlated with age (r = 0.56, p < 0.001) than the other indices. CONCLUSIONS: The proposed index outperformed the other 24 indices for evaluating vascular aging. We suggest that the IPAD is a significant factor related to the clinical information embedded in the PPG waveform.

Aging Index using Photoplethysmography for a Healthcare Device: Comparison with Brachial-Ankle Pulse Wave Velocity / 대한의료정보학회지

OBJECTIVES: Recent studies have emphasized the potential information embedded in peripheral fingertip photoplethysmogram (PPG) signals for the assessment of arterial wall stiffening during aging. For the discrimination of arterial stiffness with age, the brachial-ankle pulse wave velocity (baPWV) has been widely used in clinical applications. The second derivative of the PPG (acceleration photoplethysmogram [APG]) has been reported to correlate with the presence of atherosclerotic disorders. In this study, we investigated the association among age, the baPWV, and the APG and found a new aging index reflecting arterial stiffness for a healthcare device. METHODS: The APG and the baPWV were simultaneously applied to assess the accuracy of the APG in measuring arterial stiffness in association with age. A preamplifier and motion artifact removal algorithm were newly developed to obtain a high quality PPG signal. In total, 168 subjects with a mean +/- SD age of 58.1 +/- 12.6 years were followed for two months to obtain a set of complete data using baPWV and APG analysis. RESULTS: The baPWV and the B ratio of the APG indices were correlated significantly with age (r = 0.6685, p < 0.0001 and r = -0.4025, p < 0.0001, respectively). A regression analysis revealed that the c and d peaks were independent of age (r = -0.3553, p < 0.0001 and r = -0.3191, p < 0.0001, respectively). CONCLUSIONS: We determined the B ratio, which represents an improved aging index and suggest that the APG may provide qualitatively similar information for arterial stiffness.

Wave Detection in Acceleration Plethysmogram / 대한의료정보학회지

OBJECTIVES: Acceleration plethysmogram (APG) obtained from the second derivative of photoplethysmography (PPG) is used to predict risk factors for atherosclerosis with age. This technique is promising for early screening of atherosclerotic pathologies. However, extraction of the wave indices of APG signals measured from the fingertip is challenging. In this paper, the development of a wave detection algorithm including a preamplifier based on a microcontroller that can detect the a, b, c, and d wave indices is proposed. METHODS: The 4th order derivative of a PPG under real measurements of an APG waveform was introduced to clearly separate the components of the waveform, and to improve the rate of successful wave detection. A preamplifier with a Sallen-Key low pass filter and a wave detection algorithm with programmable gain control, mathematical differentials, and a digital IIR notch filter were designed. RESULTS: The frequency response of the digital IIR filter was evaluated, and a pulse train consisting of a specific area in which the wave indices existed was generated. The programmable gain control maintained a constant APG amplitude at the output for varying PPG amplitudes. For 164 subjects, the mean values and standard deviation of the a wave index corresponding to the magnitude of the APG signal were 1,106.45 and +/-47.75, respectively. CONCLUSIONS: We conclude that the proposed algorithm and preamplifier designed to extract the wave indices of an APG in real-time are useful for evaluating vascular aging in the cardiovascular system in a simple healthcare device.

In vivo Performance Evaluation of Implantable Wireless Neural Signal Transmission System for Brain Machine Interface

A brain-machine interface (BMI) has recently been introduced to research a reliable control of machine from the brain information processing through single neural spikes in motor brain areas for paralyzed individuals. Small, wireless, and implantable BMI system should be developed to decode movement information for classifications of neural activities in the brain. In this paper, we have developed a totally implantable wireless neural signal transmission system (TiWiNets) combined with advanced digital signal processing capable of implementing a high performance BMI system. It consisted of a preamplifier with only 2 operational amplifiers (op-amps) for each channel, wireless bluetooth module (BM), a Labview-based monitor program, and 16 bit-RISC microcontroller. Digital finite impulse response (FIR) band-pass filter based on windowed sinc method was designed to transmit neural signals corresponding to the frequency range of 400 Hz to 1.5 kHz via wireless BM, measuring over -48 dB attenuated in the other frequencies. Less than +/-2% error by inputting a sine wave at pass-band frequencies for FIR algorithm test was obtained between simulated and measured FIR results. Because of the powerful digital FIR design, the total dimension could be dramatically reduced to 23x27x4 mm including wireless BM except for battery. The power isolation was built to avoid the effect of radio-frequency interference on the system as well as to protect brain cells from system damage due to excessive power dissipation or external electric leakage. In vivo performance was evaluated in terms of long-term stability and FIR algorithm for 4 months after implantation. Four TiWiNets were implanted into experimental animals' brains, and single neural signals were recorded and analyzed in real time successfully except for one due to silicon- coated problem. They could control remote target machine by classify neural spike trains based on decoding technology. Thus, we concluded that our study could fulfill in vivo needs to study various single neuron-movement relationships in diverse fields of BMI.

Effect of patient's breathing pattern on the stress changes in third molar extraction

PURPOSE: Heart rate variability(HRV) is the clinical consequence of various influences of the autonomic nervous system(ANS) on heart beat. HRV can estimate the potential physiologic rhythm from the interval between consecutive beats (RR interval or HRV data). It is known as RSA which represents respiration-related HR rhythmic oscillation. Previous studies demonstrated a specific breathing pattern (0.1Hz, 6breaths/min) to improve a physiological body condition related to the stress. In this paper, the level of stress would be evaluated in terms of three phases of the dental treatment, combined with 6breaths/min. METHODS: These phases include before, during and after tooth extraction or anesthesia or something.36 patients'stresses were assessed using HRV stress analyzer in each phase in Kangdong Sacred Heart Hospital, and Chuncheon Sacred Heart Hospital, Hallym University Medical Center from Jun. to Sept. of 2007. HRV 5-min data collected were analyzed in time-domain and frequency-domain to evaluate the activity of autonomic nervous system (ANS) which represents the level of stress. RESULTS: All HRV parameters including HF (high frequency), LF (low frequency) and LF/HF ratio showned a significant change affecting the ANS balance. There was a 6.4% difference between R(LF/HF)s on general breathing pattern for balance of Autonomic nervous system, but on controlled breathing pattern, 0.1Hz, was made narrow till 1.4%. The activity of ANS has increased by 1.4% on general breathing pattern, and by 2.9% on controlled breathing pattern, 0.1Hz. CONCLUSION: After analysis of preoperative stress changes and effect of breathing pattern of 0.1 Hz on the stress in 36 patients who have undergone third molar extraction, following was concluded. In the preoperative stage, the sympathetic change was the greatest after the anesthetic injection, and stress was relieved by controlling the breathing pattern to a frequency of 0.1Hz.