Flexible Thermoelectric Wearable Architecture for Wireless Continuous Physiological Monitoring.

Continuous monitoring of physiological signals from the human body is critical in health monitoring, disease diagnosis, and therapeutics. Despite the needs, the existing wearable medical devices rely on either bulky wired systems or battery-powered devices needing frequent recharging. Here, we introduce a wearable, self-powered, thermoelectric flexible system architecture for wireless portable monitoring of physiological signals without recharging batteries. This system harvests an exceptionally high open circuit voltage of 175-180 mV from the human body, powering the wireless wearable bioelectronics to detect electrophysiological signals on the skin continuously. The thermoelectric system shows long-term stability in performance for 7 days with stable power management. Integrating screen printing, laser micromachining, and soft packaging technologies enables a multilayered, soft, wearable device to be mounted on any body part. The demonstration of the self-sustainable wearable system for detecting electromyograms and electrocardiograms captures the potential of the platform technology to offer various opportunities for continuous monitoring of biosignals, remote health monitoring, and automated disease diagnosis.

Detecting and Predicting Pilot Mental Workload Using Heart Rate Variability: A Systematic Review.

Measuring pilot mental workload (MWL) is crucial for enhancing aviation safety. However, MWL is a multi-dimensional construct that could be affected by multiple factors. Particularly, in the context of a more automated cockpit setting, the traditional methods of assessing pilot MWL may face challenges. Heart rate variability (HRV) has emerged as a potential tool for detecting pilot MWL during real-flight operations. This review aims to investigate the relationship between HRV and pilot MWL and to assess the performance of machine-learning-based MWL detection systems using HRV parameters. A total of 29 relevant papers were extracted from three databases for review based on rigorous eligibility criteria. We observed significant variability across the reviewed studies, including study designs and measurement methods, as well as machine-learning techniques. Inconsistent results were observed regarding the differences in HRV measures between pilots under varying levels of MWL. Furthermore, for studies that developed HRV-based MWL detection systems, we examined the diverse model settings and discovered that several advanced techniques could be used to address specific challenges. This review serves as a practical guide for researchers and practitioners who are interested in employing HRV indicators for evaluating MWL and wish to incorporate cutting-edge techniques into their MWL measurement approaches.

Joint low-rank tensor fusion and cross-modal attention for multimodal physiological signals based emotion recognition.

Objective. Physiological signals based emotion recognition is a prominent research domain in the field of human-computer interaction. Previous studies predominantly focused on unimodal data, giving limited attention to the interplay among multiple modalities. Within the scope of multimodal emotion recognition, integrating the information from diverse modalities and leveraging the complementary information are the two essential issues to obtain the robust representations.Approach. Thus, we propose a intermediate fusion strategy for combining low-rank tensor fusion with the cross-modal attention to enhance the fusion of electroencephalogram, electrooculogram, electromyography, and galvanic skin response. Firstly, handcrafted features from distinct modalities are individually fed to corresponding feature extractors to obtain latent features. Subsequently, low-rank tensor is fused to integrate the information by the modality interaction representation. Finally, a cross-modal attention module is employed to explore the potential relationships between the distinct latent features and modality interaction representation, and recalibrate the weights of different modalities. And the resultant representation is adopted for emotion recognition.Main results. Furthermore, to validate the effectiveness of the proposed method, we execute subject-independent experiments within the DEAP dataset. The proposed method has achieved the accuracies of 73.82% and 74.55% for valence and arousal classification.Significance. The results of extensive experiments verify the outstanding performance of the proposed method.

Machine learning model with output correction: Towards reliable bradycardia detection in neonates.

Bradycardia is a commonly occurring condition in premature infants, often causing serious consequences and cardiovascular complications. Reliable and accurate detection of bradycardia events is pivotal for timely intervention and effective treatment. Excessive false alarms pose a critical problem in bradycardia event detection, eroding trust in machine learning (ML)-based clinical decision support tools designed for such detection. This could result in disregarding the algorithm's accurate recommendations and disrupting workflows, potentially compromising the quality of patient care. This article introduces an ML-based approach incorporating an output correction element, designed to minimise false alarms. The approach has been applied to bradycardia detection in preterm infants. We applied five ML-based autoencoder techniques, using recurrent neural network (RNN), long-short-term memory (LSTM), gated recurrent unit (GRU), 1D convolutional neural network (1D CNN), and a combination of 1D CNN and LSTM. The analysis is performed on ∼440 hours of real-time preterm infant data. The proposed approach achieved 0.978, 0.73, 0.992, 0.671 and 0.007 in AUC-ROC, AUC-PRC, recall, F1 score, and false positive rate (FPR) respectively and a false alarms reduction of 36% when compared with methods without the correction approach. This study underscores the imperative of cultivating solutions that alleviate alarm fatigue and encourage active engagement among healthcare professionals.

Quantifying the Suitability of Biosignals Acquired During Surgery for Multimodal Analysis.

Goal: Recently, large datasets of biosignals acquired during surgery became available. As they offer multiple physiological signals measured in parallel, multimodal analysis - which involves their joint analysis - can be conducted and could provide deeper insights than unimodal analysis based on a single signal. However, it is unclear what percentage of intraoperatively acquired data is suitable for multimodal analysis. Due to the large amount of data, manual inspection and labelling into suitable and unsuitable segments are not feasible. Nevertheless, multimodal analysis is performed successfully in sleep studies since many years as their signals have proven suitable. Hence, this study evaluates the suitability to perform multimodal analysis on a surgery dataset (VitalDB) using a multi-center sleep dataset (SIESTA) as reference. Methods: We applied widely known algorithms entitled "signal quality indicators" to the common biosignals in both datasets, namely electrocardiography, electroencephalography, and respiratory signals split in segments of 10 s duration. As there are no multimodal methods available, we used only unimodal signal quality indicators. In case, all three signals were determined as being adequate by the indicators, we assumed that the whole signal segment was suitable for multimodal analysis. Results: 82% of SIESTA and 72% of VitalDB are suitable for multimodal analysis. Unsuitable signal segments exhibit constant or physiologically unreasonable values. Histogram examination indicated similar signal quality distributions between the datasets, albeit with potential statistical biases due to different measurement setups. Conclusions: The majority of data within VitalDB is suitable for multimodal analysis.

Self supervised learning based emotion recognition using physiological signals.

Introduction: The significant role of emotional recognition in the field of human-machine interaction has garnered the attention of many researchers. Emotion recognition based on physiological signals can objectively reflect the most authentic emotional states of humans. However, existing labeled Electroencephalogram (EEG) datasets are often of small scale. Methods: In practical scenarios, a large number of unlabeled EEG signals are easier to obtain. Therefore, this paper adopts self-supervised learning methods to study emotion recognition based on EEG. Specifically, experiments employ three pre-defined tasks to define pseudo-labels and extract features from the inherent structure of the data. Results and discussion: Experimental results indicate that self-supervised learning methods have the capability to learn effective feature representations for downstream tasks without any manual labels.

Comparing multimodal physiological responses to social and physical pain in healthy participants.

Background: Previous physiology-driven pain studies focused on examining the presence or intensity of physical pain. However, people experience various types of pain, including social pain, which induces negative mood; emotional distress; and neural activities associated with physical pain. In particular, comparison of autonomic nervous system (ANS) responses between social and physical pain in healthy adults has not been well demonstrated. Methods: We explored the ANS responses induced by two types of pain-social pain, associated with a loss of social ties; and physical pain, caused by a pressure cuff-based on multimodal physiological signals. Seventy-three healthy individuals (46 women; mean age = 20.67 ± 3.27 years) participated. Behavioral responses were assessed to determine their sensitivity to pain stimuli. Electrocardiogram, electrodermal activity, photoplethysmogram, respiration, and finger temperature (FT) were measured, and 12 features were extracted from these signals. Results: Social pain induced increased heart rate (HR) and skin conductance (SC) and decreased blood volume pulse (BVP), pulse transit time (PTT), respiration rate (RR), and FT, suggesting a heterogeneous pattern of sympathetic-parasympathetic coactivation. Moreover, physical pain induced increased heart rate variability (HRV) and SC, decreased BVP and PTT, and resulted in no change in FT, indicating sympathetic-adrenal-medullary activation and peripheral vasoconstriction. Conclusion: These results suggest that changes in HR, HRV indices, RR, and FT can serve as markers for differentiating physiological responses to social and physical pain stimuli.

Wearable smart contact lenses: A critical comparison of three physiological signals outputs for health monitoring.

Smart contact lenses (SCLs) have been considered as novel wearable devices for out-of-hospital and self-monitoring applications. They are capable of non-invasively and continuously monitoring physiological signals in the eyes, including vital biophysical (e.g., intraocular of pressure, temperature, and electrophysiological signal) and biochemical signals (e.g., pH, glucose, protein, nitrite, lactic acid, and ions). Recent progress mainly focuses on the rational design of wearable SCLs for physiological signal monitoring, while also facilitating the treatment of various ocular diseases. It covers contact lens materials, fabrication technologies, and integration methods. We also highlight and discuss a critical comparison of SCLs with electrical, microfluidic, and optical signal outputs in health monitoring. Their advantages and disadvantages could help researchers to make decisions when developing SCLs with desired properties for physiological signal monitoring. These unique capabilities make SCLs promising diagnostic and therapeutic tools. Despite the extensive research in SCLs, new technologies are still in their early stages of development and there are a few challenges to be addressed before these SCLs technologies can be successfully commercialized particularly in the form of rigorous clinical trials.

Biosignals, facial expressions, and speech as measures of workplace stress: Workstress3d dataset.

WorkStress3D is a comprehensive collection of multimodal data for the research of stress in the workplace. This dataset contains biosignals, facial expressions, and speech signals, making it an invaluable resource for stress analysis and related studies. The ecological validity of the dataset was ensured by the fact that the data were collected in actual workplace environments. The biosignal data contains measurements of electrodermal activity, blood volume pressure, and cutaneous temperature, among others. High-resolution video recordings were used to capture facial expressions, allowing for a comprehensive analysis of facial cues associated with tension. In order to capture vocal characteristics indicative of tension, speech signals were recorded. The dataset contains samples from both stress-free and stressful work situations, providing a proportionate representation of various stress levels. The dataset is accompanied by extensive metadata and annotations, which facilitate in-depth analysis and interpretation. WorkStress3D is a valuable resource for developing and evaluating stress detection models, examining the impact of work environments on stress levels, and exploring the potential of multimodal data fusion for stress analysis.

A comparative study in class imbalance mitigation when working with physiological signals.

Class imbalance is a common challenge that is often faced when dealing with classification tasks aiming to detect medical events that are particularly infrequent. Apnoea is an example of such events. This challenge can however be mitigated using class rebalancing algorithms. This work investigated 10 widely used data-level class imbalance mitigation methods aiming towards building a random forest (RF) model that attempts to detect apnoea events from photoplethysmography (PPG) signals acquired from the neck. Those methods are random undersampling (RandUS), random oversampling (RandOS), condensed nearest-neighbors (CNNUS), edited nearest-neighbors (ENNUS), Tomek's links (TomekUS), synthetic minority oversampling technique (SMOTE), Borderline-SMOTE (BLSMOTE), adaptive synthetic oversampling (ADASYN), SMOTE with TomekUS (SMOTETomek) and SMOTE with ENNUS (SMOTEENN). Feature-space transformation using PCA and KernelPCA was also examined as a potential way of providing better representations of the data for the class rebalancing methods to operate. This work showed that RandUS is the best option for improving the sensitivity score (up to 11%). However, it could hinder the overall accuracy due to the reduced amount of training data. On the other hand, augmenting the data with new artificial data points was shown to be a non-trivial task that needs further development, especially in the presence of subject dependencies, as was the case in this work.

Predicting Driver's mental workload using physiological signals: A functional data analysis approach.

This study investigates the impact of advanced driver-assistance systems on drivers' mental workload. Using a combination of physiological signals including ECG, EMG, EDA, EEG (af4 and fc6 channels from the theta band), and eye diameter data, this study aims to predict and categorize drivers' mental workload into low, adequate, and high levels. Data were collected from five different driving situations with varying cognitive demands. A functional linear regression model was employed for prediction, and the accuracy rate was calculated. Among the 31 tested combinations of physiological variables, 9 combinations achieved the highest accuracy result of 90%. These results highlight the potential benefits of utilizing raw physiological signal data and employing functional data analysis methods to understand and assess driver mental workload. The findings of this study have implications for the design and improvement of driver-assistance systems to optimize safety and performance.

Implementation of a Real-Time Brain-to-Brain Synchrony Estimation Algorithm for Neuroeducation Applications.

This study centers on creating a real-time algorithm to estimate brain-to-brain synchronization during social interactions, specifically in collaborative and competitive scenarios. This type of algorithm can provide useful information in the educational context, for instance, during teacher-student or student-student interactions. Positioned within the context of neuroeducation and hyperscanning, this research addresses the need for biomarkers as metrics for feedback, a missing element in current teaching methods. Implementing the bispectrum technique with multiprocessing functions in Python, the algorithm effectively processes electroencephalography signals and estimates brain-to-brain synchronization between pairs of subjects during (competitive and collaborative) activities that imply specific cognitive processes. Noteworthy differences, such as higher bispectrum values in collaborative tasks compared to competitive ones, emerge with reliability, showing a total of 33.75% of significant results validated through a statistical test. While acknowledging progress, this study identifies areas of opportunity, including embedded operations, wider testing, and improved result visualization. Beyond academia, the algorithm's utility extends to classrooms, industries, and any setting involving human interactions. Moreover, the presented algorithm is shared openly, to facilitate implementations by other researchers, and is easily adjustable to other electroencephalography devices. This research not only bridges a technological gap but also contributes insights into the importance of interactions in educational contexts.

Automatic identification of hypertension and assessment of its secondary effects using artificial intelligence: A systematic review (2013-2023).

Artificial Intelligence (AI) techniques are increasingly used in computer-aided diagnostic tools in medicine. These techniques can also help to identify Hypertension (HTN) in its early stage, as it is a global health issue. Automated HTN detection uses socio-demographic, clinical data, and physiological signals. Additionally, signs of secondary HTN can also be identified using various imaging modalities. This systematic review examines related work on automated HTN detection. We identify datasets, techniques, and classifiers used to develop AI models from clinical data, physiological signals, and fused data (a combination of both). Image-based models for assessing secondary HTN are also reviewed. The majority of the studies have primarily utilized single-modality approaches, such as biological signals (e.g., electrocardiography, photoplethysmography), and medical imaging (e.g., magnetic resonance angiography, ultrasound). Surprisingly, only a small portion of the studies (22 out of 122) utilized a multi-modal fusion approach combining data from different sources. Even fewer investigated integrating clinical data, physiological signals, and medical imaging to understand the intricate relationships between these factors. Future research directions are discussed that could build better healthcare systems for early HTN detection through more integrated modeling of multi-modal data sources.

Enhancing Stress Detection: A Comprehensive Approach through rPPG Analysis and Deep Learning Techniques.

Stress has emerged as a major concern in modern society, significantly impacting human health and well-being. Statistical evidence underscores the extensive social influence of stress, especially in terms of work-related stress and associated healthcare costs. This paper addresses the critical need for accurate stress detection, emphasising its far-reaching effects on health and social dynamics. Focusing on remote stress monitoring, it proposes an efficient deep learning approach for stress detection from facial videos. In contrast to the research on wearable devices, this paper proposes novel Hybrid Deep Learning (DL) networks for stress detection based on remote photoplethysmography (rPPG), employing (Long Short-Term Memory (LSTM), Gated Recurrent Units (GRU), 1D Convolutional Neural Network (1D-CNN)) models with hyperparameter optimisation and augmentation techniques to enhance performance. The proposed approach yields a substantial improvement in accuracy and efficiency in stress detection, achieving up to 95.83% accuracy with the UBFC-Phys dataset while maintaining excellent computational efficiency. The experimental results demonstrate the effectiveness of the proposed Hybrid DL models for rPPG-based-stress detection.

Current On-Skin Flexible Sensors, Materials, Manufacturing Approaches, and Study Trends for Health Monitoring: A Review.

Due to an ever-increasing amount of the population focusing more on their personal health, thanks to rising living standards, there is a pressing need to improve personal healthcare devices. These devices presently require laborious, time-consuming, and convoluted procedures that heavily rely on cumbersome equipment, causing discomfort and pain for the patients during invasive methods such as sample-gathering, blood sampling, and other traditional benchtop techniques. The solution lies in the development of new flexible sensors with temperature, humidity, strain, pressure, and sweat detection and monitoring capabilities, mimicking some of the sensory capabilities of the skin. In this review, a comprehensive presentation of the themes regarding flexible sensors, chosen materials, manufacturing processes, and trends was made. It was concluded that carbon-based composite materials, along with graphene and its derivates, have garnered significant interest due to their electromechanical stability, extraordinary electrical conductivity, high specific surface area, variety, and relatively low cost.

Research and application of deep learning-based sleep staging: Data, modeling, validation, and clinical practice.

Over the past few decades, researchers have attempted to simplify and accelerate the process of sleep stage classification through various approaches; however, only a few such approaches have gained widespread acceptance. Artificial intelligence technology, particularly deep learning, is promising for earning the trust of the sleep medicine community in automated sleep-staging systems, thus facilitating its application in clinical practice and integration into daily life. We aimed to comprehensively review the latest methods that are applying deep learning for enhancing sleep staging efficiency and accuracy. Starting from the requisite "data" for constructing deep learning algorithms, we elucidated the current landscape of this domain and summarized the fundamental modeling process, encompassing signal selection, data pre-processing, model architecture, classification tasks, and performance metrics. Furthermore, we reviewed the applications of automated sleep staging in scenarios such as sleep-disorder screening, diagnostic procedures, and health monitoring and management. Finally, we conducted an in-depth analysis and discussion of the challenges and future in intelligent sleep staging, particularly focusing on large-scale sleep datasets, interdisciplinary collaborations, and human-computer interactions.

Assessment of Drivers' Mental Workload by Multimodal Measures during Auditory-Based Dual-Task Driving Scenarios.

Assessing drivers' mental workload is crucial for reducing road accidents. This study examined drivers' mental workload in a simulated auditory-based dual-task driving scenario, with driving tasks as the main task, and auditory-based N-back tasks as the secondary task. A total of three levels of mental workload (i.e., low, medium, high) were manipulated by varying the difficulty levels of the secondary task (i.e., no presence of secondary task, 1-back, 2-back). Multimodal measures, including a set of subjective measures, physiological measures, and behavioral performance measures, were collected during the experiment. The results showed that an increase in task difficulty led to increased subjective ratings of mental workload and a decrease in task performance for the secondary N-back tasks. Significant differences were observed across the different levels of mental workload in multimodal physiological measures, such as delta waves in EEG signals, fixation distance in eye movement signals, time- and frequency-domain measures in ECG signals, and skin conductance in EDA signals. In addition, four driving performance measures related to vehicle velocity and the deviation of pedal input and vehicle position also showed sensitivity to the changes in drivers' mental workload. The findings from this study can contribute to a comprehensive understanding of effective measures for mental workload assessment in driving scenarios and to the development of smart driving systems for the accurate recognition of drivers' mental states.

Monitoring of Sweat Ions and Physiological Parameters via a Reconfigurable Modular System.

In recent years, wearable sensors have revolutionized health monitoring by enabling continuous, real-time tracking of human health and performance. These noninvasive devices are usually designed to monitor human physical state and biochemical markers. However, enhancing their functionalities often demands intricate customization by designers and additional expenses for users. Here, we present a strategy using assembled modular circuits to customize health monitoring wearables. The modular circuits can be effortlessly reconfigured to meet various specific requirements, facilitating the incorporation of diverse functions at a lower cost. To validate this approach, modular circuits were employed to develop four distinct systems for in vitro evaluations. These systems enabled the detection of sweat biomarkers and physical signals under various scenarios, including sedentary state, exercise, and daily activities with or without incorporating iontophoresis to induce sweat. Four key sweat markers (K+, Ca2+, Na+, and pH) and three essential physical indicators (heart rate, blood oxygen levels, and skin temperature) are selected as the detection targets. Commercial methods were also used to evaluate the potential for effective health monitoring with our technique. This reconfigurable modular wearable (ReModuWear) system promises to provide more easy-to-use and comprehensive health assessments. Additionally, it may contribute to environmental sustainability by reusing modules.

Neurophysiological and biosignal data for investigating occupational mental fatigue: MEFAR dataset.

The prevalence of mental fatigue is a noteworthy phenomenon that can affect individuals across diverse professions and working routines. This paper provides a comprehensive dataset of physiological signals obtained from 23 participants during their professional work and questionnaires to analyze mental fatigue. The questionnaires included demographic information and Chalder Fatigue Scale scores indicating mental and physical fatigue. Both physiological signal measurements and the Chalder Fatigue Scale were performed in two sessions, morning and evening. The present dataset encompasses diverse physiological signals, including electroencephalogram (EEG), blood volume pulse (BVP), electrodermal activity (EDA), heart rate (HR), skin temperature (TEMP), and 3-axis accelerometer (ACC) data. The NeuroSky MindWave EEG device was used for brain signals, and the Empatica E4 smart wristband was used for other signals. Measurements were carried out on individuals from four different occupational groups, such as academicians, technicians, computer engineers, and kitchen workers. The provision of comprehensive metadata supplements the dataset, thereby promoting inquiries about the neurophysiological concomitants of mental fatigue, autonomic activity patterns, and the repercussions of a cognitive burden on human proficiency in actual workplace settings. The accessibility of the aforementioned dataset serves to facilitate progress in the field of mental fatigue research while also laying the groundwork for the creation of customized fatigue evaluation techniques and interventions in diverse professional domains.