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Objective: Clinical adoption of innovative EEG technology is contingent on the non-inferiority of the new devices relative to conventional ones. We present the four key results from testing the signal quality of Zeto's WR19 EEG system against a conventional EEG system conducted on patients in a clinical setting. &#xD;Methods: We performed 30-minute simultaneous recordings using the Zeto WR19 (zEEG) and a conventional clinical EEG system (cEEG) in a cohort of 15 patients. We compared the signal quality between the two EEG systems by computing time domain statistics, waveform correlation, spectral density, signal-to-noise ratio, and signal stability. &#xD;Results: All statistical comparisons resulted in signal quality non-inferior relative to cEEG. (i) Time domain statistics, including the Hjorth parameters, showed equivalence between the two systems, except for a significant reduction of sensitivity to electric noise in zEEG relative to cEEG. (ii) The point-by-point waveform correlation between the two systems was acceptable (r>0.6; P<0.001). (iii) Each of the 15 datasets showed a high spectral correlation (r>0.99; P<0.001) and overlapping spectral density across all electrode positions, indicating no systematic signal distortion. (iv) The mean signal-to-noise ratio (SNR) of the zEEG system exceeded that of the cEEG by 4.82 dB, equivalent to a 16% improvement. (v) The signal stability was maintained through the recordings.&#xD;Conclusion: In terms of signal quality, the zEEG system is non-inferior to conventional clinical EEG systems with respect to all relevant technical parameters that determine EEG readability and interpretability. Zeto's WR19 wireless dry electrode system has signal quality in the clinical EEG space at least equivalent to traditional cEEG recordings., (Creative Commons Attribution license.)

Objective: Wearable nonelectroencephalographic biosignal recordings captured from the wrist offer enormous potential for seizure monitoring. However, signal quality remains a challenging factor affecting data reliability. Models trained for seizure detection depend on the quality of recordings in peri-ictal periods in performing a feature-based separation of ictal periods from interictal periods. Thus, this study aims to investigate the effect of epileptic seizures on signal quality, ensuring accurate and reliable monitoring., Methods: This study assesses the signal quality of wearable data during peri-ictal phases of generalized tonic-clonic and focal to bilateral tonic-clonic seizures (TCS), focal motor seizures (FMS), and focal nonmotor seizures (FNMS). We evaluated accelerometer (ACC) activity and the signal quality of electrodermal activity (EDA) and blood volume pulse (BVP) data. Additionally, we analyzed the influence of peri-ictal movements as assessed by ACC (ACC activity) on signal quality and examined intraictal subphases of focal to bilateral TCS., Results: We analyzed 386 seizures from 111 individuals in three international epilepsy monitoring units. BVP signal quality and ACC activity levels differed between all seizure types. We found the largest decrease in BVP signal quality and increase in ACC activity when comparing the ictal phase to the pre- and postictal phases for TCS. Additionally, ACC activity was strongly negatively correlated with BVP signal quality for TCS and FMS, and weakly for FNMS. Intraictal analysis revealed that tonic and clonic subphases have the lowest BVP signal quality and the highest ACC activity., Significance: Motor elements of seizures significantly impair BVP signal quality, but do not have significant effect on EDA signal quality, as assessed by wrist-worn wearables. The results underscore the importance of signal quality assessment methods and careful selection of robust modalities to ensure reliable seizure detection. Future research is needed to explain whether seizure detection models' decisions are based on signal responses induced by physiological processes as opposed to artifacts., (© 2024 The Author(s). Epilepsia published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.)

Induction-based breathing sensors in automobiles enable unobtrusive respiratory rate monitoring as an indicator of a driver's alertness and health. This paper introduces a quantitative method based on signal quality to guide the integration of textile inductive electrodes in automotive applications. A case study with a simplified setup illustrated the ability of the method to successfully provide basic design rules about where and how to integrate the electrodes on seat belts and seat backs to gather good quality respiratory signals in an automobile. The best signals came from the subject's waist, then from the chest, then from the upper back, and finally from the lower back. Furthermore, folding the electrodes before their integration on a seat back improves the signal quality for both the upper and lower back. This analysis provided guidelines with three design rules to increase the chance of acquiring good quality signals: (1) use a multi-electrode acquisition approach, (2) place the electrodes in locations that maximize breathing-induced body displacement, and (3) use a mechanical amplifying method such as folding the electrodes in locations with little potential for breathing-induced displacement.

Functional Near-Infrared Spectroscopy (fNIRS) holds transformative potential for research and clinical applications in neuroscience due to its non-invasive nature and adaptability to real-world settings. However, despite its promise, fNIRS signal quality is sensitive to individual differences in biophysical factors such as hair and skin characteristics, which can significantly impact the absorption and scattering of near-infrared light. If not properly addressed, these factors risk biasing fNIRS research by disproportionately affecting signal quality across diverse populations. Our results quantify the impact of various hair properties, skin pigmentation as well as head size, sex and age on signal quality, providing quantitative guidance for future hardware advances and methodological standards to help overcome these critical barriers to inclusivity in fNIRS studies. We provide actionable guidelines for fNIRS researchers, including a suggested metadata table and recommendations for cap and optode configurations, hair management techniques, and strategies to optimize data collection across varied participants. This research paves the way for the development of more inclusive fNIRS technologies, fostering broader applicability and improved interpretability of neuroimaging data in diverse populations.

Significance: The increasing sample sizes and channel densities in functional near-infrared spectroscopy (fNIRS) necessitate precise and scalable identification of signals that do not permit reliable analysis to exclude them. Despite the relevance of detecting these "bad channels," little is known about the behavior of fNIRS detection methods, and the potential of unsupervised and semi-supervised machine learning remains unexplored., Aim: We developed three novel machine learning-based detectors, unsupervised, semi-supervised, and hybrid NiReject, and compared them with existing approaches., Approach: We conducted a systematic literature search and demonstrated the influence of bad channel detection. Based on 29,924 signals from two independently rated datasets and a simulated scenario space of diverse phenomena, we evaluated the NiReject models, six of the most established detection methods in fNIRS, and 11 prominent methods from other domains., Results: Although the results indicated that a lack of proper detection can strongly bias findings, detection methods were reported in only 32% of the included studies. Semi-supervised models, specifically semi-supervised NiReject, outperformed both established thresholding-based and unsupervised detectors. Hybrid NiReject, utilizing a human feedback loop, addressed the practical challenges of semi-supervised methods while maintaining precise detection and low rating effort., Conclusions: This work contributes toward more automated and reliable fNIRS signal quality control by comprehensively evaluating existing and introducing novel machine learning-based techniques and outlining practical considerations for bad channel detection., (© 2024 The Authors.)

Bilirubin is a product of the metabolism of hemoglobin from red blood cells. Higher levels of bilirubin are a sign that either there is an unusual breaking down rate of red blood cells or the liver is not able to eliminate bilirubin, through bile, into the gastrointestinal tract. For adults, bilirubin is occasionally monitored through urine or invasive blood sampling, whilst all newborns are routinely monitored visually, or non-invasively with transcutaneous measurements (TcBs), due to their biological immaturity to conjugate bilirubin. Neonatal jaundice is a common condition, with higher levels of unconjugated bilirubin concentration having neurotoxic effects. Actual devices used in TcBs are focused on newborn populations, are hand-held, and, in some cases, operate in only two wavelengths, which does not necessarily guarantee reliable results over all skin tones. The same occurs with visual inspections. Based on that, a continuous bilirubin monitoring device for newborns is being developed to overcome visual inspection errors and to reduce invasive procedures. This device, operating optically with a mini-spectrometer in the visible range, is susceptible to patient movements and, consequently, to situations with a lower signal quality for reliable bilirubin concentration estimates on different types of skin. Therefore, as an intermediate development step and, based on skin spectra measurements from adults, this work addresses the device's placement status prediction as a signal quality indication index. This was implemented by using machine learning (ML), with the best performances being achieved by support vector machine (SVM) models, based on the spectra acquired on the arm and forehead areas.

Introduction: Wearable in-ear electroencephalographic (EEG) devices hold significant promise for integrating brain monitoring technologies into real-life applications. However, despite the introduction of various in-ear EEG systems, there remains a necessity for validating these technologies against gold-standard, clinical-grade devices. This study aims to evaluate the signal quality of a newly developed mobile in-ear EEG device compared to a standard scalp EEG system among healthy volunteers during wakefulness and sleep., Methods: The study evaluated an in-ear EEG device equipped with dry electrodes in a laboratory setting, recording a single bipolar EEG channel using a cross-ear electrode configuration. Thirty healthy participants were recorded simultaneously using the in-ear EEG device and a conventional EEG cap system with 64 wet electrodes. Based on two recording protocols, one during a resting state condition involving alternating eye opening and closure with a low degree of artifact contamination and another consisting of a daytime nap, several quality measures were used for a quantitative comparison including root mean square (RMS) analysis, artifact quantification, similarities of relative spectral power (RSP), signal-to-noise ratio (SNR) based on alpha peak criteria, and cross-signal correlations of alpha activity during eyes-closed conditions and sleep activities. The statistical significance of our results was assessed through nonparametric permutation tests with False Discovery Rate (FDR) control., Results: During the resting state, in-ear and scalp EEG signals exhibited similar fluctuations, characterized by comparable RMS values. However, intermittent signal alterations were noticed in the in-ear recordings during nap sessions, attributed to movements of the head and facial muscles. Spectral analysis indicated similar patterns between in-ear and scalp EEG, showing prominent peaks in the alpha range (8-12 Hz) during rest and in the low-frequency range during naps (particularly in the theta range of 4-7 Hz). Analysis of alpha wave characteristics during eye closures revealed smaller alpha wave amplitudes and slightly lower signal-to-noise ratio (SNR) values in the in-ear EEG compared to scalp EEG. In around 80% of cases, cross-correlation analysis between in-ear and scalp signals, using a contralateral bipolar montage of 64 scalp electrodes, revealed significant correlations with scalp EEG ( p  < 0.01), particularly evident in the FT11-FT12 and T7-T8 electrode derivations., Conclusion: Our findings support the feasibility of using in-ear EEG devices with dry-contact electrodes for brain activity monitoring, compared to a standard scalp EEG, notably for wakefulness and sleep uses. Although marginal signal degradation is associated with head and facial muscle contractions, the in-ear device offers promising applications for long-term EEG recordings, particularly in scenarios requiring enhanced comfort and user-friendliness., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Moumane, Pazuelo, Nassar, Juez, Valderrama and Le Van Quyen.)

Despite the growing adoption of wearable photoplethysmography (PPG) devices in personal health management, their measurement accuracy remains limited due to susceptibility to noise. This paper proposes a novel signal completion technique using generative adversarial networks that ensures both global and local consistency. Our approach innovatively addresses both short- and long-term PPG variations to restore waveforms while maintaining waveform consistency within and between pulses. We evaluated our model by removing up to 50 % of segments from segmented PPG waveforms and comparing the original and reconstructed waveforms, including systolic peak information. The results demonstrate that our method accurately reconstructs waveforms with high fidelity, producing natural and seamless transitions without discontinuities at reconstructed boundaries. Additionally, the reconstructed waveforms preserve typical PPG shapes with minimal distortion, underscoring the effectiveness and novelty of our technique., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Smart wearables support continuous monitoring of vital signs for early detection of deteriorating health. However, the devices and sensors require sufficient quality to produce meaningful signals, in particular, if data is acquired in motion. In this study, we equipped 48 subjects with smart shirts recording one-lead electrocardiography (ECG), thoracic and abdominal respiratory inductance plethysmography, and three-axis acceleration. For 10 min each, the subjects sit, stand, walk, and run, with a resting period of 5 min in between each activity. We preprocessed the electrocardiogram and applied a signal quality index. We analyzed the signal quality index grouped by the activity and participants. For sitting, standing, walking, and running, the ECG signals provide acceptable quality over 73.20 %, 91.85 %, 12.26 %, and 13.14 % of the recording time. In conclusion, smart wearables may be useful for continuous health monitoring of people with a sedentary lifestyle, but rather not for sportive activities.

With the growing popularity of consumer-grade electroencephalogram (EEG) devices for health, entertainment, and cognitive research, assessing their signal quality is essential. In this study, we evaluated four consumer-grade wireless and dry-electrode EEG systems widely used for brain-computer interface (BCI) research and applications, comparing them with a research-grade system. We designed an EEG phantom method that reproduced µV-level amplitude EEG signals and evaluated the five devices based on their spectral responses, temporal patterns of event-related potential (ERP), and spectral patterns of resting-state EEG. We discovered that the consumer-grade devices had limited bandwidth compared with the research-grade device. A late component (e.g., P300) was detectable in the consumer-grade devices, but the overall ERP temporal pattern was distorted. Only one device showed an ERP temporal pattern comparable to that of the research-grade device. On the other hand, we confirmed that the activation of the alpha rhythm was observable in all devices. The results provide valuable insights for researchers and developers when it comes to selecting suitable EEG devices for BCI research and applications., Competing Interests: Competing InterestsThe authors have no relevant financial or non-financial interests to disclose., (© Korean Society of Medical and Biological Engineering 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Wearable in-ear electroencephalographic (EEG) devices hold significant promise for advancing brain monitoring technologies into everyday applications. However, despite the current availability of several in-ear EEG devices in the market, there remains a critical need for robust validation against established clinical-grade systems. In this study, we carried out a detailed examination of the signal performance of a mobile in-ear EEG device from Naox Technologies. Our investigation had two main goals: firstly, evaluating the hardware circuit's reliability through simulated EEG signal experiments and, secondly, conducting a thorough comparison between the in-ear EEG device and gold-standard EEG monitoring equipment. This comparison assesses correlation coefficients with recognized physiological patterns during wakefulness and sleep, including alpha rhythms, eye artifacts, slow waves, spindles, and sleep stages. Our findings support the feasibility of using this in-ear EEG device for brain activity monitoring, particularly in scenarios requiring enhanced comfort and user-friendliness in various clinical and research settings.

The purpose of this study is to investigate the factors affecting consumers' repurchase intentions of skincare cosmetics in Can Tho city. By examining consumers' knowledge, behaviors, and factors impacting their intention of repeatedly buying skincare products, manufacturers and sales businesses are able to more effectively comprehend their clients' demands. Data were collected from 531 consumers residing in the area of Can Tho city, Vietnam, who had bought skincare products for the second time or more. The survey using the cross-sectional method and a set of questionnaires was based on the theory of planned behavior (TPB) and developed on the 5-point Likert scale. The factors impacting repurchase intentions for skincare merchandise involve attitude, reliability of signal quality, and retailer credibility, with attitude being the most powerful influence, followed by retailer credibility and reliability of signal quality respectively. These factors accounted for 27.5 % of behavior variance. The clarity element of signal quality reliability does not affect behavioral intention. Cosmetic companies can develop policies, improve the quality of their products in order to suit the customer needs, retain potential clients, and enhance their competitive capability., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Wearable electronics are increasingly common and useful as health monitoring devices, many of which feature the ability to record a single-lead electrocardiogram (ECG). However, recording the ECG commonly requires the user to touch the device to complete the lead circuit, which prevents continuous data acquisition. An alternative approach to enable continuous monitoring without user initiation is to embed the leads in a garment. This study assessed ECG data obtained from the YouCare device (a novel sensorized garment) via comparison with a conventional Holter monitor. A cohort of thirty patients (age range: 20-82 years; 16 females and 14 males) were enrolled and monitored for twenty-four hours with both the YouCare device and a Holter monitor. ECG data from both devices were qualitatively assessed by a panel of three expert cardiologists and quantitatively analyzed using specialized software. Patients also responded to a survey about the comfort of the YouCare device as compared to the Holter monitor. The YouCare device was assessed to have 70% of its ECG signals as "Good", 12% as "Acceptable", and 18% as "Not Readable". The R-wave, independently recorded by the YouCare device and Holter monitor, were synchronized within measurement error during 99.4% of cardiac cycles. In addition, patients found the YouCare device more comfortable than the Holter monitor (comfortable 22 vs. 5 and uncomfortable 1 vs. 18, respectively). Therefore, the quality of ECG data collected from the garment-based device was comparable to a Holter monitor when the signal was sufficiently acquired, and the garment was also comfortable., (© 2024. The Author(s).)

Objective: Non-sustained supraventricular tachycardia (nsSVT) is associated with a higher risk of developing atrial fibrillation (AF), and, therefore, detection of nsSVT can improve AF screening efficiency. However, the detection is challenged by the lower signal quality of ECGs recorded using handheld devices and the presence of ectopic beats which may mimic the rhythm characteristics of nsSVT., Methods: The present study introduces a new nsSVT detector for use in single-lead, 30-s ECGs, based on the assumption that beats in an nsSVT episode exhibits similar morphology, implying that episodes with beats of deviating morphology, either due to ectopic beats or noise/artifacts, are excluded. A support vector machine is used to classify successive 5-beat sequences in a sliding window with respect to similar morphology. Due to the lack of adequate training data, the classifier is trained using simulated ECGs with varying signal-to-noise ratio. In a subsequent step, a set of rhythm criteria is applied to similar beat sequences to ensure that episode duration and heart rate is acceptable., Results: The performance of the proposed detector is evaluated using the StrokeStop II database, resulting in sensitivity, specificity, and positive predictive value of 84.6%, 99.4%, and 18.5%, respectively., Conclusion: The results show that a significant reduction in expert review burden (factor of 6) can be achieved using the proposed detector.Clinical and Translational Impact: The reduction in the expert review burden shows that nsSVT detection in AF screening can be made considerably more efficiently., (© 2024 The Authors.)

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., Competing Interests: All authors declare no conflicts of interest in this manuscript., (© 2024 The Authors.)

Introduction: Recordings of electroencephalographic (EEG) rhythms and their analyses have been instrumental in basic neuroscience, clinical diagnostics, and the field of brain-computer interfaces (BCIs). While in the past such measurements have been conducted mostly in laboratory settings, recent advancements in dry electrode technology pave way to a broader range of consumer and medical application because of their greater convenience compared to gel-based electrodes., Methods: Here we conducted resting-state EEG recordings in two groups of healthy participants using three dry-electrode devices, the PSBD Headband, the PSBD Headphones and the Muse Headband, and one standard gel electrode-based system, the NVX. We examined signal quality for various spatial and spectral ranges which are essential for cognitive monitoring and consumer applications., Results: Distinctive characteristics of signal quality were found, with the PSBD Headband showing sensitivity in low-frequency ranges and replicating the modulations of delta, theta and alpha power corresponding to the eyes-open and eyes-closed conditions, and the NVX system performing well in capturing high-frequency oscillations. The PSBD Headphones were more prone to low-frequency artifacts compared to the PSBD Headband, yet recorded modulations in the alpha power and had a strong alignment with the NVX at the higher EEG frequencies. The Muse Headband had several limitations in signal quality., Discussion: We suggest that while dry-electrode technology appears to be appropriate for the EEG rhythm-based applications, the potential benefits of these technologies in terms of ease of use and accessibility should be carefully weighed against the capacity of each given system., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Kleeva, Ninenko and Lebedev.)

Aim: The aims of the study were to examine the signal quality (SQ) of home polygraphy (PG) in children and adolescents and to compare automatic and manual scoring of the PGs., Methods: Clinical Trials Registration: NCT04964830. Participants and caregivers were instructed to set up the equipment and perform home PGs themselves. The PGs were analysed according to SQ and their interpretability and differences in automatic vs. manual scoring regarding apnoea-hypopnoea index (AHI), apnoea index (AI), hypopnoea index (HI) and oxygen desaturation index (ODI) were examined., Results: 54 healthy children aged 9-14 years participated in the study. 86% of the PGs were interpretable with mean SQ of 79.1% (CI 95%: 73.5%; 84.8%). Significant differences between the automatic and manual scoring were found for AHI, AI, HI and ODI (p < 0.0001)., Conclusion: Home PGs of children and adolescents are feasible to be performed with good SQ. Significantly higher markers of sleep-disordered breathing were achieved in the automatic scoring in comparison with the manual scoring., (© 2023 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.)

Objective: A patient-independent approach for continuous estimation of vital signs using robust spectro-temporal features derived from only photoplethysmogram (PPG) signal. Methods: In the pre-processing stage, we remove baseline shifts and artifacts of the PPG signal using Incremental Merge Segmentation with adaptive thresholding. From the cleaned PPG, we extract multiple parameters independent of individual patient PPG morphology for both Respiration Rate (RR) and Blood Pressure (BP). In addition, we derived a set of novel spectral and statistical features strongly correlated to BP. We proposed robust correlation-based feature selection methods for accurate RR estimates. For fewer computations and accurate measurements of BP, the most significant features are selected using correlation and mutual information measures in the feature engineering part. Finally, RR and BP are estimated using breath counting and a neural network regression model, respectively. Results: The proposed approach outperforms the current state-of-the-art in both RR and BP. The RR algorithm results in mean absolute errors (median, 25th-75th percentiles) of 0.4 (0.1-0.7) for CapnoBase dataset and 0.5(0.3-2.8) for BIDMC dataset without discarding any data window. Similarly, BP approach has been validated on a large dataset derived from MIMIC-II ([Formula: see text]1700 records) which has errors (mean absolute, standard deviation) of 5.0(6.3) and 3.0(4.0) for systolic and diastolic BP, respectively. The results meet the American Association for the Advancement of Medical Instrumentation (AAMI) and British Hypertension Society (BHS) Class A criteria. Conclusion: By using robust features and feature selection methods, we alleviated patient dependency to have reliable estimates of vitals., (© 2023 The Authors.)

Bioimpedance monitoring is an increasingly important non-invasive technique for assessing physiological parameters such as body composition, hydration levels, heart rate, and breathing. However, sensor signals obtained from real-world experimental conditions invariably contain noise, which can significantly degrade the reliability of the derived quantities. Therefore, it is crucial to evaluate the quality of measured signals to ensure accurate physiological parameter values. In this study, we present a novel wrist-worn wearable device for bioimpedance monitoring, and propose a method for estimating signal quality for sensor signals obtained on the device. The method is based on the continuous wavelet transform of the measured signal, identification of wavelet ridges, and assessment of their energy weighted by the ridge duration. We validate the algorithm using a small-scale experimental study with the wearable device, and explore the effects of variables such as window size and different skin/electrode coupling agents on signal quality and repeatability. In comparison with traditional wavelet-based signal denoising, the proposed method is more adaptive and achieves a comparable signal-to-noise ratio.

Adaptive equalization is crucial in mitigating distortions and compensating for frequency response variations in communication systems. It aims to enhance signal quality by adjusting the characteristics of the received signal. Particle swarm optimization (PSO) algorithms have shown promise in optimizing the tap weights of the equalizer. However, there is a need to enhance the optimization capabilities of PSO further to improve the equalization performance. This paper provides a comprehensive study of the issues and challenges of adaptive filtering by comparing different variants of PSO and analyzing the performance by combining PSO with other optimization algorithms to achieve better convergence, accuracy, and adaptability. Traditional PSO algorithms often suffer from high computational complexity and slow convergence rates, limiting their effectiveness in solving complex optimization problems. To address these limitations, this paper proposes a set of techniques aimed at reducing the complexity and accelerating the convergence of PSO.

Noise and artifacts affect strongly the quality of the electrocardiogram (ECG) in long-term ECG monitoring (LTM), making some of its parts impractical for diagnosis. The clinical severity of noise defines a qualitative quality score according to the manner clinicians make the interpretation of the ECG, in contrast to assess noise from a quantitative standpoint. So clinical noise refers to a scale of different levels of qualitative severity of noise which aims at elucidating which ECG fragments are valid to achieve diagnosis from a clinical point of view, unlike the traditional approach, which assesses noise in terms of quantitative severity. This work proposes the use of machine learning (ML) techniques to categorize different qualitative noise severity using a database annotated according to a clinical noise taxonomy as gold standard. A comparative study is carried out using five representative ML methods, namely, K neareast neighbors, decision trees, support vector machine, single-layer perceptron, and random forest. The models are fed by signal quality indexes characterizing the waveform in time and frequency domains, as well as from a statistical viewpoint, to distinguish between clinically valid ECG segments from invalid ones. A solid methodology to prevent overfitting to both the dataset and the patient is developed, taking into account balance of classes, patient separation, and patient rotation in the test set. All the proposed learning systems have demonstrated good classification performance, attaining a recall, precision, and F1 score up to 0.78, 0.80, and 0.77, respectively, in the test set by a single-layer perceptron approach. These systems provide a classification solution for assessing the clinical quality of the ECG taken from LTM recordings. Graphical Abstract Clinical Noise Severity Classification based on Machine Learning techniques towards Long-Term ECG Monitoring., (© 2023. The Author(s).)

Steady-state visual-evoked potentials (SSVEPs) are widely used in human neuroscience studies and applications such as brain-computer interfaces (BCIs). Surprisingly, no previous study has systematically evaluated different reference methods for SSVEP analysis, despite that signal reference is crucial for the proper assessment of neural activities. In the present study, using four datasets from our previous SSVEP studies (Chen J, Valsecchi M, Gegenfurtner KR. J Neurophysiol 118: 749-754, 2017; Chen J, Valsecchi M, Gegenfurtner KR. Neuropsychologia 102: 206-216, 2017; Chen J, McManus M, Valsecchi M, Harris LR, Gegenfurtner KR. J Vis 19: 8, 2019) and three public datasets from other studies (Baker DH, Vilidaite G, Wade AR. PLoS Comput Biol 17: e1009507, 2021; Lygo FA, Richard B, Wade AR, Morland AB, Baker DH. NeuroImage 230: 117780, 2021; Vilidaite G, Norcia AM, West RJH, Elliott CJH, Pei F, Wade AR, Baker DH. Proc R Soc B 285: 20182255, 2018), we compared four reference methods: monopolar reference, common average reference, averaged-mastoids reference, and Laplacian reference. The quality of the resulting SSVEP signals was compared in terms of both signal-to-noise ratios (SNRs) and reliability. The results showed that Laplacian reference, which uses signals at the maximally activated electrode after subtracting the average of the nearby electrodes to reduce common noise, gave rise to the highest SNRs. Furthermore, the Laplacian reference resulted in SSVEP signals that were highly reliable across recording sessions or trials. These results suggest that Laplacian reference is optimal for SSVEP studies and applications. Laplacian reference is especially advantageous for SSVEP experiments where short preparation time is preferred as it requires only data from the maximally activated electrode and a few surrounding electrodes. NEW & NOTEWORTHY The present study provides a comprehensive evaluation of the use of different reference methods for steady-state visual-evoked potentials (SSVEPs) and has found that Laplacian reference increases signal-to-noise ratios (SNRs) and enhances reliabilities of SSVEP signals. Thus, the results suggest that Laplacian reference is optimal for SSVEP analysis.

This paper presents the performance analysis of CentiSpace low earth orbit (LEO) experiment satellites. Distinguishing them from other LEO navigation augmentation systems, the co-time and co-frequency (CCST) self-interference suppression technique is employed in CentiSpace to mitigate significant self-interference caused by augmentation signals. Consequently, CentiSpace exhibits the capability of receiving navigation signals from the Global Navigation Satellite System (GNSS) while simultaneously broadcasting augmentation signals within the same frequency bands, thus ensuring excellent compatibility for GNSS receivers. CentiSpace is a pioneering LEO navigation system to successfully complete in-orbit verification of this technique. Leveraging the on-board experiment data, this study analyzes the performance of space-borne GNSS receivers equipped with self-interference suppression and evaluates the quality of navigation augmentation signals. The results show that CentiSpace space-borne GNSS receivers are capable of covering more than 90% visible GNSS satellites and the precision of self-orbit determination is at the centimeter level. Furthermore, the quality of augmentation signals meets the requirements outlined in the BDS interface control documents. These findings underscore the potential of the CentiSpace LEO augmentation system for the establishment of global integrity monitoring and GNSS signal augmentation. Moreover, these results contribute to subsequent research on LEO augmentation techniques.

Introduction: Non-invasive fetal electrocardiography (NIFECG) has potential benefits over the computerized cardiotocography (cCTG) that may permit its development in remote fetal heart-rate monitoring. Our study aims to compare signal quality and heart-rate detection from a novel self-applicable NIFECG monitor against the cCTG, and evaluate the impact of maternal and fetal characteristics on both devices., Material and Methods: This prospective observational study took place in a university hospital in London. Women with a singleton pregnancy from 28 + 0 weeks' gestation presenting for cCTG were eligible. Concurrent monitoring with both NIFECG and cCTG were performed for up to 60 minutes. Post-processing of NIFECG produced signal loss, computed in both 0.25 (E240)- and 3.75 (E16)-second epochs, and fetal heart-rate and maternal heart-rate values. cCTG signal loss was calculated in 3.75-second epochs. Accuracy and precision analysis of 0.25-second epochal fetal heart-rate and maternal heart-rate were compared between the two devices. Multiple regression analyses were performed to assess the impact of maternal and fetal characteristics on signal loss., Clinicaltrials: gov Identifier: NCT04941534., Results: 285 women underwent concurrent monitoring. For fetal heart-rate, mean bias, precision and 95% limits of agreement were 0.1 beats per minute (bpm), 4.5 bpm and -8.7 bpm to 8.8 bpm, respectively. For maternal heart-rate, these results were -0.4 bpm, 3.3 bpm and -7.0 to 6.2 bpm, respectively. Median NIFECG E240 and E16 signal loss was 32.0% (interquartile range [IQR] 6.5%-68.5%) and 17.3% (IQR 1.8%-49.0%), respectively. E16 cCTG signal loss was 1.0% (IQR 0.0%-3.0%). For NIFECG, gestational age was negatively associated with signal loss (beta = -2.91, 95% CI -3.69 to -2.12, P < 0.001). Increased body mass index, fetal movements and lower gestational age were all associated with cCTG signal loss (beta = 0.30, 95% CI 0.17-0.43, P < 0.001; beta = 0.03, 95% CI 0.01-0.05, P = 0.014; and beta = -0.28, 95% CI -0.51 to -0.05, P = 0.017, respectively)., Conclusions: Although NIFECG is complicated by higher signal loss, it does not appear to be influenced by increased body mass index or fetal movement. NIFECG signal loss varies according to method of computation, and standards of signal acceptability need to be defined according to the ability of the device to produce clinically reliable physiological indices. The high accuracy of heart-rate indices is promising for NIFECG usage in the remote setting., (© 2023 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).)

Since electroencephalogram (EEG) is a very small electrical signal from the brain, it is very vulnerable to external noise or motion artifact, making it difficult to measure. Therefore, despite the excellent convenience of dry electrodes, wet electrodes have been used. To solve this problem, self-adhesive and conductive composites using carbon nanotubes (CNTs) in adhesive polydimethylsiloxane (aPDMS), which can have the advantages of both dry and wet electrodes, have been developed by mixing them uniformly with methyl group-terminated PDMS. The CNT/aPDMS composite has a low Young's modulus, penetrates the skin well, has a high contact area, and excellent adhesion and conductivity, so the signal quality is enhanced. As a result of the EEG measurement test, although it was a dry electrode, results comparable to those of a wet electrode were obtained in terms of impedance and motion noise. It also shows excellent biocompatibility in a human fibroblast cell test and a week-long skin reaction test, so it can measure EEG with high signal quality for a long period of time., Competing Interests: Conflict of interestThe authors have no relevant financial or non-financial interests to disclose., (© Korean Society of Medical and Biological Engineering 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

A first-level textile-based electrocardiogram (ECG) monitoring system referred to as "CardioS" (cardiac sensor) for continuous health monitoring applications is proposed in this study to address the demand for resource-constrained environments. and the signal quality assessment of a wireless CardioS was studied. The CardioS consists of a Lead-I ECG signal recorded wirelessly using silver-plated nylon woven (Ag-NyW) dry textile electrodes to compare the results of wired wearable Ag-NyW textile electrode-based ECG acquisition system and CardioS. The effect of prolonged usage of Ag-NyW dry electrodes on electrode impedance was tested in the current work. In addition, electrode half-cell potential was measured to validate the range of Ag-NyW dry electrodes for ECG signal acquisition. Further, the quality of signals recorded by the proposed wireless CardioS framework was evaluated and compared with clinical disposable (Ag-AgCl Gel) electrodes. The signal quality was assessed in terms of mean magnitude coherence spectra, signal cross-correlation, signal-to-noise-band ratio ( S band / N band ), crest factor, low and high band powers and power spectral density. The experimental results showed that the impedance was increased by 2.5-54.6% after six weeks of continuous usage. This increased impedance was less than 1 MΩ/cm 2 , as reported in the literature. The half-cell potential of the Ag-NyW textile electrode obtained was 80 mV, sufficient to acquire the ECG signal from the human body. All the fidelity parameters measured by Ag-NyW textile electrodes were correlated with standard disposable electrodes. The cardiologists validated all the measurements and confirmed that the proposed framework exhibited good performance for ECG signal acquisition from the five healthy subjects. As a result of its low-cost architecture, the proposed CardioS framework can be used in resource-constrained environments for ECG monitoring.

Ambulatory EEGs began emerging in the healthcare industry over the years, setting a new norm for long-term monitoring services. The present devices in the market are neither meant for remote monitoring due to their technical complexity nor for meeting clinical setting needs in epilepsy patient monitoring. In this paper, we propose an ambulatory EEG device, OptiEEG, that has low setup complexity, for the remote EEG monitoring of epilepsy patients. OptiEEG's signal quality was compared with a gold standard clinical device, Natus. The experiment between OptiEEG and Natus included three different tests: eye open/close (EOC); hyperventilation (HV); and photic stimulation (PS). Statistical and wavelet analysis of retrieved data were presented when evaluating the performance of OptiEEG. The SNR and PSNR of OptiEEG were slightly lower than Natus, but within an acceptable bound. The standard deviations of MSE for both devices were almost in a similar range for the three tests. The frequency band energy analysis is consistent between the two devices. A rhythmic slowdown of theta and delta was observed in HV, whereas photic driving was observed during PS in both devices. The results validated the performance of OptiEEG as an acceptable EEG device for remote monitoring away from clinical environments.

Photoplethysmography (PPG) signal quality as a proxy for accuracy in heart rate (HR) measurement is useful in various public health contexts, ranging from short-term clinical diagnostics to free-living health behavior surveillance studies that inform public health policy. Each context has a different tolerance for acceptable signal quality, and it is reductive to expect a single threshold to meet the needs across all contexts. In this study, we propose two different metrics as sliding scales of PPG signal quality and assess their association with accuracy of HR measures compared to a ground truth electrocardiogram (ECG) measurement., Methods: We used two publicly available PPG datasets (BUT PPG and Troika) to test if our signal quality metrics could identify poor signal quality compared to gold standard visual inspection. To aid interpretation of the sliding scale metrics, we used ROC curves and Kappa values to calculate guideline cut points and evaluate agreement, respectively. We then used the Troika dataset and an original dataset of PPG data collected from the chest to examine the association between continuous metrics of signal quality and HR accuracy. PPG-based HR estimates were compared with reference HR estimates using the mean absolute error (MAE) and the root-mean-square error (RMSE). Point biserial correlations were used to examine the association between binary signal quality and HR error metrics (MAE and RMSE)., Results: ROC analysis from the BUT PPG data revealed that the AUC was 0.758 (95% CI 0.624 to 0.892) for signal quality metrics of STD-width and 0.741 (95% CI 0.589 to 0.883) for self-consistency. There was a significant correlation between criterion poor signal quality and signal quality metrics in both Troika and originally collected data. Signal quality was highly correlated with HR accuracy (MAE and RMSE, respectively) between PPG and ground truth ECG., Conclusion: This proof-of-concept work demonstrates an effective approach for assessing signal quality and demonstrates the effect of poor signal quality on HR measurement. Our continuous signal quality metrics allow estimations of uncertainties in other emergent metrics, such as energy expenditure that relies on multiple independent biometrics. This open-source approach increases the availability and applicability of our work in public health settings.

Background: Fat layers in obese patients can impair R-wave detection and diagnostic performance of a subcutaneous insertable cardiac monitor (ICM). We compared safety and ICM sensing quality between obese patients [body mass index (BMI) ≥ 30 kg/m 2 ] and normal-weight controls (BMI <30 kg/m 2 ) in terms of R-wave amplitude and time in noise mode (noise burden) detected by a long-sensing-vector ICM., Materials and Methods: Patients from two multicentre, non-randomized clinical registries are included in the present analysis on January 31, 2022 (data freeze), if the follow-up period was at least 90 days after ICM insertion, including daily remote monitoring. The R-wave amplitudes and daily noise burden averaged intraindividually for days 61-90 and days 1-90, respectively, were compared between obese patients ( n  = 104) and unmatched ( n  = 268) and a nearest-neighbour propensity score (PS) matched ( n  = 69) normal-weight controls., Results: The average R-wave amplitude was significantly lower in obese (median 0.46 mV) than in normal-weight unmatched (0.70 mV, P  < 0.0001) or PS-matched (0.60 mV, P  = 0.003) patients. The median noise burden was 1.0% in obese patients, which was not significantly higher than in unmatched (0.7%; P  = 0.056) or PS-matched (0.8%; P  = 0.133) controls. The rate of adverse device effects during the first 90 days did not differ significantly between groups., Conclusion: Although increased BMI was associated with reduced signal amplitude, also in obese patients the median R-wave amplitude was >0.3 mV, a value which is generally accepted as the minimum level for adequate R-wave detection. The noise burden and adverse event rates did not differ significantly between obese and normal-weight patients. Registration : URL: https://www.clinicaltrials.gov; Unique identifier: NCT04075084 and NCT04198220., Competing Interests: DG and A G are employees of BIOTRONIK Italia. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Bisignani, De Bonis, Pierre, Lau, Hofer, Sanfins, Hain, Cabanas, Martens, Berruezo, Eschalier, Milliez, Lüsebrink, Mansourati, Papaioannou, Giacopelli, Gargaro and Ploux.)

Continuously acquired biosignals from patient monitors contain significant amounts of unusable data. During the development of a decision support system based on continuously acquired biosignals, we developed machine and deep learning algorithms to automatically classify the quality of ECG data. A total of 31,127 twenty-s ECG segments of 250 Hz were used as the training/validation dataset. Data quality was categorized into three classes: acceptable, unacceptable, and uncertain. In the training/validation dataset, 29,606 segments (95%) were in the acceptable class. Two one-step, three-class approaches and two two-step binary sequential approaches were developed using random forest (RF) and two-dimensional convolutional neural network (2D CNN) classifiers. Four approaches were tested on 9779 test samples from another hospital. On the test dataset, the two-step 2D CNN approach showed the best overall accuracy (0.85), and the one-step, three-class 2D CNN approach showed the worst overall accuracy (0.54). The most important parameter, precision in the acceptable class, was greater than 0.9 for all approaches, but recall in the acceptable class was better for the two-step approaches: one-step (0.77) vs. two-step RF (0.89) and one-step (0.51) vs. two-step 2D CNN (0.94) ( p < 0.001 for both comparisons). For the ECG quality classification, where substantial data imbalance exists, the 2-step approaches showed more robust performance than the one-step approach. This algorithm can be used as a preprocessing step in artificial intelligence research using continuously acquired biosignals.

Cardiovascular diseases (CVD) represent a serious health problem worldwide, of which atrial fibrillation (AF) is one of the most common conditions. Early and timely diagnosis of CVD is essential for successful treatment. When implemented in the healthcare system this can ease the existing socio-economic burden on health institutions and government. Therefore, developing technologies and tools to diagnose CVD in a timely way and detect AF is an important research topic. ECG monitoring patches allowing ambulatory patient monitoring over several days represent a novel technology, while we witness a significant proliferation of ECG monitoring patches on the market and in the research labs, their performance over a long period of time is not fully characterized. This paper analyzes the signal quality of ECG signals obtained using a single-lead ECG patch featuring self-adhesive dry electrode technology collected from six cardiac patients for 5 days. In particular, we provide insights into signal quality degradation over time, while changes in the average ECG quality per day were present, these changes were not statistically significant. It was observed that the quality was higher during the nights, confirming the link with motion artifacts. These results can improve CVD diagnosis and AF detection in real-world scenarios.

In this paper, we propose a new method to quantitatively evaluate the quality of the carrier phase observation signals of the BeiDou Navigation Satellite System (BDS) during weak and moderate geomagnetic storms. We take a moderate geomagnetic storm that occurred on 12 May 2021 during the 25th solar cycle as an example. The results show that the newly defined PAS (Percentage of Affected Satellites) index shows significant anomaly changes during the moderate geomagnetic storm. Its variation trend has good correlations with the geomagnetic storm Kp index and Dst index. The anomaly stations are mainly distributed in the equatorial region and auroral region in the northern and southern hemispheres. The proposed PAS index has a good indication for both BDS2 and BDS3 satellites. We further validated this index by calculating the Precise Point Position (PPP) positioning error. We found that the anomaly period of PAS has strong consistency with the abnormal period of PPP positioning accuracy. This study could provide methodological support for the evaluation of the signal quality and analysis of positioning accuracy for the BeiDou satellite navigation system under different space weather conditions.

Recently, advanced electrodes have been developed, such as semi-dry, dry contact, dry non-contact, and microneedle array electrodes. They can overcome the issues of wet electrodes and maintain high signal quality. However, the variations in these electrodes are still unclear and not explained, and there is still confusion regarding the feasibility of electrodes for different application scenarios. In this review, the physical features and electroencephalogram (EEG) signal performances of these advanced EEG electrodes are introduced in view of the differences in contact between the skin and electrodes. Specifically, contact features, biofeatures, impedance, signal quality, and artifacts are discussed. The application scenarios and prospects of different types of EEG electrodes are also elucidated., Competing Interests: The authors declare no conflict of interest.

Recent advances have enabled the creation of wireless, "dry" electroencephalography (EEG) recording systems, and easy-to-use engaging tasks, that can be operated repeatedly by naïve users, unsupervised in the home. Here, we evaluated the validity of dry-EEG, cognitive task gamification, and unsupervised home-based recordings used in combination. Two separate cohorts of participants-older and younger adults-collected data at home over several weeks using a wireless dry EEG system interfaced with a tablet for task presentation. Older adults ( n = 50; 25 females; mean age = 67.8 years) collected data over a 6-week period. Younger male adults ( n = 30; mean age = 25.6 years) collected data over a 4-week period. All participants were asked to complete gamified versions of a visual Oddball task and Flanker task 5-7 days per week. Usability of the EEG system was evaluated via participant adherence, percentage of sessions successfully completed, and quantitative feedback using the System Usability Scale. In total, 1,449 EEG sessions from older adults (mean = 28.9; SD = 6.64) and 684 sessions from younger adults (mean = 22.87; SD = 1.92) were collected. Older adults successfully completed 93% of sessions requested and reported a mean usability score of 84.5. Younger adults successfully completed 96% of sessions and reported a mean usability score of 88.3. Characteristic event-related potential (ERP) components-the P300 and error-related negativity-were observed in the Oddball and Flanker tasks, respectively. Using a conservative threshold for inclusion of artifact-free data, 50% of trials were rejected per at-home session. Aggregation of ERPs across sessions (2-4, depending on task) resulted in grand average signal quality with similar Standard Measurement Error values to those of single-session wet EEG data collected by experts in a laboratory setting from a young adult sample. Our results indicate that easy-to-use task-driven EEG can enable large-scale investigations in cognitive neuroscience. In future, this approach may be useful in clinical applications such as screening and tracking of treatment response., Competing Interests: Conflict of interest FB, AB, JD, MI, BM, HN, and LR-D are employees of Cumulus Neuroscience Ltd., a company that develops and provides dry EEG technology. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Barbey, Farina, Buick, Danyeli, Dyer, Islam, Krylova, Murphy, Nolan, Rueda-Delgado, Walter and Whelan.)

Mobile-health solutions based on heart rate variability often require electrocardiogram (ECG) recordings by inexperienced operators or real-time automatic analyses of long-term recordings by wearable devices in free-moving individuals. In this context, it is useful to associate a quality index with the ECG, scoring the adequacy of the recording for heart rate variability to identify noise or arrhythmias. Therefore, this work aims to propose and validate a computational method for assessing the adequacy of single-lead ECGs for heart rate variability analysis that may run in real time on wearable systems with low computational power. The method quantifies the ECG pseudo-periodic structure employing cepstral analysis. The cepstrum (spectrum of log-spectrum) is estimated on a running ECG window of 10 s before and after "liftering" (filtering in the cepstral domain) to remove slower noise components. The ECG periodicity generates a dominant peak in the liftered cepstrum at the "quefrency" of the mean cardiac interval. The Cepstral Quality Index (CQI) is the ratio between the cepstral-peak power and the total power of the unliftered cepstrum. Noises and arrhythmias reduce the relative power of the cepstral peak decreasing CQI. We analyzed a public dataset of 6072 single-lead ECGs manually classified in normal rhythm or inadequate for heart rate variability analysis because of noise or atrial fibrillation, and the CQI = 47% cut-off identified the inadequate recordings with 79% sensitivity and 85% specificity. We showed that the performance is independent of the lead considering a public dataset of 1,000 12-lead recordings with quality classified as "acceptable" or "unacceptable" by visual inspection. Thus, the cepstrum describes the ECG periodic structure effectively and concisely and CQI appears to be a robust score of the adequacy of ECG recording for heart rate variability analysis, evaluable in real-time on wearable devices., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Castiglioni, Parati and Faini.)

Non-invasive foetal electrocardiography (NI-FECG) has become an important prenatal monitoring method in the hospital. However, due to its susceptibility to non-stationary noise sources and lack of robust extraction methods, the capture of high-quality NI-FECG remains a challenge. Recording waveforms of sufficient quality for clinical use typically requires human visual inspection of each recording. A Signal Quality Index (SQI) can help to automate this task but, contrary to adult ECG, work on SQIs for NI-FECG is sparse. In this paper, a multi-channel signal quality classifier for NI-FECG waveforms is presented. The model can be used during the capture of NI-FECG to assist technicians to record high-quality waveforms, which is currently a labour-intensive task. A Convolutional Neural Network (CNN) is trained to distinguish between NI-FECG segments of high and low quality. NI-FECG recordings with one maternal channel and three abdominal channels were collected from 100 subjects during a routine hospital screening (102.6 min of data). The model achieves an average 10-fold cross-validated AUC of 0.95 ± 0.02. The results show that the model can reliably assess the FECG signal quality on our dataset. The proposed model can improve the automated capture and analysis of NI-FECG as well as reduce technician labour time.

Background: Continuous heart rate monitoring via mobile health technologies based on photoplethysmography (PPG) has great potential for the early detection of sustained cardiac arrhythmias such as atrial fibrillation. However, PPG measurements are impaired by motion artifacts., Objective: The aim of this investigation was to evaluate the analyzability of smartwatch-derived PPG data during everyday life and to determine the relationship between the analyzability of the data and the activity level of the participant., Methods: A total of 41 (19 female and 22 male) adults in good cardiovascular health (aged 19-79 years) continuously wore a smartwatch equipped with a PPG sensor and a 3D accelerometer (Cardio Watch 287, Corsano Health BV) for a period of 24 hours that represented their individual daily routine. For each participant, smartwatch data were analyzed on a 1-minute basis by an algorithm designed for heart rhythm analysis (Preventicus Heartbeats, Preventicus GmbH). As outcomes, the percentage of analyzable data (PAD) and the mean acceleration (ACC) were calculated. To map changes of the ACC and PAD over the course of one day, the 24-hour period was divided into 8 subintervals comprising 3 hours each., Results: Univariate analysis of variance showed a large effect (η p 2 > 0.6; P<.001) of time interval (phase) on the ACC and PAD. The PAD ranged between 34% and 100%, with an average of 71.5% for the whole day, which is equivalent to a period of 17.2 hours. Between midnight and 6 AM, the mean values were the highest for the PAD (>94%) and the lowest for the ACC (<6×10 -3 m/s 2 ). Regardless of the time of the day, the correlation between the PAD and ACC was strong (r=-0.64). A linear regression analysis for the averaged data resulted in an almost perfect coefficient of determination (r 2 =0.99)., Conclusions: This study showed a large relationship between the activity level and the analyzability of smartwatch-derived PPG data. Given the high yield of analyzable data during the nighttime, continuous arrhythmia screening seems particularly effective during sleep phases., (©Steve Merschel, Lars Reinhardt. Originally published in JMIR Formative Research (https://formative.jmir.org), 28.03.2022.)

Objective. Fetal arrhythmias are a life-threatening disorder occurring in up to 2% of pregnancies. If identified, many fetal arrhythmias can be effectively treated using anti-arrhythmic therapies. In this paper, we present a novel method of detecting fetal arrhythmias in short length non-invasive fetal electrocardiography (NI-FECG) recordings. Approach. Our method consists of extracting a fetal heart rate time series from each NI-FECG recording and computing an entropy profile using a data-driven range of the entropy tolerance parameter r . To validate our approach, we apply our entropy profiling method to a large clinical data set of 318 NI-FECG recordings. Main Results. We demonstrate that our method ( TotalSampEn ) provides strong performance for classifying arrhythmic fetuses (AUC of 0.83) and outperforms entropy measures such as SampEn (AUC of 0.68) and FuzzyEn (AUC of 0.72). We also find that NI-FECG recordings incorrectly classified using the investigated entropy measures have significantly lower signal quality, and that excluding recordings of low signal quality (13.5% of recordings) increases the classification performance of TotalSampEn (AUC of 0.90). Significance. The superior performance of our approach enables automated detection of fetal arrhythmias and warrants further investigation in a prospective clinical trial., (© 2022 Institute of Physics and Engineering in Medicine.)

Background: Injectable cardiac monitors (ICMs) are leadless subcutaneous devices for long-term monitoring of arrhythmias. The BIOTRONIK BIOMONITOR III is a novel ICM with a miniaturized profile, long sensing vector, and simplified implantation technique., Methods: R-wave amplitude was recorded immediately after implantation, the day after implantation, and after 3 months. Follow-up was scheduled after 3 months or after an event. All data from the ICM were retrieved. The anatomical position of the ICM was determined post-implantation and after 3 months. A patient questionnaire was conducted after 3 months., Results: In 36 patients (mean age 67 ± 13 years; 40% male) an ICM was inserted. Six patients were not included in the final analysis. The median time from skin cut to wound closure was 6 [IQR 5-7] minutes. Mean R-wave amplitude increased over time (0.73 ± 32 mV vs. 0.78 ± 0.38 mV vs. 0.81 ± 0.39 mV; p = ns). Three months after implantation, the ICM was in an anatomically stable position. In 14 (47%) patients, true episodes were detected. False arrhythmia alerts were detected in 13 (43%) patients. The total number of false detections was low, and the patient satisfaction rate was high., Conclusion: Implantation of the novel BIOMONITOR III is fast and uncomplicated; its sensing characteristics are excellent and improve over time, and patient satisfaction is high.

The demand for non-laboratory and long-term EEG acquisition in scientific and clinical applications has put forward new requirements for wearable EEG devices. In this paper, a new wearable frontal EEG device called Mindeep was proposed. A signal quality study was then conducted, which included simulated signal tests and signal quality comparison experiments. Simulated signals with different frequencies and amplitudes were used to test the stability of Mindeep’s circuit, and the high correlation coefficients (>0.9) proved that Mindeep has a stable and reliable hardware circuit. The signal quality comparison experiment, between Mindeep and the gold standard device, Neuroscan, included three tasks: (1) resting; (2) auditory oddball; and (3) attention. In the resting state, the average normalized cross-correlation coefficients between EEG signals recorded by the two devices was around 0.72 ± 0.02, Berger effect was observed (p < 0.01), and the comparison results in the time and frequency domain illustrated the ability of Mindeep to record high-quality EEG signals. The significant differences between high tone and low tone in auditory event-related potential collected by Mindeep was observed in N2 and P2. The attention recognition accuracy of Mindeep achieved 71.12% and 74.76% based on EEG features and the XGBoost model in the two attention tasks, respectively, which were higher than that of Neuroscan (70.19% and 72.80%). The results validated the performance of Mindeep as a prefrontal EEG recording device, which has a wide range of potential applications in audiology, cognitive neuroscience, and daily requirements.

Changes in respiratory rate have been found to be one of the early signs of health deterioration in patients. In remote environments where diagnostic tools and medical attention are scarce, such as deep space exploration, the monitoring of the respiratory signal becomes crucial to timely detect life-threatening conditions. Nowadays, this signal can be measured using wearable technology; however, the use of such technology is often hampered by the low quality of the recordings, which leads more often to wrong diagnosis and conclusions. Therefore, to apply these data in diagnosis analysis, it is important to determine which parts of the signal are of sufficient quality. In this context, this study aims to evaluate the performance of a signal quality assessment framework, where two machine learning algorithms (support vector machine-SVM, and convolutional neural network-CNN) were used. The models were pre-trained using data of patients suffering from chronic obstructive pulmonary disease. The generalization capability of the models was evaluated by testing them on data from a different patient population, presenting normal and pathological breathing. The new patients underwent bariatric surgery and performed a controlled breathing protocol, displaying six different breathing patterns. Data augmentation (DA) and transfer learning (TL) were used to increase the size of the training set and to optimize the models for the new dataset. The effect of the different breathing patterns on the performance of the classifiers was also studied. The SVM did not improve when using DA, however, when using TL, the performance improved significantly ( p < 0.05) compared to DA. The opposite effect was observed for CNN, where the biggest improvement was obtained using DA, while TL did not show a significant change. The models presented a low performance for shallow, slow and fast breathing patterns. These results suggest that it is possible to classify respiratory signals obtained with wearable technologies using pre-trained machine learning models. This will allow focusing on the relevant data and avoid misleading conclusions because of the noise, when designing bio-monitoring systems., Competing Interests: Authors RGW and WG were employed by the company Imec The Netherlands/Holst Centre. Authors CS and DR, were employed by the company Ziekenhuis Oost-Limburg. Authors SJ and VM were employed by the company Nederlandse Obesitas Kliniek. Author CVH was employed by the companies Imec OnePlanet, Imec. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Rozo, Moeyersons, Morales, Garcia van der Westen, Lijnen, Smeets, Jantzen, Monpellier, Ruttens, Van Hoof, Van Huffel, Groenendaal and Varon.)

Background: Laser-Doppler Vibrometry (LDV) is a laser-based technique that allows measuring the motion of moving targets with high spatial and temporal resolution. To demonstrate its use for the measurement of carotid-femoral pulse wave velocity, a prototype system was employed in a clinical feasibility study. Data were acquired for analysis without prior quality control. Real-time application, however, will require a real-time assessment of signal quality. In this study, we (1) use template matching and matrix profile for assessing the quality of these previously acquired signals; (2) analyze the nature and achievable quality of acquired signals at the carotid and femoral measuring site; (3) explore models for automated classification of signal quality. Methods: Laser-Doppler Vibrometry data were acquired in 100 subjects (50M/50F) and consisted of 4-5 sequences of 20-s recordings of skin displacement, differentiated two times to yield acceleration. Each recording consisted of data from 12 laser beams, yielding 410 carotid-femoral and 407 carotid-carotid recordings. Data quality was visually assessed on a 1-5 scale, and a subset of best quality data was used to construct an acceleration template for both measuring sites. The time-varying cross-correlation of the acceleration signals with the template was computed. A quality metric constructed on several features of this template matching was derived. Next, the matrix-profile technique was applied to identify recurring features in the measured time series and derived a similar quality metric. The statistical distribution of the metrics, and their correlates with basic clinical data were assessed. Finally, logistic-regression-based classifiers were developed and their ability to automatically classify LDV-signal quality was assessed. Results: Automated quality metrics correlated well with visual scores. Signal quality was negatively correlated with BMI for femoral recordings but not for carotid recordings. Logistic regression models based on both methods yielded an accuracy of minimally 80% for our carotid and femoral recording data, reaching 87% for the femoral data. Conclusion: Both template matching and matrix profile were found suitable methods for automated grading of LDV signal quality and were able to generate a quality metric that was on par with the signal quality assessment of the expert. The classifiers, developed with both quality metrics, showed their potential for future real-time implementation., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Seoni, Beeckman, Li, Aasmul, Morbiducci, Baets, Boutouyrie, Molinari, Madhu and Segers.)

It has been stated that active-transmission electrodes should improve signal quality in mobile EEG recordings. However, few studies have directly compared active- and passive-transmission electrodes during a mobile task. In this repeated measurement study, we investigated the performance of active and passive signal transmission electrodes with the same amplifier system in their respective typical configurations, during a mobile auditory task. The task was an auditory discrimination (1,000 vs. 800 Hz; counterbalanced) oddball task using approximately 560 trials (15% targets) for each condition. Eighteen participants performed the auditory oddball task both while standing and walking in an outdoor environment. While walking, there was a significant decrease in P3 amplitude, post-trial rejection trial numbers, and signal-to-noise ratio (SNR). No significant differences were found in signal quality between the two electrode configurations. SNR and P3 amplitude were test-retest reliable between recordings. We conclude that adequate use of a passive EEG electrode system achieves signal quality equivalent to that of an active system during a mobile task., (© 2021 The Authors. European Journal of Neuroscience published by Federation of European Neuroscience Societies and John Wiley & Sons Ltd.)

Theory suggests that overcrowding and increased competition in urban environments might be detrimental to individual condition in avian populations. Unfavourable living conditions could be compounded by changes in dietary niche with additional consequences for individual quality of urban birds. We analysed the isotopic signatures, signal coloration, body condition, parasitic loads (feather mites and coccidia), and immune responsiveness of 191 adult common (Indian) mynas (Acridotheres tristis) captured in 19 localities with differing levels of urbanization. The isotopic signature of myna feathers differed across low and high urbanized habitats, with a reduced isotopic niche breadth found in highly urbanized birds. This suggests that birds in high urban environments may occupy a smaller foraging niche to the one of less urbanized birds. In addition, higher degrees of urbanization were associated with a decrease in carotenoid-based coloration, higher ectoparasite loads and higher immune responsiveness. This pattern of results suggests that the health status of mynas from more urbanized environments was poorer than mynas from less modified habitats. Our findings are consistent with the theory that large proportions of individual birds that would otherwise die under natural conditions survive due to prevailing top-down and bottom-up ecological processes in cities. Detrimental urban ecological conditions and search for more favourable, less crowded habitats offers the first reasonable explanation for why an ecological invader like the common myna continues to spread within its global invasive range., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Breathing pattern parameters refer to the characteristic pattern parameters of respiratory movements, including the breathing amplitude and cycle, chest and abdomen contribution, coordination, etc. It is of great importance to analyze the breathing pattern parameters quantificationally when exploring the pathophysiological variations of breathing and providing instructions on pulmonary rehabilitation training. Our study provided detailed method to quantify breathing pattern parameters including respiratory rate, inspiratory time, expiratory time, inspiratory time proportion, tidal volume, chest respiratory contribution ratio, thoracoabdominal phase difference and peak inspiratory flow. We also brought in "respiratory signal quality index" to deal with the quality evaluation and quantification analysis of long-term thoracic-abdominal respiratory movement signal recorded, and proposed the way of analyzing the variance of breathing pattern parameters. On this basis, we collected chest and abdomen respiratory movement signals in 23 chronic obstructive pulmonary disease (COPD) patients and 22 normal pulmonary function subjects under spontaneous state in a 15 minute-interval using portable cardio-pulmonary monitoring system. We then quantified subjects' breathing pattern parameters and variability. The results showed great difference between the COPD patients and the controls in terms of respiratory rate, inspiratory time, expiratory time, thoracoabdominal phase difference and peak inspiratory flow. COPD patients also showed greater variance of breathing pattern parameters than the controls, and unsynchronized thoracic-abdominal movements were even observed among several patients. Therefore, the quantification and analyzing method of breathing pattern parameters based on the portable cardiopulmonary parameters monitoring system might assist the diagnosis and assessment of respiratory system diseases and hopefully provide new parameters and indexes for monitoring the physical status of patients with cardiopulmonary disease.

Peak-to-peak intervals in Photoplethysmography (PPG) can be used for heart rate variability (HRV) estimation if the PPG is collected from a healthy person at rest. Many factors, such as a person's movements or hardware issues, can affect the signal quality and make some parts of the PPG signal unsuitable for reliable peak detection. Therefore, a robust HRV estimation algorithm should not only detect peaks, but also identify corrupted signal parts. We introduce such an algorithm in this paper. It uses continuous wavelet transform (CWT) for peak detection and a combination of features derived from CWT and metrics based on PPG signals' self-similarity to identify corrupted parts. We tested the algorithm on three different datasets: a newly introduced Welltory-PPG-dataset containing PPG signals collected with smartphones using the Welltory app, and two publicly available PPG datasets: TROIKAand PPG-DaLiA. The algorithm demonstrated good accuracy in peak-to-peak intervals detection and HRV metric estimation.

Background: Neurostimulation is an emerging treatment option for patients resistant to pharmacotherapy and ineligible for neurosurgical intervention. Compared to intracranial stimulation placement of electrodes in the subgaleal space offers a minimally invasive option for long-term seizure monitoring for responsive systems., New Method: It was investigated, whether electrode contacts of a device being developed as a stimulation system placed in the subgaleal space are suited for recording of EEG activity for seizure detection. EEG was recorded intraoperatively in four participants participating in a clinical trial during the insertion of the device. Quantitative parameters like electrode impedance, signal amplitude ranges and amplitude spectra were determined. Epileptiform patterns in the recordings were compared to patterns occurring in scalp EEG prior to device implantation., Results: Electrode impedances, amplitude ranges for artefact free intervals and intervals containing artefacts were determined. Spectral analysis showed typical properties of EEG recordings with high amplitude content at low frequencies and a peak in the alpha band. No major noise except at power line frequency disturbed the recordings. In two patients, typical epileptiform patterns could be identified having similar characteristics as their respective scalp EEG recordings prior to device implantation., Comparison With Existing Methods: New and less invasive electrode system compared to existing solutions for responsive neurostimulation., Conclusions: The subgaleal electrode system allows for high quality EEG recordings even in an hostile unfavorable environment like an operation theatre. For the design of a signal acquisition unit of a responsive system using subgaleal electrodes, specifications could be obtained., (Copyright © 2021. Published by Elsevier B.V.)

Obstructive sleep apnea (OSA) patients would strongly benefit from comfortable home diagnosis, during which detection of wakefulness is essential. Therefore, capacitively-coupled electrocardiogram (ccECG) and bioimpedance (ccBioZ) sensors were used to record the sleep of suspected OSA patients, in parallel with polysomnography (PSG). The three objectives were quality assessment of the unobtrusive signals during sleep, prediction of sleep-wake using ccECG and ccBioZ, and detection of high-risk OSA patients. First, signal quality indicators (SQIs) determined the data coverage of ccECG and ccBioZ. Then, a multimodal convolutional neural network (CNN) for sleep-wake prediction was tested on these preprocessed ccECG and ccBioZ data. Finally, two indices derived from this prediction detected patients at risk. The data included 187 PSG recordings of suspected OSA patients, 36 (dataset "Test") of which were recorded simultaneously with PSG, ccECG, and ccBioZ. As a result, two improvements were made compared to prior studies. First, the ccBioZ signal coverage increased significantly due to adaptation of the acquisition system. Secondly, the utility of the sleep-wake classifier increased as it became a unimodal network only requiring respiratory input. This was achieved by using data augmentation during training. Sleep-wake prediction on "Test" using PSG respiration resulted in a Cohen's kappa (κ) of 0.39 and using ccBioZ in κ = 0.23. The OSA risk model identified severe OSA patients with a κ of 0.61 for PSG respiration and κ of 0.39 using ccBioZ (accuracy of 80.6% and 69.4%, respectively). This study is one of the first to perform sleep-wake staging on capacitively-coupled respiratory signals in suspected OSA patients and to detect high risk OSA patients based on ccBioZ. The technology and the proposed framework could be applied in multi-night follow-up of OSA patients.

Objectives: The aim of this study is to determine the quality of the foetal heart rate (FHR) recording, defined as signal loss, during preterm labour below 28 weeks gestational age (GA) and contribute to the discussion if cardiotocography (CTG) is of value for the extreme preterm foetus., Methods: From January 2010 to December 2019 a retrospective study was conducted with data of 95 FHR recordings of singletons born between 24 and 28 weeks GA at the Amsterdam University Medical Centre, location VUmc. FHR tracings had a duration of at least 30 min and were obtained via external ultrasound mode. Data of all recordings were divided in two groups according to gestation (24-26 weeks and 26-28 weeks). Signal loss was analysed. Statistical significance was calculated by non-parametric tests and chi-square tests. The median signal loss and the proportion of cases exceeding the International Federation of Gynaecology and Obstetrics Guidelines (FIGO) threshold of 20% signal loss were calculated., Results: One-third of the recordings exceeded the 20% FIGO-criterion for adequate signal quality during the first stage of labour. In the second stage, this was nearly 75%. Similarly, the median signal loss was 13% during the first and 30% during the second stage of labour (p<0.01)., Conclusions: The quality of FHR monitoring in the extreme preterm foetus is inadequate in a large proportion of the foetuses, especially during the second stage. FHR monitoring is therefore controversial and should be used with caution., (© 2021 Zohal Faiz et al., published by De Gruyter, Berlin/Boston.)

Objective. The evaluation of the long-term stability of ElectroCorticoGram (ECoG) signals is an important scientific question as new implantable recording devices can be used for medical purposes such as Brain-Computer Interface (BCI) or brain monitoring. Approach. The long-term clinical validation of wireless implantable multi-channel acquisition system for generic interface with neurons (WIMAGINE), a wireless 64-channel epidural ECoG recorder was investigated. The WIMAGINE device was implanted in two quadriplegic patients within the context of a BCI protocol. This study focused on the ECoG signal stability in two patients bilaterally implanted in June 2017 (P1) and in November 2019 (P2). Methods . The ECoG signal was recorded at rest prior to each BCI session resulting in a 32 month and in a 14 month follow-up for P1 and P2 respectively. State-of-the-art signal evaluation metrics such as root mean square (RMS), the band power (BP), the signal to noise ratio (SNR), the effective bandwidth (EBW) and the spectral edge frequency (SEF) were used to evaluate stability of signal over the implantation time course. The time-frequency maps obtained from task-related motor activations were also studied to investigate the long-term selectivity of the electrodes. Main results. Based on temporal linear regressions, we report a limited decrease of the signal average level (RMS), spectral distribution (BP) and SNR, and a remarkable steadiness of the EBW and SEF. Time-frequency maps obtained during motor imagery, showed a high level of discrimination 1 month after surgery and also after 2 years. Conclusions. The WIMAGINE epidural device showed high stability over time. The signal evaluation metrics of two quadriplegic patients during 32 months and 14 months respectively provide strong evidence that this wireless implant is well-suited for long-term ECoG recording. Significance. These findings are relevant for the future of implantable BCIs, and could benefit other patients with spinal cord injury, amyotrophic lateral sclerosis, neuromuscular diseases or drug-resistant epilepsy., (© 2021 IOP Publishing Ltd.)