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Various studies have looked at the efficiency of artificial vessel and tissue networks in the study of photoplethysmography (PPG) in an effort to better understand the origin of various morphological features present in the signal. Whilst there are all reasonable attempts made to replicate geometrical features such as vessel depth, vessel wall thickness and diameter etc., not many studies have attempted to replicate the mechanical properties such as vessel elasticity and tissue compressibility. This study reports two methods for tissue mechanical testing for the analysis of vessel elasticity and tissue compressibility. A two-part polydimethylsiloxane (PDMS) was used as a base material for both tissue and vessel construction, and the properties altered by changing the curing component ratio. Tissue compression properties were investigated using an industrially calibrated materials testing device using the protocol from the ASTM 0575-91 testing method. Vessel elasticity was investigated using a custom method and apparatus to report vessel diameter and length change simultaneously. Tissue compressive properties proved reasonably easy to replicate through catalyst alteration, however the vessel elasticity properties were found to be higher than expected at all reasonable catalyst ratios. The property of hyper-elasticity was observed in the artificial vessels though, leading to the conclusion that alternative material recipes or construction methods may be needed to correctly replicate the expected mechanical characteristics. Clinical Relevance- The latest generation of health monitoring devices, especially those that are wearable and used widely by individuals wishing to monitor their health daily are becoming smarter and more sophisticated in their functionality. The majority of such devices use photoplethysmography (PPG) as their primary monitoring technique. Being able to replicate the PPG in a phantom allows the continued study and development of devices, and to improve their functionality without the continued need for extensive user-testing.

Due to the widespread use and simplicity of photoplethysmography (PPG) signals, and because this signal contains information related to pulse rate, several studies have started to propose the use of Pulse Rate Variability (PRV) for the assessment of cardiovascular autonomic nervous activity, instead of using Heart Rate Variability (HRV) obtained with the electrocardiogram (ECG). However, there is a lack of standardisation and guidelines for the measurement of PRV from PPG signals, which might hinder comparability among studies and validation of results. The aim of this study was to evaluate different digital filters on PPG signals and their effects on PRV information, compared to HRV obtained from ECG. PPG and ECG signals obtained from healthy volunteers were used to measure HRV and PRV. PPG signals were filtered using different FIR and IIR digital filters, with several cut-off frequencies. The results indicate that filtering PPG signals using IIR filters and lower low-cut-off frequencies allow for the acquisition of more reliable PRV information, with lower Bland-Altman ratios and higher cross-correlations when compared to HRV. This is a first step in establishing guidelines and standards for the analysis of PRV information using PPG signals.Clinical relevance- Pulse rate variability might be a useful tool for the assessment of the cardiovascular autonomic nervous system. This study is the first step for establishing standards of measurement of this signal, which helps in the comparability and validation of the technique.

The flow profile in the artery reflects the health status of the vessel and generally the arterial system. The aim of this pilot study was to investigate in-vitro the effect of flow profiles on reflective photoplethysmography (PPG) signals at different steady state flow rates and levels of vessel constrictions. A simplified model of an arterial system was built, consisting of a steady state flow gear pump, PVC vinyl tubing, reservoir and a clamp with a micrometer gauge. The blood mimicking fluid (2.5% India ink and water solution) was pumped through the model. It was found that the waveforms of the PPG signals fluctuate irregularly and the magnitude of the frequency components was increased below 60 Hz in cases of turbulent flow (Re = 2503). These preliminary results suggest that PPG could be the basis for new technologies for assessing the profile of the blood flow in the artery. Future studies have to be carried out with pulsatile flow and more complex models that are more similar to the human arterial system.Clinical Relevance- The PPG signal reflects changes in the flow profile caused by the stenotic rigid vessel.

Heart rate variability (HRV) is a noninvasive marker of cardiac autonomic activity and has been used in different circumstances to assess the autonomic responses of the body. Pulse rate variability (PRV), a similar variable obtained from pulse waves, has been used in recent years as a valid surrogate of HRV. However, the effect that localized changes in autonomic activity have in the relationship between HRV and PRV has not been entirely understood. In this study, a whole-body cold exposure protocol was performed to generate localized changes in autonomic activity, and HRV and PRV from different body sites were obtained. PRV measured from the earlobe and the finger was shown to differ from HRV, and the correlation between these variables was affected by the cold. Also, it was found that PRV from the finger was more affected by cold exposure than PRV from the earlobe. In conclusion, PRV is affected differently to HRV when localized changes in autonomic activity occur. Hence, PRV should not be considered as a valid surrogate of HRV under certain circumstances.Clinical Relevance- This indicates that pulse rate variability is affected differently to heart rate variability when autonomic activity is modified and suggests that pulse rate variability is not always a valid surrogate of heart rate variability.

This paper introduces a novel technique for the development of custom polydimethylsiloxane (PDMS) vessels for use in phantom technologies. The method involves continuous dip coating of commercial silicone tubes with rapid curation in a single controlled process. The technique accommodates the production of different vessel diameters, wall thicknesses (56 µm-80 µm) and mechanical properties. Clear phantoms were fabricated to compare the commercial silicone tubes against the customs vessels. A pulsatile fluidic pump (BDCLabs, CO, USA) driven by a computer controlled linear motor generated the pulsatile flow through the phantom. The resulting flow profile, using the custom vessels, simulates human blood flow and the detected contact PPG signal from the phantom closely resembles the morphology of in vivo PPG waveforms with signal-to-noise ratios of 38.16 dB and 40.59 dB, compared to the closest commercially-available tubing at 5.38 dB and 10.59 dB for the red and infrared wavelengths respectively. The rigidity and thick walls of commercial silicone tubes impede the expansion of the tubing under systolic pressure. This technique eliminates this common limitation in phantom development.

The aim of this study was to investigate the effect of emitter-detector separation distance and arterial depth in reflectance photoplethysmography (PPG), utilizing a homogenous pulsatile phantom that exhibits the broad optical absorbance and scattering properties of human tissue. The developed phantom comprised of embedded silicone arteries (outer diameter = 4 mm) that were arranged parallel to one another at nine increasing depths (3.2 mm to 24.4 mm). A pulsatile pump (Harvard Apparatus, MA, USA) circulated a blood imitating fluid through the vessels at the desired heart rate (60 bpm) and stroke volume (5 Lmin -1 ). The PPG sensor's emitter and detector were isolated on a translation bridge to provide a computer-controlled separation distance between them. Recordings were taken at each vessel depth for emitter-detector separation distances from 2 mm to 8 mm in 0.1 mm steps. The optimum separation distance between the emitter and detector for vessels between depths of 3.2 mm and 10.5 mm was between 3.7 and 4.3 mm, suggesting that the maximum penetration of IR (930 nm) light in a homogenous pulsatile phantom is no greater than 10.5 mm.

Lithium medication is the gold standard of treatment in Bipolar Disorder patients, preventing and reducing mood swings and suicidality. However, despite its effectiveness, it is a potentially hazardous drug requiring regular monitoring of blood levels to ensure toxic levels are not reached. This paper describes the first steps towards developing a new portable device that can be used by Bipolar Disorder patients to facilitate the analysis of lithium blood levels at home. Solutions of lithium carbonate have been optically fingerprinted using a high-end spectrophotometer. Preliminary measurements indicate that while the visible to near infrared region of the absorption spectra fall heavily within the water band, measurements in the Ultraviolet region show a strong distinction between different lithium concentrations. The optical spectra of Lithium in the 220 nm to 230 nm region demonstrated the ability to differentiate between concentrations representing those found in patients.

Pulse oximetry is being used in everyday clinical practice in anesthesia utilizing peripheral saturation sensors. However, it may be unreliable in certain clinical situations such as peripheral hypoperfusion. Similar situations occur in burns patients and more importantly burns to extremities which limit the sites available for measurement of peripheral oxygen saturation (SpO2). To overcome these limitations, the esophagus has been investigated as an alternative measurement site, as perfusion may be preferentially preserved centrally. A miniaturized reflectance esophageal saturation (SpO2 probe has been constructed utilizing infrared and red photodiodes and a photodetector. Our case study was aimed at evaluating the reliability of esophageal pulse oximetry in a major burns infant. Measurable photoplethysmographic (PPG) traces and SpO2 values were obtained in the neonatal esophagus. It was found that the esophageal pulse oximeter results were in good agreement with oxygen saturation measurements obtained by a commercial ear lobe pulse oximeter. This study suggests that the esophagus can be used as an alternative site for monitoring arterial blood oxygen saturation by pulse oximetry in burned infants.

There is a need for more reliable, non-invasive and alternative measurement sites for the monitoring of arterial blood oxygen saturation in critically ill newborns at times of peripheral compromise. A pilot investigation on 14 Intensive Care Unit (ICU) newborns was conducted utilizing custom-made reflectance photoplethysmographic (PPG) sensors placed at the fontanelle and foot. The results suggest that the fontanelle is sensitive to changes in saturation, where saturation values obtained from the custom sensor were compared against commercial pulse oximeter values and results from a blood gas analyzer, however careful placement of the sensor at the fontanelle is an issue that needs further investigation.

There is a need for a more reliable, non-invasive and alternative measurement site for the monitoring of arterial blood oxygen saturation in critically ill neonates when peripheral perfusion is poor. The anterior fontanelle, a unique anatomical feature of the neonate, has been presented as an alternative site for the estimation of arterial blood oxygen saturation (SpO(2)). A new fontanelle photoplethysmographic sensor and processing system has been developed to investigate fontanelle photoplethysmographic (PPG) signals and estimate SpO(2) values at this anatomical location. Preliminary clinical trials have shown that good quality PPG signals with large amplitudes and high signal to noise ratio can be obtained from the neonatal fontanelle. The estimation of SpO(2) values from the fontanelle were in broad agreement with a commercial foot pulse oximeter.

There is a need for more reliable, non-invasive and alternative measurement sites for the monitoring of arterial blood oxygen saturation in critically ill newborns at times of peripheral compromise. The anterior fontanelle, a unique anatomical feature of the newborn, has been presented as an alternative site for the estimation of oxygen saturation. A multi-wavelength non-invasive optoelectronic sensor has been designed and developed for the investigation of photoplethysmographic (PPG) signals and blood oxygen saturation values from the fontanelle. In vivo thermal tests of the optical sensor show that under normal operating conditions the heating at the skin surface was negligible (<0.1 °C). Good quality PPGs with large amplitudes and high signal to noise ratio were recorded at all three (red, infrared and green) wavelengths prior to clinical measurements.