Automated Electrocardiogram (ECG) processing is an important technique which helps in identifying abnormalities in the heart before any formal diagnosis. This research presents a real-time and lightweight R-assisted feature extraction algorithm and a heartbeat classification scheme which achieves highly accurate abnormality detection. In the proposed algorithm, we extract fifteen features from each heartbeat taken from raw Lead-II ECG signals. The features carry medically valuable information such as locations, amplitude and energy of ECG waves (P, Q, R, S, T waves) which are then used for detection of any abnormality that might be present in the heartbeat using various classification algorithms. We have used four popular databases from Physionet and extracted ten thousand ECG signals from each for training the models and benchmarking results. Four classification models i.e. Naïve Bays, k-Nearest Neighbor, Neural Network, Decision Tree were used for abnormality detection validating the efficiency of the system.

The supply chain has incorporated products by putting them into hair scarfs. This study introduces the use of mini chips in health and beauty products and can reduce fatigue through enhanced sleep patterns. The mini chip could be placed in the scarf and used as a prototype. RFID technology provides the supply chain with specific information that is used to identify products and make communication easier. (Muhammad, et. al. 2013) This paper presents a new tool herein referred to as a scarf prototype which is developed to analyse EMG (electromyogram), ECG (electrocardiography), EEG (electroencephalogram), and EOG (electro-oculogram) signals that focuses in the area of sleep disorders. The mini chips used can be used to determine a solution for sleep disruption by using automated analytics. This could lead to improvement in our understanding of sleep disruption and overall sleep physiology. Automated technology allows repeated measurements, evaluation of sleep patterns, and provide suggestions to improve a person’s quality of sleep. This analysis compares the use of polysomnography and the scarf prototype. The analytics provide models and shows correlation between variables, such as EMG, ECG, EEG, and EOG. This study shows that the results from the scarf prototype is just as reliable as the original method, polysomnography.

We compared performance of a novel encoding Lempel-Ziv complexity (ELZC) with approximate entropy (ApEn), sample entropy (SmpEn) and permutation entropy (PerEn) as nonlinear metric to assess ECG quality. Firstly to compare performance of discerning randomness and inherent nonlinear properties within time series, this study calculated the aforementioned four nonlinear complexity values on several typical artificial time series i.e., Gauss noise, two kinds of noisy time series, two kinds of Logistic series and periodic series, respectively. Then for analyzing sensitivity of the aforementioned four complexity methods to content level of different types noise within ECG recordings, we investigated variation trend of ELZC, ApEn, SmpEn and PerEn in several synthetic ECG recordings containing different types noise (i.e., baseline wander, muscle artefacts, electrode motion, power line and mixed noise) and different signal noise ratios (i.e., 15, 10, 5, 0, −5 and −10 dB). Finally, the four complexity methods were employed to classify the quality of real ECG recordings from the PhysioNet/Computing in Cardiology Challenge 2011 (CINC 2011) of the MIT databases, then receiver operating characteristic curves (ROC) and their corresponding area under curve (AUC) were yielded. The results showed ELZC could not only distinguish randomness and chaotic within time series but also reflect content level of noise within time series, and the highest AUC of PerEn, ELZC, SmpEn and ApEn were 0.850, 0.695, 0.474 and 0.461, respectively. The results demonstrated PerEn and ELZC were more effectively than ApEn and SmpEn for assessing ECG quality.

The diagnosis of Cardio-Vascular diseases (CVD) is highly dependent on analysis of ECG signals. ECG analysis can be helpful in estimating the underlying cause and condition of heart in cardiac abnormality. The effectiveness of ECG signal analysis in detection of CVDs is widely accepted by professional healthcare service provider. Many algorithms have been proposed but almost all of them have some kind of limitations, and these limitations largely influence the effectiveness of ECG analysis. The performed research work is dedicated for design of unique self-organizing maps (SOMs) based neural network for classification of arrhythmia according to a particular ECG signal, the generation of SOMs is based on the certain unique signatures of ECG signals and have potential to classify different cardiac conditions. For extraction of unique features from ECG signals, we have proposed to use Fast Discrete Stockwell Transform (FDST). Since the proposed technique is a result of combining two different techniques hence called as hybrid technology. The purpose of using FDST is to identify unique signatures of ECG signals in a more improved manner than existing one, the term improved is used because it has several advantages over existing techniques such as wavelet and Fourier Transform based methods. Results obtained from the implementation of the technique are capable in visualizing the ECG sinus rhythm and arrhythmia conditions in form of unique SOM for each associated arrhythmia condition. This unique SOM based classification makes them ideal for being used as a diagnostic tool. This ability of arrhythmia classification using FDST and SOMs makes the technique unique and useful providing valuable information about patient condition. Using proposed technology a portable diagnosis tool for monitoring of patient at their site may be facilitated later, that will improve the quality of life of the patient by diagnosing cardiac condition.

The use of heart rate variability (HRV) in research has been greatly popularized over the past decades due to the ease and affordability of HRV collection, coupled with its clinical relevance and significant relationships with psychophysiological constructs and psychopathological disorders. Despite the wide use of electrocardiogram (ECG) in research and advancement in sensors technology, the analytical approach and steps applied to obtain HRV measures can be seen as complex. Thus, posing a challenge to users who may not have the adequate background knowledge to obtain the HRV indices reliably. To maximize the impact of HRV-related research and its reproducibility, parallel advances in users’ understanding of the indices and the standardization of analysis pipelines in its utility will be crucial. This paper addresses this gap and aims to provide an overview of the most up-to-date and commonly used HRV indices, as well as common research areas that these indices have shown to be very useful, particularly in psychology. In addition, we also provide a step-by-step guide on how to perform HRV analysis using an integrative neurophysiological toolkit, NeuroKit2.

Background and Objectives: The IPED study showed that a smartphone-based event recorder increased the number of patients in whom an ECG was captured during symptoms over five-fold to more than 55% at 90 days compared to standard care [1] and concluded that this safe, non-invasive and easy to use device should be considered part of on-going care to all patients presenting acutely with unexplained palpitations or pre-syncope. This study reports the process of establishing a smartphone palpitation and pre-syncope service. Materials and Methods: A clinical Standard Operating Procedure (SOP) was devised, and funding was secured through a business case for the purchase of 40 AliveCor devices in the first instance. The clinic was launched on 22nd July 2019. Results: Between 22nd July 2019 and 31st October 2019, 68 patients seen in the ED with palpitations or pre-syncope were referred to SPACC. 30 were male and 38 female and mean age was 45.8 (SD 15.1) with a range from 18 to 80 years. 50 (74%) patients underwent full investigation. 7 (11%) patients were deemed on first assessment to have non-cardiac palpitations and were not fitted with the device. All patients who underwent full investigation achieved symptomatic rhythm correlation most with sinus rhythm, ventricular ectopics or bigeminy. A symptomatic cardiac dysrhythmia was detected in 6 (8.8%) patients. 3 patients had supraventricular tachycardia; SVT (4%), 2 had atrial fibrillation (3%) and 1 atrial flutter (2%). Qualitative feedback from the SPACC team suggested several areas where improvement to the clinic could be made. Conclusion: We believe a smartphone palpitation service based in ambulatory care is simple to implement and is effective at detecting cardiac dysrhythmia in ED palpitation patients.

One of the rapidly developing research areas is the creation of systems. which are commonly referred to as cyberphysical complexes. In such systems, devices and complexes interact with a completely different physical nature. The role of a person in such systems usually consists in the formation of final tasks for “artificial intelligence” and executive mechanisms. The functioning of actuators is controlled by accurate information systems.

In personalized healthcare, an ecosystem for the manipulation of reliable and safe private data should be orchestrated. This paper describes a first approach for the generation of fake electrocardiograms (ECGs) based on Generative Adversarial Networks (GANs) with the objective of anonymizing users’ information for privacy issues. This is intended to create valuable data that can be used both, in educational and research areas, while avoiding the risk of a sensitive data leakage. As GANs are mainly exploited on images and video frames, we are proposing general raw data processing after transformation into an image, so it can be managed through a GAN, then decoded back to the original data domain. The feasibility of our transformation and processing hypothesis is primarily demonstrated. Next, from the proposed procedure, main drawbacks for each step in the procedure are addressed for the particular case of ECGs. Hence, a novel research pathway on health data anonymization using GANs is opened and further straightforward developments are expected.

The aim of this paper is to develop an intelligent event-driven Electrocardiogram (ECG) processing module in order to achieve an efficient solution for diagnosis of the cardiac diseases. The suggested method acquires the signal with an event-driven A/D converter (EDADC). The output of EDADC is passed through the activity selection and interpolation blocks. It allows focusing only on the important signal parts and resampling it uniformly. Later on, the signal is de-noised. The autoregressive (AR) method is used to extract the classifiable features of the de-noised signal. Afterwards, the output is classified by employing different robust classification techniques such as support vector machines (SVMs), K- Nearest Neighbor (KNN) and Artificial Neural Network (ANN). The event-driven feature enables to adapt the system processing load according to the signal temporal variations. This interesting feature of the devised system aptitudes a drastic reduction in its processing activity and therefore in the power consumption as compared to the traditional ones. A comparison of the performance of different classifiers is also made in terms of accuracy. Results show that the proposed system is a potential candidate for an automatic diagnosis of the cardiac diseases.

Cardiac monitoring based on wearable photoplethysmography (PPG) is widespread because of its usability and low cost. Unfortunately, PPG is negatively affected by various types of disruptions, which could introduce errors to the algorithm that extracts Pulse Rate Variability (PRV). This study aims to identify the nature of such artifacts caused by various types of factors under the conditions of precisely planned experiments. We also propose methods for their reduction based solely on the PPG signal while preserving the frequency content of PRV. The accuracy of PRV derived from PPG was compared to Heart Rate Variability (HRV) derived from the accompanying recorded ECG. The results indicate that filtering PPG signals using the Discrete Wavelet Transform and its inverse (DWT/IDWT) is suitable for removing slow components and high-frequency noise. Moreover, the main benefit of amplitude demodulation is better preparation of the PPG to determine the duration of pulse cycles and reduce the impact of some other artifacts. Postprocessing applied to HRV and PRV indicates that the correction of outliers based on local statistical measures of signals and the AR model is only important when PPG is of low-quality and has no effect under good signal quality. The main conclusion is that DWT/IDWT, followed by amplitude demodulation, enables the proper preparation of the PPG signal for the subsequent use of PRV extraction algorithms. However, postprocessing in the proposed form should be applied more in the situations of observed strong artifacts than in motionless laboratory experiments.

：Sleep stage on the whole night is not steady. Sleepers generally pass through three to five cycles. In each cycle, there are occur four typical sleep stages, such as wake stage (WS), light stage (LS), deep sleep (DS), rapid eye movement sleep stage (REM). According to the natural routine, in this paper, we investigate the stage transition and analyze the feature of stage transition using the local cluster Algorithm (LCA). Two-cycle sleep model (TCSM) is proposed to automatically classify sleep stages using over-night continuous heart rate variability (HRV) data. The generated model is based on the characteristics of the nested cycle's sleep stage distribution and the transition probabilities of sleep stages. Experiments were conducted using a public data set including 400 healthy subjects (female 239, male 161) and the model’s classification accuracy was evaluated for four sleep stages: WS, LS, DS, REM. The experimental results showed that based on the TCSM model, the segmentation classification of pure sleep is 5.2% higher than that of the traditional method, and the accuracy of segmentation classification is 11.2% higher than the traditional sleep staging accuracy. The experimental performance is promising in terms of the accuracy, sensitivity, and specificity rates compared with the ones of the state-of-the-art methods. The study contributes to improve the quality of sleep monitoring in daily life using easy-to-wear HRV sensors.

Finding an optimal combination of features and classifier is still an open problem in the development of automatic heartbeat classification systems, especially when applications that involve resource-constrained devices are considered. In this paper, a novel study of the selection of informative features and the use of a random forest classifier while following the recommendations of the Association for the Advancement of Medical Instrumentation (AAMI) and an inter-patient division of datasets is presented. Features were selected using a filter method based on the mutual information ranking criterion on the training set. Results showed that normalized R-R intervals and features relative to the width of the QRS complex are the most discriminative among those considered. The best results achieved on the MIT-BIH Arrhythmia Database were an overall accuracy of 96.14% and F1-scores of 97.97%, 73.06%, and 90.85% in the classification of normal beats, supraventricular ectopic beats, and ventricular ectopic beats respectively. In comparison with other state of the art approaches tested under similar constraints, this work represents one of the highest performances reported to date while relying on a very small feature vector.

In the context of the COVID-19 Pandemic, the use of surgical masks has become the new normal. The use of these devices in exercise and medical situations has been advocated with the purpose of reducing contagions, but some concerns exist regarding its safety. We performed maximal treadmill stress tests in 12 healthy young subjects, with and without surgical mask use, and measured exercise capacity, oxygen saturation (rest, peak exercise and post-exercise) and electrocardiographic changes. Exercise capacity and Oxygen saturation levels decreased in peak exercise vs rest in a statistically significant manner when mask was used. ECG changes, although not significant, were present in 3 subjects when mask was used and disappeared when the test was made unmasked. We conclude that masked exercise has the potential to cause decreased exercise load and oxygen saturation and potentially cause diagnostic errors in medical exams.

Blood glucose (BG) monitoring is an important issue for critically ill patients. Previous studies reported that poor sugar control was associated with increased mortality in admitted patients. However, repeated blood glucose monitoring can be resource-consuming and cause a healthcare burden in clinical practice. In this study, we aimed to develop a personalized machine-learning model to predict dysglycemia based on electrocardiogram (ECG) findings. The study included patients with more than 20 ECG records during single hospital admission in the Medical Information Mart for Intensive Care III database, focusing on the lead II recordings, along with the corresponding blood sugar data. We processed the data and used ECG features from each heartbeat as inputs to develop a one-class support vector machine (SVM) algorithm to predict dysglycemia. The model prediction for dysglycemia using a single heartbeat had an AUC level of 0.92 ± 0.09, with a sensitivity of 0.92 ± 0.10 and specificity of 0.84 ± 0.04. Based on 10 s majority voting, the model prediction for dysglycemia improved to an AUC of 0.97 ± 0.06. In this study, we found that a personalized machine-learning algorithm could accurately detect dysglycemia using a single-lead ECG.

With the advent of modern technologies, the healthcare industry is moving towards a more Personalised smart care model. The enablers of such care models are the Internet of Things (IoT) and Artificial Intelligence. These technologies collect and analyse data from persons in care to alert relevant parties if any anomaly is detected in a patient’s regular pattern. However, such reliance on IoT devices to capture continuous data extends the attack surfaces and demands high-security measures. Both patients and devices need to be authenticated to mitigate a large number of attack vectors. The biometric authentication method has been seen as a promising technique in these scenarios. To this end, this paper proposes an AI-based multimodal biometric authentication model for single and group-based users’ device-level authentication that increases protection against the traditional single modal approach. To test the efficacy of the proposed model, a series of AI models are trained and tested using physiological biometric features such as ECG (Electrocardiogram) and PPG (Photoplethysmography) signals from five publicly available datasets from Physionet and Mendeley data repositories. The multimodal fusion authentication model shows promising results with 99.8% accuracy and an Equal Error Rate (EER) of 0.16.

Driver drowsiness is one of the leading causes of traffic accidents. This paper proposes a new method for classifying driver drowsiness using deep convolution neural networks trained by wavelet scalogram images of electrocardiogram (ECG) signals. Three different classes were de-fined for drowsiness based on video observation of driving tests performed in a simulator for manual and automated modes. The Bayesian optimization method is employed to optimize the hyperparameters of the designed neural networks, such as the learning rate and the number of neurons in every layer. To assess the results of the deep network method, Heart Rate Variability (HRV) data is derived from the ECG signals, some features are extracted from this data, and finally, random forest and k-nearest neighbors (KNN) classifiers are used as two traditional methods to classify the drowsiness levels. Results show that the trained deep network achieves balanced accuracies of about 77% and 79% in the manual and automated modes, respectively. However, the best obtained balanced accuracies using traditional methods are about 62% and 64%. We conclude that designed deep networks working with wavelet scalogram images of ECG signals significantly outperform KNN and random forest classifiers which are trained on HRV-based features.

Eastern (EEEV) and Venezuelan (VEEV) equine encephalitis viruses (EEVs) are related, (+)ssRNA arboviruses that can cause severe, sometimes fatal, encephalitis in humans. EEVs are highly infectious when aerosolized, raising concerns for potential use as biological weapons. No licensed medical countermeasures exist; given the severity/rarity of natural EEV infections, efficacy studies require animal models. Cynomolgus macaques exposed to EEV aerosols develop fever, encephalitis, and other clinical signs similar to humans. Fever is nonspecific for encephalitis in macaques. Electrocardiography (ECG) metrics may predict onset, severity, or outcome of EEV-attributable disease. Macaques were implanted with thermometry/ECG radiotransmitters and exposed to aerosolized EEV. Data was collected continuously, and repeated-measures ANOVA and frequency-spectrum analyses identified differences between courses of illness and between pre-exposure and post-exposure states. EEEV-infected macaques manifested widened QRS-intervals in severely ill subjects post-exposure. Moreover, QT-intervals and RR-intervals decreased during the febrile period. VEEV-infected macaques suffered decreased QT-intervals and RR-intervals with fever onset. Frequency-spectrum analyses revealed differences in the fundamental frequencies of multiple metrics in the post-exposure and febrile periods compared to baseline and confirmed circadian dysfunction. Heart rate variability (HRV) analyses revealed diminished variability post-exposure. These analyses support using ECG data alongside fever and clinical laboratory findings for evaluating medical countermeasure efficacy.

The electrocardiogram (ECG) was the first biomedical signal where digital signal processing techniques were extensively applied. By its own nature, the ECG is typically a sparse signal, composed of regular activations (the QRS complexes and other waveforms, like the P and T waves) and periods of inactivity (corresponding to isoelectric intervals, like the PQ or ST segments), plus noise and interferences. In this work, we describe an efficient method to construct an overcomplete and multi-scale dictionary for sparse ECG representation using waveforms recorded from real-world patients. Unlike most existing methods (which require multiple alternative iterations of the dictionary learning and sparse representation stages), the proposed approach learns the dictionary first, and then applies an efficient sparse inference algorithm to model the signal using the learnt dictionary. As a result, our method is much more efficient from a computational point of view than other existing methods, thus becoming amenable to deal with long recordings from multiple patients. Regarding the dictionary construction, we locate first all the QRS complexes in the training database, then we compute a single average waveform per patient, and finally we select the most representative waveforms (using a correlation-based approach) as the basic atoms that will be resampled to construct the multi-scale dictionary. Simulations on real-world records from Physionet's PTB database show the good performance of the proposed approach.

The study investigated the influence of white vs 12 background and overlay colours on the reading process in school age children. Previous research reported that colours could affect reading skills as an important factor of the emotional and physiological state of the body. The aim of the study was to assess developmental differences between second and third grade students of elementary school and to evaluate differences in electroencephalography (EEG), ocular, electrodermal activities (EDA) and heart rate variability (HRV). Our findings showed a decreasing trend with age regarding EEG power bands (Alpha, Beta, Delta, Theta) and lower scores of reading duration and eye-tracking measures in younger children compared to older children. As shown in the results, HRV parameters showed higher scores in 12 background and overlay colours among second than third grade students which is linearly correlated to the level of stress and readable from EDA measures as well. The existing study showed the calming effect on second graders in turquoise and blue background colours. Considering other colours separately for each parameter, we assumed that there are no systematic differences in Reading duration, EEG power band, Eye-tracking and EDA measures.

While the importance of continuous monitoring of electrocardiographic (ECG) or photoplethysmographic (PPG) signals to detect cardiac anomalies is generally accepted in preventative medicine, there remain major barriers to its actual widespread adoption. Most notably, current approaches tend to lack real-time capability, exhibit high computational cost, and be based on restrictive modeling assumptions or require large amounts of training data. We propose a lightweight and model-free approach for the online detection of cardiac anomalies such as ectopic beats in ECG or PPG signals based on the change detection capabilities of Singular Spectrum Analysis (SSA) and nonparametric rank-based cumulative sum (CUSUM) control charts. The procedure is able to quickly detect anomalies without requiring the identification of fiducial points such as R-peaks and is computationally significantly less demanding than previously proposed SSA-based approaches. Therefore, the proposed procedure is equally well suited for standalone use and as an add-on to complement existing (e.g. heart rate (HR) estimation) procedures.

Reading is one of the essential processes during the maturation of an individual. It is estimated that 5-10% of school-age children are affected by dyslexia, the reading disorder characterised by difficulties in the accuracy or fluency of word recognition. There are many studies which have reported that colour overlays and background could improve the reading process, especially in children with reading disorders. As dyslexia has neurobiological origins, the aim of the present research was to understand the relationship between physiological parameters and colour modifications in the text and background during reading in children with and without dyslexia. We have measured differences in electroencephalography (EEG), heart rate variability (HRV), electrodermal activities (EDA), and eye movement of the 36 school-age children (18 with dyslexia and 18 of control group) during the reading performance in 13 combinations of background and overlay colours during the reading task. Our findings showed that the dyslexic children have longer reading duration, fixation count, fixation duration average, fixation duration total, and longer saccade count, saccade duration total, and saccade duration average while reading on white and coloured background/overlay. It was found that the turquoise, turquoise O, and yellow colours are beneficial for dyslexic readers, as they achieved the shortest time duration during the reading tasks when these colours were used. Also, dyslexic children have higher values of beta and the whole range of EEG while reading in particular colour (purple), as well as increasing theta range while reading on the purple overlay colour. We have observed no significant differences between HRV parameters on white colour, except for single colours (purple, turquoise overlay and yellow overlay) where the control group showed higher values for Mean HR, while dyslexic children scored higher with Mean RR. Regarding EDA measure we have found systematically lower values in children with dyslexia in comparison to the control group. Based on present results we can conclude that both colours (warm and cold background/overlays) are beneficial for both groups of readers and all sensor modalities could be used to better understand the neurophysiological origins in dyslexic children.

Heart Rate Monitors (HRMs) are an indispensable tool for controlling training parameters of healthy athletes. They became a source of information about stress heart rhythm disturbances, recognized as unexpected increases in heart rate (HR), which can be life-threatening for athletes. Most HRMs do not recognize the type of arrhythmia, confusing them with artifacts. The aim of the study was to assess the usefulness of ECG recording functions by sports HRMs among endurance athletes, coaches, and physicians in comparison with other basic and hypothetical functions. We conducted 3 surveys among endurance athletes (76 runners, 14 cyclists, and 10 triathletes), as well as 10 coaches and 10 sports doctors to obtain information on how important ECG recording is, and what functions of HRMs should be improved to meet their expectations in the future. The respondents were asked questions regarding use and hypothetical functions, as well as preference for HRM type (optical/strap). For athletes, the 4 most important functions were distance traveled, pace, instant heart rate, and information about reaching the oxygen threshold. ECG recording was the 8th and 9th most important for momentary and continuous, respectively. Coaches opined more importance to ECG recording. Doctors placed ECG recording as most important. All participants preferred optical HRMs to strap HRMs. Research on the improvement and implementation of HRM functions shows slightly different preferences of athletes compared to coaches and doctors. Suspected arrhythmia increases the value of the HRM’s ability to record ECGs during training by athletes and coaches. For doctors, this is the most desirable feature in any situation. Considering the expectations of all groups continuous ECG recording during training will significantly improve the safety of athletes.