Cardiac Biosignal and Adaptation in Confined Nuclear Submarine Patrol

Isolated and confined environments (ICE) present several challenges which may adversely affect human’s psychology and physiology. Submariners in Sub-Surface Ballistic Nuclear (SSBN) mission exposed to these environmental constraints must be able to perform complex tasks as part of their normal duties, as well as during crisis periods when emergency actions are required or imminent. The operational and environmental constraints they face contribute to challenge human adaptability. The impact of such a constrained environment has yet to be explored. Establishing a knowledge framework is a determining factor, particularly in view of the next long space travels. Ensuring that the crews are maintained in optimal operational conditions is a real challenge because the success of the mission depends on them. This study focused on the evaluation of the impact of stress on mental health and sensory degradation of submariners during a mission on SSBN using cardiac biosignal (heart rate variability, HRV) clustering. This is a pragmatic exploratory study of a prospective cohort included 19 submariner volunteers. HRV was recorded at baseline to classify by clustering the submariners according to their stress level based on parasympathetic (Pa) activity. Impacts of high Pa (HPa) versus low Pa (LPa) level at baseline were assessed on emotional state and sensory perception (interoception and exteroception) as a cardiac biosignal during the patrol and at a recovery time one month after. Whatever the time, no significant difference was found in mental health between groups. There are significant differences in the interoceptive, exteroceptive and physiological functioning during the patrol and at recovery time. To sum up, compared to the LPa group, the HPa maintains a higher level in psychosensory functioning during the patrol and at recovery but exhibits a decrease in Pa level. The HPa group has less adaptable HRV characteristics, less unpredictability and flexibility of cardiac biosignals while the LPa group increases them during the patrol and at recovery time. This dissociation between psychosensory and physiological adaptation suggests two treatment modalities for ICE environments. To our best knowledge, our results are the first to highlight the impact of physiological differences in the HRV profile on the adaptability of submariners. Further studies are needed to evaluate the negative emotional and cognitive effects of ICEs based on the cardiac profile. Artificial intelligence offers a promising future for maintaining high level of operational conditions. These future perspectives will not only allow submariners to be better prepared, but also to design feasible countermeasures that will help support analog environments that bring us closer to a trip to Mars.

A Continuous Real-Time Analytic for Predicting Instability in Acute Care Rapid Response Team Activations

A reliable, real-time, and non-invasive system that can identify patients at risk for hemodynamic instability is needed to aid clinicians in their efforts to anticipate patient deterioration and initiate early interventions. The purpose of this pilot study was to explore the clinical capabilities of a real-time analytic from a single lead of an electrocardiograph to correctly distinguish between rapid response team (RRT) activations due to hemodynamic (H-RRT) and non-hemodynamic (NH-RRT) causes, as well as predict H-RRT cases with actionable lead times. The study consisted of a single center, retrospective cohort of 21 patients with RRT activations from step-down and telemetry units. Through electronic health record review and blinded to the analytic’s output, each patient was categorized by clinicians into H-RRT and NH-RRT cases. The analytic output and the categorization were compared. The prediction lead time prior to the RRT call was calculated. The analytic correctly distinguished between H-RRT and NH-RRT cases with 100% accuracy, demonstrating 100% positive and negative predictive values, and 100% sensitivity and specificity. In H-RRT cases, the analytic detected hemodynamic deterioration with a median lead time of 9.5 hours prior to the RRT call (range 14 minutes to 52 hours). The study demonstrates that an electrocardiogram (ECG) based analytic has the potential for providing clinical decision and monitoring support for caregivers to identify at risk patients within a clinically relevant timeframe allowing for increased vigilance and early interventional support to reduce the chances of continued patient deterioration.

Engineering Photodynamic with Radioactive Therapeutic Systems for Sustainable Molecular Polarity: Autopoiesis Systems

This paper introduces Luhmann’s autopoietic social systems starting with the original concept of autopoiesis by biologists and scientists, including the modification of general systems based on socialized medicine. A specific type of autopoietic system is explained in the three existing groups of the ecological phenomena: interaction, social and medical sciences. This hypothesis model, nevertheless, has a nonlinear interaction with its natural environment ‘interactional cycle’ for the exchange of photon energy with molecular without any changes in topology. The external forces in the systems environment might be concomitant with the natural fluctuations’ influence (e.g. radioactive radiation, electromagnetic waves). The cantilever sensor deploys insights to the future chip processor for prevention of social metabolic systems. Thus, the circuits with resonant electric and optical properties are prototyped on board as an intra–chip inter–chip transmission for producing electromagnetic energy approximately ranges from 1.7 mA at 3.3 V to service the detection in locomotion with the least significant power losses. Nowadays, therapeutic systems are assimilated materials from embryonic stem cells to aggregate multiple functions of the vessels nature de-cellular structure for replenishment. While, the interior actuators deploy base-pair complementarity of nucleotides for the symmetric arrangement in particular bacterial nanonetworks of the sequence cycle creating double-stranded DNA strings. The DNA strands must be sequenced, assembled, and decoded in order to reconstruct the original source reliably. The design of exterior actuators have the ability in sensing different variations in the corresponding patterns regarding beat-to-beat heart rate variability (HRV) for spatial autocorrelation of molecular communication, which consists of human electromagnetic, piezoelectric, electrostatic and electrothermal energy to monitor and transfer the dynamic changes of all the cantilevers simultaneously in real-time workspace with high precision. A prototype-enabled dynamic energy sensor has been investigated in the laboratory for inclusion of nanoscale devices in the architecture with a fuzzy logic control for detection of thermal and electrostatic changes with optoelectronic devices to interpret uncertainty associated with signal interference. Ultimately, the controversial aspect of molecular frictional properties is adjusted to each other and forms its unique spatial structure modules for providing the environment mutual contribution in the investigation of mass temperature changes due to pathogenic archival architecture of clusters.

Optimal ECG Sampling Frequency for Multiscale Entropy-Based HRV

Multiscale entropy (MSE) is an extensively used index to provide a general understanding of multiple complexity of physiologic mechanism of heart rate variability (HRV) that operates on a wide range of time scales. Accurate selection of electrocardiogram (ECG) sampling frequency is an essential concern for clinically significant HRV quantification; high ECG sampling rate increase memory requirements and processing time, whereas low sampling rate degrade signal quality and results in clinically misinterpreted HRV. In this work, the impact of ECG sampling frequency on MSE based HRV have been quantified. MSE measures are found to be sensitive to ECG sampling frequency and effect of sampling frequency will be a function of time scale.

A Study of Applying the Use of Breathing Training to Palliative Care Patients, Based on the Bio-Psycho-Social Model

In clinical practices, it is common that while facing the unknown progress of their disease, palliative care patients may easily feel anxious and depressed. These types of reactions are a cause of psychosomatic diseases and may also influence treatment results. However, the purpose of palliative care is to provide relief from all kinds of pains. Therefore, how to make patients more comfortable is an issue worth studying. This study adopted the “bio-psycho-social model” proposed by Engel and applied spontaneous breathing training, in the hope of seeing patients’ psychological state changes caused by their physiological state changes, improvements in their anxious conditions, corresponding adjustments of their cognitive functions, and further enhancement of their social functions and the social support system. This study will be a one-year study. Palliative care outpatients will be recruited and assigned to the experimental group or the control group for six outpatient visits (once a month), with 80 patients in each group. The patients of both groups agreed that this study can collect their physiological quantitative data using an HRV device before the first outpatient visit. They also agreed to answer the “Beck Anxiety Inventory (BAI)”, the “Taiwanese version of the WHOQOL-BREF questionnaire” before the first outpatient visit, to fill a self-report questionnaire after each outpatient visit, and to answer the “Beck Anxiety Inventory (BAI)”, the “Taiwanese version of the WHOQOL-BREF questionnaire” after the last outpatient visit. The patients of the experimental group agreed to receive the breathing training under HRV monitoring during the first outpatient visit of this study. Before each of the following three outpatient visits, they were required to fill a self-report questionnaire regarding their breathing practices after going home. After the outpatient visits, they were taught how to practice breathing through an HRV device and asked to practice it after going home. Later, based on the results from the HRV data analyses and the pre-tests and post-tests of the “Beck Anxiety Inventory (BAI)”, the “Taiwanese version of the WHOQOL-BREF questionnaire”, the influence of the breathing training in the bio, psycho, and social aspects were evaluated. The data collected through the self-report questionnaires of the patients of both groups were used to explore the possible interfering factors among the bio, psycho, and social changes. It is expected that this study will support the “bio-psycho-social model” proposed by Engel, meaning that bio, psycho, and social supports are closely related, and that breathing training helps to transform palliative care patients’ psychological feelings of anxiety and depression, to facilitate their positive interactions with others, and to improve the quality medical care for them.

The Significant Effect of Wudu’ and Zikr in the Controlling of Emotional Pressure Using Biofeedback Emwave Technique

Wudu’ (Ablution) and Zikr are amongst some of the spiritual tools which may help an individual control his mind, emotion and attitude. These tools are deemed to be able to deliver a positive impact on an individual’s psychophysiology. The main objective of this research is to determine the effects of Wudu’ (Ablution) and Zikr therapy using the biofeedback emWave application and technology. For this research, 13 students were selected as samples from the students’ representative body at the University Tenaga National, Malaysia. The DASS (Depression Anxiety Stress Scale) questionnaire was used to help with the assessment and measurement of each student’s ability in controlling his or her emotions before and after the therapies. The biofeedback emWave technology was utilized to monitor the student’s psychophysiology level. In addition, the data obtained from the Heart rate variability (HRV) test have also been used to affirm that Wudu’ and Zikr had had significant impacts on the student’s success in controlling his or her emotional pressure.

Heart Rate Variability Analysis for Early Stage Prediction of Sudden Cardiac Death

In present scenario, cardiovascular problems are growing challenge for researchers and physiologists. As heart disease have no geographic, gender or socioeconomic specific reasons; detecting cardiac irregularities at early stage followed by quick and correct treatment is very important. Electrocardiogram is the finest tool for continuous monitoring of heart activity. Heart rate variability (HRV) is used to measure naturally occurring oscillations between consecutive cardiac cycles. Analysis of this variability is carried out using time domain, frequency domain and non-linear parameters. This paper presents HRV analysis of the online dataset for normal sinus rhythm (taken as healthy subject) and sudden cardiac death (SCD subject) using all three methods computing values for parameters like standard deviation of node to node intervals (SDNN), square root of mean of the sequences of difference between adjacent RR intervals (RMSSD), mean of R to R intervals (mean RR) in time domain, very low-frequency (VLF), low-frequency (LF), high frequency (HF) and ratio of low to high frequency (LF/HF ratio) in frequency domain and Poincare plot for non linear analysis. To differentiate HRV of healthy subject from subject died with SCD, k –nearest neighbor (k-NN) classifier has been used because of its high accuracy. Results show highly reduced values for all stated parameters for SCD subjects as compared to healthy ones. As the dataset used for SCD patients is recording of their ECG signal one hour prior to their death, it is therefore, verified with an accuracy of 95% that proposed algorithm can identify mortality risk of a patient one hour before its death. The identification of a patient’s mortality risk at such an early stage may prevent him/her meeting sudden death if in-time and right treatment is given by the doctor.

HRV Analysis Based Arrhythmic Beat Detection Using kNN Classifier

Health diseases have a vital significance affecting human being's life and life quality. Sudden death events can be prevented owing to early diagnosis and treatment methods. Electrical signals, taken from the human being's body using non-invasive methods and showing the heart activity is called Electrocardiogram (ECG). The ECG signal is used for following daily activity of the heart by clinicians. Heart Rate Variability (HRV) is a physiological parameter giving the variation between the heart beats. ECG data taken from MITBIH Arrhythmia Database is used in the model employed in this study. The detection of arrhythmic heart beats is aimed utilizing the features extracted from the HRV time domain parameters. The developed model provides a satisfactory performance with ~89% accuracy, 91.7 % sensitivity and 85% specificity rates for the detection of arrhythmic beats.

Poincaré Plot for Heart Rate Variability

Heart is the most important part in the body of living organisms. It affects and is affected by any factor in the body. Therefore, it is a good detector for all conditions in the body. Heart signal is a non-stationary signal; thus, it is utmost important to study the variability of heart signal. The Heart Rate Variability (HRV) has attracted considerable attention in psychology, medicine and has become important dependent measure in psychophysiology and behavioral medicine. The standards of measurements, physiological interpretation and clinical use for HRV that are most often used were described in many researcher papers, however, remain complex issues are fraught with pitfalls. This paper presents one of the nonlinear techniques to analyze HRV. It discusses many points like, what Poincaré plot is and how Poincaré plot works; also, Poincaré plot's merits especially in HRV. Besides, it discusses the limitation of Poincaré cause of standard deviation SD1, SD2 and how to overcome this limitation by using complex correlation measure (CCM). The CCM is most sensitive to changes in temporal structure of the Poincaré plot as compared toSD1 and SD2.

Gender Based Variability Time Series Complexity Analysis

Non linear methods of heart rate variability (HRV) analysis are becoming more popular. It has been observed that complexity measures quantify the regularity and uncertainty of cardiovascular RR-interval time series. In the present work, SampEn has been evaluated in healthy normal sinus rhythm (NSR) male and female subjects for different data lengths and tolerance level r. It is demonstrated that SampEn is small for higher values of tolerance r. Also SampEn value of healthy female group is higher than that of healthy male group for short data length and with increase in data length both groups overlap each other and it is difficult to distinguish them. The SampEn gives inaccurate results by assigning higher value to female group, because male subject have more complex HRV pattern than that of female subjects. Therefore, this traditional algorithm exhibits higher complexity for healthy female subjects than for healthy male subjects, which is misleading observation. This may be due to the fact that SampEn do not account for multiple time scales inherent in the physiologic time series and the hidden spatial and temporal fluctuations remains unexplored.

Changes in EEG and HRV during Event-Related Attention

Determination of attentional status is important because working performance and an unexpected accident is highly related with the attention. The autonomic nervous and the central nervous systems can reflect the changes in person’s attentional status. Reduced number of suitable pysiological parameters among autonomic and central nervous systems related signal parameters will be critical in optimum design of attentional devices. In this paper, we analyze the EEG (Electroencephalography) and HRV (Heart Rate Variability) signals to demonstrate the effective relation with brain signal and cardiovascular signal during event-related attention, which will be later used in selecting the minimum set of attentional parameters. Time and frequency domain parameters from HRV signal and frequency domain parameters from EEG signal are used as input to the optimum feature parameters selector.

Differentiation of Heart Rate Time Series from Electroencephalogram and Noise

Analysis of heart rate variability (HRV) has become a popular non-invasive tool for assessing the activities of autonomic nervous system. Most of the methods were hired from techniques used for time series analysis. Currently used methods are time domain, frequency domain, geometrical and fractal methods. A new technique, which searches for pattern repeatability in a time series, is proposed for quantifying heart rate (HR) time series. These set of indices, which are termed as pattern repeatability measure and pattern repeatability ratio are able to distinguish HR data clearly from noise and electroencephalogram (EEG). The results of analysis using these measures give an insight into the fundamental difference between the composition of HR time series with respect to EEG and noise.

Development of Position Changing System for Obstructive Sleep Apnea Patient using HRV

Obstructive sleep apnea in patients, between 70 and 80 percent, can be cured with just a posture correcting. The most import thing to do this is detection of obstructive sleep apnea. Detection of obstructive sleep apnea can be performed through heart rate variability analysis using power spectrum density analysis. After HRV analysis we needed to know the current position information for correcting the position. The pressure sensors of the array type were used to obtain position information. These sensors can obtain information from the experimenter about position. In addition, air cylinder corrected the position of the experimenter by lifting the bed. The experimenter can be changed position without breaking during sleep by the system. Polysomnograph recording were obtained from 10 patients. The results of HRV analysis were that NLF and LF/HF ratio increased, while NHF decreased during OSA. Position change had to be done the periods.

Synchronization of 0.1 Hz Oscillations in Heart Rate and Blood Pressure: Application to Treatment of Myocardial Infarction Patients

Synchronization between 0.1 Hz oscillations in heart rate and blood pressure is studied and its change during vertical tilt is evaluated in 37 myocardial infarction patients. Two groups of patients are identified with decreased and increased, respectively, synchronization of the studied oscillations as a response to a tilt test. It is shown that assessment of synchronization of 0.1 Hz oscillations as a response to vertical tilt can be used as a guideline for selecting optimal dose of beta-blocker treatment in post-myocardial infarction patients.

Extraction of Fetal Heart Rate and Fetal Heart Rate Variability from Mother's ECG Signal

This paper describes a new method for extracting the fetal heart rate (fHR) and the fetal heart rate variability (fHRV) signal non-invasively using abdominal maternal electrocardiogram (mECG) recordings. The extraction is based on the fundamental frequency (Fourier-s) theorem. The fundamental frequency of the mother-s electrocardiogram signal (fo-m) is calculated directly from the abdominal signal. The heart rate of the fetus is usually higher than that of the mother; as a result, the fundamental frequency of the fetal-s electrocardiogram signal (fo-f) is higher than that of the mother-s (fo-f > fo-m). Notch filters to suppress mother-s higher harmonics were designed; then a bandpass filter to target fo-f and reject fo-m is implemented. Although the bandpass filter will pass some other frequencies (harmonics), we have shown in this study that those harmonics are actually carried on fo-f, and thus have no impact on the evaluation of the beat-to-beat changes (RR intervals). The oscillations of the time-domain extracted signal represent the RR intervals. We have also shown in this study that zero-to-zero evaluation of the periods is more accurate than the peak-to-peak evaluation. This method is evaluated both on simulated signals and on different abdominal recordings obtained at different gestational ages.

Comparison of Detrending Methods in Spectral Analysis of Heart Rate Variability

Non-stationary trend in R-R interval series is considered as a main factor that could highly influence the evaluation of spectral analysis. It is suggested to remove trends in order to obtain reliable results. In this study, three detrending methods, the smoothness prior approach, the wavelet and the empirical mode decomposition, were compared on artificial R-R interval series with four types of simulated trends. The Lomb-Scargle periodogram was used for spectral analysis of R-R interval series. Results indicated that the wavelet method showed a better overall performance than the other two methods, and more time-saving, too. Therefore it was selected for spectral analysis of real R-R interval series of thirty-seven healthy subjects. Significant decreases (19.94±5.87% in the low frequency band and 18.97±5.78% in the ratio (p

Adaptive Filtering of Heart Rate Signals for an Improved Measure of Cardiac Autonomic Control

In order to provide accurate heart rate variability indices of sympathetic and parasympathetic activity, the low frequency and high frequency components of an RR heart rate signal must be adequately separated. This is not always possible by just applying spectral analysis, as power from the high and low frequency components often leak into their adjacent bands. Furthermore, without the respiratory spectra it is not obvious that the low frequency component is not another respiratory component, which can appear in the lower band. This paper describes an adaptive filter, which aids the separation of the low frequency sympathetic and high frequency parasympathetic components from an ECG R-R interval signal, enabling the attainment of more accurate heart rate variability measures. The algorithm is applied to simulated signals and heart rate and respiratory signals acquired from an ambulatory monitor incorporating single lead ECG and inductive plethysmography sensors embedded in a garment. The results show an improvement over standard heart rate variability spectral measurements.

Quantification of Heart Rate Variability: A Measure based on Unique Heart Rates

It is established that the instantaneous heart rate (HR) of healthy humans keeps on changing. Analysis of heart rate variability (HRV) has become a popular non invasive tool for assessing the activities of autonomic nervous system. Depressed HRV has been found in several disorders, like diabetes mellitus (DM) and coronary artery disease, characterised by autonomic nervous dysfunction. A new technique, which searches for pattern repeatability in a time series, is proposed specifically for the analysis of heart rate data. These set of indices, which are termed as pattern repeatability measure and pattern repeatability ratio are compared with approximate entropy and sample entropy. In our analysis, based on the method developed, it is observed that heart rate variability is significantly different for DM patients, particularly for patients with diabetic foot ulcer.

Effects of Combined Stimulation on the Autonomic Nervous System: A Pilot Study

The autonomic nervous system has a regulatory structure that helps people adapt to changes in their environment by adjusting or modifying some functions in response to stress, and regulating involuntary function of human organs. The purpose of this study was to investigate the effect of combined stimulation, both far-infrared heating and chiropractic, on the autonomic nervous system activities using thermal image and heart rate variability. Six healthy subjects participated in this test. We compared the before and after autonomic nervous system activities through obtaining thermal image and photoplethysmogram signal. The thermal images showed that the combined stimulation changed subject-s body temperature more highly and widely than before. The result of heart rate variability indicated that LF/HF ratio decreased. We concluded that combined stimulation activates autonomic nervous system, and expected other possibilities of this combined stimulation.

Detection and Correction of Ectopic Beats for HRV Analysis Applying Discrete Wavelet Transforms

The clinical usefulness of heart rate variability is limited to the range of Holter monitoring software available. These software algorithms require a normal sinus rhythm to accurately acquire heart rate variability (HRV) measures in the frequency domain. Premature ventricular contractions (PVC) or more commonly referred to as ectopic beats, frequent in heart failure, hinder this analysis and introduce ambiguity. This investigation demonstrates an algorithm to automatically detect ectopic beats by analyzing discrete wavelet transform coefficients. Two techniques for filtering and replacing the ectopic beats from the RR signal are compared. One technique applies wavelet hard thresholding techniques and another applies linear interpolation to replace ectopic cycles. The results demonstrate through simulation, and signals acquired from a 24hr ambulatory recorder, that these techniques can accurately detect PVC-s and remove the noise and leakage effects produced by ectopic cycles retaining smooth spectra with the minimum of error.