Flexible Arc-Shaped Micro-Fiber Bragg Grating Array Three-Dimensional Tactile Sensor for Fingertip Signals Detection and Human Pulse Monitoring.

A flexible arc-shaped micro-Fiber Bragg Grating (mFBG) array three-dimensional tactile sensor for fingertip signal detection and human pulse monitoring is presented. It is based on a three mFBGs array which is embedded in an arc-shaped poly (dimethylsiloxane) (PDMS) elastomer, which can effectively discriminate the normal force, left force, and right force by monitoring the reflected intensity variation of the three mFBGs. Different from the traditional FBG sensors, this sensor measures force by detecting changes in light intensity, effectively avoiding the wavelength cross-sensitivity impact of temperature variations on the sensor performance. This design strategy simplifies the sensor structure, reduces the system complexity and signal interrogation cost, and enhances reliability and practicality. Through systematic experiments, we successfully validated the sensor's superior performance, achieving a minimum detection force of 0.01 N and providing robust data support for practical applications. In addition, the sensor has been used to monitor human pulse accurately. The successful fabrication and experimental validation of this sensor lay a foundation for its widespread application in fields such as robot perception and human vital signal detection.

Non-invasive pulse arrival time is associated with cardiac index in pediatric heart transplant patients with normal ejection fraction.

Objective.Cardiac Index (CI) is a key physiologic parameter to ensure end organ perfusion in the pediatric intensive care unit (PICU). Determination of CI requires invasive cardiac measurements and is not routinely done at the PICU bedside. To date, there is no gold standard non-invasive means to determine CI. This study aims to use a novel non-invasive methodology, based on routine continuous physiologic data, called Pulse Arrival Time (PAT) as a surrogate for CI in patients with normal Ejection Fraction (EF).Approach.Electrocardiogram (ECG) and photoplethysmogram (PPG) signals were collected from beside monitors at a sampling frequency of 250 samples per second. Continuous PAT, derived from the ECG and PPG waveforms was averaged per patient. Pearson's correlation coefficient was calculated between PAT and CI, PAT and heart rate (HR), and PAT and EF.Main Results.Twenty patients underwent right heart cardiac catheterization. The mean age of patients was 11.7 ± 5.4 years old, ranging from 11 months old to 19 years old, the median age was 13.4 years old. HR in this cohort was 93.8 ± 17.0 beats per minute. The average EF was 54.4 ± 9.6%. The average CI was 3.51 ± 0.72 l min-1m-2, with ranging from 2.6 to 4.77 l min-1m-2. The average PAT was 0.31 ± 0.12 s. Pearson correlation analysis showed a positive correlation between PAT and CI (0.57,p< 0.01). Pearson correlation between HR and CI, and correlation between EF and CI was 0.22 (p= 0.35) and 0.03 (p= 0.23) respectively. The correlation between PAT, when indexed by HR (i.e. PAT × HR), and CI minimally improved to 0.58 (p< 0.01).Significance.This pilot study demonstrates that PAT may serve as a valuable surrogate marker for CI at the bedside, as a non-invasive and continuous modality in the PICU. The use of PAT in clinical practice remains to be thoroughly investigated.

A Multielectrode Layout for High Reliability of Flexible Piezoresistive Sensor: One Stimulus Signal to Three Sensing Signals.

Flexible sensors have developed rapidly due to their great application potential in the intelligent era. However, the frequent bending work requirements pose a serious challenge to the mechanical reliability of flexible sensors. Herein, a strategy of using a new multielectrode layout to achieve multiple sensing signals based on one external signal is proposed for the first time to improve the reliability of flexible piezoresistive sensors. The multielectrode layout consists of a pair of interdigital electrodes and a bottom electrode. The interdigitated electrodes are used to sense the change in the surface resistance of the sensor, and the interdigital electrodes and the bottom electrode are used to sense the change in the bulk resistance of the sensor. As a result, without increasing the sensing unit area, the electrode layout allows the sensor to generate three response electrical signals when sensing an external pressure, thus improving the reliability of the sensor. Based on the electrode layout, a highly reliable flexible piezoresistive sensor with a multilevel porous structure is obtained by a microwave foaming method with a template. In the working state of sensing surface resistance, the sensor has a 22.12 kPa-1 sensitivity. Meanwhile, in the working state of sensing bulk resistance, the sensor shows a 55.17 kPa-1 sensitivity. Furthermore, the sensor is applied to monitor human pulse and speech signals, demonstrating its multisignal output characteristics and potential applications in flexible electronics. In conclusion, the new strategy of using the proposed electrode layout to improve the reliability of flexible sensors is expected to greatly promote the practical application of flexible electronics.

High-Performance Graphene Flexible Sensors for Pulse Monitoring and Human-Machine Interaction.

Flexible sensors are of great interest due to their potential applications in human physiological signal monitoring, wearable devices, and healthcare. However, sensor devices employed for cardiovascular testing are normally bulky and expensive, which hamper wearability and point-of-care use. Herein, we report a simple method for preparing multifunctional flexible sensors using hydrazine hydrate (N2H4·H2O) as the reducing agent, graphene as the active material, and polyethylene (PE) tape as the encapsulation material. The flexible sensor produced with this method has a low detection limit of 100 mg, a fast response and recovery time of 40 and 20 ms, and shows no performance degradation even after up to 30,000 motion cycles. The sensors we have developed are capable of monitoring the pulse with relative accuracy, which presents an opportunity to replace bulky devices and normalize cardiovascular testing in the future. In order to further broaden the application field, the sensor is installed as a sensor array to recognize objects of different weights and shapes, showing that the sensor has excellent application potential in wearable artificial intelligence.

A new method of pulse control in cardiopulmonary resuscitation; Continuous femoral pulse check.

OBJECTIVES: The reliability of manual pulse checks has been questioned but is still recommended in cardiopulmonary resuscitation (CPR) guidelines. The aim is to compare the 10-s carotid pulse check (CPC) between heart massage cycles with the continuous femoral pulse check (CoFe PuC) in CPR, and to propose a better location to shorten the interruption times for pulse check. METHODS: A prospective study was conducted on 117 Non-traumatic CPR patients between January 2020 and January 2022. A total of 702 dependent pulse measurements were executed, where carotid and femoral pulses were simultaneously assessed. Cardiac ultrasound, end-tidal CO2, saturation, respiration, and blood pressure were employed for pulse validation. RESULTS: The decision time for determining the presence of a pulse in the last cycle of CPR was 3.03 ± 1.26 s for CoFe PuC, significantly shorter than the 10.31 ± 5.24 s for CPC. CoFe PuC predicted the absence of pulse with 74% sensitivity and 88% specificity, while CPC predicted the absence of pulse with 91% sensitivity and 61% specificity. CONCLUSION: CoFe PuC provides much earlier and more effective information about the pulse than CPC. This shortens the interruption times in CPR. CoFe PuC should be recommended as a new and useful method in CPR guidelines.

A flexible multimodal pulse sensor for wearable continuous blood pressure monitoring.

Monitoring of arterial blood pressure via cuffless pulse waveform measurement at the wrist has an important clinical value for the early diagnosis and prevention of cardiovascular disease. However, accurate measurement of the radial pulse waveform is challenging owing to its subtle, wideband, and preload-dependent variation characteristics. Evidence shows that uncertainties or variations of wearing pressure and skin temperature can cause artifact signals in wrist pulse measurements, thus degrading blood pressure estimate accuracy and hindering precise clinical diagnosis. Herein, we report a flexible multisensory pulse sensor utilizing natural piezo-thermic transduction of human skin in conjunction with thin-film thermistors for the accurately measuring radial artery pulse waves with high fidelity and good anti-artifact performance. The flexible pulse sensor achieved a wide pressure measuring range (228.2 kPa), low detection limit (4 Pa), good linearity (R2 = 0.999), low hysteresis (2.45%), fast response (88 ms), and good durability and stability, thereby enabling accurate pulse measurement with high fidelity. The pulse sensor also monolithically integrated the simultaneous detections of skin temperature and wearing pressure for resisting artifact effects in pulse measurements. Through the fusion of multiple features extracted from the pulse waveform, wearing pressure, skin temperature and user's personal physical characteristics using an efficient multilayer perceptron, blood pressure is accurately estimated and good generalizability is achieved.

Blood pressure pulsations modulate central neuronal activity via mechanosensitive ion channels.

The transmission of the heartbeat through the cerebral vascular system causes intracranial pressure pulsations. We discovered that arterial pressure pulsations can directly modulate central neuronal activity. In a semi-intact rat brain preparation, vascular pressure pulsations elicited correlated local field oscillations in the olfactory bulb mitral cell layer. These oscillations did not require synaptic transmission but reflected baroreceptive transduction in mitral cells. This transduction was mediated by a fast excitatory mechanosensitive ion channel and modulated neuronal spiking activity. In awake animals, the heartbeat entrained the activity of a subset of olfactory bulb neurons within ~20 milliseconds. Thus, we propose that this fast, intrinsic interoceptive mechanism can modulate perception-for example, during arousal-within the olfactory bulb and possibly across various other brain areas.

Pulse rate variability estimation method based on imaging-photoplethysmography and application to telepsychiatry.

The worldwide adoption of telehealth services may benefit people who otherwise would not be able to access mental health support. In this paper, we present a novel algorithm to obtain reliable pulse and respiration signals from non-contact facial image sequence analysis. The proposed algorithm involved a skin pixel extraction method in the image processing part and signal reconstruction using the spectral information of RGB signal in the signal processing part. The algorithm was tested on 15 healthy subjects in a laboratory setting. The results show that the proposed algorithm can accurately monitor respiration rate (RR), pulse rate (PR), and pulse rate variability (PRV) in rest conditions.Clinical Relevance- The main achievement of this study is enabling non-contact PR and RR signal extraction from facial image sequences, which has potential for future use and support for psychiatrists in telepsychiatry.

THE OUTCOME OF PULSELESS PINK HAND FOLLOWING CLOSED SUPRACONDYLAR FRACTURE HUMERUS IN PEDIATRICS.

Management of children with supracondylar humeral fractures with pulseless pink hands is still controversial, whether to choose operative or conservative treatment. Proponents of conventional treatment mentioned that most patients can restore the motor and sensory function of the hand shortly after the injury without the need to restore distal pulse by surgery. Opponents of this treatment strategy claim that many patients will develop limb shortening a few years after the injury leading to functional and psychological problems. In this study, we made a comparison of the outcomes of each treatment to help in making policy for the treatment of such types of injuries in our center. This study answers the question "Which method is preferred for treating supracondylar humeral fracture with suspected vascular injury represented by pulseless pink hand, and what are the short and long-term outcomes of each treatment method. The main objective of the study is to settle a policy for the treatment of such types of injuries in our center. This study is a retrospective for the 10-year period from 2010 to 2020, it included 74 patients with blunt trauma to one upper extremity. All patients were children aged one year to fourteen years. Patients with penetrating trauma, combined penetrating and blunt trauma, victims of burns and explosions, and patients with other co-morbidities were excluded. We have two treatment strategies: Conservative (watchful waiting) and Operative exploration. We compared the outcomes of these two strategies regarding the short-term outcome (6 months follow-up) and the long-term outcome (5 years follow-up). We looked for acute and chronic limb ischemia and chronic pain syndrome as the short-term follow-up, while we took limb shortening and chronic limb ischemia and limb function as variables of the long-term follow-up. We don't have the ability to control patients for the psychological examination by a psychiatrist, therefore; we excluded this variable from our study.

Non-contact high precision pulse-rate monitoring system for moving subjects in different motion states.

Remote photoplethysmography (rPPG) enables contact-free monitoring of the pulse rate by using a color camera. The fundamental limitation is that motion artifacts and changes in ambient light conditions greatly affect the accuracy of pulse-rate monitoring. We propose use of a high-speed camera and a motion suppression algorithm with high computational efficiency. This system incorporates a number of major improvements including reproduction of pulse wave details, high-precision pulse-rate monitoring of moving subjects, and excellent scene scalability. A series of quantization methods were used to evaluate the effect of different frame rates and different algorithms in pulse-rate monitoring of moving subjects. The experimental results show that use of 180-fps video and a Plane-Orthogonal-to-Skin (POS) algorithm can produce high-precision pulse-rate monitoring results with mean absolute error can be less than 5 bpm and the relative accuracy reaching 94.5%. Thus, it has significant potential to improve personal health care and intelligent health monitoring.

A Self-Powered Multifunctional Bracelet for Pulse Monitoring and Personal Rescue.

For outdoor workers or explorers who may be exposed to extreme or wild environments for a long time, wearable electronic devices with continuous health monitoring and personal rescue functions in emergencies could play an important role in protecting their lives. However, the limited battery capacity leads to a limited serving time, which cannot ensure normal operation anywhere and at any time. In this work, a self-powered multifunctional bracelet is proposed by integrating a hybrid energy supply module and a coupled pulse monitoring sensor with the inherent structure of the watch. The hybrid energy supply module can harvest rotational kinetic energy and elastic potential energy from the watch strap swinging simultaneously, generating a voltage of 69 V and a current of 87 mA. Meanwhile, with a statically indeterminate structure design and the coupling of triboelectric and piezoelectric nanogenerators, the bracelet enables stable pulse signal monitoring during movement with a strong anti-interference ability. With the assistance of functional electronic components, the pulse signal and position information of the wearer can be transmitted wirelessly in real-time, and the rescue light and illuminating light can be driven directly by flipping the watch strap slightly. The universal compact design, efficient energy conversion, and stable physiological monitoring demonstrate the wide application prospects of the self-powered multifunctional bracelet.

Dielectric modulation strategy of carbon nanotube field effect transistors based pressure sensor: towards precise monitoring of human pulse.

Continuous monitoring of arterial pulse has great significance for detecting the early onset of cardiovascular disease and assessing health status, while needs pressure sensors with high sensitivity and signal-to-noise ratio (SNR) to accurately capture more health information concealed in pulse waves. Field effect transistors (FETs) combined with the piezoelectric film is an ultrahigh sensitive pressure sensor category, especially when the FET works in the subthreshold regime, where the signal enhancement effect on the piezoelectric response is the most effective. However, controlling the work regime of FET needs extra external bias assistance which will interfere with the piezoelectric response signal and complicate the test system thus making the scheme difficult to implement. Here, we described a gate dielectric modulation strategy to match the subthreshold region of the FET with the piezoelectric output voltage without external gate bias, finally enhancing the sensitivity of the pressure sensor. A carbon nanotube field effect transistor and polyvinylidene fluoride (PVDF) together form the pressure sensor with a high sensitivity of 7 × 10-1kPa-1for a pressure range of 0.038-0.467 kPa and 6.86 × 10-2kPa-1for a pressure range of 0.467-15.5 kPa, SNR, and the ability to continuously monitor pulse in real-time. Additionally, the sensor enables high-resolution detection of weak pulse signals under large static pressure.

A fast sample entropy for pulse rate variability analysis.

Sample entropy is an effective nonlinear index for analyzing pulse rate variability (PRV) signal, but it has problems with a large amount of calculation and time consumption. Therefore, this study proposes a fast sample entropy calculation method to analyze the PRV signal according to the microprocessor process of data updating and the principle of sample entropy. The simulated data and PRV signal are employed as experimental data to verify the accuracy and time consumption of the proposed method. The experimental results on simulated data display that the proposed improved sample entropy can improve the operation rate of the entropy value by a maximum of 47.6 times and an average of 28.6 times and keep the entropy value unchanged. Experimental results on PRV signal display that the proposed improved sample entropy has great potential in the real-time processing of physiological signals, which can increase approximately 35 times.

Intelligent Wearable Wrist Pulse Detection System Based on Piezoelectric Sensor Array.

The human radial artery pulse carries a rich array of biomedical information. Accurate detection of pulse signal waveform and the identification of the corresponding pulse condition are helpful in understanding the health status of the human body. In the process of pulse detection, there are some problems, such as inaccurate location of radial artery key points, poor signal noise reduction effect and low accuracy of pulse recognition. In this system, the pulse signal waveform is collected by the main control circuit and the new piezoelectric sensor array combined with the wearable wristband, creating the hardware circuit. The key points of radial artery are located by an adaptive pulse finding algorithm. The pulse signal is denoised by wavelet transform, iterative sliding window and prediction reconstruction algorithm. The slippery pulse and the normal pulse are recognized by feature extraction and classification algorithm, so as to analyze the health status of the human body. The system has accurate pulse positioning, good noise reduction effect, and the accuracy of intelligent analysis is up to 98.4%, which can meet the needs of family health care.

Point-of-Care Ultrasound for Pulse Checks in Pediatric Cardiac Arrest: Two Illustrative Cases.

ABSTRACT: Cardiac arrest is an infrequent but high-stakes scenario in pediatrics. Manual central pulse checks are unreliable. Point-of-care ultrasound is a noninvasive technique to visualize the heart and central vessels during resuscitation. We describe 2 cases in which point-of-care ultrasound helped aid management decisions in pediatric cardiac arrest.

Monitoring Pulse Rate in the Background Using Front Facing Cameras of Mobile Devices.

We propose a novel framework to passively monitor pulse rate during the time spent by users on their personal mobile devices. Our framework is based on passively capturing the user's pulse signal using the front-facing camera. Signal capture is performed in the background, while the user is interacting with the device as he/she normally would, e.g., watch movies, read emails, text, and play games. The framework does not require subject participation with the monitoring procedure, thereby addressing the well-known problem of low adherence with such procedures. We investigate various techniques to suppress the impact of spontaneous user motion and fluctuations in ambient light conditions expected in non-participatory environments. Techniques include traditional signal processing, machine learning classifiers, and deep learning methods. Our performance evaluation is based on a clinical study encompassing 113 patients with a history of atrial fibrillation (Afib) who are passively monitored at home using a tablet for a period of two weeks. Our results show that the proposed framework accurately monitors pulse rate, thereby providing a gateway for long-term monitoring without relying on subject participation or the use of a dedicated wearable device.