A novel TASK channel antagonist nasal spray reduces sleep apnea severity in physiological responders: a randomized, blinded, trial.

Preclinical and human physiological studies indicate that topical, selective TASK 1/3 K+ channel antagonism increases upper airway dilator muscle activity and reduces pharyngeal collapsibility during anesthesia and nasal breathing during sleep. The primary aim of this study was to determine the effects of BAY2586116 nasal spray on obstructive sleep apnea (OSA) severity and whether individual responses vary according to differences in physiological responses and route of breathing. Ten people (5 females) with OSA [apnea-hypopnea index (AHI) = 47 ± 26 events/h (means ± SD)] who completed previous sleep physiology studies with BAY2586116 were invited to return for three polysomnography studies to quantify OSA severity. In random order, participants received either placebo nasal spray (saline), BAY2586116 nasal spray (160 µg), or BAY2586116 nasal spray (160 µg) restricted to nasal breathing (chinstrap or mouth tape). Physiological responders were defined a priori as those who had improved upper airway collapsibility (critical closing pressure ≥2 cmH2O) with BAY2586116 nasal spray (NCT04236440). There was no systematic change in apnea-hypopnea index (AHI3) from placebo versus BAY2586116 with either unrestricted or nasal-only breathing versus placebo (47 ± 26 vs. 43 ± 27 vs. 53 ± 33 events/h, P = 0.15). However, BAY2586116 (unrestricted breathing) reduced OSA severity in physiological responders compared with placebo (e.g., AHI3 = 28 ± 11 vs. 36 ± 12 events/h, P = 0.03 and ODI3 = 18 ± 10 vs. 28 ± 12 events/h, P = 0.02). Morning blood pressure was also lower in physiological responders after BAY2586116 versus placebo (e.g., systolic blood pressure = 137 ± 24 vs. 147 ± 21 mmHg, P < 0.01). In conclusion, BAY2586116 reduces OSA severity during sleep in people who demonstrate physiological improvement in upper airway collapsibility. These findings highlight the therapeutic potential of this novel pharmacotherapy target in selected individuals.NEW & NOTEWORTHY Preclinical findings in pigs and humans indicate that blocking potassium channels in the upper airway with topical nasal application increases pharyngeal dilator muscle activity and reduces upper airway collapsibility. In this study, BAY2586116 nasal spray (potassium channel blocker) reduced sleep apnea severity in those who had physiological improvement in upper airway collapsibility. BAY2586116 lowered the next morning's blood pressure. These findings highlight the potential for this novel therapeutic approach to improve sleep apnea in certain people.

Recent Innovations in Footwear and the Role of Smart Footwear in Healthcare-A Survey.

Smart shoes have ushered in a new era of personalised health monitoring and assistive technologies. Smart shoes leverage technologies such as Bluetooth for data collection and wireless transmission, and incorporate features such as GPS tracking, obstacle detection, and fitness tracking. As the 2010s unfolded, the smart shoe landscape diversified and advanced rapidly, driven by sensor technology enhancements and smartphones' ubiquity. Shoes have begun incorporating accelerometers, gyroscopes, and pressure sensors, significantly improving the accuracy of data collection and enabling functionalities such as gait analysis. The healthcare sector has recognised the potential of smart shoes, leading to innovations such as shoes designed to monitor diabetic foot ulcers, track rehabilitation progress, and detect falls among older people, thus expanding their application beyond fitness into medical monitoring. This article provides an overview of the current state of smart shoe technology, highlighting the integration of advanced sensors for health monitoring, energy harvesting, assistive features for the visually impaired, and deep learning for data analysis. This study discusses the potential of smart footwear in medical applications, particularly for patients with diabetes, and the ongoing research in this field. Current footwear challenges are also discussed, including complex construction, poor fit, comfort, and high cost.

Combined Cardiac and Respiratory Monitoring from a Single Signal: A Case Study Employing the Fantasia Database.

This study proposes a novel method for obtaining the electrocardiogram (ECG) derived respiration (EDR) from a single lead ECG and respiration-derived cardiogram (RDC) from a respiratory stretch sensor. The research aims to reconstruct the respiration waveform, determine the respiration rate from ECG QRS heartbeat complexes data, locate heartbeats, and calculate a heart rate (HR) using the respiration signal. The accuracy of both methods will be evaluated by comparing located QRS complexes and inspiration maxima to reference positions. The findings of this study will ultimately contribute to the development of new, more accurate, and efficient methods for identifying heartbeats in respiratory signals, leading to better diagnosis and management of cardiovascular diseases, particularly during sleep where respiration monitoring is paramount to detect apnoea and other respiratory dysfunctions linked to a decreased life quality and known cause of cardiovascular diseases. Additionally, this work could potentially assist in determining the feasibility of using simple, no-contact wearable devices for obtaining simultaneous cardiology and respiratory data from a single device.

Morpho-molecular diversity and avirulence genes distribution among the diverse isolates of Magnaporthe oryzae from Southern India.

AIMS: To investigate the diversity of eco-distinct isolates of Magnaporthe oryzae for their morphological, virulence and molecular diversity and relative distribution of five Avr genes. METHODS AND RESULTS: Fifty-two M. oryzae isolates were collected from different rice ecosystems of southern India. A majority of them (n = 28) formed a circular colony on culture media. Based on the disease reaction on susceptible cultivar (cv. HR-12), all 52 isolates were classified in to highly virulent (n = 28), moderately virulent (n = 11) and less-virulent (13) types. Among the 52 isolates, 38 were selected for deducing internal transcribed spacer (ITS) sequence diversity. For deducing phylogeny, another set of 36 isolates from other parts of the world was included, which yielded two distinct phylogenetic clusters. We identified eight haplotype groups and 91 variable sites within the ITS sequences, and haplotype-group-2 (Hap_2) was predominant (n = 24). The Tajima's and Fu's Fs neutrality tests exhibited many rare alleles. Furthermore, PCR analysis for detecting the presence of five Avr genes in the different M. oryzae isolates using Avr gene-specific primers in PCR revealed that Avr-Piz-t, Avr-Pik, Avr-Pia and Avr-Pita were present in 73.68%, 73.68%, 63.16% and 47.37% of the isolates studied, respectively; whereas, Avr-Pii was identified only in 13.16% of the isolates. CONCLUSIONS: Morpho-molecular and virulence studies revealed the significant diversity among eco-distinct isolates. PCR detection of Avr genes among the M. oryzae population revealed the presence of five Avr genes. Among them, Avr-Piz-t, Avr-Pik and Avr-Pia were more predominant. SIGNIFICANCE AND IMPACT OF THE STUDY: The study documented the morphological and genetic variability of eco-distinct M. oryzae isolates. This is the first study demonstrating the distribution of the Avr genes among the eco-distinct population of M. oryzae from southern India. The information generated will help plant breeders to select appropriate resistant gene/s combinations to develop blast disease-resistant rice cultivars.

Biosignal-Based Human-Machine Interfaces for Assistance and Rehabilitation: A Survey.

As a definition, Human-Machine Interface (HMI) enables a person to interact with a device. Starting from elementary equipment, the recent development of novel techniques and unobtrusive devices for biosignals monitoring paved the way for a new class of HMIs, which take such biosignals as inputs to control various applications. The current survey aims to review the large literature of the last two decades regarding biosignal-based HMIs for assistance and rehabilitation to outline state-of-the-art and identify emerging technologies and potential future research trends. PubMed and other databases were surveyed by using specific keywords. The found studies were further screened in three levels (title, abstract, full-text), and eventually, 144 journal papers and 37 conference papers were included. Four macrocategories were considered to classify the different biosignals used for HMI control: biopotential, muscle mechanical motion, body motion, and their combinations (hybrid systems). The HMIs were also classified according to their target application by considering six categories: prosthetic control, robotic control, virtual reality control, gesture recognition, communication, and smart environment control. An ever-growing number of publications has been observed over the last years. Most of the studies (about 67%) pertain to the assistive field, while 20% relate to rehabilitation and 13% to assistance and rehabilitation. A moderate increase can be observed in studies focusing on robotic control, prosthetic control, and gesture recognition in the last decade. In contrast, studies on the other targets experienced only a small increase. Biopotentials are no longer the leading control signals, and the use of muscle mechanical motion signals has experienced a considerable rise, especially in prosthetic control. Hybrid technologies are promising, as they could lead to higher performances. However, they also increase HMIs' complexity, so their usefulness should be carefully evaluated for the specific application.

Detection of Atrial Fibrillation from Single Lead ECG Signal Using Multirate Cosine Filter Bank and Deep Neural Network.

Atrial fibrillation (AF) is a cardiac arrhythmia which is characterized based on the irregsular beating of atria, resulting in, the abnormal atrial patterns that are observed in the electrocardiogram (ECG) signal. The early detection of this pathology is very helpful for minimizing the chances of stroke, other heart-related disorders, and coronary artery diseases. This paper proposes a novel method for the detection of AF pathology based on the analysis of the ECG signal. The method adopts a multi-rate cosine filter bank architecture for the evaluation of coefficients from the ECG signal at different subbands, in turn, the Fractional norm (FN) feature is evaluated from the extracted coefficients at each subband. Then, the AF detection is carried out using a deep learning approach known as the Hierarchical Extreme Learning Machine (H-ELM) from the FN features. The proposed method is evaluated by considering normal and AF pathological ECG signals from public databases. The experimental results reveal that the proposed multi-rate cosine filter bank based on FN features is effective for the detection of AF pathology with an accuracy, sensitivity and specificity values of 99.40%, 98.77%, and 100%, respectively. The performance of the proposed diagnostic features of the ECG signal is compared with other existing features for the detection of AF. The low-frequency subband FN features found to be more significant with a difference of the mean values as 0.69 between normal and AF classes.

Towards Real-Time Heartbeat Classification: Evaluation of Nonlinear Morphological Features and Voting Method.

Abnormal heart rhythms are one of the significant health concerns worldwide. The current state-of-the-art to recognize and classify abnormal heartbeats is manually performed by visual inspection by an expert practitioner. This is not just a tedious task; it is also error prone and, because it is performed, post-recordings may add unnecessary delay to the care. The real key to the fight to cardiac diseases is real-time detection that triggers prompt action. The biggest hurdle to real-time detection is represented by the rare occurrences of abnormal heartbeats and even more are some rare typologies that are not fully represented in signal datasets; the latter is what makes it difficult for doctors and algorithms to recognize them. This work presents an automated heartbeat classification based on nonlinear morphological features and a voting scheme suitable for rare heartbeat morphologies. Although the algorithm is designed and tested on a computer, it is intended ultimately to run on a portable i.e., field-programmable gate array (FPGA) devices. Our algorithm tested on Massachusetts Institute of Technology- Beth Israel Hospital(MIT-BIH) database as per Association for the Advancement of Medical Instrumentation(AAMI) recommendations. The simulation results show the superiority of the proposed method, especially in predicting minority groups: the fusion and unknown classes with 90.4% and 100%.

Real-Time EMG Based Pattern Recognition Control for Hand Prostheses: A Review on Existing Methods, Challenges and Future Implementation.

Upper limb amputation is a condition that significantly restricts the amputees from performing their daily activities. The myoelectric prosthesis, using signals from residual stump muscles, is aimed at restoring the function of such lost limbs seamlessly. Unfortunately, the acquisition and use of such myosignals are cumbersome and complicated. Furthermore, once acquired, it usually requires heavy computational power to turn it into a user control signal. Its transition to a practical prosthesis solution is still being challenged by various factors particularly those related to the fact that each amputee has different mobility, muscle contraction forces, limb positional variations and electrode placements. Thus, a solution that can adapt or otherwise tailor itself to each individual is required for maximum utility across amputees. Modified machine learning schemes for pattern recognition have the potential to significantly reduce the factors (movement of users and contraction of the muscle) affecting the traditional electromyography (EMG)-pattern recognition methods. Although recent developments of intelligent pattern recognition techniques could discriminate multiple degrees of freedom with high-level accuracy, their efficiency level was less accessible and revealed in real-world (amputee) applications. This review paper examined the suitability of upper limb prosthesis (ULP) inventions in the healthcare sector from their technical control perspective. More focus was given to the review of real-world applications and the use of pattern recognition control on amputees. We first reviewed the overall structure of pattern recognition schemes for myo-control prosthetic systems and then discussed their real-time use on amputee upper limbs. Finally, we concluded the paper with a discussion of the existing challenges and future research recommendations.

Hybrid brain-computer interface for biomedical cyber-physical system application using wireless embedded EEG systems.

BACKGROUND: One of the key challenges of the biomedical cyber-physical system is to combine cognitive neuroscience with the integration of physical systems to assist people with disabilities. Electroencephalography (EEG) has been explored as a non-invasive method of providing assistive technology by using brain electrical signals. METHODS: This paper presents a unique prototype of a hybrid brain computer interface (BCI) which senses a combination classification of mental task, steady state visual evoked potential (SSVEP) and eyes closed detection using only two EEG channels. In addition, a microcontroller based head-mounted battery-operated wireless EEG sensor combined with a separate embedded system is used to enhance portability, convenience and cost effectiveness. This experiment has been conducted with five healthy participants and five patients with tetraplegia. RESULTS: Generally, the results show comparable classification accuracies between healthy subjects and tetraplegia patients. For the offline artificial neural network classification for the target group of patients with tetraplegia, the hybrid BCI system combines three mental tasks, three SSVEP frequencies and eyes closed, with average classification accuracy at 74% and average information transfer rate (ITR) of the system of 27 bits/min. For the real-time testing of the intentional signal on patients with tetraplegia, the average success rate of detection is 70% and the speed of detection varies from 2 to 4 s.

Unraveling the complexities of pathological voice through saliency analysis.

The human voice is an essential communication tool, but various disorders and habits can disrupt it. Diagnosis of pathological and abnormal voices is very important. Conventional diagnosis of these voice pathologies can be invasive and costly. Voice pathology disorders can be effectively detected using Artificial Intelligence and computer-aided voice pathology classification tools. Previous studies focused primarily on binary classification, leaving limited attention to multi-class classification. This study proposes three different neural network architectures to investigate the feature characteristics of three voice pathologies-Hyperkinetic Dysphonia, Hypokinetic Dysphonia, Reflux Laryngitis, and healthy voices using multi-class classification and the Voice ICar fEDerico II (VOICED) dataset. The study proposes UNet++ autoencoder-based denoiser techniques for accurate feature extraction to overcome noisy data. The architectures include a Multi-Layer Perceptron (MLP) trained on structured feature sets, a Short-Time Fourier Transform (STFT) model, and a Mel-Frequency Cepstral Coefficients (MFCC) model. The MLP model on 143 features achieved 97.1% accuracy, while the STFT model showed similar performance with increased sensitivity of 99.8%. The MFCC model maintained 97.1% accuracy but with a smaller model size and improved accuracy on the Reflux Laryngitis class. The study identifies crucial features through saliency analysis and reveals that detecting voice abnormalities requires the identification of regions of inaudible high-pitch sounds. Additionally, the study highlights the challenges posed by limited and disjointed pathological voice databases and proposes solutions for enhancing the performance of voice abnormality classification. Overall, the study's findings have potential applications in clinical applications and specialized audio-capturing tools.

Morphic Sensors for Respiratory Parameters Estimation: Validation against Overnight Polysomnography.

Effective monitoring of respiratory disturbances during sleep requires a sensor capable of accurately capturing chest movements or airflow displacement. Gold-standard monitoring of sleep and breathing through polysomnography achieves this task through dedicated chest/abdomen bands, thermistors, and nasal flow sensors, and more detailed physiology, evaluations via a nasal mask, pneumotachograph, and airway pressure sensors. However, these measurement approaches can be invasive and time-consuming to perform and analyze. This work compares the performance of a non-invasive wearable stretchable morphic sensor, which does not require direct skin contact, embedded in a t-shirt worn by 32 volunteer participants (26 males, 6 females) with sleep-disordered breathing who performed a detailed, overnight in-laboratory sleep study. Direct comparison of computed respiratory parameters from morphic sensors versus traditional polysomnography had approximately 95% (95 ± 0.7) accuracy. These findings confirm that novel wearable morphic sensors provide a viable alternative to non-invasively and simultaneously capture respiratory rate and chest and abdominal motions.

Single Channel Surface Electromyogram Deconvolution is a Useful Pre-Processing for Myoelectric Control.

OBJECTIVE: Myoelectric control requires fast and stable identification of a movement from data recorded from a comfortable and straightforward system. METHODS: We consider a new real-time pre-processing method applied to a single differential surface electromyogram (EMG): deconvolution, providing an estimation of the cumulative firings of motor units. A 2 channel-10 class finger movement problem has been investigated on 10 healthy subjects. We have compared raw EMG and deconvolution signals, as sources of information for two specific classifiers (based on either Support Vector Machines or k-Nearest Neighbours), with classical time-domain input features selected using Mutual Component Analysis. RESULTS: Using the proposed pre-processing technique, classification performances statistically improve. For example, the true positive rates of the best-tested configurations were 80.9% and 86.3% when using the EMG and its deconvoluted signal, respectively. CONCLUSION: Even considering the limited dataset and range of classification approaches investigated, our preliminary results indicate the potential usefulness of the deconvolution pre-processing. SIGNIFICANCE: Deconvolution of EMG is a fast pre-processing that could be easily embedded in different myoelectric control applications.

Applications of ICA and fractal dimension in sEMG signal processing for subtle movement analysis: a review.

The surface electromyography (sEMG) signal separation and decphompositions has always been an interesting research topic in the field of rehabilitation and medical research. Subtle myoelectric control is an advanced technique concerned with the detection, processing, classification, and application of myoelectric signals to control human-assisting robots or rehabilitation devices. This paper reviews recent research and development in independent component analysis and Fractal dimensional analysis for sEMG pattern recognition, and presents state-of-the-art achievements in terms of their type, structure, and potential application. Directions for future research are also briefly outlined.

Progress in Brain Computer Interface: Challenges and Opportunities.

Brain computer interfaces (BCI) provide a direct communication link between the brain and a computer or other external devices. They offer an extended degree of freedom either by strengthening or by substituting human peripheral working capacity and have potential applications in various fields such as rehabilitation, affective computing, robotics, gaming, and neuroscience. Significant research efforts on a global scale have delivered common platforms for technology standardization and help tackle highly complex and non-linear brain dynamics and related feature extraction and classification challenges. Time-variant psycho-neurophysiological fluctuations and their impact on brain signals impose another challenge for BCI researchers to transform the technology from laboratory experiments to plug-and-play daily life. This review summarizes state-of-the-art progress in the BCI field over the last decades and highlights critical challenges.

Locomo-Net: A Low -Complex Deep Learning Framework for sEMG-Based Hand Movement Recognition for Prosthetic Control.

Background: The enhancement in the performance of the myoelectric pattern recognition techniques based on deep learning algorithm possess computationally expensive and exhibit extensive memory behavior. Therefore, in this paper we report a deep learning framework named 'Low-Complex Movement recognition-Net' (LoCoMo-Net) built with convolution neural network (CNN) for recognition of wrist and finger flexion movements; grasping and functional movements; and force pattern from single channel surface electromyography (sEMG) recording. The network consists of a two-stage pipeline: 1) input data compression; 2) data-driven weight sharing. Methods: The proposed framework was validated on two different datasets- our own dataset (DS1) and publicly available NinaPro dataset (DS2) for 16 movements and 50 movements respectively. Further, we have prototyped the proposed LoCoMo-Net on Virtex-7 Xilinx field-programmable gate array (FPGA) platform and validated for 15 movements from DS1 to demonstrate its feasibility for real-time execution. Results: The effectiveness of the proposed LoCoMo-Net was verified by a comparative analysis against the benchmarked models using the same datasets wherein our proposed model outperformed Twin- Support Vector Machine (SVM) and existing CNN based model by an average classification accuracy of 8.5 % and 16.0 % respectively. In addition, hardware complexity analysis is done to reveal the advantages of the two-stage pipeline where approximately 27 %, 49 %, 50 %, 23 %, and 43 % savings achieved in lookup tables (LUT's), registers, memory, power consumption and computational time respectively. Conclusion: The clinical significance of such sEMG based accurate and low-complex movement recognition system can be favorable for the potential improvement in quality of life of an amputated persons.

Groundtruth: A Matlab GUI for Artifact and Feature Identification in Physiological Signals.

Groundtruth is a Matlab Graphical User Interface (GUI) developed for the identification of key features and artifacts within physiological signals. The ultimate aim of this GUI is to provide a simple means of assessing the performance of new sensors. Secondary, to this is providing a means of providing marked data, enabling assessment of automated artifact rejection and feature identification algorithms. With the emergence of new wearable sensor technologies, there is an unmet need for convenient assessment of device performance, and a faster means of assessing new algorithms. The proposed GUI allows interactive marking of artifact regions as well as simultaneous interactive identification of key features, e.g., respiration peaks in respiration signals, R-peaks in Electrocardiography signals, etc. In this paper, we present the base structure of the system, together with an example of its use for two simultaneously worn respiration sensors. The respiration rates are computed for both original as well as artifact removed data and validated using Bland-Altman plots. The respiration rates computed based on the proposed GUI (after artifact removal process) demonstrated consistent results for two respiration sensors after artifact removal process. Groundtruth is customizable, and alternative processing modules are easy to add/remove. Groundtruth is intended for open-source use.

A Piezoresistive Array Armband With Reduced Number of Sensors for Hand Gesture Recognition.

Human machine interfaces (HMIs) are employed in a broad range of applications, spanning from assistive devices for disability to remote manipulation and gaming controllers. In this study, a new piezoresistive sensors array armband is proposed for hand gesture recognition. The armband encloses only three sensors targeting specific forearm muscles, with the aim to discriminate eight hand movements. Each sensor is made by a force-sensitive resistor (FSR) with a dedicated mechanical coupler and is designed to sense muscle swelling during contraction. The armband is designed to be easily wearable and adjustable for any user and was tested on 10 volunteers. Hand gestures are classified by means of different machine learning algorithms, and classification performances are assessed applying both, the 10-fold and leave-one-out cross-validations. A linear support vector machine provided 96% mean accuracy across all participants. Ultimately, this classifier was implemented on an Arduino platform and allowed successful control for videogames in real-time. The low power consumption together with the high level of accuracy suggests the potential of this device for exergames commonly employed for neuromotor rehabilitation. The reduced number of sensors makes this HMI also suitable for hand-prosthesis control.

Automated detection of congestive heart failure from electrocardiogram signal using Stockwell transform and hybrid classification scheme.

BACKGROUND AND OBJECTIVE: The congestive heart failure (CHF) is a life-threatening cardiac disease which arises when the pumping action of the heart is less than that of the normal case. This paper proposes a novel approach to design a classifier-based system for the automated detection of CHF. METHODS: The approach is founded on the use of the Stockwell (S)-transform and frequency division to analyze the time-frequency sub-band matrices stemming from electrocardiogram (ECG) signals. Then, the entropy features are evaluated from the sub-band matrices of ECG. A hybrid classification scheme is adopted taking the sparse representation classifier and the average of the distances from the nearest neighbors into account for the detection of CHF. The proposition is validated using ECG signals from CHF subjects and normal sinus rhythm from public databases. RESULTS: The results reveal that the proposed system is successful for the detection of CHF with an accuracy, a sensitivity and a specificity values of 98.78%, 98.48%, and 99.09%, respectively. A comparison with the existing approaches for the detection of CHF is accomplished. CONCLUSIONS: The time-frequency entropy features of the ECG signal in the frequency range from 11 Hz to 30 Hz have higher performance for the detection of CHF using a hybrid classifier. The approach can be used for the automated detection of CHF in tele-healthcare monitoring systems.