Side-scattered finger-photoplethysmography: experimental investigations toward practical noninvasive measurement of blood glucose.

The aim of this study was to discover a simple/convenient geometrical arrangement of radiation sources and detector to acquire finger-photoplethysmograms (PPGs) with wavelength regions of blood glucose (BGL) absorption, toward practical noninvasive BGL measurement. First, we compared PPGs with three wavelengths: 808 nm (without water absorption), 1160 nm (with weak water absorption), and 1600 nm (with nearly peak BGL absorption and strong water absorption), while the source-detector spacing was successively increased circumferentially around a fingertip. In 10 healthy subjects, we observed clear cardiac-related pulsatile components of PPG signals at 808 and 1160 nm in any incident positions with more than 15 dB of signal-to-noise ratio ( S / N ), but reliable PPG detections at 1600 nm with more than 10 dB of S / N was only possible when the source-detector distance was less than 3 mm around the fingertip circumference. Second, with this arrangement, an experiment was performed using six wavelengths to cover glucose absorption bands (from 1550 to 1749 nm), obtaining pulsatile PPG signals with more or less 15 dB of S / N . Through the present experiments, this orthogonal arrangement of the source and detector to detect forward- and side-scattered radiation through the tissue is appropriate for PPG measurements with wavelength regions where there is potential for BGL measurement.

Measurement of electrocardiograms in a bath through tap water utilizing capacitive coupling electrodes placed outside the bathtub wall.

BACKGROUND: Taking a bath sometimes poses a risk for subjects with chronic cardiopulmonary disorders, due to the thermal effect and water pressure on his/her body. The ECG measurement would be helpful for the early recognition of abnormal cardiac beats and respiratory conditions. This paper describes a new attempt to improve on previous bathtub ECG measurement techniques that had electrodes placed inside the bathtub that were intrusive to the subjects' bathing experience. This study is concerned with the initial development of a method to measure an electrocardiogram (ECG) through tap water without conscious awareness of the presence of electrodes that are placed outside the bathtub wall. METHODS: A configuration of capacitive coupling electrodes placed outside the bathtub was designed so that the electrodes could be hidden. The capacitive coupling was made from the electrodes to the water through the bathtub wall. Two electrodes with an active shielding amplifier covered further by an electromagnetic shield were fixed to the outside surface of the bathtub wall, near the bather's right scapula and left foot. The potential difference between these two electrodes, similar to the bipolar lead-II ECG, was amplified to obtain raw signals inclusive of ECG/QRS components. Respiration intervals were also derived from ECG/RR intervals. Comparison experiments between this bathtub method and conventional direct methods with spot-electrodes and a chest-band sensor were made using 10 healthy male volunteers (22.2 ± 0.98 years). RESULTS: The ECG signal was detectable through tap water as well as water with differing conductivity resulting from mixing bathwater additives with the water. ECG signals and respiration curves derived from ECG/RR intervals were successfully obtained in all subjects. The intervals of the ECG/RR and respiration obtained by the bathtub system and by the direct method were respectively agreed well with each other. CONCLUSION: The ECG signal, in particular ECG/QRS components, were successfully detected utilizing capacitive coupling electrodes placed outside the bathtub wall. Also, the ECG/RR and respiration intervals were determined with reasonable accuracy as compared with the conventional direct methods.

Integrating Sphere Finger-Photoplethysmography: Preliminary Investigation towards Practical Non-Invasive Measurement of Blood Constituents.

The aim of this study was to compare conventional photoplethysmography (PPG) in a finger with PPG using an integrating sphere (ISPPG) to enhance scattered light collection. Two representative wavelengths were used; 1160 nm, a window through the absorption spectra of water and alcohol, and 1600 nm around where water absorption is high and there is an absorption peak of blood glucose. Simultaneous transmission-type measurements were made with conventional PPG and with ISPPG for each wavelength in the tips of index fingers of both hands in a total of 10 healthy young male and female volunteers (21.7 ± 1.6 years old). During a 5 min period in which subjects were in a relaxed state we determined the signal-to-noise ratio, SNR, and the PPG detectability (or sensitivity) by the two techniques. SNR during the test period was significantly higher with ISPPG as compared with conventional PPG, especially for the 1600 nm wavelength. PPG signals with 1600 nm could scarcely be detected by conventional PPG, while they could be detected with good sensitively by ISPPG. We conclude that under controlled conditions ISPPG has better SNR and higher sensitivity than conventional transmission PPG, especially in wavelength regions where water absorption is high but where there is potential for practical measurement of blood constituents including glucose.

A novel method to detect heat illness under severe conditions by monitoring tympanic temperature.

INTRODUCTION: We report a new methodology for detecting heat illness based on continuous tympanic temperature monitoring. This is relevant to industrial workers, astronauts, and pilots, as well as athletes. Here we evaluate the method in Grand Touring (GT) car racers in the closed-cockpit category who can face life-threatening hyperthermia. METHODS: The system comprises an earpiece containing an infrared-radiation-type tympanic thermometer and a microspeaker. In 10 healthy subjects, using a temperature-controlled water bath in the laboratory, we determined the differences in measurements taken from an infrared thermometer in one ear canal and from a thermistor probe in the other ear canal for direct tympanic temperature measurement. We employed an ingestible telemetry pill for gastrointestinal temperature measurement as a reference of core temperature. Then we assessed the usefulness of the system under real racing conditions with two professional drivers in the 2010 Super GT International Series held at the Twin Ring Motegi in Japan. RESULTS: The results showed a good correlation between the infrared tympanic temperature and both the direct one (r = 0.985) and the gastrointestinal temperature (r = 0.932). The mean difference between these temperatures was +0.01 degree C and +0.27 degrees C, with 95% confidence intervals (equal to 1.96 SD) of 0.30 degrees C and 0.58 degrees C, respectively. As for the field test, the system functioned well during real competitive and extremely severe race conditions on the racing circuit. CONCLUSIONS: The new method was found to perform well in an extreme car racing setting. It has the potential to be used in other applications, including the industrial and aerospace sectors.

The effect of competition on heart rate during kart driving: A field study.

BACKGROUND: Both the act of competing, which can create a kind of mental stress, and participation in motor sports, which induces physical stress from intense g-forces, are known to increase heart rate dramatically. However, little is known about the specific effect of competition on heart rate during motor sports, particularly during four-wheel car driving. The goal of this preliminary study, therefore, was to investigate whether competition increases heart rate under such situations. FINDINGS: The participants drove an entry-level formula kart during two competitive races and during solo driving against the clock while heart rate and g-forces were measured. Analyses showed that heart rate values during the races (168.8 beats/min) were significantly higher than those during solo driving (140.9 beats/min) and rest (75.1 beats/min). CONCLUSIONS: The results of this preliminary study indicate that competition heightens heart rate during four-wheel car driving. Kart drivers should be concerned about maintaining good health and developing physical strength.

Multivariate regression and discreminant calibration models for a novel optical non-invasive blood glucose measurement method named pulse glucometry.

A novel optical non-invasive in vivo blood glucose concentration (BGL) measurement technique, named "Pulse Glucometry", was combined with a kernel method; support vector machines. The total transmitted radiation intensity (I(lambda)) and the cardiac-related pulsatile changes superimposed on I(lambda) in human adult fingertips were measured over the wavelength range from 900 to 1700 nm using a very fast spectrophotometer, obtaining a differential optical density (DeltaOD(lambda)) related to the blood component in the finger tissues. Subsequently, a calibration model using paired data of a family of DeltaOD(lambda)s and the corresponding known BGLs was constructed with support vector machines (SVMs) regression instead of using calibration by a conventional primary component regression (PCR) and partial least squares regression (PLS). Secondly, SVM method was applied to make a nonlinear discriminant calibration model for "Pulse glucometry." Our results show that the regression calibration model based on the support vector machines can provide a good regression for the 101 paired data, in which the BGLs ranged from 89.0-219 mg/dl (4.94-12.2 mmol/l). The resultant regression was evaluated by the Clarke error grid analysis and all data points fell within the clinically acceptable regions (region A: 93%, region B: 7%). The discriminant calibration model using SVMs also provided a good result for classification (accuracy rate 84% in the best case).

Attempt of a novel calibration method of pulse oximetry using support vector machines regression.

A novel calibration method using support vector machines regression (SVMsR) of pulse oximetry was proposed and attempted. Conventional calibration method of pulse oximetry that based on an optical density ratio of transmitted visible red light and infrared radiation whereas a proposed method here was not based on the optical density ratio directly. In theory, conventional calibrations using the ratio can be considered as a technique for nonlinear problem: nonlinear relation between two optical densities (red and IR) and oxygen saturation could be linearized by the ratio calculation. We thought, that nonlinear problem could be solved by using nonlinear analyses. Among them, the support vector machines regression method that has been studied well in this decade was attempted to be applied for pulse oximetry calibration. As an experiment, two photo plethysmograms (PPGs) by red and IR were measured on five subjects. Simultaneously, oxygen saturation (SpO(2)) level was measured by a commercial pulse oxymeter. SpO(2)) level was controlled by breathing 10% oxygen gas obtaining 98-75% SpO(2) level. Sequentially, feature points of two PPGs were extracted in beat by beat. Convex peaks and concave valleys on waveform and DC levels of PPGs were selected as feature points. Then, nonlinear regression using SVMs were attempted to obtain relationship between SpO2 by meter (regressand) and feature points of PPG (regressor). In result, a regression model was constructed from training data that is three fourths of measured cardiac data by using SVMsR. Finally, the constructed calibration model was evaluated by other one third data (validation data). The root mean squared error for the validation data is 1.90 [SpO(2)) level %] and 89% of validation data fell within +/- 2 % of SpO(2) level by the meter. In conclusion, SVMsR might be applicable on calibration for pulse oximetry.

Relationship between salivary Chromogranin-A and stress induced by simulated monotonous driving.

The purpose of the present study was to evaluate the use of salivary Chromogranin-A (CgA), which is already used in general as a mental stress marker, for studying the stressful situation created by simulated monotonous driving. After informed consent, 25 healthy male and female subjects were studied under constant environment-controlled conditions. We measured the following physiological variables: blood pressure (BP), cardiac output, total peripheral resistance (TPR), normalized pulse volume (NPV) as an index of alpha-adrenergic sympathetic activity to the finger arteriolar vessels, levels of cortisol and CgA during monotonous driving. The induced stress led to the expected decreases in NPV and increases in TPR and BP caused by peripherally related sympathetic acceleration. However, CgA levels were found to fall gradually in accordance with the gradual increase of subjective rating of stress (SRS) and significantly (p < 0.01) decreased over the period of the simulated monotonous driving. Our hypothesis for the gradual decrease of CgA levels during the simulated monotonous driving is as follows. CgA, catestatin and catecholamines are co-released into the extra-cellular environment. Peripheral sympathetic activity was accelerated by stress resulting from the simulated monotonous driving. Upon peripheral vessel constriction, an increase in TPR then increased BP which, in turn, activated catestatin. Consequently, secretion of CgA was blocked by the co-secreted catestatin from chromaffin granules. The results obtained strongly indicate that, although CgA has been reported as a possible marker of stress, CgA levels are not increased in the stressful situation of simulated monotonous driving.

Support vector machines as multivariate calibration model for prediction of blood glucose concentration using a new non-invasive optical method named Pulse Glucometry.

A novel optical non-invasive in vivo blood glucose concentration (BGL) measurement technique, named "Pulse Glucometry", was combined with a kernel method; support vector machines. The total transmitted radiation intensity (I lambda) and the cardiac-related pulsatile changes superimposed on I lambda in human adult fingertips were measured over the wavelength range from 900 to 1700 nm using a very fast spectrophotometer, obtaining a differential optical density (delta OD lambda) related to the blood component in the finger tissues. Subsequently, a calibration model using paired data of a family of delta OD lambda s and the corresponding known BGLs was constructed with support vector machines regression instead of using calibration by a conventional partial least squares regression (PLS). Our results show that the calibration model based on the support vector machines can provide a good regression for the 183 paired data, in which the BGLs ranged from 89.0-219 mg/dl (4.94-12.2 mmol/l). The resultant regression was evaluated by the Clarke error grid analysis and all data points fell within the clinically acceptable regions (region A: 93%, region B: 7%).