UNASSIGNED: Current guidelines recommend quantitative neuromuscular block monitoring during neuromuscular blocking agent administration. Monitors using surface electromyography (EMG) determine compound motor action potential (cMAP) amplitude or area under the curve (AUC). Rigorous evaluation of the interchangeability of these methods is lacking but necessary for clinical and research assurance that EMG interpretations of the depth of neuromuscular block are not affected by the methodology.
UNASSIGNED: Digitised EMG waveforms were studied from 48 patients given rocuronium during two published studies. The EMG amplitudes and AUCs were calculated pairwise from all cMAPs classified as valid by visual inspection. Ratios of the first twitch (T1) to the control T1 before administration of rocuronium (T1c) and train-of-four ratios (TOFRs) were compared using repeated measures Bland-Altman analysis.
UNASSIGNED: Among the 2419 paired T1/T1c differences where the average T1/T1c was ≤0.2, eight (0.33%) were outside prespecified clinical limits of agreement (-0.148 to 0.164). Among the 1781 paired TOFR differences where the average TOFR was ≥0.8, 70 (3.93%) were outside the prespecified clinical limits of agreement ((-0.109 to 0.134). Among all 7286 T1/T1c paired differences, the mean bias was 0.32 (95% confidence interval 0.202-0.043), and among all 5559 paired TOFR differences, the mean bias was 0.011 (95% confidence interval 0.0050-0.017). Among paired T1/T1c and TOFR differences, Lin\'s concordance correlation coefficients were 0.98 and 0.995, respectively. Repeatability coefficients for T1/T1c and TOFR were <0.08, with no differences between methods.
UNASSIGNED: Quantitative assessment neuromuscular block depth is clinically interchangeable when calculated using cMAP amplitude or the AUC.

The emerging integration of Brain-Computer Interfaces (BCIs) in human-robot collaboration holds promise for dynamic adaptive interaction. The use of electroencephalogram (EEG)-measured error-related potentials (ErrPs) for online error detection in assistive devices offers a practical method for improving the reliability of such devices. However, continuous online error detection faces challenges such as developing efficient and lightweight classification techniques for quick predictions, reducing false alarms from artifacts, and dealing with the non-stationarity of EEG signals. Further research is essential to address the complexities of continuous classification in online sessions. With this study, we demonstrated a comprehensive approach for continuous online EEG-based machine error detection, which emerged as the winner of a competition at the 32nd International Joint Conference on Artificial Intelligence. The competition consisted of two stages: an offline stage for model development using pre-recorded, labeled EEG data, and an online stage 3 months after the offline stage, where these models were tested live on continuously streamed EEG data to detect errors in orthosis movements in real time. Our approach incorporates two temporal-derivative features with an effect size-based feature selection technique for model training, together with a lightweight noise filtering method for online sessions without recalibration of the model. The model trained in the offline stage not only resulted in a high average cross-validation accuracy of 89.9% across all participants, but also demonstrated remarkable performance during the online session 3 months after the initial data collection without further calibration, maintaining a low overall false alarm rate of 1.7% and swift response capabilities. Our research makes two significant contributions to the field. Firstly, it demonstrates the feasibility of integrating two temporal derivative features with an effect size-based feature selection strategy, particularly in online EEG-based BCIs. Secondly, our work introduces an innovative approach designed for continuous online error prediction, which includes a straightforward noise rejection technique to reduce false alarms. This study serves as a feasibility investigation into a methodology for seamless error detection that promises to transform practical applications in the domain of neuroadaptive technology and human-robot interaction.

In modern society, the popularity of wearable devices has highlighted the need for data security. Bio-crypto keys (bio-keys), especially in the context of wearable devices, are gaining attention as a next-generation security method. Despite the theoretical advantages of bio-keys, implementing such systems poses practical challenges due to their need for flexibility and convenience. Electrocardiograms (ECGs) have emerged as a potential solution to these issues but face hurdles due to intra-individual variability. This study aims to evaluate the possibility of a stable, flexible, and convenient-to-use bio-key using ECGs. We propose an approach that minimizes biosignal variability using normalization, clustering-based binarization, and the fuzzy extractor, enabling the generation of personalized seeds and offering ease of use. The proposed method achieved a maximum entropy of 0.99 and an authentication accuracy of 95%. This study evaluated various parameter combinations for generating effective bio-keys for personal authentication and proposed the optimal combination. Our research holds potential for security technologies applicable to wearable devices and healthcare systems.

The accuracy of ultrasonic flowmeter time delay measurement is directly affected by the processing method of the ultrasonic echo signal. This paper proposes a method for estimating the time delay of the ultrasonic gas flowmeter based on the Variational Mode Decomposition (VMD)-Hilbert Spectrum and Cross-Correlation (CC). The method improves the accuracy of the ultrasonic gas flowmeter by enhancing the quality of the echo signal. To denoise forward and reverse ultrasonic echo signals collected at various wind speeds, a Butterworth filter is initially used. The ultrasonic echo signals are then analyzed by Empirical Mode De-composition (EMD) and VMD analysis to obtain the Intrinsic Mode Function (IMF) containing distinct center frequencies, respectively. The Hilbert spectrum time-frequency diagram is used to evaluate the results of the VMD and EMD decompositions. It is found that the IMF decomposed by VMD has a better filtering performance and better anti-interference performance. Therefore, the IMF with a better effect is selected for signal reconstruction. The ultrasonic time delay is then calculated using the Cross-Correlation algorithm. The self-developed ultrasonic gas flowmeter was tested on the experimental platform of the gas flow standard devices using this signal processing method. The results show a maximum indication error of 0.84% within the flow range of 60-606 m3/h, with a repeatability of no more than 0.29%. These results meet the 1-level accuracy requirements as outlined in the national ultrasonic flowmeters calibration regulation JJG1030-2007.

BACKGROUND: It is known that subjects with a cochlear implant (CI) need to exert more listening effort to achieve adequate speech recognition compared to normal hearing subjects. One tool for assessing listening effort is pupillometry. The aim of this study is to evaluate the effectiveness of adaptive directional microphones in reducing listening effort for CI recipients.
METHODS: We evaluated listening in noise and listening effort degree (by pupillometry) in eight bimodal subjects with three types of CI microphones and in three sound configurations.
RESULTS: We found a correlation only between sound configurations and listening in noise score (p-value 0.0095). The evaluation of the microphone types shows worse scores in listening in noise with Opti Omni (+3.15 dB SNR) microphone than with Split Dir (+1.89 dB SNR) and Speech Omni (+1.43 dB SNR). No correlation was found between microphones and sound configurations and within the pupillometric data.
CONCLUSIONS: Different types of microphones have different effects on the listening of CI patients. The difference in the orientation of the sound source is a factor that has an impact on the listening effort results. However, the pupillometry measurements do not significantly correlate with the different microphone types.

Pain assessment is a critical aspect of healthcare, influencing timely interventions and patient well-being. Traditional pain evaluation methods often rely on subjective patient reports, leading to inaccuracies and disparities in treatment, especially for patients who present difficulties to communicate due to cognitive impairments. Our contributions are three-fold. Firstly, we analyze the correlations of the data extracted from biomedical sensors. Then, we use state-of-the-art computer vision techniques to analyze videos focusing on the facial expressions of the patients, both per-frame and using the temporal context. We compare them and provide a baseline for pain assessment methods using two popular benchmarks: UNBC-McMaster Shoulder Pain Expression Archive Database and BioVid Heat Pain Database. We achieved an accuracy of over 96% and over 94% for the F1 Score, recall and precision metrics in pain estimation using single frames with the UNBC-McMaster dataset, employing state-of-the-art computer vision techniques such as Transformer-based architectures for vision tasks. In addition, from the conclusions drawn from the study, future lines of work in this area are discussed.

UNASSIGNED: Obsessive-compulsive disorders (OCD) are marked by distress, negative emotions, mental processes and behaviors that are reflected in physiological signals such as heart rate, electrodermal activity, and skin temperature. Continuous monitoring of physiological signals associated with OCD symptoms may make measures of OCD more objective and facilitate close monitoring of prodromal symptoms, treatment progress and risk of relapse. Thus, we explored the feasibility of capturing OCD events in the real world using an unobtrusive wrist worn biosensor and machine learning models.
UNASSIGNED: Nine adolescents (ages 10-17 years) with mild to moderate-severe OCD were recruited from child and adolescent mental health services. Participants were asked to wear the biosensor in the lab during conditions of rest and exposure to OCD symptom-triggering stimuli and for up to 8 weeks in their everyday lives and register OCD events. We explored the relationships among physiological data, registered OCD events, age, OCD symptom severity and symptom types. In the machine learning models, we considered detection of OCD events as a binary classification problem. A nested cross-validation strategy with either random 10-folds, leave-one-subject-out, or leave-week(s)-out in both layers was used. We compared the performance of four models: logistic regression, random forest (RF), feedforward neural networks, and mixed-effect random forest (MERF). To explore the ability of the models to detect OCD events in new patients, we assessed the performance of participant-based generalized models. To explore the ability of models to detect OCD events in future, unseen data from the same patients, we compared the performance of temporal generalized models trained on multiple patients with personalized models trained on single patients.
UNASSIGNED: Eight of the nine participants collected biosensor signals totaling 2, 405 h and registered 1, 639 OCD events. Better performance was obtained when generalizing across time compared to across patients. Generalized temporal models trained on multiple patients were found to perform better than personalized models trained on single patients. RF and MERF models outperformed the other models in terms of accuracy in all cross-validation strategies, reaching 70% accuracy in random and participant cross-validation.
UNASSIGNED: Our pilot results suggest that it is possible to detect OCD episodes in the everyday lives of adolescents using physiological signals captured with a wearable biosensor. Large scale studies are needed to train and test models capable of detecting and predicting episodes.
UNASSIGNED: ClinicalTrials.gov: NCT05064527, registered October 1, 2021.

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.

BACKGROUND: Obsessive compulsive disorder (OCD) in youth is characterized by behaviors, emotions, physiological reactions, and family interaction patterns. An essential component of therapy involves increasing awareness of the links among thoughts, emotions, behaviors, bodily sensations, and family interactions. An automatic assessment tool using physiological signals from a wearable biosensor may enable continuous symptom monitoring inside and outside of the clinic and support cognitive behavioral therapy for OCD.
OBJECTIVE: The primary aim of this study is to evaluate the feasibility and acceptability of using a wearable biosensor to monitor OCD symptoms. The secondary aim is to explore the feasibility of developing clinical and research tools that can detect and predict OCD-relevant internal states and interpersonal processes with the use of speech and behavioral signals.
METHODS: Eligibility criteria for the study include children and adolescents between 8 and 17 years of age diagnosed with OCD, controls with no psychiatric diagnoses, and one parent of the participating youths. Youths and parents wear biosensors on their wrists that measure pulse, electrodermal activity, skin temperature, and acceleration. Patients and their parents mark OCD episodes, while control youths and their parents mark youth fear episodes. Continuous, in-the-wild data collection will last for 8 weeks. Controlled experiments designed to link physiological, speech, behavioral, and biochemical signals to mental states are performed at baseline and after 8 weeks. Interpersonal interactions in the experiments are filmed and coded for behavior. The films are also processed with computer vision and for speech signals. Participants complete clinical interviews and questionnaires at baseline, and at weeks 4, 7, and 8. Feasibility criteria were set for recruitment, retention, biosensor functionality and acceptability, adherence to wearing the biosensor, and safety related to the biosensor. As a first step in learning the associations between signals and OCD-related parameters, we will use paired t tests and mixed effects models with repeated measures to assess associations between oxytocin, individual biosignal features, and outcomes such as stress-rest and case-control comparisons.
RESULTS: The first participant was enrolled on December 3, 2021, and recruitment closed on December 31, 2022. Nine patient dyads and nine control dyads were recruited. Sixteen participating dyads completed follow-up assessments.
CONCLUSIONS: The results of this study will provide preliminary evidence for the extent to which a wearable biosensor that collects physiological signals can be used to monitor OCD severity and events in youths. If we find the study to be feasible, further studies will be conducted to integrate biosensor signals output into machine learning algorithms that can provide patients, parents, and therapists with actionable insights into OCD symptoms and treatment progress. Future definitive studies will be tasked with testing the accuracy of machine learning models to detect and predict OCD episodes and classify clinical severity.
BACKGROUND: ClinicalTrials.gov NCT05064527; https://clinicaltrials.gov/ct2/show/NCT05064527.
UNASSIGNED: DERR1-10.2196/45123.

Due to the phenomenon of \"involution\" in China, the current generation of college and university students are experiencing escalating levels of stress, both academically and within their families. Extensive research has shown a strong correlation between heightened stress levels and overall well-being decline. Therefore, monitoring students\' stress levels is crucial for improving their well-being in educational institutions and at home. Previous studies have primarily focused on recognizing emotions and detecting stress using physiological signals like ECG and EEG. However, these studies often relied on video clips to induce various emotional states, which may not be suitable for university students who already face additional stress to excel academically. In this study, a series of experiments were conducted to evaluate students\' stress levels by engaging them in playing Sudoku games under different distracting conditions. The collected physiological signals, including PPG, ECG, and EEG, were analyzed using enhanced models such as LRCN and self-supervised CNN to assess stress levels. The outcomes were compared with participants\' self-reported stress levels after the experiments. The findings demonstrate that the enhanced models presented in this study exhibit a high level of proficiency in assessing stress levels. Notably, when subjects were presented with Sudoku-solving tasks accompanied by noisy or discordant audio, the models achieved an impressive accuracy rate of 95.13% and an F1-score of 93.72%. Additionally, when subjects engaged in Sudoku-solving activities with another individual monitoring the process, the models achieved a commendable accuracy rate of 97.76% and an F1-score of 96.67%. Finally, under comforting conditions, the models achieved an exceptional accuracy rate of 98.78% with an F1-score of 95.39%.