A Telecare System for Use in Traditional Persian Medicine

Background: In Persian Medicine (PM), measuring the wrist temperature/humidity and pulse is one of the main methods for determining a person's health status and temperament. An important problem is the dependence of the diagnosis on the physician's interpretation of the above-mentioned criteria. Perhaps this is one reason why this method has yet to be combined with modern medical methods. Also, sometimes there is a need to use PM to diagnose patients remotely, especially during a pandemic. This brings up the question of how to implement PM into a telecare system. This study addresses these concerns and outlines a system for measuring pulse signals and temperament detection based on PM. Methods: A system was designed and clinically implemented based on PM that uses data from recorded thermal distribution, a temperament questionnaire, and a customized device that logs the pulse waves on the wrist. This system was used for patient care via telecare. Results: The temperaments of 34 participants were assessed by a PM specialist using the standardized Mojahedi Mizaj Questionnaire (MMQ). Thermal images of the wrist in the supine position (named Malmas in PM), the back of the hand, and the entire face were also recorded under the supervision of the physician. Also, the wrist pulse waves were evaluated by a customized pulse measurement device. Finally, the collected data could be sent to a physician via a telecare system for further interpretation and prescription of medications. Conclusion: This preliminary study focused on the implementation of a combinational hardware-software system for patient assessment based on PM. It appears that the design and construction of a customized device that can measure the pulse waves, and some other criteria, according to PM, is possible and can decrease the dependency of the diagnostic to PM specialists. Thus, it can be incorporated into a telemedicine system.

Blood Pressure Model Based on Hybrid Feature Convolution Neural Network in Promoting Rehabilitation of Patients with Hypertensive Intracerebral Hemorrhage

Objective. Accurate prediction of the rise of blood pressure is essential for the hypertensive intracerebral hemorrhage. This study uses the hybrid feature convolution neural network to establish the blood pressure model instead of the traditional method of pulse waves. Methods. The pulse waves of 100 patients were collected, and the pulse wave was decomposed into three bell wave compound forms to obtain the accurate pulse wave propagation time. Then, the mixed feature convolution neural network model ABP-net was proposed, which combined the pulse wave propagation time characteristics with the pulse wave waveform characteristics automatically extracted by one-dimensional convolution to predict the arterial blood pressure. Finally, according to the prediction results, 20 patients were treated before the high blood pressure appeared (model group), and another 20 patients with a daily fixed treatment scheme were selected as the control group. Results. In 80 training sets, compared with linear regression and the random forest method, the hybrid feature convolution neural network has higher accuracy in predicting blood pressure. In 20 test sets, the blood pressure error was eliminated within 5 mmHg. The total effective rate in the model group and the control group was 95.0% and 85.0%, respectively ( P = 0.035 ). After treatment, the scores of self-care ability of daily life and limb motor function in the model group were higher than those in the control group ( P < 0.05 ). There were 8 cases (13.6%) in the model group and 17 cases (28.3%) in the control group due to the recurrence of cerebrovascular accident ( P = 0.043 ). Conclusion. Drug treatment guided by a blood pressure model based on a hybrid feature convolution neural network for patients with hypertensive cerebral hemorrhage can significantly and smoothly reduce blood pressure, promote the health recovery, and reduce the occurrence of cerebrovascular accidents.

Impaired Microcirculation and Vascular Hemodynamics in Relation to Macrocirculation in Patients With Systemic Lupus Erythematosus

Introduction: Systemic lupus erythematosus (SLE) is associated with premature cardiovascular disease (CVD) and mortality, unexplained by traditional risk factors. Impairment of microcirculation and vascular hemodynamics may represent early signs of vascular affection. We hypothesized that studies of microcirculation and pulse waves may provide additional information, compared to ultrasound (US) alone, for the detection of early vascular disease in SLE.Methods: Sixty well-characterized SLE-patients (52 women, eight men; mean age 43.21 ± 1.3 years) characterized by lupus nephritis (LN; n = 20), antiphospholipid syndrome (APS; n = 20) or skin and joint involvement (n = 20) and 60 healthy controls were included. Microcirculatory peak oxygen saturation (OxyP) was evaluated using a novel combined laser Doppler flowmetry/diffuse reflectance spectroscopy method. Pulse waves were recorded in the radial artery by the aid of applanation tonometry in order to calculate central augmentation index (AIx75). Intima-media thickness (IMT) and plaque occurrence were evaluated using high frequency US, in carotid and central arteries.Results: Lower OxyP (84 ± 8 vs. 87 ± 5 %, p = 0.01) and higher AIx75 (17.3 ± 13.9 vs. 10.0 ± 14.2 %, p = 0.005) were seen in the SLE cohort. OxyP was inversely correlated with IMT in internal carotid artery (ICA), (R = −0.32, p = 0.01). AIx75 correlated with IMT in common carotid artery (CCA), (R = 0.36, p = 0.005), common femoral artery (CFA), (R = 0.43, p = 0.001), and ICA (R = 0.27, p = 0.04). AIx75 correlated negatively with OxyP (R = −0.29, p = 0.02). SLE-patients with plaque had lower OxyP values (80 ± 8 vs. 85 ± 7 %, p &lt; 0.001) and higher AIx75 (23.0 ± 11.6 vs. 15.5 ± 14.2 %, p &lt; 0.001) compared to those without plaque.Conclusion: Impaired microcirculation and vessel hemodynamics were observed in SLE. These methods correlated with IMT and plaque occurrence. The importance of early macro- and micro-circulatory vascular affection for increased risk of CVD in SLE will be followed-up in future studies.

Palpation Localization of Radial Artery Based on 3-Dimensional Convolutional Neural Networks

Palpation localization is essential for detecting physiological parameters of the radial artery for pulse diagnosis of Traditional Chinese Medicine (TCM). Detecting signal or applying pressure at the wrong location can seriously affect the measurement of pulse waves and result in misdiagnosis. In this paper, we propose an effective and high accuracy regression model using 3-dimensional convolution neural networks (CNN) processing near-infrared picture sequences to locate radial artery upon radius at the wrist. Comparing with early studies using 2-dimensional models, 3D CNN introduces temporal features with the third dimension to leverage pulsation rhythms. The model had achieved superior performance accuracy as 0.87 within 50 pixels at picture resolution of 2048*1088. Model visualization shows that the additional dimension of the temporal convolution highlights dynamic changes within image sequences. This study presents the great potential of our constructed model to be applied in real wrist palpation location scenarios to bring the key convenience for pulse diagnosis.

Pulse-Coupled Synchronization Protocol and Its Optimized Algorithm for Wireless Sensor Networks

This paper proposed a pulse-coupled synchronization protocol for wireless sensor networks. The time information of the node can be encoded at the Mac layer and then sent and received in the form of pulse waves. During the exchange of time information between a pair of nodes, one node will adjust its own clock information according to certain rules after receiving the pulse time signal of the other node. This process is repeated in the entire wireless sensor network. Under certain environmental and estimated parameter conditions, all nodes in the network can finally converge to a coherent frequency and phase, thus realizing time synchronization. The relationship between time synchronization and coupling coefficient was proved theoretically, and the optimal coupling coefficient was derived. An optimized algorithm was proposed after the optimization of the protocol. Finally, the correctness of the proposed protocol and its optimized algorithm was verified by data simulation.

Subjective well-being and month-long LF/HF ratio among deskworkers

The importance of workers’ well-being has been recognized in recent years. The assessment of well-being has been subjective, and few studies have sought potential biomarkers of well-being to date. This study examined the relationship between well-being and the LF/HF ratio, an index of heart rate variability that reflects sympathetic and parasympathetic nerve activity. Pulse waves were measured using photoplethysmography through a web camera attached to the computer used by each participant. The participants were asked to measure their pulse waves while working for 4 weeks, and well-being was assessed using self-reported measures such as the Satisfaction With Life Scale (SWLS), the Positive and Negative Affect Schedule (PANAS), and the Flourishing Scale (FS). Each of the well-being scores were split into two groups according to the median value, and the LF/HF ratio during work, as well as the number of times an LF/HF ratio threshold was either exceeded or subceeded, were compared between the high and low SWLS, positive emotion, negative emotion, and FS groups. Furthermore, to examine the effects of the LF/HF ratio and demographic characteristics on well-being, a multiple regression analysis was conducted. Data were obtained from 169 participants. The results showed that the low FS group had a higher mean LF/HF ratio during work than the high FS group. No significant differences were seen between the high and low SWLS groups, the high and low positive emotion groups, or the high and low negative emotion groups. The multiple regression analysis showed that the mean LF/HF ratio during work affected the FS and SWLS scores, and the number of times the mean LF/HF ratio exceeded +3 SD had an effect on the positive emotion. No effect of the LF/HF ratio on negative emotions was shown. The LF/HF ratio might be applicable as an objective measure of well-being.

HIGH-INTENSITY TRAINING ON PULSE AND DICROTIC WAVEFORM IN CHRONIC DISEASES

ABSTRACT Introduction: The formation and propagation of pulse waves are mainly accomplished by coordinating the heart and the vascular system. The contraction and relaxation of the heart are the sources of pulse waves. The aorta vibrates regularly as the heart contracts. This vibration propagates forward along the elastic blood vessel to form a pulse wave. The pulse wave contains very rich physiological and pathological information about the cardiovascular system. If there is a problem with the heart's structure, it can cause abnormal pulse waveforms. Objective: This article analyzes pulse waveform changes and blood flow during high-intensity interval training. It combines the test results to guide the exercise rehabilitation treatment of patients with chronic diseases. Methods: Pulse waves were collected from subjects under different exercise loads and the characteristics of pulse wave parameters under intermittent exercise were studied. Results: An athlete's pulse wave response is different in the case of high-intensity intermittent exercise. There are differences in the cardiovascular response of patients with different body weights. Conclusion: High-intensity interval training can improve the cardiovascular function of patients with chronic diseases and affect their pulse waveform. Level of evidence II; Therapeutic studies - investigation of treatment results.

Wrist Band Photoplethysmography Autocorrelation Analysis Enables Detection of Atrial Fibrillation Without Pulse Detection

Atrial fibrillation is often asymptomatic and intermittent making its detection challenging. A photoplethysmography (PPG) provides a promising option for atrial fibrillation detection. However, the shapes of pulse waves vary in atrial fibrillation decreasing pulse and atrial fibrillation detection accuracy. This study evaluated ten robust photoplethysmography features for detection of atrial fibrillation. The study was a national multi-center clinical study in Finland and the data were combined from two broader research projects (NCT03721601, URL: https://clinicaltrials.gov/ct2/show/NCT03721601 and NCT03753139, URL: https://clinicaltrials.gov/ct2/show/NCT03753139). A photoplethysmography signal was recorded with a wrist band. Five pulse interval variability, four amplitude features and a novel autocorrelation-based morphology feature were calculated and evaluated independently as predictors of atrial fibrillation. A multivariate predictor model including only the most significant features was established. The models were 10-fold cross-validated. 359 patients were included in the study (atrial fibrillation n = 169, sinus rhythm n = 190). The autocorrelation univariate predictor model detected atrial fibrillation with the highest area under receiver operating characteristic curve (AUC) value of 0.982 (sensitivity 95.1%, specificity 93.7%). Autocorrelation was also the most significant individual feature (p &lt; 0.00001) in the multivariate predictor model, detecting atrial fibrillation with AUC of 0.993 (sensitivity 96.4%, specificity 96.3%). Our results demonstrated that the autocorrelation independently detects atrial fibrillation reliably without the need of pulse detection. Combining pulse wave morphology-based features such as autocorrelation with information from pulse-interval variability it is possible to detect atrial fibrillation with high accuracy with a commercial wrist band. Photoplethysmography wrist bands accompanied with atrial fibrillation detection algorithms utilizing autocorrelation could provide a computationally very effective and reliable wearable monitoring method in screening of atrial fibrillation.

MO164NOVEL PARAMETERS TO ASSESS ENDOTHELIAL DYSFUNCTION BY PULSE WAVE ANALYSIS

Background and Aims Pulse wave morphology changes under the high flow condition of reactive hyperaemia. We hypothesized, that those alterations may be able to indicate endothelial dysfunction. Method We recorded digitized pulse waves measured tonometrically with the SphygmoCor® device of 64 persons, 41 kidney transplant recipients and 23 healthy individuals, under normal conditions (NC) and under reactive hyperaemia (RH). Using matlab®, we calculated novel parameters, which had a temporal relationship with 3 charactereristic points (PO) of the normalized pulse wave, namely the maximum of the antegrade wave (1), the diacrotic notch (2) and the first diastolic inflection point (3). The following parameters were calculated: Mean slope between PO 1 and 2 (λ2), area under the curve (AUC) in the systole (Asys), AUC between PO 1 and 3 (A13), AUC between PO 1 and 2 (A12) and AUC between PO 2 and 3 (A23). Parameters were analyzed as their difference under reactive hyperaemia and under normal conditions. Also the maximum of the instantaneous difference of normalized pulse waves under NC und RH (Dmax) was analyzed. Endothelial function was evaluated by duplex sonography using ROC-analysis of peak systolic and end-diastolic flow difference under NC and RH. Results ROC-assessment of endothelial dysfunction as indicated by systolic peak flows demonstrated AUCs of 0.733 for λ2 (p=0.002), 0.751 for Dmax (p&lt; 0.001), 0.698 for Asys (p=0.006), 0.648 for A13 (p=0.077), 0.678 for A12 (p=0.027) and 0.732 for A23 (p=0.001). For the diastole the values were 0.753 for λ2 (p=0.003), 0.733 for Dmax (p=0.002) 0.670 for Asys (p=0.038), 0.566 for A13 (p=0.495), 0.664 for A12 (p=0.091) and 0.722 for A23 (p=0.015) respectively. Conclusion Pulse wave analysis under the condition of reactive hyperaemia probably is useful to assess endothelial function in kidney transplant recipients.