Hearables: feasibility of recording cardiac rhythms from single in-ear locations.

The ear is well positioned to accommodate both brain and vital signs monitoring, via so-called hearable devices. Consequently, ear-based electroencephalography has recently garnered great interest. However, despite the considerable potential of hearable based cardiac monitoring, the biophysics and characteristic cardiac rhythm of ear-based electrocardiography (ECG) are not yet well understood.

Hearables: Feasibility and Validation of In-Ear Electrocardiogram.

Out-of-clinic, continuous monitoring of vital signs is envisaged to become the backbone of future e-health. The emerging wrist worn devices have already proven to be a success in the measurement of pulse, however, a susceptibility to artefacts and missing data caused by regular motion in everyday activities, and the inability to continuously acquire the electrocardiogram call into question the utility of this technology in future e-Health. With this in mind, the head, and in particular the ear canals, have been investigated as possible locations for wearable devices.

A physiology based model of heart rate variability.

Heart rate variability (HRV) is governed by the autonomic nervous system (ANS) and is routinely used to estimate the state of body and mind. At the same time, recorded HRV features can vary substantially between people. A model for HRV that (1) correctly simulates observed HRV, (2) reliably functions for multiple scenarios, and (3) can be personalised using a manageable set of parameters, would be a significant step forward toward understanding individual responses to external influences, such as physical and physiological stress.

Early Postnatal Heart Rate Variability in Healthy Newborn Infants.

Background: Despite the increasing interest in fetal and neonatal heart rate variability (HRV) analysis and its potential use as a tool for early disease stratification, no studies have previously described the normal trends of HRV in healthy babies during the first hours of postnatal life.

Methods: We prospectively recruited 150 healthy babies from the postnatal ward and continuously recorded their electrocardiogram during the first 24 h after birth. Babies were included if born in good condition and stayed with their mother.

The ClassA Framework: HRV Based Assessment of SNS and PNS Dynamics Without LF-HF Controversies.

The powers of the low frequency (LF) and high frequency (HF) components of heart rate variability (HRV) have become the de facto standard metrics in the assessment of the stress response, and the related activities of the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS). However, the widely adopted physiological interpretations of the LF and HF components in SNS /PNS balance are now questioned, which puts under serious scrutiny stress assessments which employ the LF and HF components. To avoid these controversies, we here introduce the novel Classification Angle (ClassA) framework, which yields a family of metrics which quantify cardiac dynamics in three-dimensions.

A pilot study of preoperative heart rate variability predicting pain during local anesthetic varicose vein surgery.

Objective: Local anesthetic endovenous procedures were shown to reduce recovery time, to decrease postoperative pain, and to more quickly return the patient to baseline activities. However, a substantial number of patients experience pain during these procedures. The autonomic nervous system modulates pain perception, and its influence on stress response can be noninvasively quantified using heart rate variability (HRV) indices.

Prognostic Accuracy of Heart Rate Variability Analysis in Neonatal Encephalopathy: A Systematic Review.

Background: Heart rate variability analysis offers real-time quantification of autonomic disturbance after perinatal asphyxia, and may therefore aid in disease stratification and prognostication after neonatal encephalopathy (NE).

Objective: To systematically review the existing literature on the accuracy of early heart rate variability (HRV) to predict brain injury and adverse neurodevelopmental outcomes after NE.

Design/methods: We systematically searched the literature published between May 1947 and May 2018.

Self-assessment of surgical ward crisis management using video replay augmented with stress biofeedback.

Background: We aimed to explore the feasibility and attitudes towards using video replay augmented with real time stress quantification for the self-assessment of clinical skills during simulated surgical ward crisis management.

Methods: Twenty two clinicians participated in 3 different simulated ward based scenarios of deteriorating post-operative patients. Continuous ECG recordings were made for all participants to monitor stress levels using heart rate variability (HRV) indices.

Hearables: feasibility of recording cardiac rhythms from head and in-ear locations.

Mobile technologies for the recording of vital signs and neural signals are envisaged to underpin the operation of future health services. For practical purposes, unobtrusive devices are favoured, such as those embedded in a helmet or incorporated onto an earplug. However, these locations have so far been underexplored, as the comparably narrow neck impedes the propagation of vital signals from the torso to the head surface.

Pain Prediction From ECG in Vascular Surgery.

Varicose vein surgeries are routine outpatient procedures, which are often performed under local anaesthesia. The use of local anaesthesia both minimises the risk to patients and is cost effective, however, a number of patients still experience pain during surgery. Surgical teams must therefore decide to administer either a general or local anaesthetic based on their subjective qualitative assessment of patient anxiety and sensitivity to pain, without any means to objectively validate their decision.

Hearables: Multimodal physiological in-ear sensing.

Future health systems require the means to assess and track the neural and physiological function of a user over long periods of time, and in the community. Human body responses are manifested through multiple, interacting modalities - the mechanical, electrical and chemical; yet, current physiological monitors (e.g.

Resolving Ambiguities in the LF/HF Ratio: LF-HF Scatter Plots for the Categorization of Mental and Physical Stress from HRV.

It is generally accepted that the activities of the autonomic nervous system (ANS), which consists of the sympathetic (SNS) and parasympathetic nervous systems (PNS), are reflected in the low- (LF) and high-frequency (HF) bands in heart rate variability (HRV)-while, not without some controversy, the ratio of the powers in those frequency bands, the so called LF-HF ratio (LF/HF), has been used to quantify the degree of sympathovagal balance. Indeed, recent studies demonstrate that, in general: (i) sympathovagal balance cannot be accurately measured via the ratio of the LF- and HF- power bands; and (ii) the correspondence between the LF/HF ratio and the psychological and physiological state of a person is not unique. Since the standard LF/HF ratio provides only a single degree of freedom for the analysis of this 2D phenomenon, we propose a joint treatment of the LF and HF powers in HRV within a two-dimensional representation framework, thus providing the required degrees of freedom.

Smart Helmet: Wearable Multichannel ECG and EEG.

Modern wearable technologies have enabled continuous recording of vital signs, however, for activities such as cycling, motor-racing, or military engagement, a helmet with embedded sensors would provide maximum convenience and the opportunity to monitor simultaneously both the vital signs and the electroencephalogram (EEG). To this end, we investigate the feasibility of recording the electrocardiogram (ECG), respiration, and EEG from face-lead locations, by embedding multiple electrodes within a standard helmet. The electrode positions are at the lower jaw, mastoids, and forehead, while for validation purposes a respiration belt around the thorax and a reference ECG from the chest serve as ground truth to assess the performance.

Smart helmet: Monitoring brain, cardiac and respiratory activity.

The timing of the assessment of the injuries following a road-traffic accident involving motorcyclists is absolutely crucial, particularly in the events with head trauma. Standard apparatus for monitoring cardiac activity is usually attached to the limbs or the torso, while the brain function is routinely measured with a separate unit connected to the head-mounted sensors. In stark contrast to these, we propose an integrated system which incorporates the two functionalities inside an ordinary motorcycle helmet.