A novel method for ECG signal outlier processing based on autoencoder neural networks is presented in the article. Typically, heartbeats with serious waveform distortions are treated as outliers and are skipped from the authentication pipeline. The main idea of the paper is to correct these waveform distortions rather them in order to provide the system with better statistical base. During the experiments, the optimum autoencoder architecture was selected. An open Physionet ECGID database was used to verify the proposed method. The (...) results of the studies were compared with previous studies that considered the correction of anomalies based on a statistical approach. On the one hand, the autoencoder shows slightly lower accuracy than the statistical method, but it greatly simplifies the construction of biometric identification systems, since it does not require precise tuning of hyperparameters. (shrink)

This paper presents research regarding the monitoring of the brain and the adequacy of anesthesia during surgery. Particular variables are derived from EEG and ECG signals and are correlated to anesthetic gas (sevoflurane) concentration, in pediatric anesthesia. The methods used for parameter extraction are based on change detection theory and time-frequency representation. Preliminary results show that the expired anesthetic gas concentration modulates both the heart rate variability and the duration of the burst suppression. Monitors of the central nervous system and (...) autonomic nervous system activities can be expected to be based on these variables. (shrink)

Different approaches have been proposed in order to achieve knowledge integration for coronary care monitoring applications, usually in the form of expert systems. The clinical impact of these expert systems, which are based only on "shallow" knowledge, has not been remarkable due to the difficulties associated with the construction and maintenance of a complete knowledge base. Model-based systems represent an alternative to these problems because they allow efficient integration of the "deep" knowledge on the underlying physiological phenomena being monitored. In (...) this work, a brief review of existing model-based systems for cardiac rhythm interpretation is presented, followed by the description of a new system forCardiac Arrhythmia Recognition by Model-Based ECG Matching (CARMEM). Fundamental characteristics of CARMEM are presented; in particular, its ability to provide on-line parameter adaptation to simulate complex rhythms and to match observed ECG signals. The proposed model can be useful for the explanation of the origin of cardiac arrhythmias and contribute towards their robust characterization in the context of coronary care units. (shrink)

Cardiac disease is the leading cause of death worldwide. Cardiovascular diseases can be prevented if an effective diagnostic is made at the initial stages. The ECG test is referred to as the diagnostic assistant tool for screening of cardiac disorder. The research purposes of a cardiac disorder detection system from 12-lead-based ECG Images. The healthcare institutes used various ECG equipment that present results in nonuniform formats of ECG images. The research study proposes a generalized methodology to process all formats of (...) ECG. Single Shoot Detection MobileNet v2-based Deep Neural Network architecture was used to detect cardiovascular disease detection. The study focused on detecting the four major cardiac abnormalities with 98% accuracy results were calculated. The work is relatively rare based on their dataset; a collection of 11,148 standard 12-lead-based ECG images used in this study were manually collected from health care institutes and annotated by the domain experts. The study achieved high accuracy results to differentiate and detect four major cardiac abnormalities. Several cardiologists manually verified the proposed system’s accuracy result and recommended that the proposed system can be used to screen for a cardiac disorder. (shrink)

Art therapy encourages the use of art materials to express feelings and thoughts in a supportive environment. Art materials differ in fluidity and are postulated to thus differentially enhance emotional response (the more fluid the material the more emotion). Yet, to the best of our knowledge, this assumption has not been empirically tested. The current study aimed to examine the emotional and physiological responses to art making with different art materials. We were particularly interested in vagal activity, indexed by heart (...) rate variability (HRV), because of its association with numerous health related outcomes. In this study, fifty adults (mean age 33 ± 10.27 years, 52% males) participated in a repeated measures experiment, in which they were requested to draw with three art materials (order randomized) differing in their level of fluidity (pencil, oil-pastels and gouache paint) intermittent with periods of music. We measured the emotional response to art making with each material using a self-report measure and matrices of HRV using a wearable electrocardiogram (ECG) device. We calculated two indices of HRV, one indicative of parasympathetic nervous system (PNS) activity, and one indicative of sympathetic nervous system (SNS) activity. Art making with gouache paint and oil pastels resulted in improved positive mood, while pencil did not. Art making explained approximately 35% of the variability in parasympathetic reactivity, which may indicate changes in emotional regulation processes during the art-making task. Yet, fluidity was not sufficient to explain the reaction to art-making. Surprisingly, the largest suppression of PNS and augmentation of the SNS occurred during art-making with oil-pastels and not with Gouache. Moreover, PNS and SNS reactivity to oil-pastels were related to emotional valance, which may point to emotional engagement. We can conclude that art-making with oil-pastels, first created in Japan in 1924 to increase self-expression of students, results in a unique emotional and physiological responses. These findings might be explained by the enhanced tactile experience of art-making with oil-pastels along with their relative fluidity, triggering an arousal pattern. Further studies that take the format and presentation of the materials as well as the content of the artwork, into account, are needed. (shrink)

This article investigates the concept of sound, in relation to the new means and sciences from different perspectives, ultimately providing an analysis of the newborn artistic movement of bioart. It is divided into two parts. The first part of the study is based upon reference, investigating the interconnection between art and science. This mechanism is characterized by transformation processes in the interdisciplinary practices that are applied mainly by various artists and movements of the post-Second World War period. The expressive element (...) seeks an unworldly explanation through audio and visual conjunctions. This nature is obvious in Paul Klee’s reflections of musical elements in his paintings, and Rimmington’s attempts to marry audio-visual influences in his ‘colour organs’. The experimentations of composers such as Xenakis and Stockhausen at various locations with light and colour illustrate the continuous quest to render sound by the use of new means. Technology is a vital component of transformation as it enhances syncretic creativity for various art domains such as those that Fluxus deployed. Nam Jun Paik and Dick Higgins introduce radical techniques in their performances as they detach their selves from the parameters that define composition, and use the mind and power of sentiment in order to identify reality aurally and optically. Towards the end of the twentieth century, we witnessed the appearance of new art forms such as bioart. The human body, host of material and immaterial functions, comes to the forefront of art prac¬tice. Its relation to elements such as oscillations and vibrations that express the energy flow is analysed through the model of spiritualism that came from eastern thought. The notion of digital embodiment is presented as a reminder, highlight¬ing the importance of technology in biotechnology and genetics. The second part of the article involves an experiment. This describes how the concept of biomusic is applied with the use of electrocardiography (ECG) data from the MIT PhysioNet database. As sound penetrates the entire human body, it can be analysed in all of its phasma. Using this information, we attempt to translate/transform these biological sound phenomena into music. The sound produced by the elaboration of data that result from biological functions can be described as biomusic. It can be transformed into frequencies related to time and can be expressed in musical themes. Sonification plays an important role in this research as it constitutes a rapid and precise rendering of polymorphic information (in this case the ECG) in musical notes. This modelling and musical attribution leads to two distinguishable results, each concerning different clinical cases (all data belong to a normal heart function and a pathological one). The invention of this novel system is suggested for scientific as well as musical disciplines. It has the ability to be implemented in an experimental form and obtain an educational character. The transformation process avoids compensation throughout the matching process between ECG functions and music, while focusing on the aesthetic factor at the same time. Sound meets art in the world of biomusic as it takes shape through technology, constituting a new medium to further evolve the model of ‘biology into art’ transformation. (shrink)

BackgroundThere is much overlap among the symptomology of autistic spectrum disorders, obsessive compulsive disorders, and alexithymia, which all typically involve impaired social interactions, repetitive impulsive behaviors, problems with communication, and mental health.AimThis study aimed to identify direct and indirect associations among alexithymia, OCD, cardiac interoception, psychological inflexibility, and self-as-context, with the DV ASD and depression, while controlling for vagal related aging.MethodologyThe data involved electrocardiogram heart rate variability and questionnaire data. In total, 1,089 participant's data of ECG recordings of healthy resting (...) state HRV were recorded and grouped into age categories. In addition to this, another 224 participants completed an online survey that included the following questionnaires: Yale-Brown Obsessive Compulsive Scale ; Toronto Alexithymia Scale 20 ; Acceptance and Action Questionnaire ; Depression, Anxiety, and Stress Scale 21 ; Multi-dimensional Assessment of Interoceptive Awareness Scale ; and the Self-as-Context Scale.ResultsHeart rate variability was shown to decrease with age when controlling for BMI and gender. In the two SEMs produced, it was found that OCD and alexithymia were causally associated with autism and depression indirectly through psychological inflexibility, SAC, and ISen interoception.ConclusionThe results are discussed in relation to the limitations of the DSM with its categorical focus of protocols for syndromes and provide support for more flexible ideographic approaches in diagnosing and treating mental health and autism within the Extended Evolutionary Meta-Model. Graph theory approaches are discussed in their capacity to depict the processes of change potentially even at the level of the relational frame. (shrink)

The Economy for the Common Good proposes a more ethical and sustainable society and organizations based on the common good concept. The study investigates entrepreneurs' reasons for joining the ECG movement and organizational changes introduced following the implementation of the ECG managerial system. Semistructured interviews were held with managers of nine Italian organizations belonging to the movement. Interviews were transcribed, and qualitative content analysis was performed using NVivo 12. Eleven nodes integrating 279 answer units were coded, addressing reasons for adhering, (...) actions introduced, difficulties, overcoming strategies and enablers. The results suggest that ECG values and particularly Environmental Sustainability and Human Dignity are two main reasons to join the movement, that a Common Good Report is a valuable tool for the organizational analysis, that such analysis can be replicated with other ECG organizations, and that pursuing decent work conditions strengthens the adhesion to the ECG movement. The seven conceptual propositions highlight the congruence between the value structure of the organization and the values of the ECG, the congruence between the values held by proximal organizational stakeholders and the changes encouraged by ECG approach, and that rewards and recognition by the organizational stakeholders and society reinforce and maintain the adhesion path. (shrink)

The ventricular pressure profile is characteristic of the cardiac contraction progress and is useful to evaluate the cardiac performance. In this contribution, a tissue-level electromechanical model of the left ventricle is proposed, to assist the interpretation of left ventricular pressure waveforms. The left ventricle has been modeled as an ellipsoid composed of twelve mechano-hydraulic sub-systems. The asynchronous contraction of these twelve myocardial segments has been represented in order to reproduce a realistic pressure profiles. To take into account the different energy (...) domains involved, the tissue-level scale and to facilitate the building of a modular model, multiple formalisms have been used: Bond Graph formalism for the mechano-hydraulic aspects and cellular automata for the electrical activation. An experimental protocol has been defined to acquire ventricular pressure signals from three pigs, with different afterload conditions. Evolutionary Algorithms have been used to identify the model parameters in order to minimize the error between experimental and simulated ventricular pressure signals. Simulation results show that the model is able to reproduce experimental ventricular pressure. In addition, electro-mechanical activation times have been determined in the identification process. For example, the maximum electrical activation time is reached, respectively, 96.5, 139.3 and 131.5 ms for the first, second, and third pigs. These preliminary results are encouraging for the application of the model on non-invasive data like ECG, arterial pressure or myocardial strain. (shrink)

In this study we evaluated heart rate variability changes in a pianist, playing in a laboratory, to investigate whether HRV changes are guided by music temporal features or by technical difficulty and/or subjective factors. The pianist was equipped with a wearable telemetry device for ECG recording during the execution of 4 classical and 5 jazz pieces. From ECG we derived the RR intervals series, and, for each piece, analyzed HRV in the time and frequency domains and performed non-linear analysis. We (...) also studied the correlation between the time course of music volume envelope and tachogram. Results showed a general reduction of parasympathetic and an increase of sympathetic activity, with the greatest changes during the classical pieces execution, the pianist appraised as more demanding than the jazz ones. The most marked changes occurred during the most technically/emotionally demanding piece, and correlation analysis revealed a negative association between music volume envelope time course and tachogram only for this piece, suggesting a modulation of the limbic system on the synchronization between heart rhythm and music temporal features. Classical music was also associated with the increase of entropy with respect to rest, indicating its effectiveness in driving flexible, healthy, heart dynamics. In conclusion, HRV seems modulated not only by the music temporal features, but also by the pianist’s emotional involvement, which is greatly influenced, in a non-trivial manner, by the technical demands and musician expertise. (shrink)

BackgroundThis case report discusses an ethical communication dilemma in prehospital patient interaction, involving a patient who was about to board a plane at a busy airport. The article argues that the situation raised dilemmas about communication, patient autonomy and paternalism. Paramedics should be able to find good solutions to these dilemmas, but they have not received much attention in the literature on prehospital ambulance work.Case presentationThe patient had chest pains that were consistent with serious heart disease, but she wanted to (...) catch her plane and was unwilling to let paramedics assess her heart activity by means of an electrocardiogram (ECG). The paramedics had to decide, there and then, whether the patient’s refusal to submit to an ECG should be respected, or whether they should set the patient’s expressed wishes aside by exercising verbal power and persuasive communication techniques. The paramedics chose to do the latter. It later turned out that the patient was grateful that the paramedics had been very direct, almost brutal, in their communication. When the patient regained her autonomy, she saw clearly that taking time to obtain and monitor an ECG was the best option for her.ConclusionLooking forward in time might be a good professional strategy for deciding whether ethical paternalism in communication is justified. If there is good reason to believe that patients who later regain their autonomy will agree that paternalistic verbal actions were in their best interests, and if acting in accordance with patients’ preferences can have severe negative health consequences for them, then paramedics have good reason to believe that ethical paternalism is justified. (shrink)

The purpose of the study is to explore a new research methodology that will improve our understanding of “flow” through indicators of physiological and qualitative state. We examine indicators of “flow” experienced by musicians of a youth string quartet, two women (25, 29) and two men (23, 24). Electrocardiogram (ECG) equipment was used to record heart rate variability (HRV) data throughout the four movements in one and the same quartet performed during two concerts. Individual physiological indicators of flow were supplemented (...) by assessments of group “state flow” (means from standardized questionnaires) and a group interview in which the musicians provided qualitative data. A matrix was constructed for the characterization of different kinds of demands in the written music in each one of the four movements for each one of the musicians. HRV derived from ECG data showed non-significant trends for group state flow across the eight musical episodes. Individual-level analysis showed that compared to the other players the first violin player had the highest mean heart rate and the lowest increase in high frequency (HF) power in HRV during this particular movement, particularly during the second concert. The qualitative data illustrated how an interplay of synchronized social interactions between this player and their colleagues during the musical performance was associated with a feeling of group state flow and served to support the first violinist. The case illustrates that the proposed mixed methodology drawing on physiological and qualitative data, has the potential to provide meaningful information about experiences of a flow state, both at individual and group levels. Applications in future research are possible. (shrink)

Occupational therapy often uses craft activities as therapeutic tools, but their therapeutic effectiveness has not yet been adequately demonstrated. The aim of this study was to examine changes in frontal midline theta rhythm and autonomic nervous responses during craft activities, and to explore the physiological mechanisms underlying the therapeutic effectiveness of occupational therapy. To achieve this, we employed a simple craft activity as a task to induce Fmθ and performed simultaneous EEG and ECG recordings. For participants in which Fmθ activities (...) were provoked, parasympathetic and sympathetic activities were evaluated during the appearance of Fmθ and rest periods using the Lorenz plot analysis. Both parasympathetic and sympathetic indices increased with the appearance of Fmθ compared to during resting periods. This suggests that a relaxed-concentration state is achieved by concentrating on craft activities. Furthermore, the appearance of Fmθ positively correlated with parasympathetic activity, and theta band activity in the frontal area were associated with sympathetic activity. This suggests that there is a close relationship between cardiac autonomic function and Fmθ activity. (shrink)

Arguments about the effects of repeated exposure to a suspenseful narrative raise controversial disputes over the paradox of suspense. The lexical meaning and theoretical analyses of suspense imply that suspense cannot be experienced repeatedly because, in such cases, the knowledge from prior viewings and the resolution of outcome will eliminate tension and suspense. However, previous studies have argued that suspense can be re-experienced even when the participants know the outcome or repeatedly confront a suspenseful narrative. This study investigated the effects (...) of repeated exposure to a suspenseful film by collecting self-reported questionnaires and measuring psychophysiological responses. The participants (N = 50) watched clips of a suspenseful film three times and answered self-reported items regarding suspense, arousal, and enjoyment. Psychophysiological data, including skin conductance level (SCL) and electrocardiogram (ECG), were collected while the participants watched the video clips. It was hypothesized that self-reported suspense, arousal, and enjoyment as well as the physiological indices of arousal (SCL) and attention (ECG) would decrease upon repeated viewing of suspenseful clips. Furthermore, it was postulated that there would be inter-group differences depending on the awareness of potential or definite change in outcome at the end of repeatedly shown suspenseful events. The results showed that self-reported suspense and arousal, as well as physiological measures of SCL, declined with repeated exposure, although there were no significant differences on self-reported enjoyment. No group difference was found in self-reported items, but meaningful significant changes were observed in the group comparison of SCL and ECG. The findings suggest that repeated exposure to suspenseful films could result in affective habituation or desensitization to repeated stimuli. The implications and limitations of the current study and suggestions for future research are discussed. (shrink)

Selective attention depends on goal-directed and stimulus-driven modulatory factors, each relayed by different brain rhythms. Under certain circumstances, stress-related states can change the balance between goal-directed and stimulus-driven factors. However, the neuronal mechanisms underlying these changes remain unclear. In this study, we explored how psychosocial stress can modulate brain rhythms during an attentional task and a task-free period. We recorded the EEG and ECG activity of 42 healthy participants subjected to either the Trier Social Stress Test, a controlled procedure to (...) induce stress, or a comparable control protocol, flanked by an attentional task, a 90 s of task-free period and a state of anxiety questionnaire. We observed that psychosocial stress induced an increase in heart rate, self-reported anxiety, and alpha power synchronization. Also, psychosocial stress evoked a relative beta power increase during correct trials of the attentional task, which correlates positively with anxiety and heart rate increase, and inversely with attentional accuracy. These results suggest that psychosocial stress affects performance by redirecting attentional resources toward internal threat-related thoughts. An increment of endogenous top-down modulation reflected an increased beta-band activity that may serve as a compensatory mechanism to redirect attentional resources toward the ongoing task. The data obtained here may contribute to designing new ways of clinical management of the human stress response in the future and could help to minimize the damaging effects of persistent stressful experiences. (shrink)

BackgroundRecurrent Major Depressive Disorder is one of the most disabling mental disorders in modern society. Prior research has shown that self-compassion protects against ruminative tendencies, a key feature of recurrent MDD. In addition, self-compassion has been found to be positively related to higher psychophysiological flexibility in young, healthy adults. To our knowledge, there is a lack of studies on how self-compassion relates to vmHRV in patients with recurrent MDD. The aim of the current study was to investigate whether higher self-compassion (...) would associate with lower ruminative tendencies and higher vmHRV in a sample of adults with recurrent MDD.MethodsWe included a sample of 63 patients between 20 and 71 years old with a history of three or more depressive episodes. They filled out the Self-Compassion Scale, Beck Depression Inventory, and Rumination Rating Scale. ECG was acquired while resting and the square root of the mean squared differences of successive RR interval values was calculated as measure of vmHRV.ResultsAs hypothesized, self-compassion was associated with lower ruminative tendencies. However, self-compassion was not associated with level of vmHRV. Several confounding variables were controlled for in the statistical analyses, and higher age predicted lower vmHRV across all statistical analyses.ConclusionThe results confirmed our hypothesis that higher self-compassion would be associated with lower ruminative tendencies in recurrent MDD. Contrary to our expectation, we did not find that the tendency to be more self-compassionate was associated with higher vmHRV. As such, higher self-compassion seems to relate with a lower tendency to ruminate about past mistakes and events but does not seem to relate to a flexible autonomic stress response. Other potential explanatory factors for lower vmHRV in recurrent MDD is suggested as focus for exploration in future studies. (shrink)

Arrhythmias are irregular heartbeats that may be life-threatening. Proper monitoring and the right care at the right time are necessary to keep the heart healthy. Monitoring electrocardiogram patterns on continuous monitoring devices is time-consuming. An intense manual inspection by caregivers is not an option. In addition, such an inspection could result in errors and inter-variability. This article proposes an automated ECG beat classification method based on deep neural networks to aid in the detection of cardiac arrhythmias. The data collected by (...) an Internet of Things enabled ECG monitoring device are transferred to a server. They are analysed by a deep learning model, and the results are shared with the primary caregiver. The proposed model is trained using the MIT-BIH ECG arrhythmia database to classify into four classes: normal beat, left bundle branch block beat, right bundle branch block beat, and premature ventricular contraction. The received data are sampled with an overlapping sliding window and divided into an 80:20 ratio for training and testing, with tenfold cross-validation. The proposed method achieves higher accuracy with a simple model without any preprocessing when compared with previous works. For the train and test sets, we achieved accuracy rates of 99.09 and 99.03%, respectively. A precision, recall, and F1 scores of 0.99 is obtained. The proposed model achieves its goal of developing a simple and accurate ECG monitoring system with improved performance. This simple and efficient deep learning approach for heartbeat classification could be applied in real-time telehealth monitoring systems. (shrink)

The ventricular pressure profile is characteristic of the cardiac contraction progress and is useful to evaluate the cardiac performance. In this contribution, a tissue-level electromechanical model of the left ventricle is proposed, to assist the interpretation of left ventricular pressure waveforms. The left ventricle has been modeled as an ellipsoid composed of twelve mechano-hydraulic sub-systems. The asynchronous contraction of these twelve myocardial segments has been represented in order to reproduce a realistic pressure profiles. To take into account the different energy (...) domains involved, the tissue-level scale and to facilitate the building of a modular model, multiple formalisms have been used: Bond Graph formalism for the mechano-hydraulic aspects and cellular automata for the electrical activation. An experimental protocol has been defined to acquire ventricular pressure signals from three pigs, with different afterload conditions. Evolutionary Algorithms have been used to identify the model parameters in order to minimize the error between experimental and simulated ventricular pressure signals. Simulation results show that the model is able to reproduce experimental ventricular pressure. In addition, electro-mechanical activation times have been determined in the identification process. For example, the maximum electrical activation time is reached, respectively, 96.5, 139.3 and 131.5 ms for the first, second, and third pigs. These preliminary results are encouraging for the application of the model on non-invasive data like ECG, arterial pressure or myocardial strain. (shrink)

To provide basic health care services in rural areas is one of the major challenges for developing countries like Bangladesh because of lack of infrastructures and unavailability of qualified medical doctors in the villages. Telemedicine viewed as a new way of offering health care services that has the potential to overcome this problem. Author is a member of extended group at Dhaka University (DU) which has been developing telemedicine equipment and data acquisition software to promote telemedicine practice in Bangladesh. PC (...) based ECG equipment, Digital stethoscope, Digital microscope, Digital X-ray view box and some other essential medical equipment was developed for telemedicine services. The data acquisition software establishes an easy and appropriate patients to doctor interaction through a trained operator in a remote center that involve management and arrangement of consultation of a chosen and agreeing doctor by a patient. Upon establishing audio-visual connection between patient and doctor relevant physiological data from different diagnostic instruments will be uploaded securely in a dedicated web server which can be viewed real time using unique patient/doctor ID and password. Recently the Telemedicine group of DU and a local NGO named SAMAMA with support from Service innovation fund (SIF) of Prime Minister Office (PMO) of Bangladesh took the initiative to establish eight rural telemedicine centers and one expert center for the field trial of telemedicine in Bangladesh. The aim of this paper is to examine the ethical challenges of such health care system and our effort to overcome those problem before starting the field trial. (shrink)