Comparison of heart rate monitoring with indirect calorimetry for energy expenditure evaluation

Purpose:The purpose of this study was to compare established methods with newly-developed methods for estimating the total energy expenditure(TEE). Methods:The study subjects comprised 46 individuals,including 16 middle-aged men(mean age 51.4 years),14 middle-aged women(mean age 49.9 years) and 16 young women(mean age 19.1 years).The TEE was estimated from 24-h heart rate(HR) data using newly-developed software (MoveSense HRAnalyzer 201 la,RC1.Suunto Oy,Vantaa,Finland),and was compared against the TEE determined using doubly labeled water (DLW).Agreement between the two methods was analyzed using Bland and Altman plots. Results:The HR method yielded similar TEE values as the DLW method at the group level,with an average of 8.6 kcal/day in the difference in the mean,but with large individual variations.Forty-four(96%) out of 46 subjects fell within±2SD of the mean difference in TEE comparisons, and there was no tendency towards under- or over-estimation. Conclusion:Our results indicate that the current software using HR analysis for the estimation of daily TEE needs further development for use with free-living individuals.

An Intelligent Sensor Based System for Real Time Heart Rate Monitoring (HRM)

A method and apparatus for monitoring heart rate of the heart using a wearable system is designed and implemented in this paper. A heart rate receives from heart beat signals and stores the data to a database and after a time period this method can determine an idle heart rate of the monitoring body. This idle heart rate is compared with the stored data and can determine the normal and abnormal heart rate variability. After the certain time period this system can detect the heart rate and also can send a signal to the user in time of abnormalities. Consequent estimations of heart rate variability are contrasted with this.

An 8.12 μW wavelet denoising chip for PPG detection and portable heart rate monitoring in 0.18 μm CMOS

A low power wavelet denoising chip for photoplethysmography （PPG） detection and portable heart rate monitoring is presented. To eliminate noise and improve detection accuracy, Harr wavelet （HWT） is chosen as the processing tool. An optimized finite impulse response structure is proposed to lower the computational complexity of proposed algorithm, which is benefit for reducing the power consumption of proposed chip. The modulus max- ima pair location module is design to accurately locate the PPG peaks. A clock control unit is designed to further reduce the power consumption of the proposed chip. Fabricated with the 0.18μm N-well CMOS 1P6M technol- ogy, the power consumption of proposed chip is only 8.12μW in 1 V voltage supply. Validated with PPG signals in multiparameter intelligent monitoring in intensive care databases and signals acquired by the wrist photoelectric volume detection front end, the proposed chip can accurately detect PPG signals. The average sensitivity and positive prediction are 99.91% and 100%, respectively.

Heart Rate Monitoring Sensor Based on Singlemode-Multimode-Singlemode Fiber

The singlemode-multimode-singlemode(SMS)fiber structure for a heart rate monitoring is proposed and developed.An artificial electrocardiogram(ECG)signal is used to simulate the heart pulse at different rates ranging from 50 beats per minute(bpm)to 200 bpm.The SMS fiber structure is placed at the center of a loudspeaker and it senses the vibration of the pulse.The vibration of the pulse signal applied to the SMS fiber structure changes the intensity of the optical output power.The proposed sensor shows a linear frequency of the heart rate sensing range that matches well with the relevant heart rate from the artificial ECG.This work shows the capability of the SMS fiber structure monitoring the heart rate frequencies for a long term,high stability realization,and reproducibility,and being suitable for the observation in hospitals as well as in other environments.

Monitoring Heart Rate Variability Based on Self-powered ECG Sensor Tag

This paper proposes a batteryless sensing and computational device to collect and process electrocardiography(ECG)signals for monitoring heart rate variability(HRV).The proposed system comprises of a passive UHF radio frequency identification(RFID)tag,an extreme low power microcontroller,a low-power ECG circuit,and a radio frequency(RF)energy harvester.The microcontroller and ECG circuits consume less power of only~30μA and~3 mA,respectively.Therefore,the proposed RF harvester operating at frequency band of 902 MHz~928 MHz can sufficiently collect available energy from the RFID reader to supply power to the system within a maximum distance of~2 m.To extract R-peak of the ECG signal,a robust algorithm that consumes less time processing is also developed.The information of R-peaks is stored into an Electronic Product Code(EPC)Class 1st Generation 1st compliant ID of the tag and read by the reader.This reader is functioned to collected the R-peak data with sampling rate of 100ms;therefore,the user application can monitor fully range of HRV.The performance of the proposed system shows that this study can provide a good solution in paving the way to new classes of healthcare applications.

Critical evaluation of American categorization of fetal heart rate (FHR) decelerations and three tier classification—Shortcomings, contradictions, remedies and need for debate

Fetal heart rate (FHR) decelerations are the commonest aberrant feature on cardiotocograph (CTG) thus having a major influence on classification ofFHRpatterns into the three tier system. The unexplained paradox of early decelerations (head compression—an invariable phenomenon in labor) being extremely rare [1] should prompt a debate about scientific validity of current categorization. This paper demonstrates that there appear to be major fallacies in the pathophysiological hypothesis (cord compression—baroreceptor mechanism) underpinning of vast majority of (variable?) decelerations. Rapid decelerations during contractions with nadir matching peak of contractions are consistent with “pure” vagal reflex (head compression) rather than result of fetal blood pressure or oxygenation changes from cord compression. Hence, many American authors have reported that the abrupt FHR decelerations attributed to cord compression are actually due to head compression [2-6]. The paper debates if there are major fundamental fallacies in current categorization of FHR decelerations based concomitantly on rate of descent (reflecting putative aetiology?) and time relationship to contractions. Decelerations with consistently early timing (constituting majority) seem to get classed as “variable” because of rapid descent. A distorted unscientific categorization of FHR decelerations could lead to clinically unhelpful three tier classification system. Hence, the current unphysiological classification needs a fresh debate with consideration of alternative models and re-evaluation of clinical studies to test these. Open debate improves patient care and safety. The clue to benign reflex versus hypoxic nature of decelerations seems to be in the timing rather than the rate of descent. Although the likelihood of fetal hypxemia is related to depth and duration ofFHRdecelerations, the cut-offs are likely to be different for early/late/variable decelerations and it seems to be of paramount importance to get this discrimination right for useful visual or computerized system of CTG interpretation.

Foetal heart rate variability frequency characteristics with respect to uterine contractions

Monitoring foetal health is important to appropriately plan pregnancy management and delivery. Cardiotocography (CTG) is one of the most employed diagnostic techniques. Because CTG interpretation still lacks of complete reliability, new methods of interpretation and parameters are necessary to further support physicians’ decisions. To this aim, indexes related to variability of foetal heart rate (FHRV) are particularly studied. Frequency components of FHRV and their modifications can be analysed by applying a time-frequency approach, which allows for a distinct understanding of the spectral components related to foetal reactions to internal and external stimuli and their change over time. Being uterine contractions (UC) strong stimuli for the foetus and his autonomic nervous system (ANS), it is worth exploring the FHRV response to UC. This study analysed modifications of FHRV frequency characteristics with respect to 108 UC (relative to 35 healthy foetuses). Results showed a statistically significant (t-test, p < 0.01) power increase of the FHRV in both LF and HF bands in correspondence of the contractions. Moreover, we observed a shift to higher values of the maximum frequency contained in the signal corresponding to the power increase. Such modifications of the FHRV power spectrum can be a sign of ANS reaction and therefore represent additional, objective information about foetal reactivity and health during labour.

Interpretation of British experts’ illustrations of fetal heart rate (FHR) decelerations by Consultant Obstetricians, registrars and midwives: A prospective study—Reasons for major disagreement with experts and implications for clinical practice

Objective: To test the reproducibility of British experts’ (eFM, K2MS, Gibb and Arulkumaran) [1-3] illustrations of fetal heart rate (FHR) decelerations by trained British Obstetricians and midwives. To analyze reasons for any discrepancies by examining factors relating to the participants, British experts’ descriptions and NICE guidelines [4]. Design: Prospective observational study. Setting: National Health Service (NHS) Hospitals. Participants: 38 Obstetric Consultants, 49 registrars and 45 midwives. Methods: Printed questionnaire. Statistical Analysis: Fisher’s Exact test. Results: This largest study of its kind showed almost unbelievably high disconnect between CTG interpretation by experts and participants. 98% - 100% midwives, 80% - 100% Registrars and 74% - 100% Consultants categorized FHR decelerations differently from the five experts’ illustrations/interpretations (p < 0.0001). Remarkably, the three experts’ illustrations of early (supposedly most benign) decelerations were classed as atypical variable by 56% Consultants, 78% Registrars and 99% midwives and the CTGs as pathological by 85% of the participants. Conclusions: The high degree of disagreement with the experts’ illustrations (p < 0.0001) did not appear to be due to participant factors. The immediate reasons seemed to be the conflicting illustrations and heterogeneity of experts’ descriptions. But most importantly, these appeared to stem from non-standardized ambiguous definitions of FHR decelerations and many intrinsic systemic flaws in the current NICE guidelines [4]. The NICE concept of “true uniform” (identical) early and late decelerations seems biologically implausible (a myth) and no examples can be found. Another myth seems to be that early and late decelerations should be gradual. Only very shallow decelerations will look “gradual” on the British CTG. These systemic flaws lead to dysfunctional CTG interpretation increasing intervention as well as impairing diagnosis of fetal hypoxemia. This is because the vast majority of FHR decelerations fall in a single heterogeneous “variable” group with many further classed as “atypical” (pathological) based on disproven and discredited criteria [5-7]. There is increasing evidence in USA that a system with variable decelerations as the majority is clinically unhelpful because of loss of information [5-9]. In the interest of patient care and safety, open debate is necessary regarding a better way forward. Classification of FHR decelerations based primarily and solely on time relationship to contractions appears more scientific and clinically useful.

非Ⅲ级胎监胎心率基线变异消失时长与频率变化规律

目的探索非Ⅲ级胎监胎心率基线变异消失时长与频率变化规律。方法随机选取2020年1月至2023年5月规律产检并住院分娩的宫内单活胎孕妇2000例,依孕期是否有高危因素,分为高危组与低危组。孕28周开始行胎心监护,每天一次直至分娩,观察其基线变异消失时长与频率变化。结果孕28~40^(+6)周胎心率基线变异消失时长中位数:低危组为5.45~12.40 s/次、高危组为5.95~12.00 s/次;频率中位数:低危组为2.00~3.00次/20 min、高危组为2.00~3.00次/20 min。重复测量方差分析示:两组间胎心率基线变异消失时长与频率:时间效应、组间效应、交互效应差异均有统计学意义(P<0.05)。胎心率基线变异消失事件前12 h内:胎心率基线变异消失时长[M(P_(25),P_(75))]低危组为12.40(11.80,13.50)s/次,高危组为12.70(11.80,13.50)s/次;低危组与高危组胎心率基线变异消失频率[M(P_(25),P_(75))]均为4.00(3.00,5.00)次/20 min;重复测量方差分析示:两组间胎心率基线变异消失时长时间效应有统计学意义(P<0.05)。结论非Ⅲ级胎监胎心率基线变异消失是胎儿心率生理不成熟的表现,也受监测临床环境影响,胎儿越危险,其变异消失持续时间越长,当变异消失时长≥10 s/次,频率≥3次/20 min提示胎心率基线变异消失事件,需及时干预。

一种基于云端的老人摔倒告警系统

老人摔倒可能导致严重后果。鉴于此,开发一种基于云端的老人摔倒检测和告警系统或可避免此类问题。该系统采用STM32F103C8T6单片机作为主控,用传感器MAX30100采集老人的心率和血压值,传感器MPU6050采集老人摔倒的角度及加速度,A/D转换器转化为数字量,借助I2C总线把数字量送至微控制器,用ATK-1218-BD模块实现老人定位,ESP8266-01模块将采集的数据上传至云端,通过手机APP显示。系统可以监测老人当前状态,快速辨别其身姿,获取位置信息,满足实时监测和摔倒报警的要求。测试结果表明:系统总体布局合理,方案可行,运行稳定,误差不超过1%,实现了较精准的身姿识别,达到摔倒报警及远程监测的目的。

加味温胆汤联合西药治疗痰热内扰证失眠伴焦虑抑郁的临床观察

目的探讨加味温胆汤联合西药治疗痰热内扰证失眠伴焦虑抑郁共病患者的临床疗效。方法选取痰热内扰证失眠伴焦虑抑郁共病患者120例,随机分为对照组和治疗组各60例,对照组予以草酸艾司西酞普兰联用右佐匹克隆,治疗组在对照组的基础上予以加味温胆汤,两组患者均连续治疗6周。基线期、3个月比较两组多导睡眠监测参数和心率变异性变化,基线期、6周、3个月均比较两组量表评分。心率变异性内容包括:时域分析[正态区间的标准差(SDNN)、相邻RR间期差值的均方根(RMSSD)]和频域分析[低频(LF)、高频(HF)、LF/HF]。量表评分包括匹兹堡睡眠质量指数量表(PSQI)、失眠严重指数量表(ISI)评估睡眠情况,汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、抑郁症自我评估量表(PHQ-9)、广泛性焦虑障碍量表(GAD-7)评估焦虑抑郁情况。结果3个月时治疗组觉醒时间明显短于对照组,觉醒次数明显少于对照组,N3、REM期百分比均明显高于对照组(均P<0.05)。3个月时,治疗组RMSSD、HF值明显高于对照组,LF/HF值明显低于对照组(均P<0.05)。6周时,治疗组PSQI总分、睡眠质量、催眠药物、日间功能障碍明显低于对照组(均P<0.05),HAMA、HAMD、GAD-7评分明显低于对照组(均P<0.05);3个月时治疗组睡眠质量、催眠药物、日间功能障碍明显低于对照组(均P<0.05),HAMA、GAD-7评分均明显低于对照组(均P<0.05)。结论加味温胆汤联合西药治疗可以明显优化痰热内扰证失眠伴焦虑抑郁共病患者的睡眠结构,提高睡眠连续性、加深睡眠深度,同时可改善副交感神经功能活动,有助于自主神经功能平衡,可以改善近期失眠、抑郁症状,短期明显改善焦虑症状,且安全性好。

基于家庭远程血压/心率监测系统的医院外心衰管理效果观察

目的分析家庭远程血压/心率监测在左心力衰竭(心衰)合并高血压患者中的医院外应用效果。方法前瞻性选取2020年7月至2021年6月粤北人民医院心血管内科住院确诊为左心衰合并高血压患者420例,根据患者出院后是否同意进行家庭远程血压/心率监测分为远程监测组(112例)和常规随诊组(278例)。远程监测组每天早、晚进行血压和心率测量并上传数据至医护终端,医护团队根据测量结果及时指导患者生活方式、用药及进一步治疗;常规随访组自行测量血压和心率并登记,定期门诊随诊。记录2组患者出院后第1、3、6、12个月血压和心率控制值,非计划再次入院率及时间间距,全因死亡和心血管疾病死亡情况。结果远程监测组患者出院后第1、3、6、12个月收缩压,以及出院后第6、12个月心率均明显低于常规随访组,非计划再次入院率明显低于常规随访组,再入院时间间距明显长于常规随访组,差异均有统计学意义(P<0.05);2组患者全因死亡率、心血管疾病死亡率比较,差异均无统计学意义(P>0.05)。结论家庭远程血压/心率监测有利于平稳控制心衰合并高血压患者出院后的血压和心率,延迟患者再入院时间间距,降低患者再住院率。

基于STM32的智能健康手环设计与实现

随着我国全面进入小康社会,人们对自身健康状况越来越关注,个人健康助手类的产品也因此在市场上风靡起来。健康智能手环是一种时尚便捷的可穿戴智能设备。该文设计一款基于STM32单片机和MAX30102等模块的个人健康助手系统。使用者通过该系统可以实时了解自身的健康状况。该系统具有设计小巧、便于携带、方便使用等特点,即时反馈人的身体健康状况,起到保护使用者身体健康的作用。

基于物联网技术的智慧健康监测系统设计与实现

传统的医疗模式很难及时获取人的健康数据,不能实现对老年人健康及姿态信息的实时监控。文中以STM32F103单片机为核心控制器,采用心率血氧传感器、姿态传感器等采集身体健康数据,通过MQTT物联网协议将其上传至阿里云平台,并应用云端数据分析处理平台对身体健康数据进行实时分析和预警。系统经过测试,当用户跌倒或心率血压异常时,设备会发出警报声,提醒周围人进行救护,同时监护人手机会收到异常预警。

基于手机指尖视频的心率提取算法研究

目的:为降低环境因素对心率提取的影响,提出一种基于手机指尖视频的心率提取算法。方法:首先,采集指尖视频并按照30帧/s的帧率进行图像提取,并将图像分离成R、G、B 3个通道图像。通过对比3个通道图像的亮度变化强弱情况,选取对指尖血流信号最为敏感的G通道作为信号源,提取图像亮度变化信息生成时长为10 s的容积脉搏波。其次,对该波形进行数字滤波、去除基线漂移、傅里叶变换等信号处理后,根据最大谱峰位置信息预估心率。最后,在BUT PPG数据集(Brno University of Technology Smartphone PPG Database)上验证提出的算法对心率的预测效果。结果:提出的算法心率预测值与实际心率的均方差、均方根差和平均绝对误差分别为3.71、1.92和1.2次/min。结论:提出的算法预测心率的准确率高,适合部署于手机进行日常心率监测。

胎心仪产品服务体验优化设计策略与实践研究

随着人民对美好生活需求的日益增长,医疗康养产品设计成为设计研究的热点之一。本文以孕期胎心仪为例,对其开展体验优化的应用性设计研究。首先基于对孕妇群体的深度访谈,总结出两类典型用户画像;其后以服务可视化分析,寻找设计机会点,制订设计策略;最后完成胎心仪设计实践。实践表明,采用服务设计理念对胎心仪产品进行创新设计,能够形成具有深层特征的形态语言,完成体验结构的升级,能为相关产品的开发提供有益参考。

基于STM32的智能穿戴式人体生理参数监测仪

基于智能穿戴式人体生理参数监测仪的功能,采用STM32单片机作为核心控制器,对心率、步数和温度等生理参数进行研究,完成了步数检测模块电路、心率采集模块电路、温度采集模块、显示模块电路和电源管理模块的设计。实验测试表明,该系统测量准确率高、功耗低,可实时监控人体生理参数,具有很高的实用价值。

胎儿脐血流监测及胎心监护监测在高危妊娠中的预测价值

目的探讨高危妊娠应用胎儿脐血流监测及胎心监护监测的预测价值。方法回顾性分析2021年3月—2023年3月中国人民解放军空军特色医学中心妇产科收治的180例高危妊娠孕妇的临床资料,均开展胎儿脐血流监测和胎心监护监测。根据产前脐血流和胎心的监测结果,将研究对象分为甲组、乙组、丙组、丁组4组。对比4组的分娩指标(剖宫产、胎儿窘迫、脐带缠绕、羊水过少、胎粪污染、新生儿出生1 min内阿氏评分)、脐血流指标[脐动脉血流比值(systolic to diastolic velocity ratio,S/D)、脐动脉阻力指数(resistance index,RI)、脐动脉搏动指数(pulsatility index,PI)]。结果丁组剖宫产(79.17%)、胎儿窘迫(50.00%)、脐带缠绕(50.00%)、羊水过少(70.83%)、胎粪污染(100.00%)的不良分娩情况发生率最高,显著高于甲组、乙组,差异有统计学意义(P<0.05)。甲组新生儿出生1 min内阿氏评分8~10分比例显著高于乙组、丙组、丁组(P<0.05)。乙组和丙组新生儿出生1 min内阿氏评分8~10分比例均高于丁组(P<0.05)。丁组脐动脉血流指标(S/D值、RI、PI)高于甲组、乙组、丙组,差异有统计学意义(P<0.05)。结论对高危妊娠孕妇应用胎儿脐血流监测及胎心监护监测,可对不良妊娠结局提高预测准确性,有助于围产期的治疗与管理,减少不良分娩结局的产生,提高分娩质量。

基于物联网的胎心监护系统在孕晚期羊水量过少孕妇胎儿监测中的应用研究

目的:探讨基于物联网的胎心监护系统在孕晚期羊水量过少孕妇胎儿监测中的应用。方法:将2019年6月—2020年6月商丘市妇幼保健院产科收治的68例孕晚期羊水量过少孕妇设为对照组,将2020年7月—2021年7月收治的70例孕晚期羊水量过少孕妇设为观察组。对照组孕妇采用传统产前监护,观察组孕妇采用基于物联网的胎心监护系统实施监护。比较两组孕妇胎动异常发生率、新生儿无刺激性胎心监护(NST)异常检出率、孕妇不良妊娠结局及孕妇胎心监护满意度。结果:观察组新生儿NST异常检出率高于对照组,差异有统计学意义(U=9.992,P<0.05)。观察组胎动异常发生率比较,差异无统计学意义(χ^(2)=0.032,P>0.05)。观察组新生儿窒息发生率、早产发生率低于对照组,差异有统计学意义(χ^(2)=6.356、2.630,P<0.05);两组产妇不良妊娠结局中中转剖宫产率、新生儿吸入羊水发生率、产后出血发生率、术后感染发生率、新生儿缺血缺氧性脑病发生率比较,差异无统计学意义(χ^(2)=0.708、0.239、0.759、0.183、0.371,P>0.05)。观察组孕妇胎心监护满意度高于对照组,差异有统计学意义(χ^(2)=8.742,P<0.05)。结论:基于物联网的胎心监护系统可有效提高孕晚期羊水量过少孕妇胎儿的监测效果,有效降低孕妇不良妊娠结局发生率,提高孕妇胎心监护满意度。

产时胎心监护结合心理护理在分娩产妇中的应用

目的探讨产时胎心监护结合心理护理在分娩产妇中的应用效果。方法选取2016年11月至2020年11月在我院分娩的产妇126例,随机分为两组各63例。参照组产妇采用常规护理干预,观察组在参照组基础上采用产时胎心监护结合心理护理干预。比较两组的产妇并发症、新生儿1min Apgar评分以及新生儿不良事件。结果观察组产妇的并发症总发生率明显低于参照组,新生儿1min Apgar评分明显高于参照组,新生儿不良事件总发生率明显低于参照组(P<0.05)。结论产时胎心监护结合心理护理在分娩产妇中应用效果显著,可明显提高新生儿1minApgar评分,减少产妇并发症和新生儿不良事件的发生。