Multiple Physiological Parameters Research Articles

Fully Integrated Passive Wireless Sensor with Mechanical-Electrical Double-Gradient for Multifunctional Healthcare Monitoring.

Accurate, effective, and continuous monitoring of pressure, moisture, and temperature is essential for routine health assessments and professional patient care. In this study, we present a fully integrated multiparameter passive wireless sensor (MWS) that employs a mechanical-electrical dual-gradient structure design. The unique gradient porous structure endows the MWS with significant advantages in terms of detection dimensions (pressure, moisture, and temperature), sensitivity, and stability. Compared to single mechanical gradient designs, the sensor demonstrates 2.6 times higher pressure sensitivity and a 5-tier moisture detection capability. By bridging the technology gap between high-precision multiparameter sensing, wireless communication, and energy management, the MWS is capable of measuring multiple physiological parameters, including breath, ballistocardiograph, moisture, and temperature at multiple points, providing real-time assessments of the physiological state of the subjects. This work offers valuable quantitative insights for caregivers and paves the way for significant advancements in personal healthcare management.

Promoting tomato resilience: effects of ascorbic acid and sulfur-treated biochar in saline and non-saline cultivation environments

The resilience of tomato plants under different cultivation environments, particularly saline and non-saline conditions, was investigated by applying various treatments, including 0.5% Ascorbic Acid (AsA) and 1% Sulphur-treated Biochar (BS). The study evaluated parameters such as fruit length, diameter, yield per plant and pot, Total Soluble Solids (TSS) content, chlorophyll content, electrolyte leakage, enzyme activities (Superoxide Dismutase - SOD, Peroxidase - POD, Catalase - CAT), and nutrient content (Nitrogen - N%, Phosphorus - P%, Potassium - K%). Under saline conditions, significant enhancements were observed in fruit characteristics and yield metrics with the application of AsA and BS individually, with the combined treatment yielding the most substantial improvements. Notably, AsA and BS treatments exhibited varying effects on TSS levels, chlorophyll content, electrolyte leakage, and enzyme activities, with the combination treatment consistently demonstrating superior outcomes. Additionally, nutrient content analysis revealed notable increases, particularly under non-saline conditions, with the combined treatment showcasing the most significant enhancements. Overall, the study underscores the potential of AsA and BS treatments in promoting tomato resilience, offering insights into their synergistic effects on multiple physiological and biochemical parameters crucial for plant growth and productivity.

Sex differences in physiological responses and thermal perception during repeated extremely cold exposure (−15 °C)

People working in cold regions often need to move frequently between indoor and outdoor environments. Due to sex differences in metabolic rates and thermal sensitivity, repeated exposure to large temperature differences may stress physiological and perceptual systems of males and females differently. This study aims to explore the physiological responses and thermal perception changes in males and females repeatedly exposed to −15 °C. The experiment involved 20 participants (gender balanced), who experienced two consecutive cycles of cold exposure. Each cycle included 30 min of cold exposure and 30 min of recovery. During the experiment, multiple physiological parameters as well as overall and local thermal perception were recorded. The experimental results indicate that repeated cold exposure can lead to thermal habituation in both males and females. Males exhibited higher skin temperatures in extremities such as the hands, fingers, face, and feet, while females reported lower thermal sensations in these areas during the recovery period. Furthermore, repeated cold exposure has a greater impact on the rate of recovery of extremity skin temperatures in females, requiring a longer recovery time compared to males. This article has reference value for considering sex differences in the design of temporary transition spaces in winter, which is beneficial to improving thermal comfort and energy efficiency.

Impact of Aficamten on Echocardiographic Cardiac Structure and Function in Symptomatic Obstructive Hypertrophic Cardiomyopathy

BackgroundAficamten, a next-in-class cardiac myosin inhibitor, improved peak oxygen uptake (pVO2) and lowered resting and Valsalva left ventricular outflow (LVOT) gradients in adults with symptomatic obstructive hypertrophic cardiomyopathy (oHCM) in SEQUOIA-HCM (Phase 3 Trial to Evaluate the Efficacy and Safety of Aficamten Compared to Placebo in Adults With Symptomatic oHCM), a phase 3, multicenter, randomized, double-blinded, placebo-controlled study. ObjectivesThe authors sought to evaluate the effect of aficamten on echocardiographic measures of cardiac structure and function in SEQUOIA-HCM. MethodsSerial echocardiograms were performed over 28 weeks in patients randomized to receive placebo or aficamten in up to 4 individually titrated escalating doses (5-20 mg daily) over 24 weeks based on Valsalva LVOT gradients and left ventricular ejection fraction (LVEF). ResultsAmong 282 patients (mean age 59 ± 13 years; 41% female, 79% White, 19% Asian), mean LVEF was 75% ± 6% with resting and Valsalva LVOT gradients of 55 ± 30 mm Hg and 83 ± 32 mm Hg, respectively. Over 24 weeks, aficamten significantly lowered resting and Valsalva LVOT gradients, and improved left atrial volume index, lateral and septal eʹ velocities, and lateral and septal E/eʹ (all P ≤ 0.001). LV end-systolic volume increased and wall thickness decreased (all P ≤ 0.003). Aficamten resulted in a mild reversible decrease in LVEF (−4.8% [95% CI: −6.4% to −3.3%]; P < 0.001) and absolute LV global circumferential strain (−3.7% [95% CI: 1.8%-5.6%]; P < 0.0010), whereas LV global longitudinal strain was unchanged. Several measures, including LVEF, LVOT gradients, and E/eʹ returned to baseline following washout. Among those treated with aficamten, improved pVO2 and reduction in N-terminal pro–B-type natriuretic peptide (NT-proBNP) were associated with improvement in lateral eʹ velocity and septal and lateral E/eʹ (all P < 0.03), whereas improvement in Kansas City Cardiomyopathy Questionnaire Clinical Summary Scores (KCCQ-CSS) was associated with a decrease in both LVOT gradients (all P < 0.001). ConclusionsCompared with placebo, patients receiving aficamten demonstrated significant improvement in LVOT gradients and measures of LV diastolic function, and several of these measures were associated with improvements in pVO2, KCCQ-CSS, and NT-proBNP. A modest decrease in LVEF occurred yet remained within normal range. These findings suggest aficamten improved multiple structural and physiological parameters in oHCM without significant adverse changes in LV systolic function. (Phase 3 Trial to Evaluate the Efficacy and Safety of Aficamten Compared to Placebo in Adults With Symptomatic oHCM [SEQUOIA-HCM]; NCT05186818)

Ca2+/ethanol driven in-situ integration of tough, antifreezing and conductive silk fibroin/polyacrylamide hydrogels for wearable sensors and electronic skin

Integrating high strength, flexibility, biocompatibility, adhesion, and freezing resistance into conductive hydrogels for developing wearable electronic devices has consistently posed significant challenges in relevant research fields. Inspired by the silk dissolution behavior, a robust, flexible, antifreezing, and conductive silk fibroin/polyacrylamide (SF/PAM) hydrogel was synthesized in a CaCl2-ethanol–water (Ca2+/E/W) ternary solvent via a one-pot photogelation process. The gelation of SF and AM was enhanced by the ternary solvent, attributed to the inhibitory effects of Ca2+ ions and alcohols on hydrogen bond formation. The SF/PAM hydrogels based on Ca2+/E/W exhibited desirable mechanical properties (stretching: 800 % strain and 120 kPa stress; compression: 80 % strain and 334.0 kPa stress), excellent recoverability after deformation, high ion conductivity (2.4 S·cm−1) and strain sensitivity (gauge factor: ∼2.0), and low-temperature tolerance (−60 °C). These hydrogels were assembled into various wearable electronic devices, such as strain sensors, electronic skin, and electrodes, for detecting multiple physiological parameters, including joint activities, bioelectrical signals, and subtle movements like finger and wrist rotation, heartbeat, and vocal cord vibrations, demonstrating significant potential in flexible electronic applications.

Pulse Wave Velocity: Methodology, Clinical Applications, and Interplay with Heart Rate Variability.

Pulse wave velocity (PWV) has been established as a promising biomarker in cardiovascular diagnostics, providing deep insights into vascular health and cardiovascular risk. Defined as the velocity at which the mechanical wave propagates along the arterial wall, PWV represents a useful surrogate marker for arterial vessel stiffness. PWV has garnered clinical attention, particularly in monitoring patients suffering from vascular diseases such as hypertension and diabetes mellitus. Its utility extends to preventive cardiology, aiding in identifying and stratifying cardiovascular risk. Despite the development of various measurement techniques, direct or indirect tonometry, Doppler ultrasound, oscillometric analysis, and magnetic resonance imaging (MRI), methodological variability and lack of standardization lead to inconsistencies in PWV assessment. In addition, PWV can be estimated through surrogate parameters, such as pulse arrival or pulse transit times, although this heterogeneity limits standardization and, therefore, its clinical use. Furthermore, confounding factors, such as variations in sympathetic tone, strongly influence PWV readings, thereby necessitating careful control during assessments. The bidirectional relationship between heart rate variability (HRV) and PWV underscores the interplay between cardiac autonomic function and vascular health, suggesting that alterations in one could directly influence the other. Future research should prioritize the standardization and increase comparability of PWV measurement techniques and explore the complex physiological variables influencing PWV. Integrating multiple physiological parameters such as PWV and HRV into algorithms based on artificial intelligence holds immense promise for advancing personalized vascular health assessments and cardiovascular care.

Integrated pulmonary index during procedural sedation and analgesia: A cluster-randomized trial.

To evaluate the effectiveness of utilizing the integrated pulmonary index for capnography implementation during sedation administered by nurses. Cluster-randomized trial. Participants were enrolled from the interventional radiology department at an academic hospital in Canada. Nurses were randomized to either enable or disable the Integrated Pulmonary Index feature of the capnography monitor. Procedures were observed by a research assistant to collect information about alarm performance characteristics. The primary outcome was the number of seconds in an alert condition state without an intervention being applied. The number of seconds in an alarm state without intervention was higher in the group that enabled the integrated pulmonary index compared to the group that disabled this feature, but this difference did not reach statistical significance. Likewise, the difference between groups for the total alarm duration, total number of alarms and the total number of appropriate alarms was not statistically significant. The number of inappropriate alarms was higher in the group that enabled the Integrated Pulmonary Index, but this estimate was highly imprecise. There was no difference in the odds of an adverse event (measured by the Tracking and Reporting Outcomes of Procedural Sedation tool) occurring between groups. Desaturation events were uncommon and brief in both groups but the area under the SpO2 90% desaturation curve scores were lower for the group that enabled the integrated pulmonary index. Enabling the integrated pulmonary index during nurse-administered procedural sedation did not reduce nurses' response times to alarms. Therefore, integrating multiple physiological parameters related to respiratory assessment into a single index did not lower the threshold for intervention by nurses. The time it takes to respond to capnography monitor alarms will not be reduced if the integrated pulmonary Iindex feature of capnography monitors is enabled during nurse-administered procedural sedation. Results do not support the routine enabling of the integrated pulmonary index when nurses use capnography to monitor patients during procedural sedation as a strategy to reduce the time it takes to initiate responses to alarms. CONSORT. There was no patient or public contribution. This study was prospectively registered at ClinicalTrials.gov (ID: NCT05068700).

Defining cardiac stability during Langendorff perfusion

The Langendorff heart preparation is a valuable ex vivo technique for studying cardiac electrophysiology. For the past century it has been used in toxicology studies, drug testing, and disease modeling and has contributed significantly to understanding cardiac physiology, development, and pathological states. This study aimed to investigate the stability and reproducibility of the modern Langendorff heart preparation under various experimental conditions and to establish cardiac metric standards with corresponding exclusion criteria. Isolated hearts were extracted from adult Sprague Dawley rats and retrograde perfused with a modified Krebs-Henseleit buffer. A cohort of isolated hearts were used to establish a control baseline of multiple physiological parameters measured over time (e.g., electrocardiogram, flow rate, electrophysiology, electrical and calcium dynamics). These control baseline values were then compared to hearts exposed to the most common media additives in Langendorff studies (e.g., blebbistatin(−/−), bovine serum albumin, and voltage and calcium indicator dye). Over a three-hour period, cardiac metrics were monitored in stable Langendorff-perfused hearts. The addition of blebbistatin, DMSO or dyes did not change EP or ECG measurements as compared to control baseline. The most significant drift in all the EP values was ventricular effective refractory period (VERP). With or without blebbistatin, VERP increased from 40 to 60ms over the course of three hours. In that time heart rate and flow also decreased slightly. Blebbistatin was associated with an increased action potential duration but did not alter calcium transient duration. It was also observed that 1% circulating bovine serum albumin quenched the rh237 voltage dye signal 80% as measured by signal to noise. Constant pressure Langendorff-perfusion with a crystalloid buffer provides a reliable and reproducible model for cardiac electrophysiology research with a few caveats. The total length of study should be carefully considered to account for adaptations in cardiac physiology during longer perfusion times. As an excitation-contraction uncoupler, blebbistatin reduces motion artifact but delays action potential duration. Although BSA is used to minimize cardiac edema, it interferes with membrane bound voltage dyes. This study sets physiological parameters as a useful guide for future cardiac studies that use the isolated heart as a research model. American Physiological Society, R01HD108839 to N.G.P. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

A review of infant apnea monitor design

Apnea detection is critical to the management of infant apnea. Effective monitoring and management of apnea using apnea monitors is known to reduce complications and possible fatalities in infants. There is a need to determine the critical design considerations in apnea monitors. This article reviews the design and development of infant apnea monitors. We conducted a targeted literature review from different databases, including PubMed, ScienceDirect, and Google Scholar. We reviewed articles published between January 1995 and February 2023. The search was done using combinations of key terms, namely, “apnea,” “apnea monitors,” and “apnea monitor design.” Articles that met the inclusion criteria were extracted and analyzed. The review investigated common physiological parameters, sensor types, and validation results of apnea monitors. The review revealed important design considerations adopted in the literature as well as the different sensor types and methods of apnea detection. It was found that thoracic impedance pneumography, thermistors, respiratory inductance plethysmography, pneumotachograph, and MEMS accelerometer are the most common sensor types used to design apnea monitors. The review revealed that most apnea monitors were designed to measure multiple physiological parameters. Device validation results varied from one device to another, with sensitivity and specificity metrics ranging between 80% and 96%. With the high burden of infant apnea in developing countries and its associated mortality and morbidity, the design of functional infant apnea monitors has become increasingly important to complement the expensive and complex polysomnography technique. Therefore, we must use appropriate sensors and design approaches for effective detection of infant apnea.

Systematic Review on Fabrication, Properties, and Applications of Advanced Materials in Wearable Photoplethysmography Sensors

AbstractPhotoplethysmography (PPG) technology enables the measurement of multiple physiological and psychological parameters with low‐cost wearable sensors and is reshaping modern healthcare. Advanced materials play a vital role in improving reliability and accuracy of PPG sensors. Recently, various advanced materials have been explored to optimize PPG sensor design, while some challenges exist toward large‐scale validation and mass production. This paper focuses on advanced materials applied in the photodetectors, light sources, and circuits of PPG sensors. The materials are categorized into four groups: inorganic, organic, nanomaterials, and hybrid materials. The properties and fabrication processes are summarized. Other technical details including the mode of operation, measurement sites, testing, and validation are discussed. The merits and limitations of the state of the art are highlighted to provide some suggestions for the future development of PPG sensors based on advanced materials.

Continuous Glycemic Monitoring Enabled by A Wi‐Fi Energy‐Harvesting Wearable Sweat‐Sensing Patch

AbstractContinuous monitoring of multiple physiological parameters, such as glucose levels, temperature, and heart rate variability (HRV) is crucial for effective diabetes management and mitigating the risks associated with hypoglycemic events. These events often occur without apparent symptoms, posing a challenge for diabetic patients in managing their condition. Therefore, a non‐invasive wearable device capable of continuously measuring multiple body signals to predict hypoglycemic events would be highly beneficial. In this study, a wearable patch that continuously measures glucose, temperature, and HRV is presented. The device uses a novel power harvesting system to convert radiofrequency (RF) signals with the frequency of 2.45 GHz to direct current (DC) signals to extend the battery life for further continuous monitoring. The patch is small and has a conformal structure that can easily fit onto different body parts. The screen‐printed glucose sensor demonstrates a sensitivity of 10.3 nA cm−2 µM−1, a limit of detection (LOD) of 8.9 µM, and a limit of quantification (LOQ) of 27 µM. The device employs a photoplethysmography (PPG) module with a peak‐finding algorithm to calculate the HRV values. In vivo experiments demonstrate the validation of the device's proper operation in glucose, HRV, and temperature measurement.

Multimodal neuromonitoring in the pediatric intensive care unit

Neuromonitoring is used to assess the central nervous system in the intensive care unit. The purpose of neuromonitoring is to detect neurologic deterioration and intervene to prevent irreversible nervous system dysfunction. Neuromonitoring starts with the standard neurologic examination, which may lag behind the pathophysiologic changes. Additional modalities including continuous electroencephalography (CEEG), multiple physiologic parameters, and structural neuroimaging may detect changes earlier. Multimodal neuromonitoring now refers to an integrated combination and display of non-invasive and invasive modalities, permitting tailored treatment for the individual patient. This chapter reviews the non-invasive and invasive modalities used in pediatric neurocritical care.

Antibacterial highly sensitive eco-friendly wearable piezoresistive sensor for monitoring multiple physiological parameters

Recent progress in wearable biomedical devices has made real-time monitoring possible through non-invasive wearable strain sensors, which can transform physical or biological signals into electrical responses. This work has fabricated multifunctional wearable strain sensors by coating composites (SiE-µG) of electrochemically exfoliated micro-sized multi-layer graphene flakes (µG) and Silicone elastomer (SiE) onto stretchable textile-based orthopedic bandage having ZnO adhesive (SiE-µG@Bandage). The composite coated textile sensors exhibited a remarkable sensitivity of 18330, large stretchability of 35%, superior mechanical durability of 50000 cycles, minute detection limit of 0.04% strain, and fast response time of 400 and recovery time 900 ms. The SiE-µG@Bandage also showed antibacterial properties against Escherichia coli (E. coli) bacteria. Additionally, zinc oxide-based skin-friendly and non-toxic adhesive on the backside of the bandage allowed stable and conformal attachment with the skin. Owing to the above merits, the sensors have shown applicability in real-time monitoring of various physical activities, physiological signals, joint movements, yoga postures, and meditation. Furthermore, the relevance of the sensors in the man-machine interaction has been demonstrated via real-time monitoring of traffic signals by finger movements. Moreover, the exceptional performance and specific features of the SiE-µG@Bandage sensors have enabled their application as electronics skins in health care and preventive care.

Consensus for the Development of a New Early Warning Score for Predicting Patients' Clinical Deterioration in Angola: A Delphi Study.

Background: Nearly 30 years since its inception, the early warning scores (EWSs) remain pivotal, yet variations have emerged for hospital and prehospital use. Aggregated scores, reflecting multiple physiological parameters, outperform single-parameter systems in assessing acute illness severity, though consensus on optimal approaches is lacking. Resource-limited countries, including Angola, lack adapted EWSs, emphasizing the need for cost-effective and adaptable solutions to enhance patient care. Objective: To explore the perspectives of Angolan experts to identify physiological parameters suitable for incorporation into existing EWSs, allowing the development of a new tool adjusted to the healthcare context in Angola. Methods: We conducted a three-round Delphi survey, engaging a national expert panel comprising twenty-five physicians and nurses with expertise in internal medicine, surgery, emergency rooms, intensive care units, and/or teachers at universities or at teaching courses in these fields. Participants were asked to rate items using a five-point Likert scale. Consensus was achieved if the items received a rating ≥ 80% from the panel. Results: Consensus was evident for the inclusion of standard physiological parameters, such as systolic blood pressure, heart rate, respiratory rate, temperature, oxygen saturation, neurological status, and the presence or absence of supplemental oxygen. Furthermore, there was consensus for the consideration of specific items, namely, seizures, jaundice, cyanosis, capillary refill time, and pain-typically not included in the current EWSs. Consensus was reached regarding the exclusion of both oxygen saturation and temperature measurements in healthcare settings where oximeters and thermometers might not be readily available. Conclusion: Angolan experts were able to identify the physiological parameters suitable for incorporation into the basic EWSs. Further study must be conducted to test and validate the impact of the newly suggested vital parameters on the discriminant and predictive capability of a new aggregated model specifically adjusted to the Angolan healthcare setting.

A New Intelligent Approach for Automatic Stress Level Assessment Based on Multiple Physiological Parameters Monitoring

A New Intelligent Approach for Automatic Stress Level Assessment Based on Multiple Physiological Parameters Monitoring

Comparison of the Buffalo Concussion Treadmill Test With a Physiologically Informed Cycle Test: Calgary Concussion Cycle Test.

Sport-related concussions are a complex injury requiring multifaceted assessment, including physical exertion. Currently, concussion testing relies primarily on a treadmill-based protocol for assessing exertion-related symptoms in persons after concussion. This study compared a modified cycle protocol (Calgary Concussion Cycle Test [CCCT]) with the clinically adopted standard, the Buffalo Concussion Treadmill Test (BCTT), across multiple physiological parameters. Treadmill and cycle matched workload protocols would produce similar results for cerebral blood velocity, mean arterial pressure (MAP), and end-tidal carbon dioxide partial pressure (PETCO2), but heart rate (HR) and oxygen consumption (VO2) would be higher on the treadmill than the cycle modality. Crossover study design. Level 3. A total of 17 healthy adults (8 men, 9 women; age, 26 ± 3 years; body mass index, 23.8 ± 2.7 kg/m2) completed the BCTT and CCCT protocols, 7 days apart in a randomized order. During both exertional protocols, the physiological parameters measured were middle cerebral artery mean blood velocity (MCAv), MAP, PETCO2, VO2, and HR. Analysis of variance with effect size computations, coefficient of variation, and Bland-Altman plots with 95% limits of agreement were used to compare exercise tests. The BCTT and CCCT produced comparable results for both male and female participants with no significant differences for average MCAv, MAP, and PETCO2 (all P > 0.05; all generalized eta squared [η2G] < 0.02 [negligible]; P value range, 0.29-0.99) between stages. When accounting for exercise stage and modality, VO2 (P < 0.01) and HR (P < 0.01) were higher on the treadmill compared with the cycle. Aside from the final few stages, all physiology measures displayed good-to-excellent agreeability/variability. The CCCT was physiologically similar to the BCTT in terms of MCAv, PETCO2, and MAP; however, HR and VO2 differed between modalities. Providing a cycle-based modality to exertional testing after injury mayincrease accessibility to determine symptom thresholds in the future.

Combined Soil Microorganism Amendments and Foliar Micronutrient Nanofertilization Increased the Production of Allium cepa L. through Aquaporin Gene Regulation.

The aim of this study was to investigate the impact of changes in aquaporin expression on the growth of onion (Allium cepa L.) plants when subjected to dual applications of microorganism-based soil amendments and foliar nanoencapsulated mineral nutrients. Multiple physiological parameters related to water, gas exchange, and nutrient content in leaf, root, and bulb tissues were determined. Additionally, the gene expression of aquaporins, specifically PIP1, PIP2 (aquaporin subfamily plasma membrane intrinsic protein), and TIP2 (aquaporin subfamily tonoplast intrinsic protein), was analyzed. The findings revealed that the foliar application of nutrients in a nanoencapsulated form significantly enhanced nutrient penetration, mobilization, and overall plant growth to a greater extent than free-form fertilizers. Amendments with microorganisms alone did not promote growth but influenced the production of secondary metabolites in the bulbs. The combination of microorganisms and nanoencapsulated mineral nutrients demonstrated synergistic effects, increasing dry matter, mineral content, and aquaporin gene expression. This suggests that aquaporins play a pivotal role in the transport of nutrients from leaves to storage organs, resulting in the overexpression of PIP2 aquaporins in bulbs, improved water uptake, and enhanced cell growth. Therefore, the combined treatment with microorganisms and nanoencapsulated mineral nutrients may be an optimal approach for enhancing onion productivity by regulating aquaporins under field conditions.

Machine learning-based clinical decision support for infection risk prediction.

Healthcare-associated infection (HAI) remains a significant risk for hospitalized patients and a challenging burden for the healthcare system. This study presents a clinical decision support tool that can be used in clinical workflows to proactively engage secondary assessments of pre-symptomatic and at-risk infection patients, thereby enabling earlier diagnosis and treatment. This study applies machine learning, specifically ensemble-based boosted decision trees, on large retrospective hospital datasets to develop an infection risk score that predicts infection before obvious symptoms present. We extracted a stratified machine learning dataset of 36,782 healthcare-associated infection patients. The model leveraged vital signs, laboratory measurements and demographics to predict HAI before clinical suspicion, defined as the order of a microbiology test or administration of antibiotics. Our best performing infection risk model achieves a cross-validated AUC of 0.88 at 1 h before clinical suspicion and maintains an AUC >0.85 for 48 h before suspicion by aggregating information across demographics and a set of 163 vital signs and laboratory measurements. A second model trained on a reduced feature space comprising demographics and the 36 most frequently measured vital signs and laboratory measurements can still achieve an AUC of 0.86 at 1 h before clinical suspicion. These results compare favorably against using temperature alone and clinical rules such as the quick sequential organ failure assessment (qSOFA) score. Along with the performance results, we also provide an analysis of model interpretability via feature importance rankings. The predictive model aggregates information from multiple physiological parameters such as vital signs and laboratory measurements to provide a continuous risk score of infection that can be deployed in hospitals to provide advance warning of patient deterioration.

Continuous Physiological Monitoring of the Combined Exposure to Hypoxia and High Cognitive Load in Military Personnel.

Military aviators endure high cognitive loads and hypoxic environments during flight operations, impacting the autonomic nervous system (ANS). The synergistic effects of these exposures on the ANS, however, are less clear. This study investigated the simultaneous effects of mild hypoxia and high cognitive load on the ANS in military personnel. This study employed a two-factor experimental design. Twenty-four healthy participants aged between 19 and 45 years were exposed to mild hypoxia (14.0% O2), normoxia (21.0% O2), and hyperoxia (33.0% O2). During each epoch (n = 5), participants continuously performed one 15 min and one 10 min series of simulated, in-flight tasks separated by 1 min of rest. Exposure sequences (hypoxia-normoxia and normoxia-hyperoxia) were separated by a 60 min break. Heart rate (HR), heart rate variability (HRV), and O2 saturation (SpO2) were continuously measured via an armband monitor (Warfighter MonitorTM, Tiger Tech Solutions, Inc., Miami, FL, USA). Paired and independent t-tests were used to evaluate differences in HR, HRV, and SpO2 within and between exposure sequences. Survival analyses were performed to assess the timing and magnitude of the ANS responses. Sympathetic nervous system (SNS) activity during hypoxia was highest in epoch 1 (HR: +6.9 bpm, p = 0.002; rMSSD: -9.7 ms, p = 0.003; SDNN: -11.3 ms, p = 0.003; SpO2: -8.4%, p < 0.0000) and appeared to slightly decline with non-significant increases in HRV. During normoxia, SNS activity was heightened, albeit non-significantly, in epoch 1, with higher HR (68.5 bpm vs. 73.0 bpm, p = 0.06), lower HRV (rMSSD: 45.1 ms vs. 38.7 ms, p = 0.09 and SDNN: 52.5 ms vs. 45.1 ms, p = 0.08), and lower SpO2 (-0.7% p = 0.05). In epochs 2-4, HR, HRV, and SpO2 trended towards baseline values. Significant between-group differences in HR, HRV, and O2 saturation were observed. Hypoxia elicited significantly greater HRs (+5.0, p = 0.03), lower rMSSD (-7.1, p = 0.03), lower SDNN (-8.2, p = 0.03), and lower SpO2 (-1.4%, p = 0.002) compared to normoxia. Hyperoxia appeared to augment the parasympathetic reactivation reflected by significantly lower HR, in addition to higher HRV and O2 relative to normoxia. Hypoxia induced a greater ANS response in military personnel during the simultaneous exposure to high cognitive load. The significant and differential ANS responses to varying O2 levels and high cognitive load observed highlight the importance of continuously monitoring multiple physiological parameters during flight operations.

Smart Non-invasive Physiological Parameter Monitoring System Using IoT and Blynk App

This work aims to provide an advanced, portable and non-invasive multiple physiological parameters monitoring system using the Internet of Things (IoT) platform and Blynk App. The device detects essential physiological parameters non-invasively including heart rate (bpm), blood oxygen saturation (SpO2), blood glucose (mg/dL) and body temperature (C or F) from a person’s finger, peripheral part of the body or forehead. The sensors like pulse oximeter MAX30100 to read both heart rate and blood oxygen saturation, MLX9606 for sensing the body temperature and IR sensors to interpret blood glucose by near infrared optical method, have been calibrated and integrated with Arduino microprocessor and node MCU. The signal from the device is then sent to the Blynk App installed in an Android phone via a Wi-Fi connection, allowing the user to record and monitor the data. Test results showed that the device is capable of sensing and monitoring the physiological parameters and can transmit real time data instantly after sensing to the user. This non-invasive method of sensing parameters showed an average accuracy of 99.2% in temperature measurement, 99.07% in blood oxygen saturation level measurement and 90.52% in blood glucose measurement.