Skin Impedance Research Articles

Real-time EEG-based detection of driving fatigue using a novel semi-dry electrode with self-replenishment of conductive fluid

A novel semi-dry electrode that can realize self-replenishment of conductive liquid is proposed in this study. Driving fatigue is detected by extracting the refined composite multiscale fluctuation dispersion entropy (RCMFDE) features in electroencephalogram (EEG) signals collected by this electrode. The results show that the new semi-dry electrode can automatically complete the conductive fluid supplement according to its own humidity conditions, which not only notably improves the effective working time, but also significantly reduces the skin impedance. By comparing with the classical entropy algorithms, the computational speed and the stability of the RCMFDE method are Substantially enhanced.

Fractional-Order Modeling of the Depth of Analgesia as Reference Model for Control Purposes

Little research has been carried out in terms of modeling and control of analgesia. However, emerging new technology and recent prototypes paved the way for several ideas on pain modeling for control. Recently, such an idea has been proposed for measuring the Depth of Analgesia (DoA). In this paper, that solution is further exploited towards obtaining a novel fractional-order model and dedicated controller for DoA. First, clinical data from patients undergoing general anesthesia are used to determine a commensurate fractional-order model of the skin impedance at each sampling period. Second, we provide a proof of concept indicating that fractional order changes due to variations in the infused opioid drug (Remifentanil). Third, a fractional-order model for DoA is developed correlating the changes in the pain index (as the output signal) and the Remifentanil infusion rate (as the input signal). Standard optimization routines are used to estimate the parameters. A database of 19 real patients is used. Lastly, a preliminary fractional-order controller is designed and tested in simulation for the 19 patients. The closed-loop simulation results correspond to the expected clinical outcomes.

Electroactive Melanin Tattoo Inks for Effectively Reducing Skin Impedances

Electroactive Melanin Tattoo Inks for Effectively Reducing Skin Impedances

Effect of sequential delivery of 1- and 2-MHz bipolar microneedling radiofrequency energy on thermal tissue reactions in a minipig model.

Bipolar microneedling radiofrequency (RF) treatment generates different patterns of thermal reactions, depending on the skin impedance and RF treatment parameters, including the frequency, power, conduction time, settings of sub-pulse packs, and penetrating depth and type of microneedles used. We compared the effect of sequential delivery of 1- and 2-MHz bipolar RF energy to in vivo minipig skin on thermal tissue reaction. RF treatments at frequencies of 1 and 2MHz were sequentially delivered to minipigs' skin in vivo. A histological study was performed to analyze RF-induced skin reactions at 1-h and at 3-, 7-, and 14-days post-treatment. The skin specimens demonstrated that the two different frequencies of RF treatment generated mixed patterns of the peri-electrode coagulative necrosis (PECN) according to the experimental settings and tissue impedance. In the PECN zone, the tissue coagulation induced by the first RF treatment was surrounded by the effect of the later RF treatment at the other RF frequency. In the inter-electrode non-necrotic thermal reaction zone, the effect of the latter RF treatment was widespread and deep through the dermis, which had received RF treatment at the other frequency first. The delivery of pulsed-type RF energy at sub-pulse packs of 6 or 10 provided effective RF delivery over long conduction time without excessive thermal damage of the epidermis. Nonetheless, by sequential delivery of two different RF frequencies, RF-induced tissue reactions were found to be markedly enhanced. The sequential delivery of 1- and 2-MHz RF energy induces novel histological patterns of tissue reactions, which can synergistically enhance the thermostimulatory effects of each RF setting. Moreover, variations in patterns of tissue reactions can be generated by regulating the order of frequencies and the number of sub-pulse packs of RF used.

Coupled and radiated microwave sensors for vital signs and lung water level monitoring

This paper presents a novel approach for non-invasive monitoring of vital signs (heart rate (HR), respiration rate (RR)) and lung water levels using ultra-wideband (UWB) microwave sensors. The primary contribution of this study is the development and testing of two different sensor technologies to enhance the penetration and monitoring capabilities of electromagnetic waves within the human body. The first sensor technology employs a radiated UWB microwave that can be integrated into textiles, operating within a frequency range of 1.5 to 10 GHz, providing flexibility and comfort for wearable health monitoring. The second sensor technology involves using body-coupled UWB non-radiating sensors with a wide operational bandwidth from 1.3 to 10 GHz and a stable feeding structure, ensuring efficient reflection and transmission of waves for accurate monitoring. The shapes of flexible and textile UWB electromagnetic microwave sensor radiators and couplers, along with the measurement procedure, are tested in human clinical studies. The sensor-specific absorption rate (SAR) is evaluated at two distinct resonant frequencies on tissue masses of 1 g and 10 g, aligning with the IEEE C95.3 standard to ensure adherence to standard thresholds of 1.6 W/kg and 2 W/kg, respectively. Additionally, a denoising scheme utilizing deep learning techniques is proposed to filter Base Line Wander (BLW) noise attributable to misplaced electrodes, skin impedance, poor skin preparation, patient movement, and breathing within the frequency range of 0.05 to 3 Hz. The postprocessing outcome demonstrates the superiority of couplers over radiating sensors.

Characterising Skin Electrical Impedance Using Tape Stripping Methods: A Bioelectrical Study of a Porcine Model.

Background Recent advancements in ultra-low power electronics and wireless devices have facilitated the widespread adoption of wearable technology for fitness and health monitoring, paving the way for personalized medicine. Microneedle-based devices, comprising small epidermal patches that penetrate the skin's stratum corneum to potentially access biomarkers in the extracellular fluid of the viable epidermis, represent a promising innovation in this field. Objectives This project aimed to develop and validate a novel method to evaluate microneedle engagement in the skin in real-time. To our knowledge, there are no studies published to date that have characterized the electrical impedance of stratum corneum and epidermis using the tape stripping method to selectively remove cell layers. Additionally, no studies have been published comparing the electrical impedance of fresh to frozen-thawed porcine skin. The objective of this study was to develop and validate a novel method to evaluate microneedle engagement in skin, in real-time, that does not require processing of the tissue. Methods A tape stripping technique was employed to selectively remove the stratum corneum from fresh and frozen-thawed porcine skin samples which were then electrically characterized using an excitation frequency of 5 kHz with a peak Voltage of 1 V. Results This study demonstrated a mean impedance reduction of 97.08 ± 1.3 % for fresh porcine skin, and 98.04 ± 0.3 % for frozen-thawed porcine skin when transitioning from the surface stratum corneum to the viable epidermis. The correlation between the reduction of impedance and the number of tape strips across all 18 test sites was significant (r = 0.98, p < 0.00001). However, comparing the skin impedance of the fresh and frozen-thawed specimens showed poor equivalence, with the frozen-thawed sites approximately 5.5 times the impedance of the fresh sites before any tape stripping, and 4.19 times greater after 30 tape strips. Conclusions These findings suggest that monitoring for an interelectrode impedance decrease of greater than 95% between two projections of a microneedle device could provide a rapid and effective evaluation of skin engagement, crucial for advancing the development and clinical application of microneedle-based technologies in personalized medicine. The study also underscores the impact of the freeze-thaw process on the mechanical and electrical properties of skin, which is crucial for standardizing testing protocols.

Starfish tube feet inspired hydrogel electrode for durable underwater sEMG acquisition

Underwater surface electromyography (UW-sEMG) acquisition with long-term high quality is crucial to underwater activities, including rehabilitation, fatigue measurement, and sports monitoring. However, most UW-sEMG electrodes suffer significant performance decline, especially for hydrogel electrodes, due to the swelling-induced mechanical, electrical, and adhesive degradation. Maintaining high performance underwater over extended periods is challenging. The controlled underwater adhesion-detachment behavior of starfish is inspirative. Here, a starfish tube feet-inspired hydrogel (STFH) electrode is developed for UW-sEMG recording, including a micro-swelling hydrogel pillar, a biomimetic silicone sucker, and an Ag/AgCl disc electrode. By soaking freeze-dried hydrophilic hydrogel in tannic acid (TA) solution, the hydrogel exhibits skin-like modulus of 22.4 kPa, low skin impedance of 18.3 kΩ (10 Hz) and low equilibrium swelling ratio. Unlike traditional strategies for improving anti-swelling properties, this work leverages the interaction between the sucker and the swollen hydrogel to promote conformal contact. Consequently, the sEMG signal exhibits SNR of 26.7 dB and baseline noise of 12.8 μV even after 60 min of underwater working. The STFH electrode also shows anti-noise capability to resist skin vibration and wave oscillation. This STFH electrode enables durable UW-sEMG acquisition, which could further extend from the arm to the wrist to adapt wearing habits.

Viscoelastic Adhesive, Super-Conformable, and Semi-Flowable Liquid Metal Eutectogels for High-Fidelity Electrophysiological Monitoring.

Integrating gels with human skin through wearables provides unprecedented opportunities for health monitoring technology and artificial intelligence. However, most conductive hydrogels, organogels, and ionogels lack essential environmental stability, biocompatibility, and adhesion for reliable epidermal sensing. In this study, we have developed a liquid metal eutectogel simultaneously possessing superior viscoelasticity, semiflowability, and mechanical rigidity for low interfacial skin impedance, high skin adhesion, and durability. Liquid metal particles (LMPs) are employed to generate free radicals and gallium ions to accelerate the polymerization of acrylic acid monomers in a deep eutectic solvent (DES), obtaining highly viscoelastic polymer networks via physical cross-linking. In particular, graphene oxide (GO) is utilized to encapsulate the LMPs through a sonication-assisted electrostatic assembly to stabilize the LMPs in DES, which also enhances the mechanical toughness and regulates the rheological properties of the eutectogels. Our optimized semi-flowable eutectogel exhibits viscous fluid behavior at low shear rates, facilitating a highly conformable interface with hairy skin. Simultaneously, it demonstrates viscoelastic behavior at high shear rates, allowing for easy peel-off. These distinctive attributes enable the successful applications of on-skin adhesive strain sensing and high-fidelity human electrophysiological (EP) monitoring, showcasing the versatility of these ionically conductive liquid metal eutectogels in advanced personal health monitoring.

Polymeric Microneedles Enhance Transdermal Delivery of Therapeutics.

This research presents the efficacy of polymeric microneedles in improving the transdermal permeation of methotrexate across human skin. These microneedles were fabricated from PLGA Expansorb® 50-2A and 50-8A and subjected to comprehensive characterization via scanning electron microscopy, Fourier-transform infrared spectroscopy, and mechanical analysis. We developed and assessed a methotrexate hydrogel for physicochemical and rheological properties. Dye binding, histological examinations, and assessments of skin integrity demonstrated the effective microporation of the skin by PLGA microneedles. We measured the dimensions of microchannels in the skin using scanning electron microscopy, pore uniformity analysis, and confocal microscopy. The skin permeation and disposition of methotrexate were researched in vitro. PLGA 50-8A microneedles appeared significantly longer, sharper, and more mechanically uniform than PLGA 50-2A needles. PLGA 50-8A needles generated substantially more microchannels, as well as deeper, larger, and more uniform channels in the skin than PLGA 50-2A needles. Microneedle insertion substantially reduced skin electrical resistance, accompanied by an elevation in transepidermal water loss values. PLGA 50-8A microneedle treatment provided a significantly higher cumulative delivery, flux, diffusion coefficient, permeability coefficient, and predicted steady-state plasma concentration; however, there was a shorter lag time than for PLGA 50-2A needles, base-treated, and untreated groups (p < 0.05). Conclusively, skin microporation using polymeric microneedles significantly improved the transdermal delivery of methotrexate.

Influence of Surfactant on the Skin Permeation of Methylisothiazolinone and Methylchloroisothiazolinone.

Patch tests are often used in safety evaluations to identify the substance causing skin irritation, but the same substance can sometimes give positive or negative results depending on the test conditions. Here, we investigated differences in the skin penetration of two test compounds under different application conditions. We studied the effects of the anionic surfactant sodium dodecyl sulfate (SDS) and the nonionic surfactant polysorbate 80 (PS) on skin penetration of the preservatives methylisothiazolinone (MT) and methylchloroisothiazolinone (MCT), which are used in cosmetics such as shampoos. The skin permeation of MT was enhanced by SDS but was unchanged by PS. Skin impedance decreased in the presence of SDS whereas PS had the same effect as the control aqueous solution, suggesting that SDS reduction of the barrier function of skin affects the permeation of MT, a hydrophilic drug. Application of a mixture of MCT and MT in the presence of SDS did not affect the skin permeation of MCT whereas the permeation of MT was enhanced by SDS, indicating that the skin permeation of MCT is less affected by SDS than is MT. Thus, attention should be paid to the possible effect of co-solutes, especially hydrophilic drugs.

Possibilities of treating manifestations of post-COVID syndrome using green spectrum photo-magnetic therapy

Previously, we studied the prevalence and characteristics of the manifestations of autonomic dysfunction in patients after COVID-19 using the RaDoTech device. The device was developed based on the technology by Japanese doctor Yoshio Nakatani. Electropuncture diagnostic technology is based on measuring electrical skin resistance at known acupuncture points. By means of this device, it is possible to measure the electrical conductivity of certain points on the human body, after which the device revises all the bioelectric levels in the body and provides an overview of the functional state of a person’s health and messages about the state of various organs and systems, including a brief overview of health and potential problem areas. According to our study, most patients with post-COVID syndrome have clinical signs of autonomic dysfunction, such as postural orthostatic tachycardia syndrome, presyncope, paroxysmal headaches, decreased performance, fatigue, and sleep disturbances. In clinical practice, we have to face a situation where patients with autonomic dysfunction prefer to take a wait-and-see approach or limit themselves to syndromic treatment. However, autonomic dysfunction continues to be a social and public health issue in both developed and developing countries. Although the main features of autonomic dysfunction are well known, several unanswered questions still remain. This uncertainty also applies to treatment for autonomic dysfunction. Thus, the problem of effective methods for treating disorders of the autonomic nervous system remains an important and largely unresolved problem of modern medicine.

Development, Validation, and Comparison of a Novel Nociception/Anti-Nociception Monitor against Two Commercial Monitors in General Anesthesia.

In this paper, we present the development and the validation of a novel index of nociception/anti-nociception (N/AN) based on skin impedance measurement in time and frequency domain with our prototype AnspecPro device. The primary objective of the study was to compare the Anspec-PRO device with two other commercial devices (Medasense, Medstorm). This comparison was designed to be conducted under the same conditions for the three devices. This was carried out during total intravenous anesthesia (TIVA) by investigating its outcomes related to noxious stimulus. In a carefully designed clinical protocol during general anesthesia from induction until emergence, we extract data for estimating individualized causal dynamic models between drug infusion and their monitored effect variables. Specifically, these are Propofol hypnotic drug to Bispectral index of hypnosis level and Remifentanil opioid drug to each of the three aforementioned devices. When compared, statistical analysis of the regions before and during the standardized stimulus shows consistent difference between regions for all devices and for all indices. These results suggest that the proposed methodology for data extraction and processing for AnspecPro delivers the same information as the two commercial devices.

High-frequency characteristics of multilayer graphene nanoribbon interconnects: Exploring the implications OF SKIN effect

A study is undertaken to explore the frequency-dependent traits of crosstalk delay (X-D), crosstalk noise area (X-NA), and the mean time to failure induced by electromigration (EM-MTF) in interconnects constructed from lithium-doped multilayer graphene nanoribbon (Li-MLGNR) and their optimized counterparts, known as optimized Li-MLGNR (O-LiMLGNR) interconnects. The analysis is based on the skin depth and impedance model incorporating scatterers and the finite thickness of the interconnect. The obtained high-frequency impedance and performance characteristics reveals that O-LiMLGNR outperforms Li-MLGNR, rough copper, and mixed carbon nanotube bundle in terms of X-D, X-NA, and EM-MTF. Subsequently, the performance of O-LiMLGNR, limited by process and temperature variations, is analyzed at high frequencies under the influence of skin-effect. As a result of variations in process parameters and temperature, the O-LiMLGNR exhibits an increase in variations of X-D and X-NA, accompanied by a reduction in variation of EM-MTF as the frequency increases.

The multi‐factorial modes of action of urease in the pathogenesis of incontinence associated dermatitis

AbstractBackgroundIncontinence Associated Dermatitis (IAD) is a type of skin inflammation caused by chronic exposure to urine and/or faeces. Current treatment strategies involve creating a barrier between the skin and urine/faeces rather than targeting specific irritants. Urease expressing pathogens catalyse the conversion of urea, present in urine, into ammonia. The accumulation of ammonia causes an elevation in skin pH which is believed to activate faecal enzymes which damage skin, and opportunistic pathogens, which lead to secondary infections.ObjectivesTo develop a better, multi‐factorial model of IAD pathogenesis, including the effect of urease‐expressing bacteria on skin, mechanism of damage of urease and urease‐triggered activity of faecal enzymes and secondary pathogens. To study the effect of urease inhibition on preventing IAD skin damage.MethodsFive separate studies were made using ex vivo porcine skin and in vivo human skin models. Measurements of the change in skin barrier function were made using skin impedance, trans‐epidermal water loss (TEWL), stratum corneum moisture and pH. Skin was exposed to artificial urine, inoculated with various microbes, enzymes and chemicals to examine the influence of: 1) urease‐positive Proteus mirabilis 2) ammonia, 3) combination of P. mirabilis and a faecal enzyme, trypsin, 4) combination of P. mirabilis and opportunistic pathogens, Candida albicans and Staphylococcus aureus, 5) inhibition of urease using acetohydroxamic acid (AHA) on barrier function.ResultsThe urease‐mediated production of ammonia had two principal effects: it elevated skin pH and caused inflammation, leading to significant breakdown in skin (stratum corneum) barrier function. Urease was found to further increase the activity of faecal enzymes and opportunistic pathogens, due to elevated skin pH. The urease inhibitor, AHA, was shown to have significantly reduced damage to skin barrier function, measured as its electrical resistance.ConclusionsTargeted therapeutic strategies should be developed to prevent the manifestation of IAD, rather than creating a generic barrier between skin and urine/faeces. Urease has been identified as a crucial component in the manifestation of IAD, due to its role in the production of ammonia. Urease inhibition provides a promising therapeutic target to halt the progression of IAD.

Light-Based 3D Multi-Material Printing of Micro-Structured Bio-Shaped, Conducting and Dry Adhesive Electrodes for Bioelectronics.

In this work, a new method of multi-material printing in one-go using a commercially available 3D printer is presented. The approach is simple and versatile, allowing the manufacturing of multi-material layered or multi-material printing in the same layer. To the best of the knowledge, it is the first time that 3D printed Poly(3,4-ethylenedioxythiophene) polystyrene sulfonate (PEDOT:PSS) micro-patterns combining different materials are reported, overcoming mechanical stability issues. Moreover, the conducting ink is engineered to obtain stable in-time materials while retaining sub-100µm resolution. Micro-structured bio-shaped protuberances are designed and 3D printed as electrodes for electrophysiology. Moreover, these microstructures are combined with polymerizable deep eutectic solvents (polyDES) as functional additives, gaining adhesion and ionic conductivity. As a result of the novel electrodes, low skin impedance values showed suitable performance for electromyography recording on the forearm. Finally, this concluded that the use of polyDES conferred stability over time, allowing the usability of the electrode 90 days after fabrication without losing its performance. All in all, this demonstrated a very easy-to-make procedure that allows printing PEDOT:PSS on soft, hard, and/or flexible functional substrates, opening up a new paradigm in the manufacturing of conducting multi-functional materials for the field of bioelectronics and wearables.

A novel unsupervised dynamic feature domain adaptation strategy for cross-individual myoelectric gesture recognition

Objective. Surface electromyography pattern recognition (sEMG-PR) is considered as a promising control method for human-machine interaction systems. However, the performance of a trained classifier would greatly degrade for novel users since sEMG signals are user-dependent and largely affected by a number of individual factors such as the quantity of subcutaneous fat and the skin impedance. Approach. To solve this issue, we proposed a novel unsupervised cross-individual motion recognition method that aligned sEMG features from different individuals by self-adaptive dimensional dynamic distribution adaptation (SD-DDA) in this study. In the method, both the distances of marginal and conditional distributions between source and target features were minimized through automatically selecting the optimal feature domain dimension by using a small amount of unlabeled target data. Main results. The effectiveness of the proposed method was tested on four different feature sets, and results showed that the average classification accuracy was improved by above 10% on our collected dataset with the best accuracy reached 90.4%. Compared to six kinds of classic transfer learning methods, the proposed method showed an outstanding performance with improvements of 3.2%-13.8%. Additionally, the proposed method achieved an approximate 9% improvement on a publicly available dataset. Significance. These results suggested that the proposed SD-DDA method is feasible for cross-individual motion intention recognition, which would provide help for the application of sEMG-PR based system.

Bone Conduction: A Linear Viscoelastic Mixed Lumped-Continuum Model for the Human Skin in the Acoustic Frequency Range

Abstract In conventional and skin-drive bone conduction, the performance of the exciter is strongly influenced by the mechanical impedance of the skin. This impedance is characterized by the resonance of the cutis on the underlying adipose layer. Although the existing Kelvin–Voigt-based lumped parameter skin model allows satisfactory approximation of the magnitude of the measured skin impedance, substantial deviations appear in the associated phase. The use of the existing skin model in coupled exciter-skin response calculations may thus lead to prediction errors at resonance peaks. The present work proposes an alternative model which considers the bending wave propagation in the cutis using a continuum model combined with a Zener material model for the underlying adipose tissue. It shows good agreement with the measurement results and leads to insights in the role of the different skin layers in the observed dynamic response.

Effect of Receptor Solution in Studies of In Vitro Permeation Test (IVPT)

In Vitro Permeation Test (IVPT) is commonly used to evaluate skin penetration of chemicals and performance of dermatological products. For a permeant with low aqueous solubility, an additive that is expected not to alter the skin barrier can be used in the receptor solution to improve permeant solubility. The objective of this study was to (a) evaluate the effects of these additives in IVPT receptor solution on skin permeability of model permeants and skin electrical resistance and (b) determine the solubility of the permeants in these receptor solutions. Bovine serum albumin (BSA), 2-hydroxypropyl-beta-cyclodextrin (HPCD), ethanol, nonionic surfactant Brij-98, and propylene glycol were the additives, and phosphate buffered saline (PBS) was the control. Steady-state skin permeability coefficients and resistances were determined. The receptor solutions examined in this study did not cause a significant increase in skin permeability or decrease in resistance (less than 40 % changes) except 25 % ethanol. The receptor solution containing 25 % ethanol induced an approximately twofold average increase in skin permeability and reduced skin electrical resistance by approximately threefold. The receptor solution of 2.5 % HPCD provided the highest levels of solubility for the model lipophilic permeants, while 0.2 % Brij-98 and 5 % ethanol showed the lowest solubility enhancement from those in PBS.

Impact of regular cold exposure on electrical skin resistance in patients with joint degenerative diseases.

Common features in chronic inflammatory disease patients (CIDP) are inflammation, mental stress (MS), and autonomic nervous system imbalance. Whole-body cryotherapy (WBC) exposure and regular physical exercise are known to regulate these features. In this study, we assessed the impact of regular physical exercise and the use of WBC exposure in CIDP on the level of electrical skin resistance (SR) to evaluate the skin sympathetic nervous activity and and estimate MS levels. SR was evaluated before and after a 10-day-period of daily physical exercise preceded or not by WBC (3 min at -110°C) in two groups of 134 CIDP (WBC vs. non-WBC groups). At baseline, the number of severe MS patients was similar in both groups. However, after the training period, the number of severe MS patients significantly decreased in the WBC group, only. An increase in SR (a decrease in stress level) was noted in the WBC group only, and such increase was higher in men than in women and in patients younger than 60 versus patients older than 60 years old. The use of daily WBC combined with physical exercise induced physiological adaptations and lowered the sympathetic nervous activity that may reflect a reduced level of MS in CIDP. These adaptations seem to depend on gender and age.

Parametric Modeling and Deep Learning for Enhancing Pain Assessment in Postanesthesia.

The problem of reliable and widely accepted measures of pain is still open. It follows the objective of this work as pain estimation through post-surgical trauma modeling and classification, to increase the needed reliability compared to measurements only. This article proposes (i) a recursive identification method to obtain the frequency response and parameterization using fractional-order impedance models (FOIM), and (ii) deep learning with convolutional neural networks (CNN) classification algorithms using time-frequency data and spectrograms. The skin impedance measurements were conducted on 12 patients throughout the postanesthesia care in a proof-of-concept clinical trial. Recursive least-squares system identification was performed using a genetic algorithm for initializing the parametric model. The online parameter estimates were compared to the self-reported level by the Numeric Rating Scale (NRS) for analysis and validation of the results. Alternatively, the inputs to CNNs were the spectrograms extracted from the time-frequency dataset, being pre-labeled in four intensities classes of pain during offline and online training with the NRS. The tendency of nociception could be predicted by monitoring the changes in the FOIM parameters' values or by retraining online the network. Moreover, the tissue heterogeneity, assumed during nociception, could follow the NRS trends. The online predictions of retrained CNN have more specific trends to NRS than pain predicted by the offline population-trained CNN. We propose tailored online identification and deep learning for artefact corrupted environment. The results indicate estimations with the potential to avoid over-dosing due to the objectivity of the information. Models and artificial intelligence (AI) allow objective and personalized nociception-antinociception prediction in the patient safety era for the design and evaluation of closed-loop analgesia controllers.