Mariano Ruffo

An ultra-high input impedance ECG amplifier for long-term monitoring of athletes.

We present a new, low-power electrocardiogram (ECG) recording system with an ultra-high input impedance that enables the use of long-lasting, dry electrodes. The system incorporates a low-power Bluetooth module for wireless connectivity and is designed to be suitable for long-term monitoring during daily activities. The new system using dry electrodes was compared with a clinically approved ECG reference system using gelled Ag/AgCl electrodes and performance was found to be equivalent. In addition, the system was used to monitor an athlete during several physical tasks, and a good quality ECG was obtained in all cases, including when the athlete was totally submerged in fresh water.

An algorithm for FHR estimation from foetal phonocardiographic signals

The long-term foetal surveillance is often to be recommended. Hence, the fully non-invasive acoustic recording, through maternal abdomen, represents a valuable alternative to the ultrasonic cardiotocography. Unfortunately, the recorded heart sound signal is heavily loaded by noise, thus the determination of the foetal heart rate raises serious signal processing issues. In this paper, we present a new algorithm for foetal heart rate estimation from foetal phonocardiographic recordings. A filtering is employed as a first step of the algorithm to reduce the background noise. A block for first heart sounds enhancing is then used to further reduce other components of foetal heart sound signals. A complex logic block, guided by a number of rules concerning foetal heart beat regularity, is proposed as a successive block, for the detection of most probable first heart sounds from several candidates. A final block is used for exact first heart sound timing and in turn foetal heart rate estimation. Filtering and enhancing blocks are actually implemented by means of different techniques, so that different processing paths are proposed. Furthermore, a reliability index is introduced to quantify the consistency of the estimated foetal heart rate and, based on statistic parameters; [,] a software quality index is designed to indicate the most reliable analysis procedure (that is, combining the best processing path and the most accurate time mark of the first heart sound, provides the lowest estimation errors). The algorithm performances have been tested on phonocardiographic signals recorded in a local gynaecology private practice from a sample group of about 50 pregnant women. Phonocardiographic signals have been recorded simultaneously to ultrasonic cardiotocographic signals in order to compare the two foetal heart rate series (the one estimated by our algorithm and the other provided by cardiotocographic device). Our results show that the proposed algorithm, in particular some analysis procedures, provides reliable foetal heart rate signals, very close to the reference cardiotocographic recordings.

Simulation of foetal phonocardiographic recordings for testing of FHR extraction algorithms

A valuable alternative to traditional diagnostic tools, such as ultrasonographic cardiotocography, to monitor general foetal well-being by means of foetal heart rate analysis is foetal phonocardiography, a passive and low cost recording of foetal heart sounds. In this paper, it is presented a simulator software of foetal phonocardiographic signals relative to different foetal states and recording conditions (for example different kinds and levels of noise). Before developing the software, a data collection pilot study was conducted with the purpose of specifically identifying the characteristics of the waveforms of the foetal and maternal heart sounds, since the available literature is not rigorous in this area. The developed software, due to the possibility to simulate different physiological and pathological foetal conditions and recording situations simply modifying some system parameters, can be useful as a teaching tool for demonstration to medical students and others and also for testing and assessment of foetal heart rate extraction algorithms from foetal phonocardiographic (fPCG) recordings. On this purpose, the simulator software was used to test an algorithm developed by the authors for foetal heart rate extraction considering different foetal heart rate parameters and signal to noise ratio values. Our tests demonstrated that simulated fPCG signals are very close to real fPCG recordings.

Dry electrode bio-potential recordings

As wireless bio-medical long term monitoring moves towards personal monitoring it demands very high input impedance systems capable to extend the reading of bio-signal during the daily activities offering a kind of “stress free“, convenient connection, with no need for skin preparation. In particular we highlight the development and broad applications of our own circuits for wearable bio-potential sensor systems enabled by the use of an FET based amplifier circuit with sufficiently high impedance to allow the use of passive dry electrodes which overcome the significant barrier of gel based contacts. In this paper we present the ability of dry electrodes in long term monitoring of ECG, EEG and fetal ECG.

PSD modifications of FHRV due to interpolation and CTG storage rate

Cardiotocographic data provide physicians information about foetal development and permit to assess conditions such as foetal distress. An incorrect evaluation of the foetal status can be of course very dangerous. To improve interpretation of cardiotocographic recordings, great interest has been dedicated to foetal heart rate variability spectral analysis. It is worth reminding, however, that foetal heart rate is intrinsically an uneven series, so in order to produce an evenly sampled series a zero-order, linear or cubic spline interpolation can be employed. This is not suitable for frequency analyses because interpolation introduces alterations in the foetal heart rate power spectrum. In particular, interpolation process can produce alterations of the power spectral density that, for example, affects the estimation of the sympatho-vagal balance (computed as low-frequency/high-frequency ratio), which represents an important clinical parameter. In order to estimate the frequency spectrum alterations of the foetal heart rate variability signal due to interpolation and cardiotocographic storage rates, in this work, we simulated uneven foetal heart rate series with set characteristics, their evenly spaced versions (with different orders of interpolation and storage rates) and computed the sympatho-vagal balance values by power spectral density. For power spectral density estimation, we chose the Lomb method, as suggested by other authors to study the uneven heart rate series in adults. Summarising, the obtained results show that the evaluation of SVB values on the evenly spaced FHR series provides its overestimation due to the interpolation process and to the storage rate. However, cubic spline interpolation produces more robust and accurate results.

Investigating the role of combined acoustic-visual feedback in one-dimensional synchronous brain computer interfaces, a preliminary study

Feedback plays an important role when learning to use a brain computer interface (BCI), particularly in the case of synchronous feedback that relies on the interaction subject. In this preliminary study, we investigate the role of combined auditory-visual feedback during synchronous μ rhythm-based BCI sessions to help the subject to remain focused on the selected imaginary task. This new combined feedback, now integrated within the general purpose BCI2000 software, has been tested on eight untrained and three trained subjects during a monodimensional left-right control task. In order to reduce the setup burden and maximize subject comfort, an electroencephalographic device suitable for dry electrodes that required no skin preparation was used. Quality and index of improvement was evaluated based on a personal self-assessment questionnaire from each subject and quantitative data based on subject performance. Results for this preliminary study show that the combined feedback was well tolerated by the subjects and improved performance in 75% of the naïve subjects compared with visual feedback alone.

Floatingline estimation in FHR signal analysis

Cardiotocography provides significant information on foetal oxygenation linked to characteristics of foetal heart rate signals. Among most important we can mention foetal heart rate variability, whose spectral analysis is recognised like useful in improving diagnosis of pathologic conditions. However, despite its importance, a standardisation of definition and estimation of foetal heart rate variability is still searched. Some guidelines state that variability refers to fluctuations in the baseline free from accelerations and decelerations. This is an important limit in clinical routine since variability in correspondence of these FHR alterations has always been regarded as particularly significant in terms of prognostic value. In this work we compute foetal heart rate variability as difference between foetal heart rate and floatingline and we propose a method for extraction of floatingline which takes into account accelerations and decelerations.

A simulating software of fetal phonocardiographic signals

A valuable alternative to traditional diagnostic tool to record fetal heart rate, to monitor the general fetal well-being, is fetal phonocardiography, a passive and low cost acoustic recording of fetal heart sounds. In this paper, it is presented a simulating software of fetal phonocardiographic signals relative to different fetal physiological states and recording conditions (for example different kinds and levels of noise). This software can be useful to test and assess fetal heart rate extraction algorithms from fetal phonocardiographic recordings and as a teaching tool for demonstration to medical students and others.

Neuromuscular response to whole body vibration treatment during static and dynamic squat exercises

The impact of whole body vibrations (vibration stimulus mechanically transferred to the body) on muscular activity and neuromuscular response has been widely studied but without standard protocol and by using different kinds of exercises and parameters. In this study, we investigated how whole body vibration treatments affect electromyographic signal of rectus femoris during static and dynamic squat exercises. The aim was the identification of squat exercise characteristics useful to maximize neuromuscular activation and hence progress in training efficacy. Fourteen healthy volunteers performed both static and dynamic squat exercises without and with vibration treatments. Surface electromyographic signals of rectus femoris were recorded during the whole exercise and processed to reduce artifacts and to extract root mean square values. Paired t-test results demonstrated an increase of the root mean square values (p<;0.05) in both static and dynamic squat exercises with vibrations respectively of 63% and 108%. For each exercise, subjects gave a rating of the perceived exertion according to the Borgs scale but there were no significant changes in the perceived exertion rate between exercises with and without vibration. Finally, results from analysis of electromyographic signals identified the static squat with WBV treatment as the exercise with higher neuromuscular system response.

Non Invasive Foetal Monitoring with a Combined ECG - PCG System

Mariano Ruffo2,3, Mario Cesarelli2, Craig Jin1, Gaetano Gargiulo1,2,3, Alistair McEwan1, Colin Sullivan4, Paolo Bifulco2, Maria Romano2, Richard W. Shephard3, and Andre van Schaik1 1School of Electrical and Information Engineering (EIE), The University of Sydney 2Dept. of Biomedical, Electronic and Telecommunications Engineering, “Federico II” University of Naples 3HEARD Systems, Sydney 4David Read Laboratory, Dept. of Medicine, The University of Sydney 1,3,4Australia 2Italy