Ruben Buendia

Cole Parameter Estimation from the Modulus of the Electrical Bioimpeadance for Assessment of Body Composition. A Full Spectroscopy Approach.

Abstract Activities around applications of Electrical Bioimpedance Spectroscopy (EBIS) have proliferated in the past decade significantly. Most of these activities have been focused in the analysis of the EBIS measurements, which eventually might enable novel applications. In Body Composition Assessment (BCA), the most common analysis approach currently used in EBIS is based on the Cole function, which most often requires curve fitting. One of the most implemented approaches for obtaining the Cole parameters is performed in the impedance plane through the geometrical properties that the Cole function exhibit in such domain as depressed semi-circle. To fit the measured impedance data to a semi-circle in the impedance plane, obtaining the Cole parameters in an indirect and sequential manner has several drawbacks. Applying a Non-Linear Least Square (NLLS) iterative fitting on the spectroscopy measurement, obtains the Cole parameters considering the frequency information contained in the measurement. In this work, from experimental total right side EBIS measurements, the BCA parameters have been obtained to assess the amount and distribution of whole body fluids. The values for the BCA parameters have been obtained using values for the Cole parameters estimated with both approaches: circular fitting on the impedance plane and NLLS impedance-only fitting. The comparison of the values obtained for the BCA parameters with both methods confirms that the NLLS impedance-only is an effective alternative as Cole parameter estimation method in BCA from EBIS measurements. Using the modulus of the Cole function as the model for the fitting would eliminate the need for performing phase detection in the acquisition process, simplifying the hardware specifications of the measurement instrumentation when implementing a bioimpedance spectrometer.

A novel approach for removing the hook effect artefact from Electrical Bioimpedance spectroscopy measurements

Very often in Electrical Bioimpedance (EBI) spectroscopy measurements the presence of stray capacitances creates a measurement artefact commonly known as Hook Effect. Such an artefact creates a hook-alike deviation of the EBI data noticeable when representing the measurement on the impedance plane. Such Hook Effect is noticeable at high frequencies but it also causes a data deviation at lower measurement frequencies. In order to perform any accurate analysis of the EBI spectroscopy data, the influence of the Hook Effect must be removed. An established method to compensate the hook effect is the well known Td compensation, which consists on multiplying the obtained spectrum, Zmeas(ω) by a complex exponential in the form of exp[jωTd]. Such a method cannot correct entirely the Hook Effect since the hook-alike deviation occurs a broad frequency range in both magnitude and phase of the measured impedance, and by using a scalar value for Td. First a scalar only modifies the phase of the measured impedance and second, a single value can truly corrects the Hook Effect only at a single frequency. In addition, the process to select a value for the scalar Td by an iterative process with the aim to obtain the best Cole fitting lacks solid scientific grounds. In this work the Td compensation method is revisited and a modified approach for correcting the Hook Effect including a novel method for selecting the correcting values is proposed. The initial validation results confirm that the proposed method entirely corrects the Hook Effect at all frequencies.

Experimental validation of a method for removing the capacitive leakage artifact from electrical bioimpedance spectroscopy measurements

Often when performing electrical bioimpedance (EBI) spectroscopy measurements, the obtained EBI data present a hook-like deviation, which is most noticeable at high frequencies in the impedance plane. The deviation is due to a capacitive leakage effect caused by the presence of stray capacitances. In addition to the data deviation being remarkably noticeable at high frequencies in the phase and the reactance spectra, the measured EBI is also altered in the resistance and the modulus. If this EBI data deviation is not properly removed, it interferes with subsequent data analysis processes, especially with Cole model-based analyses. In other words, to perform any accurate analysis of the EBI spectroscopy data, the hook deviation must be properly removed. Td compensation is a method used to compensate the hook deviation present in EBI data; it consists of multiplying the obtained spectrum, Zmeas(ω), by a complex exponential in the form of exp(–jωTd). Although the method is well known and accepted, Td compensation cannot entirely correct the hook-like deviation; moreover, it lacks solid scientific grounds. In this work, the Td compensation method is revisited, and it is shown that it should not be used to correct the effect of a capacitive leakage; furthermore, a more developed approach for correcting the hook deviation caused by the capacitive leakage is proposed. The method includes a novel correcting expression and a process for selecting the proper values of expressions that are complex and frequency dependent. The correctness of the novel method is validated with the experimental data obtained from measurements from three different EBI applications. The obtained results confirm the sufficiency and feasibility of the correcting method.

Sensorized Garments and Textrode-Enabled Measurement Instrumentation for Ambulatory Assessment of the Autonomic Nervous System Response in the ATREC Project

Advances in textile materials, technology and miniaturization of electronics for measurement instrumentation has boosted the development of wearable measurement systems. In several projects sensorized garments and non-invasive instrumentation have been integrated to assess on emotional, cognitive responses as well as physical arousal and status of mental stress through the study of the autonomous nervous system. Assessing the mental state of workers under stressful conditions is critical to identify which workers are in the proper state of mind and which are not ready to undertake a mission, which might consequently risk their own life and the lives of others. The project Assessment in Real Time of the Stress in Combatants (ATREC) aims to enable real time assessment of mental stress of the Spanish Armed Forces during military activities using a wearable measurement system containing sensorized garments and textile-enabled non-invasive instrumentation. This work describes the multiparametric sensorized garments and measurement instrumentation implemented in the first phase of the project required to evaluate physiological indicators and recording candidates that can be useful for detection of mental stress. For such purpose different sensorized garments have been constructed: a textrode chest-strap system with six repositionable textrodes, a sensorized glove and an upper-arm strap. The implemented textile-enabled instrumentation contains one skin galvanometer, two temperature sensors for skin and environmental temperature and an impedance pneumographer containing a 1-channel ECG amplifier to record cardiogenic biopotentials. With such combinations of garments and non-invasive measurement devices, a multiparametric wearable measurement system has been implemented able to record the following physiological parameters: heart and respiration rate, skin galvanic response, environmental and peripheral temperature. To ensure the proper functioning of the implemented garments and devices the full series of 12 sets have been functionally tested recording cardiogenic biopotential, thoracic impedance, galvanic skin response and temperature values. The experimental results indicate that the implemented wearable measurement systems operate according to the specifications and are ready to be used for mental stress experiments, which will be executed in the coming phases of the project with dozens of healthy volunteers.

On scene injury severity prediction (OSISP) algorithm for car occupants

Many victims in traffic accidents do not receive optimal care due to the fact that the severity of their injuries is not realized early on. Triage protocols are based on physiological and anatomical criteria and subsequently on mechanisms of injury in order to reduce undertriage. In this study the value of accident characteristics for field triage is evaluated by developing an on scene injury severity prediction (OSISP) algorithm using only accident characteristics that are feasible to assess at the scene of accident. A multivariate logistic regression model is constructed to assess the probability of a car occupant being severely injured following a crash, based on the Swedish Traffic Accident Data Acquisition (STRADA) database. Accidents involving adult occupants for calendar years 2003-2013 included in both police and hospital records, with no missing data for any of the model variables, were included. The total number of subjects was 29128, who were involved in 22607 accidents. Partition between severe and non-severe injury was done using the Injury Severity Score (ISS) with two thresholds: ISS>8 and ISS>15. The model variables are: belt use, airbag deployment, posted speed limit, type of accident, location of accident, elderly occupant (>55 years old), sex and occupant seat position. The area under the receiver operator characteristic curve (AUC) is 0.78 and 0.83 for ISS>8 and ISS>15, respectively, as estimated by 10-fold cross-validation. Belt use is the strongest predictor followed by type of accident. Posted speed limit, age and accident location contribute substantially to increase model accuracy, whereas sex and airbag deployment contribute to a smaller extent and seat position is of limited value. These findings can be used to refine triage protocols used in Sweden and possibly other countries with similar traffic environments.

Influence of electrode mismatch on Cole parameter estimation from Total Right Side Electrical Bioimpedance Spectroscopy measurements

Applications based on measurements of Electrical Bioimpedance (EBI) spectroscopy analysis, like assessment of body composition, have proliferated in the past years. Currently Body Composition Assessment (BCA) based in Bioimpedance Spectroscopy (BIS) analysis relays on an accurate estimation of the Cole parameters R(0) and R(∞). A recent study by Bogonez-Franco et al. has proposed electrode mismatch as source of remarkable artefacts in BIS measurements. Using Total Right Side BIS measurements from the aforementioned study, this work has focused on the influence of electrode mismatch on the estimation of R(0) and R(∞) using the Non-Linear Least Square curve fitting technique on the modulus of the impedance. The results show that electrode mismatch on the voltage sensing electrodes produces an overestimation of the impedance spectrum leading to a wrong estimation of the parameters R(0) and R(∞), and consequently obtaining values around 4% larger that the values obtained from BIS without electrode mismatch. The specific key factors behind electrode mismatch or its influence on the analysis of single and spectroscopy measurements have not been investigated yet, no compensation or correction technique is available to overcome the deviation produced on the EBI measurement. Since textile-enabled EBI applications using dry textrodes, i.e. textile electrodes with dry skin-electrode interfaces and potentially large values of electrode polarization impedance are more prone to produce electrode mismatch, the lack of a correction or compensation technique might hinder the proliferation of textile-enabled EBI applications for personalized healthcare monitoring.

Cole parameter estimation from electrical bioconductance spectroscopy measurements

Several applications of Electrical Bioimpedance (EBI) make use of Cole parameters as base of their analysis, therefore Cole parameters estimation has become a very common practice within Multifrequency- and EBI spectroscopy. EBI measurements are very often contaminated with the influence of parasitic capacitances, which contributes to cause a hook-alike measurement artifact at high frequencies in the EBI obtained data. Such measurement artifacts might cause wrong estimations of the Cole parameters, contaminating the whole analysis process and leading to wrong conclusions. In this work, a new approach to estimate the Cole parameters from the real part of the admittance, i.e. the conductance, is presented and its performance is compared with the results produced with the traditional fitting of complex impedance to a depressed semi-circle. The obtained results prove that is feasible to obtain the full Cole equation from only the conductance data and also that the estimation process is safe from the influence capacitive leakage.

Textile electrode straps for wrist-to-ankle bioimpedance measurements for Body Composition Analysis. Initial validation & experimental results

Electrical Bioimpedance (EBI) is one of the non-invasive monitoring technologies that could benefit from the emerging textile based measurement systems. If reliable and reproducible EBI measurements could be done with textile electrodes, that would facilitate the utilization of EBI-based personalized healthcare monitoring applications. In this work the performance of a custom-made dry-textile electrode prototype is tested. Four-electrodes ankle-to-wrist EBI measurements have been taken on healthy subjects with the Impedimed spectrometer SFB7 in the frequency range 5 kHz to 1 MHz. The EBI spectroscopy measurements taken with dry electrodes were analyzed via the Cole and Body Composition Analysis (BCA) parameters, which were compared with EBI measurements obtained with standard electrolytic electrodes. The analysis of the obtained results indicate that even when dry textile electrodes may be used for EBI spectroscopy measurements, the measurements present remarkable differences that influence in the Cole parameter estimation process and in the final production of the BCA parameters. These initial results indicate that more research work must be done to in order to obtain a textile-based electrode that ensures reliable and reproducible EBI spectroscopy measurements.

Cole parameter estimation from total right side electrical bioimpedance spectroscopy measurements — Influence of the number of frequencies and the upper limit

Applications based on measurements of Electrical Bioimpedance Spectrocopy (EBIS) analysis are proliferating. The most spread and known application of EBIS is the non-invasive assessment of body composition. Fitting to the Cole function to obtain the Cole parameters, R0 and R∞, is the core of the EBIS analysis to obtain the body fluid distribution. An accurate estimation of the Cole parameters is essential for the Body Composition Assessment (BCA) and the estimation process depends on several factors. One of them is the upper frequency limit used for the estimation and the other is the number of measured frequencies in the measurement frequency range. Both of them impose requirements on the measurement hardware, influencing largely in the complexity of the bioimpedance spectrometer. In this work an analysis of the error obtained when estimating the Cole parameters with several frequency ranges and different number of frequencies has been performed. The study has been done on synthetic EBIS data obtained from experimental Total Right Side (TRS) measurements. The results suggest that accurate estimations of R0 and R∞ for BCA measurements can be achieved using much narrower frequency ranges and quite fewer frequencies than electrical bioimpedance spectrometers commercially available nowadays do.

Prehospital transportation decisions for patients sustaining major trauma in road traffic crashes in Sweden

ABSTRACT Objective: The objective of this study was to evaluate the proportion and characteristics of patients sustaining major trauma in road traffic crashes (RTCs) who could benefit from direct transportation to a trauma center (TC). Methods: Currently, there is no national classification of TC in Sweden. In this study, 7 university hospitals (UHs) in Sweden were selected to represent a TC level I or level II. These UHs have similar capabilities as the definition for level I and level II TC in the United States. Major trauma was defined as Injury Severity Score (ISS) > 15. A total of 117,730 patients who were transported by road or air ambulance were selected from the Swedish TRaffic Accident Data Acquisition (STRADA) database between 2007 to 2014. An analysis of the patient characteristics sustaining major trauma in comparison with patients sustaining minor trauma (ISS < 15) was conducted. Major trauma patients transported to a TC versus non-TC were further analysed with respect to injured body region and road user type. Results: Approximately 3% (n = 3, 411) of patients sustained major trauma. Thirty-eight percent of major trauma patients were transported to a TC, and 62% were transported to a non-TC. This results in large proportions of patients with Abbreviated Injury Scale (AIS) 3+ injuries being transported to a non-TC.  The number of AIS 3+ head injuries for major trauma patients transported to a TC versus non-TC were similar, whereas a larger number of AIS 3+ thorax injuries were present in the non-TC group. The non-TC major trauma patients had a higher probability of traveling in a car, truck, or bus and to be involved in a crash in a rural location. Conclusions: Our results show that the majority of RTC major trauma patients are transported to a non-TC. This may cause unnecessary morbidity and mortality. These findings can guide the development of improved prehospital treatment guidelines, protocols and decision support systems.