This dissertation is devoted to study of complex systems in human physiology particularly heartbeats and brain dynamics. We have studied the dynamics of heartbeats that has been a subject of investigation of two independent groups. The first group emphasized the multifractal nature of the heartbeat dynamics of healthy subjects, whereas the second group had established a close connection between healthy subjects and the occurrence of crucial events. We have analyzed the same set of data and established that in fact the heartbeats are characterized by the occurrence of crucial and Poisson events. An increase in the percentage of crucial events makes the multifractal spectrum broader, thereby bridging the results of the former group with the results of the latter group. The crucial events are characterized by a power index that signals the occurrence of 1/f noise for complex systems in the best physiological condition. These results led us to focus our analysis on the statistical properties of crucial events. We have adopted the same statistical analysis to study the statistical properties of the heartbeat dynamics of subjects practicing meditation. The heartbeats of people doing meditation are known to produce coherent fluctuations. In addition to this effect, we made the surprising discovery that meditation makes the heartbeat depart from the ideal condition of 1/f noise. We also discussed how to combine the wave-like nature of the dynamics of the brain with the existence of crucial events that are responsible for the 1/f noise. We showed that the anomalous scaling generated by the crucial events could be established by means of a direct analysis of raw data. The efficiency of the direct analysis procedure is made possible by the fact that periodicity and crucial events is the product of a spontaneous process of self-organization. We argue that the results of this study can be used to shed light into the nature of this process of self-organization.

O monitoramento de sinais vitais em pacientes tem o intuito de obter rapidamente dados relevantes para decisões médicas. No entanto, tal mensuração é pouco eficiente, difícil, quando não impossível, em determinados casos, como por exemplo em pacientes vítimas de queimaduras, em função da impossibilidade de colocar o eletrodo diretamente na pele, ou em recém-nascidos, devido à fragilidade da pele. Este estudo trata do desenvolvimento de um sistema para aquisição contínua de sinais fotopletismográficos para a telemetria da frequência cardíaca em tempo real, em uma plataforma de baixo custo, utilizando a biblioteca OpenCV e o método desenvolvido pelo MIT chamado de Magnificação de Vídeo Euleriana, que revela variações que são imperceptíveis a olho nu. Para desenvolver o sistema foi utilizada a plataforma de hardware Raspberry Pi Versão B com processador ARM11 de 700MHz e 512MB de memória RAM. Os dados da frequência cardíaca coletados dos experimentos foram comparados com os dados coletados por um oxímetro de dedo More Fitness modelo MF-425. Esse foi escolhido por utilizar o mesmo princípio "Fotopletismografia"para efetuar a medição. Após a coleta de dados foi estimado o intervalo de confiança para aferir a precisão do sistema, que correspondeu a 96,5% em relação ao oxímetro utilizado. Ficou evidente que o meio utilizado para medir a frequência cardíaca via método de magnificação de vídeo Euleriana em tempo real é uma tecnologia de baixo custo (aproximadamente R$300,00) quando comparado aos monitores multiparamétricos utilizados para o monitoramento de pacientes críticos, cujo custo varia entre R$ 8.000,00 e R$ 34.000,00. Sendo assim, também contribui com a redução de custos no tratamento ao doente que necessita de monitorização constante, possibilitando que, com a economia gerada pela aquisição e implantação desta tecnologia, viabilize um maior investimento em outras áreas dos hospitais. / Monitoring vital signs in patients is used to obtain relevant data for medical decisions in a fast way. However, this measurement is both inefficient and difficult, if not impossible in certain cases, such as in burnt victims, due to the impossibility of placing the electrodes directly on the skin or in infants, because of the fragility of skin. This study aims to develop of a system for continuous acquisition of photopletismografics (PPG) signals for the telemetry of heart rate in real time in a low cost platform using the OpenCV library and the method developed by MIT called the Eulerian Video Magnification, amplifying variations that are imperceptible to the naked eye. To develop the system were used the hardware platform Raspberry Pi version B with ARM11 700MHz processor and 512MB RAM. The heart rate data collected from the experi- ments were compared with data collected by a finger oximeter model More Fitness MF-425 it was chosen, by using the same working principle "PPG"to effect the measurement. After data collection was estimated the confidence interval to measure system accuracy, which corresponded to 96,5% compared to the oximeter used. It became clear that the developed system used to measure heart rate via magnification method of Eulerian live video is a low-cost technology (approximately R$ 300.00) compared to the multiparameter monitors used for monitoring critically patients, ranging in cost from R$ 8,000.00 to R$ 34,000.00. So also, it contributes to cost reduction in the treatment to the patient in need of constant monitoring, enabling with the savings generated by the acquisition and deployment of this technology makes possible greater investment in other areas of hospitals. / 5000

O monitoramento de sinais vitais em pacientes tem o intuito de obter rapidamente dados relevantes para decisões médicas. No entanto, tal mensuração é pouco eficiente, difícil, quando não impossível, em determinados casos, como por exemplo em pacientes vítimas de queimaduras, em função da impossibilidade de colocar o eletrodo diretamente na pele, ou em recém-nascidos, devido à fragilidade da pele. Este estudo trata do desenvolvimento de um sistema para aquisição contínua de sinais fotopletismográficos para a telemetria da frequência cardíaca em tempo real, em uma plataforma de baixo custo, utilizando a biblioteca OpenCV e o método desenvolvido pelo MIT chamado de Magnificação de Vídeo Euleriana, que revela variações que são imperceptíveis a olho nu. Para desenvolver o sistema foi utilizada a plataforma de hardware Raspberry Pi Versão B com processador ARM11 de 700MHz e 512MB de memória RAM. Os dados da frequência cardíaca coletados dos experimentos foram comparados com os dados coletados por um oxímetro de dedo More Fitness modelo MF-425. Esse foi escolhido por utilizar o mesmo princípio "Fotopletismografia"para efetuar a medição. Após a coleta de dados foi estimado o intervalo de confiança para aferir a precisão do sistema, que correspondeu a 96,5% em relação ao oxímetro utilizado. Ficou evidente que o meio utilizado para medir a frequência cardíaca via método de magnificação de vídeo Euleriana em tempo real é uma tecnologia de baixo custo (aproximadamente R$300,00) quando comparado aos monitores multiparamétricos utilizados para o monitoramento de pacientes críticos, cujo custo varia entre R$ 8.000,00 e R$ 34.000,00. Sendo assim, também contribui com a redução de custos no tratamento ao doente que necessita de monitorização constante, possibilitando que, com a economia gerada pela aquisição e implantação desta tecnologia, viabilize um maior investimento em outras áreas dos hospitais. / Monitoring vital signs in patients is used to obtain relevant data for medical decisions in a fast way. However, this measurement is both inefficient and difficult, if not impossible in certain cases, such as in burnt victims, due to the impossibility of placing the electrodes directly on the skin or in infants, because of the fragility of skin. This study aims to develop of a system for continuous acquisition of photopletismografics (PPG) signals for the telemetry of heart rate in real time in a low cost platform using the OpenCV library and the method developed by MIT called the Eulerian Video Magnification, amplifying variations that are imperceptible to the naked eye. To develop the system were used the hardware platform Raspberry Pi version B with ARM11 700MHz processor and 512MB RAM. The heart rate data collected from the experi- ments were compared with data collected by a finger oximeter model More Fitness MF-425 it was chosen, by using the same working principle "PPG"to effect the measurement. After data collection was estimated the confidence interval to measure system accuracy, which corresponded to 96,5% compared to the oximeter used. It became clear that the developed system used to measure heart rate via magnification method of Eulerian live video is a low-cost technology (approximately R$ 300.00) compared to the multiparameter monitors used for monitoring critically patients, ranging in cost from R$ 8,000.00 to R$ 34,000.00. So also, it contributes to cost reduction in the treatment to the patient in need of constant monitoring, enabling with the savings generated by the acquisition and deployment of this technology makes possible greater investment in other areas of hospitals. / 5000

Several sensor technologies have been developed and experimented over the last few decades to cater various needs of medical diagnostics. Among these, fiber optic sensors, in particular, Fiber Bragg Grating (FBG) based sensors have attracted considerable attention due to their inherent advantages such electrical passiveness, immunity to Electro Magnetic Interference (EMI), chemical inertness, etc. The present research work focuses on design, development and validation of FBG sensor based devices for measurement of certain healthcare parameters in the context of foot function/gait cycle, cardiac and breathing activity, nostril dominance, hand grip/wrist angle force function, etc. The experimental work presented here emphasizes on the effectiveness and competitiveness of the FBG devices developed, in comparison with standard tools such as Accelerometer, Load cell, Electronic Stethoscope, Electromyogram and Dynamometer. In the field of human balance, stability and geriatrics, two independent FBG devices namely, Fiber Bragg Grating based Stability Assessment Device (FBGSAD) and Optical Sensor Ground Reaction Force measurement Platform (OSGRFP) have been designed, developed and experimented for postural stability assessment and gait analysis respectively. The result of these studies have significant implications in understanding of the mechanism of plantar strain distribution, identifying issues in gait cycles, detecting foot function discrepancies, identifying individuals who are susceptible to falls and to qualify subjects for balance and stability. In the field of ergonomic assessment, Fiber Braggs Grating based Hand Grip Device (FBGHGD) is designed and developed for the measurement of hand grip force which helps in the understanding of several important biomechanical aspects such as neuromuscular system function, overall upper-limb strength, vertebral fracture, skeletal muscle function, prediction of disability, incapacity, mortality and bone mass density (forearm, skeletal sites, spine, hip etc.). Further as an extension of this work, the FBGHGD is used for measurement of force generated by the wrist in different positions of the flexion and extension which relates to the wrist muscle activity and its enactment. In the field of cardiac activity monitoring, a novel, in-vivo, non-invasive and portable device named Fiber Bragg Grating based Heart Beat Device (FBGHBD) is developed for the simultaneous measurement of respiratory and cardiac activities. The work involves designing FBGHBD, validating its performance against traditional diagnostic systems like electronic stethoscope, exploration of its clinical relevance and the usage of FBGHBD in studies involving normal persons and patients with myocardial infarction. The unique design of FBGHBD provides critical information such as nascent morphology of cardiac and breathing activity, heart rate variability, heart beat rhythm, etc., which can assist in early clinical diagnosis of many conditions associated to heart and lung malfunctioning. Further, the scope of this work extends towards evaluating several signal processing algorithms and demonstrating a suitable signal processing architecture for real-time extraction of heart beat and respiratory rates along with its nascent morphologies for critical health care application. In the area of breath monitoring, a Nostril Pressure and Temperature Device (NPTD) is designed and developed which aims at simultaneous, accurate and real-time measurement of nostril air flow pressure and temperature to aid in clinical diagnosis of nasal dysfunction and associated nose disorders. The results of NPTD can offer certain vital features like breathing pattern, respiratory rate, changes in individual nostril temperature/pressure, nostrils dominance, body core temperature etc., which can assist in early clinical diagnosis of breathing problems associated with heart, brain and lung malfunctioning. Since the research work in this thesis involve experiments engaging human subjects, necessary approvals from the ethical committee is obtained before the experiments and required ethical procedures are followed during all the experimental trials.

Introduction – Objectives. The cardiovascular system is in direct and constant interaction with its environment. Exposure to various environmental parameters, such as low temperature, air pollution and tobacco smoke, has been strongly associated with serious or even fatal cardiovascular outcomes. Arterial stiffening and greater wave reflection are age-related vascular modifications that lead to an increased risk of cardiovascular events. The aim of this work was to explore the relationship between selected environmental factors and arterial elastic properties in an effort to elucidate the underlying mechanisms that link these factors to increased cardiovascular mortality.<p><p>Study 1: Effects of cold exposure on central and peripheral vascular tone. Our first study explored the effects of cold exposure on aortic stiffness and peripheral microvascular tone. We observed that cold exposure, in addition to its chronotropic effects, provoked an increase in aortic stiffness, as assessed by aortic pulse wave velocity, as well as significant vasoconstriction of peripheral arterioles in the microcirculation. Moreover, we explored the magnitude of this effect in a different population (Black subjects of African origin), which is traditionally characterized by exaggerated reactions to adrenergic stimuli. We noted that the vascular reactions, in terms of both aortic stiffness and microvascular vasoconstriction, were more profound in Black Africans than in age-matched Caucasian-Whites. These results argue for a direct effect of cold exposure on arterial stiffness and peripheral vascular tone, probably through activation of the orthosympathetic system.<p><p>Study 2: Exposure to ambient particulate matter and arterial stiffness. We explored the effects of acute exposure to outdoor particulate matter on aortic stiffness and aortic wave reflection. We studied the relationship between central hemodynamic parameters and ambient concentration of particulate matter in a population of patients who attended the Hypertension Clinics of Athens University. After statistical correction for a number of potential confounders, we did not observe an association between ambient concentrations of particulate matter and aortic stiffness. However, in men, particulate matter concentration was related to the amplitude of the reflected wave reaching the aorta from the periphery. These results suggest a direct acute interaction between particulate matter concentration and vascular tone, leading to an enhanced arterial wave reflection.<p><p>Study 3: The role of nicotine on the vascular effects of environmental tobacco smoke. Environmental tobacco smoke is considered as the most important source of particulate matter in the indoor environment. We recently demonstrated that exposure to tobacco smoke augmented wave reflection, an effect that was not seen after equivalent exposure to the smoke of non-tobacco, herbal cigarettes. We also noticed that the increased wave reflection was proportional to the plasma concentrations of nicotine. However, a direct causal effect between nicotine, arterial wave reflection and aortic stiffness has never been clearly demonstrated. We observed that increasing nicotine plasma concentration to levels comparable to those seen after extensive exposure to environmental tobacco smoke, provoked an increase in both aortic stiffness and arterial wave reflection after correction for heart rate and blood pressure changes. These results confirm the significant participation of nicotine in the vascular effects of passive smoking.<p><p>Conclusions. Globally, our results reveal the deleterious effects of cold, particulate matter exposure, and nicotinic stimulation on arterial stiffness, peripheral microcirculation and aortic wave reflection. The hemodynamic modifications associated with these effects may at least partially explain the causal relation between cold exposure, ambient air pollution and cardiovascular mortality.<p><p>Introduction-Objectifs. Le système cardiovasculaire est en relation directe et constante avec l’environnement. L’exposition au froid, la pollution atmosphérique et le tabagisme passif sont associés à des événements cardiovasculaires aigus graves et même fatals. La rigidification des artères et l’intensification de la réflexion de l’onde de pouls au niveau de l’aorte accompagnent le vieillissement et prédisent un risque cardiovasculaire accru. Nous avons testés l’hypothèse que les effets cardiovasculaires délétères des facteurs environnementaux comportent une altération des propriétés élastiques artérielles. Ceci pourrait être un des mécanismes physiopathologiques qui lie la mortalité cardiovasculaire aux variables environnementales.<p><p>Étude 1 :Exposition au froid ;effets centraux et périphériques. Notre première étude portait sur l’effet de l’exposition au froid sur la rigidité aortique et le tonus vasculaire des artérioles périphériques. Nous avons démontré que l’exposition au froid, hormis ses effets chronotropes, provoquait une augmentation de la rigidité artérielle – mesuré par la vitesse de l’onde de pouls au niveau de l’aorte - ainsi qu’une vasoconstriction importante au niveau des artérioles de la microcirculation. Nous avons ensuite déterminé l’amplitude de cet effet dans une autre population (sujets Africains-Noirs) qui se caractérise par des réactions plus prononcées aux différentes stimulations adrénergiques. Nous avons observé que les réactions vasculaires, tant au niveau de la rigidité aortique qu’au niveau de la microcirculation, étaient plus marquées chez les Africains-Noirs que chez les Caucasiens. Ces résultats révèlent un effet délétère de l’exposition au froid sur la rigidité aortique et le tonus vasculaire des artères périphériques, probablement via une activation du système orthosympathique.<p><p>Étude 2 :Exposition aux microparticules atmosphériques et rigidité artérielle. Nous avons ensuite investigué les effets de la pollution atmosphérique sur la rigidité artérielle et la réflexion de l’onde de pouls vers l’aorte. Nous avons étudié la relation entre les paramètres hémodynamiques centraux et la concentration atmosphérique de microparticules dans une population de patients qui ont consulté la Clinique Universitaire d’Hypertension Artérielle d’Athènes. Après correction statistique pour les facteurs confondants, nous n’avons pas observé de corrélation entre la rigidité artérielle et le taux de microparticules atmosphériques dans l’ensemble de la population investiguée. Par contre, si on restreint l’analyse aux résultats obtenus chez les sujets masculins, on s’aperçoit que la concentration atmosphérique de microparticules était associée de façon significative avec l’amplitude de l’onde réfléchie par la périphérie vers l’aorte et la pression pulsée aortique. Ces résultants suggèrent un effet direct des microparticules au niveau de la microcirculation. L’augmentation de l’amplitude de l’onde réfléchie consécutive à une vasoconstriction périphérique, modifie vraisemblablement les pressions au niveau de l’aorte chez le sujet masculin lors de pics de pollution.<p><p>Etude 3 :Le rôle de la nicotine dans les effets vasculaires du tabagisme passif. Le tabagisme passif est considéré comme la source la plus importante d’émission de microparticules au niveau domestique. Cependant, la composition chimique des particules semble jouer un rôle essentiel sur les ondes de réflexion. Nous avons démontré récemment que l’exposition passive à la fumée des cigarettes du tabac augmente l’intensité de la réflexion de l’onde de pouls. Ceci n’a pas été observé avec l’exposition à la fumée des cigarettes non tabagiques, en dépit d’une concentration ambiante tout à fait comparable de microparticules. Par ailleurs, nous avons observé que l’augmentation de l’incidence de l’onde de pouls au niveau de l’aorte était fortement associée à la concentration plasmatique de la nicotine. Un lien causal entre la nicotine, réflexion de l’onde de pouls et rigidité artérielle n’avait jamais clairement été établi. Nous avons testé cette hypothèse en administrant la nicotine pure chez des sujets sains. Nous avons observé que l’augmentation des taux plasmatiques de la nicotine à des valeurs comparables à celles qui surviennent après une exposition intensive au tabagisme passif, intensifiait la réflexion de l’onde de pouls et augmentait la rigidité artérielle. La correction statistique pour l’augmentation de la fréquence cardiaque et l’augmentation de la pression artérielle en réponse à la nicotine ne modifiait pas ces conclusions. Nos résultats démontrent ainsi les effets cardiovasculaires importants de faibles concentrations de nicotine, similaires à ceux qui sont atteints en cas d’exposition à un tabagisme passif.<p><p>Conclusions. Nos résultats révèlent les effets néfastes de l’exposition au froid et aux microparticules atmosphériques sur la rigidité artérielle, la microcirculation périphérique et la réflexion de l’onde de pouls. Nous avons pu également démontrer le rôle de la stimulation nicotinique dans les effets vasculaires aigus du tabagisme passif, comme en témoigne l’augmentation de la réflexion de l’onde de pouls au niveau aortique. Ces modifications hémodynamiques favorisent l’ischémie myocardique, et constituent un des mécanismes par lesquels l’exposition au froid et à la pollution atmosphérique favorisent la pathologie cardiovasculaire.<p> / Doctorat en Sciences médicales / info:eu-repo/semantics/nonPublished

The ownership and demand for fitness trackers, smartwatches, and wrist-worn deviceshave been increasing globally. These devices offer various features such as measuringphysical activity, sleep monitoring, and health-related measurements like heart rate andheart rate variability using PhotoPlethysmoGraphy (PPG). However, research indicatesthat PPG measurements are less accurate on darker skin compared to lighter skin due to thehigher presence of melanin, a light-absorbing substance in dark skin.This thesis addresses the impact of melanin on the accuracy of heart rate measurements ondifferent skin colors using four commercial smartwatches, Apple Watch Series 5, FitbitCharge 2, Xiaomi Miband 3, and Sony mSafety. The study involves analyzing the accuracyof these smartwatches on individuals with varying skin colors while controlling forexternal factors. The collected data from the smartwatches are compared to a referencesensor that uses electrocardiography (ECG) measurements with electrodes placed aroundthe chest. Three different tests are conducted wearing the devices, with no movement,while walking, and with circular hand motions.The tests were conducted on twelve participants representing the 6 different skin typescategorized using the Fitzpatrick scale. With the presented results in this thesis, it wasconcluded that the 4 smartwatches' measurement accuracy does not seem to be dependenton specific skin types. Ranked in terms of Mean Absolute Error (MAE), the Apple Watchshowed the lowest value, followed by Xiaomi, Fitbit and the mSafety and that the accuracydid not depend on skin color. / Ägandet och efterfrågan av smartklockor har ökat globalt. Dessa enheter erbjuder olikafunktioner som mäter fysisk aktivitet, övervakning av sömn och hälsorelaterade mätningarsom puls och hjärtfrekvensvariabilitet med hjälp av PhotoPlethysmoGraphy (PPG).Forskning har dock visat att PPG-mätningar är mindre noggranna på mörkare hud jämförtmed ljusare hud på grund av den högre närvaron av substansen melanin, ettljusabsorberande ämne.Syftet med detta arbete är att undersöka påverkan av melanin på noggrannheten i pulsmätningar på olika hudfärger med hjälp av fyra kommersiella smartklockor: Apple WatchSeries 5, Fitbit Charge 2, Xiaomi Miband 3 och mSafety av Sony. Arbetet inkluderar enanalys av dessa smartklockors noggrannhet på personer med de olika hudfärger samtidigtsom externa faktorer som kan påverka noggrannheten kontrolleras. De insamlade data frånsmartklockorna jämförs med en referenssensor, Polar band, som använderelektrokardiografimätningar (ECG) med elektroder. Tre olika tester utförs med enheterna,utan rörelse, medan man går och med cirkulära handrörelser.Testerna utfördes på tolv deltagare som representerar olika hudtyper kategoriserade enligtFitzpatrick-skalan. Utifrån de presenterade resultaten i denna avhandling drogs slutsatsenatt de fyra smartklockornas mätnoggrannhet inte verkar vara beroende av specifikahudtyper. Rankade i termer av Mean Absolute Error (MAE) visade Apple Watch det lägstavärdet, följt av Xiaomi, Fitbit och mSafety.