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Fulltext A Comprehensive Review of the Recent Developments in Wearable Sweat-Sensing Devices

Ibrahim NFA, Sabani N, Johari S, Manaf AA, Wahab AA, Zakaria Z, et al.

Sensors (Basel), 2022 Oct 10;22(19).
PMID: 36236769 DOI: 10.3390/s22197670

Sweat analysis offers non-invasive real-time on-body measurement for wearable sensors. However, there are still gaps in current developed sweat-sensing devices (SSDs) regarding the concerns of mixing fresh and old sweat and real-time measurement, which are the requirements to ensure accurate the measurement of wearable devices. This review paper discusses these limitations by aiding model designs, features, performance, and the device operation for exploring the SSDs used in different sweat collection tools, focusing on continuous and non-continuous flow sweat analysis. In addition, the paper also comprehensively presents various sweat biomarkers that have been explored by earlier works in order to broaden the use of non-invasive sweat samples in healthcare and related applications. This work also discusses the target analyte's response mechanism for different sweat compositions, categories of sweat collection devices, and recent advances in SSDs regarding optimal design, functionality, and performance.

Matched MeSH terms: Monitoring, Physiologic
Fulltext Emergency medical services key performance measurement in Asian cities

Rahman NH, Tanaka H, Shin SD, Ng YY, Piyasuwankul T, Lin CH, et al.

Int J Emerg Med, 2015;8:12.
PMID: 25932052 DOI: 10.1186/s12245-015-0062-7

One of the key principles in the recommended standards is that emergency medical service (EMS) providers should continuously monitor the quality and safety of their services. This requires service providers to implement performance monitoring using appropriate and relevant measures including key performance indicators. In Asia, EMS systems are at different developmental phases and maturity. This will create difficultly in benchmarking or assessing the quality of EMS performance across the region. An attempt was made to compare the EMS performance index based on the structure, process, and outcome analysis.

Matched MeSH terms: Monitoring, Physiologic
A novel approach to detect respiratory phases from pulmonary acoustic signals using normalised power spectral density and fuzzy inference system

Palaniappan R, Sundaraj K, Sundaraj S, Huliraj N, Revadi SS

Clin Respir J, 2016 Jul;10(4):486-94.
PMID: 25515741 DOI: 10.1111/crj.12250

BACKGROUND: Monitoring respiration is important in several medical applications. One such application is respiratory rate monitoring in patients with sleep apnoea. The respiratory rate in patients with sleep apnoea disorder is irregular compared with the controls. Respiratory phase detection is required for a proper monitoring of respiration in patients with sleep apnoea.
AIMS: To develop a model to detect the respiratory phases present in the pulmonary acoustic signals and to evaluate the performance of the model in detecting the respiratory phases.
METHODS: Normalised averaged power spectral density for each frame and change in normalised averaged power spectral density between the adjacent frames were fuzzified and fuzzy rules were formulated. The fuzzy inference system (FIS) was developed with both Mamdani and Sugeno methods. To evaluate the performance of both Mamdani and Sugeno methods, correlation coefficient and root mean square error (RMSE) were calculated.
RESULTS: In the correlation coefficient analysis in evaluating the fuzzy model using Mamdani and Sugeno method, the strength of the correlation was found to be r = 0.9892 and r = 0.9964, respectively. The RMSE for Mamdani and Sugeno methods are RMSE = 0.0853 and RMSE = 0.0817, respectively.
CONCLUSION: The correlation coefficient and the RMSE of the proposed fuzzy models in detecting the respiratory phases reveals that Sugeno method performs better compared with the Mamdani method.

Matched MeSH terms: Monitoring, Physiologic/methods
Fulltext Hemodynamic monitoring and outcome-a physiological appraisal

Chan YK, Khan ZH

Acta Anaesthesiol Taiwan, 2011 Dec;49(4):154-8.
PMID: 22221689 DOI: 10.1016/j.aat.2011.11.002

Hemodynamic monitoring provides us with refined details about the cardiovascular system. In spite of increased availability of the monitoring process and monitoring equipment, hemodynamic monitoring has not significantly improved survival outcome. Care providers should be cognizant of the role of the cardiovascular system and its importance in oxygen delivery to the cells in order to sustain life. Effective hemodynamic monitoring should be able to delineate how well the system is performing in carrying out this role. Different hemodynamic monitors serve in this role to a different extent; some provide very little information on this. The cardiovascular system is only one of the many systems that need to function optimally for survival; others of equal importance include the integrity of the airway, the breathing process, the adequacy of hemoglobin level, and the health of the tissue bed, especially in the brain and the heart. Advances in hemodynamic monitoring with focus on oxygen delivery at the cellular level may ultimately provide the edge to effective monitoring that can impact outcome.

Matched MeSH terms: Monitoring, Physiologic*
Feasibility of A-mode ultrasound attenuation as a monitoring method of local hyperthermia treatment

Manaf NA, Aziz MN, Ridzuan DS, Mohamad Salim MI, Wahab AA, Lai KW, et al.

Med Biol Eng Comput, 2016 Jun;54(6):967-81.
PMID: 27039402 DOI: 10.1007/s11517-016-1480-2

Recently, there is an increasing interest in the use of local hyperthermia treatment for a variety of clinical applications. The desired therapeutic outcome in local hyperthermia treatment is achieved by raising the local temperature to surpass the tissue coagulation threshold, resulting in tissue necrosis. In oncology, local hyperthermia is used as an effective way to destroy cancerous tissues and is said to have the potential to replace conventional treatment regime like surgery, chemotherapy or radiotherapy. However, the inability to closely monitor temperature elevations from hyperthermia treatment in real time with high accuracy continues to limit its clinical applicability. Local hyperthermia treatment requires real-time monitoring system to observe the progression of the destroyed tissue during and after the treatment. Ultrasound is one of the modalities that have great potential for local hyperthermia monitoring, as it is non-ionizing, convenient and has relatively simple signal processing requirement compared to magnetic resonance imaging and computed tomography. In a two-dimensional ultrasound imaging system, changes in tissue microstructure during local hyperthermia treatment are observed in terms of pixel value analysis extracted from the ultrasound image itself. Although 2D ultrasound has shown to be the most widely used system for monitoring hyperthermia in ultrasound imaging family, 1D ultrasound on the other hand could offer a real-time monitoring and the method enables quantitative measurement to be conducted faster and with simpler measurement instrument. Therefore, this paper proposes a new local hyperthermia monitoring method that is based on one-dimensional ultrasound. Specifically, the study investigates the effect of ultrasound attenuation in normal and pathological breast tissue when the temperature in tissue is varied between 37 and 65 °C during local hyperthermia treatment. Besides that, the total protein content measurement was also conducted to investigate the relationship between attenuation and tissue denaturation level at different temperature ranges. The tissues were grouped according to their histology results, namely normal tissue with large predominance of cells (NPC), cancer tissue with large predominance of cells (CPC) and cancer with high collagen fiber content (CHF). The result shows that the attenuation coefficient of ultrasound measured following the local hyperthermia treatment increases with the increment of collagen fiber content in tissue as the CHF attenuated ultrasound at the highest rate, followed by NPC and CPC. Additionally, the attenuation increment is more pronounced at the temperature over 55 °C. This describes that the ultrasound wave experienced more energy loss when it propagates through a heated tissue as the tissue structure changes due to protein coagulation effect. Additionally, a significant increase in the sensitivity of attenuation to protein denaturation is also observed with the highest sensitivity obtained in monitoring NPC. Overall, it is concluded that one-dimensional ultrasound can be used as a monitoring method of local hyperthermia since its attenuation is very sensitive to the changes in tissue microstructure during hyperthermia.

Matched MeSH terms: Monitoring, Physiologic*
Fulltext Compliance with monitoring standards for anaesthesia in Malaysian hospitals

Khoo TH, Cardosa MS, Inbasegaran K

Med J Malaysia, 1999 Mar;54(1):72-8.
PMID: 10972008

The Malaysian Society of Anaesthesiologists published a document entitled "Recommendations for Standards of Monitoring during Anaesthesia and Recovery" in 1993. This paper examines the results of two surveys, carried out in 1995 and 1996 respectively; to determine compliance with published Monitoring Standards in Malaysian public and private hospitals. In the private sector, compliance with the recommended standards during anaesthesia varied greatly. Of the 28 government hospitals surveyed in 1996, compliance with monitoring standards during anaesthesia was almost 100%. Standards in recovery areas were less than ideal. The majority of anaesthesiologists thought that the current recommended standards were adequate.

Matched MeSH terms: Monitoring, Physiologic/standards*
Fulltext Evaluation of conventional and computerised monitoring of cardiac function in the coronary care unit

Ng KH

Med J Malaysia, 1983 Dec;38(4):289-93.
PMID: 6599984

One of the important functions of the Coronary Care Unit (CCU) is the continuous and intensive monitoring of cardiac function. To date, many monitoring techniques have been developed and tested. In this paper, both the conventional and computerised monitoring techniques are reviewed and evaluated. It is shown that a computerised system has several defirute advantages over the conventional system, e.g. lower false alarm rate, accurate and fast data processing, retrospective studies. However one also ought to be aware of the limitations,

Matched MeSH terms: Monitoring, Physiologic*
Fulltext Real-Time Smart-Digital Stethoscope System for Heart Diseases Monitoring

Chowdhury MEH, Khandakar A, Alzoubi K, Mansoor S, M Tahir A, Reaz MBI, et al.

Sensors (Basel), 2019 Jun 20;19(12).
PMID: 31226869 DOI: 10.3390/s19122781

One of the major causes of death all over the world is heart disease or cardiac dysfunction. These diseases could be identified easily with the variations in the sound produced due to the heart activity. These sophisticated auscultations need important clinical experience and concentrated listening skills. Therefore, there is an unmet need for a portable system for the early detection of cardiac illnesses. This paper proposes a prototype model of a smart digital-stethoscope system to monitor patient's heart sounds and diagnose any abnormality in a real-time manner. This system consists of two subsystems that communicate wirelessly using Bluetooth low energy technology: A portable digital stethoscope subsystem, and a computer-based decision-making subsystem. The portable subsystem captures the heart sounds of the patient, filters and digitizes, and sends the captured heart sounds to a personal computer wirelessly to visualize the heart sounds and for further processing to make a decision if the heart sounds are normal or abnormal. Twenty-seven t-domain, f-domain, and Mel frequency cepstral coefficients (MFCC) features were used to train a public database to identify the best-performing algorithm for classifying abnormal and normal heart sound (HS). The hyper parameter optimization, along with and without a feature reduction method, was tested to improve accuracy. The cost-adjusted optimized ensemble algorithm can produce 97% and 88% accuracy of classifying abnormal and normal HS, respectively.

Matched MeSH terms: Monitoring, Physiologic*
A fuzzy logic control in adjustable autonomy of a multi-agent system for an automated elderly movement monitoring application

Mostafa SA, Mustapha A, Mohammed MA, Ahmad MS, Mahmoud MA

Int J Med Inform, 2018 04;112:173-184.
PMID: 29500017 DOI: 10.1016/j.ijmedinf.2018.02.001

Autonomous agents are being widely used in many systems, such as ambient assisted-living systems, to perform tasks on behalf of humans. However, these systems usually operate in complex environments that entail uncertain, highly dynamic, or irregular workload. In such environments, autonomous agents tend to make decisions that lead to undesirable outcomes. In this paper, we propose a fuzzy-logic-based adjustable autonomy (FLAA) model to manage the autonomy of multi-agent systems that are operating in complex environments. This model aims to facilitate the autonomy management of agents and help them make competent autonomous decisions. The FLAA model employs fuzzy logic to quantitatively measure and distribute autonomy among several agents based on their performance. We implement and test this model in the Automated Elderly Movements Monitoring (AEMM-Care) system, which uses agents to monitor the daily movement activities of elderly users and perform fall detection and prevention tasks in a complex environment. The test results show that the FLAA model improves the accuracy and performance of these agents in detecting and preventing falls.

Matched MeSH terms: Monitoring, Physiologic/methods*
Adaptive neuro-fuzzy inference system for breath phase detection and breath cycle segmentation

Palaniappan R, Sundaraj K, Sundaraj S

Comput Methods Programs Biomed, 2017 Jul;145:67-72.
PMID: 28552127 DOI: 10.1016/j.cmpb.2017.04.013

BACKGROUND: The monitoring of the respiratory rate is vital in several medical conditions, including sleep apnea because patients with sleep apnea exhibit an irregular respiratory rate compared with controls. Therefore, monitoring the respiratory rate by detecting the different breath phases is crucial.
OBJECTIVES: This study aimed to segment the breath cycles from pulmonary acoustic signals using the newly developed adaptive neuro-fuzzy inference system (ANFIS) based on breath phase detection and to subsequently evaluate the performance of the system.
METHODS: The normalised averaged power spectral density for each segment was fuzzified, and a set of fuzzy rules was formulated. The ANFIS was developed to detect the breath phases and subsequently perform breath cycle segmentation. To evaluate the performance of the proposed method, the root mean square error (RMSE) and correlation coefficient values were calculated and analysed, and the proposed method was then validated using data collected at KIMS Hospital and the RALE standard dataset.
RESULTS: The analysis of the correlation coefficient of the neuro-fuzzy model, which was performed to evaluate its performance, revealed a correlation strength of r = 0.9925, and the RMSE for the neuro-fuzzy model was found to equal 0.0069.
CONCLUSION: The proposed neuro-fuzzy model performs better than the fuzzy inference system (FIS) in detecting the breath phases and segmenting the breath cycles and requires less rules than FIS.

Matched MeSH terms: Monitoring, Physiologic/methods*
Fulltext Development of a Scalable Testbed for Mobile Olfaction Verification

Zakaria SM, Visvanathan R, Kamarudin K, Yeon AS, Md Shakaff AY, Zakaria A, et al.

Sensors (Basel), 2015;15(12):30894-912.
PMID: 26690175 DOI: 10.3390/s151229834

The lack of information on ground truth gas dispersion and experiment verification information has impeded the development of mobile olfaction systems, especially for real-world conditions. In this paper, an integrated testbed for mobile gas sensing experiments is presented. The integrated 3 m × 6 m testbed was built to provide real-time ground truth information for mobile olfaction system development. The testbed consists of a 72-gas-sensor array, namely Large Gas Sensor Array (LGSA), a localization system based on cameras and a wireless communication backbone for robot communication and integration into the testbed system. Furthermore, the data collected from the testbed may be streamed into a simulation environment to expedite development. Calibration results using ethanol have shown that using a large number of gas sensor in the LGSA is feasible and can produce coherent signals when exposed to the same concentrations. The results have shown that the testbed was able to capture the time varying characteristics and the variability of gas plume in a 2 h experiment thus providing time dependent ground truth concentration maps. The authors have demonstrated the ability of the mobile olfaction testbed to monitor, verify and thus, provide insight to gas distribution mapping experiment.

Matched MeSH terms: Monitoring, Physiologic
Fulltext From ultrasound images to block based region motion estimation

Ranjit S, Sim K, Besar R, Tso C

Biomed Imaging Interv J, 2009 Jul;5(3):e32.
PMID: 21611059 MyJurnal DOI: 10.2349/biij.5.3.e32

By applying a hexagon-diamond search (HDS) method to an ultrasound image, the path of an object is able to be monitored by extracting images into macro-blocks, thereby achieving image redundancy is reduced from one frame to another, and also ascertaining the motion vector within the parameters searched. The HDS algorithm uses six search points to form the six sides of the hexagon pattern, a centre point, and a further four search points to create diamond pattern within the hexagon that clarifies the focus of the subject area.

Matched MeSH terms: Monitoring, Physiologic
Fulltext Monitoring of serum gentamicin level in a general hospital

Hussin Z, Lim VKE

Med J Malaysia, 1982 Jun;37(2):104-7.
PMID: 7132829

Gentamicin is an aminoglycoside antibiotic which is commonly used in the treatment of serious Gram-negative infections. However, gentamicin like other aminoglycosides, has a narrow therapeutic index and is potentially ototoxic and nephrotoxic. Blood levels following administration of gentamicin has been shown to be highly unpredictable and monitoring of gentamicin levels is necessary to ensure effective therapeutic levels as well as to avoid toxicity. The Department of Microbiology, Universiti Kebangsaan Malaysia offers such a monitoring service. This paper analyses the results of 135 such estimations performed between August 1979 and May 1981. It is shown that a significant proportion of patients were receiving either too much or too little gentamicin. Empirical determinations of dosages is unsatisfactory and as the microbiological assay method of determining gentamicin levels is both easy to perform and inexpensive, such a service should be offered by all general hospitals in Malaysia.

Matched MeSH terms: Monitoring, Physiologic
Determining Spatial Resolution of Gamma Cameras Using MATLAB

Velo P, Zakaria A

J Med Imaging Radiat Sci, 2017 Mar;48(1):39-42.
PMID: 31047208 DOI: 10.1016/j.jmir.2016.10.010

It is important to monitor the spatial resolution of a gamma camera on a weekly basis to acquire medical images with accurate quantitative information. A simple and fast computer program with a graphical user interface to analyze spatial resolution was successfully developed using MATLAB. The results were compared with those obtained from the standard processing system available in our gamma camera. The spatial resolution calculated using MATLAB was 1.24% lower than using the standard processing system. The developed program is cost effective, faster, and provides an easy platform for the physicists and technologists to analyze the spatial resolution based on the image of the line source.

Matched MeSH terms: Monitoring, Physiologic
Fulltext DEVELOPMENT OF BATTERY MONITORING SYSTEM USING ARDUINO UNO MICROCONTROLLER

NURUL FITRIYAH ROSLAN, WAN MARIAM WAN MUDA

UMT Journal of Undergraduate Research, 2020;2(4):41-50.
MyJurnal

Battery Monitoring System (BMoS) is an electronic system that monitors rechargeable battery cells or packs with various parameters, such as battery voltage, current and State-of-Charge (SoC). This system can be used to avoid overcharging or over-discharging of batteries to increase its shelf life. However, BMoS on the market is very expensive and not suitable for low cost embedded systems. As the Arduino Uno is widely used for low cost microcontroller boards, easy programming environment, and open-source platforms for building electronic projects, therefore, this study focuses on Arduino Uno BMoS based system. This system consists of current and voltage sensors, an Arduino Uno microcontroller and a liquid crystal display (LCD). In order to develop this system, there are three objectives to be achieved. First, the relationship between input and output of the sensors must be derived mathematically. The mathematical expression obtained can be verified by connecting and disconnecting the circuit with load and monitoring the value of output sensors. Then, a complete prototype of the BMoS was developed by connecting the LCD, current and voltage sensors to the Arduino Uno microcontroller. The complete prototype was tested using an 11.1 V of Lithium-ion battery and a DC motor as a load. From the results, the current sensor shows zero value when no load is connected as no current flow. The LCD also displays 11.1V of battery voltage when fully charged. Using the developed system, the user can monitor the current, the voltage and the SoC of the battery to ensure the battery is not overcharged and overused. The development of the BMoS can help to monitor the operation and performance of the batteries in any electronic systems. At the end of this study, the complete BMoS prototype gives benefits to the user and makes work easier.

Matched MeSH terms: Monitoring, Physiologic
Fulltext BeSafe B2.0 Smart Multisensory Platform for Safety in Workplaces

Márquez-Sánchez S, Campero-Jurado I, Robles-Camarillo D, Rodríguez S, Corchado-Rodríguez JM

Sensors (Basel), 2021 May 12;21(10).
PMID: 34066186 DOI: 10.3390/s21103372

Wearable technologies are becoming a profitable means of monitoring a person's health state, such as heart rate and physical activity. The use of the smartwatch is becoming consolidated, not only as a novelty but also as a very useful tool for daily use. In addition, other devices, such as helmets or belts, are beneficial for monitoring workers and the early detection of any anomaly. They can provide valuable information, especially in work environments, where they help reduce the rate of accidents and occupational diseases, which makes them powerful Personal Protective Equipment (PPE). The constant monitoring of the worker's health can be done in real-time, through temperature, falls, noise, impacts, or heart rate meters, activating an audible and vibrating alarm when an anomaly is detected. The gathered information is transmitted to a server in charge of collecting and processing it. In the first place, this paper provides an exhaustive review of the state of the art on works related to electronics for human activity behavior. After that, a smart multisensory bracelet, combined with other devices, developed a control platform that can improve operators' security in the working environment. Artificial Intelligence and the Internet of Things (AIoT) bring together the information to improve safety on construction sites, power stations, power lines, etc. Real-time and historic data is used to monitor operators' health and a hybrid system between Gaussian Mixture Model and Human Activity Classification. That is, our contribution is also founded on the use of two machine learning models, one based on unsupervised learning and the other one supervised. Where the GMM gave us a performance of 80%, 85%, 70%, and 80% for the 4 classes classified in real time, the LSTM obtained a result under the confusion matrix of 0.769, 0.892, and 0.921 for the carrying-displacing, falls, and walking-standing activities, respectively. This information was sent in real time through the platform that has been used to analyze and process the data in an alarm system.

Matched MeSH terms: Monitoring, Physiologic
Fulltext Assessment of transformer health index using different model

Jasni, J., Azmi, A., Azis, N., Yahaya, M.S., Talib, M.A.

Pertanika Journal of Science & Technology, 2017;25(102):143-150.
MyJurnal

Transformer failures lead to interruption of power supply. Therefore, asset management is important to monitor the efficient functioning of transformers. An important approach in asset management is condition assessment whereby the health status of the transformer is assessed via a health index. There are many methods in determining the final value of a health index. This paper examines how different assessment methods can be used in order to come up with the final health index and output of final health index. The output trend shapes are almost the same for Assessment Model A, B and C except for Assessment Model D. There is no strong correlation between the health index and age of the transformer. Generally, the value of health index of the transformer is reflected by its operation and loading history .This paper hence examines the assessment steps and results that will guide the development of a new approach to determine health index value.

Matched MeSH terms: Monitoring, Physiologic
Fulltext Investigating insulator UV signal frequency components as potential tools for condition monitoring of ceramic insulators

Saiful Mohammad Iezham Suhaimi, Nouruddeen Bashir, Nor Asiah Muhamad, Mohd Aizam Talib

Pertanika Journal of Science & Technology, 2017;25(102):291-298.
MyJurnal

Contaminated and ageing transmission line insulators often suffer from temporary or permanent loss of their insulating properties due to flashover resulting in power system failure. Surface discharges are precursors to flashover. To pre-empt any occurrence of flashovers, utility companies monitor the conditions of their insulators. There are numerous insulator surface monitoring techniques such as Leakage Current, Acoustics, and Infrared. However, these techniques may not be suitable for in-situ condition monitoring of the insulators as they are prone to noise, affected by environmental conditions or contact methods. Monitoring of the UV signals emitted by the surface discharges of these insulators has been reported to be a promising technique. However, comprehensive studies on this technique is lacking, especially on aged insulators. This paper investigated the UV signals of contaminated and aged insulators detected during surface discharge activities using UV pulse method. The time and frequency domain of the UV signals were analysed for a group of insulator samples having varying levels of contamination and phases of ageing. Results show that there is a strong correlation between the contamination level and ageing of the insulators with the amplitude and harmonic components of the UV signals. This correlation can useful to monitor in-service insulator surface conditions.

Matched MeSH terms: Monitoring, Physiologic
A study on the S2 -EWMA chart for monitoring the process variance based on the MRL Performance

Teh Sin Yin, Ong Ker Hsin, Soh Keng Lin, Khoo Michael Boon Chong, Teoh Wei Li

Sains Malaysiana, 2015;44:1067-1075.

The existing optimal design of the fixed sampling interval S2-EWMA control chart to monitor the sample variance of a process is based on the average run length (ARL) criterion. Since the shape of the run length distribution changes with the magnitude of the shift in the variance, the median run length (MRL) gives a more meaningful explanation about the in-control and out-of-control performances of a control chart. This paper proposes the optimal design of the S2-EWMA chart, based on the MRL. The Markov chain technique is employed to compute the MRLs. The performances of the S2-EWMA chart, double sampling (DS) S2 chart and S chart are evaluated and compared. The MRL results indicated that the S2-EWMA chart gives better performance for detecting small and moderate variance shifts, while maintaining almost the same sensitivity as the DS S2 and S charts toward large variance shifts, especially when the sample size increases.

Matched MeSH terms: Monitoring, Physiologic
Highly-sensitive graphene-based flexible pressure sensor platform

Muhammad Aniq Shazni, Lee MW, Lee HW

Sains Malaysiana, 2017;46:1155-1161.

In this work, graphene has been utilized as the sensing material for the development of a highly-sensitive flexible pressure sensor platform. It has been demonstrated that a graphene-based pressure sensor platform that is able to measure pressure change of up to 3 psi with a sensitivity of 0.042 psi-1 and a non-linearity of less than 1% has been accomplished. The developed device, which resides on a flexible platform, will be applicable for integration in continuous wearables health-care monitoring system for the measurement of blood pressure.

Matched MeSH terms: Monitoring, Physiologic

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