We propose the signal quality index (SQI) algorithm as a novel tool for quantitatively assessing the functional near infrared spectroscopy (fNIRS) signal quality in a numeric scale from 1 (very low quality) to 5 (very high quality). The algorithm comprises two preprocessing steps followed by three consecutive rating stages. The results on a dataset annotated by independent fNIRS experts showed SQI performed significantly better (p<0.05) than PHOEBE (placing headgear optodes efficiently before experimentation) and SCI (scalp coupling index), two existing algorithms, in both quantitatively rating and binary classifying the fNIRS signal quality. Employment of the proposed algorithm to estimate the signal quality before processing the fNIRS signals increases certainty in the interpretations.

Recent studies have established that cardiac and respiratory phases can modulate perception and related neural dynamics. While heart rate and respiratory sinus arrhythmia possibly affect interoception biomarkers, such as heartbeat-evoked potentials, the relative changes in heart rate and cardiorespiratory dynamics in interoceptive processes have not yet been investigated. In this study, we investigated the variation in heart and breathing rates, as well as higher functional dynamics including cardiorespiratory correlation and frontal hemodynamics measured with fNIRS, during a heartbeat counting task. To further investigate the functional physiology linked to changes in vagal activity caused by specific breathing rates, we performed the heartbeat counting task together with a controlled breathing rate task. The results demonstrate that focusing on heartbeats decreases breathing and heart rates in comparison, which may be part of the physiological mechanisms related to “listening” to the heart, the focus of attention, and self-awareness. Focusing on heartbeats was also observed to increase frontal connectivity, supporting the role of frontal structures in the neural monitoring of visceral inputs. However, cardiorespiratory correlation is affected by both heartbeats counting and controlled breathing tasks. Based on these results, we concluded that variations in heart and breathing rates are confounding factors in the assessment of interoceptive abilities and relative fluctuations in breathing and heart rates should be considered to be a mode of covariate measurement of interoceptive processes.

Fetal growth restriction, affecting up to 10% of pregnancies, is a critical factor contributing to perinatal mortality and morbidity. Ultrasound measurements of the fetal abdominal circumference (AC) are a key aspect of monitoring fetal growth. However, the routine practice of biometric obstetric ultrasounds is limited in low-resource settings due to the high cost of sonography equipment and the scarcity of trained sonographers. To address this issue, we organized the ACOUSLIC-AI (Abdominal Circumference Operator-agnostic UltraSound measurement in Low-Income Countries) challenge to investigate the feasibility of automatically estimating fetal AC from blind-sweep ultrasound scans acquired by novice operators using low-cost devices. Training data, collected from three Public Health Units (PHUs) in Sierra Leone are made publicly available. Private validation and test sets, containing data from two PHUs in Tanzania and a European hospital, are provided through the Grand-Challenge platform. All sets were annotated by experienced readers. Sixteen international teams participated in this challenge, with six teams submitting to the Final Test Phase. In this article, we present the results of the three top-performing AI models from the ACOUSLIC-AI challenge, which are publicly accessible. We evaluate their performance in fetal abdomen frame selection, segmentation, abdominal circumference measurement, and compare their performance against clinical standards for fetal AC measurement. Clinical comparisons demonstrated that the limits of agreement (LoA) for A2 in fetal AC measurements are comparable to the interobserver LoA reported in the literature. The algorithms developed as part of the ACOUSLIC-AI challenge provide a benchmark for future algorithms on the selection and segmentation of fetal abdomen frames to further minimize fetal abdominal circumference measurement variability.

Objective: Respiration is recognized as a systematic physiological interference in functional near-infrared spectroscopy (fNIRS). However, it remains unanswered as to whether it is possible to estimate the respiratory rate (RR) from such interference. Undoubtedly, RR estimation from fNIRS can provide complementary information that can be used alongside the cerebral activity analysis, e.g., sport studies. Thus, the objective of this paper is to propose a method for RR estimation from fNIRS. Our primary presumption is that changes in the baseline wander of oxygenated hemoglobin concentration ($O_{2}Hb$) signal are related to RR. Methods: fNIRS and respiratory signals were concurrently collected from subjects during controlled breathing tasks at a constant rate from 0.1 Hz to 0.4 Hz. Firstly, the signal quality index algorithm is employed to select the best $O_{2}Hb$ signal, and then a band-pass filter with cut-off frequencies from 0.05 to 2 Hz is used to remove very low- and high-frequency artifacts. Secondly, troughs of the filtered $O_{2}Hb$ signal are localized for synthesizing the baseline wander (S1) using cubic spline interpolation. Finally, the fast Fourier transform of the S1 signal is computed, and its dominant frequency is considered as RR. In this paper, two different datasets were employed, where the first one was used for the parameter adjustment of the proposed method, and the second one was solely used for testing. Results: The low mean absolute error between the reference and estimated RRs for the first and second datasets (2.6 and 1.3 breaths per minute, respectively) indicates the feasibility of the proposed method for RR estimation from fNIRS. Significance: This paper provides a novel view on the respiration interference as a source of complementary information in fNIRS.

Recent studies have established that cardiac and respiratory phases can modulate perception and related neural dynamics. While heart rate and respiratory sinus arrhythmia possibly affect interoception biomarkers, such as heartbeat-evoked potentials, the relative changes in heart rate and cardiorespiratory dynamics in interoceptive processes have not yet been investigated. In this study, we investigated the variation in heart and breathing rates, as well as higher functional dynamics including cardiorespiratory correlation and frontal hemodynamics measured with fNIRS, during a heartbeat counting task. To further investigate the functional physiology linked to changes in vagal activity caused by specific breathing rates, we performed the heartbeat counting task together with a controlled breathing rate task. The results demonstrate that focusing on heartbeats decreases breathing and heart rates in comparison, which may be part of the physiological mechanisms related to “listening” to the heart, the focus of attention, and self-awareness. Focusing on heartbeats was also observed to increase frontal connectivity, supporting the role of frontal structures in the neural monitoring of visceral inputs. However, cardiorespiratory correlation is affected by both heartbeats counting and controlled breathing tasks. Based on these results, we concluded that variations in heart and breathing rates are confounding factors in the assessment of interoceptive abilities and relative fluctuations in breathing and heart rates should be considered to be a mode of covariate measurement of interoceptive processes.

Blind-sweep ultrasound protocols may improve prenatal care in low-resource settings, but lower-uterus visualization is often insufficient when performed by novices. We evaluated three modifications to a standard protocol aimed at improving lower-uterus imaging: Step A (caudal probe tilt), Step B (caudal sweep with probe angled caudally), and Step C (caudo-cranial sweep with lower probe placement). Outcomes included fetal head visibility, number of scans with measurable head circumference (HC), and agreement with clinical HC measurements. Adding Steps A or B substantially increased fetal head visibility and the proportion of scans with measurable HC. Step A produced the largest improvement, raising scans with \(\ge 2/3\) head visibility from 25.5% to 93.8%, and increasing measurable HC from 55.2% to 99.5% for a reader experienced in blind-sweep analysis (\(n=210\)), and from 7.8% to 74.8% in a subset (\(n=103\)) annotated by an obstetric gynecologist. These gains were concentrated in scans where the standard protocol failed to visualize the fetal head, with no significant benefit when at least partial visibility was already achieved. Bias and limits of agreement with clinical HC were similar across all variants, indicating accurate measurements when usable frames were available. Step C provided minimal improvement. Insufficient lower-uterus visualization is a frequent but easily correctable limitation of blind-sweep protocols performed with minimal supervision. A simple caudal tilt (Step A) enhances fetal head visibility and measurable HC rate, supporting its integration into standardized protocols for novices. Prospective validation in low-resource settings is needed to confirm generalizability under varying training and supervision conditions.