{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T05:57:41Z","timestamp":1781243861984,"version":"3.54.1"},"reference-count":59,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,5,5]],"date-time":"2023-05-05T00:00:00Z","timestamp":1683244800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Union\u2019s Horizon 2020 Framework Program","award":["No. 813843"],"award-info":[{"award-number":["No. 813843"]}]},{"name":"European Union\u2019s Horizon 2020 Framework Program","award":["No. 813234"],"award-info":[{"award-number":["No. 813234"]}]},{"name":"European Union\u2019s Horizon 2020 Framework Program","award":["PROJ-00872"],"award-info":[{"award-number":["PROJ-00872"]}]},{"name":"European Fund for Regional Development (EFRO)","award":["No. 813843"],"award-info":[{"award-number":["No. 813843"]}]},{"name":"European Fund for Regional Development (EFRO)","award":["No. 813234"],"award-info":[{"award-number":["No. 813234"]}]},{"name":"European Fund for Regional Development (EFRO)","award":["PROJ-00872"],"award-info":[{"award-number":["PROJ-00872"]}]},{"name":"Dutch provinces Gelderland and Overijssel","award":["No. 813843"],"award-info":[{"award-number":["No. 813843"]}]},{"name":"Dutch provinces Gelderland and Overijssel","award":["No. 813234"],"award-info":[{"award-number":["No. 813234"]}]},{"name":"Dutch provinces Gelderland and Overijssel","award":["PROJ-00872"],"award-info":[{"award-number":["PROJ-00872"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Background: Near-infrared spectroscopy (NIRS) relative concentration signals contain \u2018noise\u2019 from physiological processes such as respiration and heart rate. Simultaneous assessment of NIRS and respiratory rate (RR) using a single sensor would facilitate a perfectly time-synced assessment of (cerebral) physiology. Our aim was to extract respiratory rate from cerebral NIRS intensity signals in neonates admitted to a neonatal intensive care unit (NICU). Methods: A novel algorithm, NRR (NIRS RR), is developed for extracting RR from NIRS signals recorded from critically ill neonates. In total, 19 measurements were recorded from ten neonates admitted to the NICU with a gestational age and birth weight of 38 \u00b1 5 weeks and 3092 \u00b1 990 g, respectively. We synchronously recorded NIRS and reference RR signals sampled at 100 Hz and 0.5 Hz, respectively. The performance of the NRR algorithm is assessed in terms of the agreement and linear correlation between the reference and extracted RRs, and it is compared statistically with that of two existing methods. Results: The NRR algorithm showed a mean error of 1.1 breaths per minute (BPM), a root mean square error of 3.8 BPM, and Bland\u2013Altman limits of agreement of 6.7 BPM averaged over all measurements. In addition, a linear correlation of 84.5% (p &lt; 0.01) was achieved between the reference and extracted RRs. The statistical analyses confirmed the significant (p &lt; 0.05) outperformance of the NRR algorithm with respect to the existing methods. Conclusions: We showed the possibility of extracting RR from neonatal NIRS in an intensive care environment, which showed high correspondence with the reference RR recorded. Adding the NRR algorithm to a NIRS system provides the opportunity to record synchronously different physiological sources of information about cerebral perfusion and respiration by a single monitoring system. This allows for a concurrent integrated analysis of the impact of breathing (including apnea) on cerebral hemodynamics.<\/jats:p>","DOI":"10.3390\/s23094487","type":"journal-article","created":{"date-parts":[[2023,5,5]],"date-time":"2023-05-05T02:56:51Z","timestamp":1683255411000},"page":"4487","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Respiratory Rate Extraction from Neonatal Near-Infrared Spectroscopy Signals"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2751-1586","authenticated-orcid":false,"given":"Naser","family":"Hakimi","sequence":"first","affiliation":[{"name":"Artinis Medical Systems, B.V., Einsteinweg 17, 6662 PW Elst, The Netherlands"},{"name":"Department of Neonatology, Wilhelmina Children\u2019s Hospital, University Medical Center Utrecht, Lundlaan 6, 3584 EA Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6625-7923","authenticated-orcid":false,"given":"Mohammad","family":"Shahbakhti","sequence":"additional","affiliation":[{"name":"Artinis Medical Systems, B.V., Einsteinweg 17, 6662 PW Elst, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rn M.","family":"Horschig","sequence":"additional","affiliation":[{"name":"Artinis Medical Systems, B.V., Einsteinweg 17, 6662 PW Elst, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3306-1830","authenticated-orcid":false,"given":"Thomas","family":"Alderliesten","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Wilhelmina Children\u2019s Hospital, University Medical Center Utrecht, Lundlaan 6, 3584 EA Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Van Bel","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Wilhelmina Children\u2019s Hospital, University Medical Center Utrecht, Lundlaan 6, 3584 EA Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willy N. J. M.","family":"Colier","sequence":"additional","affiliation":[{"name":"Artinis Medical Systems, B.V., Einsteinweg 17, 6662 PW Elst, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeroen","family":"Dudink","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Wilhelmina Children\u2019s Hospital, University Medical Center Utrecht, Lundlaan 6, 3584 EA Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"100327","DOI":"10.1016\/j.resplu.2022.100327","article-title":"Respiratory Function Monitoring during Neonatal Resuscitation: A Systematic Review","volume":"12","author":"Fuerch","year":"2022","journal-title":"Resusc. 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