{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T05:18:06Z","timestamp":1788499086281,"version":"build-2803163510"},"reference-count":41,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"FCT, Funda\u00e7\u00e3o para a Ci\u00eancia e Tecnologia, I.P.","award":["UID\/50008\/2025"],"award-info":[{"award-number":["UID\/50008\/2025"]}]},{"award":["UID\/50008\/2025"],"award-info":[{"award-number":["UID\/50008\/2025"]}],"id":[{"id":"https:\/\/ror.org\/00snfqn58","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100015494","name":"Instituto de Telecomunica\u00e7\u00f5es","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100015494","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/02ht4fk33","id-type":"ROR","asserted-by":"publisher"}]},{"name":"EU funds","award":["LISBOA2030-FEDER-01318700"],"award-info":[{"award-number":["LISBOA2030-FEDER-01318700"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biosensors"],"abstract":"<jats:p>Continuous physiological monitoring can support pilot-state assessment, but routine cockpit use requires sensing approaches that are both unobtrusive and physiologically reliable. Wearable ECG (wECG) provides stable cardiac recordings through skin-contact electrodes, whereas cockpit-integrated invisible ECG (iECG) can reduce user burden by acquiring signals through instrumented controls. However, iECG depends on intermittent hand contact and may show incomplete ECG morphology even when cardiac timing information is still preserved. This study proposes a window-based framework to assess the quality and task-specific usability of simultaneous wECG and iECG acquired during simulated flight. ECG data were collected in an Airbus A320 simulator from 14 volunteers, including experienced pilots and novices. The framework combines contact availability, R-peak reliability, PQRST morphology, and complementary signal quality indices into graded usability classes for heart rate (HR)-oriented monitoring. The iECG channel remained accessible for most of the analyzed recording time, with 93.8% of windows showing full or partial contact. Several windows classified as low quality by individual SQIs were retained as HR-usable when contact and R-peak timing remained reliable, indicating that single-metric rejection can be overly conservative for external-contact ECG. HR agreement supported the physiological relevance of the proposed classes: concordant wECG\u2013iECG windows showed a mean absolute error (MAE) of 1.1 bpm, compared with 7.1 bpm for discordant windows. Bland\u2013Altman analysis for iECG windows classified as usable for HR estimation showed a small mean bias of 1.4 bpm. These findings indicate that incomplete ECG morphology does not necessarily imply loss of HR usability, and that contact-aware, task-specific classification can preserve useful physiological information from unobtrusive cockpit interfaces.<\/jats:p>","DOI":"10.3390\/bios16090486","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T08:56:01Z","timestamp":1788339361000},"page":"486","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Wearable and Invisible ECG Quality and Usability Assessment in Cockpit Monitoring"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-3357-8615","authenticated-orcid":false,"given":"Mariangela","family":"Pinnelli","sequence":"first","affiliation":[{"name":"Department of Engineering, Universit\u00e0 Campus Bio-Medico di Roma, 00128 Rome, 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Rodrigues","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Instituto de Telecomunica\u00e7\u00f5es, Instituto Superior T\u00e9cnico, 1049-001 Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"software","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"}]},{"given":"Paulo S\u00e9rgio de Brito","family":"Andr\u00e9","sequence":"additional","affiliation":[{"name":"Instituto de Telecomunica\u00e7\u00f5es, Instituto Superior T\u00e9cnico, 1049-001 Lisbon, 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