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Sleep disorders can impact daily life, affecting physical, emotional, and cognitive well-being. Due to the time-consuming, highly obtrusive, and expensive nature of using the standard approaches such as polysomnography, it is of great interest to develop a noninvasive and unobtrusive in-home sleep monitoring system that can reliably and accurately measure cardiorespiratory parameters while causing minimal discomfort to the user’s sleep. We developed a low-cost Out of Center Sleep Testing (OCST) system with low complexity to measure cardiorespiratory parameters. We tested and validated two force-sensitive resistor strip sensors under the bed mattress covering the thoracic and abdominal regions. Twenty subjects were recruited, including 12 males and 8 females. The ballistocardiogram signal was processed using the 4th smooth level of the discrete wavelet transform and the 2nd order of the Butterworth bandpass filter to measure the heart rate and respiration rate, respectively. We reached a total error (concerning the reference sensors) of 3.24 beats per minute and 2.32 rates for heart rate and respiration rate, respectively. For males and females, heart rate errors were 3.47 and 2.68, and respiration rate errors were 2.32 and 2.33, respectively. We developed and verified the reliability and applicability of the system. It showed a minor dependency on sleeping positions, one of the major cumbersome sleep measurements. We identified the sensor under the thoracic region as the optimal configuration for cardiorespiratory measurement. Although testing the system with healthy subjects and regular patterns of cardiorespiratory parameters showed promising results, further investigation is required with the bandwidth frequency and validation of the system with larger groups of subjects, including patients.
Ballistocardiography (BCG) can be used to monitor heart rate activity. Besides, the accelerometer should have high sensitivity and minimal internal noise; a low-cost approach was taken into consideration. Several measurements have been executed to determine the optimal positioning of a sensor under the mattress to obtain a signal strong enough for further analysis. A prototype for an unobtrusive accelerometer-based measurement system has been developed and tested in a conventional bed without any specific extras. The influence of the human sleep position for the output accelerometer data was tested. The obtained results indicate the potential to capture BCG signals using accelerometers. The measurement system can detect heart rate in an unobtrusive form in the home environment.
Due to the rising need for palliative care in Russia, it is crucial to provide timely and high-quality solutions for patients, relatives, and caregivers. A methodology for remote monitoring of patients in need of palliative care and the requirements will be developed for a hardware-software complex for remote monitoring of patients' health at home.
The digital twin concept has been widely known for asset monitoring in the industry for a long time. A clear example is the automotive industry. Recently, there has also been significant interest in the application of digital twins in healthcare, especially in genomics in what is known as precision medicine. This work focuses on another medical speciality where digital twins can be applied, sleep medicine. However, there is still great controversy about the fundamentals that constitute digital twins, such as what this concept is based on and how it can be included in healthcare effectively and sustainably. This article reviews digital twins and their role so far in what is known as personalized medicine. In addition, a series of steps will be exposed for a possible implementation of a digital twin for a patient suffering from sleep disorders. For this, artificial intelligence techniques, clinical data management, and possible solutions for explaining the results derived from artificial intelligence models will be addressed.
Globalization has increased the number of road trips and vehicles. The result has been an intensification of traffic accidents, which are becoming one of the most important causes of death worldwide. Traffic accidents are often due to human error, the probability of which increases when the cognitive ability of the driver decreases. Cognitive capacity is closely related to the driver’s mental state, as well as other external factors such as the CO2 concentration inside the vehicle. The objective of this work is to analyze how these elements affect driving. We have conducted an experiment with 50 drivers who have driven for 25 min using a driving simulator. These drivers completed a survey at the start and end of the experiment to obtain information about their mental state. In addition, during the test, their stress level was monitored using biometric sensors and the state of the environment (temperature, humidity and CO2 level) was recorded. The results of the experiment show that the initial level of stress and tiredness of the driver can have a strong impact on stress, driving behavior and fatigue produced by the driving test. Other elements such as sadness and the conditions of the interior of the vehicle also cause impaired driving and affect compliance with traffic regulations.
Autism spectrum disorders (ASD) affect a large number of children both in the Russian Federation and in Germany. Early diagnosis is key for these children, because the sooner parents notice such disorders in a child and the rehabilitation and treatment program starts, the higher the likelihood of his social adaptation. The difficulties in raising such a child lie in the complexity of his learning outside of children's groups and the complexity of his medical care. In this regard, the development of digital applications that facilitate medical care and education of such children at home is important and relevant. The purpose of the project is to improve the availability and quality of healthcare and social adaptation at home of children with ASD through the use of digital technologies.
Stress is becoming an important topic in modern life. The influence of stress results in a higher rate of health disorders such as burnout, heart problems, obesity, asthma, diabetes, depressions and many others. Furthermore individual’s behavior and capabilities could be directly affected leading to altered cognition, inappropriate decision making and problem solving skills. In a dynamic and unpredictable environment, such as automotive, this can result in a higher risk for accidents. Different papers faced the estimation as well as prediction of drivers’ stress level during driving. Another important question is not only the stress level of the driver himself, but also the influence on and of a group of other drivers in the near area. This paper proposes a system, which determines a group of drivers in a near area as clusters and it derives the individual stress level. This information will be analyzed to generate a stress map, which represents a graphical view about road section with a higher stress influence. Aggregated data can be used to generate navigation routes with a lower stress influence to decrease stress influenced driving as well as improve road safety.
Stress is recognized as a predominant disease with raising costs for rehabilitation and treatment. Currently there several different approaches that can be used for determining and calculating the stress levels. Usually the methods for determining stress are divided in two categories. The first category do not require any special equipment for measuring the stress. This category useless the variation in the behaviour patterns that occur while stress. The core disadvantage for the category is their limitation to specific use case. The second category uses laboratories instruments and biological sensors. This category allow to measure stress precisely and proficiently but on the same time they are not mobile and transportable and do not support real-time feedback. This work presents a mobile system that provides the calculation of stress. For achieving this, the of a mobile ECG sensor is analysed, processed and visualised over a mobile system like a smartphone. This work also explains the used stress measurement algorithm. The result of this work is a portable system that can be used with a mobile system like a smartphone as visual interface for reporting the current stress level.
Personalized remote healthcare monitoring is in continuous development due to the technology improvements of sensors and wearable electronic systems. A state of the art of research works on wearable sensors for healthcare applications is presented in this work. Furthermore, a state of the art of wearable devices, chest and wrist band and smartwatches available on the market for health and sport monitoring is presented in this paper. Many activity trackers are commercially available. The prices are continuously reducing and the performances are improving, but commercial devices do not provide raw data and are therefore not useful for research purposes.
This paper compares two popular scripting implementations for hardware prototyping: Python scripts exe- cut from User-Space and C-based Linux-Driver processes executed from Kernel-Space, which can provide information to researchers when considering one or another in their implementations. Conclusions exhibit that deploying software scripts in the kernel space makes it possible to grant a certain quality of sensor information using a Raspberry Pi without the need for advanced real-time operational systems.
To evaluate the quality of a person's sleep it is essential to identify the sleep stages and their durations. Currently, the gold standard in terms of sleep analysis is overnight polysomnography (PSG), during which several techniques like EEG (eletroencephalogram), EOG (electrooculogram), EMG (electromyogram), ECG (electrocardiogram), SpO2 (blood oxygen saturation) and for example respiratory airflow and respiratory effort are recorded. These expensive and complex procedures, applied in sleep laboratories, are invasive and unfamiliar for the subjects and it is a reason why it might have an impact on the recorded data. These are the main reasons why low-cost home diagnostic systems are likely to be advantageous. Their aim is to reach a larger population by reducing the number of parameters recorded. Nowadays, many wearable devices promise to measure sleep quality using only the ECG and body-movement signals. This work presents an android application developed in order to proof the accuracy of an algorithm published in the sleep literature. The algorithm uses ECG and body movement recordings to estimate sleep stages. The pre-recorded signals fed into the algorithm have been taken from physionet1 online database. The obtained results have been compared with those of the standard method used in PSG. The mean agreement ratios between the sleep stages REM, Wake, NREM-1, NREM-2 and NREM-3 were 38.1%, 14%, 16%, 75% and 54.3%.
The respiratory rate is a vital sign indicating breathing illness. It is necessary to analyze the mechanical oscillations of the patient's body arising from chest movements. An inappropriate holder on which the sensor is mounted, or an inappropriate sensor position is some of the external factors which should be minimized during signal registration. This paper considers using a non-invasive device placed under the bed mattress and evaluates the respiratory rate. The aim of the work is the development of an accelerometer sensor holder for this system. The normal and deep breathing signals were analyzed, corresponding to the relaxed state and when taking deep breaths. The evaluation criterion for the holder's model is its influence on the patient's respiratory signal amplitude for each state. As a result, we offer a non-invasive system of respiratory rate detection, including the mechanical component providing the most accurate values of mentioned respiratory rate.
This paper presents a bed system able to analyze a person’s movement, breathing and recognize the positions that the subject is lying on the bed during the night without any additional physical contact. The measurements are performed with sensors placed between the mattress and the bed-frame. An Intel Edison board was used as an endpoint that served as a communication node from the mesh network to external service. Two nodes and Intel Edison are attached to the bottom of the bed frame and they are connected to the sensors. First test results have indicated the potential of the proposed approach for the recognition of sleep positions with 83% of correct recognized positions.
The process of restoring our body and brain from fatigue is directly depend-ing on the quality of sleep. It can be determined from the report of the sleep study results. Classification of sleep stages is the first step of this study and this includes the measurement of biovital data and its further processing.
In this work, the sleep analysis system is based on a hardware sensor net, namely a grid of 24 pressure sensors, supporting sleep phase recognition. In comparison to the leading standard, which is polysomnography, the proposed approach is a non-invasive system. It recognises respiration and body move-ment with only one type of low-cost pressure sensors forming a mesh archi-tecture. The nodes implement as a series of pressure sensors connected to a low-power and performant microcontroller. All nodes are connected via a system wide bus with address arbitration. The embedded processor is the mesh network endpoint that enables network configuration, storing and pre-processing of the data, external data access and visualization.
The system was tested by executing experiments recording the sleep of different healthy young subjects. The results obtained have indicated the po-tential to detect breathing rate and body movement. A major difference of this system in comparison to other approaches is the innovative way to place the sensors under the mattress. This characteristic facilitates the continuous using of the system without any influence on the common sleep process.
Methods based exclusively on heart rate hardly allow to differentiate between physical activity, stress, relaxation, and rest, that is why an additional sensor like activity/movement sensor added for detection and classification. The response of the heart to physical activity, stress, relaxation, and no activity can be very similar. In this study, we can observe the influence of induced stress and analyze which metrics could be considered for its detection. The changes in the Root Mean Square of the Successive Differences provide us with information about physiological changes. A set of measurements collecting the RR intervals was taken. The intervals are used as a parameter to distinguish four different stages. Parameters like skin conductivity or skin temperature were not used because the main aim is to maintain a minimum number of sensors and devices and thereby to increase the wearability in the future.
We consider the problem of increasing the informative value of electrocardiographic (ECG) surveys using data from multichannel electrocardiographic leads, that include both recorded electrocardiosignals and the coordinates of the electrodes placed on the surface of the human torso. In this area, we were interested in reconstruction of the surface distribution of the equivalent sources during the cardiac cycle at relatively low hardware cost. In our work, we propose to reconstruct the equivalent electrical sources by numerical methods, based on integral connection between the density of electrical sources and potential in a conductive medium. We consider maps of distributions of equivalent electric sources on the heart surface (HSSM), presenting source distributions in the form of a simple or double electrical layer. We indicate the dynamics of the heart electrical activity by the space-time mapping of equivalent electrical sources in HSSM.
The recovery of our body and brain from fatigue directly depends on the quality of sleep, which can be determined from the results of a sleep study. The classification of sleep stages is the first step of this study and includes the measurement of vital data and their further processing. The non-invasive sleep analysis system is based on a hardware sensor network of 24 pressure sensors providing sleep phase detection. The pressure sensors are connected to an energy-efficient microcontroller via a system-wide bus. A significant difference between this system and other approaches is the innovative way in which the sensors are placed under the mattress. This feature facilitates the continuous use of the system without any noticeable influence on the sleeping person. The system was tested by conducting experiments that recorded the sleep of various healthy young people. Results indicate the potential to capture respiratory rate and body movement.
This document presents an algorithm for a non-obtrusive recognition of Sleep/Wake states using signals derived from ECG, respiration, and body movement captured while lying in a bed. As a core mathematical base of system data analytics, multinomial logistic regression techniques were chosen. Derived parameters of the three signals are used as the input for the proposed method. The overall achieved accuracy rate is 84% for Wake/Sleep stages, with Cohen’s kappa value 0.46. The presented algorithm should support experts in analyzing sleep quality in more detail. The results confirm the potential of this method and disclose several ways for its improvement.
With the advancement in sensor technology and the trend shift of health measurement from treatment after diagnosis to abnormalities detection long before the occurrence, the approach of turning private spaces into diagnostic spaces has gained much attention. In this work, we designed and implemented a low-cost and compact form factor module that can be deployed on the steering wheel of cars as well as most frequently touch objects at home in order to measure physiological signals from the fingertip of the subject as well as environmental parameters. We estimated the heart rate and SpO2 with the error of 2.83 bpm and 3.52%, respectively. The signal evaluation of skin temperature shows a promising output with respect to environmental recalibration. In addition, the electrodermal activity sensor followed the reference signal, appropriately which indicates the potential for further development and application in stress measurement.
Preliminary results of homomorphic deconvolution application to surface EMG signals during walking
(2021)
Homomorphic deconvolution is applied to sEMG signals recorded during walking. Gastrocnemius lateralis and tibialis anterior signals were acquired according to SENIAM recommendation. MUAP parameters like amplitude and scale were estimated, whilst the MUAP shape parameter was fixed. This features a useful time-frequency representation of sEMG signal. Estimation of scale MUAP parameter was verified extracting the mean frequency of filtered EMG signal, extracted from the scale parameter estimated with two different MUAP shape values.
The number of home office workers sitting for many hours is increasing. The sensor chair is tracking users’ sitting behavior which the help of pressure sensors and tries to avoid wrong postures which may cause diseases. The system provides live monitoring of the pressure distribution via web interface, as well as sitting posture prediction in real time. Posture analysis is realized through machine learning algorithm using a decision tree classifier that is compared to a random forest. Data acquisition and aggregation for the learning process happens with a mobile app adding users biometrical data and the taken sitting posture as label. The sensor chair is able to differentiate between an arched back, a neutral posture or a laid back position taken on the chair. The classifier achieves an accuracy of 97.4% on our test set and is comparable to the performance of the random forest with 98.9%.
The overall goal of this work is to detect and analyze a person's movement, breathing and heart rate during sleep in a common bed overnight without any additional physical contact. The measurement is performed with the help of
sensors placed between the mattress and the frame. A two-stage pattern classification algorithm based has been implemented that applies statistics analysis to recognize the position of patients. The system is implemented in a sensors-network, hosting several nodes and communication end-points to support quick and efficient classification. The overall tests show convincing results for the position recognition and a reasonable overlap in matching.
Assistive environments are entering our homes faster than ever. However, there are still various barriers to be broken. One of the crucial points is a personalization of offered services and integration of assistive technologies in common objects and therefore in a regular daily routine. Recognition of sleep patterns for the preliminary sleep study is one of the health services that could be performed in an undisturbing way. This article proposes the hardware system for the measurement of bio-vital signals necessary for initial sleep study in a non-obtrusive way. The first results confirm the potential of measurement of breathing and movement signals with the proposed system.
Sleep is an important aspect in life of every human being. The average sleep duration for an adult is approximately 7 h per day. Sleep is necessary to regenerate physical and psychological state of a human. A bad sleep quality has a major impact on the health status and can lead to different diseases. In this paper an approach will be presented, which uses a long-term monitoring of vital data gathered by a body sensor during the day and the night supported by mobile application connected to an analyzing system, to estimate sleep quality of its user as well as give recommendations to improve it in real-time. Actimetry and historical data will be used to improve the individual recommendations, based on common techniques used in the area of machine learning and big data analysis.
Monitoring heart rate and breathing is essential in understanding the physiological processes for sleep analysis. Polysomnography (PSG) system have traditionally been used for sleep monitoring, but alternative methods can help to make sleep monitoring more portable in someone's home. This study conducted a series of experiments to investigate the use of pressure sensors placed under the bed as an alternative to PSG for monitoring heart rate and breathing during sleep. The following sets of experiments involved the addition of small rubber domes - transparent and black - that were glued to the pressure sensor. The resulting data were compared with the PSG system to determine the accuracy of the pressure sensor readings. The study found that the pressure sensor provided reliable data for extracting heart rate and respiration rate, with mean absolute errors (MAE) of 2.32 and 3.24 for respiration and heart rate, respectively. However, the addition of small rubber hemispheres did not significantly improve the accuracy of the readings, with MAEs of 2.3 bpm and 7.56 breaths per minute for respiration rate and heart rate, respectively. The findings of this study suggest that pressure sensors placed under the bed may serve as a viable alternative to traditional PSG systems for monitoring heart rate and breathing during sleep. These sensors provide a more comfortable and non-invasive method of sleep monitoring. However, the addition of small rubber domes did not significantly enhance the accuracy of the readings, indicating that it may not be a worthwhile addition to the pressure sensor system.
Stress and physical activities are important aspects of life of people. Body reactions on stress and on physical activities can be very similar but long-term stress leads to diseases and damages the body. Currently there is no method to differentiate easily and clearly between these two aspects in a time slot. We have confronted this problem while developing a mobile system for detection and analysis of stress. This paper presents an approach, which uses a long-term monitor with ECG/EKG capabilities and analysis of the heart rate data that is extracted from the device. The focus of the work is to find characteristics that are useful for differentiation between physical activity and stress.
To assess the quality of a person’s sleep, it is essential to examine the sleep behaviour by identifying the several sleep stages, their durations and sleep cycles. The established and gold standard procedure for sleep stage scoring is overnight polysomnography (PSG) with the Rechtschaffen and Kales (R-K) method. Unfortunately, the conduct of PSG is timeconsuming and unfamiliar for the subjects and might have an impact of the recorded data. To avoid the disadvantages with PSG, it is important to make further investigations in low-cost home diagnostic systems. For this intention it is necessary to find suitable bio vital parameters for classifying sleep stages without any physical impairments at the same time.
Due to the promising results in several publications we want to analyse existing methods for sleep stage classification based on the parameters body movement,
heartbeat and respiration. Our aim was to find different behaviour patterns in the several sleep stages. Therefore, the average values of 15 wholenight PSG recordings -obtained from the ‘DREAMS Subjects Database’- where analysed in the light of heartbeat, body movement and respiration with 10 different methods.
Background: Polysomnography (PSG) is the gold standard for detecting obstructive sleep apnea (OSA). However, this technique has many disadvantages when using it outside the hospital or for daily use. Portable monitors (PMs) aim to streamline the OSA detection process through deep learning (DL).
Materials and methods: We studied how to detect OSA events and calculate the apnea-hypopnea index (AHI) by using deep learning models that aim to be implemented on PMs. Several deep learning models are presented after being trained on polysomnography data from the National Sleep Research Resource (NSRR) repository. The best hyperparameters for the DL architecture are presented. In addition, emphasis is focused on model explainability techniques, concretely on Gradient-weighted Class Activation Mapping (Grad-CAM).
Results: The results for the best DL model are presented and analyzed. The interpretability of the DL model is also analyzed by studying the regions of the signals that are most relevant for the model to make the decision. The model that yields the best result is a one-dimensional convolutional neural network (1D-CNN) with 84.3% accuracy.
Conclusion: The use of PMs using machine learning techniques for detecting OSA events still has a long way to go. However, our method for developing explainable DL models demonstrates that PMs appear to be a promising alternative to PSG in the future for the detection of obstructive apnea events and the automatic calculation of AHI.
Polysomnography is a gold standard for a sleep study, and it provides very accurate results, but its cost (both personnel and material) are quite high. Therefore, the development of a low-cost system for overnight breathing and heartbeat monitoring, which provides more comfort while recording the data, is a well-motivated challenge. The system proposed in this manuscript is based on the usage of resistive pressure sensors installed under the mattress. These sensors can measure slight pressure changes provoked during breathing and heartbeat. The captured signal requires advanced processing, like applying filters and amplifiers before the analog signal is ready for the next step. Then, the output signal is digitalized and further processed by an algorithm that performs a custom filtering before it can recognize breathing and heart rate in real-time. The result can be directly visualized. Furthermore, a CSV file is created containing the raw data, timestamps, and unique IDs to facilitate further processing. The achieved results are promising, and the average deviation from a reference device is about 4bpm.
Healthy and good sleep is a prerequisite for a rested mind and body. Both form the basis for physical and mental health. Healthy sleep is hindered by sleep disorders, the medically diagnosed frequency of which increases sharply from the age of 40. This chapter describes the formal specification of an on-course practical implementation for a non-invasive system based on biomedical signal processing to support the diagnosis and treatment of sleep-related diseases. The system aims to continuously monitor vital data during sleep in a patient’s home environment over long periods by using non-invasive technologies. At the center of the development is the MORPHEUS Box (MoBo), which consists of five main conceptualizations: the MoBo core, the MoBo-HW, the MoBo algorithm, the MoBo API, and the MoBo app. These synergistic elements aim to support the diagnosis and treatment of sleep-related diseases. Although there are related developments in individual aspects concerning the system, no comparative approach is known that gives a similar scope of functionality, deployment flexibility, extensibility, or the possibility to use multiple user groups. With the specification provided in this chapter, the MORPHEUS project sets a good platform, data model, and transmission strategies to bring an innovative proposal to measure sleep quality and detect sleep diseases from non-invasive sensors.
Sleep study can be used for detection of sleep quality and in general bed behaviors. These results can helpful for regulating sleep and recognizing different sleeping disorders of human. In comparison to the leading standard measuring system, which is Polysomnography (PSG), the system proposed in this work is a non-invasive sleep monitoring device. For continuous analysis or home use, the PSG or wearable Actigraphy devices tends to be uncomfortable. Besides, these methods not only decrease practicality due to the process of having to put them on, but they are also very expensive. The system proposed in this paper classifies respiration and body movement with only one type of sensor and also in a noninvasive way. The sensor used is a pressure sensor. This sensor is low cost and can be used for commercial proposes. The system was tested by carrying out an experiment that recorded the sleep process of a subject. These recordings showed excellent results in the classification of breathing rate and body movements.
Respiratory diseases are leading causes of death and disability in the world. The recent COVID-19 pandemic is also affecting the respiratory system. Detecting and diagnosing respiratory diseases requires both medical professionals and the clinical environment. Most of the techniques used up to date were also invasive or expensive.
Some research groups are developing hardware devices and techniques to make possible a non-invasive or even remote respiratory sound acquisition. These sounds are then processed and analysed for clinical, scientific, or educational purposes.
We present the literature review of non-invasive sound acquisition devices and techniques.
The results are about a huge number of digital tools, like microphones, wearables, or Internet of Thing devices, that can be used in this scope.
Some interesting applications have been found. Some devices make easier the sound acquisition in a clinic environment, but others make possible daily monitoring outside that ambient. We aim to use some of these devices and include the non-invasive recorded respiratory sounds in a Digital Twin system for personalized health.
Sleep analysis using a Polysomnography system is difficult and expensive. That is why we suggest a non-invasive and unobtrusive measurement. Very few people want the cables or devices attached to their bodies during sleep. The proposed approach is to implement a monitoring system, so the subject is not bothered. As a result, the idea is a non-invasive monitoring system based on detecting pressure distribution. This system should be able to measure the pressure differences that occur during a single heartbeat and during breathing through the mattress. The system consists of two blocks signal acquisition and signal processing. This whole technology should be economical to be affordable enough for every user. As a result, preprocessed data is obtained for further detailed analysis using different filters for heartbeat and respiration detection. In the initial stage of filtration, Butterworth filters are used.
Sleep is extremely important for physical and mental health. Although polysomnography is an established approach in sleep analysis, it is quite intrusive and expensive. Consequently, developing a non-invasive and non-intrusive home sleep monitoring system with minimal influence on patients, that can reliably and accurately measure cardiorespiratory parameters, is of great interest. The aim of this study is to validate a non-invasive and unobtrusive cardiorespiratory parameter monitoring system based on an accelerometer sensor. This system includes a special holder to install the system under the bed mattress. The additional aim is to determine the optimum relative system position (in relation to the subject) at which the most accurate and precise values of measured parameters could be achieved. The data were collected from 23 subjects (13 males and 10 females). The obtained ballistocardiogram signal was sequentially processed using a sixth-order Butterworth bandpass filter and a moving average filter. As a result, an average error (compared to reference values) of 2.24 beats per minute for heart rate and 1.52 breaths per minute for respiratory rate was achieved, regardless of the subject’s sleep position. For males and females, the errors were 2.28 bpm and 2.19 bpm for heart rate and 1.41 rpm and 1.30 rpm for respiratory rate. We determined that placing the sensor and system at chest level is the preferred configuration for cardiorespiratory measurement. Further studies of the system’s performance in larger groups of subjects are required, despite the promising results of the current tests in healthy subjects.
The present work proposes the use of modern ICT technologies such as smartphones, NFCs, internet, and web technologies, to help patients in carrying out their therapies. The implemented system provides a calendar with a reminder of the assumptions, ensures the drug identification through NFC, allows remote assistance from healthcare staff and family members to check and manage the therapy in real-time. The system also provides centralized information on the patient's therapeutic situation, helpful in choosing new compatible therapies.
The use of deep learning models with medical data is becoming more widespread. However, although numerous models have shown high accuracy in medical-related tasks, such as medical image recognition (e.g. radiographs), there are still many problems with seeing these models operating in a real healthcare environment. This article presents a series of basic requirements that must be taken into account when developing deep learning models for biomedical time series classification tasks, with the aim of facilitating the subsequent production of the models in healthcare. These requirements range from the correct collection of data, to the existing techniques for a correct explanation of the results obtained by the models. This is due to the fact that one of the main reasons why the use of deep learning models is not more widespread in healthcare settings is their lack of clarity when it comes to explaining decision making.
The evaluation of the effectiveness of different machine learning algorithms on a publicly available database of signals derived from wearable devices is presented with the goal of optimizing human activity recognition and classification. Among the wide number of body signals we choose a couple of signals, namely photoplethysmographic (optically detected subcutaneous blood volume) and tri-axis acceleration signals that are easy to be simultaneously acquired using commercial widespread devices (e.g. smartwatches) as well as custom wearable wireless devices designed for sport, healthcare, or clinical purposes. To this end, two widely used algorithms (decision tree and k-nearest neighbor) were tested, and their performance were compared to two new recent algorithms (particle Bernstein and a Monte Carlo-based regression) both in terms of accuracy and processing time. A data preprocessing phase was also considered to improve the performance of the machine learning procedures, in order to reduce the problem size and a detailed analysis of the compression strategy and results is also presented.
In recent decades, it can be observed that a steady increase in the volume of tourism is a stable trend. To offer travel opportunities to all groups, it is also necessary to prepare offers for people in need of long-term care or people with disabilities. One of the ways to improve accessibility could be digital technologies, which could help in planning as well as in carrying out trips. In the work presented, a study of barriers was first conducted, which led to selecting technologies for a test setup after analysis. The main focus was on a mobile app with travel information and 360° tours. The evaluation results showed that both technologies could increase accessibility, but some essential aspects (such as usability, completeness, relevance, etc.) need to be considered when implementing them.
Sleep is a multi-dimensional influencing factor on physical health, cognitive function, emotional well-being, mental health, daily performance, and productivity. The barriers such as time-consuming, invasiveness, and expense have caused a gradual shift in sleep monitoring from traditional and standard in-lab approach, e. g., polysomnography (PSG) to unobtrusive and noninvasive in-home sleep monitoring, yet further improvement is required. Despite an increasing interest in fiberoptic-based methods for cardiorespiratory estimation, the traditional mechanical-based sensors consist of force-sensitive resistors (FSR), lead zirconate titanate piezoelectric (PZT), and accelerometers yet serve as the dominant approach. The part of popularity lies in reducing the system’s complexity, expense, easy maintenance, and user-friendliness. However, care must be taken regarding the performance of such sensors with respect to accuracy and calibration.
Healthy sleep is required for sufficient restoration of the human body and brain. Therefore, in the case of sleep disorders, appropriate therapy should be applied timely, which requires a prompt diagnosis. Traditionally, a sleep diary is a part of diagnosis and therapy monitoring for some sleep disorders, such as cognitive behaviour therapy for insomnia. To automatise sleep monitoring and make it more comfortable for users, substituting a sleep diary with a smartwatch measurement could be considered. With the aim of providing accurate results, a study with a total of 30 night recordings was conducted. Objective sleep measurement with a Samsung Galaxy Watch 4 was compared with a subjective approach (sleep diary), evaluating the four relevant sleep characteristics: time of getting asleep, wake up time, sleep efficiency (SE), and total sleep time (TST). The performed analysis has demonstrated that the median difference between both measurement approaches was equal to 7 and 3 minutes for a time of getting asleep and wake up time correspondingly, which allows substituting a subjective measurement with a smartwatch. The SE was determined with a median difference between the two measurement methods of 5.22%. This result also implicates a possibility of substitution. Some single recordings have indicated a higher variance between the two approaches. Therefore, the conclusion can be made that a substitution provides reliable results primarily in the case of long-term monitoring. The results of the evaluation of the TST measurement do not allow to recommend substitution of the measurement method.
The exposure to the light has a great influence on human beings in their everyday life. Various lighting sources produce light that reaches the human eye and influences a rhythmic release of melatonin hormone, that is a sleep promoting factor.
Since the development of new technologies provides more control over illuminance, this work uses an IoT based lighting system to set up dim and bright scenarios. A small study has been performed on the influence of illuminance on sleep latency. The system consists of different light bulbs, sensors and a central bridge which are interconnected like a mesh network. Also, a mobile app has been developed, that allows to adjust the lighting in various rooms. With the help of a ferro-electret sensor, like applied in sleep monitoring systems, a subject’s sleep was monitored. The sensor is placed below the mattress and it collects data, which is stored and processed in a cloud or in other alternative locations.
The research was conducted on healthy young subjects after being previously exposed to the preconfigured illuminance for at least three hours before bedtime. The results indicate correlation between sleep onset latency and exposure to different illuminance before bedtime. In a dimmed environment, the subject fell asleep in average 28% faster compared to the brighter environment.
The massive use of patient data for the training of artificial intelligence algorithms is common nowadays in medicine. In this scientific work, a statistical analysis of one of the most used datasets for the training of artificial intelligence models for the detection of sleep disorders is performed: sleep health heart study 2. This study focuses on determining whether the gender and age of the patients have a relevant influence to consider working with differentiated datasets based on these variables for the training of artificial intelligence models.
Apnea is a sleep disorder characterized by breathing interruptions during sleep, impacting cardiorespiratory function and overall health. Traditional diagnostic methods, like polysomnography (PSG), are unobtrusive, leading to noninvasive monitoring. This study aims to develop and validate a novel sleep monitoring system using noninvasive sensor technology to estimate cardiorespiratory parameters and detect sleep apnea. We designed a seamless monitoring system integrating noncontact force-sensitive resistor sensors to collect ballistocardiogram signals associated with cardiorespiratory activity. We enhanced the sensor’s sensitivity and reduced the noise by designing a new concept of edge-measuring sensor using a hemisphere dome and mechanical hanger to distribute the force and mechanically amplify the micromovement caused by cardiac and respiration activities. In total, we deployed three edge-measuring sensors, two deployed under the thoracic and one under the abdominal regions. The system is supported with onboard signal preprocessing in multiple physical layers deployed under the mattress. We collected the data in four sleeping positions from 16 subjects and analyzed them using ensemble empirical mode decomposition (EMD) to avoid frequency mixing. We also developed an adaptive thresholding method to identify sleep apnea. The error was reduced to 3.98 and 1.43 beats/min (BPM) in heart rate (HR) and respiration estimation, respectively. The apnea was detected with an accuracy of 87%. We optimized the system such that only one edge-measuring sensor can measure the cardiorespiratory parameters. Such a reduction in the complexity and simplification of the instruction of use shows excellent potential for in-home and continuous monitoring.
Measuring cardiorespiratory parameters in sleep, using non-contact sensors and the Ballistocardiography technique has received much attention due to the low-cost, unobtrusive, and non-invasive method. Designing a user-friendly, simple-to-use, and easy-to-deployment preserving less errorprone remains open and challenging due to the complex morphology of the signal. In this work, using four forcesensitive resistor sensors, we conducted a study by designing four distributions of sensors, in order to simplify the complexity of the system by identifying the region of interest for heartbeat and respiration measurement. The sensors are deployed under the mattress and attached to the bed frame without any interference with the subjects. The four distributions are combined in two linear horizontal, one linear vertical, and one square, covering the influencing region in cardiorespiratory activities. We recruited 4 subjects and acquired data in four regular sleeping positions, each for a duration of 80 seconds. The signal processing was performed using discrete wavelet transform bior 3.9 and smooth level of 4 as well as bandpass filtering. The results indicate that we have achieved the mean absolute error of 2.35 and 4.34 for respiration and heartbeat, respectively. The results recommend the efficiency of a triangleshaped structure of three sensors for measuring heartbeat and respiration parameters in all four regular sleeping positions.
The goal of the presented project is to develop the concept of home ehealth centers for barrier-free and cross-border telemedicine. AAL technologies are already present on the market but there is still a gap to close until they can be used for ordinary patient needs. The general idea needs to be accompanied by new services, which should be brought together in order to provide a full coverage of service for the users. Sleep and stress were chosen as predominant diseases for a detailed study within this project because of their widespread influence in the population. The executed scientific study of available home devices analyzing sleep has provided the necessary to select appropriate devices. The first choice for the project implementation is the device EMFIT QS+. This equipment provides a part of a complete system that a home telemedical hospital can provide at a level of precision and communication with internal and/or external health services.
The development of home health systems can provide continuous and user-friendly monitoring of key health parameters. This project aims to create a concept for such a system, implement it on a test basis, and evaluate it. Three health areas were selected for this purpose:
Sleep, Stress, and Rehabilitation. Appropriate devices were installed in the homes of test subjects and used by them for two weeks. Besides, relevant questionnaires were completed to obtain a complete picture. Finally, the implemented system was evaluated, and the results of the conducted study showed that home health systems have great potential. However, it is necessary to consider some points to increase the usability of the system and the motivation of the users. Among others, ease of use of the equipment is of extreme importance.
These days computer analysis of ECG (Electrocardiograms) signals is common. There are many real-time QRS recognition algorithms; one of these algorithms is Pan-Tompkins Algorithm. Which the Pan-Tompkins Algorithm can detect QRS complexes of ECG signals. The proposed algorithm is analysed the data stream of the heartbeat based on the digital analysis of the amplitude, the bandwidth, and the slope. In addition to that, the stress algorithm compares whether the current heartbeat is similar or different to the last heartbeat after detecting the ECG signals. This algorithm determines the stress detection for the patient on the real-time. In order to implement the new algorithm with higher performance, the parallel programming language CUDA is used. The algorithm determines stress at the same time by determining the RR interval. The algorithm uses a different function as beat detector and a beat classifier of stress.
Stress is recognized as a factor of predominant disease and in the future the costs for treatment will increase. The presented approach tries to detect stress in a very basic and easy to implement way, so that the cost for the device and effort to wear it remain low. The user should benefit from the fact that the system offers an easy interface reporting the status of his body in real time. In parallel, the system provides interfaces to pass the obtained data forward for further processing and (professional) analyses, in case the user agrees. The system is designed to be used in every day’s activities and it is not restricted to laboratory use or environments. The implementation of the enhanced prototype shows that the detection of stress and the reporting can be managed using correlation plots and automatic pattern recognition even on a very light-weighted microcontroller platform.
To evaluate the quality of sleep, it is important to determine how much time was spent in each sleep stage during the night. The gold standard in this domain is an overnight polysomnography (PSG). But the recording of the necessary electrophysiological signals is extensive and complex and the environment of the sleep laboratory, which is unfamiliar to the patient, might lead to distorted results. In this paper, a sleep stage detection algorithm is proposed that uses only the heart rate signal, derived from electrocardiogram (ECG), as a discriminator. This would make it possible for sleep analysis to be performed at home, saving a lot of effort and money. From the heart rate, using the fast Fourier transformation (FFT), three parameters were calculated in order to distinguish between the different sleep stages. ECG data along with a hypnogram scored by professionals was used from Physionet database, making it easy to compare the results. With an agreement rate of 41.3%, this approach is a good foundation for future research.
Accurate monitoring of a patient's heart rate is a key element in the medical observation and health monitoring. In particular, its importance extends to the identification of sleep-related disorders. Various methods have been established that involve sensor-based recording of physiological signals followed by automated examination and analysis. This study attempts to evaluate the efficacy of a non-invasive HR monitoring framework based on an accelerometer sensor specifically during sleep. To achieve this goal, the motion induced by thoracic movements during cardiac contractions is captured by a device installed under the mattress. Signal filtering techniques and heart rate estimation using the symlets6 wavelet are part of the implemented computational framework described in this article. Subsequent analysis indicates the potential applicability of this system in the prognostic domain, with an average error margin of approximately 3 beats per minute. The results obtained represent a promising advancement in non-invasive heart rate monitoring during sleep, with potential implications for improved diagnosis and management of cardiovascular and sleep-related disorders.
The ballistocardiography is a technique that measures the heart rate from the mechanical vibrations of the body due to the heart movement. In this work a novel noninvasive device placed under the mattress of a bed estimates the heart rate using the ballistocardiography. Different algorithms for heart rate estimation have been developed.
Sleep is an important part of our life that significantly influences our health and well-being. The monitoring of sleep can provide data based on which sleep quality could be improved. This paper presents a system for heart rate detection during sleep. The data is collected from sensors underneath the test subjects. Though the data contains noise, it needs to be filtered to remove it. Due to the low strength of the signals, they need to be amplified after filtering. At some points of the signal, particular heartbeats may not be tracked by sensors due to the failure of a sensor or other reasons, which should be considered. The heart rate is detected in intervals of 15 s. A tool is implemented that detects the heart rate and visualizes it. The preprocessing of the data is performed with several filters: a highpass filter, a band-reject filter, a lowpass filter, and a motion detector. After the preprocessing of the data, the quality of the signal is significantly increased, and detection is possible.
In many cases continuous monitoring of vital signals is required and low intrusiveness is an important requirement. Incorporating monitoring systems in the hospital or home bed could have benefits for patients and caregivers. The objective of this work is the definition of a measurement protocol and the creation of a data set of measurements using commercial and low-cost prototypes devices to estimate heart rate and breathing rate. The experimental data will be used to compare results achieved by the devices and to develop algorithms for feature extraction of vital signals.
Generating synthetic data is a relevant point in the machine learning community. As accessible data is limited, the generation of synthetic data is a significant point in protecting patients' privacy and having more possibilities to train a model for classification or other machine learning tasks. In this work, some generative adversarial networks (GAN) variants are discussed, and an overview is given of how generative adversarial networks can be used for data generation in different fields. In addition, some common problems of the GANs and possibilities to avoid them are shown. Different evaluation methods of the generated data are also described.
Gamification is one of the recognized methods of motivating people in various life processes, and it has spread to many spheres of life, including healthcare. This article proposes a system design for long-term care patients using the method mentioned. The proposed system aims to increase patient engagement in the treatment and rehabilitation process via gamification. Literature research on available and earlier proposed systems was conducted to develop a suited system design. The primary target group includes bedridden patients and a sedentary lifestyle (predominantly lying in bed). One of the main criteria for selecting a suitable option was its contactless realization for the mentioned target groups in long-term care cases. As a result, we developed the system design for hardware and software that could prevent bedsores and other health problems from occurring because of low activity. The proposed design can be tested in hospitals, nursing homes, and rehabilitation centers.
Nowadays there is a rich diversity of sleep monitoring systems available on the market. They promise to offer information about sleep quality of the user by recording a limited number of vital signals, mainly heart rate and body movement. Typically, fitness trackers, smart watches, smart shirts, smartphone applications or patches do not provide access to the raw sensor data. Moreover, the sleep classification algorithm and the agreement ratio with the gold standard, polysomnography (PSG) are not disclosed. Some commercial systems record and store the data on the wearable device, but the user needs to transfer and import it into specialised software applications or return it to the doctor, for clinical evaluation of the data set. Thus an immediate feedback mechanism or the possibility of remote control and supervision are lacking. Furthermore, many such systems only distinguish between sleep and wake states, or between wake, light sleep and deep sleep. It is not always clear how these stages are mapped to the four known sleep stages: REM, NREM1, NREM2, NREM3-4. [1] The goal of this research is to find a reduced complexity method to process a minimum number of bio vital signals, while providing accurate sleep classification results. The model we propose offers remote control and real time supervision capabilities, by using Internet of Things (IoT) technology. This paper focuses on the data processing method and the sleep classification logic. The body sensor network representing our data acquisition system will be described in a separate publication. Our solution showed promising results and a good potential to overcome the limitations of existing products. Further improvements will be made and subjects with different age and health conditions will be tested.
The principal objective of this study is to investigate the impact of perceived stress on traffic and road safety. Therefore, we designed a study that allows the generation and collection of stress-relevant data. Drivers often experience stress due to their perception of lack of control during the driving process. This can lead to an increased likelihood of traffic accidents, driver errors, and traffic violations. To explore this phenomenon, we used the Stress Perceived Questionnaire (PSQ) to evaluate perceived stress levels during driving simulations and the EPQR questionnaire to determine the personality of the driver. With the presented study, participants can categorised based on their emotional stability and personality traits. Wearable devices were utilised to monitor each participant's instantaneous heart rate (HR) due to their non-intrusive and portable nature. The findings of this study deliver an overview of the link between stress and traffic and road safety. These findings can be utilised for future research and implementing strategies to reduce road accidents and promote traffic safety.
The importance of sleep for human life is enormous. It affects physical, mental, and psychological health. Therefore, it is vital to recognise sleep disorders in a timely manner in order to be able to initiate therapy. There are two methods for measuring sleep-related parameters - objective and subjective. Whether the substitution of a subjective method for an objective one is possible is investigated in this paper. Such replacement may bring several advantages, including increased comfort for the user. To answer this research question, a study was conducted in which 75 overnight recordings were evaluated. The primary purpose of this study was to compare both ways of measurement for total sleep time and sleep efficiency, which are essential parameters for, e.g., insomnia diagnosis and treatment. The evaluation results demonstrated that, on average, there are 32 minutes of difference between the two measurement methods when total sleep time is analysed. In contrast, on average, both measurement methods differ by 7.5% for sleep efficiency measurement. It should also be noted that people typically overestimate total sleep time and efficiency with the subjective method, where the perceived values are measured.
Nowadays, the importance of early active patient mobilization in the recovery and rehabilitation phase has increased significantly. One way to involve patients in the treatment is a gamification-like approach, which is one of the methods of motivation in various life processes. This article shows a system prototype for patients who require physical activity because of active early mobilization after medical interventions or during illness. Bedridden patients and people with a sedentary lifestyle (predominantly lying in bed) are also potential users. The main idea for the concept was non-contact system implementation for the patients making them feel effortless during its usage. The system consists of three related parts: hardware, software, and game application. To test the relevance and coherence of the system, it was used by 35 people. The participants were asked to play a video game requiring them to make body movements while lying down. Then they were asked to take part in a small survey to evaluate the system's usability. As a result, we offer a prototype consisting of hardware and software parts that can increase and diversify physical activity during active early mobilization of patients and prevent the occurrence of possible health problems due to predominantly low activity. The proposed design can be possibly implemented in hospitals, rehabilitation centers, and even at home.
Evaluation of a Contactless Accelerometer Sensor System for Heart Rate Monitoring During Sleep
(2024)
The monitoring of a patient's heart rate (HR) is critical in the diagnosis of diseases. In the detection of sleep disorders, it also plays an important role. Several techniques have been proposed, including using sensors to record physiological signals that are automatically examined and analysed. This work aims to evaluate using a contactless HR monitoring system based on an accelerometer sensor during sleep. For this purpose, the oscillations caused by chest movements during heart contractions are recorded by an installation mounted under the bed mattress. The processing algorithm presented in this paper filters the signals and determines the HR. As a result, an average error of about 5 bpm has been documented, i.e., the system can be considered to be used for the forecasted domain.
Recognition of sleep and wake states is one of the relevant parts of sleep analysis. Performing this measurement in a contactless way increases comfort for the users. We present an approach evaluating only movement and respiratory signals to achieve recognition, which can be measured non-obtrusively. The algorithm is based on multinomial logistic regression and analyses features extracted out of mentioned above signals. These features were identified and developed after performing fundamental research on characteristics of vital signals during sleep. The achieved accuracy of 87% with the Cohen’s kappa of 0.40 demonstrates the appropriateness of a chosen method and encourages continuing research on this topic.
The purpose of this paper is to examine the effects of perceived stress on traffic and road safety. One of the leading causes of stress among drivers is the feeling of having a lack of control during the driving process. Stress can result in more traffic accidents, an increase in driver errors, and an increase in traffic violations. To study this phenomenon, the Stress Perceived Questionnaire (PSQ) was used to evaluate the perceived stress while driving in a simulation. The study was conducted with participants from Germany, and they were grouped into different categories based on their emotional stability. Each participant was monitored using wearable devices that measured their instantaneous heart rate (HR). The preference for wearable devices was due to their non-intrusive and portable nature. The results of this study provide an overview of how stress can affect traffic and road safety, which can be used for future research or to implement strategies to reduce road accidents and promote traffic safety.
The scoring of sleep stages is an essential part of sleep studies. The main objective of this research is to provide an algorithm for the automatic classification of sleep stages using signals that may be obtained in a non-obtrusive way. After reviewing the relevant research, the authors selected a multinomial logistic regression as the basis for their approach. Several parameters were derived from movement and breathing signals, and their combinations were investigated to develop an accurate and stable algorithm. The algorithm was implemented to produce successful results: the accuracy of the recognition of Wake/NREM/REM stages is equal to 73%, with Cohen's kappa of 0.44 for the analyzed 19324 sleep epochs of 30 seconds each. This approach has the advantage of using the only movement and breathing signals, which can be recorded with less effort than heart or brainwave signals, and requiring only four derived parameters for the calculations. Therefore, the new system is a significant improvement for non-obtrusive sleep stage identification compared to existing approaches.
This paper presents a generic method to enhance performance and incorporate temporal information for cardiorespiratory-based sleep stage classification with a limited feature set and limited data. The classification algorithm relies on random forests and a feature set extracted from long-time home monitoring for sleep analysis. Employing temporal feature stacking, the system could be significantly improved in terms of Cohen’s κ and accuracy. The detection performance could be improved for three classes of sleep stages (Wake, REM, Non-REM sleep), four classes (Wake, Non-REM-Light sleep, Non-REM Deep sleep, REM sleep), and five classes (Wake, N1, N2, N3/4, REM sleep) from a κ of 0.44 to 0.58, 0.33 to 0.51, and 0.28 to 0.44 respectively by stacking features before and after the epoch to be classified. Further analysis was done for the optimal length and combination method for this stacking approach. Overall, three methods and a variable duration between 30 s and 30 min have been analyzed. Overnight recordings of 36 healthy subjects from the Interdisciplinary Center for Sleep Medicine at Charité-Universitätsmedizin Berlin and Leave-One-Out-Cross-Validation on a patient-level have been used to validate the method.
The goal of this paper pretends to show how a bed system with an embedded system with sensor is able to analyze a person’s movement, breathing and recognizing the positions that the subject is lying on the bed during the night without any additional physical contact. The measurements are performed with sensors placed between the mattress and the frame. An Intel Edison board was used as an endpoint that served as a communication node from the mesh network to external service. Two nodes and Intel Edison are attached to the bottom of the bed frame and they are connected to the sensors.
This document presents a new complete standalone system for a recognition of sleep apnea using signals from the pressure sensors placed under the mattress. The developed hardware part of the system is tuned to filter and to amplify the signal. Its software part performs more accurate signal filtering and identification of apnea events. The overall achieved accuracy of the recognition of apnea occurrence is 91%, with the average measured recognition delay of about 15 seconds, which confirms the suitability of the proposed method for future employment. The main aim of the presented approach is the support of the healthcare system with the cost-efficient tool for recognition of sleep apnea in the home environment.
Fatigue and drowsiness are responsible for a significant percentage of road traffic accidents. There are several approaches to monitor the driver’s drowsiness, ranging from the driver’s steering behavior to analysis of the driver, e.g. eye tracking, blinking, yawning or electrocardiogram (ECG). This paper describes the development of a low-cost ECG sensor to derive heart rate variability (HRV) data for the drowsiness detection. The work includes the hardware and the software design. The hardware has been implemented on a printed circuit board (PCB) designed so that the board can be used as an extension shield for an Arduino. The PCB contains a double, inverted ECG channel including low-pass filtering and provides two analog outputs to the Arduino, that combined them and performs the analog-to-digital conversion. The digital ECG signal is transferred to an NVidia embedded PC where the processing takes place, including QRS-complex, heart rate and HRV detection as well as visualization features. The compact resulting sensor provides good results in the extraction of the main ECG parameters. The sensor is being used in a larger frame, where facial-recognition-based drowsiness detection is combined with ECG-based detection to improve the recognition rate under unfavorable light or occlusion conditions.
The last decades have shown that the volume of tourism, in general, is constantly increasing (with some justified exceptions). To offer a possibility of travel for all groups of people, it is necessary to pay attention to accessibility. One of the possibilities for increasing accessibility is digital technologies, which could assist in planning and the implementation and completion of trips. To make a selection of technologies, first, a study of barriers was conducted, which was then analyzed, and finally, some technologies were made available in a test setup. A focus on two technologies was made: 360°-Tours and mobile app with the travel information. The two technologies were implemented and presented to the test subjects.
The evaluation results showed that both technologies could increase accessibility if some essential aspects (such as usability, completeness, relevance, etc.) are considered during the implementation.
Sustainable technologies are being increasingly used in various areas of human life. While they have a multitude of benefits, they are especially useful in health monitoring, especially for certain groups of people, such as the elderly. However, there are still several issues that need to be addressed before its use becomes widespread. This work aims to clarify the aspects that are of great importance for increasing the acceptance of the use of this type of technology in the elderly. In addition, we aim to clarify whether the technologies that are already available are able to ensure acceptable accuracy and whether they could replace some of the manual approaches that are currently being used. A two-week study with people 65 years of age and over was conducted to address the questions posed here, and the results were evaluated. It was demonstrated that simplicity of use and automatic functioning play a crucial role. It was also concluded that technology cannot yet completely replace traditional methods such as questionnaires in some areas. Although the technologies that were tested were classified as being “easy to use”, the elderly population in the current study indicated that they were not sure that they would use these technologies regularly in the long term because the added value is not always clear, among other issues. Therefore, awareness-raising must take place in parallel with the development of technologies and services.
Health monitoring in a home environment can have broader use since it may provide continuous control of health parameters with relatively minor intrusiveness into regular life. This work aims to verify if it is possible to replace the typical in some sleep medicine areas subjective questioning by an objective measurement using electronic devices. For this purpose, a study was conducted with ten subjects, in which objective and subjective measurement of relevant sleep parameters took place. The results of both measurement methods were evaluated and analyzed. The results showed that while for some measures, such as Total Time in Bed, there is a high agreement between objective and subjective measurements, for others, such as sleep quality, there are significant differences. For this reason, currently, a combination of both measurement methods may be beneficial and provide the most detailed results, while a partial replacement can already reduce the number of questions at the subjective measurement by measurement through electronic devices.
Development of an expert system to overpass citizens technological barriers on smart home and living
(2023)
Adopting new technologies can be overwhelming, even for people with experience in the field. For the general public, learning about new implementations, releases, brands, and enhancements can cause them to lose interest. There is a clear need to create point sources and platforms that provide helpful information about the novel and smart technologies, assisting users, technicians, and providers with products and technologies. The purpose of these platforms is twofold, as they can gather and share information on interests common to manufacturers and vendors. This paper presents the ”Finde-Dein-SmartHome” tool. Developed in association with the Smart Home & Living competence center [5] to help users learn about, understand, and purchase available technologies that meet their home automation needs. This tool aims to lower the usability barrier and guide potential customers to clear their doubts about privacy and pricing. Communities can use the information provided by this tool to identify market trends that could eventually lower costs for providers and incentivize access to innovative home technologies and devices supporting long-term care.
The person’s heart rate is an important indicator of their health status. A heart rate that is too high or too low could be a sign of several different diseases, such as a heart disorder, obesity, asthma, or many others. Many devices require users to wear the device on their chest or place a finger on the device. The approach presented in this paper describes the principle and implementation of a heart rate monitoring device, which is able to detect the heart rate with high precision with the sensor integrated in a wristband. One method to measure the heart rate is the photoplethysmogram technique. This method measures the change of blood volume through the absorption or reflection of light. A light emitting diode (LED) shines through a thin amount of tissue. A photo-diode registers the intensity of light that traverses the tissue or is reflected by the tissue. Since blood changes its volume with each heartbeat, the photo-diode detects more or less light from the LED. The device is able to measure the heart rate with a high precision, it has low performance and hardware requirements, and it allows an implementation with small micro-controllers.
Determination of accelerometer sensor position for respiration rate detection: Initial research
(2022)
Continuous monitoring of a patient's vital signs is essential in many chronic illnesses. The respiratory rate (RR) is one of the vital signs indicating breathing diseases. This article proposes the initial investigation for determining the accelerometric sensor position of a non-invasive and unobtrusive respiratory rate monitoring system. This research aims to determine the sensor position in relation to the patient, which can provide the most accurate values of the mentioned physiological parameter. In order to achieve the result, the particular system setup, including a mechanical sensor holder construction was used. The breathing signals from 5 participants were analyzed corresponding to the relaxed state. The main criterion for selecting a suitable sensor position was each patient's average acceleration amplitude excursion, which corresponds to the respiratory signal. As a result, we provided one more defined important parameter for the considered system, which was not determined before.
The proposed approach applies current unsupervised clustering approaches in a different dynamic manner. Instead of taking all the data as input and finding clusters among them, the given approach clusters Holter ECG data (long-term electrocardiography data from a holter monitor) on a given interval which enables a dynamic clustering approach (DCA). Therefore advanced clustering techniques based on the well known Dynamic Time Warping algorithm are used. Having clusters e.g. on a daily basis, clusters can be compared by defining cluster shape properties. Doing this gives a measure for variation in unsupervised cluster shapes and may reveal unknown changes in healthiness. Embedding this approach into wearable devices offers advantages over the current techniques. On the one hand users get feedback if their ECG data characteristic changes unforeseeable over time which makes early detection possible. On the other hand cluster properties like biggest or smallest cluster may help a doctor in making diagnoses or observing several patients. Further, on found clusters known processing techniques like stress detection or arrhythmia classification may be applied.
Sleep is essential to existence, much like air, water, and food, as we spend nearly one-third of our time sleeping. Poor sleep quality or disturbed sleep causes daytime solemnity, which worsens daytime activities' mental and physical qualities and raises the risk of accidents. With advancements in sensor and communication technology, sleep monitoring is moving out of specialized clinics and into our everyday homes. It is possible to extract data from traditional overnight polysomnographic recordings using more basic tools and straightforward techniques. Ballistocardiogram is an unobtrusive, non-invasive, simple, and low-cost technique for measuring cardiorespiratory parameters. In this work, we present a sensor board interface to facilitate the communication between force sensitive resistor sensor and an embedded system to provide a high-performing prototype with an efficient signal-to-noise ratio. We have utilized a multi-physical-layer approach to locate each layer on top of another, yet supporting a low-cost, compact design with easy deployment under the bed frame.
A significant proportion of road traffic accidents are due to inattentiveness or fatigue at the wheel. Approaches to monitoring the driver's condition range from eye tracking and driving behavior analysis to yawn and blink detection and ECG measurement. This work describes the development of a mobile system for the measurement and processing of ECG data. The aim of the signal processing is to quantify the driver’s fatigue with the heartrate variability (HRV). The work includes the hardware and software design of the sensor. First, the development of low-noise electronics including AD conversion is described. Then the software signal processing with QRS complex detection and plotting front end is explained. The resulting sensor is compact, low-cost and provides a good signal for HRV extraction.
Normal breathing during sleep is essential for people’s health and well-being. Therefore, it is crucial to diagnose apnoea events at an early stage and apply appropriate therapy. Detection of sleep apnoea is a central goal of the system design described in this article. To develop a correctly functioning system, it is first necessary to define the requirements outlined in this manuscript clearly. Furthermore, the selection of appropriate technology for the measurement of respiration is of great importance. Therefore, after performing initial literature research, we have analysed in detail three different methods and made a selection of a proper one according to determined requirements. After considering all the advantages and disadvantages of the three approaches, we decided to use the impedance measurement-based one. As a next step, an initial conceptual design of the algorithm for detecting apnoea events was created. As a result, we developed an activity diagram on which the main system components and data flows are visually represented.
There have been substantial research efforts for algorithms to improve continuous and automated assessment of various health-related questions in recent years. This paper addresses the deployment gap between those improving algorithms and their usability in care and mobile health applications. In practice, most algorithms require significant and founded technical knowledge to be deployed at home or support healthcare professionals. Therefore, the digital participation of persons in need of health care professionals lacks a usable interface to use the current technological advances. In this paper, we propose applying algorithms taken from research as web-based microservices following the common approach of a RESTful service to bridge the gap and make algorithms accessible to caregivers and patients without technical knowledge and extended hardware capabilities. We address implementation details, interpretation and realization of guidelines, and privacy concerns using our self-implemented example. Also, we address further usability guidelines and our approach to those.
The perception of the amount of stress is subjective to every person, and the perception of it changes depending on many factors. One of the factors that has an impact on perceived stress is the emotional state. In this work, we compare the emotional state of 40 German driving students and present different partitions that can be advantageous for using artificial intelligence and classification. Like this, we evaluate the data quality and prepare for the specific use. The Stress Perceived Questionnaire (PSQ20) was employed to assess the level of stress experienced by individuals while participating in a driving simulation for 5 and 25 min. As a result of our analysis, we present a categorisation of various emotional states into intervals, comparing different classifications and facilitating a more straightforward implementation of artificial intelligence for classification purposes.
Deep Learning-based EEG Detection of Mental Alertness States from Drivers under Ethical Aspects
(2022)
One of the most critical factors for a successful road trip is a high degree of alertness while driving. Even a split second of inattention or sleepiness in a crucial moment, will make the difference between life and death. Several prestigious car manufacturers are currently pursuing the aim of automated drowsiness identification to resolve this problem. The path between neuro-scientific research in connection with artificial intelligence and the preservation of the dignity of human individual’s and its inviolability, is very narrow. The key contribution of this work is a system of data analysis for EEGs during a driving session, which draws on previous studies analyzing heart rate (ECG), brain waves (EEG), and eye function (EOG). The gathered data is hereby treated as sensitive as possible, taking ethical regulations into consideration. Obtaining evaluable signs of evolving exhaustion includes techniques that obtain sleeping stage frequencies, problematic are hereby the correlated interference’s in the signal. This research focuses on a processing chain for EEG band splitting that involves band-pass filtering, principal component analysis (PCA), independent component analysis (ICA) with automatic artefact severance, and fast fourier transformation (FFT). The classification is based on a step-by-step adaptive deep learning analysis that detects theta rhythms as a drowsiness predictor in the pre-processed data. It was possible to obtain an offline detection rate of 89% and an online detection rate of 73%. The method is linked to the simulated driving scenario for which it was developed. This leaves space for more optimization on laboratory methods and data collection during wakefulness-dependent operations.
Unintrusive health monitoring systems is important when continuous monitoring of the patient vital signals is required. In this paper, signals obtained from accelerometers placed under a bed are processed with ballistocardiography algorithms and compared with synchronized electrocardiographic signals.
The scoring of sleep stages is one of the essential tasks in sleep analysis. Since a manual procedure requires considerable human and financial resources, and incorporates some subjectivity, an automated approach could result in several advantages. There have been many developments in this area, and in order to provide a comprehensive overview, it is essential to review relevant recent works and summarise the characteristics of the approaches, which is the main aim of this article. To achieve it, we examined articles published between 2018 and 2022 that dealt with the automated scoring of sleep stages. In the final selection for in-depth analysis, 125 articles were included after reviewing a total of 515 publications. The results revealed that automatic scoring demonstrates good quality (with Cohen's kappa up to over 0.80 and accuracy up to over 90%) in analysing EEG/EEG + EOG + EMG signals. At the same time, it should be noted that there has been no breakthrough in the quality of results using these signals in recent years. Systems involving other signals that could potentially be acquired more conveniently for the user (e.g. respiratory, cardiac or movement signals) remain more challenging in the implementation with a high level of reliability but have considerable innovation capability. In general, automatic sleep stage scoring has excellent potential to assist medical professionals while providing an objective assessment.
The actual task of electrocardiographic examinations is to increase the reliability of diagnosing the condition of the heart. Within the framework of this task, an important direction is the solution of the inverse problem of electrocardiography, based on the processing of electrocardiographic signals of multichannel cardio leads at known electrode coordinates in these leads (Titomir et al. Noninvasiv electrocardiotopography, 2003), (Macfarlane et al. Comprehensive Electrocardiology, 2nd ed. (Chapter 9), 2011).
Sleep is essential to physical and mental health. However, the traditional approach to sleep analysis—polysomnography (PSG)—is intrusive and expensive. Therefore, there is great interest in the development of non-contact, non-invasive, and non-intrusive sleep monitoring systems and technologies that can reliably and accurately measure cardiorespiratory parameters with minimal impact on the patient. This has led to the development of other relevant approaches, which are characterised, for example, by the fact that they allow greater freedom of movement and do not require direct contact with the body, i.e., they are non-contact. This systematic review discusses the relevant methods and technologies for non-contact monitoring of cardiorespiratory activity during sleep. Taking into account the current state of the art in non-intrusive technologies, we can identify the methods of non-intrusive monitoring of cardiac and respiratory activity, the technologies and types of sensors used, and the possible physiological parameters available for analysis. To do this, we conducted a literature review and summarised current research on the use of non-contact technologies for non-intrusive monitoring of cardiac and respiratory activity. The inclusion and exclusion criteria for the selection of publications were established prior to the start of the search. Publications were assessed using one main question and several specific questions. We obtained 3774 unique articles from four literature databases (Web of Science, IEEE Xplore, PubMed, and Scopus) and checked them for relevance, resulting in 54 articles that were analysed in a structured way using terminology. The result was 15 different types of sensors and devices (e.g., radar, temperature sensors, motion sensors, cameras) that can be installed in hospital wards and departments or in the environment. The ability to detect heart rate, respiratory rate, and sleep disorders such as apnoea was among the characteristics examined to investigate the overall effectiveness of the systems and technologies considered for cardiorespiratory monitoring. In addition, the advantages and disadvantages of the considered systems and technologies were identified by answering the identified research questions. The results obtained allow us to determine the current trends and the vector of development of medical technologies in sleep medicine for future researchers and research.
Long-term sleep monitoring can be done primarily in the home environment. Good patient acceptance requires low user and installation barriers. The selection of parameters in this approach is significantly limited compared to a PSG session. The aim is a qualified selection of parameters, which on the one hand allow a sufficiently good classification of sleep phases and on the other hand can be detected by non-invasive methods.
Healthy sleep is one of the prerequisites for a good human body and brain condition, including general well-being. Unfortunately, there are several sleep disorders that can negatively affect this. One of the most common is sleep apnoea, in which breathing is impaired. Studies have shown that this disorder often remains undiagnosed. To avoid this, developing a system that can be widely used in a home environment to detect apnoea and monitor the changes once therapy has been initiated is essential. The conceptualisation of such a system is the main aim of this research. After a thorough analysis of the available literature and state of the art in this area of knowledge, a concept of the system was created, which includes the following main components: data acquisition (including two parts), storage of the data, apnoea detection algorithm, user and device management, data visualisation. The modules are interchangeable, and interfaces have been defined for data transfer, most of which operate using the MQTT protocol. System diagrams and detailed component descriptions, including signal requirements and visualisation mockups, have also been developed. The system's design includes the necessary concepts for the implementation and can be realised in a prototype in the next phase.
Good sleep is crucial for a healthy life of every person. Unfortunately, its quality often decreases with aging. A common approach to measuring the sleep characteristics is based on interviews with the subjects or letting them fill in a daily questionnaire and afterward evaluating the obtained data. However, this method has time and personal costs for the interviewer and evaluator of responses. Therefore, it would be important to execute the collection and evaluation of sleep characteristics automatically. To do that, it is necessary to investigate the level of agreement between measurements performed in a traditional way using questionnaires and measurements obtained using electronic monitoring devices. The study presented in this manuscript performs this investigation, comparing such sleep characteristics as "time going to bed", "total time in bed", "total sleep time" and "sleep efficiency". A total number of 106 night records of elderly persons (aged 65+) were analyzed. The results achieved so far reveal the fact that the degree of agreement between the two measurement methods varies substantially for different characteristics, from 31 minutes of mean difference for "time going to bed" to 77 minutes for "total sleep time". For this reason, a direct exchange of objective and subjective measuring methods is currently not possible.
Cardiovascular diseases (CVD) are leading contributors to global mortality, necessitating advanced methods for vital sign monitoring. Heart Rate Variability (HRV) and Respiratory Rate, key indicators of cardiovascular health, are traditionally monitored via Electrocardiogram (ECG). However, ECG's obtrusiveness limits its practicality, prompting the exploration of Ballistocardiography (BCG) as a non-invasive alternative. BCG records the mechanical activity of the body with each heartbeat, offering a contactless method for HRV monitoring. Despite its benefits, BCG signals are susceptible to external interference and present a challenge in accurately detecting J-Peaks. This research uses advanced signal processing and deep learning techniques to overcome these limitations. Our approach integrates accelerometers for long-term BCG data collection during sleep, applying Discrete Wavelet Transforms (DWT) and Ensemble Empirical Mode Decomposition (EEMD) for feature extraction. The Bi-LSTM model, leveraging these features, enhances heartbeat detection, offering improved reliability over traditional methods. The study's findings indicate that the combined use of DWT, EEMD, and Bi-LSTM for J-Peak detection in BCG signals is effective, with potential applications in unobtrusive long-term cardiovascular monitoring. Our results suggest that this methodology could contribute to HRV monitoring, particularly in home settings, enhancing patient comfort and compliance.
The citizen-centered health platform project is intended to provide a platform that can be used in EU cross-border regions, where social and economic exchange occurs across national borders. The overriding challenges are: (a) social: improving citizen-centered health and care provision; (b) technical: providing a digital platform for networking citizens, service providers, and municipal actors; (c) economic: developing long-term successful (sustainable) business models/value chains. The platform should strengthen and expand existing networks and establish new regional networks. Each network addresses particular challenges and apply them in a region-specific manner. Here, the national boundary conditions and the interregional needs play an essential role. These objectives require sufficient participation of civil society representatives. Furthermore, the platform will establish an overarching, sustainable, and knowledge-based network of health experts. The platform is to be jointly developed and implemented in the regions and follow an open-access approach. Therefore, synergies will be shared more quickly, strengthening competencies and competitiveness. In addition to practice partners, scientific and municipal institutions and SMEs are involved. The actors thus contribute to scientific performance, innovative strength, and resilience.