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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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.