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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.
Autismus-Spektrum-Störungen (ASD) bei Kindern werden häufig zu spät diagnostiziert und die Begleitung der chronischen Krankheit gestaltet sich schwierig. Der vorgestellte Ansatz erlaubt die Behandlung der Kinder in dem bekannten häuslichen Umfeld und versucht die Beziehungen zwischen Schlaf und Verhalten herauszuarbeiten. Die gewonnenen Erkenntnisse sollen die Lebensqualität der Patienten verbessern und den Eltern Hilfestellung geben. Die notwendige infrastrukturelle Unterstützung wird durch medizinisches Fachpersonal geleistet, das auf einen web-basierten Service zurückgreifen kann, der sämtliche Prozesse (Diagnostik, Datenerfassung, -aufzeichnung und Training etc.) begleitet. Die anonymisierten Daten werden in einem Diagnosesystem zentral abgelegt und können so für zukünftige Behandlungsstrategien nutzbar sein. Die umfassende Lösung setzt auf zentrale Elemente von Smart-Homes und AAL auf.
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.
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.
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.
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 diesem Beitrag wird eine Methode des maschinellen Lernens entwickelt, die die Schlafstadienerkennung untersucht. Übliche Methoden der Schlafanalyse basieren auf der Polysomnographie (PSG). Der präsentierte Ansatz basiert auf Signalen, die ausschließlich nicht-invasiv in einer häuslichen Umgebung gemessen werden können. Bewegungs-, Herzschlags- und Atmungssignale können vergleichsweise leicht erfasst werden aber die Erkennung der Schlafstadien ist dadurch erschwert. Die Signale werden als Zeitreihenfolge strukturiert und in Epochen überführt. Die Leistungsfähigkeit von maschinellem Lernen wird der Polysomnographie gegenübergestellt und bewertet.
Die Schlafapnoe ist eine häufig auftretende Schlafstörung,
die unterschiedliche Auswirkungen auf unseren Alltag hat; so wurde z. B.
über eine Tagesschläfrigkeit von etwa 25 % der Patienten mit obstruktiver
Schlafapnoe (OSA) berichtet. Ziel dieser Arbeit ist die Entwicklung eines
Systems, das eine nichtinvasive Erkennung der Schlafapnoe in häuslicher
Umgebung ermöglichen soll.
Für die Überwachung des Schlafs zu Hause sind nichtinvasive Methoden besonders gut anwendbar. Die Signale, die häufig überwacht werden, sind Herzfrequenz und Atemfrequenz. Die Ballistokardiographie (BCG)ist eine Technik, bei der die Herzfrequenz aus den mechanischen Schwingungen des Körpers bei jedem Herzzyklus gemessen wird. Kürzlich wurden Übersichtsarbeiten veröffentlicht. Die Untersuchung soll in einem ersten Ansatz bewerten, ob die Herzfrequenz anhand von BCG erkannt werden kann. Die wesentlichen Randbedingungen sind, ob dies gelingt, wenn der Sensor unter der Matratze positioniert wird und kostengünstige Sensoren zum Einsatz kommen.
This paper presents the implementation of deep learning methods for sleep stage detection by using three signals that can be measured in a non-invasive way: heartbeat signal, respiratory signal, and movement signal. Since signals are measurements taken during the time, the problem is seen as time-series data classification. Deep learning methods are chosen to solve the problem are convolutional neural network and long-short term memory network. Input data is structured as a time-series sequence of mentioned signals that represent 30 seconds epoch, which is a standard interval for sleep analysis. The records used belong to the overall 23 subjects, which are divided into two subsets. Records from 18 subjects were used for training the data and from 5 subjects for testing the data. For detecting four sleep stages: REM (Rapid Eye Movement), Wake, Light sleep (Stage 1 and Stage 2), and Deep sleep (Stage 3 and Stage 4), the accuracy of the model is 55%, and F1 score is 44%. For five stages: REM, Stage 1, Stage 2, Deep sleep (Stage 3 and 4), and Wake, the model gives an accuracy of 40% and F1 score of 37%.
This work is a study about a comparison of survey tools and it should help developers in selecting a suited tool for application in an AAL environment. The first step was to identify the basic required functionality of the survey tools used for AAL technologies and to compare these tools by their functionality and assignments. The comparative study was derived from the data obtained, previous literature studies and further technical data. A list of requirements was stated and ordered in terms of relevance to the target application domain. With the help of an integrated assessment method, the calculation of a generalized estimate value was performed and the result is explained. Finally, the planned application of this tool in a running project is explained.
Cardiovascular diseases are directly or indirectly responsible for up to 38.5% of all deaths in Germany and thus represent the most frequent cause of death. At present, heart diseases are mainly discovered by chance during routine visits to the doctor or when acute symptoms occur. However, there is no practical method to proactively detect diseases or abnormalities of the heart in the daily environment and to take preventive measures for the person concerned. Long-term ECG devices, as currently used by physicians, are simply too expensive, impractical, and not widely available for everyday use. This work aims to develop an ECG device suitable for everyday use that can be worn directly on the body. For this purpose, an already existing hardware platform will be analyzed, and the corresponding potential for improvement will be identified. A precise picture of the existing data quality is obtained by metrological examination, and corresponding requirements are defined. Based on these identified optimization potentials, a new ECG device is developed. The revised ECG device is characterized by a high integration density and combines all components directly on one board except the battery and the ECG electrodes. The compact design allows the device to be attached directly to the chest. An integrated microcontroller allows digital signal processing without the need for an additional computer. Central features of the evaluation are a peak detection for detecting R-peaks and a calculation of the current heart rate based on the RR interval. To ensure the validity of the detected R-peaks, a model of the anatomical conditions is used. Thus, unrealistic RR-intervals can be excluded. The wireless interface allows continuous transmission of the calculated heart rate. Following the development of hardware and software, the results are verified, and appropriate conclusions about the data quality are drawn. As a result, a very compact and wearable ECG device with different wireless technologies, data storage, and evaluation of RR intervals was developed. Some tests yelled runtimes up to 24 hours with wireless Lan activated and streaming.
A residual neural network was adapted and applied to the Physionet/Computing data in Cardiology Challenge 2020 to detect 24 different classes of cardiac abnormalities from 12-lead. Additive Gaussian noise, signal shifting, and the classification of signal sections of different lengths were applied to prevent the network from overfitting and facilitating generalization. Due to the use of a global pooling layer after the feature extractor, the network is independent of the signal’s length. On the hidden test set of the challenge, the model achieved a validation score of 0.656 and a full test score of 0.27, placing us 15th out of 41 officially ranked teams (Team name: UC_Lab_Kn). These results show the potential of deep neural networks for ap- plication to raw data and a complex multi-class multi-label classification problem, even if the training data is from di- verse datasets and of differing lengths.
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.
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.
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.
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.
In previous studies, we used a method for detecting stress that was based exclusively on heart rate and ECG for differentiation between such situations as mental stress, physical activity, relaxation, and rest. As a response of the heart to these situations, we observed different behavior in the Root Mean Square of the Successive differences heartbeats (RMSSD). This study aims to analyze Virtual Reality via a virtual reality headset as an effective stressor for future works. The value of the Root Mean Square of the Successive Differences is an important marker for the parasympathetic effector on the heart and can provide information about stress. For these measurements, the RR interval was collected using a breast belt. In these studies, we can observe the Root Mean Square of the successive differences heartbeats. Additional sensors for the analysis were not used. We conducted experiments with ten subjects that had to drive a simulator for 25 minutes using monitors and 25 minutes using virtual reality headset. Before starting and after finishing each simulation, the subjects had to complete a survey in which they had to describe their mental state. The experiment results show that driving using virtual reality headset has some influence on the heart rate and RMSSD, but it does not significantly increase the stress of driving.
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.
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.
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.
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.
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.
Introduction. Despite its high accuracy, polysomnography (PSG) has several drawbacks for diagnosing obstructive sleep apnea (OSA). Consequently, multiple portable monitors (PMs) have been proposed. Objective. This systematic review aims to investigate the current literature to analyze the sets of physiological parameters captured by a PM to select the minimum number of such physiological signals while maintaining accurate results in OSA detection. Methods. Inclusion and exclusion criteria for the selection of publications were established prior to the search. The evaluation of the publications was made based on one central question and several specific questions. Results. The abilities to detect hypopneas, sleep time, or awakenings were some of the features studied to investigate the full functionality of the PMs to select the most relevant set of physiological signals. Based on the physiological parameters collected (one to six), the PMs were classified into sets according to the level of evidence. The advantages and the disadvantages of each possible set of signals were explained by answering the research questions proposed in the methods. Conclusions. The minimum number of physiological signals detected by PMs for the detection of OSA depends mainly on the purpose and context of the sleep study. The set of three physiological signals showed the best results in the detection of OSA.
Identifikation von Schlaf- und Wachzuständen durch die Auswertung von Atem- und Bewegungssignalen
(2021)
Background:
One of the most promising health care development areas is introducing telemedicine services and creating solutions based on blockchain technology. The study of systems combining both these domains indicates the ongoing expansion of digital technologies in this market segment.
Objective:
This paper aims to review the feasibility of blockchain technology for telemedicine.
Methods:
The authors identified relevant studies via systematic searches of databases including PubMed, Scopus, Web of Science, IEEE Xplore, and Google Scholar. The suitability of each for inclusion in this review was assessed independently. Owing to the lack of publications, available blockchain-based tokens were discovered via conventional web search engines (Google, Yahoo, and Yandex).
Results:
Of the 40 discovered projects, only 18 met the selection criteria. The 5 most prevalent features of the available solutions (N=18) were medical data access (14/18, 78%), medical service processing (14/18, 78%), diagnostic support (10/18, 56%), payment transactions (10/18, 56%), and fundraising for telemedical instrument development (5/18, 28%).
Conclusions:
These different features (eg, medical data access, medical service processing, epidemiology reporting, diagnostic support, and treatment support) allow us to discuss the possibilities for integration of blockchain technology into telemedicine and health care on different levels. In this area, a wide range of tasks can be identified that could be accomplished based on digital technologies using blockchains.
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.
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.
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.
The main aim of presented in this manuscript research is to compare the results of objective and subjective measurement of sleep quality for older adults (65+) in the home environment. A total amount of 73 nights was evaluated in this study. Placing under the mattress device was used to obtain objective measurement data, and a common question on perceived sleep quality was asked to collect the subjective sleep quality level. The achieved results confirm the correlation between objective and subjective measurement of sleep quality with the average standard deviation equal to 2 of 10 possible quality points.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Home health applications have evolved over the last few decades. Assistive systems such as a data platform in connection with health devices can allow for health-related data to be automatically transmitted to a database. However, there remain significant challenges concerning intermodular communication. Central among them is the challenge of achieving interoperability, the ability of devices to communicate and share data with each other. A major goal of this project was to extend an existing data platform (COMES®) and establish working interoperability by connecting assistive devices with differing approaches. We describe this process for a sleep monitoring and a physical exercise device. Furthermore, we aimed to test this setup and the implementation with a data platform in both a laboratory and an in-home setting with 11 elderly participants. The platform modification was realized, and the relevant changes were made so that the incoming data could be processed by the data platform, as well as visually displayed in real-time. Data was recorded by the respective device and transmitted into the data server with minor disruptions. Our observations affirmed that difficulties and data loss are far more likely to occur with increasing technical complexity, in the event of instable internet connection, or when the device setup requires (elderly) subjects to take specific steps for proper functioning. We emphasize the importance for tests and evaluations of home health technologies in real-life circumstances.
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.
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.
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.
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.
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.
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 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.
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.
oday many scientific works are using deep learning algorithms and time series, which can detect physiological events of interest. In sleep medicine, this is particularly relevant in detecting sleep apnea, specifically in detecting obstructive sleep apnea events. Deep learning algorithms with different architectures are used to achieve decent results in accuracy, sensitivity, etc. Although there are models that can reliably determine apnea and hypopnea events, another essential aspect to consider is the explainability of these models, i.e., why a model makes a particular decision. Another critical factor is how these deep learning models determine how severe obstructive sleep apnea is in patients based on the apnea-hypopnea index (AHI). Deep learning models trained by two approaches for AHI determination are exposed in this work. Approaches vary depending on the data format the models are fed: full-time series and window-based time series.