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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.
We quantify the effects of GATT/WTO membership on trade and welfare. Using an extensive database covering manufacturing trade for 186 countries over the period 1980–2016, we find that the average partial equilibrium impact of GATT/WTO membership on trade among member countries is large, positive, and significant. We contribute to the literature by estimating country-specific estimates and find them to vary widely across the countries in our sample with poorer members benefitting more. Using these estimates, we simulate the general equilibrium effects of GATT/WTO on welfare, which are sizable and heterogeneous across members. We show that countries not experiencing positive trade effects from joining GATT/WTO can still gain in terms of welfare, due to lower import prices and higher export demand.
While driving, stress is caused by situations in which the driver estimates their ability to manage the driving demands as insufficient or loses the capability to handle the situation. This leads to increased numbers of driver mistakes and traffic violations. Additional stressing factors are time pressure, road conditions, or dislike for driving. Therefore, stress affects driver and road safety. Stress is classified into two categories depending on its duration and the effects on the body and psyche: short-term eustress and constantly present distress, which causes degenerative effects. In this work, we focus on distress. Wearable sensors are handy tools for collecting biosignals like heart rate, activity, etc. Easy installation and non-intrusive nature make them convenient for calculating stress. This study focuses on the investigation of stress and its implications. Specifically, the research conducts an analysis of stress within a select group of individuals from both Spain and Germany. The primary objective is to examine the influence of recognized psychological factors, including personality traits such as neuroticism, extroversion, psychoticism, stress and road safety. The estimation of stress levels was accomplished through the collection of physiological parameters (R-R intervals) using a Polar H10 chest strap. We observed that personality traits, such as extroversion, exhibited similar trends during relaxation, with an average heart rate 6% higher in Spain and 3% higher in Germany. However, while driving, introverts, on average, experienced more stress, with rates 4% and 1% lower than extroverts in Spain and Germany, respectively.
Study design:
Retrospective, mono-centric cohort research study.
Objectives:
The purpose of this study is to validate a novel artificial intelligence (AI)-based algorithm against human-generated ground truth for radiographic parameters of adolescent idiopathic scoliosis (AIS).
Methods:
An AI-algorithm was developed that is capable of detecting anatomical structures of interest (clavicles, cervical, thoracic, lumbar spine and sacrum) and calculate essential radiographic parameters in AP spine X-rays fully automatically. The evaluated parameters included T1-tilt, clavicle angle (CA), coronal balance (CB), lumbar modifier, and Cobb angles in the proximal thoracic (C-PT), thoracic, and thoracolumbar regions. Measurements from 2 experienced physicians on 100 preoperative AP full spine X-rays of AIS patients were used as ground truth and to evaluate inter-rater and intra-rater reliability. The agreement between human raters and AI was compared by means of single measure Intra-class Correlation Coefficients (ICC; absolute agreement; .75 rated as excellent), mean error and additional statistical metrics.
Results:
The comparison between human raters resulted in excellent ICC values for intra- (range: .97-1) and inter-rater (.85-.99) reliability. The algorithm was able to determine all parameters in 100% of images with excellent ICC values (.78-.98). Consistently with the human raters, ICC values were typically smallest for C-PT (eg, rater 1A vs AI: .78, mean error: 4.7°) and largest for CB (.96, -.5 mm) as well as CA (.98, .2°).
Conclusions:
The AI-algorithm shows excellent reliability and agreement with human raters for coronal parameters in preoperative full spine images. The reliability and speed offered by the AI-algorithm could contribute to the efficient analysis of large datasets (eg, registry studies) and measurements in clinical practice.
Cities around the world are facing the implications of a changing climate as an increasingly pressing issue. The negative effects of climate change are already being felt today. Therefore, adaptation to these changes is a mission that every city must master. Leading practices worldwide demonstrate various urban efforts on climate change adaptation (CCA) which are already underway. Above all, the integration of climate data, remote sensing, and in situ data is key to a successful and measurable adaptation strategy. Furthermore, these data can act as a timely decision support tool for municipalities to develop an adaptation strategy, decide which actions to prioritize, and gain the necessary buy-in from local policymakers. The implementation of agile data workflows can facilitate the integration of climate data into climate-resilient urban planning. Due to local specificities, (supra)national, regional, and municipal policies and (by) laws, as well as geographic and related climatic differences worldwide, there is no single path to climate-resilient urban planning. Agile data workflows can support interdepartmental collaboration and, therefore, need to be integrated into existing management processes and government structures. Agile management, which has its origins in software development, can be a way to break down traditional management practices, such as static waterfall models and sluggish stage-gate processes, and enable an increased level of flexibility and agility required when urgent. This paper presents the findings of an empirical case study conducted in cooperation with the City of Constance in southern Germany, which is pursuing a transdisciplinary and trans-sectoral co-development approach to make management processes more agile in the context of climate change adaptation. The aim is to present a possible way of integrating climate data into CCA planning by changing the management approach and implementing a toolbox for low-threshold access to climate data. The city administration, in collaboration with the University of Applied Sciences Constance, the Climate Service Center Germany (GERICS), and the University of Stuttgart, developed a co-creative and participatory project, CoKLIMAx, with the objective of integrating climate data into administrative processes in the form of a toolbox. One key element of CoKLIMAx is the involvement of the population, the city administration, and political decision-makers through targeted communication and regular feedback loops among all involved departments and stakeholder groups. Based on the results of a survey of 72 administrative staff members and a literature review on agile management in municipalities and city administrations, recommendations on a workflow and communication structure for cross-departmental strategies for resilient urban planning in the City of Constance were developed.
AbstractSanctions encompass a wide set of policy instruments restricting cross‐border economic activities. In this paper, we study how different types of sanctions affect the export behavior of firms to the targeted countries. We combine Danish register data, including information on firm‐destination‐specific exports, with information on sanctions imposed by Denmark from the Global Sanctions Database. Our data allow us to study firms' export behavior in 62 sanctioned countries, amounting to a total of 453 country‐years with sanctions over the period 2000–2015. Methodologically, we apply a two‐stage estimation strategy to properly account for multilateral resistance terms. We find that, on average, sanctions lead to a significant reduction in firms' destination‐specific exports and a significant increase in firms' probability to exit the destination. Next, we study heterogeneity in the effects of sanctions across (i) sanction types and sanction packages, (ii) the objectives of sanctions, and (iii) countries subject to sanctions. Results confirm that the effects of sanctions on firms' export behavior vary considerably across these three dimensions.
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.
Increasing demand for sustainable, resilient, and low-carbon construction materials has highlighted the potential of Compacted Mineral Mixtures (CMMs), which are formulated from various soil types (sand, silt, clay) and recycled mineral waste. This paper presents a comprehensive inter- and transdisciplinary research concept that aims to industrialise and scale up the adoption of CMM-based construction materials and methods, thereby accelerating the construction industry’s systemic transition towards carbon neutrality. By drawing upon the latest advances in soil mechanics, rheology, and automation, we propose the development of a robust material properties database to inform the design and application of CMM-based materials, taking into account their complex, time-dependent behaviour. Advanced soil mechanical tests would be utilised to ensure optimal performance under various loading and ageing conditions. This research has also recognised the importance of context-specific strategies for CMM adoption. We have explored the implications and limitations of implementing the proposed framework in developing countries, particularly where resources may be constrained. We aim to shed light on socio-economic and regulatory aspects that could influence the adoption of these sustainable construction methods. The proposed concept explores how the automated production of CMM-based wall elements can become a fast, competitive, emission-free, and recyclable alternative to traditional masonry and concrete construction techniques. We advocate for the integration of open-source digital platform technologies to enhance data accessibility, processing, and knowledge acquisition; to boost confidence in CMM-based technologies; and to catalyse their widespread adoption. We believe that the transformative potential of this research necessitates a blend of basic and applied investigation using a comprehensive, holistic, and transfer-oriented methodology. Thus, this paper serves to highlight the viability and multiple benefits of CMMs in construction, emphasising their pivotal role in advancing sustainable development and resilience in the built environment.
This paper introduces the third update/release of the Global Sanctions Data Base (GSDB-R3). The GSDB-R3 extends the period of coverage from 1950–2019 to 1950–2022, which includes two special periods—COVID-19 and the new sanctions against Russia. This update of the GSDB contains a total of 1325 cases. In response to multiple inquiries and requests, the GSDB-R3 has been amended with a new variable that distinguishes between unilateral and multilateral sanctions. As before, the GSDB comes in two versions, case-specific and dyadic, which are freely available upon request at GSDB@drexel.edu. To highlight one of the new features of the GSDB, we estimate the heterogeneous effects of unilateral and multilateral sanctions on trade. We also obtain estimates of the effects on trade of the 2014 sanctions on Russia.
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.
In order to ensure sufficient recovery of the human body and brain, healthy sleep is indispensable. For this purpose, appropriate therapy should be initiated at an early stage in the case of sleep disorders. For some sleep disorders (e.g., insomnia), a sleep diary is essential for diagnosis and therapy monitoring. However, subjective measurement with a sleep diary has several disadvantages, requiring regular action from the user and leading to decreased comfort and potential data loss. To automate sleep monitoring and increase user comfort, one could consider replacing a sleep diary with an automatic measurement, such as a smartwatch, which would not disturb sleep. To obtain accurate results on the evaluation of the possibility of such a replacement, a field study was conducted with a total of 166 overnight recordings, followed by an analysis of the results. In this evaluation, objective sleep measurement with a Samsung Galaxy Watch 4 was compared to a subjective approach with a sleep diary, which is a standard method in sleep medicine. The focus was on comparing four relevant sleep characteristics: falling asleep time, waking up time, total sleep time (TST), and sleep efficiency (SE). After evaluating the results, it was concluded that a smartwatch could replace subjective measurement to determine falling asleep and waking up time, considering some level of inaccuracy. In the case of SE, substitution was also proved to be possible. However, some individual recordings showed a higher discrepancy in results between the two approaches. For its part, the evaluation of the TST measurement currently does not allow us to recommend substituting the measurement method for this sleep parameter. The appropriateness of replacing sleep diary measurement with a smartwatch depends on the acceptable levels of discrepancy. We propose four levels of similarity of results, defining ranges of absolute differences between objective and subjective measurements. By considering the values in the provided table and knowing the required accuracy, it is possible to determine the suitability of substitution in each individual case. The introduction of a “similarity level” parameter increases the adaptability and reusability of study findings in individual practical cases.
This study aims to investigate the utilization of Bayesian techniques for the calibration of micro-electro-mechanical system (MEMS) accelerometers. These devices have garnered substantial interest in various practical applications and typically require calibration through error-correcting functions. The parameters of these error-correcting functions are determined during a calibration process. However, due to various sources of noise, these parameters cannot be determined with precision, making it desirable to incorporate uncertainty in the calibration models. Bayesian modeling offers a natural and complete way of reflecting uncertainty by treating the model parameters as variables rather than fixed values. In addition, Bayesian modeling enables the incorporation of prior knowledge, making it an ideal choice for calibration. Nevertheless, it is infrequently used in sensor calibration. This study introduces Bayesian methods for the calibration of MEMS accelerometer data in a straightforward manner using recent advances in probabilistic programming.
Non-volatile NAND flash memories store information as an electrical charge. Different read reference voltages are applied to read the data. However, the threshold voltage distributions vary due to aging effects like program erase cycling and data retention time. It is necessary to adapt the read reference voltages for different life-cycle conditions to minimize the error probability during readout. In the past, methods based on pilot data or high-resolution threshold voltage histograms were proposed to estimate the changes in voltage distributions. In this work, we propose a machine learning approach with neural networks to estimate the read reference voltages. The proposed method utilizes sparse histogram data for the threshold voltage distributions. For reading the information from triple-level cell (TLC) memories, several read reference voltages are applied in sequence. We consider two histogram resolutions. The simplest histogram consists of the zero-and-one ratios for the hard decision read operation, whereas a higher resolution is obtained by considering the quantization levels for soft-input decoding. This approach does not require pilot data for the voltage adaptation. Furthermore, only a few measurements of extreme points of the threshold voltage distributions are required as training data. Measurements with different conditions verify the proposed approach. The resulting neural networks perform well under other life-cycle conditions.
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.
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.
Insecurity Refactoring is a change to the internal structure of software to inject a vulnerability without changing the observable behavior in a normal use case scenario. An implementation of Insecurity Refactoring is formally explained to inject vulnerabilities in source code projects by using static code analysis. It creates learning examples with source code patterns from known vulnerabilities.
Insecurity Refactoring is achieved by creating an Adversary Controlled Input Dataflow tree based on a Code Property Graph. The tree is used to find possible injection paths. Transformation of the possible injection paths allows to inject vulnerabilities. Insertion of data flow patterns introduces different code patterns from related Common Vulnerabilities and Exposures (CVE) reports. The approach is evaluated on 307 open source projects. Additionally, insecurity-refactored projects are deployed in virtual machines to be used as learning examples. Different static code analysis tools, dynamic tools and manual inspections are used with modified projects to confirm the presence of vulnerabilities.
The results show that in 8.1% of the open source projects it is possible to inject vulnerabilities. Different inspected code patterns from CVE reports can be inserted using corresponding data flow patterns. Furthermore the results reveal that the injected vulnerabilities are useful for a small sample size of attendees (n=16). Insecurity Refactoring is useful to automatically generate learning examples to improve software security training. It uses real projects as base whereas the injected vulnerabilities stem from real CVE reports. This makes the injected vulnerabilities unique and realistic.
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.
Short-Term Density Forecasting of Low-Voltage Load using Bernstein-Polynomial Normalizing Flows
(2023)
The transition to a fully renewable energy grid requires better forecasting of demand at the low-voltage level to increase efficiency and ensure reliable control. However, high fluctuations and increasing electrification cause huge forecast variability, not reflected in traditional point estimates. Probabilistic load forecasts take uncertainties into account and thus allow more informed decision-making for the planning and operation of low-carbon energy systems. We propose an approach for flexible conditional density forecasting of short-term load based on Bernstein polynomial normalizing flows, where a neural network controls the parameters of the flow. In an empirical study with 3639 smart meter customers, our density predictions for 24h-ahead load forecasting compare favorably against Gaussian and Gaussian mixture densities. Furthermore, they outperform a non-parametric approach based on the pinball loss, especially in low-data scenarios.
Background
This is a systematic review protocol to identify automated features, applied technologies, and algorithms in the electronic early warning/track and triage system (EW/TTS) developed to predict clinical deterioration (CD).
Methodology
This study will be conducted using PubMed, Scopus, and Web of Science databases to evaluate the features of EW/TTS in terms of their automated features, technologies, and algorithms. To this end, we will include any English articles reporting an EW/TTS without time limitation. Retrieved records will be independently screened by two authors and relevant data will be extracted from studies and abstracted for further analysis. The included articles will be evaluated independently using the JBI critical appraisal checklist by two researchers.
Discussion
This study is an effort to address the available automated features in the electronic version of the EW/TTS to shed light on the applied technologies, automated level of systems, and utilized algorithms in order to smooth the road toward the fully automated EW/TTS as one of the potential solutions of prevention CD and its adverse consequences.