Showing papers in "IEEE Journal of Translational Engineering in Health and Medicine in 2018"

An IoT-Enabled Stroke Rehabilitation System Based on Smart Wearable Armband and Machine Learning

Abstract: Surface electromyography signal plays an important role in hand function recovery training. In this paper, an IoT-enabled stroke rehabilitation system was introduced which was based on a smart wearable armband (SWA), machine learning (ML) algorithms, and a 3-D printed dexterous robot hand. User comfort is one of the key issues which should be addressed for wearable devices. The SWA was developed by integrating a low-power and tiny-sized IoT sensing device with textile electrodes, which can measure, pre-process, and wirelessly transmit bio-potential signals. By evenly distributing surface electrodes over user’s forearm, drawbacks of classification accuracy poor performance can be mitigated. A new method was put forward to find the optimal feature set. ML algorithms were leveraged to analyze and discriminate features of different hand movements, and their performances were appraised by classification complexity estimating algorithms and principal components analysis. According to the verification results, all nine gestures can be successfully identified with an average accuracy up to 96.20%. In addition, a 3-D printed five-finger robot hand was implemented for hand rehabilitation training purpose. Correspondingly, user’s hand movement intentions were extracted and converted into a series of commands which were used to drive motors assembled inside the dexterous robot hand. As a result, the dexterous robot hand can mimic the user’s gesture in a real-time manner, which shows the proposed system can be used as a training tool to facilitate rehabilitation process for the patients after stroke.

A Community-Based IoT Personalized Wireless Healthcare Solution Trial

Abstract: This paper presents an advanced Internet of Things point-of-care bio-fluid analyzer; a LoRa/Bluetooth-enabled electronic reader for biomedical strip-based diagnostics system for personalized monitoring. We undertake test simulations (technology trial without patient subjects) to demonstrate potential of long-range analysis, using a disposable test ‘key’ and companion Android app to form a diagnostic platform suitable for remote point-of-care screening for urinary tract infection (UTI). The 868 MHz LoRaWAN-enabled personalized monitor demonstrated sound potential with UTI test results being correctly diagnosed and transmitted to a remote secure cloud server in every case. Tests ranged over distances of 1.1–6.0 Km with radio path losses from 119–141 dB. All tests conducted were correctly and robustly received at the base station and relayed to the secure server for inspection. The UTI test strips were visually inspected for correct diagnosis based on color change and verified as 100% accurate. Results from testing across a number of regions indicate that such an Internet of Things medical solution is a robust and simple way to deliver next generation community-based smart diagnostics and disease management to best benefit patients and clinical staff alike. This significant step can be applied to any type of home or region, particularly those lacking suitable mobile signals, broadband connections, or even landlines. It brings subscription-free long-range bio-telemetry to healthcare providers and offers savings on regular clinician home visits or frequent clinic visits by the chronically ill. This paper highlights practical hurdles in establishing an Internet of Medical Things network, assisting informed deployment of similar future systems.

Integrating Brain Implants With Local and Distributed Computing Devices: A Next Generation Epilepsy Management System

Abstract: Brain stimulation has emerged as an effective treatment for a wide range of neurological and psychiatric diseases. Parkinson’s disease, epilepsy, and essential tremor have FDA indications for electrical brain stimulation using intracranially implanted electrodes. Interfacing implantable brain devices with local and cloud computing resources have the potential to improve electrical stimulation efficacy, disease tracking, and management. Epilepsy, in particular, is a neurological disease that might benefit from the integration of brain implants with off-the-body computing for tracking disease and therapy. Recent clinical trials have demonstrated seizure forecasting, seizure detection, and therapeutic electrical stimulation in patients with drug-resistant focal epilepsy. In this paper, we describe a next-generation epilepsy management system that integrates local handheld and cloud-computing resources wirelessly coupled to an implanted device with embedded payloads (sensors, intracranial EEG telemetry, electrical stimulation, classifiers, and control policy implementation). The handheld device and cloud computing resources can provide a seamless interface between patients and physicians, and realtime intracranial EEG can be used to classify brain state (wake/sleep, preseizure, and seizure), implement control policies for electrical stimulation, and track patient health. This system creates a flexible platform in which low demand analytics requiring fast response times are embedded in the implanted device and more complex algorithms are implemented in offthebody local and distributed cloud computing environments. The system enables tracking and management of epileptic neural networks operating over time scales ranging from milliseconds to months.

Algorithms for Monitoring Heart Rate and Respiratory Rate From the Video of a User’s Face

Abstract: Smartphone cameras can measure heart rate (HR) by detecting pulsatile photoplethysmographic (iPPG) signals from post-processing the video of a subject’s face. The iPPG signal is often derived from variations in the intensity of the green channel as shown by Poh et. al. and Verkruysse et. al. . In this pilot study, we have introduced a novel iPPG method where by measuring variations in color of reflected light, i.e., Hue, and can therefore measure both HR and respiratory rate (RR) from the video of a subject’s face. This paper was performed on 25 healthy individuals (Ages 20–30, 15 males and 10 females, and skin color was Fitzpatrick scale 1–6). For each subject we took two 20 second video of the subject’s face with minimal movement, one with flash ON and one with flash OFF. While recording the videos we simultaneously measuring HR using a Biosync B-50DL Finger Heart Rate Monitor, and RR using self-reporting. This paper shows that our proposed approach of measuring iPPG using Hue (range 0–0.1) gives more accurate readings than the Green channel. HR/Hue (range 0–0.1) ( $r=0.9201$ , $p$ -value = 4.1617, and RMSE = 0.8887) is more accurate compared with HR/Green ( $r=0.4916$ , $p$ -value = 11.60172, and RMSE = 0.9068). RR/Hue (range 0–0.1) ( $r=0.6575$ , $p$ -value = 0.2885, and RMSE = 3.8884) is more accurate compared with RR/Green ( $r=0.3352$ , $p$ -value = 0.5608, and RMSE = 5.6885). We hope that this hardware agnostic approach for detection of vital signals will have a huge potential impact in telemedicine, and can be used to tackle challenges, such as continuous non-contact monitoring of neo-natal and elderly patients. An implementation of the algorithm can be found at https://pulser.thinkbiosolution.com

Enabling Stroke Rehabilitation in Home and Community Settings: A Wearable Sensor-Based Approach for Upper-Limb Motor Training

Abstract: High-dosage motor practice can significantly contribute to achieving functional recovery after a stroke. Performing rehabilitation exercises at home and using, or attempting to use, the stroke-affected upper limb during Activities of Daily Living (ADL) are effective ways to achieve high-dosage motor practice in stroke survivors. This paper presents a novel technological approach that enables 1) detecting goal-directed upper limb movements during the performance of ADL, so that timely feedback can be provided to encourage the use of the affected limb, and 2) assessing the quality of motor performance during in-home rehabilitation exercises so that appropriate feedback can be generated to promote high-quality exercise. The results herein presented show that it is possible to detect 1) goal-directed movements during the performance of ADL with a $c$ -statistic of 87.0% and 2) poorly performed movements in selected rehabilitation exercises with an $F$ -score of 84.3%, thus enabling the generation of appropriate feedback. In a survey to gather preliminary data concerning the clinical adequacy of the proposed approach, 91.7% of occupational therapists demonstrated willingness to use it in their practice, and 88.2% of stroke survivors indicated that they would use it if recommended by their therapist.

Passive Radar for Opportunistic Monitoring in E-Health Applications

Abstract: This paper proposes a passive Doppler radar as a non-contact sensing method to capture human body movements, recognize respiration, and physical activities in e-Health applications. The system uses existing in-home wireless signal as the source to interpret human activity. This paper shows that passive radar is a novel solution for multiple healthcare applications which complements traditional smart home sensor systems. An innovative two-stage signal processing framework is outlined to enable the multi-purpose monitoring function. The first stage is to obtain premier Doppler information by using the high speed passive radar signal processing. The second stage is the functional signal processing including micro Doppler extraction for breathing detection and support vector machine classifier for physical activity recognition. The experimental results show that the proposed system provides adequate performance for both purposes, and prove that non-contact passive Doppler radar is a complementary technology to meet the challenges of future healthcare applications.

Effectively Measuring Respiratory Flow With Portable Pressure Data Using Back Propagation Neural Network

Abstract: Continuous respiratory monitoring is an important tool for clinical monitoring. The most widely used flow measure device is nasal cannulae connected to a pressure transducer. However, most of these devices are not easy to carry and continue working in uncontrolled environments which is also a problem. For portable breathing equipment, due to the volume limit, the pressure signals acquired by using the airway tube may be too weak and contain some noise, leading to huge errors in respiratory flow measures. In this paper, a cost-effective portable pressure sensor-based respiratory measure device is designed. This device has a new airway tube design, which enables the pressure drop efficiently after the air flowing through the airway tube. Also, a new back propagation (BP) neural network-based algorithm is proposed to stabilize the device calibration and remove pressure signal noise. For improving the reliability and accuracy of proposed respiratory device, a through experimental evaluation and a case study of the proposed BP neural network algorithm have been carried out. The results show that giving proper parameters setting, the proposed BP neural network algorithm is capable of efficiently improving the reliability of newly designed respiratory device.

An Initial Investigation of Unmanned Aircraft Systems (UAS) and Real-Time Organ Status Measurement for Transporting Human Organs

Abstract: Organ transportation has yet to be substantially innovated. If organs could be moved by drone, instead of ill-timed commercial aircraft or expensive charter flights, lifesaving organs could be transplanted more quickly. A modified, six-rotor UAS was used to model situations relevant to organ transportation. To monitor the organ, we developed novel technologies that provided the real-time organ status using a wireless biosensor combined with an organ global positioning system. Fourteen drone organ missions were performed. Temperatures remained stable and low (2.5 °C). Pressure changes (0.37–0.86 kPa) correlated with increased altitude. Drone travel was associated with less vibration ( 2.0 G). Peak velocity was 67.6 km/h (42 m/h). Biopsies of the kidney taken prior to and after organ shipment revealed no damage resulting from drone travel. The longest flight was 3.0 miles, modeling an organ flight between two inner city hospitals. Organ transportation may be an ideal use-case for drones. With the development of faster, larger drones, long-distance drone organ shipment may result in substantially reduced cold ischemia times, subsequently improved organ quality, and thousands of lives saved.

Patient-Specific Pose Estimation in Clinical Environments

Abstract: Reliable posture labels in hospital environments can augment research studies on neural correlates to natural behaviors and clinical applications that monitor patient activity. However, many existing pose estimation frameworks are not calibrated for these unpredictable settings. In this paper, we propose a semi-automated approach for improving upper-body pose estimation in noisy clinical environments, whereby we adapt and build around an existing joint tracking framework to improve its robustness to environmental uncertainties. The proposed framework uses subject-specific convolutional neural network models trained on a subset of a patient’s RGB video recording chosen to maximize the feature variance of each joint. Furthermore, by compensating for scene lighting changes and by refining the predicted joint trajectories through a Kalman filter with fitted noise parameters, the extended system yields more consistent and accurate posture annotations when compared with the two state-of-the-art generalized pose tracking algorithms for three hospital patients recorded in two research clinics.

Automatic Lung Segmentation With Juxta-Pleural Nodule Identification Using Active Contour Model and Bayesian Approach

Abstract: Objective: chest computed tomography (CT) images and their quantitative analyses have become increasingly important for a variety of purposes, including lung parenchyma density analysis, airway analysis, diaphragm mechanics analysis, and nodule detection for cancer screening. Lung segmentation is an important prerequisite step for automatic image analysis. We propose a novel lung segmentation method to minimize the juxta-pleural nodule issue, a notorious challenge in the applications. Method: we initially used the Chan–Vese (CV) model for active lung contours and adopted a Bayesian approach based on the CV model results, which predicts the lung image based on the segmented lung contour in the previous frame image or neighboring upper frame image. Among the resultant juxta-pleural nodule candidates, false positives were eliminated through concave points detection and circle/ellipse Hough transform. Finally, the lung contour was modified by adding the final nodule candidates to the area of the CV model results. Results: to evaluate the proposed method, we collected chest CT digital imaging and communications in medicine images of 84 anonymous subjects, including 42 subjects with juxta-pleural nodules. There were 16 873 images in total. Among the images, 314 included juxta-pleural nodules. Our method exhibited a disc similarity coefficient of 0.9809, modified hausdorff distance of 0.4806, sensitivity of 0.9785, specificity of 0.9981, accuracy of 0.9964, and juxta-pleural nodule detection rate of 96%. It outperformed existing methods, such as the CV model used alone, the normalized CV model, and the snake algorithm. Clinical impact: the high accuracy with the juxta-pleural nodule detection in the lung segmentation can be beneficial for any computer aided diagnosis system that uses lung segmentation as an initial step.

A Novel Cardiac Auscultation Monitoring System Based on Wireless Sensing for Healthcare

Abstract: Heart sounds deliver vital physiological and pathological evidence about health. Wireless cardiac auscultation offers continuous cardiac monitoring of an individual without 24*7 manual healthcare care services. In this paper, a novel wireless sensing system to monitor and analyze cardiac condition is proposed, which sends the information to the caregiver as well as a medical practitioner with an application of the Internet of Things (IoT). An integrated system for heart sound acquisition, storage, and asynchronous analysis has been developed, from scratch to information uploading through IoT and signal analysis. Cardiac auscultation sensing unit has been designed to monitor cardiovascular health of an individual. Bluetooth protocol is used to offer power efficiency and moderate data transmission rate. The Hilbert–Huang transform is used to eliminate interference signals and to help to extract the heart sound signal features. Subsequence segmentation algorithm based on double-threshold has been developed to extract physiological parameters. Preprocessing, segmentation, and clustering technique were performed for significant health information interpretation. The cardiac auscultation monitoring system may provide a way for heart disease self-management.

Optimize Transfer Learning for Lung Diseases in Bronchoscopy Using a New Concept: Sequential Fine-Tuning

Abstract: Bronchoscopy inspection, as a follow-up procedure next to the radiological imaging, plays a key role in the diagnosis and treatment design for lung disease patients. When performing bronchoscopy, doctors have to make a decision immediately whether to perform a biopsy. Because biopsies may cause uncontrollable and life-threatening bleeding of the lung tissue, thus doctors need to be selective with biopsies. In this paper, to help doctors to be more selective on biopsies and provide a second opinion on diagnosis, we propose a computer-aided diagnosis (CAD) system for lung diseases, including cancers and tuberculosis (TB). Based on transfer learning (TL), we propose a novel TL method on the top of DenseNet: sequential fine-tuning (SFT). Compared with traditional fine-tuning (FT) methods, our method achieves the best performance. In a data set of recruited 81 normal cases, 76 TB cases and 277 lung cancer cases, SFT provided an overall accuracy of 82% while other traditional TL methods achieved an accuracy from 70% to 74%. The detection accuracy of SFT for cancers, TB, and normal cases are 87%, 54%, and 91%, respectively. This indicates that the CAD system has the potential to improve lung disease diagnosis accuracy in bronchoscopy and it may be used to be more selective with biopsies.

CHOBS: Color Histogram of Block Statistics for Automatic Bleeding Detection in Wireless Capsule Endoscopy Video

Abstract: Wireless capsule endoscopy (WCE) is the most advanced technology to visualize whole gastrointestinal (GI) tract in a non-invasive way. But the major disadvantage here, it takes long reviewing time, which is very laborious as continuous manual intervention is necessary. In order to reduce the burden of the clinician, in this paper, an automatic bleeding detection method for WCE video is proposed based on the color histogram of block statistics, namely CHOBS. A single pixel in WCE image may be distorted due to the capsule motion in the GI tract. Instead of considering individual pixel values, a block surrounding to that individual pixel is chosen for extracting local statistical features. By combining local block features of three different color planes of RGB color space, an index value is defined. A color histogram, which is extracted from those index values, provides distinguishable color texture feature. A feature reduction technique utilizing color histogram pattern and principal component analysis is proposed, which can drastically reduce the feature dimension. For bleeding zone detection, blocks are classified using extracted local features that do not incorporate any computational burden for feature extraction. From extensive experimentation on several WCE videos and 2300 images, which are collected from a publicly available database, a very satisfactory bleeding frame and zone detection performance is achieved in comparison to that obtained by some of the existing methods. In the case of bleeding frame detection, the accuracy, sensitivity, and specificity obtained from proposed method are 97.85%, 99.47%, and 99.15%, respectively, and in the case of bleeding zone detection, 95.75% of precision is achieved. The proposed method offers not only low feature dimension but also highly satisfactory bleeding detection performance, which even can effectively detect bleeding frame and zone in a continuous WCE video data.

Smartphone-Based Point-of-Care Urinalysis Under Variable Illumination

Abstract: Urine tests are performed by using an off-the-shelf reference sheet to compare the color of test strips. However, the tabular representation is difficult to use and more prone to visual errors, especially when the reference color-swatches to be compared are spatially apart. Thus, making it is difficult to distinguish between the subtle differences of shades on the reagent pads. This manuscript represents a new arrangement of reference arrays for urine test strips (urinalysis). Reference color swatches are grouped in a doughnut chart, surrounding each reagent pad on the strip. The urine test can be evaluated using naked eye by referring to the strip with no additional sheet necessary. Along with this new strip, an algorithm for smartphone based application is also proposed as an alternative to deliver diagnostic results. The proposed colorimetric detection method evaluates the captured image of the strip, under various color spaces and evaluates ten different tests for urine. Thus, the proposed system can deliver results on the spot using both naked eye and smartphone. The proposed scheme delivered accurate results under various environmental illumination conditions without any calibration requirements, exhibiting performances suitable for real-life applications and an ease for a common user.

An Open-Source Feature Extraction Tool for the Analysis of Peripheral Physiological Data

Abstract: Electrocardiogram, electrodermal activity, electromyogram, continuous blood pressure, and impedance cardiography are among the most commonly used peripheral physiological signals (biosignals) in psychological studies and healthcare applications, including health tracking, sleep quality assessment, disease early-detection/diagnosis, and understanding human emotional and affective phenomena. This paper presents the development of a biosignal-specific processing toolbox (Bio-SP tool) for preprocessing and feature extraction of these physiological signals according to the state-of-the-art studies reported in the scientific literature and feedback received from the field experts. Our open-source Bio-SP tool is intended to assist researchers in affective computing, digital and mobile health, and telemedicine to extract relevant physiological patterns (i.e., features) from these biosignals semi-automatically and reliably. In this paper, we describe the successful algorithms used for signal-specific quality checking, artifact/noise filtering, and segmentation along with introducing features shown to be highly relevant to category discrimination in several healthcare applications (e.g., discriminating patterns associated with disease versus non-disease). Further, the Bio-SP tool is a publicly-available software written in MATLAB with a user-friendly graphical user interface (GUI), enabling future crowd-sourced modification to these tools. The GUI is compatible with MathWorks Classification Learner app for inference model development, such as model training, cross-validation scheme farming, and classification result computation.

An Ultra-Low Power Smart Headband for Real-Time Epileptic Seizure Detection

Abstract: In this paper, the design of a smart headband for epileptic seizure detection is presented. The proposed headband consists of four key components: 1) an analog front-end circuitry; 2) an epileptic seizure detection tag (ESDT); 3) a Bluetooth low-power chip; and 4) customized electrodes. All the above components are integrated into a fabric headband with only 50.3 g. The smart headband system dissipates 55.89 mW. The epileptic seizure detection algorithm inside ESDT is validated by using Boston Children’s Hospital’s CHB-MIT scalp EEG clinical database with the detection rate of 92.68% and the false alarm of 0.527/h. We develop a service APP connected to the cloud so that the patients’ health condition can be recorded and then referenced by doctors for further diagnosis or research.

Design and Integration of an Inexpensive Wearable Mechanotactile Feedback System for Myoelectric Prostheses

Abstract: The aim of this paper was to demonstrate the functionality of an inexpensive mechanotactile sensory feedback system for transhumeral myoelectric prostheses. We summarize the development of a tactile-integrated prosthesis, including 1) evaluation of sensors that were retrofit onto existing commercial terminal devices; 2) design of two custom mechanotactile tactors that were integrated into a socket without compromising suction suspension; 3) design of a modular controller which translated sensor input to tactor output, was wirelessly adjusted, and fit within a prosthetic forearm; and 4) evaluation of the system with a single transhumeral participant. Prosthesis functionality was demonstrated over three test sessions; the participant was able to identify tactor stimulation location and demonstrated a reduction in grasp force with the mechanotactile stimulation. This system offers an inexpensive and modular solution for integration of a mechanotactile sensory feedback system into a prosthetic socket without compromising the suction seal. These principles can be applied in future studies to investigate the direct impact of sensory feedback on tangible outcomes for prosthetic users, thereby reducing barriers to clinical translation.

A Meshfree Representation for Cardiac Medical Image Computing

Abstract: The prominent advantage of meshfree method, is the way to build the representation of computational domain, based on the nodal points without any explicit meshing connectivity. Therefore, meshfree method can conveniently process the numerical computation inside interested domains with large deformation or inhomogeneity. In this paper, we adopt the idea of meshfree representation into cardiac medical image analysis in order to overcome the difficulties caused by large deformation and inhomogeneous materials of the heart. In our implementation, as element-free Galerkin method can efficiently build a meshfree representation using its shape function with moving least square fitting, we apply this meshfree method to handle large deformation or inhomogeneity for solving cardiac segmentation and motion tracking problems. We evaluate the performance of meshfree representation on a synthetic heart data and an in-vivo cardiac MRI image sequence. Results showed that the error of our framework against the ground truth was 0.1189 ± 0.0672 while the error of the traditional FEM was 0.1793 ± 0.1166. The proposed framework has minimal consistency constraints, handling large deformation and material discontinuities are simple and efficient, and it provides a way to avoid the complicated meshing procedures while preserving the accuracy with a relatively small number of nodes.

An AI-Based Heart Failure Treatment Adviser System

Abstract: Management of heart failure is a major health care challenge. Healthcare providers are expected to use best practices described in clinical practice guidelines, which typically consist of a long series of complex rules. For heart failure management, the relevant guidelines are nearly 80 pages long. Due to their complexity, the guidelines are often difficult to fully comply with, which can result in suboptimal medical practices. In this paper, we describe a heart failure treatment adviser system that automates the entire set of rules in the guidelines for heart failure management. The system is based on answer set programming , a form of declarative programming suited for simulating human-style reasoning. Given a patient’s information, the system is able to generate a set of guideline-compliant recommendations. We conducted a pilot study of the system on 21 real and 10 simulated patients with heart failure. The results show that the system can give treatment recommendations compliant with the guidelines. Out of 187 total recommendations made by the system, 176 were agreed upon by the expert cardiologists. Also, the system missed eight valid recommendations. The reason for the missed and discordant recommendations seems to be insufficient information, differing style, experience, and knowledge of experts in decision-making that were not captured in the system at this time. The system can serve as a point-of-care tool for clinics. Also, it can be used as an educational tool for training physicians and an assessment tool to measure the quality metrics of heart failure care of an institution.

Correlated Regression Feature Learning for Automated Right Ventricle Segmentation

Abstract: Accurate segmentation of right ventricle (RV) from cardiac magnetic resonance (MR) images can help a doctor to robustly quantify the clinical indices including ejection fraction. In this paper, we develop one regression convolutional neural network (RegressionCNN) which combines a holistic regression model and a convolutional neural network (CNN) together to determine boundary points’ coordinates of RV directly and simultaneously. In our approach, we take the fully connected layers of CNN as the holistic regression model to perform RV segmentation, and the feature maps extracted by convolutional layers of CNN are converted into 1-D vector to connect holistic regression model. Such connection allows us to make full use of the optimization algorithm to constantly optimize the convolutional layers to directly learn the holistic regression model in the training process rather than separate feature extraction and regression model learning. Therefore, RegressionCNN can achieve optimally convolutional feature learning for accurately catching the regression features that are more correlated to RV regression segmentation task in training process, and this can reduce the latent mismatch influence between the feature extraction and the following regression model learning. We evaluate the performance of RegressionCNN on cardiac MR images acquired of 145 human subjects from two clinical centers. The results have shown that RegressionCNN’s results are highly correlated (average boundary correlation coefficient equals 0.9827) and consistent with the manual delineation (average dice metric equals 0.8351). Hence, RegressionCNN could be an effective way to segment RV from cardiac MR images accurately and automatically.

Automatic Detection of Compensation During Robotic Stroke Rehabilitation Therapy

Abstract: Robotic stroke rehabilitation therapy can greatly increase the efficiency of therapy delivery. However, when left unsupervised, users often compensate for limitations in affected muscles and joints by recruiting unaffected muscles and joints, leading to undesirable rehabilitation outcomes. This paper aims to develop a computer vision system that augments robotic stroke rehabilitation therapy by automatically detecting such compensatory motions. Nine stroke survivors and ten healthy adults participated in this study. All participants completed scripted motions using a table-top rehabilitation robot. The healthy participants also simulated three types of compensatory motions. The 3-D trajectories of upper body joint positions tracked over time were used for multiclass classification of postures. A support vector machine (SVM) classifier detected lean-forward compensation from healthy participants with excellent accuracy (AUC = 0.98, F1 = 0.82), followed by trunk-rotation compensation (AUC = 0.77, F1 = 0.57). Shoulder-elevation compensation was not well detected (AUC = 0.66, F1 = 0.07). A recurrent neural network (RNN) classifier, which encodes the temporal dependency of video frames, obtained similar results. In contrast, F1-scores in stroke survivors were low for all three compensations while using RNN: lean-forward compensation (AUC = 0.77, F1 = 0.17), trunk-rotation compensation (AUC = 0.81, F1 = 0.27), and shoulder-elevation compensation (AUC = 0.27, F1 = 0.07). The result was similar while using SVM. To improve detection accuracy for stroke survivors, future work should focus on predefining the range of motion, direct camera placement, delivering exercise intensity tantamount to that of real stroke therapies, adjusting seat height, and recording full therapy sessions.

A Novel Antibacterial Membrane Electrode Based on Bacterial Cellulose/Polyaniline/AgNO 3 Composite for Bio-Potential Signal Monitoring

Abstract: We propose a flexible, dry, and antibacterial electrode with a low and stable skin electrode contact impedance for bio-potential signal monitoring. We fabricated a bacterial cellulose/polyaniline/AgNO3 nanocomposite membrane (BC/PANI/AgNO3) and used it for bio-potential signal monitoring. The bacterial cellulose (BC) provides a 3-D nanoporous network structure, and it was used as a substrate material in the BC/PANI/AgNO3 nanocomposite membrane. Polyaniline (PANI) and AgNO3, acting as conductive and antibacterial components, respectively, were polymerized and deposited on the surfaces of BC nanofibers to produce uniform thin film membrane with flexible, antibacterial, and conductive properties. Various measurements were conducted, in terms of antibacterial activity, skin electrode contact impedance, and qualitative analysis of ECG signal recordings. The BC/PANI/AgNO3 membrane revealed 100% antibacterial activities against both the Staphylococcus aureus and Escherichia coli bacteria. The skin electrode contact impedance of the proposed BC/PANI/AgNO3 electrode is lower than that of the Ag/AgCl gel electrode, with the same active area. In addition, the electrocardiogram (ECG) signals acquired with the proposed electrodes have stable characteristic waveforms, and they are not contaminated by noise. The waveform fidelity of the BC/PANI/AgNO3 membrane electrodes over 800 ECG cardiac cycles is 99.49%, and after the electrodes were worn for 24 hours, a fidelity of 98.40% was recorded over the same number of cardiac cycles. With the low and stable skin electrode contact impedance, the proposed dry BC/PANI/AgNO3 membrane electrode provided high fidelity for ECG signal recordings, thus offering a potential approach for bio-potential signal monitoring. With the above benefits, the novel flexible and dry BC/PANI/AgNO3 electrode has a significant antibacterial. Most of all, it is the first research to develop antibacterial in the electrode design.

An Alternative Myoelectric Pattern Recognition Approach for the Control of Hand Prostheses: A Case Study of Use in Daily Life by a Dysmelia Subject

Abstract: The functionality of upper limb prostheses can be improved by intuitive control strategies that use bioelectric signals measured at the stump level. One such strategy is the decoding of motor volition via myoelectric pattern recognition (MPR), which has shown promising results in controlled environments and more recently in clinical practice. Moreover, not much has been reported about daily life implementation and real-time accuracy of these decoding algorithms. This paper introduces an alternative approach in which MPR allows intuitive control of four different grips and open/close in a multifunctional prosthetic hand. We conducted a clinical proof-of-concept in activities of daily life by constructing a self-contained, MPR-controlled, transradial prosthetic system provided with a novel user interface meant to log errors during real-time operation. The system was used for five days by a unilateral dysmelia subject whose hand had never developed, and who nevertheless learned to generate patterns of myoelectric activity, reported as intuitive, for multi-functional prosthetic control. The subject was instructed to manually log errors when they occurred via the user interface mounted on the prosthesis. This allowed the collection of information about prosthesis usage and real-time classification accuracy. The assessment of capacity for myoelectric control test was used to compare the proposed approach to the conventional prosthetic control approach, direct control. Regarding the MPR approach, the subject reported a more intuitive control when selecting the different grips, but also a higher uncertainty during proportional continuous movements. This paper represents an alternative to the conventional use of MPR, and this alternative may be particularly suitable for a certain type of amputee patients. Moreover, it represents a further validation of MPR with dysmelia cases.

Histogram-Based Features Selection and Volume of Interest Ranking for Brain PET Image Classification

Abstract: Positron emission tomography (PET) is a molecular medical imaging modality which is commonly used for neurodegenerative diseases diagnosis. Computer-aided diagnosis, based on medical image analysis, could help quantitative evaluation of brain diseases such as Alzheimer’s disease (AD). A novel method of ranking the effectiveness of brain volume of interest (VOI) to separate healthy control from AD brains PET images is presented in this paper. Brain images are first mapped into anatomical VOIs using an atlas. Histogram-based features are then extracted and used to select and rank VOIs according to the area under curve (AUC) parameter, which produces a hierarchy of the ability of VOIs to separate between groups of subjects. The top-ranked VOIs are then input into a support vector machine classifier. The developed method is evaluated on a local database image and compared to the known selection feature methods. Results show that using AUC outperforms classification results in the case of a two group separation.

Sleep Apnea Syndrome Sensing at C-Band

Abstract: A non-intrusive sleep apnea detection system using a C-Band channel sensing technique is proposed to monitor sleep apnea syndrome in real time. The system utilizes perturbations of RF signals to differentiate between patient’s breathing under normal and sleep apnea conditions. The peak distance calculation is used to obtain the respiratory rates. A comparison of the datasets generated by the proposed method and a wearable sensor is made using a concordance correlation coefficient to establish its accuracy. The results show that the proposed sensing technique exhibits high accuracy and robustness, with more than 80% concordance with the wearable breathing sensor. This method is, therefore, a good candidate for the real-time wireless detection of sleep apnea.

Kinect-Based In-Home Exercise System for Lymphatic Health and Lymphedema Intervention

Abstract: Using Kinect sensors to monitor and provide feedback to patients performing intervention or rehabilitation exercises is an upcoming trend in healthcare. However, the joint positions measured by the Kinect sensor are often unreliable, especially for joints that are occluded by other parts of the body. Also, users’ motion sequences differ significantly even when doing the same exercise and are not temporally aligned, making the evaluation of the correctness of their movement challenging. This paper aims to develop a Kinect-based intervention system, which can guide the users to perform the exercises more effectively. To circumvent the unreliability of the Kinect measurements, we developed a denoising algorithm using a Gaussian Process regression model. We simultaneously capture the joint positions using both a Kinect sensor and a motion capture (MOCAP) system during a training stage and train a Gaussian process regression model to map the noisy Kinect measurements to the more accurate MOCAP measurements. For the sequences alignment issue, we develop a gradient-weighted dynamic time warping approach that can automatically recognize the endpoints of different subsequences from the original user’s motion sequence, and furthermore temporally align the subsequences from multiple actors. During a live exercise session, the system applies the same alignment algorithm to a live-captured Kinect sequence to divide it into subsequences, and furthermore compare each subsequence with its corresponding reference subsequence, and generates feedback to the user based on the comparison results. Our results show that the denoised Kinect measurements by the proposed denoising algorithm are more accurate than several benchmark methods and the proposed temporal alignment approach can precisely detect the end of each subsequence in an exercise with very small amount of delay. These methods have been integrated into a prototype system for guiding patients with risks for breast-cancer related lymphedema to perform a set of lymphatic exercises. The system can provide relevant feedback to the patient performing an exercise in real time.

Clinician-Driven Design of VitalPAD –An Intelligent Monitoring and Communication Device to Improve Patient Safety in the Intensive Care Unit

Abstract: The pediatric intensive care unit (ICU) is a complex environment, in which a multidisciplinary team of clinicians (registered nurses, respiratory therapists, and physicians) continually observe and evaluate patient information. Data are provided by multiple, and often physically separated sources, cognitive workload is high, and team communication can be challenging. Our aim is to combine information from multiple monitoring and therapeutic devices in a mobile application, the VitalPAD , to improve the efficiency of clinical decision-making, communication, and thereby patient safety. We observed individual ICU clinicians, multidisciplinary rounds, and handover procedures for 54 h to identify data needs, workflow, and existing cognitive aid use and limitations. A prototype was developed using an iterative participatory design approach; usability testing, including general and task-specific feedback, was obtained from 15 clinicians. Features included map overviews of the ICU showing clinician assignment, patient status, and respiratory support; patient vital signs; a photo-documentation option for arterial blood gas results; and team communication and reminder functions. Clinicians reported the prototype to be an intuitive display of vital parameters and relevant alerts and reminders, as well as a user-friendly communication tool. Future work includes implementation of a prototype, which will be evaluated under simulation and real-world conditions, with the aim of providing ICU staff with a monitoring device that will improve their daily work, communication, and decision-making capacity. Mobile monitoring of vital signs and therapy parameters might help improve patient safety in wards with single-patient rooms and likely has applications in many acute and critical care settings.

Classification of Alzheimer’s Disease, Mild Cognitive Impairment and Normal Control Subjects Using Resting-State fMRI Based Network Connectivity Analysis

Abstract: This paper proposes a robust method for the Alzheimer’s disease (AD), mild cognitive impairment (MCI), and normal control subject classification under size limited fMRI data samples by exploiting the brain network connectivity pattern analysis. First, we select the regions of interest (ROIs) within the default mode network and calculate the correlation coefficients between all possible ROI pairs to form a feature vector for each subject. Second, we propose a regularized linear discriminant analysis (LDA) approach to reduce the noise effect due to the limited sample size. The feature vectors are then projected onto a one-dimensional axis using the proposed regularized LDA. Finally, an AdaBoost classifier is applied to carry out the classification task. The numerical analysis demonstrates that the purposed approach can increase the classification accuracy significantly. Our analysis confirms the previous findings that the hippocampus and the isthmus of the cingulate cortex are closely involved in the development of AD and MCI.

A Ballistographic Approach for Continuous and Non-Obtrusive Monitoring of Movement in Neonates

Abstract: Continuously monitoring body movement in preterm infants can have important clinical applications since changes in movement-patterns can be a significant marker for clinical deteriorations including the onset of sepsis, seizures, and apneas. This paper proposes a system and method to monitor body movement of preterm infants in a clinical environment using ballistography. The ballistographic signal (BSG) is acquired using a thin and a film-like sensor that is placed underneath an infant. Manual annotations based on video-recordings served as a reference standard for identifying movement. We investigated the performance of multiple features, constructed from the BSG waveform, to discriminate movement from no movement based on data acquired from 10 preterm infants. Since routine cardiorespiratory monitoring is prone to movement artifacts, we also compared the application of these features on the simultaneously acquired cardiorespiratory waveforms, i.e., the electrocardiogram, the chest impedance, and the photoplethysmogram. The BSG-based-features consistently outperformed those based on the routinely acquired cardiorespiratory waveforms. The best performing BSG-based feature-the signal instability index-had a mean (standard deviation) effect size of 0.90 (0.06), as measured by the area under the receiver operating curve. The proposed system for monitoring body movement is robust to noise, non-obtrusive, and has high performance in clinical settings.

Design of a Continuous Blood Pressure Measurement System Based on Pulse Wave and ECG Signals

Abstract: With increasingly fierce competition for jobs, the pressures on people have risen in recent years, leading to lifestyle and diet disorders that result in significantly higher risks of cardiovascular disease Hypertension is one of the common chronic cardiovascular diseases; however, mainstream blood pressure measurement devices are relatively heavy When multiple measurements are required, the user experience and the measurement results may be unsatisfactory In this paper, we describe the design of a signal collection module that collects pulse waves and electrocardiograph (ECG) signals The collected signals are input into a signal processing module to filter the noise and amplify the useful physiological signals Then, we use a wavelet transform to eliminate baseline drift noise and detect the feature points of the pulse waves and ECG signals We propose the concept of detecting the wave shape associated with an instance, an approach that minimizes the impact of atypical pulse waves on blood pressure measurements Finally, we propose an improved method for measuring blood pressure based on pulse wave velocity that improves the accuracy of blood pressure measurements by 58% Moreover, the results meet the american medical instrument promotion association standards, which demonstrate the feasibility of our measurement system