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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.
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.
Nowadays there is a rich diversity of sleep monitoring systems available on the market. They promise to offer information about sleep quality of the user by recording a limited number of vital signals, mainly heart rate and body movement. Typically, fitness trackers, smart watches, smart shirts, smartphone applications or patches do not provide access to the raw sensor data. Moreover, the sleep classification algorithm and the agreement ratio with the gold standard, polysomnography (PSG) are not disclosed. Some commercial systems record and store the data on the wearable device, but the user needs to transfer and import it into specialised software applications or return it to the doctor, for clinical evaluation of the data set. Thus an immediate feedback mechanism or the possibility of remote control and supervision are lacking. Furthermore, many such systems only distinguish between sleep and wake states, or between wake, light sleep and deep sleep. It is not always clear how these stages are mapped to the four known sleep stages: REM, NREM1, NREM2, NREM3-4. [1] The goal of this research is to find a reduced complexity method to process a minimum number of bio vital signals, while providing accurate sleep classification results. The model we propose offers remote control and real time supervision capabilities, by using Internet of Things (IoT) technology. This paper focuses on the data processing method and the sleep classification logic. The body sensor network representing our data acquisition system will be described in a separate publication. Our solution showed promising results and a good potential to overcome the limitations of existing products. Further improvements will be made and subjects with different age and health conditions will be tested.
The 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.
Today 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.
An ongoing challenge in our days is to lower the impact on the quality of life caused by dysfunctionality through individual support. With the background of an aging society and continuous increases in costs for care, a holistic solution is needed. This solution must integrate individual needs and preferences, locally available possibilities, regional conditions, professional and informal caregivers and provide the flexibility to implement future requirements. The proposed model is a result of a common initiative to overcome the major obstacles and to center a solution on individual needs caused by dysfunctionality.
Autism spectrum disorders (ASD) affect a large number of children both in the Russian Federation and in Germany. Early diagnosis is key for these children, because the sooner parents notice such disorders in a child and the rehabilitation and treatment program starts, the higher the likelihood of his social adaptation. The difficulties in raising such a child lie in the complexity of his learning outside of children's groups and the complexity of his medical care. In this regard, the development of digital applications that facilitate medical care and education of such children at home is important and relevant. The purpose of the project is to improve the availability and quality of healthcare and social adaptation at home of children with ASD through the use of digital technologies.
The goal of the presented project is to develop the concept of home e-health 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 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.
Assistive environments are entering our homes faster than ever. However, there are still various barriers to be broken. One of the crucial points is a personalization of offered services and integration of assistive technologies in common objects and therefore in a regular daily routine. Recognition of sleep patterns for the preliminary sleep study is one of the Health services that could be performed in an undisturbing way. This article proposes the hardware system for the measurement of bio-vital signals necessary for initial sleep study in a nonobtrusive way. The first results confirm the potential of measurement of breathing and movement signals with the proposed system.
Measuring cardiorespiratory parameters in sleep, using non-contact sensors and the Ballistocardiography technique has received much attention due to the low-cost, unobtrusive, and non-invasive method. Designing a user-friendly, simple-to-use, and easy-to-deployment preserving less error-prone remains open and challenging due to the complex morphology of the signal. In this work, using four forcesensitive resistor sensors, we conducted a study by designing four distributions of sensors, in order to simplify the complexity of the system by identifying the region of interest for heartbeat and respiration measurement. The sensors are deployed under the mattress and attached to the bed frame without any interference with the subjects. The four distributions are combined in two linear horizontal, one linear vertical, and one square, covering the influencing region in cardiorespiratory activities. We recruited 4 subjects and acquired data in four regular sleeping positions, each for a duration of 80 seconds. The signal processing was performed using discrete wavelet transform bior 3.9 and smooth level of 4 as well as bandpass filtering. The results indicate that we have achieved the mean absolute error of 2.35 and 4.34 for respiration and heartbeat, respectively. The results recommend the efficiency of a triangleshaped structure of three sensors for measuring heartbeat and respiration parameters in all four regular sleeping positions.
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 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 investigation of stress requires to distinguish between stress caused by physical activity and stress that is caused by psychosocial factors. The behaviour of the heart in response to stress and physical activity is very similar in case the set of monitored parameters is reduced to one. Currently, the differentiation remains difficult and methods which only use the heart rate are not able to differentiate between stress and physical activity, without using additional sensor data input. The approach focusses on methods which generate signals providing characteristics that are useful for detecting stress, physical activity, no activity and relaxation.
Stress is recognized as a factor of predominant disease and in the future the costs for treatment will increase. The presented approach tries to detect stress in a very basic and easy to implement way, so that the cost for the device and effort to wear it remain low. The user should benefit from the fact that the system offers an easy interface reporting the status of his body in real time. In parallel, the system provides interfaces to pass the obtained data forward for further processing and (professional) analyses, in case the user agrees. The system is designed to be used in every day’s activities and it is not restricted to laboratory use or environments. The implementation of the enhanced prototype shows that the detection of stress and the reporting can be managed using correlation plots and automatic pattern recognition even on a very light weighted microcontroller platform.
Deep learning-based EEG detection of mental alertness states from drivers under ethical aspects
(2021)
One of the most critical factors for a successful road trip is a high degree of alertness while driving. Even a split second of inattention or sleepiness in a crucial moment, will make the difference between life and death. Several prestigious car manufacturers are currently pursuing the aim of automated drowsiness identification to resolve this problem. The path between neuro-scientific research in connection with artificial intelligence and the preservation of the dignity of human individual’s and its inviolability, is very narrow. The key contribution of this work is a system of data analysis for EEGs during a driving session, which draws on previous studies analyzing heart rate (ECG), brain waves (EEG), and eye function (EOG). The gathered data is hereby treated as sensitive as possible, taking ethical regulations into consideration. Obtaining evaluable signs of evolving exhaustion includes techniques that obtain sleeping stage frequencies, problematic are hereby the correlated interference’s in the signal. This research focuses on a processing chain for EEG band splitting that involves band-pass filtering, principal component analysis (PCA), independent component analysis (ICA) with automatic artefact severance, and fast fourier transformation (FFT). The classification is based on a step-by-step adaptive deep learning analysis that detects theta rhythms as a drowsiness predictor in the pre-processed data. It was possible to obtain an offline detection rate of 89% and an online detection rate of 73%. The method is linked to the simulated driving scenario for which it was developed. This leaves space for more optimization on laboratory methods and data collection during wakefulness-dependent operations.
The goal of this paper pretends to show how a bed system with an embedded system with sensor is able to analyze a person’s movement, breathing and recognizing the positions that the subject is lying on the bed during the night without any additional physical contact. The measurements are performed with sensors placed between the mattress and the frame. An Intel Edison board was used as an endpoint that served as a communication node from the mesh network to external service. Two nodes and Intel Edison are attached to the bottom of the bed frame and they are connected to the sensors.
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.
Due to the rising need for palliative care in Russia, it is crucial to provide timely and high-quality solutions for patients, relatives, and caregivers. A methodology for remote monitoring of patients in need of palliative care and the requirements will be developed for a hardware-software complex for remote monitoring of patients' health at home.