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Parab S, Boster J, Washington P. Parkinson Disease Recognition Using a Gamified Website: Machine Learning Development and Usability Study. JMIR Form Res 2023; 7:e49898. [PMID: 37773607 PMCID: PMC10576230 DOI: 10.2196/49898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/16/2023] [Accepted: 09/04/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Parkinson disease (PD) affects millions globally, causing motor function impairments. Early detection is vital, and diverse data sources aid diagnosis. We focus on lower arm movements during keyboard and trackpad or touchscreen interactions, which serve as reliable indicators of PD. Previous works explore keyboard tapping and unstructured device monitoring; we attempt to further these works with structured tests taking into account 2D hand movement in addition to finger tapping. Our feasibility study uses keystroke and mouse movement data from a remotely conducted, structured, web-based test combined with self-reported PD status to create a predictive model for detecting the presence of PD. OBJECTIVE Analysis of finger tapping speed and accuracy through keyboard input and analysis of 2D hand movement through mouse input allowed differentiation between participants with and without PD. This comparative analysis enables us to establish clear distinctions between the two groups and explore the feasibility of using motor behavior to predict the presence of the disease. METHODS Participants were recruited via email by the Hawaii Parkinson Association (HPA) and directed to a web application for the tests. The 2023 HPA symposium was also used as a forum to recruit participants and spread information about our study. The application recorded participant demographics, including age, gender, and race, as well as PD status. We conducted a series of tests to assess finger tapping, using on-screen prompts to request key presses of constant and random keys. Response times, accuracy, and unintended movements resulting in accidental presses were recorded. Participants performed a hand movement test consisting of tracing straight and curved on-screen ribbons using a trackpad or mouse, allowing us to evaluate stability and precision of 2D hand movement. From this tracing, the test collected and stored insights concerning lower arm motor movement. RESULTS Our formative study included 31 participants, 18 without PD and 13 with PD, and analyzed their lower limb movement data collected from keyboards and computer mice. From the data set, we extracted 28 features and evaluated their significances using an extra tree classifier predictor. A random forest model was trained using the 6 most important features identified by the predictor. These selected features provided insights into precision and movement speed derived from keyboard tapping and mouse tracing tests. This final model achieved an average F1-score of 0.7311 (SD 0.1663) and an average accuracy of 0.7429 (SD 0.1400) over 20 runs for predicting the presence of PD. CONCLUSIONS This preliminary feasibility study suggests the possibility of using technology-based limb movement data to predict the presence of PD, demonstrating the practicality of implementing this approach in a cost-effective and accessible manner. In addition, this study demonstrates that structured mouse movement tests can be used in combination with finger tapping to detect PD.
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Affiliation(s)
- Shubham Parab
- University of Hawaii at Manoa, Honolulu, HI, United States
| | - Jerry Boster
- Hawaii Parkinson Association, Honolulu, HI, United States
| | - Peter Washington
- Department of Information & Computer Sciences, University of Hawaii at Manoa, Honolulu, HI, United States
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Liu WM, Yeh CL, Chen PW, Lin CW, Liu AB. Keystroke Biometrics as a Tool for the Early Diagnosis and Clinical Assessment of Parkinson's Disease. Diagnostics (Basel) 2023; 13:3061. [PMID: 37835803 PMCID: PMC10572112 DOI: 10.3390/diagnostics13193061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/22/2023] [Accepted: 09/23/2023] [Indexed: 10/15/2023] Open
Abstract
(1) Background: Parkinson's disease (PD) is the second most common neurodegenerative disease. Early diagnosis and reliable clinical assessments are essential for appropriate therapy and improving patients' quality of life. Keystroke biometrics, which capture unique typing behavior, have shown potential for early PD diagnosis. This study aimed to evaluate keystroke biometric parameters from two datasets to identify indicators that can effectively distinguish de novo PD patients from healthy controls. (2) Methods: Data from natural typing tasks in Physionet were analyzed to estimate keystroke biometric parameters. The parameters investigated included alternating-finger tapping (afTap) and standard deviations of interkey latencies (ILSD) and release latencies (RLSD). Sensitivity rates were calculated to assess the discriminatory ability of these parameters. (3) Results: Significant differences were observed in three parameters, namely afTap, ILSD, and RLSD, between de novo PD patients and healthy controls. The sensitivity rates were high, with values of 83%, 88%, and 96% for afTap, ILSD, and RLSD, respectively. Correlation analysis revealed a significantly negative correlation between typing speed and number of words typed with the standard motor assessment for PD, UPDRS-III, in patients with early PD. (4) Conclusions: Simple algorithms utilizing keystroke biometric parameters can serve as effective screening tests in distinguishing de novo PD patients from healthy controls. Moreover, typing speed and number of words typed were identified as reliable tools for assessing clinical statuses in PD patients. These findings underscore the potential of keystroke biometrics for early PD diagnosis and clinical severity assessment.
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Affiliation(s)
- Wei-Min Liu
- Department of Computer Science and Information Engineering, Advanced Institute of Manufacturing with High-Tech Innovations, National Chung Cheng University, Chiayi 621301, Taiwan; (W.-M.L.); (C.-L.Y.)
| | - Che-Lun Yeh
- Department of Computer Science and Information Engineering, Advanced Institute of Manufacturing with High-Tech Innovations, National Chung Cheng University, Chiayi 621301, Taiwan; (W.-M.L.); (C.-L.Y.)
| | - Po-Wei Chen
- Department of Physical Medicine and Rehabilitation, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970473, Taiwan;
| | - Che-Wei Lin
- Department of Biomedical Engineering, College of Engineering, National Cheng Kung University, Tainan 701401, Taiwan;
| | - An-Bang Liu
- Department of Medicine, School of Medicine, Tzu Chi University, Hualien 970374, Taiwan
- Department of Neurology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien 970473, Taiwan
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Shah P, Snitman A, McCaney J, Rose LM, Sheridan D, Espinoza Salomon J. PMDedu: Assessing the educational needs of startups and academic investigators focused on pediatric medical device development. J Clin Transl Sci 2023; 7:e235. [PMID: 38028345 PMCID: PMC10663766 DOI: 10.1017/cts.2023.633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 09/01/2023] [Accepted: 09/14/2023] [Indexed: 12/01/2023] Open
Abstract
Background The pediatric medical device development (PMDD) process is highly complex, beset by a variety of financial, technical, medical, and regulatory barriers. Startup company innovators and academic investigators often struggle with accessing specialized knowledge relating to regulatory requirements, product development, research, and marketing strategies. Objectives The West Coast Consortium for Technology & Innovation in Pediatrics (CTIP) conducted an educational needs assessment to understand knowledge gaps and inform our educational strategy. Methods We surveyed a total of 49 medical device startups and 52 academic investigators. Electronic surveys were developed for each group on Qualtrics and focused on manufacturing, regulatory, research, commercialization, and funding. Descriptive statistics were used. Results A larger proportion of academic investigator respondents had a clinical background compared to the startup respondents (45% vs. 22%). The biggest barriers for academic investigators were understanding regulatory and safety requirements testing (52%) and finding and obtaining non-dilutive funding was the most difficult (54%). Among startups, understanding clinical research methods and requirements was the biggest barrier (79%). Conclusion Startup companies and academic investigators have similar, but not identical, educational needs to better understand the PMD development process. Investigators need more support in identifying funding sources, while startup companies identified an increased need for education on research regulatory topics. These findings can help guide curriculum development as well as opportunities for partnerships between academia and startups.
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Affiliation(s)
- Payal Shah
- Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, CA, USA
| | | | - Jennifer McCaney
- Department of Decisions, Operations and Technology Management, University of California Los Angeles, Los Angeles, CA, USA
| | - Lynn M. Rose
- Department of Pharmacy, University of Washington, Seattle, WA, USA
| | - David Sheridan
- Department of Emergency medicine, Oregon Health & Science University, Portland, OR, USA
| | - Juan Espinoza Salomon
- Stanley Manne Children’s Research Institute, Ann & Robert H. Lurie Children’s Hospital of Chicago. Chicago, IL, USA
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Chong MK, Hickie IB, Cross SP, McKenna S, Varidel M, Capon W, Davenport TA, LaMonica HM, Sawrikar V, Guastella A, Naismith SL, Scott EM, Iorfino F. Digital Application of Clinical Staging to Support Stratification in Youth Mental Health Services: Validity and Reliability Study. JMIR Form Res 2023; 7:e45161. [PMID: 37682588 PMCID: PMC10517388 DOI: 10.2196/45161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 05/31/2023] [Accepted: 06/26/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND As the demand for youth mental health care continues to rise, managing wait times and reducing treatment delays are key challenges to delivering timely and quality care. Clinical staging is a heuristic model for youth mental health that can stratify care allocation according to individuals' risk of illness progression. The application of staging has been traditionally limited to trained clinicians yet leveraging digital technologies to apply clinical staging could increase the scalability and usability of this model in services. OBJECTIVE The aim of this study was to validate a digital algorithm to accurately differentiate young people at lower and higher risk of developing mental disorders. METHODS We conducted a study with a cohort comprising 131 young people, aged between 16 and 25 years, who presented to youth mental health services in Australia between November 2018 and March 2021. Expert psychiatrists independently assigned clinical stages (either stage 1a or stage 1b+), which were then compared to the digital algorithm's allocation based on a multidimensional self-report questionnaire. RESULTS Of the 131 participants, the mean age was 20.3 (SD 2.4) years, and 72% (94/131) of them were female. Ninety-one percent of clinical stage ratings were concordant between the digital algorithm and the experts' ratings, with a substantial interrater agreement (κ=0.67; P<.001). The algorithm demonstrated an accuracy of 91% (95% CI 86%-95%; P=.03), a sensitivity of 80%, a specificity of 93%, and an F1-score of 73%. Of the concordant ratings, 16 young people were allocated to stage 1a, while 103 were assigned to stage 1b+. Among the 12 discordant cases, the digital algorithm allocated a lower stage (stage 1a) to 8 participants compared to the experts. These individuals had significantly milder symptoms of depression (P<.001) and anxiety (P<.001) compared to those with concordant stage 1b+ ratings. CONCLUSIONS This novel digital algorithm is sufficiently robust to be used as an adjunctive decision support tool to stratify care and assist with demand management in youth mental health services. This work could transform care pathways and expedite care allocation for those in the early stages of common anxiety and depressive disorders. Between 11% and 27% of young people seeking care may benefit from low-intensity, self-directed, or brief interventions. Findings from this study suggest the possibility of redirecting clinical capacity to focus on individuals in stage 1b+ for further assessment and intervention.
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Affiliation(s)
- Min K Chong
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
| | - Ian B Hickie
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
| | | | - Sarah McKenna
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
| | - Mathew Varidel
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
| | - William Capon
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
| | - Tracey A Davenport
- Design and Strategy Division, Australian Digital Health Agency, Sydney, Australia
| | - Haley M LaMonica
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
| | - Vilas Sawrikar
- School of Health and Social Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Adam Guastella
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
- Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Sharon L Naismith
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
- Healthy Brain Ageing Program, University of Sydney, Sydney, Australia
| | - Elizabeth M Scott
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
- St Vincent's and Mater Clinical School, The University of Notre Dame, Sydney, Australia
| | - Frank Iorfino
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
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Vasquez ED, Simpson CS, Zhou G, Lansberg M, Okamura AM. Evaluation of a Passive Wearable Device for Post-Stroke Shoulder Abduction Support. IEEE Int Conf Rehabil Robot 2023; 2023:1-6. [PMID: 37941216 DOI: 10.1109/icorr58425.2023.10304815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
Post-stroke upper extremity function can be improved by devices that support shoulder abduction. However, many of these devices provide limited assistance in activities of daily living due to their complexity and encumbrance. We developed and evaluated a passive, lightweight (0.6 kg) wearable device consisting of an aluminum frame and elastic bands attached to a posture vest to aid in shoulder abduction. The number and thickness of bands can be adjusted to provide supportive forces to the affected arm. We measured reachable workspace area and Wolf Motor Function Test (WMFT) performance in people with a history of stroke (n = 11) with and without the wearable. The device increased workspace area in 6 participants and improved average WMFT functional and timing scores in 7 and 12 tasks, respectively, out of 16 total tasks. On average, participants increased their arm motion within 20 cm of shoulder level by 22.4% and decreased their hand's average distance from trunk by 15.2%, both improvements in the device case.
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Chiang AA, Khosla S. Consumer Wearable Sleep Trackers: Are They Ready for Clinical Use? Sleep Med Clin 2023; 18:311-330. [PMID: 37532372 DOI: 10.1016/j.jsmc.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Abstract
As the importance of good sleep continues to gain public recognition, the market for sleep-monitoring devices continues to grow. Modern technology has shifted from simple sleep tracking to a more granular sleep health assessment. We examine the available functionalities of consumer wearable sleep trackers (CWSTs) and how they perform in healthy individuals and disease states. Additionally, the continuum of sleep technology from consumer-grade to medical-grade is detailed. As this trend invariably grows, we urge professional societies to develop guidelines encompassing the practical clinical use of CWSTs and how best to incorporate them into patient care plans.
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Affiliation(s)
- Ambrose A Chiang
- Division of Sleep Medicine, Louis Stokes Cleveland VA Medical Center, 10701 East Blvd, Suite 2B-129, Cleveland, OH 44106, USA; Division of Pulmonary, Critical Care, and Sleep Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Department of Medicine, Case Western Reserve University, Cleveland, OH, USA.
| | - Seema Khosla
- North Dakota Center for Sleep, 1531 32nd Avenue S Ste 103, Fargo, ND 58103, USA
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Kwan RYC, Ng F, Lam LCW, Yung RC, Sin OSK, Chan S. The effects of therapeutic virtual reality experience to promote mental well-being in older people living with physical disabilities in long-term care facilities. Trials 2023; 24:558. [PMID: 37633916 PMCID: PMC10464193 DOI: 10.1186/s13063-023-07592-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 08/17/2023] [Indexed: 08/28/2023] Open
Abstract
BACKGROUND Mental well-being is poor in long-term care facilities (LTCF) residents. Physical disabilities, impaired social engagement, and environmental stress are also common in LTCF which exacerbate the decline of the mental well-being of older people living in LTCF. Protective elements, including nature-based, reminiscence, outdoor, and group activities, are known to be effective to promote the mental well-being of older people living in LTCF. However, limited by their physical disabilities and poor social support, older people living in LTCF are not likely to benefit from these effective measures. Virtual reality has been proven to be feasible to be environmentally unrestricted to providing LTCF residents with all protective elements promoting mental well-being. However, its effects on the mental well-being of LTCF residents living with physical disabilities are unclear. METHODS This study employs a single-blinded, two-parallel-group (intervention-to-control group ratio = 1:1), non-inferiority, randomized controlled trial. Eligible participants are aged 60 years or above, LTCF residents, and living with physical disabilities. The study will be conducted in LTCF. In the intervention group, participants will receive a 6-week VR experience program. In the control group, participants will receive the usual care provided by the LTCF. The primary outcome is mental well-being, as measured by World Health Organization Five Well-being Index at the time point of baseline (i.e., week 0) and after completion of the intervention (i.e., week 7). This study aims to recruit a total of 216 participants. Generalized estimating equations (GEE) will be used to examine the effects of the intervention. TRIAL REGISTRATION The trial has been registered at ClinicalTrials.gov (Identifier: NCT05818579 ), Registered on April 5, 2023. The latest version of the protocol was published online on 19 April 2023. All items come from the World Health Organization Trial Registration Data Set. This study has been approved by the Research Ethics Committee of Tung Wah College, Hong Kong (reference number: REC2023158). The findings will be disseminated in peer-reviewed journals, presented at international and local conferences with related themes, and shared in local media.
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Affiliation(s)
| | - Fowie Ng
- School of Management, Tung Wah College, Hong Kong SAR, China
| | - Linda Chiu Wa Lam
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
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Ausín JL, Ramos J, Lorido A, Molina P, Duque-Carrillo JF. Wearable and Noninvasive Device for Integral Congestive Heart Failure Management in the IoMT Paradigm. SENSORS (BASEL, SWITZERLAND) 2023; 23:7055. [PMID: 37631594 PMCID: PMC10457917 DOI: 10.3390/s23167055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/03/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023]
Abstract
Noninvasive remote monitoring of hemodynamic variables is essential in optimizing treatment opportunities and predicting rehospitalization in patients with congestive heart failure. The objective of this study is to develop a wearable bioimpedance-based device, which can provide continuous measurement of cardiac output and stroke volume, as well as other physiological parameters for a greater prognosis and prevention of congestive heart failure. The bioimpedance system, which is based on a robust and cost-effective measuring principle, was implemented in a CMOS application specific integrated circuit, and operates as the analog front-end of the device, which has been provided with a radio-frequency section for wireless communication. The operating parameters of the proposed wearable device are remotely configured through a graphical user interface to measure the magnitude and the phase of complex impedances over a bandwidth of 1 kHz to 1 MHz. As a result of this study, a cardiac activity monitor was implemented, and its accuracy was evaluated in 33 patients with different heart diseases, ages, and genders. The proposed device was compared with a well-established technique such as Doppler echocardiography, and the results showed that the two instruments are clinically equivalent.
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Affiliation(s)
- José L. Ausín
- Department of Electrical, Electronics and Control Engineering, University of Extremadura, 06006 Badajoz, Spain;
| | - Javier Ramos
- BioBee Technologies S.L., Extremadura Science and Technology Park, 06006 Badajoz, Spain; (J.R.); (A.L.); (P.M.)
| | - Antonio Lorido
- BioBee Technologies S.L., Extremadura Science and Technology Park, 06006 Badajoz, Spain; (J.R.); (A.L.); (P.M.)
| | - Pedro Molina
- BioBee Technologies S.L., Extremadura Science and Technology Park, 06006 Badajoz, Spain; (J.R.); (A.L.); (P.M.)
| | - J. Francisco Duque-Carrillo
- Department of Electrical, Electronics and Control Engineering, University of Extremadura, 06006 Badajoz, Spain;
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Savargaonkar AV, Munshi AH, Soares P, Popat KC. Antifouling Behavior of Copper-Modified Titania Nanotube Surfaces. J Funct Biomater 2023; 14:413. [PMID: 37623658 PMCID: PMC10455356 DOI: 10.3390/jfb14080413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 07/28/2023] [Accepted: 08/01/2023] [Indexed: 08/26/2023] Open
Abstract
Titanium and its alloys are commonly used to fabricate orthopedic implants due to their excellent mechanical properties, corrosion resistance, and biocompatibility. In recent years, orthopedic implant surgeries have considerably increased. This has also resulted in an increase in infection-associated revision surgeries for these implants. To combat this, various approaches are being investigated in the literature. One of the approaches is modifying the surface topography of implants and creating surfaces that are not only antifouling but also encourage osteointegration. Titania nanotube surfaces have demonstrated a moderate decrease in bacterial adhesion while encouraging mesenchymal stem cell adhesion, proliferation, and differentiation, and hence were used in this study. In this work, titania nanotube surfaces were fabricated using a simple anodization technique. These surfaces were further modified with copper using a physical vapor deposition technique, since copper is known to be potent against bacteria once in contact. In this study, scanning electron microscopy was used to evaluate surface topography; energy-dispersive X-ray spectroscopy and X-ray photoelectron spectroscopy were used to evaluate surface chemistry; contact angle goniometry was used to evaluate surface wettability; and X-ray diffraction was used to evaluate surface crystallinity. Antifouling behavior against a gram-positive and a gram-negative bacterium was also investigated. The results indicate that copper-modified titania nanotube surfaces display enhanced antifouling behavior when compared to other surfaces, and this may be a potential way to prevent infection in orthopedic implants.
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Affiliation(s)
- Aniruddha Vijay Savargaonkar
- Department of Mechanical Engineering, Colorado State University, Fort Collins, CO 80523, USA; (A.V.S.); (A.H.M.)
| | - Amit H. Munshi
- Department of Mechanical Engineering, Colorado State University, Fort Collins, CO 80523, USA; (A.V.S.); (A.H.M.)
| | - Paulo Soares
- Department of Mechanical Engineering, Pontifícia Universidade Católica do Paraná, Curitiba 80215-901, PR, Brazil;
| | - Ketul C. Popat
- Department of Mechanical Engineering, Colorado State University, Fort Collins, CO 80523, USA; (A.V.S.); (A.H.M.)
- School of Biomedical Engineering, Colorado State University, Fort Collins, CO 80523, USA
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Kowahl N, Shin S, Barman P, Rainaldi E, Popham S, Kapur R. Accuracy and Reliability of a Suite of Digital Measures of Walking Generated Using a Wrist-Worn Sensor in Healthy Individuals: Performance Characterization Study. JMIR Hum Factors 2023; 10:e48270. [PMID: 37535417 PMCID: PMC10436116 DOI: 10.2196/48270] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 05/22/2023] [Accepted: 06/21/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Mobility is a meaningful aspect of an individual's health whose quantification can provide clinical insights. Wearable sensor technology can quantify walking behaviors (a key aspect of mobility) through continuous passive monitoring. OBJECTIVE Our objective was to characterize the analytical performance (accuracy and reliability) of a suite of digital measures of walking behaviors as critical aspects in the practical implementation of digital measures into clinical studies. METHODS We collected data from a wrist-worn device (the Verily Study Watch) worn for multiple days by a cohort of volunteer participants without a history of gait or walking impairment in a real-world setting. On the basis of step measurements computed in 10-second epochs from sensor data, we generated individual daily aggregates (participant-days) to derive a suite of measures of walking: step count, walking bout duration, number of total walking bouts, number of long walking bouts, number of short walking bouts, peak 30-minute walking cadence, and peak 30-minute walking pace. To characterize the accuracy of the measures, we examined agreement with truth labels generated by a concurrent, ankle-worn, reference device (Modus StepWatch 4) with known low error, calculating the following metrics: intraclass correlation coefficient (ICC), Pearson r coefficient, mean error, and mean absolute error. To characterize the reliability, we developed a novel approach to identify the time to reach a reliable readout (time to reliability) for each measure. This was accomplished by computing mean values over aggregation scopes ranging from 1 to 30 days and analyzing test-retest reliability based on ICCs between adjacent (nonoverlapping) time windows for each measure. RESULTS In the accuracy characterization, we collected data for a total of 162 participant-days from a testing cohort (n=35 participants; median observation time 5 days). Agreement with the reference device-based readouts in the testing subcohort (n=35) for the 8 measurements under evaluation, as reflected by ICCs, ranged between 0.7 and 0.9; Pearson r values were all greater than 0.75, and all reached statistical significance (P<.001). For the time-to-reliability characterization, we collected data for a total of 15,120 participant-days (overall cohort N=234; median observation time 119 days). All digital measures achieved an ICC between adjacent readouts of >0.75 by 16 days of wear time. CONCLUSIONS We characterized the accuracy and reliability of a suite of digital measures that provides comprehensive information about walking behaviors in real-world settings. These results, which report the level of agreement with high-accuracy reference labels and the time duration required to establish reliable measure readouts, can guide the practical implementation of these measures into clinical studies. Well-characterized tools to quantify walking behaviors in research contexts can provide valuable clinical information about general population cohorts and patients with specific conditions.
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Affiliation(s)
- Nathan Kowahl
- Verily Life Sciences, South San Francisco, CA, United States
| | - Sooyoon Shin
- Verily Life Sciences, South San Francisco, CA, United States
| | - Poulami Barman
- Verily Life Sciences, South San Francisco, CA, United States
| | - Erin Rainaldi
- Verily Life Sciences, South San Francisco, CA, United States
| | - Sara Popham
- Verily Life Sciences, South San Francisco, CA, United States
| | - Ritu Kapur
- Verily Life Sciences, South San Francisco, CA, United States
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Fanning RM, Gaba DM. Collaborative Use of Lung Mechanics Simulation for Testing and Iterative Design for Three Emergency Use Ventilation Device Projects. Simul Healthc 2023; 18:266-271. [PMID: 36055223 DOI: 10.1097/sih.0000000000000683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
SUMMARY STATEMENT We describe our collaboration with engineering, clinical, and simulation colleagues to use a lung simulator (IngMar Medical ASL 5000) to aid in the development of 3 open-source ventilation devices for patients with COVID-19.Twenty-nine test conditions were created by programming software lung models of varying disease severity in the ASL 5000 to test basic functionality, safety features, and compliance with regulatory requirements for emergency use authorization for the 3 projects' prototypes. More than 200 simulations were performed, with the design team present to enable rapid troubleshooting and design iteration in real time.Working with 3 separate simultaneous ventilation device projects allowed us to rapidly learn from each, improving our ability to successfully collaborate with the different design/build teams.This project illustrates the role of simulation in facilitating collaborative innovation in health care, both in emergency and everyday settings that extend beyond the COVID-19 pandemic.
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Affiliation(s)
- Ruth M Fanning
- From the Department of Anesthesiology, Perioperative and Pain Medicine (R.M.F., D.M.G.), Stanford University School of Medicine, CA; Simulation Center (D.M.G.), VA Palo Alto Health Care System, CA; and Center for Immersive and Simulation-based Learning (D.M.G.), Stanford University School of Medicine, CA
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Soller T, Huang S, Horiuchi S, Wilson AN, Vogel JP. Portable digital devices for paediatric height and length measurement: A scoping review and target product profile matching analysis. PLoS One 2023; 18:e0288995. [PMID: 37494355 PMCID: PMC10370750 DOI: 10.1371/journal.pone.0288995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 07/09/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND Routine anthropometry of children, including length/height measurement, is an essential component of paediatric clinical assessments. UNICEF has called for the accelerated development of novel, digital height/length measurement devices to improve child nutrition and growth surveillance programs. This scoping review aimed to identify all digital, portable height/length measurement devices in the literature or otherwise available internationally. We also assessed identified devices against the UNICEF Target Product Profile (TPP) to identify those of highest potential for clinical and public health use. METHOD We searched four databases (Medline, Embase, CINAHL and Global Health) and the grey literature between 1st January 1992 and 2nd February 2023. We looked for studies or reports on portable, digital devices for height or length measurement in children up to 18 years old. Citations were screened independently by two reviewers, with data extraction and quality assessment performed in duplicate and disagreements resolved. Devices were evaluated and scored against the 34 criteria of the UNICEF TPP. RESULTS Twenty studies describing twelve height/length measurement devices were identified, most of which used prospective validation designs. Additional devices were found in the grey literature, but these did not report key performance data so were not included. Across the twelve devices, only 10 of 34 UNICEF criteria on average could be fully assessed. Six met UNICEF's ideal accuracy standard and one device met the minimum accuracy standard. The Leica DistoD2 device scored highest (41%), followed by Autoanthro in a controlled environment (33%) and GLM30 (32%). These devices may be high potential for further assessment and development, though further research is required. CONCLUSION While 12 portable, digital devices exist for child height/length measurement, insufficient data are available to fully assess whether they meet the industry's needs. Although some devices show promise, further research is needed to test the validity of these devices in varying contexts, and continued development and commercialization will be important to improve reliability and precision of these devices for widespread use.
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Affiliation(s)
- Tasmyn Soller
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Shan Huang
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Sayaka Horiuchi
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Alyce N Wilson
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Joshua P Vogel
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Frasch MG. Heart Rate Variability Code: Does It Exist and Can We Hack It? Bioengineering (Basel) 2023; 10:822. [PMID: 37508849 PMCID: PMC10375964 DOI: 10.3390/bioengineering10070822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/13/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
A code is generally defined as a system of signals or symbols for communication. Experimental evidence is synthesized for the presence and utility of such communication in heart rate variability (HRV) with particular attention to fetal HRV: HRV contains signatures of information flow between the organs and of response to physiological or pathophysiological stimuli as signatures of states (or syndromes). HRV exhibits features of time structure, phase space structure, specificity with respect to (organ) target and pathophysiological syndromes, and universality with respect to species independence. Together, these features form a spatiotemporal structure, a phase space, that can be conceived of as a manifold of a yet-to-be-fully understood dynamic complexity. The objective of this article is to synthesize physiological evidence supporting the existence of HRV code: hereby, the process-specific subsets of HRV measures indirectly map the phase space traversal reflecting the specific information contained in the code required for the body to regulate the physiological responses to those processes. The following physiological examples of HRV code are reviewed, which are reflected in specific changes to HRV properties across the signal-analytical domains and across physiological states and conditions: the fetal systemic inflammatory response, organ-specific inflammatory responses (brain and gut), chronic hypoxia and intrinsic (heart) HRV (iHRV), allostatic load (physiological stress due to surgery), and vagotomy (bilateral cervical denervation). Future studies are proposed to test these observations in more depth, and the author refers the interested reader to the referenced publications for a detailed study of the HRV measures involved. While being exemplified mostly in the studies of fetal HRV, the presented framework promises more specific fetal, postnatal, and adult HRV biomarkers of health and disease, which can be obtained non-invasively and continuously.
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Affiliation(s)
- Martin Gerbert Frasch
- Department of Obstetrics and Gynecology and Institute on Human Development and Disability, University of Washington School of Medicine, Seattle, WA 98195, USA
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Boiko A, Gaiduk M, Scherz WD, Gentili A, Conti M, Orcioni S, Martínez Madrid N, Seepold R. Monitoring of Cardiorespiratory Parameters during Sleep Using a Special Holder for the Accelerometer Sensor. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23115351. [PMID: 37300078 DOI: 10.3390/s23115351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 06/01/2023] [Accepted: 06/04/2023] [Indexed: 06/12/2023]
Abstract
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.
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Affiliation(s)
- Andrei Boiko
- Ubiquitous Computing Lab, Department of Computer Science, HTWG Konstanz-University of Applied Sciences, 78462 Konstanz, Germany
| | - Maksym Gaiduk
- Ubiquitous Computing Lab, Department of Computer Science, HTWG Konstanz-University of Applied Sciences, 78462 Konstanz, Germany
| | - Wilhelm Daniel Scherz
- Ubiquitous Computing Lab, Department of Computer Science, HTWG Konstanz-University of Applied Sciences, 78462 Konstanz, Germany
| | - Andrea Gentili
- Dipartimento di Ingegneria dell'Informazione, Università Politecnica delle Marche, 60131 Ancona, Italy
| | - Massimo Conti
- Dipartimento di Ingegneria dell'Informazione, Università Politecnica delle Marche, 60131 Ancona, Italy
| | - Simone Orcioni
- Dipartimento di Ingegneria dell'Informazione, Università Politecnica delle Marche, 60131 Ancona, Italy
| | | | - Ralf Seepold
- Ubiquitous Computing Lab, Department of Computer Science, HTWG Konstanz-University of Applied Sciences, 78462 Konstanz, Germany
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Siddi S, Bailon R, Giné-Vázquez I, Matcham F, Lamers F, Kontaxis S, Laporta E, Garcia E, Lombardini F, Annas P, Hotopf M, Penninx BWJH, Ivan A, White KM, Difrancesco S, Locatelli P, Aguiló J, Peñarrubia-Maria MT, Narayan VA, Folarin A, Leightley D, Cummins N, Vairavan S, Ranjan Y, Rintala A, de Girolamo G, Simblett SK, Wykes T, Myin-Germeys I, Dobson R, Haro JM. The usability of daytime and night-time heart rate dynamics as digital biomarkers of depression severity. Psychol Med 2023; 53:3249-3260. [PMID: 37184076 DOI: 10.1017/s0033291723001034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND Alterations in heart rate (HR) may provide new information about physiological signatures of depression severity. This 2-year study in individuals with a history of recurrent major depressive disorder (MDD) explored the intra-individual variations in HR parameters and their relationship with depression severity. METHODS Data from 510 participants (Number of observations of the HR parameters = 6666) were collected from three centres in the Netherlands, Spain, and the UK, as a part of the remote assessment of disease and relapse-MDD study. We analysed the relationship between depression severity, assessed every 2 weeks with the Patient Health Questionnaire-8, with HR parameters in the week before the assessment, such as HR features during all day, resting periods during the day and at night, and activity periods during the day evaluated with a wrist-worn Fitbit device. Linear mixed models were used with random intercepts for participants and countries. Covariates included in the models were age, sex, BMI, smoking and alcohol consumption, antidepressant use and co-morbidities with other medical health conditions. RESULTS Decreases in HR variation during resting periods during the day were related with an increased severity of depression both in univariate and multivariate analyses. Mean HR during resting at night was higher in participants with more severe depressive symptoms. CONCLUSIONS Our findings demonstrate that alterations in resting HR during all day and night are associated with depression severity. These findings may provide an early warning of worsening depression symptoms which could allow clinicians to take responsive treatment measures promptly.
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Affiliation(s)
- S Siddi
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain
| | - R Bailon
- Aragón Institute of Engineering Research (I3A), University of Zaragoza, Zaragoza, Spain
- Centros de investigación biomédica en red en el área de bioingeniería, biomateriales y nanomedicina (CIBER-BBN), Madrid, Spain
| | - I Giné-Vázquez
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain
| | - F Matcham
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- School of Psychology, University of Sussex, Falmer, UK
| | - F Lamers
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - S Kontaxis
- Aragón Institute of Engineering Research (I3A), University of Zaragoza, Zaragoza, Spain
- Centros de investigación biomédica en red en el área de bioingeniería, biomateriales y nanomedicina (CIBER-BBN), Madrid, Spain
| | - E Laporta
- Centros de investigación biomédica en red en el área de bioingeniería, biomateriales y nanomedicina (CIBER-BBN), Madrid, Spain
| | - E Garcia
- Centros de investigación biomédica en red en el área de bioingeniería, biomateriales y nanomedicina (CIBER-BBN), Madrid, Spain
- Microelectrónica y Sistemas Electrónicos, Universidad Autónoma de Barcelona, CIBERBBN, Barcelona, Spain
| | - F Lombardini
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain
| | - P Annas
- H. Lundbeck A/S, Valby, Denmark
| | - M Hotopf
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - B W J H Penninx
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - A Ivan
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - K M White
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - S Difrancesco
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - P Locatelli
- Department of Engineering and Applied Science, University of Bergamo, Bergamo, Italy
| | - J Aguiló
- Centros de investigación biomédica en red en el área de bioingeniería, biomateriales y nanomedicina (CIBER-BBN), Madrid, Spain
- Microelectrónica y Sistemas Electrónicos, Universidad Autónoma de Barcelona, CIBERBBN, Barcelona, Spain
| | - M T Peñarrubia-Maria
- Catalan Institute of Health, Primary Care Research Institute (IDIAP Jordi Gol), CIBERESP, Barcelona, Spain
| | - V A Narayan
- Research and Development Information Technology, Janssen Research & Development, LLC, Titusville, NJ, USA
| | - A Folarin
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - D Leightley
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - N Cummins
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - S Vairavan
- Research and Development Information Technology, Janssen Research & Development, LLC, Titusville, NJ, USA
| | - Y Ranjan
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - A Rintala
- Department for Neurosciences, Center for Contextual Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium
- Faculty of Social Services and Health Care, LAB University of Applied Sciences, Lahti, Finland
| | - G de Girolamo
- IRCCS Instituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - S K Simblett
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - T Wykes
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - I Myin-Germeys
- Department for Neurosciences, Center for Contextual Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium
| | - R Dobson
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - J M Haro
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain
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Bouraghi H, Mohammadpour A, Khodaveisi T, Ghazisaeedi M, Saeedi S, Familgarosian S. Virtual Reality and Cardiac Diseases: A Systematic Review of Applications and Effects. JOURNAL OF HEALTHCARE ENGINEERING 2023; 2023:8171057. [PMID: 37287540 PMCID: PMC10243949 DOI: 10.1155/2023/8171057] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 01/22/2023] [Accepted: 03/04/2023] [Indexed: 06/09/2023]
Abstract
Introduction Cardiac diseases have grown significantly in recent years, causing many deaths globally. Cardiac diseases can impose a significant economic burden on societies. The development of virtual reality technology has attracted the attention of many researchers in recent years. This study aimed to investigate the applications and effects of virtual reality (VR) technology on cardiac diseases. Methods A comprehensive search was carried out in four databases, including Scopus, Medline (through PubMed), Web of Science, and IEEE Xplore to identify related articles published until May 25, 2022. Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guideline for systematic reviews was followed. All randomized trials that investigated the effects of virtual reality on cardiac diseases were included in this systematic review. Results Twenty-six studies were included in this systematic review. The results illustrated that virtual reality applications in cardiac diseases can be classified in three categories of physical rehabilitation, psychological rehabilitation, and education/training. This study revealed that the use of virtual reality in psychological and physical rehabilitation can reduce stress, emotional tension, Hospital Anxiety and Depression Scale (HADS) total score, anxiety, depression, pain, systolic blood pressure, and length of hospitalization. Finally, the use of virtual reality in education/training can enhance technical performance, increase the speed of procedures, and improve the user's skills, level of knowledge, and self-confidence as well as facilitate learning. Also, the most limitations mentioned in the studies included small sample size and lack of or short duration of follow-up. Conclusions The results showed that the positive effects of using virtual reality in cardiac diseases are much more than its negative effects. Considering that the most limitations mentioned in the studies were the small sample size and short duration of follow-up, it is necessary to conduct studies with adequate methodological quality to report their effects in the short term and long term.
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Affiliation(s)
- Hamid Bouraghi
- Department of Health Information Technology, School of Allied Medical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ali Mohammadpour
- Department of Health Information Technology, School of Allied Medical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Taleb Khodaveisi
- Department of Health Information Technology, School of Allied Medical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Marjan Ghazisaeedi
- Department of Health Information Management and Medical Informatics, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheila Saeedi
- Department of Health Information Technology, School of Allied Medical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
- Clinical Research Development Unit of Farshchian Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
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Kwon S, Kim HS, Kwon K, Kim H, Kim YS, Lee SH, Kwon YT, Jeong JW, Trotti LM, Duarte A, Yeo WH. At-home wireless sleep monitoring patches for the clinical assessment of sleep quality and sleep apnea. SCIENCE ADVANCES 2023; 9:eadg9671. [PMID: 37224243 DOI: 10.1126/sciadv.adg9671] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 04/17/2023] [Indexed: 05/26/2023]
Abstract
Although many people suffer from sleep disorders, most are undiagnosed, leading to impairments in health. The existing polysomnography method is not easily accessible; it's costly, burdensome to patients, and requires specialized facilities and personnel. Here, we report an at-home portable system that includes wireless sleep sensors and wearable electronics with embedded machine learning. We also show its application for assessing sleep quality and detecting sleep apnea with multiple patients. Unlike the conventional system using numerous bulky sensors, the soft, all-integrated wearable platform offers natural sleep wherever the user prefers. In a clinical study, the face-mounted patches that detect brain, eye, and muscle signals show comparable performance with polysomnography. When comparing healthy controls to sleep apnea patients, the wearable system can detect obstructive sleep apnea with an accuracy of 88.5%. Furthermore, deep learning offers automated sleep scoring, demonstrating portability, and point-of-care usability. At-home wearable electronics could ensure a promising future supporting portable sleep monitoring and home healthcare.
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Affiliation(s)
- Shinjae Kwon
- IEN Center for Human-Centric Interfaces and Engineering at the Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA 30332, USA
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Hyeon Seok Kim
- IEN Center for Human-Centric Interfaces and Engineering at the Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA 30332, USA
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Kangkyu Kwon
- IEN Center for Human-Centric Interfaces and Engineering at the Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA 30332, USA
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Hodam Kim
- IEN Center for Human-Centric Interfaces and Engineering at the Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA 30332, USA
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Yun Soung Kim
- Department of Radiology, Icahn School of Medicine at Mount Sinai, BioMedical Engineering and Imaging Institute, New York, NY 10029, USA
| | - Sung Hoon Lee
- IEN Center for Human-Centric Interfaces and Engineering at the Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA 30332, USA
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Young-Tae Kwon
- Metal Powder Department, Korea Institute of Materials Science, Changwon 51508, Republic of Korea
| | - Jae-Woong Jeong
- School of Electrical Engineering, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea
| | - Lynn Marie Trotti
- Emory Sleep Center and Department of Neurology, Emory University School of Medicine, Atlanta, GA 30329, USA
| | - Audrey Duarte
- Department of Psychology, University of Texas at Austin, Austin, TX 78712, USA
| | - Woon-Hong Yeo
- IEN Center for Human-Centric Interfaces and Engineering at the Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA 30332, USA
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Tech and Emory University, Atlanta, GA 30332, USA
- Parker H. Petit Institute for Bioengineering and Biosciences, Institute for Materials, Neural Engineering Center, Institute for Robotics and Intelligent Machines, Georgia Institute of Technology, Atlanta, GA 30332, USA
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Li W, Cao Y, Wang C, Sepúlveda N. Ferroelectret nanogenerators for the development of bioengineering systems. CELL REPORTS. PHYSICAL SCIENCE 2023; 4:101388. [PMID: 37693856 PMCID: PMC10487350 DOI: 10.1016/j.xcrp.2023.101388] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Bioengineering devices and systems will become a practical and versatile technology in society when sustainability issues, primarily pertaining to their efficiency, sustainability, and human-machine interaction, are fully addressed. It has become evident that technological paths should not rely on a single operation mechanism but instead on holistic methodologies that integrate different phenomena and approaches with complementary advantages. As an intriguing invention, the ferroelectret nanogenerator (FENG) has emerged with promising potential in various fields of bioengineering. Utilizing the changes in the engineered macro-scale electric dipoles to create displacement current (and vice versa), FENGs have been demonstrated to be a compelling strategy for bidirectional conversion of energy between the electrical and mechanical domains. Here we provide a comprehensive overview of the latest advancements in integrating FENGs in bioengineering systems, focusing on the applications with the most potential and the underlying current constraints.
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Affiliation(s)
- Wei Li
- Department of Mechanical Engineering, University of Vermont, Burlington, VT 05405, USA
- College of Integrated Circuit Science and Engineering, Nanjing University of Posts and Telecommunications, Nanjing, Jiangsu 210023, China
| | - Yunqi Cao
- State Key Laboratory of Industrial Control Technology, College of Control Science and Engineering, Zhejiang University, Hangzhou, Zhejiang 310027, China
| | - Chuan Wang
- Electrical and Systems Engineering, Washington University in St. Louis, St. Louis, MO 63130, USA
- Institute of Materials Science and Engineering, Washington University in St. Louis, St. Louis, MO 63130, USA
| | - Nelson Sepúlveda
- Department of Electrical and Computer Engineering, Michigan State University, East Lansing, MI 48824, USA
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Vasilica C, Wynn M, Davis D, Charnley K, Garwood-Cross L. The digital future of nursing: making sense of taxonomies and key concepts. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2023; 32:442-446. [PMID: 37173087 DOI: 10.12968/bjon.2023.32.9.442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Digital technology is becoming increasingly common in routine nursing practice. The adoption of digital technologies such as video calling, and other digital communication, has been hastened by the recent COVID-19 pandemic. Use of these technologies has the potential to revolutionise nursing practice, leading to potentially more accurate patient assessment, monitoring processes and improved safety in clinical areas. This article outlines key concepts related to the digitalisation of health care and the implications for nursing practice. The aim of this article is to encourage nurses to consider the implications, opportunities and challenges associated with the move towards digitalisation and advances in technology. Specifically, this means understanding key digital developments and innovations associated with healthcare provision and appreciating the implications of digitalisation for the future of nursing practice.
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Affiliation(s)
- Cristina Vasilica
- Reader, Digital Health, School of Health and Society, University of Salford, Salford
| | - Matthew Wynn
- Lecturer, Adult Nursing, School of Health and Society, University of Salford, Salford
| | - Dilla Davis
- Lecturer, Adult Nursing, School of Health and Society, University of Salford, Salford
| | - Kyle Charnley
- Lecturer, Mental Health Nursing, School of Health and Society, University of Salford, Salford
| | - Lisa Garwood-Cross
- Research Fellow, Digital Health, School of Health and Society, University of Salford, Salford
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Wenjian W, Qian X, Jun X, Zhikun H. DynamicSleepNet: a multi-exit neural network with adaptive inference time for sleep stage classification. Front Physiol 2023; 14:1171467. [PMID: 37250117 PMCID: PMC10213983 DOI: 10.3389/fphys.2023.1171467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 04/26/2023] [Indexed: 05/31/2023] Open
Abstract
Sleep is an essential human physiological behavior, and the quality of sleep directly affects a person's physical and mental state. In clinical medicine, sleep stage is an important basis for doctors to diagnose and treat sleep disorders. The traditional method of classifying sleep stages requires sleep experts to classify them manually, and the whole process is time-consuming and laborious. In recent years, with the help of deep learning, automatic sleep stage classification has made great progress, especially networks using multi-modal electrophysiological signals, which have greatly improved in terms of accuracy. However, we found that the existing multimodal networks have a large number of redundant calculations in the process of using multiple electrophysiological signals, and the networks become heavier due to the use of multiple signals, and difficult to be used in small devices. To solve these two problems, this paper proposes DynamicSleepNet, a network that can maximize the use of multiple electrophysiological signals and can dynamically adjust between accuracy and efficiency. DynamicSleepNet consists of three effective feature extraction modules (EFEMs) and three classifier modules, each EFEM is connected to a classifier. Each EFEM is able to extract signal features while making the effective features more prominent and the invalid features are suppressed. The samples processed by the EFEM are given to the corresponding classifier for classification, and if the classifier considers the uncertainty of the sample to be below the threshold we set, the sample can be output early without going through the whole network. We validated our model on four datasets. The results show that the highest accuracy of our model outperforms all baselines. With accuracy close to baselines, our model is faster than the baselines by a factor of several to several tens, and the number of parameters of the model is lower or close. The implementation code is available at: https://github.com/Quinella7291/A-Multi-exit-Neural-Network-with-Adaptive-Inference-Time-for-Sleep-Stage-Classification/.
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Brearley M, Berry R, Hunt AP, Pope R. A Systematic Review of Post-Work Core Temperature Cooling Rates Conferred by Passive Rest. BIOLOGY 2023; 12:biology12050695. [PMID: 37237510 DOI: 10.3390/biology12050695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/04/2023] [Accepted: 05/05/2023] [Indexed: 05/28/2023]
Abstract
Physical work increases energy expenditure, requiring a considerable elevation of metabolic rate, which causes body heat production that can cause heat stress, heat strain, and hyperthermia in the absence of adequate cooling. Given that passive rest is often used for cooling, a systematic search of literature databases was conducted to identify studies that reported post-work core temperature cooling rates conferred by passive rest, across a range of environmental conditions. Data regarding cooling rates and environmental conditions were extracted, and the validity of key measures was assessed for each study. Forty-four eligible studies were included, providing 50 datasets. Eight datasets indicated a stable or rising core temperature in participants (range 0.000 to +0.028 °C min-1), and forty-two datasets reported reducing core temperature (-0.002 to -0.070 °C min-1) during passive rest, across a range of Wet-Bulb Globe Temperatures (WBGT). For 13 datasets where occupational or similarly insulative clothing was worn, passive rest resulted in a mean core temperature decrease of -0.004 °C min-1 (-0.032 to +0.013 °C min-1). These findings indicate passive rest does not reverse the elevated core temperatures of heat-exposed workers in a timely manner. Climate projections of higher WBGT are anticipated to further marginalise the passive rest cooling rates of heat-exposed workers, particularly when undertaken in occupational attire.
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Affiliation(s)
- Matt Brearley
- Thermal Hyperformance, Hervey Bay, QLD 4655, Australia
- National Critical Care and Trauma Response Centre, Darwin, NT 0800, Australia
- School of Allied Health, Exercise & Sports Sciences, Charles Sturt University, Albury, NSW 2640, Australia
| | - Rachel Berry
- School of Biomedical Sciences, University of New South Wales, Sydney, NSW 2052, Australia
| | - Andrew P Hunt
- School of Biomedical Sciences, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD 4059, Australia
| | - Rodney Pope
- School of Allied Health, Exercise & Sports Sciences, Charles Sturt University, Albury, NSW 2640, Australia
- Tactical Research Unit, Bond University, Robina, QLD 4229, Australia
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Haghi M, Asadov A, Boiko A, Ortega JA, Martínez Madrid N, Seepold R. Validating Force Sensitive Resistor Strip Sensors for Cardiorespiratory Measurement during Sleep: A Preliminary Study. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23083973. [PMID: 37112315 PMCID: PMC10141142 DOI: 10.3390/s23083973] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/05/2023] [Accepted: 04/12/2023] [Indexed: 06/12/2023]
Abstract
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.
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Affiliation(s)
- Mostafa Haghi
- Ubiquitous Computing Laboratory, Department of Computer Science, HTWG Konstanz, 78462 Konstanz, Germany; (A.A.); (A.B.); (R.S.)
| | - Akhmadbek Asadov
- Ubiquitous Computing Laboratory, Department of Computer Science, HTWG Konstanz, 78462 Konstanz, Germany; (A.A.); (A.B.); (R.S.)
| | - Andrei Boiko
- Ubiquitous Computing Laboratory, Department of Computer Science, HTWG Konstanz, 78462 Konstanz, Germany; (A.A.); (A.B.); (R.S.)
| | | | - Natividad Martínez Madrid
- Internet of Things Laboratory, School of Informatics, Reutlingen University, 72762 Reutlingen, Germany;
| | - Ralf Seepold
- Ubiquitous Computing Laboratory, Department of Computer Science, HTWG Konstanz, 78462 Konstanz, Germany; (A.A.); (A.B.); (R.S.)
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Wang K, Tan D, Li Z, Sun Z. Supporting Tremor Rehabilitation Using Optical See-Through Augmented Reality Technology. SENSORS (BASEL, SWITZERLAND) 2023; 23:3924. [PMID: 37112264 PMCID: PMC10143754 DOI: 10.3390/s23083924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/14/2023] [Accepted: 04/04/2023] [Indexed: 06/19/2023]
Abstract
Tremor is a movement disorder that significantly impacts an individual's physical stability and quality of life, and conventional medication or surgery often falls short in providing a cure. Rehabilitation training is, therefore, used as an auxiliary method to mitigate the exacerbation of individual tremors. Video-based rehabilitation training is a form of therapy that allows patients to exercise at home, reducing pressure on rehabilitation institutions' resources. However, it has limitations in directly guiding and monitoring patients' rehabilitation, leading to an ineffective training effect. This study proposes a low-cost rehabilitation training system that utilizes optical see-through augmented reality (AR) technology to enable tremor patients to conduct rehabilitation training at home. The system provides one-on-one demonstration, posture guidance, and training progress monitoring to achieve an optimal training effect. To assess the system's effectiveness, we conducted experiments comparing the movement magnitudes of individuals with tremors in the proposed AR environment and video environment, while also comparing them with standard demonstrators. Participants wore a tremor simulation device during uncontrollable limb tremors, with tremor frequency and amplitude calibrated to typical tremor standards. The results showed that participants' limb movement magnitudes in the AR environment were significantly higher than those in the video environment, approaching the movement magnitudes of the standard demonstrators. Hence, it can be inferred that individuals receiving tremor rehabilitation in the AR environment experience better movement quality than those in the video environment. Furthermore, participant experience surveys revealed that the AR environment not only provided a sense of comfort, relaxation, and enjoyment but also effectively guided them throughout the rehabilitation process.
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Affiliation(s)
- Kai Wang
- School of Art and Design, Wuhan University of Technology, Wuhan 430070, China; (K.W.)
- Graduate School of Engineering Science, Osaka University, Toyonaka 5608531, Japan
| | - Dong Tan
- School of Art and Design, Wuhan University of Technology, Wuhan 430070, China; (K.W.)
| | - Zhe Li
- College of Education, Fujian Normal University, Fuzhou 350117, China
- Graduate School of Human Sciences, Osaka University, Suita 5650871, Japan
| | - Zhi Sun
- School of Art and Design, Wuhan University of Technology, Wuhan 430070, China; (K.W.)
- Graduate School of Human Sciences, Osaka University, Suita 5650871, Japan
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Sato S, Hiratsuka T, Hasegawa K, Watanabe K, Obara Y, Kariya N, Shinba T, Matsui T. Screening for Major Depressive Disorder Using a Wearable Ultra-Short-Term HRV Monitor and Signal Quality Indices. SENSORS (BASEL, SWITZERLAND) 2023; 23:3867. [PMID: 37112208 PMCID: PMC10143236 DOI: 10.3390/s23083867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/06/2023] [Accepted: 04/07/2023] [Indexed: 06/19/2023]
Abstract
To encourage potential major depressive disorder (MDD) patients to attend diagnostic sessions, we developed a novel MDD screening system based on sleep-induced autonomic nervous responses. The proposed method only requires a wristwatch device to be worn for 24 h. We evaluated heart rate variability (HRV) via wrist photoplethysmography (PPG). However, previous studies have indicated that HRV measurements obtained using wearable devices are susceptible to motion artifacts. We propose a novel method to improve screening accuracy by removing unreliable HRV data (identified on the basis of signal quality indices (SQIs) obtained by PPG sensors). The proposed algorithm enables real-time calculation of signal quality indices in the frequency domain (SQI-FD). A clinical study conducted at Maynds Tower Mental Clinic enrolled 40 MDD patients (mean age, 37.5 ± 8.8 years) diagnosed on the basis of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and 29 healthy volunteers (mean age, 31.9 ± 13.0 years). Acceleration data were used to identify sleep states, and a linear classification model was trained and tested using HRV and pulse rate data. Ten-fold cross-validation showed a sensitivity of 87.3% (80.3% without SQI-FD data) and specificity of 84.0% (73.3% without SQI-FD data). Thus, SQI-FD drastically improved sensitivity and specificity.
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Affiliation(s)
- Shohei Sato
- Department of Electrical Engineering and Computer Science, Faculty of Systems Design, Tokyo Metropolitan University, Tokyo 191-0065, Japan
| | - Takuma Hiratsuka
- Department of Electrical Engineering and Computer Science, Faculty of Systems Design, Tokyo Metropolitan University, Tokyo 191-0065, Japan
| | - Kenya Hasegawa
- Department of Electrical Engineering and Computer Science, Faculty of Systems Design, Tokyo Metropolitan University, Tokyo 191-0065, Japan
| | - Keisuke Watanabe
- Department of Electrical Engineering and Computer Science, Faculty of Systems Design, Tokyo Metropolitan University, Tokyo 191-0065, Japan
| | - Yusuke Obara
- Maynds Tower Mental Clinic, Tokyo 151-0053, Japan
| | | | - Toshikazu Shinba
- Department of Psychiatry, Shizuoka Saiseikai General Hospital, Shizuoka 422-8527, Japan
- Research Division, Saiseikai Research Institute of Health Care and Welfare, Tokyo 108-0073, Japan
| | - Takemi Matsui
- Department of Electrical Engineering and Computer Science, Graduate School of System Design, Tokyo Metropolitan University, Tokyo 191-0065, Japan
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75
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Manuel Román-Belmonte J, De la Corte-Rodríguez H, Adriana Rodríguez-Damiani B, Carlos Rodríguez-Merchán E. Artificial Intelligence in Musculoskeletal Conditions. ARTIF INTELL 2023. [DOI: 10.5772/intechopen.110696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
Artificial intelligence (AI) refers to computer capabilities that resemble human intelligence. AI implies the ability to learn and perform tasks that have not been specifically programmed. Moreover, it is an iterative process involving the ability of computerized systems to capture information, transform it into knowledge, and process it to produce adaptive changes in the environment. A large labeled database is needed to train the AI system and generate a robust algorithm. Otherwise, the algorithm cannot be applied in a generalized way. AI can facilitate the interpretation and acquisition of radiological images. In addition, it can facilitate the detection of trauma injuries and assist in orthopedic and rehabilitative processes. The applications of AI in musculoskeletal conditions are promising and are likely to have a significant impact on the future management of these patients.
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76
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Weber KS, Godkin FE, Cornish BF, McIlroy WE, Van Ooteghem K. Wrist Accelerometer Estimates of Physical Activity Intensity During Walking in Older Adults and People Living With Complex Health Conditions: Retrospective Observational Data Analysis Study. JMIR Form Res 2023; 7:e41685. [PMID: 36920452 PMCID: PMC10131658 DOI: 10.2196/41685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 01/10/2023] [Accepted: 01/10/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Accurate measurement of daily physical activity (PA) is important as PA is linked to health outcomes in older adults and people living with complex health conditions. Wrist-worn accelerometers are widely used to estimate PA intensity, including walking, which composes much of daily PA. However, there is concern that wrist-derived PA data in these cohorts is unreliable due to slow gait speed, mobility aid use, disease-related symptoms that impact arm movement, and transient activities of daily living. Despite the potential for error in wrist-derived PA intensity estimates, their use has become ubiquitous in research and clinical application. OBJECTIVE The goals of this work were to (1) determine the accuracy of wrist-based estimates of PA intensity during known walking periods in older adults and people living with cerebrovascular disease (CVD) or neurodegenerative disease (NDD) and (2) explore factors that influence wrist-derived intensity estimates. METHODS A total of 35 older adults (n=23 with CVD or NDD) wore an accelerometer on the dominant wrist and ankle for 7 to 10 days of continuous monitoring. Stepping was detected using the ankle accelerometer. Analyses were restricted to gait bouts ≥60 seconds long with a cadence ≥80 steps per minute (LONG walks) to identify periods of purposeful, continuous walking likely to reflect moderate-intensity activity. Wrist accelerometer data were analyzed within LONG walks using 15-second epochs, and published intensity thresholds were applied to classify epochs as sedentary, light, or moderate-to-vigorous physical activity (MVPA). Participants were stratified into quartiles based on the percent of walking epochs classified as sedentary, and the data were examined for differences in behavioral or demographic traits between the top and bottom quartiles. A case series was performed to illustrate factors and behaviors that can affect wrist-derived intensity estimates during walking. RESULTS Participants averaged 107.7 (SD 55.8) LONG walks with a median cadence of 107.3 (SD 10.8) steps per minute. Across participants, wrist-derived intensity classification was 22.9% (SD 15.8) sedentary, 27.7% (SD 14.6) light, and 49.3% (SD 25.5) MVPA during LONG walks. All participants measured a statistically lower proportion of wrist-derived activity during LONG walks than expected (all P<.001), and 80% (n=28) of participants had at least 20 minutes of LONG walking time misclassified as sedentary based on wrist-derived intensity estimates. Participants in the highest quartile of wrist-derived sedentary classification during LONG walks were significantly older (t16=4.24, P<.001) and had more variable wrist movement (t16=2.13, P=.049) compared to those in the lowest quartile. CONCLUSIONS The current best practice wrist accelerometer method is prone to misclassifying activity intensity during walking in older adults and people living with complex health conditions. A multidevice approach may be warranted to advance methods for accurately assessing PA in these groups.
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Affiliation(s)
- Kyle S Weber
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - F Elizabeth Godkin
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Benjamin F Cornish
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - William E McIlroy
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Karen Van Ooteghem
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
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77
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Washington P. Digitally Diagnosing Multiple Developmental Delays using Crowdsourcing fused with Machine Learning: A Research Protocol. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.03.05.23286817. [PMID: 36945467 PMCID: PMC10029023 DOI: 10.1101/2023.03.05.23286817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
Background Roughly 17% percent of minors in the United States aged 3 through 17 years have a diagnosis of one or more developmental or psychiatric conditions, with the true prevalence likely being higher due to underdiagnosis in rural areas and for minority populations. Unfortunately, timely diagnostic services are inaccessible to a large portion of the United States and global population due to cost, distance, and clinician availability. Digital phenotyping tools have the potential to shorten the time-to-diagnosis and to bring diagnostic services to more people by enabling accessible evaluations. While automated machine learning (ML) approaches for detection of pediatric psychiatry conditions have garnered increased research attention in recent years, existing approaches use a limited set of social features for the prediction task and focus on a single binary prediction. Objective I propose the development of a gamified web system for data collection followed by a fusion of novel crowdsourcing algorithms with machine learning behavioral feature extraction approaches to simultaneously predict diagnoses of Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) in a precise and specific manner. Methods The proposed pipeline will consist of: (1) a gamified web applications to curate videos of social interactions adaptively based on needs of the diagnostic system, (2) behavioral feature extraction techniques consisting of automated ML methods and novel crowdsourcing algorithms, and (3) development of ML models which classify several conditions simultaneously and which adaptively request additional information based on uncertainties about the data. Conclusions The prospective for high reward stems from the possibility of creating the first AI-powered tool which can identify complex social behaviors well enough to distinguish conditions with nuanced differentiators such as ASD and ADHD.
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78
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Raya L, Ruiz JJ, Fabian M, Ron A, Garcia J, Verdu C, Potel M. Development of a Virtual Reality Tool for the Treatment of Pediatric Patients in the ICU. IEEE COMPUTER GRAPHICS AND APPLICATIONS 2023; 43:69-77. [PMID: 37030834 DOI: 10.1109/mcg.2023.3239676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Prolonged stays in the intensive care unit (ICU) cause difficulties in rehabilitation and other disorders for patients. This problem is exacerbated in the case of pediatric patients. The use of virtual reality can help with the lack of external stimuli and contribute as potential nonpharmacological therapies in some patient rehabilitation processes. To this end, we have developed a virtual reality application for use in the pediatric ICU as a tool for the treatment and rehabilitation of delirium. The tool consists of two applications: an immersive environment for a virtual reality headset used by the patient, and a web application managed by a therapist with which they can customize, control, adapt, and analyze in real time everything that happens in the patient's virtual world. Our application has been designed jointly with a university center and a hospital, and initial evaluations indicate the results to be promising.
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79
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Washington V, Franklin JB, Huang ES, Mega JL, Abernethy AP. Diversity, Equity, and Inclusion in Clinical Research: A Path Toward Precision Health for Everyone. Clin Pharmacol Ther 2023; 113:575-584. [PMID: 36423203 DOI: 10.1002/cpt.2804] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 11/18/2022] [Indexed: 11/25/2022]
Abstract
Healthcare disparities are a persistent societal problem. One of the contributing factors to this status quo is the lack of diversity and representativeness of research efforts, which result in nongeneralizable evidence that, in turn, provides suboptimal means to enable the best possible outcomes at the individual level. There are several strategies that research teams can adopt to improve the diversity, equity, and inclusion (DEI) of their efforts; these strategies span the totality of the research path, from initial design to the shepherding of clinical data through a potential regulatory process. These strategies include more intentionality and DEI-based goal-setting, more diverse research and leadership teams, better community engagement to set study goals and approaches, better tailored outreach interventions, decentralization of study procedures and incorporation of innovative technology for more flexible data collection, and self-surveillance to identify and prevent biases. Within their remit of overlooking research efforts, regulatory authorities, as stakeholders, also have the potential for a positive effect on the DEI of emerging clinical evidence. All these are implementable tools and mechanisms that can make study participation more approachable to diverse communities, and ultimately generate evidence that is more generalizable and a conduit for better outcomes. The research community has an imperative to make DEI principles key foundational aspects in study conduct in order to pursue better personalized medicine for diverse patient populations.
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Affiliation(s)
| | | | - Erich S Huang
- Verily Life Sciences, South San Francisco, California, USA
| | - Jessica L Mega
- Verily Life Sciences, South San Francisco, California, USA
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80
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Ge W, Lueck C, Suominen H, Apthorp D. Has machine learning over-promised in healthcare? A critical analysis and a proposal for improved evaluation, with evidence from Parkinson’s disease. Artif Intell Med 2023; 139:102524. [PMID: 37100503 DOI: 10.1016/j.artmed.2023.102524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 02/22/2023] [Accepted: 02/28/2023] [Indexed: 03/17/2023]
Abstract
Adoption of artificial intelligence (AI) by the medical community has long been anticipated, endorsed by a stream of machine learning literature showcasing AI systems that yield extraordinary performance. However, many of these systems are likely over-promising and will under-deliver in practice. One key reason is the community's failure to acknowledge and address the presence of inflationary effects in the data. These simultaneously inflate evaluation performance and prevent a model from learning the underlying task, thus severely misrepresenting how that model would perform in the real world. This paper investigated the impact of these inflationary effects on healthcare tasks, as well as how these effects can be addressed. Specifically, we defined three inflationary effects that occur in medical data sets and allow models to easily reach small training losses and prevent skillful learning. We investigated two data sets of sustained vowel phonation from participants with and without Parkinson's disease, and revealed that published models which have achieved high classification performances on these were artificially enhanced due to the inflationary effects. Our experiments showed that removing each inflationary effect corresponded with a decrease in classification accuracy, and that removing all inflationary effects reduced the evaluated performance by up to 30%. Additionally, the performance on a more realistic test set increased, suggesting that the removal of these inflationary effects enabled the model to better learn the underlying task and generalize. Source code is available at https://github.com/Wenbo-G/pd-phonation-analysis under the MIT license.
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81
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Martín-Escudero P, Cabanas AM, Dotor-Castilla ML, Galindo-Canales M, Miguel-Tobal F, Fernández-Pérez C, Fuentes-Ferrer M, Giannetti R. Are Activity Wrist-Worn Devices Accurate for Determining Heart Rate during Intense Exercise? Bioengineering (Basel) 2023; 10:bioengineering10020254. [PMID: 36829748 PMCID: PMC9952291 DOI: 10.3390/bioengineering10020254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/28/2023] [Accepted: 01/30/2023] [Indexed: 02/17/2023] Open
Abstract
The market for wrist-worn devices is growing at previously unheard-of speeds. A consequence of their fast commercialization is a lack of adequate studies testing their accuracy on varied populations and pursuits. To provide an understanding of wearable sensors for sports medicine, the present study examined heart rate (HR) measurements of four popular wrist-worn devices, the (Fitbit Charge (FB), Apple Watch (AW), Tomtom runner Cardio (TT), and Samsung G2 (G2)), and compared them with gold standard measurements derived by continuous electrocardiogram examination (ECG). Eight athletes participated in a comparative study undergoing maximal stress testing on a cycle ergometer or a treadmill. We analyzed 1,286 simultaneous HR data pairs between the tested devices and the ECG. The four devices were reasonably accurate at the lowest activity level. However, at higher levels of exercise intensity the FB and G2 tended to underestimate HR values during intense physical effort, while the TT and AW devices were fairly reliable. Our results suggest that HR estimations should be considered cautiously at specific intensities. Indeed, an effective intervention is required to register accurate HR readings at high-intensity levels (above 150 bpm). It is important to consider that even though none of these devices are certified or sold as medical or safety devices, researchers must nonetheless evaluate wrist-worn wearable technology in order to fully understand how HR affects psychological and physical health, especially under conditions of more intense exercise.
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Affiliation(s)
- Pilar Martín-Escudero
- Professional Medical School of Physical Education and Sport, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Ana María Cabanas
- Departamento de Física, FACI, Universidad de Tarapacá, Arica 1010069, Chile
- Correspondence:
| | | | - Mercedes Galindo-Canales
- Professional Medical School of Physical Education and Sport, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Francisco Miguel-Tobal
- Professional Medical School of Physical Education and Sport, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Cristina Fernández-Pérez
- Servicio de Medicina Preventiva Complejo Hospitalario de Santiago de Compostela, Instituto de Investigación Sanitaria de Santiago, 15706 Santiago de Compostela, Spain
| | - Manuel Fuentes-Ferrer
- Unidad de Investigación, Hospital Universitario Nuestra Señora de Candelaria, 38010 Santa Cruz de Tenerife, Spain
| | - Romano Giannetti
- IIT, Institute of Technology Research, Universidad Pontificia Comillas, 28015 Madrid, Spain
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Meskher H, Mustansar HC, Thakur AK, Sathyamurthy R, Lynch I, Singh P, Han TK, Saidur R. Recent trends in carbon nanotube (CNT)-based biosensors for the fast and sensitive detection of human viruses: a critical review. NANOSCALE ADVANCES 2023; 5:992-1010. [PMID: 36798507 PMCID: PMC9926911 DOI: 10.1039/d2na00236a] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 10/13/2022] [Indexed: 06/18/2023]
Abstract
The current COVID-19 pandemic, with its numerous variants including Omicron which is 50-70% more transmissible than the previously dominant Delta variant, demands a fast, robust, cheap, and easily deployed identification strategy to reduce the chain of transmission, for which biosensors have been shown as a feasible solution at the laboratory scale. The use of nanomaterials has significantly enhanced the performance of biosensors, and the addition of CNTs has increased detection capabilities to an unrivaled level. Among the various CNT-based detection systems, CNT-based field-effect transistors possess ultra-sensitivity and low-noise detection capacity, allowing for immediate analyte determination even in the presence of limited analyte concentrations, which would be typical of early infection stages. Recently, CNT field-effect transistor-type biosensors have been successfully used in the fast diagnosis of COVID-19, which has increased research and commercial interest in exploiting current developments of CNT field-effect transistors. Recent progress in the design and deployment of CNT-based biosensors for viral monitoring are covered in this paper, as are the remaining obstacles and prospects. This work also highlights the enormous potential for synergistic effects of CNTs used in combination with other nanomaterials for viral detection.
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Affiliation(s)
- Hicham Meskher
- Department of Process Engineering, Kasdi-Merbah University Ouargla 30000 Algeria
| | | | - Amrit Kumar Thakur
- Department of Mechanical Engineering, KPR Institute of Engineering and Technology Arasur Coimbatore 641407 Tamil Nadu India
| | - Ravishankar Sathyamurthy
- Mechanical Engineering Department, King Fahd University of Petroleum and Minerals Dhahran 31261 Saudi Arabia
- Interdisciplinary Research Center for Renewable Energy and Power Systems (IRC-REPS), King Fahd University of Petroleum and Minerals Dhahran 31261 Saudi Arabia
| | - Iseult Lynch
- School of Geography, Earth and Environmental Sciences, University of Birmingham Edgbaston Birmingham B15 2TT UK
| | - Punit Singh
- Institute of Engineering and Technology, Department of Mechanical Engineering, GLA University Mathura Uttar Pradesh 281406 India
| | - Tan Kim Han
- Research Centre for Nano-Materials and Energy Technology (RCNMET), School of Engineering and Technology, Sunway University No. 5, Jalan Universiti, Bandar Sunway Petaling Jaya 47500 Malaysia
| | - Rahman Saidur
- Research Centre for Nano-Materials and Energy Technology (RCNMET), School of Engineering and Technology, Sunway University No. 5, Jalan Universiti, Bandar Sunway Petaling Jaya 47500 Malaysia
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Prediction of Angina Pectoris Events in Middle-Aged and Elderly People Using RR Interval Time Series in the Resting State: A Cohort Study Based on SHHS. INT J COMPUT INT SYS 2023. [DOI: 10.1007/s44196-023-00182-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
AbstractAngina pectoris is associated with adverse cardiovascular events. In this study, a Bi-directional Long Short-Term Memory (Bi-LSTM) prediction model with the Attention layer was established to explore the predictive value of the resting-state RR interval time series on the occurrence of angina pectoris. The data of this cohort study were from the Sleep Heart Health Study database, 2,977 people were included with the follow-up of 15 years. We used the RR interval time series of electrocardiogram signals in the resting state. The outcome variables were any angina events during the follow-up. We randomly divided 2,977 participants into training (n = 2680) and testing sets (n = 297) with a partition ratio of 9:1. The prediction model of Bi-LSTM with Attention layer was developed and the predictive performance was assessed. 1,236 had angina pectoris and 1,741 patients did not have angina pectoris during the follow-up period. The predictive performance of the Bi-LSTM model was great with the value of accuracy = 0.913, area under the curve (AUC) = 0.922, precision = 0.913 in the testing set. RR intervals may be the potential predictors of angina events. It is more and more convenient to obtain heart rate with the development of wearable devices; the Bi-LSTM prediction model established in this study is expected to provide support for the intelligent prediction of angina pectoris events.
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84
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Schuetz I, Karimpur H, Fiehler K. vexptoolbox: A software toolbox for human behavior studies using the Vizard virtual reality platform. Behav Res Methods 2023; 55:570-582. [PMID: 35322350 PMCID: PMC10027796 DOI: 10.3758/s13428-022-01831-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2022] [Indexed: 11/08/2022]
Abstract
Virtual reality (VR) is a powerful tool for researchers due to its potential to study dynamic human behavior in highly naturalistic environments while retaining full control over the presented stimuli. Due to advancements in consumer hardware, VR devices are now very affordable and have also started to include technologies such as eye tracking, further extending potential research applications. Rendering engines such as Unity, Unreal, or Vizard now enable researchers to easily create complex VR environments. However, implementing the experimental design can still pose a challenge, and these packages do not provide out-of-the-box support for trial-based behavioral experiments. Here, we present a Python toolbox, designed to facilitate common tasks when developing experiments using the Vizard VR platform. It includes functionality for common tasks like creating, randomizing, and presenting trial-based experimental designs or saving results to standardized file formats. Moreover, the toolbox greatly simplifies continuous recording of eye and body movements using any hardware supported in Vizard. We further implement and describe a simple goal-directed reaching task in VR and show sample data recorded from five volunteers. The toolbox, example code, and data are all available on GitHub under an open-source license. We hope that our toolbox can simplify VR experiment development, reduce code duplication, and aid reproducibility and open-science efforts.
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Affiliation(s)
- Immo Schuetz
- Experimental Psychology, Justus Liebig University, Otto-Behaghel-Str. 10 F, 35394, Giessen, Germany.
- Center for Mind, Brain and Behavior (CMBB), University of Marburg and Justus Liebig University Giessen, Giessen, Germany.
| | - Harun Karimpur
- Experimental Psychology, Justus Liebig University, Otto-Behaghel-Str. 10 F, 35394, Giessen, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg and Justus Liebig University Giessen, Giessen, Germany
| | - Katja Fiehler
- Experimental Psychology, Justus Liebig University, Otto-Behaghel-Str. 10 F, 35394, Giessen, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg and Justus Liebig University Giessen, Giessen, Germany
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Radhakrishnan B. L., Ezra K, Jebadurai IJ. Feature Extraction From Single-Channel EEG Using Tsfresh and Stacked Ensemble Approach for Sleep Stage Classification. INTERNATIONAL JOURNAL OF E-COLLABORATION 2023. [DOI: 10.4018/ijec.316774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The smart world under Industry 4.0 is witnessing a notable spurt in sleep disorders and sleep-related issues in patients. Artificial intelligence and IoT are taking a giant leap in connecting sleep patients remotely with healthcare providers. The contemporary single-channel-based monitoring devices play a tremendous role in predicting sleep quality and related issues. Handcrafted feature extraction is a time-consuming job in machine learning-based automatic sleep classification. The proposed single-channel work uses Tsfresh to extract features from both the EEG channels (Pz-oz and Fpz-Cz) of the SEDFEx database individually to realise a single-channel EEG. The adopted mRMR feature selection approach selected 55 features from the extracted 787 features. A stacking ensemble classifier achieved 95%, 94%, 91%, and 88% accuracy using stratified 5-fold validation in 2, 3, 4, and 5 class classification employing healthy subjects data. The outcome of the experiments indicates that Tsfresh is an excellent tool to extract standard features from EEG signals.
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Affiliation(s)
- Radhakrishnan B. L.
- Department of Computer Science and Engineering, Karunya Institute of Technology and Sciences, Coimbatore, India
| | - Kirubakaran Ezra
- Department of Computer Science and Engineering, GRACE College of Engineering, Thoothukudi, India
| | - Immanuel Johnraja Jebadurai
- Department of Computer Science and Engineering, Karunya Institute of Technology and Sciences, Coimbatore, India
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Moloney M, Doody O, O’Reilly M, Lucey M, Callinan J, Exton C, Colreavy S, O’Mahony F, Meskell P, Coffey A. Virtual reality use and patient outcomes in palliative care: A scoping review. Digit Health 2023; 9:20552076231207574. [PMID: 37928326 PMCID: PMC10621306 DOI: 10.1177/20552076231207574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 09/28/2023] [Indexed: 11/07/2023] Open
Abstract
Objective Virtual reality is increasingly used in healthcare settings. Potentially, it's use in palliative carecould have a positive impact; however, there is limited evidence on the scope, purpose and patient outcomes relating to virtual reality use in this context. The objective of this scoping review is to chart the literature on virtual reality use in palliative care, identifying any evidence relating to biopsychosocial patient outcomes which could support its use in practice. Methods A scoping review of the literature, involving . a systematic search across 10 electronic bibliographic databases in December 2021, . Eligibility criteria were primary research studies, of any research designwithin a 10-year timeframe, which reported on virtual reality use and patient outcomes in palliative care. A total of 993 papers were identified, andcomprehensive screening resulted in 10 papers for inclusion. Results This scoping review identified 10 papers addressing virtual reality in palliative care, published within a three-year timeframe 2019-2021. Research methodologies included mixed methods, quantitative and qualitative. The evidence highlightsvirtual reality use with patients receiving palliative care in a variety of settings, and data around useability, feasibility and acceptability is positive. However, the evidence regarding biopsychosocial patient outcomes linked to virtual reality use is limited. Conclusion Virtual reality is gathering momentum in palliative care and is potentially a helpful intervention; however more research is needed to underpin the evidence base supporting its application, particularly in understanding the impact on biopsychosocial patient outcomes and ascertaining the best approach for measuring intervention effectiveness.
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Affiliation(s)
- Mairead Moloney
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
- Health Implementation Science and Technology, University of Limerick, Limerick, Ireland
| | - Owen Doody
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
- Health Implementation Science and Technology, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | | | | | | | - Chris Exton
- Department of Computer Science and Information Systems, University of Limerick, Limerick, Ireland
| | - Simon Colreavy
- Department of Computer Science and Information Systems, University of Limerick, Limerick, Ireland
| | | | - Pauline Meskell
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Alice Coffey
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
- Health Implementation Science and Technology, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
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van Rijssen IM, Hulst RY, Gorter JW, Gerritsen A, Visser-Meily JMA, Dudink J, Voorman JM, Pillen S, Verschuren O. Device-based and subjective measurements of sleep in children with cerebral palsy: a comparison of sleep diary, actigraphy, and bed sensor data. J Clin Sleep Med 2023; 19:35-43. [PMID: 35975545 PMCID: PMC9806786 DOI: 10.5664/jcsm.10246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 08/11/2022] [Accepted: 08/11/2022] [Indexed: 01/07/2023]
Abstract
STUDY OBJECTIVES To investigate how subjective assessments and device-based measurements of sleep relate to each other in children with cerebral palsy (CP). METHODS Sleep of children with CP, classified at Gross Motor Function Classification System levels I-III, was measured during 7 consecutive nights using 1 subjective (ie, sleep diary) and 2 device-based (ie, actigraphy and bed sensor) instruments. The agreement between the instruments was assessed for all nights and separately for school- and weekend nights, using intraclass correlation coefficients (ICC) and Bland-Altman plots. RESULTS A total of 227 nights from 38 children with CP (53% male; median age [range] 6 [2-12] years), were included in the analyses. Sleep parameters showed poor agreement between the 3 instruments, except for total time in bed, which showed satisfactory agreement between (1) actigraphy and sleep diary (ICC > 0.86), (2) actigraphy and bed sensor (ICC > 0.84), and (3) sleep diary and bed sensor (ICC > 0.83). Furthermore, agreement between sleep diary and bed sensor was also satisfactory for total sleep time (ICC > 0.70) and wakefulness after sleep onset (ICC = 0.55; only during weekend nights). CONCLUSIONS Researchers and clinicians need to be aware of the discrepancies between instruments for sleep monitoring in children with CP. We recommend combining both subjective and device-based measures to provide information on the perception as well as an unbiased estimate of sleep. Further research needs to be conducted on the use of a bed sensor for sleep monitoring in children with CP. CITATION van Rijssen IM, Hulst RY, Gorter JW, et al. Device-based and subjective measurements of sleep in children with cerebral palsy: a comparison of sleep diary, actigraphy, and bed sensor data. J Clin Sleep Med. 2023;19(1):35-43.
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Affiliation(s)
- Ilse Margot van Rijssen
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Raquel Yvette Hulst
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Jan Willem Gorter
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- Department of Rehabilitation, Physical Therapy Science and Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
- CanChild, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Anke Gerritsen
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Johanna Maria Augusta Visser-Meily
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- Department of Rehabilitation, Physical Therapy Science and Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jeroen Dudink
- Department of Neonatology, Wilhelmina Children’s Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Jeanine M. Voorman
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- Department of Rehabilitation, Physical Therapy Science and Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Sigrid Pillen
- Kinderslaapexpert BV (Pediatric Sleep Expert LTd), Mook, The Netherlands
- Department of Electrical Engineering, Technical University Eindhoven, Eindhoven, The Netherlands
| | - Olaf Verschuren
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
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A Novel In-Home Sleep Monitoring System Based on Fully Integrated Multichannel Front-End Chip and Its Multilevel Analyses. IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE 2023; 11:211-222. [PMID: 36950263 PMCID: PMC10027079 DOI: 10.1109/jtehm.2023.3248621] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 01/17/2023] [Accepted: 02/15/2023] [Indexed: 03/06/2023]
Abstract
OBJECTIVE A novel in-home sleep monitoring system with an 8-channel biopotential acquisition front-end chip is presented and validated via multilevel data analyses and comparision with advanced polysomnography. METHODS AND PROCEDURES The chip includes a cascaded low-noise programmable gain amplifier (PGA) and 24-bit [Formula: see text]-[Formula: see text] analog-to-digital converter (ADC). The PGA is based on three op-amp structure while the ADC adopts cascade of integrator feedforward and feedback (CIFF-B) architecture. An innovative chopper-modulated input-scaling-down technique enhances the dynamic range. The proposed system and commercial polysomnography were used for in-home sleep monitoring of 20 healthy participants. The consistency and significance of the two groups' data were analyzed. RESULTS Fabricated in 180 nm BCD technology, the input-referred noise, input impedance, common-mode rejection ratio, and dynamic range of the acquisition front-end chip were [Formula: see text]Vpp, 1.25 GN), 113.9 dB, and 119.8 dB. The kappa coefficients between the sleep stage labels of the three scorers were 0.80, 0.76, and 0.79. The consistency of the slowing index, multiscale entropy, and percentile features between the two devices reached 0.958, 0.885, and 0.834. The macro sleep architecture characteristics of the two devices were not significantly different (all p [Formula: see text] 0.05). CONCLUSION The proposed chip was applied to develop an in-home sleep monitoring system with significantly reduced size, power, and cost. Multilevel analyses demonstrated that this system collects stable and accurate in-home sleep data. CLINICAL IMPACT The proposed system can be applied for long-term in-home sleep monitoring outside of laboratory environments and sleep disorders screening that with low cost.
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Kim H, Cho B, Jung J, Kim J. Attitudes and perspectives of nurses and physicians in South Korea towards the clinical use of person-generated health data. Digit Health 2023; 9:20552076231218133. [PMID: 38033521 PMCID: PMC10685775 DOI: 10.1177/20552076231218133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2023] [Indexed: 12/02/2023] Open
Abstract
This study aimed to explore the adoption of person-generated health data in clinical settings and discern the factors influencing clinicians' willingness to use it. A web-based survey containing 48 questions was developed based on prior research and the Unified Theory of Acceptance and Use of Technology 2 model. The survey was administered to a convenience sample of 486 nurses and physicians in South Korea recruited through an online community and snowball sampling. Of these, 70.7% were physicians. While 65% had used mobile health apps and devices, only 12.8% were familiar with person-generated health data. Still, a promising 73.3% expressed interest in incorporating person-generated health data into patient care, particularly data on blood glucose and vital signs. The findings of the study also indicated that clinicians specializing in internal medicine (OR: 1.9, CI: 1.16-3.19), familiar with person-generated health data (OR: 2.6, CI: 1.58-4.29), with a positive view of information and communication technology adoption (OR: 2.6, CI: 1.65-4.13), and who see the value in person-generated health data (OR: 3.9, CI: 2.55-6.09) showed higher inclination to utilize it. However, those in outpatient settings (OR: 0.4, CI: 0.19-0.73) showed less enthusiasm. The findings of this study suggest that despite the willingness of clinicians to use person-generated health data, various barriers must be addressed first, including a lack of knowledge regarding its use, concerns about data reliability and quality, and a lack of provider incentives. Overcoming these challenges demands concerted organizational or policy support. This research underscores person-generated health data's untapped potential in healthcare and the pressing need for strategies that facilitate its clinical integration.
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Affiliation(s)
- Hyeoneui Kim
- The College of Nursing, Seoul National University, Seoul, Republic of Korea
- The Research Institute of Nursing Science, Seoul National University, Seoul, Republic of Korea
- The Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 Four Project, College of Nursing, Seoul National University, Seoul, Republic of Korea
| | - Boseul Cho
- The College of Nursing, Seoul National University, Seoul, Republic of Korea
- The Critical Care Nursing, Asan Medical Center, Seoul, Republic of Korea
| | - Jinsun Jung
- The College of Nursing, Seoul National University, Seoul, Republic of Korea
- The Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 Four Project, College of Nursing, Seoul National University, Seoul, Republic of Korea
| | - Jinsol Kim
- The College of Nursing, Seoul National University, Seoul, Republic of Korea
- The Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 Four Project, College of Nursing, Seoul National University, Seoul, Republic of Korea
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Branson RD, Rodriquez D. COVID-19 Lessons Learned: Response to the Anticipated Ventilator Shortage. Respir Care 2023; 68:129-150. [PMID: 36566030 PMCID: PMC9993519 DOI: 10.4187/respcare.10676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Early in the COVID-19 pandemic predictions of a worldwide ventilator shortage prompted a worldwide search for solutions. The impetus for the scramble for ventilators was spurred on by inaccurate and often unrealistic predictions of ventilator requirements. Initial efforts looked simply at acquiring as many ventilators as possible from national and international sources. Ventilators from the Strategic National Stockpile were distributed to early hotspots in the Northeast and Northwest United States. In a triumph of emotion over logic, well-intended experts from other industries turned their time, talent, and treasure toward making a ventilator for the first time. Interest in shared ventilation (more than one patient per ventilator) was ignited by an ill-advised video on social media that ignored the principles of gas delivery in deference to social media notoriety. With shared ventilation, a number of groups mistook a physiologic problem for a plumbing problem. The United States government invoked the Defense Production Act to push automotive manufacturers to partner with existing ventilator manufacturers to speed production. The FDA granted emergency use authorization for "splitters" to allow shared ventilation as well as for ventilators and ancillary equipment. Rationing of ventilators was discussed in the lay press and medical literature but was never necessary in the US. Finally, planners realized that staff with expertise in providing mechanical ventilation were the most important shortage. Over 200,000 ventilators were purchased by the United States government, states, cities, health systems, and individuals. Most had little value in caring for patients with COVID-19 ARDS. This paper attempts to look at where miscalculations were made, with an eye toward what we can do better in the future.
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Affiliation(s)
- Richard D Branson
- Division of Trauma/Critical Care, Department of Surgery, University of Cincinnati, Cincinnati, Ohio.
| | - Dario Rodriquez
- Division of Trauma/Critical Care, Department of Surgery, University of Cincinnati, Cincinnati, Ohio; and Airman Biosciences Division, Airman Systems Directorate, Wright-Patterson Air Force Base, Dayton, Ohio
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Smith MJ, Gao Z, Chafe R, Alwashmi M. A mobile health intervention for improving the technique of inhaled medications among children with asthma: A pilot study. Digit Health 2023; 9:20552076231216589. [PMID: 38033513 PMCID: PMC10685774 DOI: 10.1177/20552076231216589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2023] [Indexed: 12/02/2023] Open
Abstract
Objective BreatheSuite MDI is a Bluetooth-enabled inhaler attachment and mobile application which aims to improve asthma control. The objective was to compare pressurized metered dose inhaler (pMDI) technique and asthma control test (ACT) scores pre- and post-use of the device and mobile application. Secondary objectives were to assess user satisfaction and therapy adherence. Methods Patients between the ages of 8 and 18 were recruited from several pediatric asthma clinics. Technique and ACT scores were assessed at baseline. Users were given no prompts on technique during the first month of device use. For the subsequent three months, users were given technique scores through the mobile application after each inhaler use and provided weekly performance summaries. At the end of the study, technique and ACT scores were analyzed and an exit survey was completed. Conditional logistic regression was used to examine the association between well-controlled asthma (ACT score > 19) and the intervention. Results 24 patients completed the study. Technique scores improved following the use of Breathesuite (44.19 vs. 62.54; P = 0.01). Well-controlled asthma did not significantly improve (OR = 1.20 [0.4-3.9], P = 0.76). 87% of study subjects agreed or strongly agreed that their asthma control improved while using BreatheSuite; 79% were satisfied with the device and mobile application; and 91% preferred using the device compared to a standard logbook to track inhaler usage. Conclusions In this pilot study, the use of BreatheSuite device was associated with improved technique scores. These results need to be confirmed by a randomized controlled trial. There was high user satisfaction with the BreatheSuite device.
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Affiliation(s)
- Mary Jane Smith
- Faculty of Medicine, Memorial University of Newfoundland, St John’s, Canada
- Janeway Children’s Health and Rehabilitation Centre, Eastern Health, St John’s, Canada
| | - Zhiwei Gao
- Faculty of Medicine, Memorial University of Newfoundland, St John’s, Canada
| | - Roger Chafe
- Faculty of Medicine, Memorial University of Newfoundland, St John’s, Canada
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Khatun F, Distler R, Rahman M, O'Donnell B, Gachuhi N, Alwani M, Wang Y, Rahman A, Frøen JF, Friberg IK. Comparison of a palm-based biometric solution with a name-based identification system in rural Bangladesh. Glob Health Action 2022; 15:2045769. [PMID: 35343885 PMCID: PMC8967207 DOI: 10.1080/16549716.2022.2045769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Unique identifiers are not universal in low- and middle-income countries. Biometric solutions have the potential to augment existing name-based searches used for identification in these settings. This paper describes a comparison of the searching accuracy of a palm-based biometric solution with a name-based database. Objective To compare the identification of individuals between a palm-based biometric solution to a name-based District Health Information Software 2 (DHIS2) Android application, in a low-resource setting. Methods The study was conducted in Chandpur district, Bangladesh. Trained data collectors enrolled 150 women of reproductive age into two android applications – i) a name-based DHIS2 application, and ii) a palm-based biometric solution – both run on tablets. One week after enrollment, a different research team member attempted to re-identify each enrolled woman using both systems. A single image or text-based name was used for searching at the time of re-identification. We interviewed data collectors at the end of the study. Results Significantly more women were successfully identified on the first attempt with a palm-based biometric application (84%) compared with the name-based DHIS2 application (61%). The proportion of identifications that required three or more attempts was similar between name-based (7%, CI 3.7–12.3) and palm-based biometric system (5%, CI: 1.9–9.4). However, the total number of attempts needed was significantly lower with the palm-based solution (mean 1.2 vs. 1.5, p < 0.001). In a group discussion, data collectors reported that the palm-based biometric identification system was both accurate and easy to use. Conclusion A palm-based biometric identification system on mobile devices was found to be an easy-to-use and accurate technology for the unique identification of individuals compared to an existing name-based application. Our findings imply that palm-based biometrics on mobile devices may be the next step in establishing unique identifiers in remote and rural settings where they are currently absent.
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Affiliation(s)
- Fatema Khatun
- Norwegian Institute of Public Health, Oslo, Norway.,International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | - Monjur Rahman
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | - Noni Gachuhi
- Intellectual Ventures, Global Good Fund, Bellevue, WA, USA
| | | | | | - Anisur Rahman
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - J Frederik Frøen
- Norwegian Institute of Public Health, Oslo, Norway.,University of Bergen, Bergen, Norway
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Garr Barry V, Chiang JL, Bowman KG, Johnson KD, Gower BA. Bioimpedance-Derived Membrane Capacitance: Clinically Relevant Sources of Variability, Precision, and Reliability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:686. [PMID: 36613010 PMCID: PMC9819400 DOI: 10.3390/ijerph20010686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/23/2022] [Accepted: 12/26/2022] [Indexed: 06/17/2023]
Abstract
Membrane capacitance (CM), a bioimpedance-derived measure of cell membrane health, has been suggested as an indicator of health status. However, there are few published data to support its use in clinical settings. Hence, this study evaluated clinically relevant sources of variation, precision, and reliability of CM measurements. This longitudinal study included 60 premenopausal women. Sources of variability (e.g., demographics, body composition, serum measures, diet) were identified by stepwise regression. Precision and reliability were assessed by the coefficient of variation (CV), intraclass correlation coefficients (ICC), and technical error of the measurement (TEM) for intra-day (30 min apart) and inter-day measurements (7-14 days apart). Body composition, temperature, and metabolic activity were identified as sources of variability. CM measurements had high precision (CV = 0.42%) and high reliability for intra-day (ICC = 0.996) and inter-day (ICC = 0.959) measurements, independent of menstrual cycle and obesity status. Our results showed that CM measurements are sensitive to clinical factors and have high precision and reliability. The results of this study suggest that CM is sufficiently reliable for health status monitoring in conditions with variation in body composition, metabolic activity, or body temperature among premenopausal women.
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Affiliation(s)
- Valene Garr Barry
- Department of Obstetrics and Gynecology, Division of Clinical Research, School of Medicine in St. Louis, Washington University, St. Louis, MO 63108, USA
| | - Jasmine L. Chiang
- Department of Obstetrics and Gynecology, School of Medicine, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Kaylan G. Bowman
- Department of Nutrition Sciences, School of Health Professions, The University of Alabama at Birmingham; Birmingham, AL 35294, USA
| | - Kristina D. Johnson
- Department of Nutrition Sciences, School of Health Professions, The University of Alabama at Birmingham; Birmingham, AL 35294, USA
| | - Barbara A. Gower
- Department of Nutrition Sciences, School of Health Professions, The University of Alabama at Birmingham; Birmingham, AL 35294, USA
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Kabir SM, Bhuiyan MIH. Correlated-Weighted Statistically Modeled Contourlet and Curvelet Coefficient Image-Based Breast Tumor Classification Using Deep Learning. Diagnostics (Basel) 2022; 13:diagnostics13010069. [PMID: 36611361 PMCID: PMC9818942 DOI: 10.3390/diagnostics13010069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/14/2022] [Accepted: 12/22/2022] [Indexed: 12/28/2022] Open
Abstract
Deep learning-based automatic classification of breast tumors using parametric imaging techniques from ultrasound (US) B-mode images is still an exciting research area. The Rician inverse Gaussian (RiIG) distribution is currently emerging as an appropriate example of statistical modeling. This study presents a new approach of correlated-weighted contourlet-transformed RiIG (CWCtr-RiIG) and curvelet-transformed RiIG (CWCrv-RiIG) image-based deep convolutional neural network (CNN) architecture for breast tumor classification from B-mode ultrasound images. A comparative study with other statistical models, such as Nakagami and normal inverse Gaussian (NIG) distributions, is also experienced here. The weighted entitled here is for weighting the contourlet and curvelet sub-band coefficient images by correlation with their corresponding RiIG statistically modeled images. By taking into account three freely accessible datasets (Mendeley, UDIAT, and BUSI), it is demonstrated that the proposed approach can provide more than 98 percent accuracy, sensitivity, specificity, NPV, and PPV values using the CWCtr-RiIG images. On the same datasets, the suggested method offers superior classification performance to several other existing strategies.
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Affiliation(s)
- Shahriar M. Kabir
- Department of Electrical and Electronic Engineering, Green University of Bangladesh, Dhaka 1207, Bangladesh
- Department of Electrical and Electronic Engineering, Bangladesh University of Engineering and Technology, Dhaka 1000, Bangladesh
- Correspondence: ; Tel.: +88-017-6461-0728
| | - Mohammed I. H. Bhuiyan
- Department of Electrical and Electronic Engineering, Bangladesh University of Engineering and Technology, Dhaka 1000, Bangladesh
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95
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Gaboury I, Dostie R, Corriveau H, Demoustier A, Tousignant M. Use of a Telerehabilitation Platform in a Stroke Continuum: A Qualitative Study of Patient and Therapist Acceptability. Int J Telerehabil 2022; 14:e6453. [PMID: 38026556 PMCID: PMC10681045 DOI: 10.5195/ijt.2022.6453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
The purpose of this study was to describe the acceptability of a stroke telerehabilitation platform from the perspective of both patients and therapists. Two public rehabilitation centers participated in a pilot telerehabilitation trial. A theoretical framework was used to conceptualize acceptability. Semi-structured individual interviews with patients and focus groups of therapists were conducted. Most participants and therapists were satisfied with the intervention. Participants emphasized the advantages of staying at home to get their treatments. Therapists were more skeptical at first about their self-efficacy to deliver therapy remotely. There was a consensus among therapists about the need for a combination of telerehabilitation and in-person visits to optimize treatments. While we found overall good acceptability, effectiveness of this technology could be improved via an accessible user interface, complementary rehabilitation material, and ongoing training and technical just-in-time support with therapists.
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Affiliation(s)
- Isabelle Gaboury
- Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Longueuil, Québec, Canada
| | - Rosalie Dostie
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Hélène Corriveau
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Arnaud Demoustier
- School of Nursing, Université de Sherbrooke, Longueuil, Québec, Canada
| | - Michel Tousignant
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Québec, Canada
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96
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Whiston A, Igou ER, Fortune DG, Semkovska M. Examining Stress and Residual Symptoms in Remitted and Partially Remitted Depression Using a Wearable Electrodermal Activity Device: A Pilot Study. IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE 2022; 11:96-106. [PMID: 36644642 PMCID: PMC9833495 DOI: 10.1109/jtehm.2022.3228483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 11/06/2022] [Accepted: 11/30/2022] [Indexed: 12/15/2022]
Abstract
Consistent evidence suggests residual symptoms and stress are the most reliable predictors of relapse in remitted depression. Prevailing methodologies often do not enable continuous real-time sampling of stress. Thus, little is known about day-to-day interactions between residual symptoms and stress in remitted depression. In preparation for a full-scale trial, this study aimed to pilot a wrist-worn wearable electrodermal activity monitor: ADI (Analog Devices, Inc.) Study Watch for assessing interactions between physiological stress and residual depressive symptoms following depression remission. 13 individuals remitted from major depression completed baseline, daily diary, and post-daily diary assessments. Self-reported stress and residual symptoms were measured at baseline and post-daily diary. Diary assessments required participants to wear ADI's Study Watch during waking hours and complete self-report questionnaires every evening over one week. Sleep problems, fatigue, energy loss, and agitation were the most frequently reported residual symptoms. Average skin conductance responses (SCRs) were 16.09 per-hour, with an average of 11.30 hours of wear time per-day. Increased residual symptoms were associated with enhanced self-reported stress on the same day. Increased SCRs on one day predicted increased residual symptoms on the next day. This study showed a wearable electrodermal activity device can be recommended for examining stress as a predictor of remitted depression. This study also provides preliminary work on relationships between residual symptoms and stress in remitted depression. Importantly, significant findings from the small sample of this pilot are preliminary with an aim to follow up with a 3-week full-scale study to draw conclusions about psychological processes explored. Clinical and Translational Impact Statemen-ADI's wearable electrodermal activity device enables a continuous measure of physiological stress for identifying its interactions with residual depressive symptoms following remission. This novel procedure is promising for future studies.
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Affiliation(s)
- Aoife Whiston
- Department of PsychologyUniversity of Limerick Limerick V94 T9PX Ireland
| | - Eric R Igou
- Department of PsychologyUniversity of Limerick Limerick V94 T9PX Ireland
| | - Donal G Fortune
- Department of PsychologyUniversity of Limerick Limerick V94 T9PX Ireland
| | - Maria Semkovska
- Department of PsychologyUniversity of Southern Denmark 5230 Odense Denmark
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97
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Healy D, Flynn A, Conlan O, McSharry J, Walsh J. Older Adults' Experiences and Perceptions of Immersive Virtual Reality: Systematic Review and Thematic Synthesis. JMIR Serious Games 2022; 10:e35802. [PMID: 36472894 PMCID: PMC9768659 DOI: 10.2196/35802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 05/30/2022] [Accepted: 06/12/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Immersive virtual reality (IVR) can be defined as a fully computer-generated environment shown on a head-mounted display. Existing research suggests that key features of IVR can assist older adults in their everyday lives, providing opportunities for health promotion and tackling social isolation and loneliness. There has been a surge in qualitative studies exploring older adults' experiences and perceptions of IVR. However, there has been no systematic synthesis of these studies to inform the design of new, more accessible IVR technologies. OBJECTIVE This study aimed to systematically review and synthesize qualitative studies exploring older adults' experiences and perceptions of IVR. METHODS A systematic review and thematic synthesis were conducted following the ENTREQ (Enhancing Transparency in Reporting the Synthesis of Qualitative Research) guidelines. In total, 2 reviewers completed title and abstract screening, full-text screening, data extraction, and quality appraisal. Thematic synthesis is derived from the qualitative method, thematic analysis. It involves 3 key steps: initial coding and grouping of these codes, the formation of descriptive themes from these codes, and going beyond these data to form analytical themes. Confidence in the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation-Confidence in the Evidence from Reviews of Qualitative Research approach. RESULTS Overall, 13 studies were included in the final synthesis, including 224 participants across 9 countries and 5 continents. Confidence in the evidence ranged from high to moderate. Three descriptive themes were generated: practical aspects of IVR use, experiencing unique features of IVR, and perceptions of IVR. The findings from the descriptive themes suggested that there are several improvements that need to be made to existing IVR devices to facilitate older adults' use of this technology. However, older adults' responses to IVR were generally positive. Three analytical themes were generated: tolerating the bad to experience the good, buying in to IVR (don't judge a book by its cover), and "it proves to me I can do it." The analytical themes illustrated that older adults were willing to tolerate discomforts that accompany existing IVR technologies to experience features such as immersive social networking. There was a discrepancy between older adults' perceptions of IVR before use-which were generally negative-and after use-which were generally positive-and IVR provided a platform for older adults to access certain activities and environments more easily than in the real world because of limitations caused by aging. CONCLUSIONS This review offers insights into older adults' experiences and perceptions of IVR and suggests how a few improvements to its existing hardware and software as well as how it is first presented could offer new opportunities for older adults to take part in meaningful activities tailored to their needs and preferences. TRIAL REGISTRATION PROSPERO CRD42020200774; https://tinyurl.com/8f48w2vt. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1177/16094069211009682.
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Affiliation(s)
- David Healy
- School of Psychology, University of Galway, Galway, Ireland
| | - Aisling Flynn
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
| | - Owen Conlan
- School of Computer Science and Statistics, Trinity College Dublin, Dublin, Ireland
| | - Jenny McSharry
- School of Psychology, University of Galway, Galway, Ireland
| | - Jane Walsh
- School of Psychology, University of Galway, Galway, Ireland
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98
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Saracoglu H, Baskol M, Saracoglu H, Baskol G. If AFP is elevated, where is cancer? The case report on hereditary persistence of Alpha-fetoprotein. Malawi Med J 2022; 34:291-293. [PMID: 38125776 PMCID: PMC10645828 DOI: 10.4314/mmj.v34i4.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
Alpha-fetoprotein (AFP) is expressed by tumors with a high mitotic index such as hepatocellular carcinoma and germ cell tumors, therefore it is used as a tumor biomarker. Interestingly, although there is no underlying cause, elevated AFP has been reported in some genetically predisposed individuals. This is a very rare and benign condition called "hereditary persistence of AFP (HPAFP)" and an inherited in an autosomal dominant manner. To our knowledge, only 28 families have been reported to date. Some of the reported cases received inappropriate treatments such as chemotherapy and surgery. The possibility of HPAFP should be kept in mind in patients with high AFP in the absence of radiological evidence of hepatocellular carcinoma or germ cell tumor to avoid harmful procedures. It can be easily confirmed by analyzing AFP levels in other family members. We report a case of HPAFP with surprisingly higher AFP levels than previously reported cases and this is the first case reported from Turkey.
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Affiliation(s)
- Hatice Saracoglu
- Department of Medical Biochemistry, Faculty of Medicine, Erciyes University, Kayseri/Turkey
| | - Mevlut Baskol
- Department of Gastroenterology, Faculty of Medicine, Erciyes University, Kayseri/Turkey
| | - Hakan Saracoglu
- Department of Internal Medicine, Faculty of Medicine, Erciyes University, Kayseri/Turkey
| | - Gulden Baskol
- Department of Medical Biochemistry, Faculty of Medicine, Erciyes University, Kayseri/Turkey
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99
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Veiko V, Karlagina Y, Zernitckaia E, Egorova E, Radaev M, Yaremenko A, Chernenko G, Romanov V, Shchedrina N, Ivanova E, Chichkov B, Odintsova G. Laser-Induced µ-Rooms for Osteocytes on Implant Surface: An In Vivo Study. NANOMATERIALS (BASEL, SWITZERLAND) 2022; 12:4229. [PMID: 36500852 PMCID: PMC9737095 DOI: 10.3390/nano12234229] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 11/21/2022] [Accepted: 11/25/2022] [Indexed: 06/17/2023]
Abstract
Laser processing of dental implant surfaces is becoming a more widespread replacement for classical techniques due to its undeniable advantages, including control of oxide formation and structure and surface relief at the microscale. Thus, using a laser, we created several biomimetic topographies of various shapes on the surface of titanium screw-shaped implants to research their success and survival rates. A distinctive feature of the topographies is the presence of "µ-rooms", which are special spaces created by the depressions and elevations and are analogous to the µ-sized room in which the osteocyte will potentially live. We conducted the comparable in vivo study using dental implants with continuous (G-topography with µ-canals), discrete (S-topography with μ-cavities), and irregular (I-topography) laser-induced topographies. A histological analysis performed with the statistical method (with p-value less than 0.05) was conducted, which showed that G-topography had the highest BIC parameter and contained the highest number of mature osteocytes, indicating the best secondary stability and osseointegration.
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Affiliation(s)
- Vadim Veiko
- Institute of Laser Technologies, ITMO University, Saint-Petersburg 197101, Russia
| | - Yuliya Karlagina
- Institute of Laser Technologies, ITMO University, Saint-Petersburg 197101, Russia
| | - Ekaterina Zernitckaia
- Department of Dental Surgery and Maxillofacial Surgery, Pavlov First Saint-Petersburg State Medical University, Saint-Petersburg 197022, Russia
| | - Elena Egorova
- Institute of Laser Technologies, ITMO University, Saint-Petersburg 197101, Russia
| | - Maxim Radaev
- Institute of Laser Technologies, ITMO University, Saint-Petersburg 197101, Russia
| | - Andrey Yaremenko
- Department of Dental Surgery and Maxillofacial Surgery, Pavlov First Saint-Petersburg State Medical University, Saint-Petersburg 197022, Russia
| | - Gennadiy Chernenko
- Lenmiriot Dental Implant Prosthetics Manufacture, Saint-Petersburg 193079, Russia
| | - Valery Romanov
- Institute of Laser Technologies, ITMO University, Saint-Petersburg 197101, Russia
| | - Nadezhda Shchedrina
- Institute of Laser Technologies, ITMO University, Saint-Petersburg 197101, Russia
| | - Elena Ivanova
- STEM, School of Science, RMIT University, Melbourne 3000, Australia
| | - Boris Chichkov
- Institute of Quantum Optics, Leibniz University of Hanover, 30167 Hannover, Germany
| | - Galina Odintsova
- Institute of Laser Technologies, ITMO University, Saint-Petersburg 197101, Russia
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100
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Epalte K, Grjadovojs A, Bērziņa G. Use of the digital assistant “Vigo” at home environment for stroke recovery: focus group discussion with specialists working in neurorehabilitation (Preprint). JMIR Rehabil Assist Technol 2022; 10:e44285. [PMID: 37058334 PMCID: PMC10148207 DOI: 10.2196/44285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/03/2023] [Accepted: 03/04/2023] [Indexed: 03/07/2023] Open
Abstract
BACKGROUND There is a lack of resources for the provision of adequate rehabilitation after a stroke, thus creating a challenge to provide the necessary high-quality, patient-centered, and cost-efficient rehabilitation services at a time when they are needed the most. Tablet-based therapeutic programs present an alternative way to access rehabilitation services and show a new paradigm for providing therapeutic interventions following a stroke anytime and anywhere. The digital assistant Vigo is an artificial intelligence-based app that provides an opportunity for a new, more integrative way of carrying out a home-based rehabilitation program. Considering the complexity of the stroke recovery process, factors such as a suitable population, appropriate timing, setting, and the necessary patient-specialist support structure need to be thoroughly researched. There is a lack of qualitative research exploring the perspectives of professionals working in neurorehabilitation of the content and usability of the digital tool for the recovery of patients after a stroke. OBJECTIVE The aim of this study is to identify the requirements for a tablet-based home rehabilitation program for stroke recovery from the perspective of a specialist working in stroke rehabilitation. METHODS The focus group study method was chosen to explore specialists' attitudes, experience, and expectations related to the use of the digital assistant Vigo as a home-based rehabilitation program for stroke recovery in domains of the app's functionality, compliance, usability, and content. RESULTS In total, 3 focus groups were conducted with a participant count of 5-6 per group and the duration of the discussion ranging from 70 to 80 minutes. In total, 17 health care professionals participated in the focus group discussions. The participants represented physiotherapists (n=7, 41.2%), occupational therapists (n=7, 41.2%), speech and language therapists (n=2, 11.8%), and physical medicine and rehabilitation physicians (n=1, 5.9%). Audio and video recordings of each discussion were created for further transcription and analysis. In total, 4 themes were identified: (1) the clinician's views on using Vigo as a home-based rehabilitation system, (2) patient-related circumstances facilitating and limiting the use of Vigo; (3) Vigo's functionality and use process (program creation, individual use, remote support); and (4) complementary and alternative Vigo use perspectives. The last 3 themes were divided further into 10 subthemes, and 2 subthemes had 2 sub-subthemes each. CONCLUSIONS Health care professionals expressed a positive attitude toward the usability of the Vigo app. It is important that the content and use of the app be coherent with the aim to avoid (1) misunderstanding its practical use and the need for integration in practice and (2) misusing the app. In all focus groups, the importance of close involvement of rehabilitation specialists in the process of app development and research was highlighted.
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Affiliation(s)
- Klinta Epalte
- Department of Rehabilitation, Riga Stradiņš University, Riga, Latvia
| | | | - Guna Bērziņa
- Department of Rehabilitation, Riga Stradiņš University, Riga, Latvia
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