Investigation of an Indoor Air Quality Sensor for Asthma Management in Children

Real-Time Learning and Monitoring System in Fighting against SARS-CoV-2 in a Private Indoor Environment

The SARS-CoV-2 virus has posed formidable challenges that must be tackled through scientific and technological investigations on each environmental scale. This research aims to learn and report about the current state of user activities, in real-time, in a specially designed private indoor environment with sensors in infection transmission control of SARS-CoV-2. Thus, a real-time learning system that evolves and updates with each incoming piece of data from the environment is developed to predict user activities categorized for remote monitoring. Accordingly, various experiments are conducted in the private indoor space. Multiple sensors, with their inputs, are analyzed through the experiments. The experiment environment, installed with microgrids and Internet of Things (IoT) devices, has provided correlating data of various sensors from that special care context during the pandemic. The data is applied to classify user activities and develop a real-time learning and monitoring system to predict the IoT data. The microgrids were operated with the real-time learning system developed by comprehensive experiments on classification learning, regression learning, Error-Correcting Output Codes (ECOC), and deep learning models. With the help of machine learning experiments, data optimization, and the multilayered-tandem organization of the developed neural networks, the efficiency of this real-time monitoring system increases in learning the activity of users and predicting their actions, which are reported as feedback on the monitoring interfaces. The developed learning system predicts the real-time IoT data, accurately, in less than 5 milliseconds and generates big data that can be deployed for different usages in larger-scale facilities, networks, and e-health services.

Real-Time In-Vehicle Air Quality Monitoring System Using Machine Learning Prediction Algorithm

This paper presents the development of a real-time cloud-based in-vehicle air quality monitoring system that enables the prediction of the current and future cabin air quality. The designed system provides predictive analytics using machine learning algorithms that can measure the drivers’ drowsiness and fatigue based on the air quality presented in the cabin car. It consists of five sensors that measure the level of CO₂, particulate matter, vehicle speed, temperature, and humidity. Data from these sensors were collected in real-time from the vehicle cabin and stored in the cloud database. A predictive model using multilayer perceptron, support vector regression, and linear regression was developed to analyze the data and predict the future condition of in-vehicle air quality. The performance of these models was evaluated using the Root Mean Square Error, Mean Squared Error, Mean Absolute Error, and coefficient of determination (R²). The results showed that the support vector regression achieved excellent performance with the highest linearity between the predicted and actual data with an R² of 0.9981.

An Approximation for Metal-Oxide Sensor Calibration for Air Quality Monitoring Using Multivariable Statistical Analysis

Good air quality is essential for both human beings and the environment in general. The three most harmful air pollutants are nitrogen dioxide (NO₂), ozone (O₃) and particulate matter. Due to the high cost of monitoring stations, few examples of this type of infrastructure exist, and the use of low-cost sensors could help in air quality monitoring. The cost of metal-oxide sensors (MOS) is usually below EUR 10 and they maintain small dimensions, but their use in air quality monitoring is only valid through an exhaustive calibration process and subsequent precision analysis. We present an on-field calibration technique, based on the least squares method, to fit regression models for low-cost MOS sensors, one that has two main advantages: it can be easily applied by non-expert operators, and it can be used even with only a small amount of calibration data. In addition, the proposed method is adaptive, and the calibration can be refined as more data becomes available. We apply and evaluate the technique with a real dataset from a particular area in the south of Spain (Granada city). The evaluation results show that, despite the simplicity of the technique and the low quantity of data, the accuracy obtained with the low-cost MOS sensors is high enough to be used for air quality monitoring.

Determination of Personalized Asthma Triggers From Multimodal Sensing and a Mobile App: Observational Study

BACKGROUND

Asthma is a chronic pulmonary disease with multiple triggers. It can be managed by strict adherence to an asthma care plan and by avoiding these triggers. Clinicians cannot continuously monitor their patients' environment and their adherence to an asthma care plan, which poses a significant challenge for asthma management.

OBJECTIVE

In this study, pediatric patients were continuously monitored using low-cost sensors to collect asthma-relevant information. The objective of this study was to assess whether kHealth kit, which contains low-cost sensors, can identify personalized triggers and provide actionable insights to clinicians for the development of a tailored asthma care plan.

METHODS

The kHealth asthma kit was developed to continuously track the symptoms of asthma in pediatric patients and monitor the patients' environment and adherence to their care plan for either 1 or 3 months. The kit consists of an Android app-based questionnaire to collect information on asthma symptoms and medication intake, Fitbit to track sleep and activity, the Peak Flow meter to monitor lung functions, and Foobot to monitor indoor air quality. The data on the patient's outdoor environment were collected using third-party Web services based on the patient's zip code. To date, 107 patients consented to participate in the study and were recruited from the Dayton Children's Hospital, of which 83 patients completed the study as instructed.

RESULTS

Patient-generated health data from the 83 patients who completed the study were included in the cohort-level analysis. Of the 19% (16/83) of patients deployed in spring, the symptoms of 63% (10/16) and 19% (3/16) of patients suggested pollen and particulate matter (PM2.5), respectively, to be their major asthma triggers. Of the 17% (14/83) of patients deployed in fall, symptoms of 29% (4/17) and 21% (3/17) of patients suggested pollen and PM2.5, respectively, to be their major triggers. Among the 28% (23/83) of patients deployed in winter, PM2.5 was identified as the major trigger for 83% (19/23) of patients. Similar correlations were not observed between asthma symptoms and factors such as ozone level, temperature, and humidity. Furthermore, 1 patient from each season was chosen to explain, in detail, his or her personalized triggers by observing temporal associations between triggers and asthma symptoms gathered using the kHealth asthma kit.

CONCLUSIONS

The continuous monitoring of pediatric asthma patients using the kHealth asthma kit generates insights on the relationship between their asthma symptoms and triggers across different seasons. This can ultimately inform personalized asthma management and intervention plans.

The effects of filters for an intelligent air pollutant control system considering natural ventilation and the occupants

Experimental analysis was conducted on the indoor air pollutant concentration using natural ventilation and filters. The study targeted two office rooms each of which was occupied by four people, and with the same outdoor environments. A non-woven fabric filter (room A) and an electrostatic filter (room B) were installed on the window frame, and the indoor air pollutant concentration and indoor climate factors were monitored based on the number of occupants and the occupants' activities. The results are as follows: (i) when the number of occupants in each room increased from 0.03-0.06 to 1.53-1.63, room A showed a 60% average PM₁₀ concentration increase while room B showed an opposite result (10% average PM₁₀ concentration decrease), meaning the electrostatic filter's lower resistance to flow contributed to better ventilation and also decreased the influence of the occupants on the indoor air pollutant concentration. A low correlation (0.323-0.350) between the CO₂ concentration and the occupants in room B also proved these results; (ii) while the average PM₁₀ concentration in room A was 9 μg/m³ higher than that in room B, the average PM_2.5 concentration in room A was higher by only 0.2 μg/m³, which showing that much of the generated or resuspended indoor particulate matter was PM₁₀; and (iii) due to the more frequent heat transfer from outdoors to indoors, room B consumed 23% more heating energy. The results of this study are expected to be used as bases for the establishment of an appropriate management strategy that considers the indoor air pollutant concentration caused by the number of occupants and occupants' activities by combining natural ventilation and filters.

"How Is My Child's Asthma?" Digital Phenotype and Actionable Insights for Pediatric Asthma

BACKGROUND

In the traditional asthma management protocol, a child meets with a clinician infrequently, once in 3 to 6 months, and is assessed using the Asthma Control Test questionnaire. This information is inadequate for timely determination of asthma control, compliance, precise diagnosis of the cause, and assessing the effectiveness of the treatment plan. The continuous monitoring and improved tracking of the child's symptoms, activities, sleep, and treatment adherence can allow precise determination of asthma triggers and a reliable assessment of medication compliance and effectiveness. Digital phenotyping refers to moment-by-moment quantification of the individual-level human phenotype in situ using data from personal digital devices, in particular, mobile phones. The kHealth kit consists of a mobile app, provided on an Android tablet, that asks timely and contextually relevant questions related to asthma symptoms, medication intake, reduced activity because of symptoms, and nighttime awakenings; a Fitbit to monitor activity and sleep; a Microlife Peak Flow Meter to monitor the peak expiratory flow and forced exhaled volume in 1 second; and a Foobot to monitor indoor air quality. The kHealth cloud stores personal health data and environmental data collected using Web services. The kHealth Dashboard interactively visualizes the collected data.

OBJECTIVE

The objective of this study was to discuss the usability and feasibility of collecting clinically relevant data to help clinicians diagnose or intervene in a child's care plan by using the kHealth system for continuous and comprehensive monitoring of child's symptoms, activity, sleep pattern, environmental triggers, and compliance. The kHealth system helps in deriving actionable insights to help manage asthma at both the personal and cohort levels. The Digital Phenotype Score and Controller Compliance Score introduced in the study are the basis of ongoing work on addressing personalized asthma care and answer questions such as, "How can I help my child better adhere to care instructions and reduce future exacerbation?"

METHODS

The Digital Phenotype Score and Controller Compliance Score summarize the child's condition from the data collected using the kHealth kit to provide actionable insights. The Digital Phenotype Score formalizes the asthma control level using data about symptoms, rescue medication usage, activity level, and sleep pattern. The Compliance Score captures how well the child is complying with the treatment protocol. We monitored and analyzed data for 95 children, each recruited for a 1- or 3-month-long study. The Asthma Control Test scores obtained from the medical records of 57 children were used to validate the asthma control levels calculated using the Digital Phenotype Scores.

RESULTS

At the cohort level, we found asthma was very poorly controlled in 37% (30/82) of the children, not well controlled in 26% (21/82), and well controlled in 38% (31/82). Among the very poorly controlled children (n=30), we found 30% (9/30) were highly compliant toward their controller medication intake-suggesting a re-evaluation for change in medication or dosage-whereas 50% (15/30) were poorly compliant and candidates for a more timely intervention to improve compliance to mitigate their situation. We observed a negative Kendall Tau correlation between Asthma Control Test scores and Digital Phenotype Score as -0.509 (P<.01).

CONCLUSIONS

kHealth kit is suitable for the collection of clinically relevant information from pediatric patients. Furthermore, Digital Phenotype Score and Controller Compliance Score, computed based on the continuous digital monitoring, provide the clinician with timely and detailed evidence of a child's asthma-related condition when compared with the Asthma Control Test scores taken infrequently during clinic visits.

Augmented Personalized Health: How Smart Data with IoTs and AI is about to Change Healthcare

Healthcare as we know it is in the process of going through a massive change - from episodic to continuous, from disease focused to wellness and quality of life focused, from clinic centric to anywhere a patient is, from clinician controlled to patient empowered, and from being driven by limited data to 360-degree, multimodal personal-public-population physical-cyber-social big data driven. While ability to create and capture data is already here, the upcoming innovations will be in converting this big data into smart data through contextual and personalized processing such that patients and clinicians can make better decisions and take timely actions for augmented personalized health. This paper outlines current opportunities and challenges, with a focus on key AI approaches to make this a reality. The broader vision is exemplified using three ongoing applications (asthma in children, bariatric surgery, and pain management) as part of the Kno.e.sis kHealth personalized digital health initiative.

Feasibility of a Secure Wireless Sensing Smartwatch Application for the Self-Management of Pediatric Asthma

To address the need for asthma self-management in pediatrics, the authors present the feasibility of a mobile health (mHealth) platform built on their prior work in an asthmatic adult and child. Real-time asthma attack risk was assessed through physiological and environmental sensors. Data were sent to a cloud via a smartwatch application (app) using Health Insurance Portability and Accountability Act (HIPAA)-compliant cryptography and combined with online source data. A risk level (high, medium or low) was determined using a random forest classifier and then sent to the app to be visualized as animated dragon graphics for easy interpretation by children. The feasibility of the system was first tested on an adult with moderate asthma, then usability was examined on a child with mild asthma over several weeks. It was found during feasibility testing that the system is able to assess asthma risk with 80.10 ± 14.13% accuracy. During usability testing, it was able to continuously collect sensor data, and the child was able to wear, easily understand and enjoy the use of the system. If tested in more individuals, this system may lead to an effective self-management program that can reduce hospitalization in those who suffer from asthma.

PhD Forum: Multimodal IoT and EMR based Smart Health Application for Asthma Management in Children

According to a study done in 2014 by National Health Interview Survey around 6.3 million children in United States suffer from asthma [1]. Asthma remains one of the leading reasons for pediatric admissions to children's hospitals, and has a prevalence rate of approximately 10% in children and it leads to missed days from school and other societal costs. This occurs despite improved medications to control asthma symptoms. Asthma management is challenging as it involves understanding asthma causes and avoiding asthma triggers that are both multi-factorial and individualistic in nature. It is almost impossible for doctors to constantly monitor each patient's health and environmental triggers. According to a recent article, the IoT device market in health-care will increase to a worth of $117 billion by the year 2020 [2]. The monitoring segment of IoT devices have predicted to increase $15 billion in 2017 [5]. The sales of smart watches, fitness and health trackers, are expected to account for more than 70% of all wearables sale worldwide in 2016 [6]. According to IBM, the volume of health-care data has reached to 150 exabytes in 2017 [7]. The data generated from these consumer graded devices is increasing day by day. This data collection has exacerbated the problem of understanding the data and making sense of it.