Design and Implementation of Wireless Point-Of-Care Health Monitoring Systems: Diagnosis For Sleep Disorders and Cardiovascular Diseases

Chronic sleep disorders are present in 40 million people in the United States. More than 25 million people remain undiagnosed and untreated, which accounts for over $22 billion in unnecessary healthcare costs. In addition, another major chronic disease is the heart diseases which cause 23.8% of the deaths in the United States. Thus, there is a need for a low cost, reliable, and ubiquitous patient monitoring system. A remote point-of-care system can satisfy this need by providing real time monitoring of the patient\u27s health condition at remote places. However, the currently available POC systems have some drawbacks; the fixed number of physiological channels and lack of real time monitoring. In this dissertation, several remote POC systems are reported to diagnose sleep disorders and cardiovascular diseases to overcome the drawbacks of the current systems. First, two types of remote POC systems were developed for sleep disorders. One was designed with ZigBee and Wi-Fi network, which provides increase/decrease the number of physiological channels flexibly by using ZigBee star network. It also supports the remote real-time monitoring by extending WPAN to WLAN with combination of two wireless communication topologies, ZigBee and Wi-Fi. The other system was designed with GSM/WCDMA network, which removes the restriction of testing places and provides remote real-time monitoring in the true sense of the word. Second, a fully wearable textile integrated real-time ECG acquisition system for football players was developed to prevent sudden cardiac death. To reduce power consumption, adaptive RF output power control was implemented based on RSSI and the power consumption was reduced up to 20%. Third, as an application of measuring physiological signals, a wireless brain machine interface by using the extracted features of EOG and EEG was implemented to control the movement of a robot. The acceleration/deceleration of the robot is controlled based on the attention level from EEG. The left/right motion of eyeballs of EOG is used to control the direction of the robot. The accuracy rate was about 95%. These kinds of health monitoring systems can reduce the exponentially increasing healthcare costs and cater the most important healthcare needs of the society

The feasibility of the Emfit movement sensor as an automated screening tool for sleep apnea in the ischemic stroke patients

Stroke is a common cause of death and a major reason for disability. Stroke survivors can have very difficult symptoms and require very intensive and expensive rehabilitation. Sleep disordered breathing, sleep apnea, is common among stroke patients, it's a high risk factor for recurrent stroke and untreated sleep apnea has a negative influence on the stroke recovery. All stroke patients are recommended to be measured for sleep apnea, but the lack of resources don't allow it. Therefore there is a need for a screening tool to find the stroke patients who need the measurement most and who benefit the most of the treatment of the sleep apnea. We studied the possibility to use the Emfit movement sensor combined with a pulse oximeter as a screening tool. The Emfit movement sensor doesn't have connections to the patient, therefore it wouldn't require lots of resources to set up the measurement and there are no contacts that can cause interference during the measurement. The automatic scoring of the measurement would remove the need for an expert to manually score every measurement. The test subjects were measured at the same night using both the Emfit movement sensor and a conventional respiratory polygraphy device. The Emfit movement sensor and the standard respiratory polygraphy measurements were scored using Noxturnal's automatic analysis tool and the results were compared. The results were also compared to the manual scoring of the standard respiratory polygraphy. The Emfit movement sensor measurement slightly overestimates the apnea hypopnea index, as does the automatically scored standard respiratory polygraphy too. The automatic analysis ability to detect correctly the duration and timing of a respiratory event in the Emfit movement sensor measurement seems to depend on the amount of noise in the measurement. Our study indicates that the Emfit movement sensor has potential to be used as a screening tool for sleep apnea in the ischemic stroke patients, but the automatic analysis still needs improvements to provide more accurate results

Effects of dance therapy on balance, gait and neuro-psychological performances in patients with Parkinson's disease and postural instability

Postural Instability (PI) is a core feature of Parkinson’s Disease (PD) and a major cause of falls and disabilities. Impairment of executive functions has been called as an aggravating factor on motor performances. Dance therapy has been shown effective for improving gait and has been suggested as an alternative rehabilitative method. To evaluate gait performance, spatial-temporal (S-T) gait parameters and cognitive performances in a cohort of patients with PD and PI modifications in balance after a cycle of dance therapy

Southwest Research Institute assistance to NASA in biomedical areas of the technology utilization program

The activities are reported of the NASA Biomedical Applications Team at Southwest Research Institute between 25 August, 1972 and 15 November, 1973. The program background and methodology are discussed along with the technology applications, and biomedical community impacts

Biomarkers of conversion to alpha-synucleinopathy in isolated rapid-eye-movement sleep behaviour disorder

Patients with isolated rapid-eye-movement sleep behaviour disorder (RBD) are commonly regarded as being in the early stages of a progressive neurodegenerative disease involving \u3b1-synuclein pathology, such as Parkinson's disease, dementia with Lewy bodies, or multiple system atrophy. Abnormal \u3b1-synuclein deposition occurs early in the neurodegenerative process across the central and peripheral nervous systems and might precede the appearance of motor symptoms and cognitive decline by several decades. These findings provide the rationale to develop reliable biomarkers that can better predict conversion to clinically manifest \u3b1-synucleinopathies. In addition, biomarkers of disease progression will be essential to monitor treatment response once disease-modifying therapies become available, and biomarkers of disease subtype will be essential to enable prediction of which subtype of \u3b1-synucleinopathy patients with isolated RBD might develop

MRI in vertebral artery dissection (multiple letters) [9]

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Sleep Medicine and the Evolution of Contemporary Sleep Pharmacotherapy

Sleep is a fundamental physiological feature experienced by all known mammalian, and most non-mammalian, species. Underscoring its importance is the wide array of neural and cellular processes that have evolved to govern when and how it occurs, its duration, sequence of phases, and the influence it exerts on numerous other brain functions. This book takes up the growing prevalence of sleep disorders affecting these processes and the panorama of pharmaceutical tools that have evolved for their medical care. Its wide-ranging discussion promises not only recent updates on their clinical management but a contemporary window into sleep’s cross-cutting relevance for the many neurological dysfunctions now known to associate with sleep disturbances

The perception, aetiology and clinical assessment of restless legs syndrome and periodic limb movements

thesis submitted to the Faculty of Science, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree Doctor of Philosophy. Johannesburg, 2013Restless Legs Syndrome (RLS) and Periodic Limb Movements (PLM) are common neurological disorders for which the underlying aetiology is not fully understood. Currently RLS and PLM are thought to be caused by a central deficiency of dopamine or other functional abnormalities of the central nervous system. The work included in this thesis investigated different new methods of assessing the sensory and motor features of RLS and PLM, in an attempt to extend our understanding of their aetiology and improve the accuracy of diagnosis of these conditions. The first two studies in the thesis described and characterized the sensations of RLS symptoms, and whether they are influenced by the presence of pain, in an English speaking South African population. The most frequently cited descriptors were different to those used in the current RLS diagnostic criteria. Inclusion of the most commonly used RLS descriptors in the diagnostic criteria may help to improve the accuracy of RLS diagnosis. Patients who experienced painful RLS had greater McGill Pain Questionnaire scores and used different terms to describe their RLS to those that did not have painful RLS sensations. The third project quantified the responses of the Hoffman and patellar reflexes in RLS patients using electromyography and kinematics. The RLS patients exhibited hyporeflexia in the evening compared to the morning, and compared to control participants. This data suggests that RLS is not the result of a global state of hyperexcitability, as the literature suggests, but may reflect more discrete functional abnormalities of the spinal cord. A diurnal variation in the patellar reflex was found, supporting the notion of circadian variations of spinal excitability in RLS patients. The final investigation assessed the sensory qualities (discomfort and pain) of RLS in conjunction with motor activity evoked by using the Suggested Immobilization Test. Despite rating significant levels of discomfort, the majority of the RLS patients did not exhibit PLM; possibly suggesting a disconnect between the sensory and motor components of RLS. In conclusion, it is the major finding of this thesis that inclusion of new assessment techniques for the measurement of sensory and motor features of RLS and PLM provides both new insights and potential clinical tools enhancing our understanding of these disorders

Doppler radar-based non-contact health monitoring for obstructive sleep apnea diagnosis: A comprehensive review

Today’s rapid growth of elderly populations and aging problems coupled with the prevalence of obstructive sleep apnea (OSA) and other health related issues have affected many aspects of society. This has led to high demands for a more robust healthcare monitoring, diagnosing and treatments facilities. In particular to Sleep Medicine, sleep has a key role to play in both physical and mental health. The quality and duration of sleep have a direct and significant impact on people’s learning, memory, metabolism, weight, safety, mood, cardio-vascular health, diseases, and immune system function. The gold-standard for OSA diagnosis is the overnight sleep monitoring system using polysomnography (PSG). However, despite the quality and reliability of the PSG system, it is not well suited for long-term continuous usage due to limited mobility as well as causing possible irritation, distress, and discomfort to patients during the monitoring process. These limitations have led to stronger demands for non-contact sleep monitoring systems. The aim of this paper is to provide a comprehensive review of the current state of non-contact Doppler radar sleep monitoring technology and provide an outline of current challenges and make recommendations on future research directions to practically realize and commercialize the technology for everyday usage