Secure steganography, compression and diagnoses of electrocardiograms in wireless body sensor networks

Submission of this completed form results in your thesis/project being lodged online at the RMIT Research Repository. Further information about the RMIT Research Repository is available at http://researchbank.rmit.edu.au Please complete abstract and keywords below for cataloguing and indexing your thesis/project. Abstract (Minimum 200 words, maximum 500 words) The usage of e-health applications is increasing in the modern era. Remote cardiac patients monitoring application is an important example of these e-health applications. Diagnosing cardiac disease in time is of crucial importance to save many patients lives. More than 3.5 million Australians suffer from long-term cardiac diseases. Therefore, in an ideal situation, a continuous cardiac monitoring system should be provided for this large number of patients. However, health-care providers lack the technology required to achieve this objective. Cloud services can be utilized to fill the technology gap for health-care providers. However, three main problems prevent health-care providers from using cloud services. Privacy, performance and accuracy of diagnoses. In this thesis we are addressing these three problems. To provide strong privacy protection services, two steganography techniques are proposed. Both techniques could achieve promising results in terms of security and distortion measurement. The differences between original and resultant watermarked ECG signals were less then 1%. Accordingly, the resultant ECG signal can be still used for diagnoses purposes, and only authorized persons who have the required security information, can extract the hidden secret data in the ECG signal. Consequently, to solve the performance problem of storing huge amount of data concerning ECG into the cloud, two types of compression techniques are introduced: Fractal based lossy compression technique and Gaussian based lossless compression technique. This thesis proves that, fractal models can be efficiently used in ECG lossy compression. Moreover, the proposed fractal technique is a multi-processing ready technique that is suitable to be implemented inside a cloud to make use of its multi processing capability. A high compression ratio could be achieved with low distortion effects. The Gaussian lossless compression technique is proposed to provide a high compression ratio. Moreover, because the compressed files are stored in the cloud, its services should be able to provide automatic diagnosis capability. Therefore, cloud services should be able to diagnose compressed ECG files without undergoing a decompression stage to reduce additional processing overhead. Accordingly, the proposed Gaussian compression provides the ability to diagnose the resultant compressed file. Subsequently, to make use of this homomorphic feature of the proposed Gaussian compression algorithm, in this thesis we have introduced a new diagnoses technique that can be used to detect life-threatening cardiac diseases such as Ventricular Tachycardia and Ventricular Fibrillation. The proposed technique is applied directly to the compressed ECG files without going through the decompression stage. The proposed technique could achieve high accuracy results near to 100% for detecting Ventricular Arrhythmia and 96% for detecting Left Bundle Branch Block. Finally, we believe that in this thesis, the first steps towards encouraging health-care providers to use cloud services have been taken. However, this journey is still long

Design for energy-efficient and reliable fog-assisted healthcare IoT systems

Cardiovascular disease and diabetes are two of the most dangerous diseases as they are the leading causes of death in all ages. Unfortunately, they cannot be completely cured with the current knowledge and existing technologies. However, they can be effectively managed by applying methods of continuous health monitoring. Nonetheless, it is difficult to achieve a high quality of healthcare with the current health monitoring systems which often have several limitations such as non-mobility support, energy inefficiency, and an insufficiency of advanced services. Therefore, this thesis presents a Fog computing approach focusing on four main tracks, and proposes it as a solution to the existing limitations. In the first track, the main goal is to introduce Fog computing and Fog services into remote health monitoring systems in order to enhance the quality of healthcare. In the second track, a Fog approach providing mobility support in a real-time health monitoring IoT system is proposed. The handover mechanism run by Fog-assisted smart gateways helps to maintain the connection between sensor nodes and the gateways with a minimized latency. Results show that the handover latency of the proposed Fog approach is 10%-50% less than other state-of-the-art mobility support approaches. In the third track, the designs of four energy-efficient health monitoring IoT systems are discussed and developed. Each energy-efficient system and its sensor nodes are designed to serve a specific purpose such as glucose monitoring, ECG monitoring, or fall detection; with the exception of the fourth system which is an advanced and combined system for simultaneously monitoring many diseases such as diabetes and cardiovascular disease. Results show that these sensor nodes can continuously work, depending on the application, up to 70-155 hours when using a 1000 mAh lithium battery. The fourth track mentioned above, provides a Fog-assisted remote health monitoring IoT system for diabetic patients with cardiovascular disease. Via several proposed algorithms such as QT interval extraction, activity status categorization, and fall detection algorithms, the system can process data and detect abnormalities in real-time. Results show that the proposed system using Fog services is a promising approach for improving the treatment of diabetic patients with cardiovascular disease

ECG reduction for wearable sensor

The transmission, storage and analysis of electrocardiogram (ECG) data in real-time is essential for remote patient monitoring with wearable ECG devices and mobile ECG contexts. However, this remains a challenge to achieve within the processing power and the storage capacity of mobile devices. ECG reduction algorithms have an important role to play in reducing the processing requirements for mobile devices, however many existing ECG reduction and compression algorithms are computationally expensive to execute in mobile devices and have not been designed for real-time computation and incremental data arrival. In this paper, we describe a computationally naive, yet effective, algorithm that achieves high ECG reduction rates while maintaining key diagnostic features including PR, QRS, ST, QT and RR intervals. While reduction does not enable ECG waves to be reproduced, the ability to transmit key indicators (diagnostic features) using minimal computational resources, is particularly useful in mobile health contexts involving power constrained sensors and devices. Results of the proposed reduction algorithm indicate that the proposed algorithm outperforms other ECG reduction algorithms at a reduction/compression ratio (CR) of 5:1. If power or processing capacity is low, the algorithm can readily switch to a compression ratio of up to 10: 1 while still maintaining an error rate below 10%

Networking Architecture and Key Technologies for Human Digital Twin in Personalized Healthcare: A Comprehensive Survey

Digital twin (DT), refers to a promising technique to digitally and accurately represent actual physical entities. One typical advantage of DT is that it can be used to not only virtually replicate a system's detailed operations but also analyze the current condition, predict future behaviour, and refine the control optimization. Although DT has been widely implemented in various fields, such as smart manufacturing and transportation, its conventional paradigm is limited to embody non-living entities, e.g., robots and vehicles. When adopted in human-centric systems, a novel concept, called human digital twin (HDT) has thus been proposed. Particularly, HDT allows in silico representation of individual human body with the ability to dynamically reflect molecular status, physiological status, emotional and psychological status, as well as lifestyle evolutions. These prompt the expected application of HDT in personalized healthcare (PH), which can facilitate remote monitoring, diagnosis, prescription, surgery and rehabilitation. However, despite the large potential, HDT faces substantial research challenges in different aspects, and becomes an increasingly popular topic recently. In this survey, with a specific focus on the networking architecture and key technologies for HDT in PH applications, we first discuss the differences between HDT and conventional DTs, followed by the universal framework and essential functions of HDT. We then analyze its design requirements and challenges in PH applications. After that, we provide an overview of the networking architecture of HDT, including data acquisition layer, data communication layer, computation layer, data management layer and data analysis and decision making layer. Besides reviewing the key technologies for implementing such networking architecture in detail, we conclude this survey by presenting future research directions of HDT

SS-FD: Internet of medical things based patient health monitoring system

Internet of Medical Things (IoMT) consists of connected devices used to collect patient health information in a real-time environment. The IoMT device effectively handles medical issues by using health wearable and medical-grade wearables. Although IoMT can process the collected data, it has few pitfalls, such as interoperability of data, standardization issues, and computation complexity while detecting disease. By considering these issues, in this work, IoMT is utilized in the field of the remote patient monitoring system. Initially, the IoMT devices are placed on the human body and collect their health information continuously. The gathered details are processed using a salp swarm optimized fuzzy deep neural network (SS-FD). This system supports the patient health monitoring process with minimum low-cost consumption. The SS-FD classifier processes the obtained data; primary and emergency data is classified according to the fuzzy rule. This process improves the remote patient health data analysis and reduces the difficulties involved in the patient health analysis. Then the efficiency of the system is evaluated using experimental result

Personalized data analytics for internet-of-things-based health monitoring

The Internet-of-Things (IoT) has great potential to fundamentally alter the delivery of modern healthcare, enabling healthcare solutions outside the limits of conventional clinical settings. It can offer ubiquitous monitoring to at-risk population groups and allow diagnostic care, preventive care, and early intervention in everyday life. These services can have profound impacts on many aspects of health and well-being. However, this field is still at an infancy stage, and the use of IoT-based systems in real-world healthcare applications introduces new challenges. Healthcare applications necessitate satisfactory quality attributes such as reliability and accuracy due to their mission-critical nature, while at the same time, IoT-based systems mostly operate over constrained shared sensing, communication, and computing resources. There is a need to investigate this synergy between the IoT technologies and healthcare applications from a user-centered perspective. Such a study should examine the role and requirements of IoT-based systems in real-world health monitoring applications. Moreover, conventional computing architecture and data analytic approaches introduced for IoT systems are insufficient when used to target health and well-being purposes, as they are unable to overcome the limitations of IoT systems while fulfilling the needs of healthcare applications. This thesis aims to address these issues by proposing an intelligent use of data and computing resources in IoT-based systems, which can lead to a high-level performance and satisfy the stringent requirements. For this purpose, this thesis first delves into the state-of-the-art IoT-enabled healthcare systems proposed for in-home and in-hospital monitoring. The findings are analyzed and categorized into different domains from a user-centered perspective. The selection of home-based applications is focused on the monitoring of the elderly who require more remote care and support compared to other groups of people. In contrast, the hospital-based applications include the role of existing IoT in patient monitoring and hospital management systems. Then, the objectives and requirements of each domain are investigated and discussed. This thesis proposes personalized data analytic approaches to fulfill the requirements and meet the objectives of IoT-based healthcare systems. In this regard, a new computing architecture is introduced, using computing resources in different layers of IoT to provide a high level of availability and accuracy for healthcare services. This architecture allows the hierarchical partitioning of machine learning algorithms in these systems and enables an adaptive system behavior with respect to the user's condition. In addition, personalized data fusion and modeling techniques are presented, exploiting multivariate and longitudinal data in IoT systems to improve the quality attributes of healthcare applications. First, a real-time missing data resilient decision-making technique is proposed for health monitoring systems. The technique tailors various data resources in IoT systems to accurately estimate health decisions despite missing data in the monitoring. Second, a personalized model is presented, enabling variations and event detection in long-term monitoring systems. The model evaluates the sleep quality of users according to their own historical data. Finally, the performance of the computing architecture and the techniques are evaluated in this thesis using two case studies. The first case study consists of real-time arrhythmia detection in electrocardiography signals collected from patients suffering from cardiovascular diseases. The second case study is continuous maternal health monitoring during pregnancy and postpartum. It includes a real human subject trial carried out with twenty pregnant women for seven months

Cardiovascular data analytics for real time patient monitoring

Improvements in wearable sensor devices make it possible to constantly monitor physiological parameters such as electrocardiograph (ECG) signals for long periods. Remote patient monitoring with wearable sensors has an important role to play in health care, particularly given the prevalence of chronic conditions such as cardiovascular disease (CVD)—one of the prominent causes of morbidity and mortality worldwide. Approximately 4.2 million Australians suffer from long-term CVD with approximately one death every 12 minutes. The assessment of ECG features, especially heart rate variability (HRV), represents a non-invasive technique which provides an indication of the autonomic nervous system (ANS) function. Conditions such as sudden cardiac death, hypertension, heart failure, myocardial infarction, ischaemia, and coronary heart disease can be detected from HRV analysis. In addition, the analysis of ECG features can also be used to diagnose many types of life-threatening arrhythmias, including ventricular fibrillation and ventricular tachycardia. Non-cardiac conditions, such as diabetes, obesity, metabolic syndrome, insulin resistance, irritable bowel syndrome, dyspepsia, anorexia nervosa, anxiety, and major depressive disorder have also been shown to be associated with HRV. The analysis of ECG features from real time ECG signals generated from wearable sensors provides distinctive challenges. The sensors that receive and process the signals have limited power, storage and processing capacity. Consequently, algorithms that process ECG signals need to be lightweight, use minimal storage resources and accurately detect abnormalities so that alarms can be raised. The existing literature details only a few algorithms which operate within the constraints of wearable sensor networks. This research presents four novel techniques that enable ECG signals to be processed within the limitations of resource constraints on devices to detect some key abnormalities in heart function. - The first technique is a novel real-time ECG data reduction algorithm, which detects and transmits only those key points that are critical for the generation of ECG features for diagnoses. - The second technique accurately predicts the five-minute HRV measure using only three minutes of data with an algorithm that executes in real-time using minimal computational resources. - The third technique introduces a real-time ECG feature recognition system that can be applied to diagnose life threatening conditions such as premature ventricular contractions (PVCs). - The fourth technique advances a classification algorithm to enhance the performance of automated ECG classification to determine arrhythmic heart beats based on noisy ECG signals. The four novel techniques are evaluated in comparison with benchmark algorithms for each task on the standard MIT-BIH Arrhythmia Database and with data generated from patients in a major hospital using Shimmer3 wearable ECG sensors. The four techniques are integrated to demonstrate that remote patient monitoring of ECG using HRV and ECG features is feasible in real time using minimal computational resources. The evaluation show that the ECG reduction algorithm is significantly better than existing algorithms that can be applied within sensor nodes, such as time-domain methods, transformation methods and compressed sensing methods. Furthermore, the proposed ECG reduction is found to be computationally less complex for resource constrained sensors and achieves higher compression ratios than existing algorithms. The prediction of a common HRV measure, the five-minute standard deviation of inter-beat variations (SDNN) and the accurate detection of PVC beats was achieved using a Count Data Model, combined with a Poisson-generated function from three-minute ECG recordings. This was achieved with minimal computational resources and was well suited to remote patient monitoring with wearable sensors. The PVC beats detection was implemented using the same count data model together with knowledge-based rules derived from clinical knowledge. A real-time cardiac patient monitoring system was implemented using an ECG sensor and smartphone to detect PVC beats within a few seconds using artificial neural networks (ANN), and it was proven to provide highly accurate results. The automated detection and classification were implemented using a new wrapper-based hybrid approach that utilized t-distributed stochastic neighbour embedding (t-SNE) in combination with self-organizing maps (SOM) to improve classification performance. The t-SNE-SOM hybrid resulted in improved sensitivity, specificity and accuracy compared to most common hybrid methods in the presence of noise. It also provided a better, more accurate identification for the presence of many types of arrhythmias from the ECG recordings, leading to a more timely diagnosis and treatment outcome.Doctor of Philosoph