Pervasive body sensor network: an approach to monitoring the post-operative surgical patient

Patients recovering from abdominal surgery are at risk of complications due to reduced mobility as a result of post-operative pain. The ability to pervasively monitor the recovery of this group of patients and identify those at risk of developing complications is therefore clinically desirable, which may result in an early intervention to prevent adverse outcomes. This paper describes the development and evaluation of a pervasive network of body sensors developed for monitoring the recovery of post-operative patients both in the hospital and homecare settings. © 2006 IEEE

A flexible organic reflectance oximeter array.

Transmission-mode pulse oximetry, the optical method for determining oxygen saturation in blood, is limited to only tissues that can be transilluminated, such as the earlobes and the fingers. The existing sensor configuration provides only single-point measurements, lacking 2D oxygenation mapping capability. Here, we demonstrate a flexible and printed sensor array composed of organic light-emitting diodes and organic photodiodes, which senses reflected light from tissue to determine the oxygen saturation. We use the reflectance oximeter array beyond the conventional sensing locations. The sensor is implemented to measure oxygen saturation on the forehead with 1.1% mean error and to create 2D oxygenation maps of adult forearms under pressure-cuff-induced ischemia. In addition, we present mathematical models to determine oxygenation in the presence and absence of a pulsatile arterial blood signal. The mechanical flexibility, 2D oxygenation mapping capability, and the ability to place the sensor in various locations make the reflectance oximeter array promising for medical sensing applications such as monitoring of real-time chronic medical conditions as well as postsurgery recovery management of tissues, organs, and wounds

Knock! Knock! Who Is There? Investigating Data Leakage from a Medical Internet of Things Hijacking Attack

The amalgamation of Medical Internet of Things (MIoT) devices into everyday life is influencing the landscape of modern medicine. The implementation of these devices potentially alleviates the pressures and physical demands of healthcare systems through the remote monitoring of patients. However, there are concerns that the emergence of MIoT ecosystems is introducing an assortment of security and privacy challenges. While previous research has shown that multiple vulnerabilities exist within MIoT devices, minimal research investigates potential data leakage from MIoT devices through hijacking attacks. The research contribution of this paper is twofold. First, it provides a proof of concept that certain MIoT devices and their accompanying smartphone applications are vulnerable to hijacking attacks. Second, it highlights the effectiveness of using digital forensics tools as a lens to identify patient and medical device information on a hijacker’s smartphone

A pervasive body sensor network for monitoring post-operative recovery

Over the past decade, miniaturisation and cost reduction brought about by the semiconductor industry has led to computers smaller in size than a pin head, powerful enough to carry out the processing required, and affordable enough to be disposable. Similar technological advances in wireless communication, sensor design, and energy storage have resulted in the development of wireless “Body Sensor Network (BSN) platforms comprising of tiny integrated micro sensors with onboard processing and wireless data transfer capability, offering the prospect of pervasive and continuous home health monitoring. In surgery, the reduced trauma of minimally invasive interventions combined with initiatives to reduce length of hospital stay and a socioeconomic drive to reduce hospitalisation costs, have all resulted in a trend towards earlier discharge from hospital. There is now a real need for objective, pervasive, and continuous post-operative home recovery monitoring systems. Surgical recovery is a multi-faceted and dynamic process involving biological, physiological, functional, and psychological components. Functional recovery (physical independence, activities of daily living, and mobility) is recognised as a good global indicator of a patient’s post-operative course, but has traditionally been difficult to objectively quantify. This thesis outlines the development of a pervasive wireless BSN system to objectively monitor the functional recovery of post-operative patients at home. Biomechanical markers were identified as surrogate measures for activities of daily living and mobility impairment, and an ear-worn activity recognition (e-AR) sensor containing a three-axis accelerometer and a pulse oximeter was used to collect this data. A simulated home environment was created to test a Bayesian classifier framework with multivariate Gaussians to model activity classes. A real-time activity index was used to provide information on the intensity of activity being performed. Mobility impairment was simulated with bracing systems and a multiresolution wavelet analysis and margin-based feature selection framework was used to detect impaired mobility. The e-AR sensor was tested in a home environment before its clinical use in monitoring post-operative home recovery of real patients who have undergone surgery. Such a system may eventually form part of an objective pervasive home recovery monitoring system tailored to the needs of today’s post-operative patient.Open acces

Multi-wavelength SPAD photoplethysmography for cardio-respiratory monitoring

There is a growing interest in photoplethysmography (PPG) for the continuous monitoring of cardio-respiratory signals by portable instrumentation aimed at the early diagnosis of cardiovascular diseases. In this context, it is conceivable that PPG sensors working at different wavelengths simultaneously can optimize the identification of apneas and the quantification of the associated heart-rate changes or other parameters that depend on the PPG shape (e.g., systematic vascular resistance and pressure), when evaluating the severity of breathing disorders during sleep and in general for health monitoring. Therefore, the objective of this work is to present a novel pulse oximeter that provides synchronous data logging related to three light wavelengths (green, red, and infrared) in transmission mode to optimize both heart rate measurements and a reliable and continuous assessment of oxygen saturation. The transmission mode is considered more robust over motion artifacts than reflection mode, but current pulse oximeters cannot employ green light in transmission mode due to the high absorbance of body tissues at this wavelength. For this reason, our device is based on a Single-Photon Avalanche Diode (SPAD) with very short deadtime (less than 1 ns) to have, at the same time, the single photon sensitivity and high-count rate that allows acquiring all the wavelengths of interest on the same site and in transmission mode. Previous studies have shown that SPAD cameras can be used for measuring the heart rate through remote PPG, but oxygen saturation and heart-rate measures through contact SPAD-based PPG sensors have never been addressed so far. The results of the preliminary validation on six healthy volunteers reflect the expected physiological phenomena, providing rms errors in the Inter Beat Interval estimation smaller than 70 ms (with green light) and a maximum error in the oxygen saturation smaller than 1% during the apneas. Our prototype demonstrates the reliability of SPAD-based devices for continuous long-term monitoring of cardio-respiratory variables as an alternative to photodiodes especially when minimal area and optical power are required

Wireless body sensor networks for health-monitoring applications

This is an author-created, un-copyedited version of an article accepted for publication in Physiological Measurement. The publisher is not responsible for any errors or omissions in this version of the manuscript or any version derived from it. The Version of Record is available online at http://dx.doi.org/10.1088/0967-3334/29/11/R01

Optoelectronic Neural Implant Sensors for Cerebral Blood Volume Monitoring

Nearly 50 million people are afflicted with epilepsy, worldwide. These patients suffer from unprovoked seizures, where neurons in the cerebral cortex under go uncontrolled, hypersynchronous firing of neurons. 30\% of patients with epilepsy do not respond to drug treatments. For these patients, surgical treatment involving the removal or disconnection of brain matter is one of the only alternatives. Such surgical treatments often rely on long-term monitoring of neuronal activity in the brain using subdurally implanted surface electrodes to locate the epileptic focus, but these clinical methods for mapping neuronal activity suffer from low spatial resolutions and poor noise, which can limit the success of surgical treatments where an error of even 1 mm can be critical. The work described here involves the development of an implantable system for performing optical recordings of intrinsic signal (ORIS) on the surface of the brain. By taking advantage of the unique absorption spectrum of hemoglobin, cerebral blood volume (CBV) can be measured via reflectivity changes in the brain at at specific wavelengths of light. Due to the metabolic demands of the brain, the exaggerated neuronal activity and spiking associated with epileptic seizures can be detected indirectly through changes in CBV. While high resolution ORIS measurements have been recorded using externally mounted CCD sensors, this work presents some of the first developments in producing a fully implantable ORIS sensor. Progress in the development of an implantable ORIS sensor described here includes: an implantable organic light emitting diode (OLED) and organic photodetector (OPD) integrated on a highly flexible parylene-c substrate, an implantable sensor using a microLED array embedded on a flexible polyimide substrate, and the application of quantum dots to microLEDs for optical down-conversion. Successful in vivo detection of seizures is achieved with high signal-to-noise using these methods. Additionally, spatial localization of seizure activity is performed using the microLED array. These developments represent crucial first steps in the development of a full 2D neuronal mapping system using implantable ORIS devices

Multi-wavelength SPAD photoplethysmography for cardio-respiratory monitoring

There is a growing interest in photoplethysmography (PPG) for the continuous monitoring of cardio-respiratory signals by portable instrumentation aimed at the early diagnosis of cardiovascular diseases. In this context, it is conceivable that PPG sensors working at different wavelengths simultaneously can optimize the identification of apneas and the quantification of the associated heart-rate changes or other parameters that depend on the PPG shape (e.g., systematic vascular resistance and pressure), when evaluating the severity of breathing disorders during sleep and in general for health monitoring. Therefore, the objective of this work is to present a novel pulse oximeter that provides synchronous data logging related to three light wavelengths (green, red, and infrared) in transmission mode to optimize both heart rate measurements and a reliable and continuous assessment of oxygen saturation. The transmission mode is considered more robust over motion artifacts than reflection mode, but current pulse oximeters cannot employ green light in transmission mode due to the high absorbance of body tissues at this wavelength. For this reason, our device is based on a Single-Photon Avalanche Diode (SPAD) with very short deadtime (less than 1 ns) to have, at the same time, the single photon sensitivity and high-count rate that allows acquiring all the wavelengths of interest on the same site and in transmission mode. Previous studies have shown that SPAD cameras can be used for measuring the heart rate through remote PPG, but oxygen saturation and heart-rate measures through contact SPAD-based PPG sensors have never been addressed so far. The results of the preliminary validation on six healthy volunteers reflect the expected physiological phenomena, providing rms errors in the Inter Beat Interval estimation smaller than 70 ms (with green light) and a maximum error in the oxygen saturation smaller than 1% during the apneas. Our prototype demonstrates the reliability of SPAD-based devices for continuous long-term monitoring of cardio-respiratory variables as an alternative to photodiodes especially when minimal area and optical power are required

Telemonitoring of Home Oxygen Therapy: A Review of the State of the Art and Introduction of a New Cloud-based System

Home oxygen therapy allows patients requiring long-term oxygen therapy to receive care at home and helps improve the prognosis of patients with chronic respiratory failure. The usage conditions of oxygen concentrators, which are used to supply gaseous oxygen, and the effects of oxygen inhaled at a prescribed flow rate have not been confirmed in adequate detail. As a result of advances in information and communications technology, internet communication functions can now be incorporated into medical devices installed in patients’ homes. This allows time-series data on oxygen concentrator usage and biological variables to be stored on a server and accessed remotely by health care providers, enabling them to check the validity of home oxygen therapy and intervene appropriately. In Japan, telemonitoring of home oxygen therapy is covered by social insurance systems and is recognized as a new medical technology. This article reviews the usefulness of telemonitoring of home oxygen therapy and describes the cloud-based analytical system we have developed