Interpreting streaming biosignals:in search of best approaches to augmenting mobile health monitoring with machine learning for adaptive clinical decision support

We investigate Body Area Networks for ambulant patient monitoring. As well as sensing physiological parameters, BAN applications may provide feedback to patients. Automating formulation of feedback requires realtime analysis and interpretation of streaming biosignals and other context and knowledge sources. We illustrate with two prototype applications: the first is designed to detect epileptic seizures and support appropriate intervention. The second is a decision support application aiding weight management; the goal is to promote health and prevent chronic illnesses associated with overweight/obesity. We begin to explore extending these and other m-health applications with generic AI-based decision support and machine learning. Monitoring success of different behavioural change strategies could provide a basis for machine learning, enabling adaptive clinical decision support by personalising and adapting strategies to individuals and their changing needs. Data mining applied to BAN data aggregated from large numbers of patients opens up possibilities for discovery of new clinical knowledge

Embedded machine learning using microcontrollers in wearable and ambulatory systems for health and care applications: a review

The use of machine learning in medical and assistive applications is receiving significant attention thanks to the unique potential it offers to solve complex healthcare problems for which no other solutions had been found. Particularly promising in this field is the combination of machine learning with novel wearable devices. Machine learning models, however, suffer from being computationally demanding, which typically has resulted on the acquired data having to be transmitted to remote cloud servers for inference. This is not ideal from the system’s requirements point of view. Recently, efforts to replace the cloud servers with an alternative inference device closer to the sensing platform, has given rise to a new area of research Tiny Machine Learning (TinyML). In this work, we investigate the different challenges and specifications trade-offs associated to existing hardware options, as well as recently developed software tools, when trying to use microcontroller units (MCUs) as inference devices for health and care applications. The paper also reviews existing wearable systems incorporating MCUs for monitoring, and management, in the context of different health and care intended uses. Overall, this work addresses the gap in literature targeting the use of MCUs as edge inference devices for healthcare wearables. Thus, can be used as a kick-start for embedding machine learning models on MCUs, focusing on healthcare wearables

Distributed brain co-processor for tracking spikes, seizures and behaviour during electrical brain stimulation

Early implantable epilepsy therapy devices provided open-loop electrical stimulation without brain sensing, computing, or an interface for synchronized behavioural inputs from patients. Recent epilepsy stimulation devices provide brain sensing but have not yet developed analytics for accurately tracking and quantifying behaviour and seizures. Here we describe a distributed brain co-processor providing an intuitive bi-directional interface between patient, implanted neural stimulation and sensing device, and local and distributed computing resources. Automated analysis of continuous streaming electrophysiology is synchronized with patient reports using a handheld device and integrated with distributed cloud computing resources for quantifying seizures, interictal epileptiform spikes and patient symptoms during therapeutic electrical brain stimulation. The classification algorithms for interictal epileptiform spikes and seizures were developed and parameterized using long-term ambulatory data from nine humans and eight canines with epilepsy, and then implemented prospectively in out-of-sample testing in two pet canines and four humans with drug-resistant epilepsy living in their natural environments. Accurate seizure diaries are needed as the primary clinical outcome measure of epilepsy therapy and to guide brain-stimulation optimization. The brain co-processor system described here enables tracking interictal epileptiform spikes, seizures and correlation with patient behavioural reports. In the future, correlation of spikes and seizures with behaviour will allow more detailed investigation of the clinical impact of spikes and seizures on patients

Artifact Removal Methods in EEG Recordings: A Review

To obtain the correct analysis of electroencephalogram (EEG) signals, non-physiological and physiological artifacts should be removed from EEG signals. This study aims to give an overview on the existing methodology for removing physiological artifacts, e.g., ocular, cardiac, and muscle artifacts. The datasets, simulation platforms, and performance measures of artifact removal methods in previous related research are summarized. The advantages and disadvantages of each technique are discussed, including regression method, filtering method, blind source separation (BSS), wavelet transform (WT), empirical mode decomposition (EMD), singular spectrum analysis (SSA), and independent vector analysis (IVA). Also, the applications of hybrid approaches are presented, including discrete wavelet transform - adaptive filtering method (DWT-AFM), DWT-BSS, EMD-BSS, singular spectrum analysis - adaptive noise canceler (SSA-ANC), SSA-BSS, and EMD-IVA. Finally, a comparative analysis for these existing methods is provided based on their performance and merits. The result shows that hybrid methods can remove the artifacts more effectively than individual methods

Complementary Detection for Hardware Efficient On-site Monitoring of Parkinsonian Progress

The progress of Parkinson & #x2019;s disease (PD) in patients is conventionally monitored through follow-up visits. These may be insufficient for clinicians to obtain a good understanding of the occurrence and severity of symptoms in order to adjust therapy to the patients & #x2019; needs. Portable platforms for PD diagnostics can provide in-depth information, thus reducing the frequency of face-to-face visits. This paper describes the first known on-site PD detection and monitoring processor. This is achieved by employing complementary detection which uses a combination of weak k-NN classifiers to produce a classifier with a higher consistency and confidence level than the individual classifiers. Various implementations of the classifier are investigated for trade-offs in terms of area, power and detection performance. Detection performances are validated on an FPGA platform. Achieved accuracy measures were: Matthews correlation coefficient of 0.6162, mean F1-score of 91.38 & #x0025;, and mean classification accuracy of 91.91 & #x0025;. By mapping the implemented designs on a 45 nm CMOS process, the optimal configuration achieved a dynamic power per channel of 2.26 & #x03BC;W and an area per channel of 0.24 mm2

Optimized Biosignals Processing Algorithms for New Designs of Human Machine Interfaces on Parallel Ultra-Low Power Architectures

The aim of this dissertation is to explore Human Machine Interfaces (HMIs) in a variety of biomedical scenarios. The research addresses typical challenges in wearable and implantable devices for diagnostic, monitoring, and prosthetic purposes, suggesting a methodology for tailoring such applications to cutting edge embedded architectures. The main challenge is the enhancement of high-level applications, also introducing Machine Learning (ML) algorithms, using parallel programming and specialized hardware to improve the performance. The majority of these algorithms are computationally intensive, posing significant challenges for the deployment on embedded devices, which have several limitations in term of memory size, maximum operative frequency, and battery duration. The proposed solutions take advantage of a Parallel Ultra-Low Power (PULP) architecture, enhancing the elaboration on specific target architectures, heavily optimizing the execution, exploiting software and hardware resources. The thesis starts by describing a methodology that can be considered a guideline to efficiently implement algorithms on embedded architectures. This is followed by several case studies in the biomedical field, starting with the analysis of a Hand Gesture Recognition, based on the Hyperdimensional Computing algorithm, which allows performing a fast on-chip re-training, and a comparison with the state-of-the-art Support Vector Machine (SVM); then a Brain Machine Interface (BCI) to detect the respond of the brain to a visual stimulus follows in the manuscript. Furthermore, a seizure detection application is also presented, exploring different solutions for the dimensionality reduction of the input signals. The last part is dedicated to an exploration of typical modules for the development of optimized ECG-based applications

Sensor selection for energy-efficient ambulatory medical monitoring

Epilepsy affects over three million Americans of all ages. Despite recent advances, more than 20% of individuals with epilepsy never achieve adequate control of their seizures. The use of a small, portable, non-invasive seizure monitor could benefit these individuals tremendously. However, in order for such a device to be suitable for long-term wear, it must be both comfortable and lightweight. Typical state-of-the-art non-invasive seizure onset detection algorithms require 21 scalp electrodes to be placed on the head. These electrodes are used to generate 18 data streams, called channels. The large number of electrodes is inconvenient for the patient and processing 18 channels can consume a considerable amount of energy, a problem for a battery-powered device. In this paper, we describe an automated way to construct detectors that use fewer channels, and thus fewer electrodes. Starting from an existing technique for constructing 18 channel patient-specific detectors, we use machine learning to automatically construct reduced channel detectors. We evaluate our algorithm on data from 16 patients used in an earlier study. On average, our algorithm reduced the number of channels from 18 to 4.6 while decreasing the mean fraction of seizure onsets detected from 99% to 97%. For 12 out of the 16 patients, there was no degradation in the detection rate. While the average detection latency increased from 7.8 s to 11.2 s, the average rate of false alarms per hour decreased from 0.35 to 0.19. We also describe a prototype implementation of a single channel EEG monitoring device built using off-the-shelf components, and use this implementation to derive an energy consumption model. Using fewer channels reduced the average energy consumption by 69%, which amounts to a 3.3x increase in battery lifetime. Finally, we show how additional energy savings can be realized by using a low-power screening detector to rule out segments of data that are obviously not seizures. Though this technique does not reduce the number of electrodes needed, it does reduce the energy consumption by an additional 16%