Vital Sensory Kit For Use With Telemedicine In Developing Countries

In many developing countries, a large percentage of the population lacks access to adequate healthcare. This is especially true in India where close to 70% of the population lives in rural areas and has little to no access to hospitals or clinics. People living in rural India often times cannot afford to pay to see a doctor should they need to make the journey to a hospital. Telemedicine, a breakthrough in the past couple decades, has broken down the barrier between the patient and the physician. It has slowly been implemented in India to make doctors more available to patients through the use of video conferences and other forms of communication. A compact and affordable kit has been developed that will be used to take a patient’s blood pressure, heart rate, blood glucose concentration and oxygen saturation. Our most novel contribution is the non-invasive glucose sensor that will use a near-infrared LED and photodiode in the patient’s earlobe. Currently millions of diabetics do this by pricking their finger. By wirelessly sending data results from the vital sign kit, the first essential part of a treatment can be carried out via wireless communication, saving the doctor and patient time and money

Skin temperature reveals the intensity of acute stress

Acute stress triggers peripheral vasoconstriction, causing a rapid, short-term drop in skin temperature in homeotherms. We tested, for the first time, whether this response has the potential to quantify stress, by exhibiting proportionality with stressor intensity. We used established behavioural and hormonal markers: activity level and corticosterone level, to validate a mild and more severe form of an acute restraint stressor in hens (Gallus gallus domesticus). We then used infrared thermography (IRT) to non-invasively collect continuous temperature measurements following exposure to these two intensities of acute handling stress. In the comb and wattle, two skin regions with a known thermoregulatory role, stressor intensity predicted the extent of initial skin cooling, and also the occurrence of a more delayed skin warming, providing two opportunities to quantify stress. With the present, cost-effective availability of IRT technology, this non-invasive and continuous method of stress assessment in unrestrained animals has the potential to become common practice in pure and applied research

Protocol of the SOMNIA project : an observational study to create a neurophysiological database for advanced clinical sleep monitoring

Introduction Polysomnography (PSG) is the primary tool for sleep monitoring and the diagnosis of sleep disorders. Recent advances in signal analysis make it possible to reveal more information from this rich data source. Furthermore, many innovative sleep monitoring techniques are being developed that are less obtrusive, easier to use over long time periods and in the home situation. Here, we describe the methods of the Sleep and Obstructive Sleep Apnoea Monitoring with Non-Invasive Applications (SOMNIA) project, yielding a database combining clinical PSG with advanced unobtrusive sleep monitoring modalities in a large cohort of patients with various sleep disorders. The SOMNIA database will facilitate the validation and assessment of the diagnostic value of the new techniques, as well as the development of additional indices and biomarkers derived from new and/or traditional sleep monitoring methods. Methods and analysis We aim to include at least 2100 subjects (both adults and children) with a variety of sleep disorders who undergo a PSG as part of standard clinical care in a dedicated sleep centre. Full-video PSG will be performed according to the standards of the American Academy of Sleep Medicine. Each recording will be supplemented with one or more new monitoring systems, including wrist-worn photoplethysmography and actigraphy, pressure sensing mattresses, multimicrophone recording of respiratory sounds including snoring, suprasternal pressure monitoring and multielectrode electromyography of the diaphragm

Use of functional near-infrared spectroscopy to evaluate cognitive change when using healthcare simulation tools

This is an accepted manuscript of an article published by BMJ on 01/11/2020, available online: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8936993/ The accepted version of the publication may differ from the final published version.Background The use of brain imaging techniques in healthcare simulation is relatively rare. However, the use of mobile, wireless technique, such as functional nearinfrared spectroscopy (fNIRS), is becoming a useful tool for assessing the unique demands of simulation learning. For this study, this imaging technique was used to evaluate cognitive load during simulation learning events. Methods This study took place in relation to six simulation activities, paired for similarity, and evaluated comparative cognitive change between the three task pairs. The three paired tasks were: receiving a (1) face-toface and (2) video patient handover; observing a simulated scene in (1) two dimensions and (2) 360° field of vision; and on a simulated patient (1) taking a pulse and (2) taking a pulse and respiratory rate simultaneously. The total number of participants was n=12. Results In this study, fNIRS was sensitive to variations in task difficulty in common simulation tools and scenarios, showing an increase in oxygenated haemoglobin concentration and a decrease in deoxygenated haemoglobin concentration, as tasks increased in cognitive load. Conclusion Overall, findings confirmed the usefulness of neurohaemoglobin concentration markers as an evaluation tool of cognitive change in healthcare simulation. Study findings suggested that cognitive load increases in more complex cognitive tasks in simulation learning events. Task performance that increased in complexity therefore affected cognitive markers, with increase in mental effort required

Recent Advances and the Potential for Clinical Use of Autofluorescence Detection of Extra-Ophthalmic Tissues

The autofluorescence (AF) characteristics of endogenous fluorophores allow the label-free assessment and visualization of cells and tissues of the human body. While AF imaging (AFI) is well-established in ophthalmology, its clinical applications are steadily expanding to other disciplines. This review summarizes clinical advances of AF techniques published during the past decade. A systematic search of the MEDLINE database and Cochrane Library databases was performed to identify clinical AF studies in extra-ophthalmic tissues. In total, 1097 articles were identified, of which 113 from internal medicine, surgery, oral medicine, and dermatology were reviewed. While comparable technological standards exist in diabetology and cardiology, in all other disciplines, comparability between studies is limited due to the number of differing AF techniques and non-standardized imaging and data analysis. Clear evidence was found for skin AF as a surrogate for blood glucose homeostasis or cardiovascular risk grading. In thyroid surgery, foremost, less experienced surgeons may benefit from the AF-guided intraoperative separation of parathyroid from thyroid tissue. There is a growing interest in AF techniques in clinical disciplines, and promising advances have been made during the past decade. However, further research and development are mandatory to overcome the existing limitations and to maximize the clinical benefits

IR THERMOGRAPHY AND IMAGE PHOTOPLETHYSMOGRAPHY : NON-CONTACT MEDICAL COUNTER MEASURES FOR INFECTION SCREENING

Screening based on non-contact infrared thermometers (NCITs) and IRTGs shows promising results for mass fever screening. IRTGs were found to be powerful, quick and non-invasive methods to detect elevated temperatures. In the case of temperature measurement using IRTGs, regions medically adjacent to inner canthi are preferred sites for fever screening (IEC 80601-2-59:2008), which show good stability and correlation with body temperature. However, detection of canthi in thermal images is challenging due to the absence of features unlike visible images, which have sharp features that can be used for eye corner detection. We use registration of thermal images with visible light images (also called white-light images) to localize canthi regions in thermal images. We study the accuracy of such multi-modal image registration in the context of canthi detection and measure the feasibility of automatic canthi based temperature measurement as an alternative to manual measurement. The second part of thesis refers to the study of image photoplethysmography (IPPG), a cost-effective and flexible method for heart rate monitoring using videos recorded in ambient light. We use low-cost commercial grade video recording equipment (mobile camera/Digital camera) with an ambient light source. The study includes information about signal processing algorithms for estimating heart rate, relevant parameters, and comparison with standard techniques. Such low-cost, multi-purpose solutions for quick screening of subjects provides us with sensible and useful information on elevated body temperature and heart rate. Hence, these methods show promising results that enable mass fever screening as a possibility through temperature and heart rate monitoring, where low cost of installation and flexibility are important