Eye-CU: Sleep Pose Classification for Healthcare using Multimodal Multiview Data

Manual analysis of body poses of bed-ridden patients requires staff to continuously track and record patient poses. Two limitations in the dissemination of pose-related therapies are scarce human resources and unreliable automated systems. This work addresses these issues by introducing a new method and a new system for robust automated classification of sleep poses in an Intensive Care Unit (ICU) environment. The new method, coupled-constrained Least-Squares (cc-LS), uses multimodal and multiview (MM) data and finds the set of modality trust values that minimizes the difference between expected and estimated labels. The new system, Eye-CU, is an affordable multi-sensor modular system for unobtrusive data collection and analysis in healthcare. Experimental results indicate that the performance of cc-LS matches the performance of existing methods in ideal scenarios. This method outperforms the latest techniques in challenging scenarios by 13% for those with poor illumination and by 70% for those with both poor illumination and occlusions. Results also show that a reduced Eye-CU configuration can classify poses without pressure information with only a slight drop in its performance.Comment: Ten-page manuscript including references and ten figure

Non-Contact Sleep Monitoring

"The road ahead for preventive medicine seems clear. It is the delivery of high quality, personalised (as opposed to depersonalised) comprehensive medical care to all." Burney, Steiger, and Georges (1964) This world's population is ageing, and this is set to intensify over the next forty years. This demographic shift will result in signicant economic and societal burdens (partic- ularly on healthcare systems). The instantiation of a proactive, preventative approach to delivering healthcare is long recognised, yet is still proving challenging. Recent work has focussed on enabling older adults to age in place in their own homes. This may be realised through the recent technological advancements of aordable healthcare sen- sors and systems which continuously support independent living, particularly through longitudinally monitoring deviations in behavioural and health metrics. Overall health status is contingent on multiple factors including, but not limited to, physical health, mental health, and social and emotional wellbeing; sleep is implicitly linked to each of these factors. This thesis focusses on the investigation and development of an unobtrusive sleep mon- itoring system, particularly suited towards long-term placement in the homes of older adults. The Under Mattress Bed Sensor (UMBS) is an unobstrusive, pressure sensing grid designed to infer bed times and bed exits, and also for the detection of development of bedsores. This work extends the capacity of this sensor. Specically, the novel contri- butions contained within this thesis focus on an in-depth review of the state-of-the-art advances in sleep monitoring, and the development and validation of algorithms which extract and quantify UMBS-derived sleep metrics. Preliminary experimental and community deployments investigated the suitability of the sensor for long-term monitoring. Rigorous experimental development rened algorithms which extract respiration rate as well as motion metrics which outperform traditional forms of ambulatory sleep monitoring. Spatial, temporal, statistical and spatiotemporal features were derived from UMBS data as a means of describing movement during sleep. These features were compared across experimental, domestic and clinical data sets, and across multiple sleeping episodes. Lastly, the optimal classier (built using a combina- tion of the UMBS-derived features) was shown to infer sleep/wake state accurately and reliably across both younger and older cohorts. Through long-term deployment, it is envisaged that the UMBS-derived features (in- cluding spatial, temporal, statistical and spatiotemporal features, respiration rate, and sleep/wake state) may be used to provide unobtrusive, continuous insights into over- all health status, the progression of the symptoms of chronic conditions, and allow the objective measurement of daily (sleep/wake) patterns and routines

Digital Optical Ballistocardiographic System for Activity, Heart Rate, and Breath Rate Determination during Sleep

In this work, we present a ballistocardiographic (BCG) system for the determination of heart and breath rates and activity of a user lying in bed. Our primary goal was to simplify the analog and digital processing usually required in these kinds of systems while retaining high performance. A novel sensing approach is proposed consisting of a white LED facing a digital light detector. This detector provides precise measurements of the variations of the light intensity of the incident light due to the vibrations of the bed produced by the subject’s breathing, heartbeat, or activity. Four small springs, acting as a bandpass filter, connect the boards where the LED and the detector are mounted. Owing to the mechanical bandpass filtering caused by the compressed springs, the proposed system generates a BCG signal that reflects the main frequencies of the heartbeat, breathing, and movement of the lying subject. Without requiring any analog signal processing, this device continuously transmits the measurements to a microcontroller through a twowire communication protocol, where they are processed to provide an estimation of the parameters of interest in configurable time intervals. The final information of interest is wirelessly sent to the user’s smartphone by means of a Bluetooth connection. For evaluation purposes, the proposed system has been compared with typical BCG systems showing excellent performance for different subject positions. Moreover, applied postprocessing methods have shown good behavior for information separation from a single-channel signal. Therefore, the determination of the heart rate, breathing rate, and activity of the patient is achieved through a highly simplified signal processing without any need for analog signal conditioning.Junta de Andalucia European Commission PYC20-RE-040 UGR MCIN/AEI/10.13039/501100011033/with PID2019-103938RB-I00European Commissio

Continuous sensing and quantification of body motion in infants:A systematic review

Abnormal body motion in infants may be associated with neurodevelopmental delay or critical illness. In contrast to continuous patient monitoring of the basic vitals, the body motion of infants is only determined by discrete periodic clinical observations of caregivers, leaving the infants unattended for observation for a longer time. One step to fill this gap is to introduce and compare different sensing technologies that are suitable for continuous infant body motion quantification. Therefore, we conducted this systematic review for infant body motion quantification based on the PRISMA method (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). In this systematic review, we introduce and compare several sensing technologies with motion quantification in different clinical applications. We discuss the pros and cons of each sensing technology for motion quantification. Additionally, we highlight the clinical value and prospects of infant motion monitoring. Finally, we provide suggestions with specific needs in clinical practice, which can be referred by clinical users for their implementation. Our findings suggest that motion quantification can improve the performance of vital sign monitoring, and can provide clinical value to the diagnosis of complications in infants.</p

Data-driven methods for analyzing ballistocardiograms in longitudinal cardiovascular monitoring

Cardiovascular disease (CVD) is the leading cause of death in the US; about 48% of American adults have one or more types of CVD. The importance of continuous monitoring of the older population, for early detection of changes in health conditions, has been shown in the literature, as the key to a successful clinical intervention. We have been investigating environmentally-embedded in-home networks of non-invasive sensing modalities. This dissertation concentrates on the signal processing techniques required for the robust extraction of morphological features from the ballistocardiographs (BCG), and machine learning approaches to utilize these features in non-invasive monitoring of cardiovascular conditions. At first, enhancements in the time domain detection of the cardiac cycle are addressed due to its importance in the estimation of heart rate variability (HRV) and sleep stages. The proposed enhancements in the energy-based algorithm for BCG beat detection have shown at least 50% improvement in the root mean square error (RMSE) of the beat to beat heart rate estimations compared to the reference estimations from the electrocardiogram (ECG) R to R intervals. These results are still subject to some errors, primarily due to the contamination of noise and motion artifacts caused by floor vibration, unconstrained subject movements, or even the respiratory activities. Aging, diseases, breathing, and sleep disorders can also affect the quality of estimation as they slightly modify the morphology of the BCG waveform.Includes bibliographical reference

Vauvojen unen luokittelu patja-sensorilla ja EKG:lla

Infants spend the majority of their time asleep. Although extensive studies have been carried out, the role of sleep for infant cognitive, psychomotor, temperament and developmental outcomes is not clear. The current contradictory results may be due to the limited precision when monitoring infant sleep for prolonged periods of time, from weeks to even months. Sleep-wake cycle can be assessed with sleep questionnaires and actigraphy, but they cannot separate sleep stages. The gold standard for sleep state annotation is polysomnography (PSG), which consist of several signal modalities such as electroencephalogram, electrooculogram, electrocardiogram (ECG), electromyogram, respiration sensor and pulse oximetry. A sleep clinician manually assigns sleep stages for 30 sec epochs based on the visual observation of these signals. Because method is obtrusive and laborious it is not suitable for monitoring long periods. There is, therefore, a need for an automatic and unobtrusive sleep staging approach. In this work, a set of classifiers for infant sleep staging was created and evaluated. The cardiorespiratory and gross body movement signals were used as an input. The different classifiers aim to distinguish between two or more different sleep states. The classifiers were built on a clinical sleep polysomnography data set of 48 infants with ages ranging from 1 week to 18 weeks old (a median of 5 weeks). Respiration and gross body movements were observed using an electromechanical film bed mattress sensor manufactured by Emfit Ltd. ECG of the PSG setup was used for extracting cardiac activity. Signals were preprocessed to remove artefacts and an extensive set of features (N=81) were extracted on which the classifiers were trained. The NREM3 vs other states classifier provided the most accurate results. The median accuracy was 0.822 (IQR: 0.724-0.914). This is comparable to previously published studies on other sleep classifiers, as well as to the level of clinical interrater agreement. Classification methods were confounded by the lack of muscle atonia and amount of gross body movements in REM sleep. The proposed method could be readily applied for home monitoring, as well as for monitoring in neonatal intensive care units.Vauvat nukkuvat suurimman osan vuorokaudesta. Vaikkakin laajasti on tutkittu unen vaikutusta lapsen kognitioon, psykomotoriikkaan, temperamenttiin ja kehitykseen, selkeää kuvaa ja yhtenäistä konsensusta tiedeyhteisössä ei ole saavutettu. Yksi syy tähän on että ei ole olemassa menetelmää, joka soveltuisi jatkuva-aikaiseen ja pitkäkestoiseen unitilan monitorointiin. Vauvojen uni-valve- sykliä voidaan selvittää vanhemmille suunnatuilla kyselyillä ja aktigrafialla, mutta näillä ei voi havaita unitilojen rakennetta. Kliinisenä standardina unitilojen seurannassa on polysomnografia, jossa samanaikaisesti mitataan mm. potilaan elektroenkelografiaa, elektro-okulografiaa, elektrokardiografiaa, electromyografiaa, hengitysinduktiivisesta pletysmografiaa, happisaturaatiota ja hengitysvirtauksia. Kliinikko suorittaa univaiheluokittelun signaaleista näkyvien, vaiheille tyypillisten, hahmojen perusteella. Työläyden ja häiritsevän mittausasetelman takia menetelmä ei sovellu pitkäaikaiseen seurantaan. On tarvetta kehittää tarkoitukseen sopivia automaattisia ja huomaamattomia unenseurantamenetelmiä. Tässä työssä kehitettiin ja testattiin sydämen syke-, hengitys ja liikeanalyysiin perustuvia koneluokittimia vauvojen unitilojen havainnointiin. Luokittimet opetettiin kliinisessa polysomnografiassa kerätyllä datalla 48 vauvasta, joiden ikä vaihteli 1. viikosta 18. viikkoon (mediaani 5 viikkoa). Vauvojen hengitystä ja liikkeitä seurattiin Emfit Oy:n valmistamalla elektromekaaniseen filmiin pohjatuvalla patja-sensorilla. Lisäksi ECG:lla seurattiin sydäntä ja opetuksessa käytettiin lääkärin suorittamaa PSG-pohjaista luokitusta. Esikäsittelyn jälkeen signaaleista laskettiin suuri joukko piirrevektoreita (N=81), joihin luokittelu perustuu. NREM3-univaiheen tunnistus onnistui parhaiten 0.822 mediaani-tarkkuudella ja [0.724,0.914] kvartaaleilla. Tulos on yhtenevä kirjallisuudessa esitettyjen arvojen kanssa ja vastaa kliinikkojen välistä toistettavuutta. Muilla luokittimilla univaiheet sekoituivat keskenään, mikä on oletattavasti selitettävissä aikuisista poikeavalla REM-unen aikaisella lihasjäykkyydellä ja kehon liikkeillä. Työ osoittaa, että menetelmällä voi seurata vauvojen uniluokkien oskillaatiota. Järjestelmää voisi käyttää kotiseurannassa tai vastasyntyneiden teholla unenvalvontaan

Low-cost plastic optical fiber sensor embedded in mattress for sleep performance monitoring

[EN] In this study, we investigated plastic optical fiber (POF) pressure sensors embedded in mattresses to measure respiration and heart rate for sleep performance monitoring. The signal is amplified in the circuit using a two stage amplification scheme to collect weak respiration and heart rate signals while an algorithm was designed to obtain respiration and heart rate. We also propose a good reliability cutting-POF technology which can be used to improve pressure sensitivity. The experimental results indicate that the mattress can distinguish four behavioral states related to sleep (on bed, lying, moving and leaving bed) and can detect respiration and heart rate values in different positions and postures. Validation experiments on 10 participants showed that absolute error was less than one breath per minute and two beats per minute, making our approach suitable for household sleeping monitoring.National Natural Science Foundation of China (62003046) ; National Defense Basic Scientific Research Program of China (JCKY2018110B011) ; The Spanish Ministerio de Ciencia, Innovacion y Universidades RTI2018-101658-B-I00 FOCAL Project; Guangdong Recruitment Program of Foreign Experts (2020A1414010393) ; Guangdong Basic and Applied Basic Research Foundation (2021A1515011997) ; C. Marques acknowledges Fundacao para a Ciencia e a Tecnologia (FCT) through the CEECIND/00034/2018 (iFish project) and this work was developed within the scope of the project i3N, UIDB/50025/2020 &UIDP/50025/2020, financed by national funds through the FCT/MEC.Han, P.; Li, L.; Zhang, H.; Guan, L.; Marques, C.; Savovic, S.; Ortega Tamarit, B.... (2021). Low-cost plastic optical fiber sensor embedded in mattress for sleep performance monitoring. Optical Fiber Technology. 64:1-8. https://doi.org/10.1016/j.yofte.2021.102541186

Lying-People Pressure-Map Datasets: A Systematic Review

Bedded or lying-people pressure-map datasets can be used to identify patients’ in-bed postures and can be very useful in numerous healthcare applications. However, the construction of these datasets is not always easy, and many researchers often resort to existing datasets to carry out their experiments and validate their solutions. This systematic review aimed to identify and characterise pressure-map datasets on lying-people- or bedded-people positions. We used a systematic approach to select nine studies that were thoroughly reviewed and summarised them considering methods of data collection, fields considered in the datasets, and results or their uses after collection. As a result of the review, six research questions were answered that allowed a characterisation of existing datasets regarding of the types of data included, number and types of poses considered, participant characteristics and size of the dataset, and information on how the datasets were built. This study might represent an important basis for academics and researchers to understand the information collected in each pressure-map dataset, the possible uses of such datasets, or methods to build new datasets.info:eu-repo/semantics/publishedVersio