427 research outputs found
Desarrollo de nuevos dispositivos y algoritmos para la monitorizaciĂłn ambulatoria de personas con epilepsia
La epilepsia es una enfermedad crĂłnica con un enorme impacto sociosanitario. Aunque en la actualidad se dispone de una gran cantidad de fármacos antiepilĂ©pticos y de otros tratamientos más selectivos como la cirugĂa o la estimulaciĂłn cerebral, un porcentaje considerable de pacientes no están controlados y continĂşan teniendo crisis epilĂ©pticas. Estas personas suelen vivir condicionadas por la posibilidad de un ataque epilĂ©ptico y sus posibles consecuencias, como accidentes, lesiones o incluso la muerte sĂşbita inexplicable. En este contexto, un dispositivo capaz de monitorizar el estado de salud y avisar de un posible ataque epilĂ©ptico contribuirĂa a mejorar la calidad de vida de estas personas.
La presente Tesis Doctoral se centra en el desarrollo de un novedoso sistema de monitorización ambulatoria que permita identificar y predecir los ataques epilépticos. Dicho sistema está compuesto por diferentes sensores capaces de registrar de forma sincronizada diferentes señales biomédicas. Mediante técnicas de aprendizaje automático supervisado, se han desarrollado diferentes modelos predictivos capaces de clasificar el estado de la persona epiléptica en normal, preictal (antes de la crisis) e ictal (crisis)
Electrocardiogram Monitoring Wearable Devices and Artificial-Intelligence-Enabled Diagnostic Capabilities: A Review
Worldwide, population aging and unhealthy lifestyles have increased the incidence of high-risk health conditions such as cardiovascular diseases, sleep apnea, and other conditions. Recently, to facilitate early identification and diagnosis, efforts have been made in the research and development of new wearable devices to make them smaller, more comfortable, more accurate, and increasingly compatible with artificial intelligence technologies. These efforts can pave the way to the longer and continuous health monitoring of different biosignals, including the real-time detection of diseases, thus providing more timely and accurate predictions of health events that can drastically improve the healthcare management of patients. Most recent reviews focus on a specific category of disease, the use of artificial intelligence in 12-lead electrocardiograms, or on wearable technology. However, we present recent advances in the use of electrocardiogram signals acquired with wearable devices or from publicly available databases and the analysis of such signals with artificial intelligence methods to detect and predict diseases. As expected, most of the available research focuses on heart diseases, sleep apnea, and other emerging areas, such as mental stress. From a methodological point of view, although traditional statistical methods and machine learning are still widely used, we observe an increasing use of more advanced deep learning methods, specifically architectures that can handle the complexity of biosignal data. These deep learning methods typically include convolutional and recurrent neural networks. Moreover, when proposing new artificial intelligence methods, we observe that the prevalent choice is to use publicly available databases rather than collecting new data
The 2023 wearable photoplethysmography roadmap
Photoplethysmography is a key sensing technology which is used in wearable devices such as smartwatches and fitness trackers. Currently, photoplethysmography sensors are used to monitor physiological parameters including heart rate and heart rhythm, and to track activities like sleep and exercise. Yet, wearable photoplethysmography has potential to provide much more information on health and wellbeing, which could inform clinical decision making. This Roadmap outlines directions for research and development to realise the full potential of wearable photoplethysmography. Experts discuss key topics within the areas of sensor design, signal processing, clinical applications, and research directions. Their perspectives provide valuable guidance to researchers developing wearable photoplethysmography technology
Continuous Estimation of Smoking Lapse Risk from Noisy Wrist Sensor Data Using Sparse and Positive-Only Labels
Estimating the imminent risk of adverse health behaviors provides opportunities for developing effective behavioral intervention mechanisms to prevent the occurrence of the target behavior. One of the key goals is to find opportune moments for intervention by passively detecting the rising risk of an imminent adverse behavior. Significant progress in mobile health research and the ability to continuously sense internal and external states of individual health and behavior has paved the way for detecting diverse risk factors from mobile sensor data. The next frontier in this research is to account for the combined effects of these risk factors to produce a composite risk score of adverse behaviors using wearable sensors convenient for daily use. Developing a machine learning-based model for assessing the risk of smoking lapse in the natural environment faces significant outstanding challenges requiring the development of novel and unique methodologies for each of them. The first challenge is coming up with an accurate representation of noisy and incomplete sensor data to encode the present and historical influence of behavioral cues, mental states, and the interactions of individuals with their ever-changing environment. The next noteworthy challenge is the absence of confirmed negative labels of low-risk states and adequate precise annotations of high-risk states. Finally, the model should work on convenient wearable devices to facilitate widespread adoption in research and practice. In this dissertation, we develop methods that account for the multi-faceted nature of smoking lapse behavior to train and evaluate a machine learning model capable of estimating composite risk scores in the natural environment. We first develop mRisk, which combines the effects of various mHealth biomarkers such as stress, physical activity, and location history in producing the risk of smoking lapse using sequential deep neural networks. We propose an event-based encoding of sensor data to reduce the effect of noises and then present an approach to efficiently model the historical influence of recent and past sensor-derived contexts on the likelihood of smoking lapse. To circumvent the lack of confirmed negative labels (i.e., annotated low-risk moments) and only a few positive labels (i.e., sensor-based detection of smoking lapse corroborated by self-reports), we propose a new loss function to accurately optimize the models. We build the mRisk models using biomarker (stress, physical activity) streams derived from chest-worn sensors. Adapting the models to work with less invasive and more convenient wrist-based sensors requires adapting the biomarker detection models to work with wrist-worn sensor data. To that end, we develop robust stress and activity inference methodologies from noisy wrist-sensor data. We first propose CQP, which quantifies wrist-sensor collected PPG data quality. Next, we show that integrating CQP within the inference pipeline improves accuracy-yield trade-offs associated with stress detection from wrist-worn PPG sensors in the natural environment. mRisk also requires sensor-based precise detection of smoking events and confirmation through self-reports to extract positive labels. Hence, we develop rSmoke, an orientation-invariant smoking detection model that is robust to the variations in sensor data resulting from orientation switches in the field. We train the proposed mRisk risk estimation models using the wrist-based inferences of lapse risk factors. To evaluate the utility of the risk models, we simulate the delivery of intelligent smoking interventions to at-risk participants as informed by the composite risk scores. Our results demonstrate the envisaged impact of machine learning-based models operating on wrist-worn wearable sensor data to output continuous smoking lapse risk scores. The novel methodologies we propose throughout this dissertation help instigate a new frontier in smoking research that can potentially improve the smoking abstinence rate in participants willing to quit
Influence of photoplethysmogram signal quality on pulse arrival time during polysomnography
Intervals of low-quality photoplethysmogram (PPG) signals might lead to significant inaccuracies in estimation of pulse arrival time (PAT) during polysomnography (PSG) studies. While PSG is considered to be a “gold standard” test for diagnosing obstructive sleep apnea (OSA), it also enables tracking apnea-related nocturnal blood pressure fluctuations correlated with PAT. Since the electrocardiogram (ECG) is recorded synchronously with the PPG during PSG, it makes sense to use the ECG signal for PPG signal-quality assessment. (1) Objective: to develop a PPG signal-quality assessment algorithm for robust PAT estimation, and investigate the influence of signal quality on PAT during various sleep stages and events such as OSA. (2) Approach: the proposed algorithm uses R and T waves from the ECG to determine approximate locations of PPG pulse onsets. The MESA database of 2055 PSG recordings was used for this study. (3) Results: the proportions of high-quality PPG were significantly lower in apnea-related oxygen desaturation (matched-pairs rc = 0.88 and rc = 0.97, compared to OSA and hypopnea, respectively, when p < 0.001) and arousal (rc = 0.93 and rc = 0.98, when p < 0.001) than in apnea events. The significantly large effect size of interquartile ranges of PAT distributions was between low- and high-quality PPG (p < 0.001, rc = 0.98), and regular and irregular pulse waves (p < 0.001, rc = 0.74), whereas a lower quality of the PPG signal was found to be associated with a higher interquartile range of PAT across all subjects. Suggested PPG signal quality-based PAT evaluation reduced deviations (e.g., rc = 0.97, rc = 0.97, rc = 0.99 in hypopnea, oxygen desaturation, and arousal stages, respectively, when p < 0.001) and allowed obtaining statistically larger differences between different sleep stages and events. (4) Significance: the implemented algorithm has the potential to increase the robustness of PAT estimation in PSG studies related to nocturnal blood pressure monitoring
Artificial Intelligence for the Edge Computing Paradigm.
With modern technologies moving towards the internet of things where seemingly every financial, private, commercial and medical transaction being carried out by portable and intelligent devices; Machine Learning has found its way into every smart device and application possible. However, Machine Learning cannot be used on the edge directly due to the limited capabilities of small and battery-powered modules. Therefore, this thesis aims to provide light-weight automated Machine Learning models which are applied on a standard edge device, the Raspberry Pi, where one framework aims to limit parameter tuning while automating feature extraction and a second which can perform Machine Learning classification on the edge traditionally, and can be used additionally for image-based explainable Artificial Intelligence. Also, a commercial Artificial Intelligence software have been ported to work in a client/server setups on the Raspberry Pi board where it was incorporated in all of the Machine Learning frameworks which will be presented in this thesis. This dissertation also introduces multiple algorithms that can convert images into Time-series for classification and explainability but also introduces novel Time-series feature extraction algorithms that are applied to biomedical data while introducing the concept of the Activation Engine, which is a post-processing block that tunes Neural Networks without the need of particular experience in Machine Leaning. Also, a tree-based method for multiclass classification has been introduced which outperforms the One-to-Many approach while being less complex that the One-to-One method.\par
The results presented in this thesis exhibit high accuracy when compared with the literature, while remaining efficient in terms of power consumption and the time of inference. Additionally the concepts, methods or algorithms that were introduced are particularly novel technically, where they include:
• Feature extraction of professionally annotated, and poorly annotated time-series.
• The introduction of the Activation Engine post-processing block.
• A model for global image explainability with inference on the edge.
• A tree-based algorithm for multiclass classification
Continuous monitoring of health and mobility indicators in patients with cardiovascular disease: a review of recent technologies
Cardiovascular diseases kill 18 million people each year. Currently, a patient’s health is assessed only during clinical visits, which are often infrequent and provide little information on the person’s health during daily life. Advances in mobile health technologies have allowed for the continuous monitoring of indicators of health and mobility during daily life by wearable and other devices. The ability to obtain such longitudinal, clinically relevant measurements could enhance the prevention, detection and treatment of cardiovascular diseases. This review discusses the advantages and disadvantages of various methods for monitoring patients with cardiovascular disease during daily life using wearable devices. We specifically discuss three distinct monitoring domains: physical activity monitoring, indoor home monitoring and physiological parameter monitoring
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