Improved Touchless Respiratory Rate Sensing

Recently, remote respiratory rate measurement techniques gained much attention as they were developed to overcome the limitations of device-based classical methods and manual counting. Many approaches for RR extraction from the video stream of the visible light camera were proposed, including the pixel intensity changes method. In this paper, we propose a new method for 1D profile creation for pixel intensity changes-based method, which significantly increases the algorithm's performance. Additional accuracy gain is obtained via a new method of motion signals grouping presented in this work. We introduce several changes to the standard pipeline, which enables real-time continuous RR monitoring and allows applications in the human-computer interaction systems. Evaluation results on two internal and one public datasets showed 0.7 BPM, 0.6 BPM, and 1.4 BPM MAE, respectively.Comment: 5 pages, 1 figure, 2 tables. This work was presented on the IMET 2022 workshop on Haptics, AI and RR

Multimedia delivery in the future internet

The term “Networked Media” implies that all kinds of media including text, image, 3D graphics, audio and video are produced, distributed, shared, managed and consumed on-line through various networks, like the Internet, Fiber, WiFi, WiMAX, GPRS, 3G and so on, in a convergent manner [1]. This white paper is the contribution of the Media Delivery Platform (MDP) cluster and aims to cover the Networked challenges of the Networked Media in the transition to the Future of the Internet. Internet has evolved and changed the way we work and live. End users of the Internet have been confronted with a bewildering range of media, services and applications and of technological innovations concerning media formats, wireless networks, terminal types and capabilities. And there is little evidence that the pace of this innovation is slowing. Today, over one billion of users access the Internet on regular basis, more than 100 million users have downloaded at least one (multi)media file and over 47 millions of them do so regularly, searching in more than 160 Exabytes1 of content. In the near future these numbers are expected to exponentially rise. It is expected that the Internet content will be increased by at least a factor of 6, rising to more than 990 Exabytes before 2012, fuelled mainly by the users themselves. Moreover, it is envisaged that in a near- to mid-term future, the Internet will provide the means to share and distribute (new) multimedia content and services with superior quality and striking flexibility, in a trusted and personalized way, improving citizens’ quality of life, working conditions, edutainment and safety. In this evolving environment, new transport protocols, new multimedia encoding schemes, cross-layer inthe network adaptation, machine-to-machine communication (including RFIDs), rich 3D content as well as community networks and the use of peer-to-peer (P2P) overlays are expected to generate new models of interaction and cooperation, and be able to support enhanced perceived quality-of-experience (PQoE) and innovative applications “on the move”, like virtual collaboration environments, personalised services/ media, virtual sport groups, on-line gaming, edutainment. In this context, the interaction with content combined with interactive/multimedia search capabilities across distributed repositories, opportunistic P2P networks and the dynamic adaptation to the characteristics of diverse mobile terminals are expected to contribute towards such a vision. Based on work that has taken place in a number of EC co-funded projects, in Framework Program 6 (FP6) and Framework Program 7 (FP7), a group of experts and technology visionaries have voluntarily contributed in this white paper aiming to describe the status, the state-of-the art, the challenges and the way ahead in the area of Content Aware media delivery platforms

Neonatal non-contact respiratory monitoring based on real-time infrared thermography

<p>Abstract</p> <p>Background</p> <p>Monitoring of vital parameters is an important topic in neonatal daily care. Progress in computational intelligence and medical sensors has facilitated the development of smart bedside monitors that can integrate multiple parameters into a single monitoring system. This paper describes non-contact monitoring of neonatal vital signals based on infrared thermography as a new biomedical engineering application. One signal of clinical interest is the spontaneous respiration rate of the neonate. It will be shown that the respiration rate of neonates can be monitored based on analysis of the anterior naris (nostrils) temperature profile associated with the inspiration and expiration phases successively.</p> <p>Objective</p> <p>The aim of this study is to develop and investigate a new non-contact respiration monitoring modality for neonatal intensive care unit (NICU) using infrared thermography imaging. This development includes subsequent image processing (region of interest (ROI) detection) and optimization. Moreover, it includes further optimization of this non-contact respiration monitoring to be considered as physiological measurement inside NICU wards.</p> <p>Results</p> <p>Continuous wavelet transformation based on Debauches wavelet function was applied to detect the breathing signal within an image stream. Respiration was successfully monitored based on a 0.3°C to 0.5°C temperature difference between the inspiration and expiration phases.</p> <p>Conclusions</p> <p>Although this method has been applied to adults before, this is the first time it was used in a newborn infant population inside the neonatal intensive care unit (NICU). The promising results suggest to include this technology into advanced NICU monitors.</p

Resuscitation of term and near-term newborns in low-resourced settings : Studies of positive end-expiratory pressure and expired CO2 during bag-mask ventilation at birth

Background: An estimated 0.7 million newborns die due to perinatal asphyxia each year, most are born at or near term. The major burden of preventable newborn deaths occur in low-resourced settings. A self-inflating bag is the most used and available equipment to save newborn lives globally. To aerate the lungs is key to survival. Expired CO2 (ECO2) may be an indicator for lung aeration, and positive end-expiratory pressure (PEEP) may facilitate aeration of the lungs. Research aiming to improve ventilation in term and near-term newborns using a self-inflating bag is needed. Aims: To investigate interpretation of ECO2 measured during bag-mask ventilation in the immediate newborn period, and assess whether this can be used as a marker for lung aeration, effective ventilation technique and prognosis. To study the effects of PEEP during bag-mask ventilation at or near term. Methods: Two observational studies and one randomized clinical trial were performed at Haydom Lutheran Hospital in Tanzania. Data were collected using direct observation, side-stream CO2-monitoring, respiratory function monitoring and dry-electrode ECG. In the randomized trial, newborns in need of ventilation were assigned in blocks based on weeks to receive ventilations by self-inflating bag with or without a PEEP-valve. Results: ECO2 during bag-mask ventilation at birth was significantly associated with both ventilation factors and clinical factors. Tidal volumes of 10-14 ml/kg and a low ventilation frequency of around 30 inflations/minute were associated with the fastest rise and highest levels of ECO2. ECO2 increased before heart rate, and measured levels of ECO2 during resuscitation could, similar to heart rate, predict 24-hours survival. Adding a PEEP-valve to the self-inflating bag did not improve heart rate, ECO2 or outcomes in term and near-term newborns despite delivery of an adequate PEEP. Conclusions: ECO2 may be seen as a combined marker for lung aeration, airway patency and pulmonary circulation at birth. Tidal volumes of 10-14 ml/kg and ventilation frequencies of around 30 inflations/minute may be favorable to achieve a fast lung aeration. We found no clinical benefit of adding a PEEP-valve during bag-mask ventilation at birth in term and near-term newborns, and our study does not support routine use

Continuous Health Interface Event Retrieval

Knowing the state of our health at every moment in time is critical for advances in health science. Using data obtained outside an episodic clinical setting is the first step towards building a continuous health estimation system. In this paper, we explore a system that allows users to combine events and data streams from different sources to retrieve complex biological events, such as cardiovascular volume overload. These complex events, which have been explored in biomedical literature and which we call interface events, have a direct causal impact on relevant biological systems. They are the interface through which the lifestyle events influence our health. We retrieve the interface events from existing events and data streams by encoding domain knowledge using an event operator language.Comment: ACM International Conference on Multimedia Retrieval 2020 (ICMR 2020), held in Dublin, Ireland from June 8-11, 202

Physiological Self Regulation with Biofeedback Games

Mental stress is a global epidemic that can have serious health consequences including cardiovascular diseases and diabetes. Several techniques are available to teach stress self-regulation skills including therapy, meditation, deep breathing, and biofeedback. While effective, these methods suffer from high drop-outs due to the monotonic nature of the exercises and are generally practiced in quiet relaxed environment, which may not transfer to real-world scenarios. To address these issues, this dissertation presents a novel intervention for stress training using games and wearable sensors. The approach consists of monitoring the user’s physiological signals during gameplay, mapping them into estimates of stress levels, and adapting the game in a way that promotes states of low arousal. This approach offers two key advantages. First, it allows users to focus on the gameplay rather than on monitoring their physiological signals, which makes the training far more engaging. More importantly, it teaches users to self-regulate their stress response, while performing a task designed to increase arousal. Within this broad framework, this dissertation studies three specific problems. First, the dissertation evaluates three physiological signals (breathing rate, heart rate variability, and electrodermal activity) that span across the dimensions of degrees of selectivity in measuring arousal and voluntary control in their effectiveness in lowering arousal. This will identify the signal appropriate for game based stress training and the associated bio-signal processing techniques for real-time arousal estimation. Second, this dissertation investigates different methods of biofeedback presentation e.g. visual feedback and game adaptation during gameplay. Selection of appropriate biofeedback mechanism is critical since it provides the necessary information to improve the perception of visceral states (e.g. stress) to the user. Furthermore, these modalities facilitate skill acquisition in distinct ways (i.e., top-down and bottom-up learning) and influence retention of skills. Third, this dissertation studies reinforcement scheduling in a game and its effect on skill learning and retention. A reinforcement schedule determines which occurrences of the target response are reinforced. This study focuses on continuous and partial reinforcement schedules in GBF and their effect on resistance to extinction (i.e. ability to retain learned skills) after the biofeedback is removed. The main contribution of this dissertation is in demonstrating that stress self-regulation training can be embedded in videogames and help individuals develop more adaptive responses to reduce physiological stress encountered both at home and work

Wearable Wireless Devices

No abstract available

Wearable Wireless Devices

No abstract available

A prospective observational study on newborn resuscitation in a high-resource setting

Bakgrunn: Omkring åtte prosent av verdens nyfødte har behov for pustehjelp for å klare overgangen fra intra- til ekstrauterint liv. Nøyaktig forekomst er usikker og varierer antagelig mellom ulike settinger, men resuscitering av nyfødte er likevel en av de vanligste akuttbehandlinger i sykehus rundt om i verden. Internasjonale retningslinjer for nyfødtresuscitering skal sikre lik og optimal behandling av syke nyfødte. Imidlertid er kunnskapsgrunnlaget for internasjonale retningslinjer mangelfullt, og baserer seg i stor grad på prekliniske studier uten sikker forankring i den kliniske hverdagen. Pustestøtte ansees som det viktigste tiltaket, og retningslinjer presiserer at overtrykksventilering bør starte innen ett minutt fra fødsel hos barn som ikke puster selv. Lav hjertefrekvens kan indikere behov for pustestøtte, og ved eventuelle tiltak vil rask bedring i hjertefrekvens indikere at behandlingen er effektiv. Retningslinjer anbefaler derfor tidlig vurdering av barnets hjertefrekvens, og at hjertefrekvens overvåkes under resuscitering ved hjelp av pulsoksymetri (PO) eller elektrokardiografi (EKG). Likevel finnes det lite kunnskap om hva som faktisk er normal hjertefrekvens de første minuttene etter fødsel, og man vet ikke hvilken metode som mest effektivt overvåker barnets hjertefrekvens under resuscitering. T-stykke ventilator er blitt et vanlig apparat for å gi luftveisstøtte til nyfødte. Forskning på bruk av disse apparatene under resuscitering i hovedsak utprøvd på premature nyfødte. Resultater fra forskning på nyfødtresuscitering danner et viktig grunnlag for videre utvikling av evidensbaserte anbefalinger. Mål: Mål for dette prosjektet var å i) studere forekomst av, karakteristika ved, og utfall av nyfødtresuscitering på kort sikt i en høyressurs setting, ii) studere etterlevelsen av retningslinjer for nyfødtresuscitering og undersøke hvor effektivt PO og EKG er til å overvåke hjertefrekvens under resuscitering, iii) beskrive normal hjertefrekvens hos friske nyfødte etter vaginal forløsning og sen avnavling, og iv) beskrive hvilke trykk og volum som leveres ved overtrykksventilering av ikke-pustende nyfødte til termin, når man bruker en T-stykke ventilator. Metode: Denne sammenstillingen bygger på fire prospektive observasjonsstudier. Alle studiene er utført ved Stavanger Universitetssjukehus. Studie I benyttet seg av rapporteringsskjema og videofilming over 12 måneder for å registrere og analysere tiltak ved nyfødtresuscitering. Vi registrerte forekomst av overtrykksventilering, kontinuerlig positivt luftveistrykk (CPAP), intubasjon, hjertekompresjoner og intravenøs administrasjon av adrenalin. Utfall etter resuscitering ble hentet fra elektroniske pasientjournaler. I studie II brukte vi videofilmer fra resuscitering av ikke-pustende barn ≥ 34 gestasjonsuker sammen med PO og/eller EKG-signal fra pasientmonitor. Vi målte tid fra fødsel til vurdering av hjerterytme og tid til oppstart av overtrykksventilering. Videre målte vi tid til pålitelig signal fra PO og EKG. I studie III målte vi hjertefrekvens de første fem minuttene etter fødsel hos friske, vaginalforløste terminbarn med sen avnavling, ved hjelp av en nyutviklet hjertefrekvensmåler med tørrelektrode-EKG (NeoBeat). Vi brukte ‘locally estimated scatterplot smoothing’ for å beregne og tegne percentiler. I studie IV brukte vi en ventilasjonsmonitor for å måle og analysere venilasjonsparametre under overtrykksventilering av terminbarn etter fødsel med T-stykke ventilator som var innstilt etter internasjonale anbefalinger (30/5 cmH2O). Vi analyserte de første 100 innblåsingene i hver resuscitering, og delte dem inn i tidlig (1.-20. innblåsing) og sen (21.-100. innblåsing) fase. Vi brukte ‘general estimating equations’ for å analysere assosiasjoner mellom tidalvolum og topptrykk, innblåsingstid og ventilasjonsfrekvens. Resultat: I studie I inkluderte vi 4693 nyfødte. Av disse ble 291 (6.2%) behandlet med pustehjelp eller annen støtte umiddelbart etter fødsel. Antall nyfødte som ble behandlet med overtrykksventilering, CPAP, intubasjon, brystkompresjoner og intravenøs administrasjon av adrenalin var henholdsvis 170 (3.6%), 121 (2.6%), 19 (0.4%), ti (0.2%), og tre (0.1%). Median (IQR) varighet av overtrykksventilasjon var 106 (54-221) sekunder. 63% av de resusciterte nyfødte ≥34 gestasjonsuker ble igjen hos foreldre etter resusciteringen. I studie II analyserte vi resusciteringer av 104 nyfødte som ikke pustet etter fødsel. I bare 35% av tilfellene ble hjertefrekvens vurdert (ved palpasjon eller auskultasjon) og overtrykksventilering startet innen 60 sekunder etter fødsel. Tiden fra fødsel til vurdering av hjertefrekvens og oppstart av overtrykksventilering var henholdsvis 70 (47-118) og 78 (42-118) sekunder. Tiden fra fødsel til pålitelig registrering av hjertefrekvens fra PO og EKG var henholdsvis 348 (217-524) og 174 (105-227) sekunder (p<0.001). Tiden fra PO måler eller EKG elektroder ble festet på barnet og til pålitelig registrering av hjertefrekvens var henholdsvis 199 (77-352) og 16 (11-22) sekunder (p<0.001). I studie III målte vi hjertefrekvens etter fødsel hos 898 friske nyfødte terminbarn. Hjertefrekvensen økte raskt fra 123 (98-147) slag per minutt ved 5 sekunders alder til 175 (157-189) slag per minutt ved 61 sekunders alder. I studie IV analyserte vi venilasjonsparametre under resuscitering av 129 nyfødte terminbarn. Topptrykket var 30 (28-31) mbar i tidlig fase og 30 (27-31) mbar i sen fase. Tidalvolum var 4.5 (1.6-7.8) ml/kg i tidlig fase og 5.7 (2.2-9.8) ml/kg i sen fase. Innblåsingstid på mer enn 0.41 sekunder i tidlig fase og 0.50 sekunder i sen fase var assosiert med de høyeste tidalvolumene. Ventilasjonsfrekvens på mer enn 32 innblåsinger per minutt i tidlig fase og 41 innblåsinger i per minutt i sen fase var assosiert med reduserte tidalvolum. Konklusjon: Nyfødtresuscitering forekom hyppig i denne høyressurs-settingen. De fleste nyfødte responderte raskt på luftveisstøtte. Etterlevelsen av gjeldende retningslinjer var dårlig. Under resuscitering av nyfødte ble pålitelig overvåkning av hjertefrekvens etablert raskere med EKG enn med PO. Vi har presentert percentiler for normal hjertefrekvens etter fødsel hos friske vaginalforløste terminbarn etter sen avnavling. Når man ventilerte nyfødte terminbarn ved hjelp av en T-stykke ventilator ble det levert stabile topptrykk, men det var vesentlig variasjon i tidalvolum. Innblåsingstid på omtrent 0.5 sekunder og ventilasjonsfrekvens på 30-40 innblåsinger i minuttet var assosiert med det høyeste tidalvolumet.Background: An estimated eight percent of newborns globally need respiratory support at birth to make the transition from intra- to extra uterine life. Although these estimates are uncertain, and presumably vary between settings, newborn resuscitation remains one of the most commonly occurring emergencies in the hospital. Resuscitation guidelines should ensure optimal treatment of compromised newborns; however, there is a general lack of evidence to support the different treatment recommendations. Existing knowledge is in large part derived from pre-clinical studies, and the transferability to real-world resuscitations is uncertain. Guidelines highlight support of breathing as the single most important task during newborn resuscitation, and positive pressure ventilation (PPV) should be initiated within the first minute of life in apnoeic newborns. Furthermore, guidelines acknowledge the newborn heart rate as an important factor to guide resuscitative interventions, and recommend continuous heart rate monitoring during resuscitation by either pulse oximetry (PO) or electrocardiography (ECG). However, there is limited data on the normal heart rate in healthy newborns, and the optimal method for monitoring heart rate during newborn resuscitation remains unknown. The flow driven T-piece resuscitator is a widely used device for respiratory support at birth. However, research into its ventilation performance during resuscitation is limited to premature newborns. Studies on newborn resuscitations provide important feedback to support the process of evolving evidence based resuscitation guidelines. Aim: The aim of this thesis was to i) study the incidence, characteristics and short-term outcomes in newborn resuscitation in a high-resource setting, ii) study compliance with resuscitation algorithms and efficacy of PO versus ECG as heart rate monitoring during resuscitation, iii) describe the normal heart rate in vaginally delivered healthy term newborns after delayed cord clamping, and iv) describe delivered pressures and tidal volumes during positive pressure ventilation of apnoeic term newborns with a T-piece resuscitator. Method: This thesis consists of four prospective observational studies. All studies were conducted at Stavanger University Hospital in Norway. Study I used incident report forms and video recordings to register and analyse resuscitative interventions during a period of 12 months. We recorded the incidence of PPV, continuous positive airway pressure (CPAP), intubation, chest compressions and intravenous administration of adrenaline. From electronic patient records we extracted short-term outcomes after resuscitation. In study II, we combined video recordings of resuscitations with PO and ECG signals from the patient monitor, to analyse guideline compliance and efficacy of heart rate monitoring in newborns ≥34 weeks of gestation receiving PPV after birth. We recorded the time from birth to initiation of PPV and time from birth to initial heart rate assessment by palpation or stethoscope. We compared time to accurate heart rate monitoring between PO and 3-lead ECG. For study III, we used a novel dry electrode ECG heart rate meter (NeoBeat, Laerdal Medical, Stavanger, Norway) to record physiological newborn heart rate in healthy vaginally born newborns after delayed cord clamping the first five minutes after birth. Heart rate centiles were drawn using a local regression model. In study IV we combined video recordings of resuscitations and a respiratory function monitor to record and analyse ventilation parameters during PPV of apnoeic term newborns after birth, using a T-piece resuscitator at standard internationally recommended settings of 30/5 cmH2O. We analysed the first 100 inflations from each resuscitation, and divided them into an early (inflation 1-20) and a late (inflation 21-100) phase. We applied general estimating equations to analyse the association between delivered tidal volumes, and peak inflating pressure, inflation time, and inflation rate. Results: Study I included 4693 newborns. Of those, 291 (6.2%) received interventions after birth. The incidence of PPV, CPAP (only), intubation, chest compressions, and intravenous administration of adrenaline were 170 (3.6%), 121 (2.6%), 19 (0.4%), ten (0.2%), and three (0.1%), respectively. Median (IQR) duration of PPV was 106 (54-221) seconds. 63% of newborns ≥34 weeks of gestation were returned to parental care immediately after resuscitation. For study II, we analysed video- and heart rate recordings of 104 resuscitations. Initial heart rate assessment (stethoscope or palpation) and initiation of PPV were achieved within 60 seconds for 35% of the resuscitated newborns. The time from birth to initial heart rate assessment and initiation of PPV was 70 (47-118) and 78 (42-118) seconds, respectively. Time from birth to provision of a reliable heart rate signal was 348 (217-524) seconds for PO, and 174 (105-227) seconds for ECG (p<0.001). Time from sensor application to a reliable heart rate signal was 199 (77-352) seconds for PO, and 16 (11-22) seconds for ECG (p<0.001). In study III, we recorded heart rates from five seconds to five minutes in 898 healthy, vaginally delivered term newborns. Following birth, the heart rate increased rapidly from 123 (98-147) beats per minute at five seconds after birth to 175 (157-189) beats per minute at 61 seconds after birth. In study IV we analysed ventilation parameters from the resuscitation of 129 term newborns. PIP was 30 (28-31) mbar in the early phase and 30 (27-31) mbar in the late phase. Tidal volume was 4.5 (1.6-7.8) ml/kg in the early phase and 5.7 (2.2-9.8) ml/kg in the late phase. Inflation times exceeding 0.41 seconds in the early phase and 0.50 seconds in the late phase were associated with the highest delivered tidal volumes. Inflation rates exceeding 32 per minute during the early phase and 41 per minute in the late phase were associated with a decrease in tidal volumes. Conclusion: The need of resuscitative interventions after birth was frequent in this high-resource setting, and most newborns responded quickly to airway support. The adherence to guidelines was poor. ECG provided a reliable heart rate signal significantly faster than PO during newborn resuscitation. We presented normal heart rate centiles in vaginally delivered term newborns after delayed cord clamping. When ventilating apnoeic newborns at birth with a T-piece resuscitator, there was a consistent delivery of PIP, however, tidal volumes varied substantially. Inflation time of approximately 0.5 seconds and rates of approximately 30-40 per minute were associated with the highest delivered tidal volumes.Doktorgradsavhandlin

Emotions in context: examining pervasive affective sensing systems, applications, and analyses

Pervasive sensing has opened up new opportunities for measuring our feelings and understanding our behavior by monitoring our affective states while mobile. This review paper surveys pervasive affect sensing by examining and considering three major elements of affective pervasive systems, namely; “sensing”, “analysis”, and “application”. Sensing investigates the different sensing modalities that are used in existing real-time affective applications, Analysis explores different approaches to emotion recognition and visualization based on different types of collected data, and Application investigates different leading areas of affective applications. For each of the three aspects, the paper includes an extensive survey of the literature and finally outlines some of challenges and future research opportunities of affective sensing in the context of pervasive computing