Internet of medical things – integrated, ultrasound-based respiration monitoring system for incubators

The study's aim was to develop a non-contact, ultrasound (US) based respiration rate and respiratory signal monitor suitable for babies in incubators. Respiration rate indicates average number of breaths per minute and is higher in young children than adults. It is an important indicator of health deterioration in critically ill patients. The current incubators do not have an integrated respiration monitor due to complexities in its adaptation. Monitoring respiratory signal assists in diagnosing respiration rated problems such as central Apnoea that can affect infants. US sensors are suitable for integration into incubators as US is a harmless and cost-effective technology. US beam is focused on the chest or abdomen. Chest or abdomen movements, caused by respiration process, result in variations in their distance to the US transceiver located at a distance of about 0.5 m. These variations are recorded by measuring the time of flight from transmitting the signal and its reflection from the monitored surface. Measurement of this delay over a time interval enables a respiration signal to be produced from which respiration rate and pauses in breathing are determined. To assess the accuracy of the developed device, a platform with a moving surface was devised. The magnitude and frequency of its surface movement were accurately controlled by its signal generator. The US sensor was mounted above this surface at a distance of 0.5 m. This US signal was wirelessly transmitted to a microprocessor board to digitise. The recorded signal that simulated a respiratory signal was subsequently stored and displayed on a computer or an LCD screen. The results showed that US could be used to measure respiration rate accurately. To cater for possible movement of the infant in the incubator, four US sensors were adapted. These monitored the movements from different angles. An algorithm to interpret the output from the four US sensors was devised and evaluated. The algorithm interpreted which US sensor best detected the chest movements. An IoMT system was devised that incorporated NodeMcu to capture signals from the US sensor. The detected data were transmitted to the ThingSpeak channel and processed in real-time by ThingSpeak’s add-on Matlab© feature. The data were processed on the cloud and then the results were displayed in real-time on a computer screen. The respiration rate and respiration signal could be observed remotely on portable devices e.g. mobile phones and tablets. These features allow caretakers to have access to the data at any time and be alerted to respiratory complications. A method to interpret the recorded US signals to determine respiration patterns, e.g. intermittent pauses, were implemented by utilising Matlab© and ThingSpeak Server. The method successfully detected respiratory pauses by identifying lack of chest movements. The approach can be useful in diagnosing central apnoea. In central apnoea, respiratory pauses are accompanied by cessation of chest or abdominal movements. The devised system will require clinical trials and integration into an incubator by conforming to the medical devices directives. The study demonstrated the integration of IoMT-US for measuring respiration rate and respiratory signal. The US produced respiration rate readings compared well with the actual signal generator's settings of the platform that simulated chest movements

Respiration Measurement in a Simulated Setting Incorporating the Internet of Things

The Internet of Things (IoT) in healthcare has gained significant attention in recent years. This study demonstrates an adaptation of IoT in healthcare by illustrating a method of respiration rate measurement from a platform that simulates breathing. Respiration rate is a crucial physiological measure in monitoring critically ill patients. The devised approach, with further development, may be suitable for integration into neonatal intensive care units (NICUs) to measure infants’ respiration rate. A potential advantage of this method is that it monitors respiration using a wireless non-contact method and could add benefits such as preservation of skin integrity. The paper aimed to assess the accuracy of an IoT-integrated ultrasound (US)-based method for measuring respiration rate. Chest movement due to respiration was simulated by a platform with a controllable moving surface. The magnitude and frequency of the movements were accurately controlled by a signal generator. The surface movements were tracked using US as a reliable and cost-effective technology. ESP8266 NodeMCU was used to wirelessly record the US signal and ThingSpeak and Matlab© were used to analyze and visualize the data in the cloud. A close relationship between the measured rate of the simulated respiration and the actual frequency was observed. The study demonstrated a possible adaption of IoT for respiration rate measurement, however further work will be needed to ensure security and reliability of data handling before use of the system in medical environments

Identifying Conservation Priorities for a Widespread Dugong Population in the Red Sea: Megaherbivore Grazing Patterns Inform Management Planning

Extensive home ranges of marine megafauna present a challenge for systematic conservation planning because they exceed spatial scales of conventional management. For elusive species like dugongs, their management is additionally hampered by a paucity of basic distributional information across much of their range. The Red Sea is home to a wide-spread, globally important but data-poor population of dugongs. We surveyed the north-eastern Red Sea in the waters of NEOM, Kingdom of Saudi Arabia, to locate feeding sites and determine priority areas for dugong conservation. We conducted large-scale in-water surveys of dugong feeding trails across 27 seagrass meadows that span 0.7 degree of latitude and recorded nine seagrass species and 13 dugong feeding sites. Spread over ~ 4‚061 km2 of nearshore and offshore waters, many of these sites clustered around five main core feeding areas. Dugong feeding trails were mostly recorded at sites dominated by the fast-growing pioneer seagrasses Halodule uninervis, Halophila ovalis and/or H. stipulacea. Multispecific meadows with pioneer seagrasses tended to be sheltered and shallow, reflecting a similar spatial pattern to the identified dugong feeding sites. Often close to hotels and fishing harbours, these high-use dugong areas are subject to high boat traffic, fishing, and coastal development which places considerable pressures on this vulnerable mammal and its seagrass habitat. The rapidly accelerating coastal development in the northern Red Sea directly threatens the future of its dugong population. Although our sampling focuses on feeding signs in early successional seagrasses, the results are valuable to spatial conservation planning as they will trigger overdue conservation interventions for a globally threatened species in a data-poor area. Urgent dugong conservation management actions in the northern Red Sea should focus on shallow waters sheltered by coastal lagoons, bays and the lee of large islands.Peer reviewe