Antepartum Fetal Monitoring through a Wearable System and a Mobile Application

Prenatal monitoring of Fetal Heart Rate (FHR) is crucial for the prevention of fetal pathologies and unfavorable deliveries. However, the most commonly used Cardiotocographic exam can be performed only in hospital-like structures and requires the supervision of expert personnel. For this reason, a wearable system able to continuously monitor FHR would be a noticeable step towards a personalized and remote pregnancy care. Thanks to textile electrodes, miniaturized electronics, and smart devices like smartphones and tablets, we developed a wearable integrated system for everyday fetal monitoring during the last weeks of pregnancy. Pregnant women at home can use it without the need for any external support by clinicians. The transmission of FHR to a specialized medical center allows its remote analysis, exploiting advanced algorithms running on high-performance hardware able to obtain the best classification of the fetal condition. The system has been tested on a limited set of pregnant women whose fetal electrocardiogram recordings were acquired and classified, yielding an overall score for both accuracy and sensitivity over 90%. This novel approach can open a new perspective on the continuous monitoring of fetus development by enhancing the performance of regular examinations, making treatments really personalized, and reducing hospitalization or ambulatory visits. Keywords: tele-monitoring; wearable devices; fetal heart rate; telemedicin

Parental evaluation of a telemonitoring service for children with Type 1 Diabetes

Introduction In the past years, we developed a telemonitoring service for young patients affected by Type 1 Diabetes. That service provides data to the clinical staff and offers an important tool to the parents, that are able to oversee in real time their children. The aim of this work was to analyze the parents' perceived usefulness of the service. Methods The service was tested by the parents of 31 children enrolled in a seven-day clinical trial during a summer camp. To study the parents' perception we proposed and analyzed two questionnaires. A baseline questionnaire focused on the daily management and implications of their children's diabetes, while a post-study one measured the perceived benefits of telemonitoring. Questionnaires also included free text comment spaces. Results Analysis of the baseline questionnaires underlined the parents' suffering and fatigue: 51% of total responses showed a negative tendency and the mean value of the perceived quality of life was 64.13 in a 0-100 scale. In the post-study questionnaires about half of the parents believed in a possible improvement adopting telemonitoring. Moreover, the foreseen improvement in quality of life was significant, increasing from 64.13 to 78.39 ( p-value\u2009=\u20090.0001). The analysis of free text comments highlighted an improvement in mood, and parents' commitment was also proved by their willingness to pay for the service (median\u2009=\u2009200\u2009euro/year). Discussion A high number of parents appreciated the telemonitoring service and were confident that it could improve communication with physicians as well as the family's own peace of mind

Combining multivariate statistics and the think-aloud protocol to assess Human-Computer Interaction barriers in symptom checkers

[EN] Symptom checkers are software tools that allow users to submit a set of symptoms and receive advice related to them in the form of a diagnosis list, health information or triage. The heterogeneity of their potential users and the number of different components in their user interfaces can make testing with end-users unaffordable. We designed and executed a two-phase method to test the respiratory diseases module of the symptom checker Erdusyk. Phase I consisted of an online test with a large sample of users (n = 53). In Phase I, users evaluated the system remotely and completed a questionnaire based on the Technology Acceptance Model. Principal Component Analysis was used to correlate each section of the interface with the questionnaire responses, thus identifying which areas of the user interface presented significant contributions to the technology acceptance. In the second phase, the think-aloud procedure was executed with a small number of samples (n = 15), focusing on the areas with significant contributions to analyze the reasons for such contributions. Our method was used effectively to optimize the testing of symptom checker user interfaces. The method allowed kept the cost of testing at reasonable levels by restricting the use of the think-aloud procedure while still assuring a high amount of coverage. The main barriers detected in Erdusyk were related to problems understanding time repetition patterns, the selection of levels in scales to record intensities, navigation, the quantification of some symptom attributes, and the characteristics of the symptoms. (C) 2017 Elsevier Inc. All rights reserved.This work was supported by Helse Nord [grant HST1121-13], the Faculty of Health Sciences from UIT The Arctic University of Norway [researcher code 1108], and The Research Council of Norway [grant 248150/O70]. We thank Professor Emeritus Rafael Romero-Villafranca for reviewing the statistical analysis of this paper.Marco-Ruiz, L.; Bones, E.; De La Asuncion, E.; Gabarron, E.; Aviles-Solis, JC.; Lee, E.; Traver Salcedo, V.... (2017). Combining multivariate statistics and the think-aloud protocol to assess Human-Computer Interaction barriers in symptom checkers. Journal of Biomedical Informatics. 74:104-122. https://doi.org/10.1016/j.jbi.2017.09.002S1041227

Obesity, diet and body temperature

Studies conducted thus far on the pathogenesis of obesity have not clearly determined the role of body temperature in the energy balance. In an attempt to explore this relationship further, research has been undertaken, a part of which is represented by the present investigation carried out on 22 adult males: 11 having a BMI less than or equal to 25 (group A) and 11 with BMI greater than 25 (group B). Body temperature was measured by mouth and on the skin surface (in 4 points according to Ramanathan) on 2 consecutive days (every 30 min from noon to 6:30 p.m.), the 1st day with the participants fasting and the 2nd day after consumption of a meal whose energy content represented a part (45%) of the 24-hour energy intake of the subjects, as previously ascertained by a survey of their food consumption. The study was carried out under frequently checked microclimatic conditions. During the week prior to the measurements, the alimentary consumption of the subjects was monitored by direct weighing for 5 consecutive days. A significant rise in body temperature, probably due to dietary thermogenesis, was observed in group A (internal temperature: F = 13.05; skin temperature: F = 6.48) as well as in group B (internal temperature: F = 24.88; skin temperature: F = 5.35) after the meal. However in group B the skin temperature showed a smaller increase than in group A (delta t degree 0.31 vs. 0.49) and an earlier trend towards the basal values (nearly 5 vs. 6 h after the meal). In both groups a decrease in the skin delta t degrees is evident at 3 and 3.5 h, respectively, after the meal, followed by a more remarkable increase in this difference between the 4th and the 5th hour. The meaning of this decrease as well as the difference in body temperature versus caloric intake is discussed. Normal weight individuals demonstrated a positive correlation (r = 0.83) between usual caloric intake per square meter of body surface and fasting internal body temperature. This correlation was not observed in subjects with BMI greater than 25

Effects of various dietary selenium intakes on the levels of blood glutathione-peroxidase and selenium in long-term fed rats

Female Sprague-Dawley rats were fed a torula diet or wheat diets containing 4 levels of Se partially supplemented (24-402 ppb) for 120 days. Selenium content and glutathione-peroxidase (GSH-Px) activity in plasma and erythrocytes were measured every 20 days. In rats fed torula diet or basal wheat diet, plasma Se (P-Se) increased for up to 60 days, then remained constant, while erythrocytes Se (E-Se) and E-GSH-Px decreased in basal-diet rats during the first 40-60 days, then increased. In rats fed supplemented diets, P-Se and P-GSH-Px increased more rapidly than E-Se and E-GSH-Px, plateauing at 60-80 days. The best correlation was found between P-GSH-Px and dietary Se indicating that this index is the most sensitive for evaluating changes resulting from different Se intakes. In addition, correlations became more significant with time. The results from rats fed a low Se diet suggest the existence of regulatory mechanisms working in different ways and at different times in plasma and erythrocytes

A Novel Algorithm for the Design of Ketogenic Meals

Introduction: The authors previously developed Ketty as a smartphone app for Ketogenic Diet patients. Ketty includes a food intake diary and a parameters monitoring section that allows the clinical staff to remotely oversee patients. In this work we describe a companion tool that has been implemented for empowering those patients in designing tasty meals. Methods: We used the Banca Dati Alimenti (BDA) provided by the Istituto Europeo di Oncologia as the source for the nutrition facts of the food ingredients and The Meal Db which is publicly available on the Internet as a source of recipes. We designed an algorithm for reshaping available recipes making them compliant with the dietary prescription.Results: A first standalone prototype written in Java has been implemented importing data from the BDA and interfacing through a Web Service with The Meal DB database. When a target prescription is provided in terms of lipids, carbohydrates and proteins, the algorithm first proposes a set of recipes to work with and then reshapes the selected one solving the planning meal problem.Conclusions: The prototype is be able to create recipes matching very closely the target provided and preserving their tastiness. We are planning to set up a formal validation study for the prototype and to integrate it into Ketty