Sensor Technologies to Manage the Physiological Traits of Chronic Pain: A Review

Non-oncologic chronic pain is a common high-morbidity impairment worldwide and acknowledged as a condition with significant incidence on quality of life. Pain intensity is largely perceived as a subjective experience, what makes challenging its objective measurement. However, the physiological traces of pain make possible its correlation with vital signs, such as heart rate variability, skin conductance, electromyogram, etc., or health performance metrics derived from daily activity monitoring or facial expressions, which can be acquired with diverse sensor technologies and multisensory approaches. As the assessment and management of pain are essential issues for a wide range of clinical disorders and treatments, this paper reviews different sensor-based approaches applied to the objective evaluation of non-oncological chronic pain. The space of available technologies and resources aimed at pain assessment represent a diversified set of alternatives that can be exploited to address the multidimensional nature of pain.Ministerio de Economía y Competitividad (Instituto de Salud Carlos III) PI15/00306Junta de Andalucía PIN-0394-2017Unión Europea "FRAIL

Special Issue “Body Sensors Networks for E-Health Applications”

Body Sensor Networks (BSN) have emerged as a particularization of Wireless Sensor Networks (WSN) in the context of body monitoring environments, closely linked to healthcare applications. These networks are made up of smart biomedical sensors that allow the monitoring of physiological parameters and serve as the basis for e-Health applications. This Special Issue collects some of the latest developments in the field of BSN related to new developments in biomedical sensor technologies, the design and experimental characterization of on-body/in-body antennas and new communication protocols for BSN, including some review studies

Lessons Learned about the Design and Active Characterization of On-Body Antennas in the 2.4 GHz Frequency Band

This work addresses the design and experimental characterization of on-body antennas, which play an essential role within Body Sensor Networks. Four antenna designs were selected from a set of eighteen antenna choices and finally implemented for both passive and active measurements. The issues raised during the process of this work (requirements study, technology selection, development and optimization of antennas, impedance matching, unbalanced to balanced transformation, passive and active characterization, off-body and on-body configurations, etc.) were studied and solved, driving a methodology for the characterization of on-body antennas, including transceiver effects. Despite the influence of the body, the antennas showed appropriate results for an in-door environment. Another novelty is the proposal and validation of a phantom to emulate human experimentation. The differences between experimental and simulated results highlight a set of circumstances to be taken into account during the design process of an on-body antenna: more comprehensive simulation schemes to take into account the hardware effects and a custom design process that considers the application for which the device will be used, as well as the effects that can be caused by the human body.Ministerio de Economía y Competitividad (Instituto de Salud Carlos III) PI15/00306Junta de Andalucía PIN-0394-2017Unión Europea "FRAIL

Adaptation and application of the IEEE 2413-2019 standard security mechanisms to IoMT systems

Healthcare information systems are evolving from traditional centralised architectures towards highly-mobile distributed environments within the connected health context. The IoMT paradigm is at the forefront of this technological revolution underlying the development of communication infrastructures connecting smart medical devices, healthcare information systems and services. The IEEE 2413 standard, a promising general architectural framework for the design and implementation of IoT systems, has recently been announced. This standard proposes a general description for different types of domains, including healthcare, but it does not contain an extension developed for the IoMT systems domain. This paper presents a first approach to adapt the IEEE 2413 standard to the design of IoMT systems from a security perspective, considering the most relevant aspects of the standard for the construction of this type of systems. The application to an IoMT system for monitoring patients with chronic obstructive pulmonary disease is presented as a use case.Fundación Mutua MadrileñaSociedad Española de Diabete

Segmentation-based lossless compression of burn wound images

Color images may be encoded by using a gray-scale image compression technique on each of the three color planes. Such an approach, however, does not take advantage of the correlation existing between the color planes. In this paper, a new segmentation-based lossless compression method is proposed for color images. The method exploits the correlation existing among the three color planes by treating each pixel as a vector of three components, performing region growing and difference operations using the vectors, and applying a color coordinate transformation. The method performed better than the Joint Photographic Experts Group (JPEG) standard by an average of 3.40 bits/pixel with a database including four natural color images of scenery, four images of burn wounds, and four fractal images, and it outperformed the Joint Bi-Level Image experts Group (JBIG) standard by an average of 3.01 bits/pixel. When applied to a database of 20 burn wound images, the 24 bits/pixel images were efficiently compressed to 4.79 bits/pixel, then requiring 4.16 bits/pixel less than JPEG and 5.41 bits/pixel less than JBIG

Segmentation and classification of burn images by color and texture information

In this paper, a burn color image segmentation and classification system is proposed. The aim of the system is to separate burn wounds from healthy skin, and to distinguish among the different types of burns (burn depths). Digital color photographs are used as inputs to the system. The system is based on color and texture information, since these are the characteristics observed by physicians in order to form a diagnosis. A perceptually uniform color space (L *u*v *) was used, since Euclidean distances calculated in this space correspond to perceptual color differences. After the burn is segmented, a set of color and texture features is calculated that serves as the input to a Fuzzy-ARTMAP neural network. The neural network classifies burns into three types of burn depths: superficial dermal, deep dermal, and full thickness. Clinical effectiveness of the method was demonstrated on 62 clinical burn wound images, yielding an average classification success rate of 82

CAD Tool for Burn Diagnosis

In this paper a new system for burn diagnosis is proposed. The aim of the system is to separate burn wounds from healthy skin, and the different types of burns (burn depths) from each other, identifying each one. The system is based on the colour and texture information, as these are the characteristics observed by physicians in order to give a diagnosis. We use a perceptually uniform colour space (L*u*v*), since Euclidean distances calculated in this space correspond to perceptually colour differences. After the burn is segmented, some colour and texture descriptors are calculated and they are the inputs to a Fuzzy-ARTMAP neural network. The neural network classifies them into three types of burns: superficial dermal, deep dermal and full thickness. Clinical effectiveness of the method was demonstrated on 62 clinical burn wound images obtained from digital colour photographs, yielding an average classification success rate of 82 % compared to expert classified images

Smart Device for the Determination of Heart Rate Variability in Real Time

This work presents a first approach to the design, development, and implementation of a smart device for the real-time measurement and detection of alterations in heart rate variability (HRV). The smart device follows a modular design scheme, which consists of an electrocardiogram (ECG) signal acquisition module, a processing module and a wireless communications module. From five-minute ECG signals, the processing module algorithms perform a spectral estimation of the HRV. The experimental results demonstrate the viability of the smart device and the proposed processing algorithms.Fundación Pública Andaluza Progreso y Salud. Gobierno de Andalucía PI-0010-2013 y PI-0041-2014Ministerio de Economía y Competitividad (Instituto de Salud Carlos III) PI15 / 00306 y DTS15 / 00195CIBER-BBN INT-2-CAR

Smart vest for respiratory rate monitoring of COPD patients based on non-contact capacitive sensing

In this paper, a first approach to the design of a portable device for non-contact monitoring of respiratory rate by capacitive sensing is presented. The sensing system is integrated into a smart vest for an untethered, low-cost and comfortable breathing monitoring of Chronic Obstructive Pulmonary Disease (COPD) patients during the rest period between respiratory rehabilitation exercises at home. To provide an extensible solution to the remote monitoring using this sensor and other devices, the design and preliminary development of an e-Health platform based on the Internet of Medical Things (IoMT) paradigm is also presented. In order to validate the proposed solution, two quasi-experimental studies have been developed, comparing the estimations with respect to the golden standard. In a first study with healthy subjects, the mean value of the respiratory rate error, the standard deviation of the error and the correlation coefficient were 0.01 breaths per minute (bpm), 0.97 bpm and 0.995 (p < 0.00001), respectively. In a second study with COPD patients, the values were -0.14 bpm, 0.28 bpm and 0.9988 (p < 0.0000001), respectively. The results for the rest period show the technical and functional feasibility of the prototype and serve as a preliminary validation of the device for respiratory rate monitoring of patients with COPD.Ministerio de Ciencia e Innovación PI15/00306Ministerio de Ciencia e Innovación DTS15/00195Junta de Andalucía PI-0010-2013Junta de Andalucía PI-0041-2014Junta de Andalucía PIN-0394-201

Aplicación de la especificación Data Distribution Service (DDS) al control de glucosa en pacientes diabéticos

En este trabajo se ha investigado la posibilidad de utilizar el estándar DDS (Data Distribution Service) desarrollado por el OMG (Object Management Group) para la monitorización en tiempo real del nivel de glucosa en pacientes diabéticos. Dicho estándar sigue el patrón publicador/suscriptor de modo que, en la prueba de concepto desarrollada, los sensores del punto de cuidado son publicadores de los valores de glucosa de los pacientes y diferentes supervisores se suscriben a esa información. Estos supervisores reaccionan de la forma más adecuada a los valores y la evolución del nivel de glucosa en el paciente, por ejemplo, registrando el valor de la muestra o generando una alarma. El software de intermediación que soporta la comunicación de datos sigue el estándar DDS. Esto facilita por un lado la escalabilidad e interoperatividad de la solución desarrollada y por otro la monitorización de niveles de glucosa y la activación de protocolos predefinidos en tiempo real. La investigación se enmarca dentro del proyecto intramural PERSONA del CIBER-BBN, cuyo objetivo es el diseño de herramientas de soporte a la decisión para la monitorización continua de pacientes personalizadas e integradas en una plataforma tecnológica para diabetes