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Distributed Diagnosis and Home Healthcare, 2006. D2H2. 1st Transdisciplinary Conference on

Date 2-4 April 2006

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  • Conference Proceedings - 1st Transdisciplinary Conference on Distributed Diagnosis and Home Healthcare 2006 - D2H2

    Page(s): 0
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  • 1st Transdisciplinary Conference on Distributed Diagnosis and Home Healthcare 2006 - D2H2 2006

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  • Copyright

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  • Dear Colleagues: Welcome

    Page(s): iii
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  • Editor's notes

    Page(s): iv
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  • Conference Chairs / Program Committee

    Page(s): v
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  • Sponsors / Co-organizers

    Page(s): vi
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  • D2H2 Conference Program

    Page(s): vii - xii
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  • Table of contents

    Page(s): xiii - xx
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  • Micromachined Amperometric Cells for Continuous Monitoring of Glucose and Lactate

    Page(s): 1 - 4
    Save to Project icon | Request Permissions | Click to expandQuick Abstract | PDF file iconPDF (285 KB) |  | HTML iconHTML  

    Design, set-up and test of miniaturized amperometric cells are described. These sensors are produced using silicon micromachining technologies to minimise geometrical sensor dimensions and chemical conversion rate for measurements in small sample volumes. The sensors use conventional reactions of glucose- or lactate-oxidase with amperometric detection of H2O2. A novel sensor design is described with external dimensions of 3,0 mmtimes6,0 mmtimes0,7 mm that includes a working-, counter- and an iridium reference electrode. This chip contains a cavity filled with immobilised glucose- or lactate-oxidase. The reaction chamber exchanges material with the analyte by diffusion through a thin (12mum) silicon membrane with an array of well-defined holes etched through the silicon membrane. Number and size of the pores can be varied to adjust the sensor to the required sensitivity and linear measuring range. These sensors have been developed and adjusted for continuous and reliable supervision of mobile persons. All sensors were tested and characterised in vitro prior to using them for measurements in saliva and interstitial fluid. For glucose sensors the linear range was designed between 0,5 and 20 mM glucose concentration. The glucose sensors were tested in interstitial fluid and used in clinical trials for continuous glucose measurement in patients. Linear range of lactate sensors was adjusted from 0,1 to 5 mM. Tests for lactate sensors were performed using saliva of persons under exercise. Sensor readings of both sensor types were compared to blood concentrations of glucose or lactate determined using standard laboratory equipment View full abstract»

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  • Sensors on Textile Substrates for Home-Based Healthcare Monitoring

    Page(s): 5 - 7
    Save to Project icon | Request Permissions | Click to expandQuick Abstract | PDF file iconPDF (372 KB) |  | HTML iconHTML  

    In this paper we describe progress in developing textile-based sensors for wearable physiological monitoring systems. Active electrodes on nonwoven textile substrates are described for capturing ECG and EOG data. A capacitive sensor for monitoring breathing is presented. Data transmission by coplanar waveguides is also a topic introduced. The future of these devices for home-based healthcare monitoring is considered View full abstract»

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  • Ease of Use Considerations for Wearable Point-Of-Care Devices in Home Environments

    Page(s): 8 - 11
    Save to Project icon | Request Permissions | Click to expandQuick Abstract | PDF file iconPDF (241 KB) |  | HTML iconHTML  

    The sub-population with the greatest need for home healthcare services also demonstrates the greatest variation in their ability to operate devices, so ease of use is critically important for wearable devices used in home environments. In this scenario, "ease of use" has multiple connotations, each of which requires different design elements. This paper reviews recent progress in the areas of wearable devices and wireless sensor networks. It then summarizes recent efforts in the Medical Component Design Laboratory at Kansas State University to create wearable components that address ease of use via the incorporation of plug-and-play, wireless, and interoperability standards. Specifically, this project employed the IEEE/ISO 11073 and Bluetooth standards to achieve device auto-association, interoperability, and simple reconfigurability. Moreover, this paper stresses that, even with plug-and-play interactions between devices, human-device interactions are still desirable, especially when a user needs just-in-time information or device assistance. Human-device interactions, if properly directed, will enable patients to play a greater role in their care View full abstract»

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  • In-Home Hand-Held Device to Measure Respiratory Resistance

    Page(s): 12 - 15
    Save to Project icon | Request Permissions | Click to expandQuick Abstract | PDF file iconPDF (375 KB) |  | HTML iconHTML  

    A small hand-held Airflow Perturbation Device (APD) has been developed that is capable of noninvasively evaluating respiratory resistance. The APD has several advantages over commercially available spirometers. The APD is small, compact, self-contained, and low cost. It can measure respiratory resistance noninvasively in inhalation and exhalation accurately and reliably. Because of its size, cost, and ease of operation, it can be a suitable diagnostic device for home use View full abstract»

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  • Dry-Reagent Storage for Disposable Lab-On-Card Diagnosis of Enteric Pathogens

    Page(s): 16 - 19
    Save to Project icon | Request Permissions | Click to expandQuick Abstract | PDF file iconPDF (1553 KB) |  | HTML iconHTML  

    This paper presents a process for dry-reagent storage and handling for a microfluidic lab-on-a-card platform for point-of-care applications to identify enteric bacterial pathogens in patients presenting with acute diarrhea, with special reference to infections that might be encountered in developing countries. Three different reagents are studied: i) antibody-coated magnetic beads for pathogen capture, ii) lysis buffer for extraction of nucleic acids from the pathogens, and iii) DNA amplification of the nucleic acids by polymerase chain reaction. This presentation will report on the process of dry reagent storage, resuspension and its functionality View full abstract»

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  • A Distributed Multimodality Sensor System for Home-Used Sleep Condition Inference and Monitoring

    Page(s): 20 - 23
    Save to Project icon | Request Permissions | Click to expandQuick Abstract | PDF file iconPDF (513 KB) |  | HTML iconHTML  

    In this paper, we propose a distributed system consists of heart-rate, passive infrared, and audio sensors for sleep condition inference. We apply machine learning methods to infer the sleep-awake condition during the time a user spends on the bed. This sleep-awake information would be useful for estimating critical factors including sleep latency, sleep duration, and habitual sleep efficiency related to sleep quality measurement. Our experimental results show that the proposed approach could be a good alternative to the traditional motion sensor Actigraph, with competitive performance on the sleep-related activity monitoring. Furthermore, the distributed computation nature of our system also makes it favorable for practical health-care applications View full abstract»

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  • The Case for Applying the Point of Care Testing Standard to Home Monitoring Devices

    Page(s): 24 - 27
    Save to Project icon | Request Permissions | Click to expandQuick Abstract | PDF file iconPDF (165 KB) |  | HTML iconHTML  

    Diabetes is a major health concern that is growing rapidly. Daily point-of-care testing (POCT) of one's blood sugar using a glucose meter plays an integral role in managing diabetes. By integrating these self-monitoring devices with a centralized information system both patients and providers can view the blood sugar readings. This capability facilitates collaborative disease management that can lead to better control and education for the patient. In the current proprietary environment however, capturing the data stored in a glucose meter is not straightforward. Although a POCT standard has been developed to address connectivity issues for POC devices, the standard has been applied to devices used in clinic settings rather than home settings. As care of chronic diseases moves towards remote management, the need for device connectivity will propel the application of the POCT1-A standard to include devices, like glucose meters that are used outside of a clinic setting. This paper demonstrates the immediate need for standardization of connectivity to glucose meters so that patients and providers can use the readings to improve diabetes control View full abstract»

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  • Diagnostically Lossless Compression-2 of Medical Images

    Page(s): 28 - 32
    Save to Project icon | Request Permissions | Click to expandQuick Abstract | PDF file iconPDF (425 KB) |  | HTML iconHTML  

    A method is proposed for compression of medical images. The approach is called DLC2 (Diagnostically Lossless Compression-2). To get lossless effect, we use lossy coding followed by error image coding. An NNVQ (Neural Network Vector Quantizer) is used for lossy compression and Huffman coding is used to code the difference image losslessly. It is an spatial domain technique. No frequency domain transformations are required, this makes the proposed scheme simple and computationally economical. Proposed method can achieve higher compression ratios than existing standard lossless compression techniques and also meets the legal requirement of medical image archiving View full abstract»

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  • Home Monitoring of Congestive Heart Failure Patients

    Page(s): 33 - 36
    Save to Project icon | Request Permissions | Click to expandQuick Abstract | PDF file iconPDF (536 KB) |  | HTML iconHTML  

    Home healthcare technologies can help patients maintain their independence, allow them to stay in their own homes, improve health outcomes, and reduce costs. Mindmy-Heart, a CMS-funded project at Georgetown University Medical Center, has successfully implemented multiple technologies, such as home monitoring devices and care management tools, to allow for in-home management of congestive heart failure View full abstract»

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  • The Relationship between Pulse Transit Time and Systolic Blood Pressure on Individual Subjects after Exercises

    Page(s): 37 - 38
    Save to Project icon | Request Permissions | Click to expandQuick Abstract | PDF file iconPDF (129 KB) |  | HTML iconHTML  

    Continuous monitoring of blood pressure (BP) is always important to critically ill patients and to the patients who undergo major vascular and intracavitary surgeries. Pulse transit time (PTT) is one of the potential parameters which can be utilized for non-invasive and continuous monitoring of BP. PTTp and PTTf are the time intervals measured from the R-wave of electrocardiographic signal to the peak and the foot of photoplethysmographic signal respectively. In this study, the relationship between systolic blood pressure (SBP) and PTTs on 12 healthy subjects, aged 25plusmn2 years, was investigated after exercises. Results showed that SBP was correlated with PTTp and PTTf wherein the means of individual correlation were r=-0.77 and r=-0.92 respectively. The means of the standard deviation of the difference between the measured SBP and the SBP predicted from regression lines in scatter plots of SBP~PTTp and SBP~PTTf were 6.6 mmHg and 4.3 mmHg respectively. In summary, the results supported that PTTf was a potential parameter which could be implemented in a personalized wearable device for continuous SBP monitoring at home View full abstract»

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  • A Customized Human Fall Detection System Using Omni-Camera Images and Personal Information

    Page(s): 39 - 42
    Save to Project icon | Request Permissions | Click to expandQuick Abstract | PDF file iconPDF (218 KB) |  | HTML iconHTML  

    This paper proposes a new approach to detect the fall of the elderly. The detection system uses a MapCam (omni-camera) to capture images and performs image processing over the images. The personal information of each individual is considered in the processing task. The MapCam is used to capture 360deg scenes simultaneously and eliminate any blind viewing zone. The personal information is combined into the system and makes it smarter by customizing the system for each individual. With personal information such as height, weight, and electronic health history, we can adjust the detection sensitivity on a case by case basis to reduce unnecessary alarms, and put more attention on the elderly with special diseases or conditions. We perform a simple experiment to verify the feasibility of our approach. The experimental results show that the successful rates of fall detections with and without personal information are 79.8% and 68%, respectively. The Kappa value of the system is 0.798 which is higher than 0.75, showing that we have a reliable system View full abstract»

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  • Gait Analysis for Detecting a Leg Accident with an Accelerometer

    Page(s): 43 - 46
    Save to Project icon | Request Permissions | Click to expandQuick Abstract | PDF file iconPDF (582 KB) |  | HTML iconHTML  

    We analyzed an acceleration pattern during natural walking and walking hampered by wearing weights to predict falls. These two types of walking could be distinguished with a peak at the half of the principal frequency of the gait in anterior movement. We measured walking while wearing each individual hampering weight and then analyzed. The peak was bigger when a subject wore the hampering weight that was restrictive and made the body unbalanced. As leg accidents are considered to occur with a change of the body balance, our system may be used to detect a leg accident by checking the peak at the half of the principal frequency of the gait in anterior movement View full abstract»

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  • Automated Beat-To-Beat Heart Sound Analyzer for Distributed Diagnosis and Home Healthcare Application

    Page(s): 47 - 50
    Save to Project icon | Request Permissions | Click to expandQuick Abstract | PDF file iconPDF (385 KB) |  | HTML iconHTML  

    In this paper, a heart sound analyzer is presented for interpretation of heart sound signals and automated diagnosis of valvular heart disease. The heart sound analyzer includes data acquisition from multiple positions, signal analysis to extract auscultatory features and information, and a knowledge-based program to provide a likely diagnosis. Experiments using clinical data from real patients show good performance for the automatic analysis. Due to its simplicity and fast implementation, the method has potential for clinical deployment and eventually to be used in distributed diagnosis settings View full abstract»

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  • A Passive and Portable System for Monitoring Heart Rate and Detecting Sleep Apnea and Arousals: Preliminary Validation

    Page(s): 51 - 54
    Save to Project icon | Request Permissions | Click to expandQuick Abstract | PDF file iconPDF (276 KB) |  | HTML iconHTML  

    The National Institutes of Health (NIH) Sleep Disorders Research Plan expresses a need for methods that can non-invasively monitor sleep characteristics. Forty subjects were tested using a novel, passive ballistocardiography-based system during an overnight study. We examined our system's ability to measure heart rate as compared to EKG while we also investigated our system's apnea and arousal detection capabilities as compared to conventional polysomnography. We found a strong correlation (r=0.972, p<0.0001) in average heart rate computed over 480 thirty-second epochs when our method was compared to EKG. Additionally, we achieved a sensitivity of 89.2% and specificity of 94.6% in the automated detection of apneas. Similarly we attained a sensitivity of 77.3% and a specificity of 96.2% in the detection of arousals. These preliminary results demonstrate the effectiveness of our portable ballistocardiography-based system as compared to polysomnography and show promise that high quality sleep assessment can be performed in a home environment View full abstract»

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  • Low-Cost Detection and Monitoring of Coronary Artery Disease Using Ultrasound

    Page(s): 55 - 58
    Save to Project icon | Request Permissions | Click to expandQuick Abstract | PDF file iconPDF (361 KB) |  | HTML iconHTML  

    Cardiovascular disease has a significant impact on global public health both due to its prevalence and high morbidity and mortality as well as its large financial burden. Prevention strategies using traditional risk factors miss many opportunities, because these risk factors do not identify the atherosclerotic plaques that are responsible for the target ischemic events. We present a new technology that could be used to develop a new prevention strategy by providing a low-cost tool for detection of coronary artery disease (CAD). This technology can be used in a decentralized primary care setting. This technology uses ultrasound for measuring minute local vibrations in the cardiac wall associated with acoustic markers of CAD. We have developed a programmable ultrasound platform that has enabled the rapid translation of this technology from the research laboratory to clinical evaluation. Preliminary feasibility studies indicate the promising potential of this technology for detecting and classifying CAD in a symptomatic population. For more effective secondary prevention of patients with diagnosed CAD, this technology can be used in conjunction with another new ultrasound-based method for measuring local variation of mechanical strain in the carotid artery wall as a surrogate for monitoring the progression or regression of CAD View full abstract»

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  • A Semi-Reversible Watermark for Medical Image Authentication

    Page(s): 59 - 62
    Save to Project icon | Request Permissions | Click to expandQuick Abstract | PDF file iconPDF (881 KB) |  | HTML iconHTML  

    This paper addresses the secure storage and transmission of medical informatics in rapidly growing applications such as teleradiology and telesurgery. In particular, we propose a frequency domain digital watermarking technique that can be used to authenticate medical images in a distributed diagnosis and home healthcare environment. The most significant result of our method is the semi-reversibility property that undoes most of the degradation attributable to the watermarking process View full abstract»

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