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At least 91 records · Page 5Linked to original sources

The reception of environmental sounds through wearable tactual Aids.

OBJECTIVE: The objective of this study was to investigate the ability to identify environmental sounds through a wearable tactual aid. DESIGN: A test of the ability to identify environmental sounds was developed, employing closed sets of ten sounds in each of four different settings (General Home, Kitchen, Office, and Outdoors). The participants in the study included a group of three laboratory-trained subjects with normal hearing and a group of three subjects with profound deafness who were experienced users of a tactual device (the Tactaid 7). Identification testing was conducted in each of the four environmental-sound settings using a one-interval, ten-alternative, forced-choice procedure. The laboratory-trained subjects received training with trial-by-trial correct-answer feedback, followed by testing in the absence of feedback using the Tactaid 7 device. The experienced tactual-aid users were tested initially without feedback to establish baseline levels of performance derived from their prior field experience with the Tactaid 7. These subjects then received additional trials in the presence of correct-answer feedback to determine the effects of training on their performance. The data were summarized in terms of overall percent-correct identification scores and information transfer (IT) in bits. Confusion patterns were described using a hierarchical clustering analysis. RESULTS: Post-training results with the laboratory-trained subjects on the Tactaid 7 indicated that performance was similar for the four test environments, with percent-correct scores averaging 65% (and IT of 2.0 bits). For the experienced tactual-aid users, performance was similar across the four environments, averaging 36% correct (and IT of 1.4 bits) for initial testing without feedback. Scores were increased to 60% correct (and IT of 1.9 bits) in the presence of correct-answer feedback. Similar trends were observed in the hierarchical-clustering analysis across both groups of subjects. Within each stimulus set, certain items tended to cluster together, whereas other items tended to appear in single-item clusters. The highly identified stimuli tended to be characterized by unique temporal patterns and confused stimuli seemed to be most similar in terms of their spectral characteristics. CONCLUSIONS: Through the multi-channel spectral display of the Tactaid 7 device, subjects were able to identify roughly 2 bits of information in each of four 10-item sets of sounds representative of different environmental settings. Temporal cues appeared to play a larger role in identification of sounds than spectral or intensive cues.

Adult↗

Continuous renal replacement therapy for congestive heart failure: the wearable continuous ultrafiltration system.

Ultrafiltration is effective in the treatment of fluid and sodium overload in congestive heart failure. There is no available device to provide this therapy to ambulatory patients. We built and tested in vivo a wearable belt that can provide continuous ultrafiltration, 168 hours a week. Nine pigs underwent ureteral ligation and subsequently were allowed fluids ad lib, producing fluid overload. Next day, ultrafiltration was performed for 8 hours. The device consists of a hollow-fiber filter, a 9 V battery-operated pulsatile blood pump, a micro pump for heparin infusion, and another micro pump to control ultrafiltration rate. Blood flow was 65 ml/min and the weight of the device is less than 2.5 lb. Fluid removal rate ranged from 0 to 700 ml/h and averaged 106 ml/h. Salt removed was 7.6 g. No complications were observed. The potential impact on the quality of life of these patients by reducing the shortness of breath, leg swelling, and returning their ability to enjoy salt in their food might be significant, and a reduction in morbidity could be expected. The economic impact in reducing hospital admissions and length of stay, intensive care unit utilization, and drug consumption could be significant. Further studies are needed to compare this innovative approach with traditional drug-based therapy.

Animals↗

AMON: a wearable multiparameter medical monitoring and alert system.

This paper describes an advanced care and alert portable telemedical monitor (AMON), a wearable medical monitoring and alert system targeting high-risk cardiac/respiratory patients. The system includes continuous collection and evaluation of multiple vital signs, intelligent multiparameter medical emergency detection, and a cellular connection to a medical center. By integrating the whole system in an unobtrusive, wrist-worn enclosure and applying aggressive low-power design techniques, continuous long-term monitoring can be performed without interfering with the patients' everyday activities and without restricting their mobility. In the first two and a half years of this EU IST sponsored project, the AMON consortium has designed, implemented, and tested the described wrist-worn device, a communication link, and a comprehensive medical center software package. The performance of the system has been validated by a medical study with a set of 33 subjects. The paper describes the main concepts behind the AMON system and presents details of the individual subsystems and solutions as well as the results of the medical validation.

Activities of Daily Living↗

A wearable health care system based on knitted integrated sensors.

A comfortable health monitoring system named WEALTHY is presented. The system is based on a textile wearable interface implemented by integrating sensors, electrodes, and connections in fabric form, advanced signal processing techniques, and modern telecommunication systems. Sensors, electrodes and connections are realized with conductive and piezoresistive yarns. The sensorized knitted fabric is produced in a one step process. The purpose of this paper is to show the feasibility of a system based on fabric sensing elements. The capability of this system to acquire simultaneously several biomedical signals (i.e. electrocardiogram, respiration, activity) has been investigated and compared with a standard monitoring system. Furthermore, the paper presents two different methodologies for the acquisition of the respiratory signal with textile sensors. Results show that the information contained in the signals obtained by the integrated systems is comparable with that obtained by standard sensors. The proposed system is designed to monitor individuals affected by cardiovascular diseases, in particular during the rehabilitation phase. The system can also help professional workers who are subject to considerable physical and psychological stress and/or environmental and professional health risks.

Clothing↗

Activity classification using realistic data from wearable sensors.

Automatic classification of everyday activities can be used for promotion of health-enhancing physical activities and a healthier lifestyle. In this paper, methods used for classification of everyday activities like walking, running, and cycling are described. The aim of the study was to find out how to recognize activities, which sensors are useful and what kind of signal processing and classification is required. A large and realistic data library of sensor data was collected. Sixteen test persons took part in the data collection, resulting in approximately 31 h of annotated, 35-channel data recorded in an everyday environment. The test persons carried a set of wearable sensors while performing several activities during the 2-h measurement session. Classification results of three classifiers are shown: custom decision tree, automatically generated decision tree, and artificial neural network. The classification accuracies using leave-one-subject-out cross validation range from 58 to 97% for custom decision tree classifier, from 56 to 97% for automatically generated decision tree, and from 22 to 96% for artificial neural network. Total classification accuracy is 82 % for custom decision tree classifier, 86% for automatically generated decision tree, and 82% for artificial neural network.

Activities of Daily Living↗

Developing wearable bio-feedback systems: a general-purpose platform.

Microprocessors, even those in PocketPCs, have adequate power for many real-time biofeedback applications for disabled people. This power allows design of portable or wearable devices that are smaller and lighter, and that have longer battery life compared to notebook-based systems. In this paper, we discuss a general-purpose hardware/software solution based on industrial or consumer devices and a C++ framework. Its flexibility and modularity make it adaptable to a wide range of situations. Moreover, its design minimizes system requirements and programming effort, thus allowing efficient systems to be built quickly and easily. Our design has been used to build two brain computer interface systems that were easily ported from the Win32 platform.

Biofeedback, Psychology↗

Studies on a wearable, electronic, transdermal alcohol sensor.

The measurement of alcohol consumption over long time periods is important for monitoring treatment outcome and for research applications. Giner, Inc. has developed a wearable device that senses ethanol vapor at the surface of the skin, using an electrochemical cell that produces a continuous current signal proportional to ethanol concentration. A thermistor monitors continuous contact of the sensor with the skin, and a data-acquisition/logic circuit stores days of data recorded at 2- to 5-min intervals. Testing of this novel ethanol sensor/recorder was conducted on nonalcoholic human subjects consuming known quantities of ethanol and on intoxicated alcoholic subjects. The transdermal sensor signal closely follows the pattern of the blood alcohol concentration curve, although with a delay. This paper describes the concept of electrochemical ethanol measurement and presents some of the clinical data collected in support of the sensor/recorder development.

Adult↗

Comparison of different forms of compression using wearable digital hearing aids.

Four different compression algorithms were implemented in wearable digital hearing aids: (1) The slow-acting dual-front-end automatic gain control (AGC) system [B. C. J. Moore, B. R. Glasberg, and M. A. Stone, Br. J. Audiol. 25, 171-182 (1991)], combined with appropriate frequency response equalization, with a compression threshold of 63 dB sound pressure level (SPL) and with a compression ratio of 30 (DUAL-HI); (2) The dual-front-end AGC system combined with appropriate frequency response equalization, with a compression threshold of 55 dB SPL and with a compression ratio of 3 (DUAL-LO). This was intended to give some impression of the levels of sounds in the environment; (3) Fast-acting full dynamic range compression in four channels (FULL-4). The compression was designed to minimize envelope distortion due to overshoots and undershoots; (4) A combination of (2) and (3) above, where each applied less compression than when used alone (DUAL-4). Initial fitting was partly based on the concept of giving a flat specific-loudness pattern for a 65-dB SPL speech-shaped noise input, and this was followed by fine tuning using an adaptive procedure with speech stimuli. Eight subjects with moderate to severe cochlear hearing loss were tested in a counter-balanced design. Subjects had at least 2 weeks experience with each system in everyday life before evaluation using the Abbreviated Profile of Hearing Aid Benefit (APHAB) test and measures of speech intelligibility in quiet (AB word lists at 50 and 80 dB SPL) and noise (adoptive sentence lists in speech-shaped noise, or that same noise amplitude modulated with the envelope of speech from a single talker). The APHAB scores did not indicate clear differences between the four systems. Scores for the AB words in quiet were high for all four systems at both 50 and 80 dB SPL. The speech-to-noise ratios required for 50% intelligibility were low (indicating good performance) and similar for all the systems, but there was a slight trend for better performance in modulated noise with the DUAL-4 system than with the other systems. A subsequent trial where three subjects directly compared each of the four systems in their everyday lives indicated a slight preference for the DUAL-LO system. Overall, the results suggest that it is not necessary to compress fast modulations of the input signal.

Acoustic Stimulation↗

Continuous renal replacement therapy for end-stage renal disease. The wearable artificial kidney (WAK).

Daily dialysis offers many benefits but is difficult to implement. CRRT allows dialysis 24/7 but is not suitable for ESRD patients. Thus, the need for a miniaturized ambulatory CRRT device those patients can wear permanently. We report the feasibility, safety and efficiency in uremic pigs, of such a wearable artificial kidney (WAK) that can be worn as a belt, operated with batteries, and weights less than 5 lbs. We used a hollow fiber dialyzer with a surface area of 0.2 sqm. Dialysate was continuously regenerated by a series of cartridges containing several sorbents allowing the use of approximately 375 ml of dialysate. The device includes reservoirs with heparin and electrolytes. Average fluid removal was 100 ml/hr. The Creatinine was 25 ml/min. In 8 hrs the total Creatinine removed was 1 gr, Urea 12 gr, P0.8 gr and K 72 mEq. Weekly st kt/v was extrapolated to approximately 7. There were no side effects. The WAK can be operated safely and continuously 168 hr/week. This would allow for all the advantages of daily dialysis and reduce morbidity and mortality in the ESRD population. It will also reduce cost and manpower utilization.

Animals↗

First behind the ear-wearable speech processor for the Vienna cochlear prosthesis. A preliminary report.

A behind the ear-wearable speech processor for the Vienna cochlear prosthesis has been designed. In a comparative study 6 patients used the new device for 1 week and were then tested. The results from the auditory test battery and a speech tracking were about the same, only the perception of speech from an open list was better when the patients used the conventional processor. It is possible to reduce the size of a speech processor substantially by modifying the speech-processing strategy without major decrease of the performance. More patients have to be tested after using the device for a longer time.

Adult↗

Design considerations for a wearable monitor to measure finger posture.

BACKGROUND: Objective measures of hand function as individuals participate in home and community activities are needed in order to better plan and evaluate rehabilitation treatments. Traditional measures collected in the clinical setting are often not reflective of actual functional performance. Recent advances in technology, however, enable the development of a lightweight, comfortable data collection monitor to measure hand kinematics. METHODS: This paper presents the design analysis of a wearable sensor glove with a specific focus on the sensors selected to measure bend. The most important requirement for the glove is easy donning and removal for individuals with significantly reduced range of motion in the hands and fingers. Additional requirements include comfort and durability, cost effectiveness, and measurement repeatability. These requirements eliminate existing measurement gloves from consideration. Glove construction is introduced, and the sensor selection and glove evaluation process are presented. RESULTS: Evaluation of commercial bend sensors shows that although most are not appropriate for repeatable measurements of finger flexion, one has been successfully identified. A case study for sensor glove repeatability using the final glove configuration and sensors does show a high degree of repeatability in both the gripped and flat hand positions (average coefficient of variability = 2.96% and 0.10%, respectively). CONCLUSION: Measuring functional outcomes in a portable manner can provide a wealth of information important to clinicians for the evaluation and treatment of movement disorders in the hand and fingers. This device is an important step in that direction as both a research and an evaluation method.

Journal Article↗

Comparing comfort and wearability: custom-made vs. self-adapted mouthguards.

Several studies have shown that mouthguards can reduce orofacial injuries among athletes. Comfort and wearability factors were compared among 40 high-school athletes for custom-made and self-adapted mouthguards. Both offered adequate protection, but overall the participants preferred the custom-made mouthguard.

Adolescent↗

Influence of contact forces on wrist photoplethysmography--prestudy for a wearable patient monitor.

The practical setting shows that gentle manual pressure on a photosensor suffices to improve the detectability of arterial pulses, but changes in the pressure applied may also produce signal artefacts. To study these effects, stepwise increasing contact forces (0.5 to 4 N) were applied to a photosensor placed over the radial artery. Additionally, the influence of optical coupling between sensor and skin surface was examined by introducing an elastic distance ring. The AC and DC components from the recorded photoplethysmogram were analysed. The AC component (absorption due to arterial pulsation) increased with the pressure applied; at lower forces (0.5 to 3 N) an introduction of the ring enhanced this effect. The characteristic of the DC component (backscattering from non-pulsating tissues) depends on optical coupling: without the ring the DC component increased stepwise with force (slope 0.035 V/N), but with the ring in place this component decreased (slope -0.075 V/N). Since the sensitivity of the pulse signal to artifacts is related to the slope of the DC component, such artefacts can be minimized by making the slope small. The utilization of these results to improve pulse detection and reduce motion artefacts in a wearable wrist device is discussed.

Equipment Design↗

A wearable tremor-suppression orthosis.

The Viscous Beam is a wearable tremor-suppression orthosis that applies viscous resistance to motion of the wrist in flexion and extension. The orthosis reduces tremor amplitude and is small enough to be worn under the sleeve of a shirt. Hand and forearm cuffs couple the damper to the user. The cuffs permit full thumb and finger motion, wrist flexion and extension, and forearm pronation and supination. Damping is provided by a constrained-layer-damping (CLD) system, distinct in that it can damp large rotary deflections through a small bending radius. A bending-plate transmission linearly converts wrist extension/flexion to rectilinear translation within the damper. Bending deformation of two plates held a fixed distance apart within the transmission results in relative displacement along the lengths of the plates. A viscous fluid incorporated between the plates provides shear damping. Silicone fluids with viscosities as high as 10 million centistokes (cS) and shear layers as thin as 0.76 mm have been tested. With these parameter values, damping constants as high as 2.0x10(-3) N-m/(degrees/s) have been measured. This testing was conducted with strain rates as high as 4,580 degrees/s. The elastic stiffness of this beam was measured to be 4.1x10(-2) N-m/degrees.

Activities of Daily Living↗

MediLink: a wearable telemedicine system for emergency and mobile applications.

The practical needs of the medical professional faced with critical care or emergency situations differ from those working in many environments where telemedicine and mobile computing have been introduced and tested. One constructive criticism of the telemedicine initiative has been to question what positive benefits are gained from videoconferencing, paperless transactions, and online access to patient record. With a goal of producing a positive answer to such questions an architecture for multipurpose mobile telemedicine applications has been developed. The core technology is based upon a wearable personal computer with a smart-card interface coupled with speech, pen, video input and wireless intranet connectivity. The TransPAC system with the MedLink software system is designed to provide an integrated solution for a broad range of health care functions where mobile and hands-free or limited-access systems are preferred or necessary and where the capabilities of other mobile devices are insufficient or inappropriate. Structured and noise-resistant speech-to-text interfacing plus the use of a web browser-like display, accessible through either a flatpanel, standard, or headset monitor, gives the beltpack TransPAC computer the functions of a complete desktop including PCMCIA card interfaces for internet connectivity and a secure smartcard with 16-bit microprocessor and upwards of 64K memory. The card acts to provide user access control for security, user custom configuration of applications and display and vocabulary, and memory to diminish the need for PC-server communications while in an active session. TransPAC is being implemented for EMT and ER staff usage.

Emergency Medical Services↗

Evaluation of a new, wearable, precision phase-change thermometer in neonates.

The primary purpose of this research was to examine the quantitative relationship between a new, wearable, continuous-read, precision phase-change thermometer (WCPPT) and a glass-mercury thermometer used in the axilla (GMA) in neonates. The study design was prospective and quasi-experimental with each subject acting as his/her own control. Data were collected in a tertiary teaching facility in the Southwestern United States from a convenience sample of 29 neonates. Simultaneous test and reference temperature measurements were taken from each neonate. Measurements were compared to determine clinical bias (mean difference +/- 1 standard deviation [SD]) and clinical agreement portrayed graphically (mean difference and limits of agreement plotted against the mean of both test and reference measurements) (Bland & Altman, 1986). Key findings included a clinical bias between the GMA and the TraxIt WCPPT of 0.04 degrees C (+/- 0.22) (mean difference +/- 1 SD) during the first measurement session with the GMA slightly higher, and -0.11 degrees C (+/- 0.17) (mean difference +/- 1 SD) during the second measurement with the WCPPT slightly higher. Bland and Altman representations supported these findings. These outcomes support a conclusion that the TraxIt WCPPT is neither clinically nor statistically different from the GMA on initial placement and exceeds GMA readings during prolonged, continuous axillary contact. Continuous thermometer placement eliminates drawdown, the transitory, local cooling effect of intermittent thermometer placement.

Female↗

Classification of movement states in Parkinson's disease using a wearable ambulatory monitor.

For Parkinson's patients to function at their best, the clinicians who care for them must be able to manage and offset the fluctuations in movement that occur throughout the day. Symptoms of Parkinsonism such as bradykinesia, hypokinesia and akinesia and medication-related side effects such as dyskinesia need to be reported to the clinician in a manner that accurately conveys the timing and severity of symptoms. The clinician can then tightly adjust and titrate the timing and dosing of medication, allowing the patient to function at his or her best. Patient history and patient self reporting diaries are currently used for this purpose, but they have problems with compliance, completeness and reliability. A monitor that could be worn by the patient while he or she is at home and could issue to the clinician a report of how the patient has been moving over the course of the day would be a great help to clinicians. Wearable devices have been studied for the measurement of movement in Parkinson's patients, but none have been designed in a manner that would be useful for the titration of medications 1, 2, 3.

Dyskinesias↗

New paradigms in telemedicine: ambient intelligence, wearable, pervasive and personalized.

After decades of development of information systems dedicated to health professionals, there is an increasing demand for personalized and non-hospital based care. An especially critical domain is cardiology: almost two third of cardiac deaths occur out of hospital, and victims do not survive long enough to benefit from in-hospital treatments. We need to reduce the time before treatment. But symptoms are often interpreted wrongly. The only immediate diagnostic tool to assess the possibility of a cardiac event is the electrocardiogram (ECG). Event and transtelephonic ECG recorders are used to improve decision making but require setting up new infrastructures. The European EPI-MEDICS project has developed an intelligent Personal ECG Monitor (PEM) for the early detection of cardiac events. The PEM embeds advanced decision making techniques, generates different alarm levels and forwards alarm messages to the relevant care providers by means of new generation wireless communication. It is cost saving, involving care provider only if necessary and requiring no specific infrastructure. This solution is a typical example of pervasive computing and ambient intelligence that demonstrates how personalized, wearable, ubiquitous devices could improve healthcare.

Artificial Intelligence↗