RESUMEN
BACKGROUND: Remote monitoring of patients with heart failure (HF) using wearable devices can allow patient-specific adjustments to treatments and thereby potentially reduce hospitalizations. We aimed to assess HF state using wearable measurements of electrical and mechanical aspects of cardiac function in the context of exercise. METHODS AND RESULTS: Patients with compensated (outpatient) and decompensated (hospitalized) HF were fitted with a wearable ECG and seismocardiogram sensing patch. Patients stood at rest for an initial recording, performed a 6-minute walk test, and then stood at rest for 5 minutes of recovery. The protocol was performed at the time of outpatient visit or at 2 time points (admission and discharge) during an HF hospitalization. To assess patient state, we devised a method based on comparing the similarity of the structure of seismocardiogram signals after exercise compared with rest using graph mining (graph similarity score). We found that graph similarity score can assess HF patient state and correlates to clinical improvement in 45 patients (13 decompensated, 32 compensated). A significant difference was found between the groups in the graph similarity score metric (44.4±4.9 [decompensated HF] versus 35.2±10.5 [compensated HF]; P<0.001). In the 6 decompensated patients with longitudinal data, we found a significant change in graph similarity score from admission (decompensated) to discharge (compensated; 44±4.1 [admitted] versus 35±3.9 [discharged]; P<0.05). CONCLUSIONS: Wearable technologies recording cardiac function and machine learning algorithms can assess compensated and decompensated HF states by analyzing cardiac response to submaximal exercise. These techniques can be tested in the future to track the clinical status of outpatients with HF and their response to pharmacological interventions.
Asunto(s)
Algoritmos , Electrocardiografía/instrumentación , Insuficiencia Cardíaca/fisiopatología , Cinetocardiografía/instrumentación , Aprendizaje Automático , Dispositivos Electrónicos Vestibles , Adulto , Anciano , Diseño de Equipo , Ejercicio Físico/fisiología , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
OBJECTIVE: To study knee acoustical emission patterns in subjects with acute knee injury immediately following injury and several months after surgery and rehabilitation. METHODS: We employed an unsupervised graph mining algorithm to visualize heterogeneity of the high-dimensional acoustical emission data, and then to derive a quantitative metric capturing this heterogeneity-the graph community factor (GCF). A total of 42 subjects participated in the studies. Measurements were taken once each from 33 healthy subjects with no known previous knee injury, and twice each from 9 subjects with unilateral knee injury: first, within seven days of the injury, and second, 4-6 months after surgery when the subjects were determined to start functional activities. Acoustical signals were processed to extract time and frequency domain features from multiple time windows of the recordings from both knees, and k-nearest neighbor graphs were then constructed based on these features. RESULTS: The GCF calculated from these graphs was found to be 18.5 ± 3.5 for healthy subjects, 24.8 ± 4.4 (p = 0.01) for recently injured, and 16.5 ± 4.7 (p = 0.01) at 4-6 months recovery from surgery. CONCLUSION: The objective GCF scores changes were consistent with a medical professional's subjective evaluations and subjective functional scores of knee recovery. SIGNIFICANCE: Unsupervised graph mining to extract GCF from knee acoustical emissions provides a novel, objective, and quantitative biomarker of knee injury and recovery that can be incorporated with a wearable joint health system for use outside of clinical settings, and austere/under resourced conditions, to aid treatment/therapy.
Asunto(s)
Articulación de la Rodilla/fisiología , Procesamiento de Señales Asistido por Computador , Espectrografía del Sonido/métodos , Adulto , Algoritmos , Biomarcadores , Minería de Datos , Femenino , Estado de Salud , Humanos , Traumatismos de la Rodilla/fisiopatología , Traumatismos de la Rodilla/rehabilitación , Masculino , Rango del Movimiento Articular/fisiología , Dispositivos Electrónicos Vestibles , Adulto JovenRESUMEN
Electroencephalography (EEG) is an essential component in evaluation of epilepsy. However, full-channel EEG signals recorded from 18 to 23 electrodes on the scalp is neither wearable nor computationally effective. This paper presents advantages of both channel selection and nonlinear dimension reduction for accurate automatic seizure detection. We first extract the frequency domain features from the full-channel EEG signals. Then, we use a random forest algorithm to determine which channels contribute the most in discriminating seizure from non-seizure events. Next, we apply a non-linear dimension reduction technique to capture the relationship among data elements and map them in low dimension. Finally, we apply a KNN classifier technique to discriminate between seizure and non-seizure events. The experimental results for 23 patients show that our proposed approach outperforms other techniques in terms of accuracy. It also visualizes long-term data in 2D to enhance physician cognition of occurrence and disease progression.
Asunto(s)
Algoritmos , Diagnóstico por Computador/métodos , Electroencefalografía/métodos , Aprendizaje Automático , Reconocimiento de Normas Patrones Automatizadas/métodos , Convulsiones/diagnóstico , Interpretación Estadística de Datos , Humanos , Dinámicas no Lineales , Reproducibilidad de los Resultados , Tamaño de la Muestra , Sensibilidad y EspecificidadRESUMEN
Pressure ulcers (PUs) are common among vulnerable patients such as elderly, bedridden and diabetic. PUs are very painful for patients and costly for hospitals and nursing homes. Assessment of sleeping parameters on at-risk limbs is critical for ulcer prevention. An effective assessment depends on automatic identification and tracking of at-risk limbs. An accurate limb identification can be used to analyze the pressure distribution and assess risk for each limb. In this paper, we propose a graph-based clustering approach to extract the body limbs from the pressure data collected by a commercial pressure map system. A robust signature-based technique is employed to automatically label each limb. Finally, an assessment technique is applied to evaluate the experienced stress by each limb over time. The experimental results indicate high performance and more than 94% average accuracy of the proposed approach.