Framework for Simultaneous Indoor Localization, Mapping, and Human Activity Recognition in Ambient Assisted Living Scenarios.

Indoor localization and human activity recognition are two important sources of information to provide context-based assistance. This information is relevant in ambient assisted living (AAL) scenarios, where older adults usually need supervision and assistance in their daily activities. However, indoor localization and human activity recognition have been mostly considered isolated problems. This work presents and evaluates a framework that takes advantage of the relationship between location and activity to simultaneously perform indoor localization, mapping, and human activity recognition. The proposed framework provides a non-intrusive configuration, which fuses data from an inertial measurement unit (IMU) placed in the person's shoe, with proximity and human activity-related data from Bluetooth low energy beacons (BLE) deployed in the indoor environment. A variant of the simultaneous location and mapping (SLAM) framework was used to fuse the location and human activity recognition (HAR) data. HAR was performed using data streaming algorithms. The framework was evaluated in a pilot study, using data from 22 people, 11 young people, and 11 older adults (people aged 65 years or older). As a result, seven activities of daily living were recognized with an F1 score of 88%, and the in-door location error was 0.98 ± 0.36 m for the young and 1.02 ± 0.24 m for the older adults. Furthermore, there were no significant differences between the groups, indicating that our proposed method works adequately in broad age ranges.

Simultaneous Indoor Pedestrian Localization and House Mapping Based on Inertial Measurement Unit and Bluetooth Low-Energy Beacon Data.

Indoor location estimation is crucial to provide context-based assistance in home environments. In this study, a method for simultaneous indoor pedestrian localization and house mapping is proposed and evaluated. The method fuses a person's movement data from an Inertial Measurement Unit (IMU) with proximity and activity-related data from Bluetooth Low-Energy (BLE) beacons deployed in the indoor environment. The person's and beacons' localization is performed simultaneously using a combination of particle and Kalman Filters. We evaluated the method using data from eight participants who performed different activities in an indoor environment. As a result, the average participant's localization error was 1.05 ± 0.44 m, and the average beacons' localization error was 0.82 ± 0.24 m. The proposed method is able to construct a map of the indoor environment by localizing the BLE beacons and simultaneously locating the person. The results obtained demonstrate that the proposed method could point to a promising roadmap towards the development of simultaneous localization and home mapping system based only on one IMU and a few BLE beacons. To the best of our knowledge, this is the first method that includes the beacons' data movement as activity-related events in a method for pedestrian Simultaneous Localization and Mapping (SLAM).

Indoor Trajectory Reconstruction of Walking, Jogging, and Running Activities Based on a Foot-Mounted Inertial Pedestrian Dead-Reckoning System.

The evaluation of trajectory reconstruction of the human body obtained by foot-mounted Inertial Pedestrian Dead-Reckoning (IPDR) methods has usually been carried out in controlled environments, with very few participants and limited to walking. In this study, a pipeline for trajectory reconstruction using a foot-mounted IPDR system is proposed and evaluated in two large datasets containing activities that involve walking, jogging, and running, as well as movements such as side and backward strides, sitting, and standing. First, stride segmentation is addressed using a multi-subsequence Dynamic Time Warping method. Then, detection of Toe-Off and Mid-Stance is performed by using two new algorithms. Finally, stride length and orientation estimation are performed using a Zero Velocity Update algorithm empowered by a complementary Kalman filter. As a result, the Toe-Off detection algorithm reached an F-score between 90% and 100% for activities that do not involve stopping, and between 71% and 78% otherwise. Resulting return position errors were in the range of 0.5% to 8.8% for non-stopping activities and 8.8% to 27.4% otherwise. The proposed pipeline is able to reconstruct indoor trajectories of people performing activities that involve walking, jogging, running, side and backward walking, sitting, and standing.

DF-DM: A foundational process model for multimodal data fusion in the artificial intelligence era.

In the big data era, integrating diverse data modalities poses significant challenges, particularly in complex fields like healthcare. This paper introduces a new process model for multimodal Data Fusion for Data Mining, integrating embeddings and the Cross-Industry Standard Process for Data Mining with the existing Data Fusion Information Group model. Our model aims to decrease computational costs, complexity, and bias while improving efficiency and reliability. We also propose "disentangled dense fusion," a novel embedding fusion method designed to optimize mutual information and facilitate dense inter-modality feature interaction, thereby minimizing redundant information. We demonstrate the model's efficacy through three use cases: predicting diabetic retinopathy using retinal images and patient metadata, domestic violence prediction employing satellite imagery, internet, and census data, and identifying clinical and demographic features from radiography images and clinical notes. The model achieved a Macro F1 score of 0.92 in diabetic retinopathy prediction, an R-squared of 0.854 and sMAPE of 24.868 in domestic violence prediction, and a macro AUC of 0.92 and 0.99 for disease prediction and sex classification, respectively, in radiological analysis. These results underscore the Data Fusion for Data Mining model's potential to significantly impact multimodal data processing, promoting its adoption in diverse, resource-constrained settings.

A multimodal framework for extraction and fusion of satellite images and public health data.

In low- and middle-income countries, the substantial costs associated with traditional data collection pose an obstacle to facilitating decision-making in the field of public health. Satellite imagery offers a potential solution, but the image extraction and analysis can be costly and requires specialized expertise. We introduce SatelliteBench, a scalable framework for satellite image extraction and vector embeddings generation. We also propose a novel multimodal fusion pipeline that utilizes a series of satellite imagery and metadata. The framework was evaluated generating a dataset with a collection of 12,636 images and embeddings accompanied by comprehensive metadata, from 81 municipalities in Colombia between 2016 and 2018. The dataset was then evaluated in 3 tasks: including dengue case prediction, poverty assessment, and access to education. The performance showcases the versatility and practicality of SatelliteBench, offering a reproducible, accessible and open tool to enhance decision-making in public health.

Multidimensional Machine Learning Model to Calculate a COVID-19 Vulnerability Index.

In Colombia, the first case of COVID-19 was confirmed on 6 March 2020. On 13 March 2023, Colombia registered 6,360,780 confirmed positive cases of COVID-19, representing 12.18% of the total population. The National Administrative Department of Statistics (DANE) in Colombia published in 2020 a COVID-19 vulnerability index, which estimates the vulnerability (per city block) of being infected with COVID-19. Unfortunately, DANE did not consider multiple factors that could increase the risk of COVID-19 (in addition to demographic and health), such as environmental and mobility data (found in the related literature). The proposed multidimensional index considers variables of different types (unemployment rate, gross domestic product, citizens' mobility, vaccination data, and climatological and spatial information) in which the incidence of COVID-19 is calculated and compared with the incidence of the COVID-19 vulnerability index provided by DANE. The collection, data preparation, modeling, and evaluation phases of the Cross-Industry Standard Process for Data Mining methodology (CRISP-DM) were considered for constructing the index. The multidimensional index was evaluated using multiple machine learning models to calculate the incidence of COVID-19 cases in the main cities of Colombia. The results showed that the best-performing model to predict the incidence of COVID-19 in Colombia is the Extra Trees Regressor algorithm, obtaining an R-squared of 0.829. This work is the first step toward a multidimensional analysis of COVID-19 risk factors, which has the potential to support decision making in public health programs. The results are also relevant for calculating vulnerability indexes for other viral diseases, such as dengue.

Architectural approach for semantic EHR systems development based on Detailed Clinical Models.

The integrative approach to health information in general and the development of pHealth systems in particular, require an integrated approach of formally modeled system architectures. Detailed Clinical Models (DCM) is one of the most promising modeling efforts for clinical concept representation in EHR system architectures. Although the feasibility of DCM modeling methodology has been demonstrated through examples, there is no formal, generic and automatic modeling transformation technique to ensure a semantic lossless transformation of clinical concepts expressed in DCM to either clinical concept representations based on ISO 13606/openEHR Archetypes or HL7 Templates. The objective of this paper is to propose a generic model transformation method and tooling for transforming DCM Clinical Concepts into ISO/EN 13606/openEHR Archetypes or HL7 Template models. The automation of the transformation process is supported by Model Driven-Development (MDD) transformation mechanisms and tools. The availability of processes, techniques and tooling for automatic DCM transformation would enable the development of intelligent, adaptive information systems as demanded for pHealth solutions.

Adaptive intelligent systems for pHealth - an architectural approach.

Health systems around the globe, especially in developing countries, are facing the challenge of delivering effective, safe, and high quality public health and individualized health services independent of time and location, and with minimum of allocated resources (pHealth). In this context, health promotion and health education services are very important, especially in primary care settings. The objective of this paper is to describe the architecture of an adaptive intelligent system mainly developed to support education and training of citizens, but also of health professionals. The proposed architecture describes a system consisting of several agents that cooperatively interact to find and process tutoring materials to disseminate them to users (multi-agent system). A prototype is being implemented which includes medical students from the Medical Faculty at University of Cauca (Colombia). In the experimental process, the student´s learning style - detected with the Bayesian Model - is compared against the learning style obtained from a questioner (manual approach).

Architectural analysis of clinical ontologies for pHealth interoperability.

Comprehensive interoperability between eHealth/pHealth systems requires properly represented shared knowledge. Formal ontologies allow specifying the semantics of health knowledge representation in a well-defined and unambiguous manner. The objective of this paper is to formally analyze - from a system-theoretical architectural perspective - existing clinical ontologies. The paper defines important ontology requirements for semantically interoperable pHealth/eHealth systems. Then, based on those requirements, 17 criteria are defined and used for analyzing 129 clinical ontologies. Statistical results confirm that most ontologies do not meet the defined criteria. OBO foundry defines a good approach to meet all defined criteria, but it does not cover yet the clinical domain as a whole. SNOMED CT was found the more comprehensive one, despite several restrictions.

Architectural approach for quality and safety aware healthcare social networks.

Quality of information and privacy and safety issues are frequently identified as main limitations to make most benefit from social media in healthcare. The objective of the paper is to contribute to the analysis of healthcare social networks (SN), and online healthcare social network services (SNS) by proposing a formal architectural analysis of healthcare SN and SNS, considering the complexity of both systems, but stressing on quality, safety and usability aspects. Quality policies are necessary to control the quality of content published by experts and consumers. Privacy and safety policies protect against inappropriate use of information and users responsibility for sharing information. After the policies are established and documented, a proof of concept online SNS supporting primary healthcare promotion is presented in the paper.

Formal specification of an ontology-based service for EHR interoperability.

OBJECTIVE: The objective of this paper is to describe by a Platform Independent Model, the formal specification of an ontology-based service for electronic health records interoperability. METHODS: The GCM is used as a framework for the service's architectural design. The formal specification of the service is an extension of the OMG CTS 2 specification. A review of mapping approaches is also provided. RESULTS: The paper describes the service' information and computation models, including the mapping process workflow. The platform specific implementation (Platform Specific Model) is provided as a set of WSDL interfaces. The specification includes ontology mapping algorithms and tools needed.

A system-theoretical, architecture-based approach to ontology management.

Comprehensive interoperability between distributed eHealth/pHealth environments requires that the systems involved are based on a common architectural framework and share common knowledge. The paper deals with the representation of systems by related ontologies. Therefore, the architectural principles ruling the system design and the interrelations of its components also rule the design of those ontologies and their management as exemplified.

Transformation of Health and Social Care Systems-An Interdisciplinary Approach Toward a Foundational Architecture.

Objective: For realizing pervasive and ubiquitous health and social care services in a safe and high quality as well as efficient and effective way, health and social care systems have to meet new organizational, methodological, and technological paradigms. The resulting ecosystems are highly complex, highly distributed, and highly dynamic, following inter-organizational and even international approaches. Even though based on international, but domain-specific models and standards, achieving interoperability between such systems integrating multiple domains managed by multiple disciplines and their individually skilled actors is cumbersome. Methods: Using the abstract presentation of any system by the universal type theory as well as universal logics and combining the resulting Barendregt Cube with parameters and the engineering approach of cognitive theories, systems theory, and good modeling best practices, this study argues for a generic reference architecture model moderating between the different perspectives and disciplines involved provide on that system. To represent architectural elements consistently, an aligned system of ontologies is used. Results: The system-oriented, architecture-centric, and ontology-based generic reference model allows for re-engineering the existing and emerging knowledge representations, models, and standards, also considering the real-world business processes and the related development process of supporting IT systems for the sake of comprehensive systems integration and interoperability. The solution enables the analysis, design, and implementation of dynamic, interoperable multi-domain systems without requesting continuous revision of existing specifications.

Challenges and solutions for transforming health ecosystems in low- and middle-income countries through artificial intelligence.

Background: Recent studies demonstrate the potential of Artificial Intelligence to support diagnosis, mortality assessment, and clinical decisions in low-and-middle-income countries (LMICs). However, explicit evidence of strategies to overcome the particular challenges for transformed health systems in these countries does not exist. Objective: The present study undertakes a review of research on the current status of artificial intelligence (AI) to identify requirements, gaps, challenges, and possible strategies to strengthen the large, complex, and heterogeneous health systems in LMICs. Design: After introducing the general challenges developing countries face, the methodology of systematic reviews and the meta-analyses extension for scoping reviews (PRISMA-ScR) is introduced according to the preferred reporting items. Scopus and Web of Science databases were used to identify papers published between 2011-2022, from which we selected 151 eligible publications. Moreover, a narrative review was conducted to analyze the evidence in the literature about explicit evidence of strategies to overcome particular AI challenges in LMICs. Results: The analysis of results was divided into two groups: primary studies, which include experimental studies or case studies using or deploying a specific AI solution (n = 129), and secondary studies, including opinion papers, systematic reviews, and papers with strategies or guidelines (n = 22). For both study groups, a descriptive statistical analysis was performed describing their technological contribution, data used, health context, and type of health interventions. For the secondary studies group, an in-deep narrative review was performed, identifying a set of 40 challenges gathered in eight different categories: data quality, context awareness; regulation and legal frameworks; education and change resistance; financial resources; methodology; infrastructure and connectivity; and scalability. A total of 89 recommendations (at least one per challenge) were identified. Conclusion: Research on applying AI and ML to healthcare interventions in LMICs is growing; however, apart from very well-described ML methods and algorithms, there are several challenges to be addressed to scale and mainstream experimental and pilot studies. The main challenges include improving the quality of existing data sources, training and modeling AI solutions based on contextual data; and implementing privacy, security, informed consent, ethical, liability, confidentiality, trust, equity, and accountability policies. Also, robust eHealth environments with trained stakeholders, methodological standards for data creation, research reporting, product certification, sustained investment in data sharing, infrastructures, and connectivity are necessary. Systematic review registration: [https://rb.gy/frn2rz].

Risk Factors for COVID-19: A Systematic Mapping Study.

INTRODUCTION: COVID-19 has affected people in several countries around the world. They experience respiratory symptoms that can be mild, moderate, or severe. Several reviews that characterize the risk factors of COVID-19 have been performed, but most address only risk factors associated with medical conditions, ignoring environmental and sociodemographic-socioeconomic factors. OBJECTIVE: This study aims at characterizing different risk factors in the published literature that influence contagion by COVID-19. METHODS: The review consists of three stages, including a systematic mapping with studies found in the Scopus database, an analysis of results, and finally the identification of relevant COVID-19 risk factors. RESULTS: A map of studies id provided considering two main groups: the type of research and context. Most studies consider risk factors associated with medical conditions, while research on other factors is scarce. CONCLUSIONS: Medical conditions such as diabetes, obesity, cardiovascular disease, hypertension, and factors such as age and sex, appear to be the ones that increase the risk of contracting COVID-19. Further research is needed on environmental, sociodemographic, and socioeconomic risk factors.

Ontology-based framework for electronic health records interoperability.

The use of Electronic Health Records (EHR) is wide spread in healthcare. One of the most challenging tasks for EHR systems is to achieve computable semantic interoperability. To address EHR interoperability, a number of standardization efforts are progressing, however these standards are either incomplete in terms of functionality or lacking specification of precise meaning of underlying data. This paper describes an interoperable EHR framework that uses an ontology-based approach to facilitate exchange of information and knowledge among EHR. Based on the proposed framework, an interoperability scenario between a Personal Health Record System, an EHR and a Laboratory System is described.

A reference architecture for integrated EHR in Colombia.

The implementation of national EHR infrastructures has to start by a detailed definition of the overall structure and behavior of the EHR system (system architecture). Architectures have to be open, scalable, flexible, user accepted and user friendly, trustworthy, based on standards including terminologies and ontologies. The GCM provides an architectural framework created with the purpose of analyzing any kind of system, including EHR system´s architectures. The objective of this paper is to propose a reference architecture for the implementation of an integrated EHR in Colombia, based on the current state of system´s architectural models, and EHR standards. The proposed EHR architecture defines a set of services (elements) and their interfaces, to support the exchange of clinical documents, offering an open, scalable, flexible and semantically interoperable infrastructure. The architecture was tested in a pilot tele-consultation project in Colombia, where dental EHR are exchanged.

Evaluating the impact of multivariate imputation by MICE in feature selection.

Handling missing values is a crucial step in preprocessing data in Machine Learning. Most available algorithms for analyzing datasets in the feature selection process and classification or estimation process analyze complete datasets. Consequently, in many cases, the strategy for dealing with missing values is to use only instances with full data or to replace missing values with a mean, mode, median, or a constant value. Usually, discarding missing samples or replacing missing values by means of fundamental techniques causes bias in subsequent analyzes on datasets. AIM: Demonstrate the positive impact of multivariate imputation in the feature selection process on datasets with missing values. RESULTS: We compared the effects of the feature selection process using complete datasets, incomplete datasets with missingness rates between 5 and 50%, and imputed datasets by basic techniques and multivariate imputation. The feature selection algorithms used are well-known methods. The results showed that the datasets imputed by multivariate imputation obtained the best results in feature selection compared to datasets imputed by basic techniques or non-imputed incomplete datasets. CONCLUSIONS: Considering the results obtained in the evaluation, applying multivariate imputation by MICE reduces bias in the feature selection process.

Correction: Evaluating the impact of multivariate imputation by MICE in feature selection.

[This corrects the article DOI: 10.1371/journal.pone.0254720.].

Multi-Dimensional Dataset of Open Data and Satellite Images for Characterization of Food Security and Nutrition.

BACKGROUND: Nutrition is one of the main factors affecting the development and quality of life of a person. From a public health perspective, food security is an essential social determinant for promoting healthy nutrition. Food security embraces four dimensions: physical availability of food, economic and physical access to food, food utilization, and the sustainability of the dimensions above. Integrally addressing the four dimensions is vital. Surprisingly most of the works focused on a single dimension of food security: the physical availability of food. OBJECTIVE: The paper proposes a multi-dimensional dataset of open data and satellite images to characterize food security in the department of Cauca, Colombia. METHODS: The food security dataset integrates multiple open data sources; therefore, the Cross-Industry Standard Process for Data Mining methodology was used to guide the construction of the dataset. It includes sources such as population and agricultural census, nutrition surveys, and satellite images. RESULTS: An open multidimensional dataset for the Department of Cauca with 926 attributes and 9 rows (each row representing a Municipality) from multiple sources in Colombia, is configured. Then, machine learning models were used to characterize food security and nutrition in the Cauca Department. As a result, The Food security index calculated for Cauca using a linear regression model (Mean Absolute Error of 0.391) is 57.444 in a range between 0 and 100, with 100 the best score. Also, an approach for extracting four features (Agriculture, Habitation, Road, Water) of satellite images were tested with the ResNet50 model trained from scratch, having the best performance with a macro-accuracy, macro-precision, macro-recall, and macro-F1-score of 91.7, 86.2, 66.91, and 74.92%, respectively. CONCLUSION: It shows how the CRISP-DM methodology can be used to create an open public health data repository. Furthermore, this methodology could be generalized to other types of problems requiring the creation of a dataset. In addition, the use of satellite images presents an alternative for places where data collection is challenging. The model and methodology proposed based on open data become a low-cost and effective solution that could be used by decision-makers, especially in developing countries, to support food security planning.