Validation of an app-based portable spirometer in adolescents with asthma.

OBJECTIVES: Objective measurements of asthma impairment could aid teens in recognition of changes in asthma status over time. Ready access to a conventional spirometer is not realistic outside of the clinical setting. In this proof-of-concept study, we compared the performance of the VitalFlo mobile spirometer to the nSpire KoKo® sx1000 spirometer for accuracy in measuring Forced Expiratory Volume in one second (FEV1) and Forced Vital Capacity (FVC) in adolescents with asthma. METHODS: Two hundred forty pulmonary function measurements were collected from 48 adolescents with persistent asthma from the University of North Carolina's pediatric allergy and pulmonology subspecialty clinics. Participants performed spirometry with the nSpireKoKo® sx1000 spirometer and the VitalFlo spirometer during their clinic visits. 119 simulated FVC maneuvers were conducted on both devices to standardize measurements. Pearson correlations, Bland-Altman procedure, and two-sample comparison tests were performed to assess the relationship between the two spirometers. RESULTS: VitalFlo measurements were significantly highly correlated with nSpireKoKo® spirometer values for FEV1, (r2=0.721, [95% CI, 0.749 ± 0.120], P < 0.001) and moderately for FVC (r2= 0.617, [95% CI, 0.640 ± 0.130], P < 0.001) measurements. There were no statistically significant differences of the mean FEV1 (M = 0.00764, SD = 0.364, t(59)=0.16, P = 0.87) and FVC measurements (M = 0.00261, SD = 0.565, t(59)=0.036, P = 0.97.) between the VitalFlo and nSpireKoKo® systems. Both devices demonstrated significantly high correlation when comparing the automated FVC (r2 = 0.997, [95% CI, 1.00 ± 0.00974], P < 0.001) measurements. Bland-Altman plots did not demonstrate significant bias between devices for both FEV1 (0.00764 L) and FVC (0.00261 L) measurements. CONCLUSIONS: Lung function measurements from the VitalFlo mobile spirometer were comparable to a commercially-available spirometer commonly used in clinical settings. This validated app-based spirometer for home use has the potential to improve asthma self-management.

Social facilitation of insect reproduction with motor-driven tactile stimuli.

Tactile stimuli provide animals with important information about the environment, including physical features such as obstacles, and biologically relevant cues related to food, mates, hosts and predators. The antennae, the principal sensory organs of insects, house an array of sensory receptors for olfaction, gustation, audition, nociception, balance, stability, graviception, static electric fields, and thermo-, hygro- and mechanoreception. The antennae, being the anteriormost sensory appendages, play a prominent role in social interactions with conspecifics that involve primarily chemosensory and tactile stimuli. In the German cockroach (Blattella germanica) antennal contact during social interactions modulates brain-regulated juvenile hormone production, ultimately accelerating the reproductive rate in females. The primary sensory modality mediating this social facilitation of reproduction is antennal mechanoreception. We investigated the key elements, or stimulus features, of antennal contact that socially facilitate reproduction in B. germanica females. Using motor-driven antenna mimics, we assessed the physiological responses of females to artificial tactile stimulation. Our results indicate that tactile stimulation with artificial materials, some deviating significantly from the native antennal morphology, can facilitate female reproduction. However, none of the artificial stimuli matched the effects of social interactions with a conspecific female.

A Wearable System for Continuous Monitoring and Assessment of Speech, Gait, and Cognitive Decline for Early Diagnosis of ADRD.

Early detection of cognitive decline is essential to study mild cognitive impairment and Alzheimer's Disease in order to develop targeted interventions and prevent or stop the progression of dementia. This requires continuous and longitudinal assessment and tracking of the related physiological and behavioral changes during daily life. In this paper, we present a low cost and low power wearable system custom designed to track the trends in speech, gait, and cognitive stress while also considering the important human factor needs such as privacy and compliance. In the form factors of a wristband and waist-patch, this multimodal, multi-sensor system measures inertial signals, sound, heart rate, electrodermal activity and pulse transit time. A total power consumption of 2.6 mW without any duty cycling allows for more than 3 weeks of run time between charges when 1500 mAh batteries are used.Clinical Relevance- Much earlier detection of Alzheimer's disease and related dementias may be possible by continuous monitoring of physiological and behavioral state using application specific wearable sensors during the activities of daily life.

Towards Wearable Health Monitoring Devices.

Humans have searched far beyond our planet to understand the fundamental principles and mechanisms of life [...].

An Ultra-miniaturized Near Infrared Spectroscopy System to Assess Sleep Apnea in Children with Down Syndrome.

Down syndrome is one of the health disorders that interferes with regular and healthy sleep. Most children with Down syndrome are referred to a sleep clinic for the assessment of the severity of their apnea. Regular polysomnography based assessment of apnea has been challenging with this sensitive patient population. We present our efforts towards developing a flexible adhesive bandage sized near infrared spectroscopy system (pediBand) for home-assessment of apnea in children with Down syndrome. Combined with inertial measurement units, pediBand record heart rate, heart rate variability, respiratory rate, arterial oxygen saturation and cerebral oxygen saturation. These are the essential parameters to assess sleep apnea and could also potentially be used in the assessment of sleep performance in general. A modified version of pediBand system was evaluated on adult patients and successfully demonstrated the changes in hemodynamic system triggered by sleep apnea.

Accelerometer based Active Snore Detection for Behavioral Modification.

Habitual snoring has been known to increase the risk for serious health problems in addition to affecting the quality of others' sleep. Several recent consumer products aim to automatically detect snoring events and wake the snorer to elicit a posture change. In this paper, we present a study comparing two of the methods, electromyography vs. accelerometry, proposed for automated snoring detection and incorporation of these into a wearable system. The study includes (a) the testing of various sensor configurations and placements to obtain optimal electromyography and accelerometry signals, (b) a review of the accuracy of a variety of snore detection algorithms from previously attained biological signals, and (3) design of an embedded device with integrated sensors and haptic feedback capability. Our preliminary results indicate superiority of accelerometry over electromyography. Further research opportunities to prove the concept and improve the design are then detailed for future work.

A System for Assessment of Canine-Human Interaction during Animal-Assisted Therapies.

Animal-assisted therapies (AAT) are becoming increasingly common to help hospitalized patients, especially in oncology units. There is a critical need for methods and technologies that can enable a quantifiable understanding of AAT to objectively demonstrate its efficacy and improve its efficiency. In this paper, we present our preliminary efforts towards the development of wireless sensor systems to simultaneously detect the related behavioral (activity level, movement, stroking) and physiological signals (heart rate/variability) of humans and animals during their interaction. To detect heart rate, we tested two different techniques based on wearable or contactless electrocardiography. In this preliminary evaluation, we were able to assess these parameters successfully and identify the design challenges towards deployment of these systems in larger clinical studies.

Low-Power Wearable Systems for Continuous Monitoring of Environment and Health for Chronic Respiratory Disease.

We present our efforts toward enabling a wearable sensor system that allows for the correlation of individual environmental exposures with physiologic and subsequent adverse health responses. This system will permit a better understanding of the impact of increased ozone levels and other pollutants on chronic asthma conditions. We discuss the inefficiency of existing commercial off-the-shelf components to achieve continuous monitoring and our system-level and nano-enabled efforts toward improving the wearability and power consumption. Our system consists of a wristband, a chest patch, and a handheld spirometer. We describe our preliminary efforts to achieve a submilliwatt system ultimately powered by the energy harvested from thermal radiation and motion of the body with the primary contributions being an ultralow-power ozone sensor, an volatile organic compounds sensor, spirometer, and the integration of these and other sensors in a multimodal sensing platform. The measured environmental parameters include ambient ozone concentration, temperature, and relative humidity. Our array of sensors also assesses heart rate via photoplethysmography and electrocardiography, respiratory rate via photoplethysmography, skin impedance, three-axis acceleration, wheezing via a microphone, and expiratory airflow. The sensors on the wristband, chest patch, and spirometer consume 0.83, 0.96, and 0.01 mW, respectively. The data from each sensor are continually streamed to a peripheral data aggregation device and are subsequently transferred to a dedicated server for cloud storage. Future work includes reducing the power consumption of the system-on-chip including radio to reduce the entirety of each described system in the submilliwatt range.

Solar powered wrist worn acquisition system for continuous photoplethysmogram monitoring.

We present a solar-powered, wireless, wrist-worn platform for continuous monitoring of physiological and environmental parameters during the activities of daily life. In this study, we demonstrate the capability to produce photoplethysmogram (PPG) signals using this platform. To adhere to a low power budget for solar-powering, a 574 nm green light source is used where the PPG from the radial artery would be obtained with minimal signal conditioning. The system incorporates two monocrystalline solar cells to charge the onboard 20 mAh lithium polymer battery. Bluetooth Low Energy (BLE) is used to tether the device to a smartphone that makes the phone an access point to a dedicated server for long term continuous storage of data. Two power management schemes have been proposed depending on the availability of solar energy. In low light situations, if the battery is low, the device obtains a 5-second PPG waveform every minute to consume an average power of 0.57 mW. In scenarios where the battery is at a sustainable voltage, the device is set to enter its normal 30 Hz acquisition mode, consuming around 13.7 mW. We also present our efforts towards improving the charge storage capacity of our on-board super-capacitor.