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1.
JMIR Mhealth Uhealth ; 12: e50620, 2024 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-38717366

RESUMEN

Background: Wearables that measure vital parameters can be potential tools for monitoring patients at home during cancer treatment. One type of wearable is a smart T-shirt with embedded sensors. Initially, smart T-shirts were designed to aid athletes in their performance analyses. Recently however, researchers have been investigating the use of smart T-shirts as supportive tools in health care. In general, the knowledge on the use of wearables for symptom monitoring during cancer treatment is limited, and consensus and awareness about compliance or adherence are lacking. objectives: The aim of this study was to evaluate adherence to and experiences with using a smart T-shirt for the home monitoring of biometric sensor data among adolescent and young adult patients undergoing cancer treatment during a 2-week period. Methods: This study was a prospective, single-cohort, mixed methods feasibility study. The inclusion criteria were patients aged 18 to 39 years and those who were receiving treatment at Copenhagen University Hospital - Rigshospitalet, Denmark. Consenting patients were asked to wear the Chronolife smart T-shirt for a period of 2 weeks. The smart T-shirt had multiple sensors and electrodes, which engendered the following six measurements: electrocardiogram (ECG) measurements, thoracic respiration, abdominal respiration, thoracic impedance, physical activity (steps), and skin temperature. The primary end point was adherence, which was defined as a wear time of >8 hours per day. The patient experience was investigated via individual, semistructured telephone interviews and a paper questionnaire. Results: A total of 10 patients were included. The number of days with wear times of >8 hours during the study period (14 d) varied from 0 to 6 (mean 2 d). Further, 3 patients had a mean wear time of >8 hours during each of their days with data registration. The number of days with any data registration ranged from 0 to 10 (mean 6.4 d). The thematic analysis of interviews pointed to the following three main themes: (1) the smart T-shirt is cool but does not fit patients with cancer, (2) the technology limits the use of the smart T-shirt, and (3) the monitoring of data increases the feeling of safety. Results from the questionnaire showed that the patients generally had confidence in the device. Conclusions: Although the primary end point was not reached, the patients' experiences with using the smart T-shirt resulted in the knowledge that patients acknowledged the need for new technologies that improve supportive cancer care. The patients were positive when asked to wear the smart T-shirt. However, technical and practical challenges in using the device resulted in low adherence. Although wearables might have potential for home monitoring, the present technology is immature for clinical use.


Asunto(s)
Estudios de Factibilidad , Neoplasias , Dispositivos Electrónicos Vestibles , Humanos , Adolescente , Masculino , Estudios Prospectivos , Femenino , Neoplasias/psicología , Neoplasias/terapia , Adulto , Dispositivos Electrónicos Vestibles/estadística & datos numéricos , Dispositivos Electrónicos Vestibles/normas , Dispositivos Electrónicos Vestibles/psicología , Estudios de Cohortes , Dinamarca , Monitoreo Fisiológico/instrumentación , Monitoreo Fisiológico/métodos , Adulto Joven
2.
Sci Rep ; 14(1): 10449, 2024 05 07.
Artículo en Inglés | MEDLINE | ID: mdl-38714775

RESUMEN

The body temperature of infants at equilibrium with their surroundings is balanced between heat production from metabolism and the transfer of heat to the environment. Total heat production is related to body size, which is closely related to metabolic rate and oxygen consumption. Body temperature control is a crucial aspect of neonatal medicine but we have often struggled with temperature measures. Contactless infrared thermography (IRT) is useful for vulnerable neonates and may be able to assess their spontaneous thermal metabolism. The present study focused on heat oscillations and their cause. IRT was used to measure the skin temperature every 15 s of neonates in an incubator. We analyzed the thermal data of 27 neonates (32 measurements), calculated the average temperature within specified regions, and extracted two frequency components-Components A and B-using the Savitzky-Golay method. Furthermore, we derived an equation describing the cycle-named cycle T-for maintaining body temperature according to body weight. A positive correlation was observed between cycle T and Component B (median [IQR]: 368 [300-506] s). This study sheds light on the physiological thermoregulatory function of newborns and will lead to improved temperature management methods for newborns, particularly premature, low-birth-weight infants.


Asunto(s)
Regulación de la Temperatura Corporal , Termografía , Humanos , Recién Nacido , Termografía/métodos , Regulación de la Temperatura Corporal/fisiología , Femenino , Masculino , Monitoreo Fisiológico/métodos , Temperatura Corporal/fisiología , Temperatura Cutánea/fisiología
3.
Curr Opin Crit Care ; 30(3): 260-267, 2024 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-38690955

RESUMEN

PURPOSE OF REVIEW: Venous pressure is an often-unrecognized cause of patient morbidity. However, bedside assessment of PV is challenging. We review the clinical significance of venous pressure measurement, existing techniques, and introduce the Venous Excess Ultrasound (VExUS) Score as a novel approach using doppler ultrasound to assess venous pressure. RECENT FINDINGS: Studies show clear associations between elevated venous pressure and adverse outcomes in critically ill patients. Current venous pressure measurement techniques include physical examination, right heart catheterization (RHC), two-dimensional ultrasound, and a variety of labor-intensive research-focused physiological maneuvers. Each of these techniques have specific shortcomings, limiting their clinical utility. To address these gaps, Beaubien-Souligny et al. introduced the VExUS Score, a novel doppler ultrasound-based method that integrates IVC diameter with doppler measurements of the hepatic, portal, and renal veins to generate a venous congestion assesment. Studies show strong correlations between VExUS score and RHC measurements, and well as an association between VExUS score and improvement in cardiorenal acute kidney injury, diuretic response, and fluid status shifts. However, studies in noncardiac populations have been small, heterogenous, and inconclusive. SUMMARY: Early studies evaluating the use of doppler ultrasound to assess venous congestion show promise, but further research is needed in diverse patient populations and clinical settings.


Asunto(s)
Ultrasonografía Doppler , Humanos , Ultrasonografía Doppler/métodos , Enfermedad Crítica , Presión Venosa/fisiología , Vena Cava Inferior/diagnóstico por imagen , Vena Cava Inferior/fisiopatología , Monitoreo Fisiológico/métodos , Cuidados Críticos/métodos
4.
Curr Opin Crit Care ; 30(3): 275-282, 2024 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-38690957

RESUMEN

PURPOSE OF REVIEW: Wearable wireless sensors for continuous vital signs monitoring (CVSM) offer the potential for early identification of patient deterioration, especially in low-intensity care settings like general wards. This study aims to review advances in wearable CVSM - with a focus on the general ward - highlighting the technological characteristics of CVSM systems, user perspectives and impact on patient outcomes by exploring recent evidence. RECENT FINDINGS: The accuracy of wearable sensors measuring vital signs exhibits variability, especially notable in ambulatory patients within hospital settings, and standard validation protocols are lacking. Usability of CMVS systems is critical for nurses and patients, highlighting the need for easy-to-use wearable sensors, and expansion of the number of measured vital signs. Current software systems lack integration with hospital IT infrastructures and workflow automation. Imperative enhancements involve nurse-friendly, less intrusive alarm strategies, and advanced decision support systems. Despite observed reductions in ICU admissions and Rapid Response Team calls, the impact on patient outcomes lacks robust statistical significance. SUMMARY: Widespread implementation of CVSM systems on the general ward and potentially outside the hospital seems inevitable. Despite the theoretical benefits of CVSM systems in improving clinical outcomes, and supporting nursing care by optimizing clinical workflow efficiency, the demonstrated effects in clinical practice are mixed. This review highlights the existing challenges related to data quality, usability, implementation, integration, interpretation, and user perspectives, as well as the need for robust evidence to support their impact on patient outcomes, workflow and cost-effectiveness.


Asunto(s)
Signos Vitales , Dispositivos Electrónicos Vestibles , Humanos , Monitoreo Fisiológico/instrumentación , Monitoreo Fisiológico/métodos , Tecnología Inalámbrica/instrumentación
5.
Curr Opin Crit Care ; 30(3): 251-259, 2024 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-38690954

RESUMEN

PURPOSE OF REVIEW: To describe current and near future developments and applications of CO2 kinetics in clinical respiratory and cardiovascular monitoring. RECENT FINDINGS: In the last years, we have witnessed a renewed interest in CO2 kinetics in relation with a better understanding of volumetric capnography and its derived parameters. This together with technological advances and improved measurement systems have expanded the monitoring potential of CO2 kinetics including breath by breath continuous end-expiratory lung volume and continuous noninvasive cardiac output. Dead space has slowly been gaining relevance in clinical monitoring and prognostic evaluation. Easy to measure dead space surrogates such as the ventilatory ratio have demonstrated a strong prognostic value in patients with acute respiratory failure. SUMMARY: The kinetics of carbon dioxide describe many relevant physiological processes. The clinical introduction of new ways of assessing respiratory and circulatory efficiency based on advanced analysis of CO2 kinetics are paving the road to a long-desired goal in clinical monitoring of critically ill patients: the integration of respiratory and circulatory monitoring during mechanical ventilation.


Asunto(s)
Capnografía , Dióxido de Carbono , Humanos , Dióxido de Carbono/análisis , Capnografía/métodos , Monitoreo Fisiológico/métodos , Respiración Artificial/métodos , Cinética , Gasto Cardíaco/fisiología , Biomarcadores , Espacio Muerto Respiratorio/fisiología
6.
Curr Opin Crit Care ; 30(3): 268-274, 2024 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-38690956

RESUMEN

PURPOSE OF REVIEW: This review explores lung recruitment monitoring, covering techniques, challenges, and future perspectives. RECENT FINDINGS: Various methodologies, including respiratory system mechanics evaluation, arterial bold gases (ABGs) analysis, lung imaging, and esophageal pressure (Pes) measurement are employed to assess lung recruitment. In support to ABGs analysis, the assessment of respiratory mechanics with hysteresis and recruitment-to-inflation ratio has the potential to evaluate lung recruitment and enhance mechanical ventilation setting. Lung imaging tools, such as computed tomography scanning, lung ultrasound, and electrical impedance tomography (EIT) confirm their utility in following lung recruitment with the advantage of radiation-free and repeatable application at the bedside for sonography and EIT. Pes enables the assessment of dorsal lung tendency to collapse through end-expiratory transpulmonary pressure. Despite their value, these methodologies may require an elevated expertise in their application and data interpretation. However, the information obtained by these methods may be conveyed to build machine learning and artificial intelligence algorithms aimed at improving the clinical decision-making process. SUMMARY: Monitoring lung recruitment is a crucial component of managing patients with severe lung conditions, within the framework of a personalized ventilatory strategy. Although challenges persist, emerging technologies offer promise for a personalized approach to care in the future.


Asunto(s)
Respiración Artificial , Humanos , Monitoreo Fisiológico/métodos , Respiración Artificial/métodos , Mecánica Respiratoria/fisiología , Pulmón/diagnóstico por imagen , Pulmón/fisiopatología , Impedancia Eléctrica , Tomografía Computarizada por Rayos X , Análisis de los Gases de la Sangre/métodos , Ultrasonografía/métodos
7.
Crit Care Explor ; 6(5): e1094, 2024 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-38727717

RESUMEN

OBJECTIVES: Near-infrared spectroscopy (NIRS) is a potentially valuable modality to monitor the adequacy of oxygen delivery to the brain and other tissues in critically ill patients, but little is known about the physiologic determinants of NIRS-derived tissue oxygen saturations. The purpose of this study was to assess the contribution of routinely measured physiologic parameters to tissue oxygen saturation measured by NIRS. DESIGN: An observational sub-study of patients enrolled in the Role of Active Deresuscitation After Resuscitation-2 (RADAR-2) randomized feasibility trial. SETTING: Two ICUs in the United Kingdom. PATIENTS: Patients were recruited for the RADAR-2 study, which compared a conservative approach to fluid therapy and deresuscitation with usual care. Those included in this sub-study underwent continuous NIRS monitoring of cerebral oxygen saturations (SctO2) and quadriceps muscle tissue saturations (SmtO2). INTERVENTION: Synchronized and continuous mean arterial pressure (MAP), heart rate (HR), and pulse oximetry (oxygen saturation, Spo2) measurements were recorded alongside NIRS data. Arterial Paco2, Pao2, and hemoglobin concentration were recorded 12 hourly. Linear mixed effect models were used to investigate the association between these physiologic variables and cerebral and muscle tissue oxygen saturations. MEASUREMENTS AND MAIN RESULTS: Sixty-six patients were included in the analysis. Linear mixed models demonstrated that Paco2, Spo2, MAP, and HR were weakly associated with SctO2 but only explained 7.1% of the total variation. Spo2 and MAP were associated with SmtO2, but together only explained 0.8% of its total variation. The remaining variability was predominantly accounted for by between-subject differences. CONCLUSIONS: Our findings demonstrated that only a small proportion of variability in NIRS-derived cerebral and tissue oximetry measurements could be explained by routinely measured physiologic variables. We conclude that for NIRS to be a useful monitoring modality in critical care, considerable further research is required to understand physiologic determinants and prognostic significance.


Asunto(s)
Enfermedad Crítica , Oximetría , Saturación de Oxígeno , Espectroscopía Infrarroja Corta , Humanos , Espectroscopía Infrarroja Corta/métodos , Masculino , Femenino , Saturación de Oxígeno/fisiología , Persona de Mediana Edad , Anciano , Oximetría/métodos , Monitoreo Fisiológico/métodos , Encéfalo/metabolismo , Encéfalo/irrigación sanguínea , Reino Unido , Oxígeno/metabolismo , Oxígeno/sangre , Oxígeno/análisis , Unidades de Cuidados Intensivos , Músculo Cuádriceps/metabolismo , Músculo Cuádriceps/irrigación sanguínea
8.
Health Aff (Millwood) ; 43(5): 701-706, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38709970

RESUMEN

Remote physiologic monitoring use increased more than 1,300 percent from 2019 to 2021, and use varied by state. This increase was driven by a small number of (predominantly internal medicine) providers. Female beneficiaries, residents of metropolitan areas, and people diagnosed with diabetes or hypertension had the highest rates of use.


Asunto(s)
Medicaid , Humanos , Estados Unidos , Femenino , Medicaid/estadística & datos numéricos , Masculino , Monitoreo Fisiológico/métodos , Persona de Mediana Edad , Adulto , Anciano , Telemedicina/estadística & datos numéricos
9.
BMC Health Serv Res ; 24(1): 595, 2024 May 07.
Artículo en Inglés | MEDLINE | ID: mdl-38714998

RESUMEN

BACKGROUND: Critically ill children require close monitoring to facilitate timely interventions throughout their hospitalisation. In low- and middle-income countries with a high disease burden, scarce paediatric critical care resources complicates effective monitoring. This study describes the monitoring practices for critically ill children in a paediatric high-dependency unit (HDU) in Malawi and examines factors affecting this vital process. METHODS: A formative qualitative study based on 21 in-depth interviews of healthcare providers (n = 12) and caregivers of critically ill children (n = 9) in the HDU along with structured observations of the monitoring process. Interviews were transcribed and translated for thematic content analysis. RESULTS: The monitoring of critically ill children admitted to the HDU was intermittent, using devices and through clinical observations. Healthcare providers prioritised the most critically ill children for more frequent monitoring. The ward layout, power outages, lack of human resources and limited familiarity with available monitoring devices, affected monitoring. Caregivers, who were present throughout admission, were involved informally in monitoring and flagging possible deterioration of their child to the healthcare staff. CONCLUSION: Barriers to the monitoring of critically ill children in the HDU were related to ward layout and infrastructure, availability of accurate monitoring devices and limited human resources. Potential interventions include training healthcare providers to prioritise the most critically ill children, allocate and effectively employ available devices, and supporting caregivers to play a more formal role in escalation.


Asunto(s)
Cuidadores , Enfermedad Crítica , Personal de Salud , Investigación Cualitativa , Centros de Atención Terciaria , Humanos , Malaui , Enfermedad Crítica/terapia , Cuidadores/psicología , Masculino , Femenino , Niño , Personal de Salud/psicología , Monitoreo Fisiológico/métodos , Entrevistas como Asunto , Preescolar , Lactante , Unidades de Cuidado Intensivo Pediátrico , Adulto
10.
JMIR Nurs ; 7: e53592, 2024 May 09.
Artículo en Inglés | MEDLINE | ID: mdl-38723253

RESUMEN

BACKGROUND: Health monitoring technologies help patients and older adults live better and stay longer in their own homes. However, there are many factors influencing their adoption of these technologies. Privacy is one of them. OBJECTIVE: The aim of this study was to provide an overview of the privacy barriers in health monitoring from current research, analyze the factors that influence patients to adopt assisted living technologies, provide a social psychological explanation, and propose suggestions for mitigating these barriers in future research. METHODS: A scoping review was conducted, and web-based literature databases were searched for published studies to explore the available research on privacy barriers in a health monitoring environment. RESULTS: In total, 65 articles met the inclusion criteria and were selected and analyzed. Contradictory findings and results were found in some of the included articles. We analyzed the contradictory findings and provided possible explanations for current barriers, such as demographic differences, information asymmetry, researchers' conceptual confusion, inducible experiment design and its psychological impacts on participants, researchers' confirmation bias, and a lack of distinction among different user roles. We found that few exploratory studies have been conducted so far to collect privacy-related legal norms in a health monitoring environment. Four research questions related to privacy barriers were raised, and an attempt was made to provide answers. CONCLUSIONS: This review highlights the problems of some research, summarizes patients' privacy concerns and legal concerns from the studies conducted, and lists the factors that should be considered when gathering and analyzing people's privacy attitudes.


Asunto(s)
Privacidad , Humanos , Privacidad/legislación & jurisprudencia , Monitoreo Fisiológico/métodos
11.
Artículo en Inglés | MEDLINE | ID: mdl-38723798

RESUMEN

Wearable and implantable sensing of biomechanical signals such as pressure, strain, shear, and vibration can enable a multitude of human-integrated applications, including on-skin monitoring of vital signs, motion tracking, monitoring of internal organ condition, restoration of lost/impaired mechanoreception, among many others. The mechanical conformability of such sensors to the human skin and tissue is critical to enhancing their biocompatibility and sensing accuracy. As such, in the recent decade, significant efforts have been made in the development of soft mechanical sensors. To satisfy the requirements of different wearable and implantable applications, such sensors have been imparted with various additional properties to make them better suited for the varied contexts of human-integrated applications. In this review, focusing on the four major types of soft mechanical sensors for pressure, strain, shear, and vibration, we discussed the recent material and device design innovations for achieving several important properties, including flexibility and stretchability, bioresorbability and biodegradability, self-healing properties, breathability, transparency, wireless communication capabilities, and high-density integration. We then went on to discuss the current research state of the use of such novel soft mechanical sensors in wearable and implantable applications, based on which future research needs were further discussed. This article is categorized under: Diagnostic Tools > Biosensing Diagnostic Tools > Diagnostic Nanodevices Implantable Materials and Surgical Technologies > Nanomaterials and Implants.


Asunto(s)
Prótesis e Implantes , Dispositivos Electrónicos Vestibles , Humanos , Diseño de Equipo , Técnicas Biosensibles/instrumentación , Monitoreo Fisiológico/instrumentación
12.
Respir Res ; 25(1): 194, 2024 May 03.
Artículo en Inglés | MEDLINE | ID: mdl-38702779

RESUMEN

Asthma is a common chronic disease amongst children. Epidemiological studies showed that the mortality rate of asthma in children is still high worldwide. Asthma control is therefore essential to minimize asthma exacerbations, which can be fatal if the condition is poorly controlled. Frequent monitoring could help to detect asthma progression and ensure treatment effectiveness. Although subjective asthma monitoring tools are available, the results vary as they rely on patients' self-perception. Emerging evidence suggests several objective tools could have the potential for monitoring purposes. However, there is no consensus to standardise the use of objective monitoring tools. In this review, we start with the prevalence and severity of childhood asthma worldwide. Then, we detail the latest available objective monitoring tools, focusing on their effectiveness in paediatric asthma management. Publications of spirometry, fractional exhaled nitric oxide (FeNO), hyperresponsiveness tests and electronic monitoring devices (EMDs) between 2016 and 2023 were included. The potential advantages and limitations of each tool were also discussed. Overall, this review provides a summary for researchers dedicated to further improving objective paediatric asthma monitoring and provides insights for clinicians to incorporate different objective monitoring tools in clinical practices.


Asunto(s)
Asma , Humanos , Asma/diagnóstico , Asma/terapia , Asma/fisiopatología , Asma/epidemiología , Niño , Espirometría/métodos , Monitoreo Fisiológico/métodos , Manejo de la Enfermedad , Prueba de Óxido Nítrico Exhalado Fraccionado/métodos
13.
Sensors (Basel) ; 24(9)2024 Apr 23.
Artículo en Inglés | MEDLINE | ID: mdl-38732771

RESUMEN

Human activity recognition (HAR) technology enables continuous behavior monitoring, which is particularly valuable in healthcare. This study investigates the viability of using an ear-worn motion sensor for classifying daily activities, including lying, sitting/standing, walking, ascending stairs, descending stairs, and running. Fifty healthy participants (between 20 and 47 years old) engaged in these activities while under monitoring. Various machine learning algorithms, ranging from interpretable shallow models to state-of-the-art deep learning approaches designed for HAR (i.e., DeepConvLSTM and ConvTransformer), were employed for classification. The results demonstrate the ear sensor's efficacy, with deep learning models achieving a 98% accuracy rate of classification. The obtained classification models are agnostic regarding which ear the sensor is worn and robust against moderate variations in sensor orientation (e.g., due to differences in auricle anatomy), meaning no initial calibration of the sensor orientation is required. The study underscores the ear's efficacy as a suitable site for monitoring human daily activity and suggests its potential for combining HAR with in-ear vital sign monitoring. This approach offers a practical method for comprehensive health monitoring by integrating sensors in a single anatomical location. This integration facilitates individualized health assessments, with potential applications in tele-monitoring, personalized health insights, and optimizing athletic training regimes.


Asunto(s)
Dispositivos Electrónicos Vestibles , Humanos , Adulto , Masculino , Femenino , Persona de Mediana Edad , Adulto Joven , Actividades Humanas , Oído/fisiología , Algoritmos , Actividades Cotidianas , Aprendizaje Automático , Aprendizaje Profundo , Monitoreo Fisiológico/instrumentación , Monitoreo Fisiológico/métodos , Movimiento (Física) , Caminata/fisiología
14.
Sensors (Basel) ; 24(9)2024 Apr 23.
Artículo en Inglés | MEDLINE | ID: mdl-38732777

RESUMEN

Optical fiber sensors are extensively employed for their unique merits, such as small size, being lightweight, and having strong robustness to electronic interference. The above-mentioned sensors apply to more applications, especially the detection and monitoring of vital signs in medical or clinical. However, it is inconvenient for daily long-term human vital sign monitoring with conventional monitoring methods under the uncomfortable feelings generated since the skin and devices come into direct contact. This study introduces a non-invasive surveillance system that employs an optical fiber sensor and advanced deep-learning methodologies for precise vital sign readings. This system integrates a monitor based on the MZI (Mach-Zehnder interferometer) with LSTM networks, surpassing conventional approaches and providing potential uses in medical diagnostics. This could be potentially utilized in non-invasive health surveillance, evaluation, and intelligent health care.


Asunto(s)
Aprendizaje Profundo , Fibras Ópticas , Signos Vitales , Humanos , Signos Vitales/fisiología , Monitoreo Fisiológico/métodos , Monitoreo Fisiológico/instrumentación , Redes Neurales de la Computación
15.
Sensors (Basel) ; 24(9)2024 Apr 23.
Artículo en Inglés | MEDLINE | ID: mdl-38732781

RESUMEN

INTRODUCTION: Diabetic foot ulcers (DFU) are a devastating complication of diabetes. There are numerous challenges with preventing diabetic foot complications and barriers to achieving the care processes suggested in established foot care guidelines. Multi-faceted digital health solutions, which combine multimodal sensing, patient-facing biofeedback, and remote patient monitoring (RPM), show promise in improving our ability to understand, prevent, and manage DFUs. METHODS: Patients with a history of diabetic plantar foot ulcers were enrolled in a prospective cohort study and equipped with custom sensory insoles to track plantar pressure, plantar temperature, step count, and adherence data. Sensory insole data enabled patient-facing biofeedback to cue active plantar offloading in response to sustained high plantar pressures, and RPM assessments in response to data trends of concern in plantar pressure, plantar temperature, or sensory insole adherence. Three non-consecutive case participants that ultimately presented with pre-ulcerative lesions (a callus and/or erythematous area on the plantar surface of the foot) during the study were selected for this case series. RESULTS: Across three illustrative patients, continuous plantar pressure monitoring demonstrated promise for empowering both the patient and provider with information for data-driven management of pressure offloading treatments. CONCLUSION: Multi-faceted digital health solutions can naturally enable and reinforce the integrative foot care guidelines. Multi-modal sensing across multiple physiologic domains supports the monitoring of foot health at various stages along the DFU pathogenesis pathway. Furthermore, digital health solutions equipped with remote patient monitoring unlock new opportunities for personalizing treatments, providing periodic self-care reinforcement, and encouraging patient engagement-key tools for improving patient adherence to their diabetic foot care plan.


Asunto(s)
Pie Diabético , Humanos , Pie Diabético/terapia , Masculino , Femenino , Persona de Mediana Edad , Anciano , Estudios Prospectivos , Presión , Monitoreo Fisiológico/métodos , Salud Digital
16.
Sensors (Basel) ; 24(9)2024 Apr 26.
Artículo en Inglés | MEDLINE | ID: mdl-38732888

RESUMEN

In today's health-monitoring applications, there is a growing demand for wireless and wearable acquisition platforms capable of simultaneously gathering multiple bio-signals from multiple body areas. These systems require well-structured software architectures, both to keep different wireless sensing nodes synchronized each other and to flush collected data towards an external gateway. This paper presents a quantitative analysis aimed at validating both the wireless synchronization task (implemented with a custom protocol) and the data transmission task (implemented with the BLE protocol) in a prototype wearable monitoring platform. We evaluated seven frequencies for exchanging synchronization packets (10 Hz, 20 Hz, 30 Hz, 40 Hz, 50 Hz, 60 Hz, 70 Hz) as well as two different BLE configurations (with and without the implementation of a dynamic adaptation of the BLE Connection Interval parameter). Additionally, we tested BLE data transmission performance in five different use case scenarios. As a result, we achieved the optimal performance in the synchronization task (1.18 ticks as median synchronization delay with a Min-Max range of 1.60 ticks and an Interquartile range (IQR) of 0.42 ticks) when exploiting a synchronization frequency of 40 Hz and the dynamic adaptation of the Connection Interval. Moreover, BLE data transmission proved to be significantly more efficient with shorter distances between the communicating nodes, growing worse by 30.5% beyond 8 m. In summary, this study suggests the best-performing network configurations to enhance the synchronization task of the prototype platform under analysis, as well as quantitative details on the best placement of data collectors.


Asunto(s)
Dispositivos Electrónicos Vestibles , Tecnología Inalámbrica , Tecnología Inalámbrica/instrumentación , Humanos , Monitoreo Fisiológico/instrumentación , Monitoreo Fisiológico/métodos , Redes de Comunicación de Computadores/instrumentación , Programas Informáticos
17.
Sensors (Basel) ; 24(9)2024 Apr 27.
Artículo en Inglés | MEDLINE | ID: mdl-38732899

RESUMEN

This comprehensive review investigates the transformative potential of sensor-driven digital twin technology in enhancing healthcare delivery within smart environments. We explore the integration of smart environments with sensor technologies, digital health capabilities, and location-based services, focusing on their impacts on healthcare objectives and outcomes. This work analyzes the foundational technologies, encompassing the Internet of Things (IoT), Internet of Medical Things (IoMT), machine learning (ML), and artificial intelligence (AI), that underpin the functionalities within smart environments. We also examine the unique characteristics of smart homes and smart hospitals, highlighting their potential to revolutionize healthcare delivery through remote patient monitoring, telemedicine, and real-time data sharing. The review presents a novel solution framework leveraging sensor-driven digital twins to address both healthcare needs and user requirements. This framework incorporates wearable health devices, AI-driven health analytics, and a proof-of-concept digital twin application. Furthermore, we explore the role of location-based services (LBS) in smart environments, emphasizing their potential to enhance personalized healthcare interventions and emergency response capabilities. By analyzing the technical advancements in sensor technologies and digital twin applications, this review contributes valuable insights to the evolving landscape of smart environments for healthcare. We identify the opportunities and challenges associated with this emerging field and highlight the need for further research to fully realize its potential to improve healthcare delivery and patient well-being.


Asunto(s)
Inteligencia Artificial , Atención a la Salud , Internet de las Cosas , Telemedicina , Dispositivos Electrónicos Vestibles , Humanos , Telemedicina/métodos , Aprendizaje Automático , Monitoreo Fisiológico/métodos , Monitoreo Fisiológico/instrumentación
18.
Sensors (Basel) ; 24(9)2024 Apr 27.
Artículo en Inglés | MEDLINE | ID: mdl-38732910

RESUMEN

IoT has seen remarkable growth, particularly in healthcare, leading to the rise of IoMT. IoMT integrates medical devices for real-time data analysis and transmission but faces challenges in data security and interoperability. This research identifies a significant gap in the existing literature regarding a comprehensive ontology for vulnerabilities in medical IoT devices. This paper proposes a fundamental domain ontology named MIoT (Medical Internet of Things) ontology, focusing on cybersecurity in IoMT (Internet of Medical Things), particularly in remote patient monitoring settings. This research will refer to similar-looking acronyms, IoMT and MIoT ontology. It is important to distinguish between the two. IoMT is a collection of various medical devices and their applications within the research domain. On the other hand, MIoT ontology refers to the proposed ontology that defines various concepts, roles, and individuals. MIoT ontology utilizes the knowledge engineering methodology outlined in Ontology Development 101, along with the structured life cycle, and establishes semantic interoperability among medical devices to secure IoMT assets from vulnerabilities and cyberattacks. By defining key concepts and relationships, it becomes easier to understand and analyze the complex network of information within the IoMT. The MIoT ontology captures essential key terms and security-related entities for future extensions. A conceptual model is derived from the MIoT ontology and validated through a case study. Furthermore, this paper outlines a roadmap for future research, highlighting potential impacts on security automation in healthcare applications.


Asunto(s)
Seguridad Computacional , Internet de las Cosas , Humanos , Monitoreo Fisiológico/métodos , Monitoreo Fisiológico/instrumentación , Telemedicina/métodos
19.
Sensors (Basel) ; 24(9)2024 Apr 30.
Artículo en Inglés | MEDLINE | ID: mdl-38732992

RESUMEN

In this contribution, a wearable microwave imaging system for real-time monitoring of brain stroke in the post-acute stage is described and validated. The system exploits multistatic/multifrequency (only 50 frequency samples) data collected via a low-cost and low-complexity architecture. Data are collected by an array of only 16 antennas moved by pneumatic system. Phantoms, built from ABS material and filled with appropriate Triton X-100-based mixtures to mimic the different head human tissues, are employed for the experiments. The microwave system exploits the differential scattering measures and the Incoherent MUSIC algorithm to provide a 3D image of the region under investigation. The shown results, although preliminary, confirm the potential of the proposed microwave system in providing reliable results, including for targets whose evolution is as small as 16 mL in volume.


Asunto(s)
Fantasmas de Imagen , Accidente Cerebrovascular , Humanos , Accidente Cerebrovascular/diagnóstico por imagen , Encéfalo/diagnóstico por imagen , Encéfalo/patología , Algoritmos , Monitoreo Fisiológico/métodos , Monitoreo Fisiológico/instrumentación , Microondas , Dispositivos Electrónicos Vestibles , Imagenología Tridimensional/métodos
20.
Sensors (Basel) ; 24(9)2024 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-38733009

RESUMEN

Recent advancements in polymer-assisted layer-by-layer (LbL) fabrication have revolutionized the development of wearable sensors for health monitoring. LbL self-assembly has emerged as a powerful and versatile technique for creating conformal, flexible, and multi-functional films on various substrates, making it particularly suitable for fabricating wearable sensors. The incorporation of polymers, both natural and synthetic, has played a crucial role in enhancing the performance, stability, and biocompatibility of these sensors. This review provides a comprehensive overview of the principles of LbL self-assembly, the role of polymers in sensor fabrication, and the various types of LbL-fabricated wearable sensors for physical, chemical, and biological sensing. The applications of these sensors in continuous health monitoring, disease diagnosis, and management are discussed in detail, highlighting their potential to revolutionize personalized healthcare. Despite significant progress, challenges related to long-term stability, biocompatibility, data acquisition, and large-scale manufacturing are still to be addressed, providing insights into future research directions. With continued advancements in polymer-assisted LbL fabrication and related fields, wearable sensors are poised to improve the quality of life for individuals worldwide.


Asunto(s)
Técnicas Biosensibles , Polímeros , Dispositivos Electrónicos Vestibles , Polímeros/química , Humanos , Monitoreo Fisiológico/instrumentación , Monitoreo Fisiológico/métodos , Técnicas Biosensibles/instrumentación , Técnicas Biosensibles/métodos
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