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1.
Sensors (Basel) ; 20(17)2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32872310

RESUMO

The non-invasive estimation of blood oxygen saturation (SpO2) by pulse oximetry is of vital importance clinically, from the detection of sleep apnea to the recent ambulatory monitoring of hypoxemia in the delayed post-infective phase of COVID-19. In this proof of concept study, we set out to establish the feasibility of SpO2 measurement from the ear canal as a convenient site for long term monitoring, and perform a comprehensive comparison with the right index finger-the conventional clinical measurement site. During resting blood oxygen saturation estimation, we found a root mean square difference of 1.47% between the two measurement sites, with a mean difference of 0.23% higher SpO2 in the right ear canal. Using breath holds, we observe the known phenomena of time delay between central circulation and peripheral circulation with a mean delay between the ear and finger of 12.4 s across all subjects. Furthermore, we document the lower photoplethysmogram amplitude from the ear canal and suggest ways to mitigate this issue. In conjunction with the well-known robustness to temperature induced vasoconstriction, this makes conclusive evidence for in-ear SpO2 monitoring being both convenient and superior to conventional finger measurement for continuous non-intrusive monitoring in both clinical and everyday-life settings.


Assuntos
Meato Acústico Externo , Hipóxia/diagnóstico , Monitorização Fisiológica/instrumentação , Oximetria/instrumentação , Fotopletismografia/instrumentação , Dispositivos Eletrônicos Vestíveis , Adulto , Betacoronavirus/fisiologia , Infecções por Coronavirus/sangue , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/terapia , Estudos de Equivalência como Asunto , Estudos de Viabilidade , Feminino , Dedos , Humanos , Hipóxia/sangue , Masculino , Monitorização Fisiológica/métodos , Oximetria/métodos , Oxigênio/análise , Oxigênio/sangue , Pandemias , Fotopletismografia/métodos , Pneumonia Viral/sangue , Pneumonia Viral/diagnóstico , Pneumonia Viral/terapia , Adulto Jovem
3.
Nat Commun ; 11(1): 4683, 2020 09 17.
Artigo em Inglês | MEDLINE | ID: mdl-32943621

RESUMO

Wearable dry electrodes are needed for long-term biopotential recordings but are limited by their imperfect compliance with the skin, especially during body movements and sweat secretions, resulting in high interfacial impedance and motion artifacts. Herein, we report an intrinsically conductive polymer dry electrode with excellent self-adhesiveness, stretchability, and conductivity. It shows much lower skin-contact impedance and noise in static and dynamic measurement than the current dry electrodes and standard gel electrodes, enabling to acquire high-quality electrocardiogram (ECG), electromyogram (EMG) and electroencephalogram (EEG) signals in various conditions such as dry and wet skin and during body movement. Hence, this dry electrode can be used for long-term healthcare monitoring in complex daily conditions. We further investigated the capabilities of this electrode in a clinical setting and realized its ability to detect the arrhythmia features of atrial fibrillation accurately, and quantify muscle activity during deep tendon reflex testing and contraction against resistance.


Assuntos
Condutividade Elétrica , Epiderme , Monitorização Fisiológica/instrumentação , Movimento (Física) , Pele , Artefatos , Impedância Elétrica , Eletrocardiografia/instrumentação , Eletrocardiografia/métodos , Eletrodos , Eletroencefalografia/instrumentação , Eletroencefalografia/métodos , Eletromiografia/instrumentação , Eletromiografia/métodos , Desenho de Equipamento , Humanos , Monitorização Fisiológica/métodos , Polímeros/química , Sorbitol
4.
IEEE Trans Biomed Circuits Syst ; 14(5): 1088-1096, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32870799

RESUMO

In response to anticipated shortages of ventilators caused by the COVID-19 pandemic, many organizations have designed low-cost emergency ventilators. Many of these devices are pressure-cycled pneumatic ventilators, which are easy to produce but often do not include the sensing or alarm features found on commercial ventilators. This work reports a low-cost, easy-to-produce electronic sensor and alarm system for pressure-cycled ventilators that estimates clinically useful metrics such as pressure and respiratory rate and sounds an alarm when the ventilator malfunctions. A low-complexity signal processing algorithm uses a pair of nonlinear recursive envelope trackers to monitor the signal from an electronic pressure sensor connected to the patient airway. The algorithm, inspired by those used in hearing aids, requires little memory and performs only a few calculations on each sample so that it can run on nearly any microcontroller.


Assuntos
Alarmes Clínicos , Infecções por Coronavirus/terapia , Monitorização Fisiológica/instrumentação , Pneumonia Viral/terapia , Respiração Artificial/instrumentação , Processamento de Sinais Assistido por Computador , Ventiladores Mecânicos , Algoritmos , Eletrônica , Desenho de Equipamento , Humanos , Pandemias , Respiração , Software
5.
PLoS One ; 15(9): e0238181, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32877408

RESUMO

BACKGROUND: Studies have shown a positive correlation between higher physical activity (PA) and health benefits. However, device-based assessment of PA and sedentary time (ST) in people with adolescent idiopathic scoliosis (AIS) has not been deeply investigated. OBJECTIVE: Analysis and comparison of weekend and weekdays PA and ST using multiple accelerometers in people with AIS with different curvature severity compared to healthy controls. METHODS: 24 participants with AIS divided into 2 groups of 12 with Cobb angles < 40° and > 40°, along with 12 age and BMI matched healthy controls. Daily PA and ST during four consecutive days were measured using four tri-axial accelerometers. Clinical functional assessment was performed using the scoliosis research society (SRS-22) questionnaire. RESULTS: The combined weekend and weekdays average daily step count was found to be 22% and 29% lower in the AIS groups with Cobb angle < 40° and > 40°, respectively, compared to the controls. The average ST was also reported to be 5% and 7% higher in the AIS groups with Cobb angle < 40° and > 40°, respectively, compared to the controls. The reported differences were significant in the AIS group with higher Cobb angle (p≤0.05). No significant differences in PA or ST were reported between the AIS groups based on curvature severity. CONCLUSIONS: Decreased PA and increased ST observed in patients with AIS may have long term health implications and may play a role in the disease process. The device-based assessment of PA to understand potential benefits in clinical practice is recommended.


Assuntos
Acelerometria/instrumentação , Exercício Físico , Monitorização Fisiológica/instrumentação , Escoliose/fisiopatologia , Comportamento Sedentário , Adolescente , Estudos de Casos e Controles , Criança , Feminino , Humanos , Masculino , Processamento de Sinais Assistido por Computador , Fatores de Tempo
6.
Nat Commun ; 11(1): 3823, 2020 07 30.
Artigo em Inglês | MEDLINE | ID: mdl-32732934

RESUMO

An accurate extraction of physiological and physical signals from human skin is crucial for health monitoring, disease prevention, and treatment. Recent advances in wearable bioelectronics directly embedded to the epidermal surface are a promising solution for future epidermal sensing. However, the existing wearable bioelectronics are susceptible to motion artifacts as they lack proper adhesion and conformal interfacing with the skin during motion. Here, we present ultra-conformal, customizable, and deformable drawn-on-skin electronics, which is robust to motion due to strong adhesion and ultra-conformality of the electronic inks drawn directly on skin. Electronic inks, including conductors, semiconductors, and dielectrics, are drawn on-demand in a freeform manner to develop devices, such as transistors, strain sensors, temperature sensors, heaters, skin hydration sensors, and electrophysiological sensors. Electrophysiological signal monitoring during motion shows drawn-on-skin electronics' immunity to motion artifacts. Additionally, electrical stimulation based on drawn-on-skin electronics demonstrates accelerated healing of skin wounds.


Assuntos
Monitorização Fisiológica/instrumentação , Sistemas Automatizados de Assistência Junto ao Leito , Pele/fisiopatologia , Dispositivos Eletrônicos Vestíveis , Artefatos , Estimulação Elétrica , Epiderme/fisiologia , Humanos , Movimento (Física) , Semicondutores , Auxiliares Sensoriais , Pele/lesões , Cicatrização
7.
J Med Syst ; 44(10): 177, 2020 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-32845385

RESUMO

BACKGROUND: The outbreak of Coronavirus disease (COVID-19) pandemic has become the most serious global health issue. Isolation policy in hospitals is one of the most crucial protocols to prevent nosocomial infection of COVID-19. It is important to monitor and assess the physical conditions of the patients in isolation. METHODS: Our institution has installed the novel non-contact wireless sensor for vital sign sensing and body movement monitoring for patients in COVID-19 isolation ward. RESULTS: We have collected and compared data between the radar record with the nurse's handover record of two patients, one recorded for 13 days and the other recorded for 5 days. The P value by Fisher's exact test were 0.139 (temperature, P > 0.05) and 0.292 (heart beat rate, P > 0.05) respectively. CONCLUSIONS: This is the first report about the application experience of this equipment. Therefore we attempted to share the experience and try to apply this equipment in COVID-19 patients in future to offer the more reliable and safe policy.


Assuntos
Infecções por Coronavirus/epidemiologia , Monitorização Fisiológica/instrumentação , Pneumonia Viral/epidemiologia , Radar/instrumentação , Telemetria/instrumentação , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Infecção Hospitalar/prevenção & controle , Administração Hospitalar , Humanos , Movimento , Pandemias/prevenção & controle , Isolamento de Pacientes , Pneumonia Viral/prevenção & controle
8.
PLoS One ; 15(7): e0236795, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32735625

RESUMO

Osteoarthritis in cats is more prevalent because cats are living longer with advancement in veterinary medicine. Objective evaluation of behavioral changes in cats with osteoarthritis can facilitate an early diagnosis. The objective of this study was to investigate the utility of a novel activity monitor for analyzing physical activities and sleep quality in cats. First, a novel activity monitor (Plus Cycle®; JARMeC, Kanagawa, Japan), with a built-in three-directional accelerometer and an air pressure sensor specifically designed for cats, was compared to a human activity monitor (Actical®; Philips Respironics, OR, USA) previously used in cats (n = 10). Second, the validity of the measurement accuracy of the amount of physical activity, the number of vibrations, the number of jumps, and the resting and sleeping time was evaluated using Plus Cycle® in healthy cats (n = 6). Finally, the effects of gender and age of cats and time of day on the amount of physical activity, the number of vibrations, the number of jumps, and the resting and sleeping time were investigated in client-owned cats (n = 61). There were strong correlations between Plus Cycle® and Actical® in total activity (p < 0.05) and activity intensity (p < 0.05). When the physical activities were measured using Plus Cycle® in healthy cats, those data were quantified with high accuracy. In addition, it was also found to be very accurate in discriminating the resting and sleeping conditions of cats. In client-owned cats, there were no significant differences with respect to gender in any measured traits. The amount of physical activity and the number of jumps significantly decreased with the age of the cat. In contrast, the resting and sleeping times significantly increased with the age of the cat. In conclusion, Plus Cycle® can accurately and objectively assess physical activities and sleep quality with age of the cat, suggesting that this novel activity monitor can be used to manage the feline musculoskeletal health.


Assuntos
Monitores de Aptidão Física/veterinária , Monitorização Fisiológica/veterinária , Animais , Artrite/veterinária , Doenças do Gato , Gatos , Japão , Monitorização Fisiológica/instrumentação , Monitorização Fisiológica/métodos , Descanso , Sono
9.
PLoS One ; 15(8): e0237090, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32764796

RESUMO

Plantar pressure force data derived from gait and posture are commonly used as health indicators for foot diagnosis, injury prevention, and rehabilitation. This study developed a wearable plantar pressure force measurement and analysis (WPPFMA) system based on a flexible sensor matrix film to monitor plantar pressure force in real time. The developed system comprised a flexible sensor matrix film embedded in the insole of the shoe, a wearable data acquisition (DAQ) device with a Bluetooth module, and dedicated software with an intuitive graphical user interface for displaying the plantar pressure force data from receivers by using a terminal unit (laptop or smart-phone). The flexible sensor matrix film integrated 16 piezoresistive cell sensors to detect pressure force at different anatomical zones of the plantar and under different body positions. The signals from the flexible sensor matrix film were collected using the DAQ module embedded in the shoe and transmitted to the receivers through Bluetooth. The real-time display and analysis software can monitor, visualize, and record the detailed plantar pressure force data, such as average pressure force, maximum pressure force, and pressure force distributions and variations over time. The outcomes of the trials in which the system was worn revealed the applicability of the developed WPPFMA system for monitoring plantar pressure force under static and dynamic wearing conditions. The plantar pressure force data derived from this system provide valuable insights for personal foot care, gait analysis, and clinical diagnosis.


Assuntos
Doenças do Pé/diagnóstico , Pé/fisiologia , Análise da Marcha/instrumentação , Monitorização Fisiológica/instrumentação , Dispositivos Eletrônicos Vestíveis , Fenômenos Biomecânicos , Estudos de Viabilidade , Doenças do Pé/fisiopatologia , Humanos , Postura/fisiologia , Pressão , Sapatos , Smartphone , Software
10.
J Biomed Inform ; 108: 103483, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32603793

RESUMO

Monitoring patients through robotics telehealth systems is an interesting scenario where patients' conditions, and their environment, are dynamic and unknown variables. We propose to improve telehealth systems' features to include the ability to serve patients with their needs, operating as human caregivers. The objective is to support the independent living of patients at home without losing the opportunity to monitor their health status. Application scenarios are several, and they spread from simple clinical assisting scenarios to an emergency one. For instance, in the case of a nursing home, the system would support in continuously monitoring the elderly patients. In contrast, in the case of an epidemic diffusion, such as COVID-19 pandemic, the system may help in all the early triage phases, significantly reducing the risk of contagion. However, the system has to let medical assistants perform actions remotely such as changing therapies or interacting with patients that need support. The paper proposes and describes a multi-agent architecture for intelligent medical care. We propose to use the beliefs-desires-intentions agent architecture, part of it is devised to be deployed in a robot. The result is an intelligent system that may allow robots the ability to select the most useful plan for unhandled situations and to communicate the choice to the physician for his validation and permission.


Assuntos
Monitorização Fisiológica/instrumentação , Robótica/tendências , Idoso , Inteligência Artificial , Sistemas Computacionais , Infecções por Coronavirus/terapia , Medicina de Emergência/instrumentação , Geriatria/instrumentação , Humanos , Infectologia/instrumentação , Informática Médica , Modelos Teóricos , Monitorização Fisiológica/métodos , Casas de Saúde , Pandemias , Pneumonia Viral/terapia , Risco , Telemedicina/instrumentação , Telemedicina/métodos
11.
Recenti Prog Med ; 111(7): 404-410, 2020.
Artigo em Italiano | MEDLINE | ID: mdl-32658879

RESUMO

Lockdown and self-isolation are to date the only solution to limit the spread of recent outbreak of coronavirus disease (CoViD-19), highlighting the great advantage of home dialysis in a patient otherwise forced to travel from / to the dialysis center to receive this "life-saving" treatment. Indeed, to prevent spreading of CoViD-19 infection among extremely fragile dialysis patients, as well as among dialysis workers, hemodialysis (HD) centers are adopting specific procedures ("dedicated" dialysis facilities, portable osmosis, etc.) with a great economic and organizational commitment. Peritoneal dialysis (PD) represents a type of home dialysis therapy not yet adequately implemented to date, in spite of safe and simple practice, as well as similar dialytic efficiency vs in-center hemodialysis. Remote patient monitoring (RPM) systems have been developed in automated PD (APD) cyclers in order to improve the acceptance of this dialysis method, to increase the compliance to the prescribed therapy and to control treatment adequacy. In this review we assess the potential advantages of RPM in APD, that are the chance for patients to acquire greater independence and safety in the home treatment, to allow better access to care for residents in remote areas, faster resolution of problems, reduction in hospitalizations and mortality rates, as well as time and cost saving for both the patient and the staff. The use of medical devices (sphygmomanometer, glucometer, balance, etc.), connected by wireless to the clinician's portal, might also allow a wider diffusion of incremental dialysis, an integrated therapy that combines conservative management of ESKD patients with a soft dialysis based on the residual kidney function and symptomatology, with potential prognosis and economic benefits. Although the majority of the studies are small and observational, a wider use of RPM systems is desirable to broaden the spread of home dialysis, as we learnt from Coronavirus pandemic.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Hemodiálise no Domicílio , Monitorização Fisiológica/métodos , Pandemias , Pneumonia Viral , Automação , Infecções por Coronavirus/prevenção & controle , Redução de Custos , Suscetibilidade a Doenças , Acesso aos Serviços de Saúde , Hemodiálise no Domicílio/economia , Hemodiálise no Domicílio/métodos , Humanos , Falência Renal Crônica/psicologia , Falência Renal Crônica/terapia , Monitorização Fisiológica/instrumentação , Pandemias/prevenção & controle , Cooperação do Paciente , Diálise Peritoneal/instrumentação , Diálise Peritoneal/métodos , Pneumonia Viral/prevenção & controle , Medicina de Precisão , Isolamento Social , Telemedicina
12.
Proc Natl Acad Sci U S A ; 117(31): 18292-18301, 2020 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-32661158

RESUMO

Pencils and papers are ubiquitous in our society and have been widely used for writing and drawing, because they are easy to use, low-cost, widely accessible, and disposable. However, their applications in emerging skin-interfaced health monitoring and interventions are still not well explored. Herein, we report a variety of pencil-paper-based on-skin electronic devices, including biophysical (temperature, biopotential) sensors, sweat biochemical (pH, uric acid, glucose) sensors, thermal stimulators, and humidity energy harvesters. Among these devices, pencil-drawn graphite patterns (or combined with other compounds) serve as conductive traces and sensing electrodes, and office-copy papers work as flexible supporting substrates. The enabled devices can perform real-time, continuous, and high-fidelity monitoring of a range of vital biophysical and biochemical signals from human bodies, including skin temperatures, electrocardiograms, electromyograms, alpha, beta, and theta rhythms, instantaneous heart rates, respiratory rates, and sweat pH, uric acid, and glucose, as well as deliver programmed thermal stimulations. Notably, the qualities of recorded signals are comparable to those measured with conventional methods. Moreover, humidity energy harvesters are prepared by creating a gradient distribution of oxygen-containing groups on office-copy papers between pencil-drawn electrodes. One single-unit device (0.87 cm2) can generate a sustained voltage of up to 480 mV for over 2 h from ambient humidity. Furthermore, a self-powered on-skin iontophoretic transdermal drug-delivery system is developed as an on-skin chemical intervention example. In addition, pencil-paper-based antennas, two-dimensional (2D) and three-dimensional (3D) circuits with light-emitting diodes (LEDs) and batteries, reconfigurable assembly and biodegradable electronics (based on water-soluble papers) are explored.


Assuntos
Eletrônica/instrumentação , Grafite , Monitorização Fisiológica/instrumentação , Pele , Dispositivos Eletrônicos Vestíveis , Fontes de Energia Elétrica , Eletrodos , Desenho de Equipamento , Humanos , Papel
13.
J Vis Exp ; (161)2020 07 09.
Artigo em Inglês | MEDLINE | ID: mdl-32716388

RESUMO

Low-flow digital vaporizers commonly utilize a syringe pump to directly administer volatile anesthetics into a stream of carrier gas. Per animal welfare recommendations, animals are warmed and monitored during procedures requiring anesthesia. Common anesthesia and physiological monitoring equipment include gas tanks, anesthetic vaporizers and stands, warming controllers and pads, mechanical ventilators, and pulse oximeters. A computer is also necessary for data collection and to run equipment software. In smaller spaces or when performing field work, it can be challenging to configure all this equipment in limited space. The goal of this protocol is to demonstrate best practices for use of a low-flow digital vaporizer using both compressed oxygen and room air, along with an integrated mechanical ventilator, pulse oximeter, and far infrared warming as an all-inclusive anesthesia and physiological monitoring suite ideal for rodents.


Assuntos
Anestésicos Inalatórios/administração & dosagem , Anestésicos/administração & dosagem , Monitorização Fisiológica/instrumentação , Nebulizadores e Vaporizadores , Ventiladores Mecânicos , Animais , Oxigênio/administração & dosagem , Roedores
14.
Arch Dis Child Fetal Neonatal Ed ; 105(6): 666-668, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32616559

RESUMO

BACKGROUND: A respiratory function monitor (RFM) provides real-time positive pressure ventilation feedback. Whether providers use RFM during neonatal resuscitation is unknown. METHODS: Ancillary study to the MONITOR(NCT03256578) randomised controlled trial. Neonatal resuscitation leaders at two centres wore eye-tracking glasses, and visual attention (VA) patterns were compared between RFM-visible and RFM-masked groups. RESULTS: 14 resuscitations (6 RFM-visible, 8 RFM-masked) were analysed. The median total gaze duration on the RFM was significantly higher with a visible RFM (29% vs 1%, p<0.01), while median total gaze duration on other physical objects was significantly lower with a visible RFM (3% vs 8%, p=0.02). Median total gaze duration on the infant was lower with RFM visible, although not statistically significantly (29% vs 46%, p=0.05). CONCLUSION: Providers' VA patterns differed during neonatal resuscitation when the RFM was visible, emphasising the importance of studying the impact of additional delivery room technology on providers' behaviour.


Assuntos
Atenção , Corpo Clínico Hospitalar/psicologia , Monitorização Fisiológica/instrumentação , Respiração com Pressão Positiva , Óculos , Feminino , Humanos , Recém-Nascido , Masculino , Ressuscitação/instrumentação
15.
Nat Protoc ; 15(8): 2301-2320, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32632319

RESUMO

The locus coeruleus (LC) is a region in the brainstem that produces noradrenaline and is involved in both normal and pathological brain function. Pupillometry, the measurement of pupil diameter, provides a powerful readout of LC activity in rodents, primates and humans. The protocol detailed here describes a miniaturized setup that can screen LC activity in rodents in real-time and can be established within 1-2 d. Using low-cost Raspberry Pi computers and cameras, the complete custom-built system costs only ~300 euros, is compatible with stereotaxic surgery frames and seamlessly integrates into complex experimental setups. Tools for pupil tracking and a user-friendly Pupillometry App allow quantification, analysis and visualization of pupil size. Pupillometry can discriminate between different, physiologically relevant firing patterns of the LC and can accurately report LC activation as measured by noradrenaline turnover. Pupillometry provides a rapid, non-invasive readout that can be used to verify accurate placement of electrodes/fibers in vivo, thus allowing decisions about the inclusion/exclusion of individual animals before experiments begin.


Assuntos
Locus Cerúleo/fisiologia , Monitorização Fisiológica/instrumentação , Pupila/fisiologia , Animais , Camundongos , Camundongos Endogâmicos C57BL , Fatores de Tempo
16.
PLoS One ; 15(6): e0231167, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32511248

RESUMO

Cough is a characteristic symptom of tuberculosis, is the main cause of transmission, and is used to assess treatment response. We aimed to identify the best measure of cough severity and characterize changes during initial tuberculosis therapy. We conducted a prospective cohort of recently diagnosed ambulatory adult patients with pulmonary tuberculosis in two tertiary hospitals in Lima, Peru. Pre-treatment and five times during the first two months of treatment, a vibrometer was used to capture 4-hour recordings of involuntary cough. A total of 358 recordings from 69 participants were analyzed using a computer algorithm. Total time spent coughing (seconds per hour) was a better predictor of microbiologic indicators of disease severity and treatment response than the frequency of cough episodes or cough power. Patients with prior tuberculosis tended to cough more than patients without prior tuberculosis, and patients with tuberculosis and diabetes coughed more than patients without diabetes co-morbidity. Cough characteristics were similar regardless of HIV co-infection and for drug-susceptible versus drug-resistant tuberculosis. Tuberculosis treatment response may be meaningfully assessed by objectively monitoring the time spent coughing. This measure demonstrated that cough was increased in patients with TB recurrence or co-morbid diabetes, but not because of drug resistance or HIV co-infection.


Assuntos
Antituberculosos/uso terapêutico , Tosse/complicações , Tosse/fisiopatologia , Monitorização Fisiológica/instrumentação , Tuberculose Pulmonar/complicações , Tuberculose Pulmonar/tratamento farmacológico , Adulto , Feminino , Humanos , Masculino , Vibração , Adulto Jovem
17.
Int J Infect Dis ; 96: 648-654, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32497806

RESUMO

Optimal management of infectious diseases is guided by up-to-date information at the individual and public health levels. For infections of global importance, including emerging pandemics such as COVID-19 or prevalent endemic diseases such as dengue, identifying patients at risk of severe disease and clinical deterioration can be challenging, considering that the majority present with a mild illness. In our article, we describe the use of wearable technology for continuous physiological monitoring in healthcare settings. Deployment of wearables in hospital settings for the management of infectious diseases, or in the community to support syndromic surveillance during outbreaks, could provide significant, cost-effective advantages and improve healthcare delivery. We highlight a range of promising technologies employed by wearable devices and discuss the technical and ethical issues relating to implementation in the clinic, focusing on low- and middle- income countries. Finally, we propose a set of essential criteria for the rollout of wearable technology for clinical use.


Assuntos
Controle de Doenças Transmissíveis/instrumentação , Assistência à Saúde , Monitorização Fisiológica/instrumentação , Dispositivos Eletrônicos Vestíveis , Betacoronavirus , Infecções por Coronavirus , Hospitais , Humanos , Estudos Longitudinais , Pandemias , Pneumonia Viral
18.
PLoS One ; 15(6): e0235144, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32579613

RESUMO

BACKGROUND: Commercial physical activity monitors have wide utility in the assessment of physical activity in research and clinical settings, however, the removal of devices results in missing data and has the potential to bias study conclusions. This study aimed to evaluate methods to address missingness in data collected from commercial activity monitors. METHODS: This study utilised 1526 days of near complete data from 109 adults participating in a European weight loss maintenance study (NoHoW). We conducted simulation experiments to test a novel scaling methodology (NoHoW method) and alternative imputation strategies (overall/individual mean imputation, overall/individual multiple imputation, Kalman imputation and random forest imputation). Methods were compared for hourly, daily and 14-day physical activity estimates for steps, total daily energy expenditure (TDEE) and time in physical activity categories. In a second simulation study, individual multiple imputation, Kalman imputation and the NoHoW method were tested at different positions and quantities of missingness. Equivalence testing and root mean squared error (RMSE) were used to evaluate the ability of each of the strategies relative to the true data. RESULTS: The NoHoW method, Kalman imputation and multiple imputation methods remained statistically equivalent (p<0.05) for all physical activity metrics at the 14-day level. In the second simulation study, RMSE tended to increase with increased missingness. Multiple imputation showed the smallest RMSE for Steps and TDEE at lower levels of missingness (<19%) and the Kalman and NoHoW methods were generally superior for imputing time in physical activity categories. CONCLUSION: Individual centred imputation approaches (NoHoW method, Kalman imputation and individual Multiple imputation) offer an effective means to reduce the biases associated with missing data from activity monitors and maximise data retention.


Assuntos
Exercício Físico/fisiologia , Monitores de Aptidão Física/estatística & dados numéricos , Monitorização Fisiológica/estatística & dados numéricos , Projetos de Pesquisa/estatística & dados numéricos , Adulto , Idoso , Algoritmos , Viés , Peso Corporal/fisiologia , Simulação por Computador , Metabolismo Energético/fisiologia , Feminino , Monitores de Aptidão Física/normas , Frequência Cardíaca/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica/instrumentação , Monitorização Fisiológica/métodos , Projetos de Pesquisa/normas , Perda de Peso/fisiologia , Adulto Jovem
19.
PLoS One ; 15(6): e0232465, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32520952

RESUMO

This study investigated the inter- and intra-device agreement of four new devices marketed for barbell velocity measurement. Mean, mean propulsive and peak velocity outcomes were obtained for bench press and full squat exercises along the whole load-velocity spectrum (from light to heavy loads). Measurements were simultaneously registered by two linear velocity transducers T-Force, two linear position transducers Speed4Lifts, two smartphone video-based systems My Lift, and one 3D motion analysis system STT. Calculations included infraclass correlation coefficient (ICC), Bland-Altman Limits of Agreement (LoA), standard error of measurement (SEM), smallest detectable change (SDC) and maximum errors (MaxError). Results were reported in absolute (m/s) and relative terms (%1RM). Three velocity segments were differentiated according to the velocity-load relationships for each exercise: heavy (≥ 80% 1RM), medium (50% < 1RM < 80%) and light loads (≤ 50% 1RM). Criteria for acceptable reliability were ICC > 0.990 and SDC < 0.07 m/s (~5% 1RM). The T-Force device shown the best intra-device agreement (SDC = 0.01-0.02 m/s, LoA <0.01m/s, MaxError = 1.3-2.2%1RM). The Speed4Lifts and STT were found as highly reliable, especially against lifting velocities ≤1.0 m/s (Speed4Lifts, SDC = 0.01-0.05 m/s; STT, SDC = 0.02-0.04 m/s), whereas the My Lift app showed the worst results with errors well above the acceptable levels (SDC = 0.26-0.34 m/s, MaxError = 18.9-24.8%1RM). T-Force stands as the preferable option to assess barbell velocity and to identify technical errors of measurement for emerging monitoring technologies. Both the Speed4Lifts and STT are fine alternatives to T-Force for measuring velocity against high-medium loads (velocities ≤ 1.0 m/s), while the excessive errors of the newly updated My Lift app advise against the use of this tool for velocity-based resistance training.


Assuntos
Monitorização Fisiológica/métodos , Treinamento de Resistência , Levantamento de Peso , Adulto , Humanos , Masculino , Monitorização Fisiológica/instrumentação , Smartphone , Adulto Jovem
20.
Clin Transl Sci ; 13(5): 838-841, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32526077

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic has rapidly challenged the pharmaceutical industry to implement remote clinical trials. The industry's lack of extensive experience with remote measurements initiates multiple questions about how to select candidates for remote collection, their validity, and regulatory implications of moving certain assessments to a remote mode. We propose a decision tree for migration of clinic to remote assessments and highlight activities required to ensure that these measurements are valid, safe, and usable.


Assuntos
Ensaios Clínicos como Assunto/métodos , Infecções por Coronavirus/prevenção & controle , Controle de Infecções/normas , Monitorização Fisiológica/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Projetos de Pesquisa , Betacoronavirus/patogenicidade , Ensaios Clínicos como Assunto/normas , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Coleta de Dados/instrumentação , Coleta de Dados/métodos , Humanos , Monitorização Fisiológica/instrumentação , Monitorização Fisiológica/tendências , Participação do Paciente , Seleção de Pacientes , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Tecnologia de Sensoriamento Remoto , Telemedicina/instrumentação , Telemedicina/métodos , Telemedicina/tendências
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