Laser-Induced Graphene for Heartbeat Monitoring with HeartPy Analysis.

The HeartPy Python toolkit for analysis of noisy signals from heart rate measurements is an excellent tool to use in conjunction with novel wearable sensors. Nevertheless, most of the work to date has focused on applying the toolkit to data measured with commercially available sensors. We demonstrate the application of the HeartPy functions to data obtained with a novel graphene-based heartbeat sensor. We produce the sensor by laser-inducing graphene on a flexible polyimide substrate. Both graphene on the polyimide substrate and graphene transferred onto a PDMS substrate show piezoresistive behavior that can be utilized to measure human heartbeat by registering median cubital vein motion during blood pumping. We process electrical resistance data from the graphene sensor using HeartPy and demonstrate extraction of several heartbeat parameters, in agreement with measurements taken with independent reference sensors. We compare the quality of the heartbeat signal from graphene on different substrates, demonstrating that in all cases the device yields results consistent with reference sensors. Our work is a first demonstration of successful application of HeartPy to analysis of data from a sensor in development.

A narrative review of e-health systems' evolution - evidence from a regional study.

PURPOSE: The growing implementation of electronic health (e-health) systems has raised the importance of analyzing how these systems have been implemented in diverse regions. By employing a contextual sensitive approach and social mechanism theory, this study aims to better understand the reasons for the success and failure of e-health initiatives in the ex-Yugoslav region and derive useful insights for policymakers. DESIGN/METHODOLOGY/APPROACH: We employ a narrative review process grounded in the social mechanism theory, extended with field experts' review, to acquire state-of-the-art information. FINDINGS: Findings indicate that different e-health systems coexist and evolve in different contexts in different countries, with varying levels of success. The contextual differences shape the broader environment, affecting the level of preparedness and capability for e-health implementation. Top-down approaches dominate e-health implementation in most countries when it comes to design process features, and more developed countries do not rely on strong social mechanisms for implementing e-health due to the openness of their culture towards e-health innovations. PRACTICAL IMPLICATIONS: Analyzing the milestones, challenges and functionalities of e-health systems in the region of interest can assist policymakers, academics and practitioners in making informed decisions and recommendations to enhance future e-health implementation. ORIGINALITY/VALUE: No known studies evaluated e-health initiatives in the former ex-Yugoslav countries holistically and evolutionarily in the form of a comprehensive regional study. Further, our research endeavor is contextually specific since the health systems of these countries in the past were tied together under the federative umbrella health system and then diverged in terms of e-health development.

Mobile wireless monitoring system for prehospital emergency care.

BACKGROUND: Latest achievement technologies allow engineers to develop medical systems that medical doctors in the health care system could not imagine years ago. The development of signal theory, intelligent systems, biophysics and extensive collaboration between science and technology researchers and medical professionals, open up the potential for preventive, real-time monitoring of patients. With the recent developments of new methods in medicine, it is also possible to predict the trends of the disease development as well the systemic support in diagnose setting. Within the framework of the needs to track the patient health parameters in the hospital environment or in the case of road accidents, the researchers had to integrate the knowledge and experiences of medical specialists in emergency medicine who have participated in the development of a mobile wireless monitoring system designed for real-time monitoring of victim vital parameters. Emergency medicine responders are first point of care for trauma victim providing prehospital care, including triage and treatment at the scene of incident and transport from the scene to the hospital. Continuous monitoring of life functions allows immediate detection of a deterioration in health status and helps out in carrying out principle of continuous e-triage. In this study, a mobile wireless monitoring system for measuring and recording the vital parameters of the patient was presented and evaluated. Based on the measured values, the system is able to make triage and assign treatment priority for the patient. The system also provides the opportunity to take a picture of the injury, mark the injured body parts, calculate Glasgow Coma Score, or insert/record the medication given to the patient. Evaluation of the system was made using the Technology Acceptance Model (TAM). In particular we measured: perceived usefulness, perceived ease of use, attitude, intention to use, patient status and environmental status. METHODS: A functional prototype of a developed wireless sensor-based system was installed at the emergency medical (EM) department, and presented to the participants of this study. Thirty participants, paramedics and doctors from the emergency department participated in the study. Two scenarios common for the prehospital emergency routines were considered for the evaluation. Participants were asked to answer the questions referred to these scenarios by rating each of the items on a 5-point Likert scale. RESULTS: Path coefficients between each measured variable were calculated. All coefficients were positive, but the statistically significant were only the following: patient status and perceive usefulness (ß = 0.284, t = 2.097), environment (both urban a nd rural) and perceive usefulness (ß = 0.247, t = 2.570; ß = 0.329, t = 2.083, respectively), and perceive usefulness and behavioral intention (ß = 0.621 t = 7.269). The variance of intention is 47.9%. CONCLUSIONS: The study results show that the proposed system is well accepted by the EM personnel and can be used as a complementary system in EM department for continuous monitoring of patients' vital signs.

Automated triage parameters estimation from ECG.

Low-cost biosensors combined with low-cost portable devices can be very useful in time critical situations of mass casualties, when fast triage procedure must be attained. A methodology that uses ECG to derive the vital parameters (heart rate and respiratory rate) needed for the triage procedure is presented and it is aimed to leverage affordable low-cost equipment that can be easily utilized by urgent medical units or even volunteers in events of considerable number of injured civilians. The methodology relies on selected well-known and published algorithms for heart rate and respiratory rate derivation from a given ECG signal. It consists of methods for R-wave detection, kurtosis computation, smoothing, and finding peaks. The proposed approach is shown to offer a good trade-off between the accurate measurement of the parameters and their fast derivation. It has been evaluated by using a publicly available database. Its robustness is measured in terms of accuracy estimation, showing a sensitivity of 0.87 for heart rate and 0.74 for respiratory rate, a sensitivity of 0.76 considering the triage process and an average-case execution time of 0.02 seconds, making it suitable for real-time applications.