scholarly journals Flex-Printed Ear-EEG Sensors for Adequate Sleep Staging at Home

2021 ◽  
Vol 3 ◽  
Author(s):  
Carlos F. da Silva Souto ◽  
Wiebke Pätzold ◽  
Karen Insa Wolf ◽  
Marina Paul ◽  
Ida Matthiesen ◽  
...  
Keyword(s):  
Home Environment ◽  
Sleep Stages ◽  
Sleep Staging ◽  
Night Sleep ◽  
Substantial Agreement ◽  
Average Correlation ◽  
Sleep Monitoring ◽  
The One ◽  
Channel Combination ◽  
At Home

A comfortable, discrete and robust recording of the sleep EEG signal at home is a desirable goal but has been difficult to achieve. We investigate how well flex-printed electrodes are suitable for sleep monitoring tasks in a smartphone-based home environment. The cEEGrid ear-EEG sensor has already been tested in the laboratory for measuring night sleep. Here, 10 participants slept at home and were equipped with a cEEGrid and a portable amplifier (mBrainTrain, Serbia). In addition, the EEG of Fpz, EOG_L and EOG_R was recorded. All signals were recorded wirelessly with a smartphone. On average, each participant provided data for M = 7.48 h. An expert sleep scorer created hypnograms and annotated grapho-elements according to AASM based on the EEG of Fpz, EOG_L and EOG_R twice, which served as the baseline agreement for further comparisons. The expert scorer also created hypnograms using bipolar channels based on combinations of cEEGrid channels only, and bipolar cEEGrid channels complemented by EOG channels. A comparison of the hypnograms based on frontal electrodes with the ones based on cEEGrid electrodes (κ = 0.67) and the ones based on cEEGrid complemented by EOG channels (κ = 0.75) both showed a substantial agreement, with the combination including EOG channels showing a significantly better outcome than the one without (p = 0.006). Moreover, signal excerpts of the conventional channels containing grapho-elements were correlated with those of the cEEGrid in order to determine the cEEGrid channel combination that optimally represents the annotated grapho-elements. The results show that the grapho-elements were well-represented by the front-facing electrode combinations. The correlation analysis of the grapho-elements resulted in an average correlation coefficient of 0.65 for the most suitable electrode configuration of the cEEGrid. The results confirm that sleep stages can be identified with electrodes placement around the ear. This opens up opportunities for miniaturized ear-EEG systems that may be self-applied by users.

scholarly journals Expert-level sleep scoring with deep neural networks

2018 ◽  
Vol 25 (12) ◽  
pp. 1643-1650 ◽  
Author(s):  
Siddharth Biswal ◽  
Haoqi Sun ◽  
Balaji Goparaju ◽  
M Brandon Westover ◽  
Jimeng Sun ◽  
...  
Keyword(s):  
Neural Networks ◽  
Sleep Apnea ◽  
Deep Neural Networks ◽  
Training Data ◽  
Sleep Stages ◽  
Apnea Hypopnea Index ◽  
Sleep Staging ◽  
Limb Movements ◽  
Sleep Scoring ◽  
At Home

Abstract Objectives Scoring laboratory polysomnography (PSG) data remains a manual task of visually annotating 3 primary categories: sleep stages, sleep disordered breathing, and limb movements. Attempts to automate this process have been hampered by the complexity of PSG signals and physiological heterogeneity between patients. Deep neural networks, which have recently achieved expert-level performance for other complex medical tasks, are ideally suited to PSG scoring, given sufficient training data. Methods We used a combination of deep recurrent and convolutional neural networks (RCNN) for supervised learning of clinical labels designating sleep stages, sleep apnea events, and limb movements. The data for testing and training were derived from 10 000 clinical PSGs and 5804 research PSGs. Results When trained on the clinical dataset, the RCNN reproduces PSG diagnostic scoring for sleep staging, sleep apnea, and limb movements with accuracies of 87.6%, 88.2% and 84.7% on held-out test data, a level of performance comparable to human experts. The RCNN model performs equally well when tested on the independent research PSG database. Only small reductions in accuracy were noted when training on limited channels to mimic at-home monitoring devices: frontal leads only for sleep staging, and thoracic belt signals only for the apnea-hypopnea index. Conclusions By creating accurate deep learning models for sleep scoring, our work opens the path toward broader and more timely access to sleep diagnostics. Accurate scoring automation can improve the utility and efficiency of in-lab and at-home approaches to sleep diagnostics, potentially extending the reach of sleep expertise beyond specialty clinics.

scholarly journals A Systematic Review of Sensing Technologies for Wearable Sleep Staging

Sensors ◽  
2021 ◽  
Vol 21 (5) ◽  
pp. 1562
Author(s):  
Syed Anas Imtiaz
Keyword(s):  
Systematic Review ◽  
Classification Accuracy ◽  
Sleep Stages ◽  
Sleep Staging ◽  
Regulatory Requirements ◽  
Wearable System ◽  
Wearable Systems

Designing wearable systems for sleep detection and staging is extremely challenging due to the numerous constraints associated with sensing, usability, accuracy, and regulatory requirements. Several researchers have explored the use of signals from a subset of sensors that are used in polysomnography (PSG), whereas others have demonstrated the feasibility of using alternative sensing modalities. In this paper, a systematic review of the different sensing modalities that have been used for wearable sleep staging is presented. Based on a review of 90 papers, 13 different sensing modalities are identified. Each sensing modality is explored to identify signals that can be obtained from it, the sleep stages that can be reliably identified, the classification accuracy of systems and methods using the sensing modality, as well as the usability constraints of the sensor in a wearable system. It concludes that the two most common sensing modalities in use are those based on electroencephalography (EEG) and photoplethysmography (PPG). EEG-based systems are the most accurate, with EEG being the only sensing modality capable of identifying all the stages of sleep. PPG-based systems are much simpler to use and better suited for wearable monitoring but are unable to identify all the sleep stages.

Detection of the Sleep Stages Throughout Non-Obtrusive Measures of Inter-Beat Fluctuations and Motion: Night and Day Sleep of Female Shift Workers

2017 ◽  
Vol 16 (04) ◽  
pp. 1750033 ◽  
Author(s):  
Martin O. Mendez ◽  
Elvia R. Palacios-Hernandez ◽  
Alfonso Alba ◽  
Juha M. Kortelainen ◽  
Mirja L. Tenhunen ◽  
...  
Keyword(s):  
Eye Movement ◽  
Performance Measures ◽  
Night Shift ◽  
Sleep Stages ◽  
Support Vector ◽  
Rapid Eye Movement ◽  
Sleep Staging ◽  
Kappa Index ◽  
Extensive Evaluation ◽  
Night And Day

Automatic sleep staging based on inter-beat fluctuations and motion signals recorded through a pressure bed sensor during sleep is presented. The analysis of the sleep was based on the three major divisions of the sleep time: Wake, non-rapid eye movement (nREM) and rapid eye movement (REM) sleep stages. Twelve sleep recordings, from six females working alternate shift, with their respective annotations were used in the study. Six recordings were acquired during the night and six during the day after a night shift. A Time-Variant Autoregressive Model was used to extract features from inter-beat fluctuations which later were fed to a Support Vector Machine classifier. Accuracy, Kappa index, and percentage in wake, REM and nREM were used as performance measures. Comparison between the automatic sleep staging detection and the standard clinical annotations, shows mean values of [Formula: see text]% for accuracy [Formula: see text] for kappa index, and mean errors of 5% for sleep stages. The performance measures were similar for night and day sleep recordings. In this sample of recordings, the results suggest that inter-beat fluctuations and motions acquired in non-obtrusive way carried valuable information related to the sleep macrostructure and could be used to support to the experts in extensive evaluation and monitoring of sleep.

COMMUNICATING EMPIRE: THE HABSBURGS AND THEIR CRITICS, 1700–1919

2009 ◽  
Vol 19 ◽  
pp. 117-138 ◽  
Author(s):  
R. J. W. Evans
Keyword(s):  
Eighteenth Century ◽  
Roman Empire ◽  
Theory And Practice ◽  
Holy Roman Empire ◽  
The Other ◽  
Current Debate ◽  
Free Standing ◽  
Power Base ◽  
The One ◽  
At Home

ABSTRACTIn the vibrant current debate about European empires and their ideologies, one basic dichotomy still tends to be overlooked: that between, on the one hand, the plurality of modern empires of colonisation, commerce and settlement; and, on the other, the traditional claim to single and undividedimperiumso long embodied in the Roman Empire and its successor, the Holy Roman Empire, or (First) Reich. This paper examines the tensions between the two, as manifested in the theory and practice of Habsburg imperial rule. The Habsburgs, emperors of the Reich almost continuously through its last centuries, sought to build their own power-base within and beyond it. The first half of the paper examines how by the eighteenth century their ‘Monarchy’, subsisting alongside the Reich, dealt with the associated legacy of empire. After the dissolution of the Holy Roman Empire in 1806 the Habsburgs could pursue a free-standing Austrian ‘imperialism’, but it rested on an uneasy combination of old and new elements and was correspondingly vulnerable to challenge from abroad and censure at home. The second half of the article charts this aspect of Habsburg government through an age of international imperialism and its contribution to the collapse of the Dual Monarchy in 1918.

scholarly journals Home environment and noise disturbance in a national sample of multi-family buildings in Sweden-associations with medical symptoms

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Juan Wang ◽  
Dan Norbäck
Keyword(s):  
Mechanical Ventilation ◽  
Population Density ◽  
Home Environment ◽  
Road Traffic ◽  
Personal Factors ◽  
Ground Floor ◽  
Noise Disturbance ◽  
Younger Age ◽  
Medical Symptoms ◽  
At Home

Abstract Background Poor acoustic conditions at home can have negative health impact. The aim was to investigate home environment factors and medical symptoms associated with noise disturbance. Methods All adults (≥18 y) registered in selected apartments in Sweden were invited to participate in a questionnaire survey including medical questions and personal factors. Totally 5775 adults participated (response rate 46%). Information on home environment was obtained through an indoor environment questionnaire. Two-level logistic regression models (individual, municipality) were performed to estimate associations. Results Totally 11.9% reported noise disturbance in general at home. Noise disturbance from voice/radio/TV/music/similar sounds from neighbours (13.2%), scraping sound/footsteps/thumping from neighbours (16.5%) and road traffic (16.1%) were common. Younger age and smoking were related to more noise disturbance and more medical symptoms. Noise disturbance was related to tiredness, headache and difficulty concentrating (OR = 1.70–8.19). Renting the apartment (OR = 2.53) and living above ground floor (OR = 1.37) were related to more noise disturbance in general. Living in newer buildings (constructed from 1986 to 2005) was related to less noise disturbance in general (OR = 0.40–0.59). A warmer climate (OR = 1.95), higher municipality population density (OR = 1.24), a longer living time (OR = 1.34), construction year (1961–1975) (OR = 2.42), renting (OR = 1.80–2.32), living above ground floor (OR = 1.45) and having a bathroom fan (OR = 1.84) were associated with increased noise disturbance from neighbours. Factors associated with increased noise disturbance from installations or ventilation/fans/heat pumps included a warmer climate, higher municipality population density, construction year (1961–1995), renting and any mechanical ventilation. Higher municipality population density, construction year (especially 1961–1985) and renting were associated with more noise disturbance from traffic (OR = 1.77–3.92). Renting the apartment (OR = 1.73) and living above ground floor (OR = 1.60) were related to more severe traffic noise disturbances. Noise disturbance in general was partly a mediator of the effects of old buildings, renting the apartment and lack of mechanical ventilation on medical symptoms (% of total effect mediated by noise disturbance: 19–44.8%). Conclusions Noise disturbance can be associated medical symptoms. Younger age, smoking, a warmer climate, higher municipality population density and different building factors (e.g. renting the apartment, construction period 1961–1985) can be associated with noise disturbance.

scholarly journals Asian Attitudes and Perceptions Toward Hospital-At-Home: A Cross-Sectional Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Yi Feng Lai ◽  
Yee Wei Lim ◽  
Win Sen Kuan ◽  
Joel Goh ◽  
John Tshon Yit Soong ◽  
...  
Keyword(s):  
Home Environment ◽  
The United States ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Attitudes And Perceptions ◽  
Hospital At Home ◽  
Medical Wards ◽  
Survey Responses ◽  
At Home

Introduction: Hospital-at-Home (HaH) programmes are well-established in Australia, Europe, and the United States. However, there is limited experience in Asia, where the hospital is traditionally seen as a safe and trusted space for healing. This cross-sectional study aimed to explore attitudes and perceptions among patients and caregivers in Singapore toward this care model.Methods: A quantitative study design was adopted to collect data among patients and their caregivers from medical wards within two acute hospitals in Singapore. Using a series of closed-ended and open-ended questions, the investigator-administered survey aimed to explore barriers and facilitators determining patients' and caregivers' responses. The study questionnaire was pretested and validated. Data were summarised using descriptive statistics, and logistic regression was performed to determine key factors influencing patients' decisions to enrol in such programmes.Results: Survey responses were collected from 120 participants (101 patients, 19 caregivers; response rate: 76%), of which 87 respondents (72.5%) expressed willingness to try HaH if offered. Many respondents valued non-quantifiable programme benefits, including perceived gains in quality of life. Among them, reasons cited for acceptance included preference for the comfort of their home environment, presence of family members, and confidence toward remote monitoring modalities. Among respondents who were unwilling to accept HaH, a common reason indicated was stronger confidence toward hospital care.Discussion: Most patients surveyed were open to having acute care delivered in their home environment, and concerns expressed may largely be addressed by operational considerations. The findings provide useful insights toward the planning of HaH programmes in Singapore.

Points of Departure: Comments on Religious Pilgrimage in Sri Lanka and Japan

1979 ◽  
Vol 38 (2) ◽  
pp. 271-281 ◽  
Author(s):  
William LaFleur
Keyword(s):  
Sri Lanka ◽  
Social Hierarchy ◽  
Cross Cultural ◽  
Left Behind ◽  
Victor Turner ◽  
The Cross ◽  
The One ◽  
At Home

AbstractThe anthropologist Victor Turner has proposed a new theory of religious pilgrimage, holding that people on pilgrimage have entered into a social modality that contrasts sharply with the one they ordinarily experience at home; roles, ranks, and social hierarchy have all been left behind, and what Turner calls communitas has come into being en route. Studies in Japanese by Eiki Hoshino confirm the cross-cultural applicability of Turner's theory, and show that it most adequately explains an ancient and famous pilgrimage tradition in Japan, that to the eighty-eight sites on Shikoku. It especially helps us account for the unusual tensions between pilgrims and government during the Tokugawa era. These materials and analyses are used, then, to suggest that in his study of the Kataragama pilgrimage, Bryan Pfaffenberger has misinterpreted Turner's theory and has overlooked ways in which it does, in fact, explain the materials from Sri Lanka.

Analyzing Sleep Stages in Home Environment Based on Ballistocardiography

2015 ◽  
pp. 56-68 ◽  
Author(s):  
Hongbo Ni ◽  
Tingzhi Zhao ◽  
Xingshe Zhou ◽  
Zhu Wang ◽  
Lei Chen ◽  
...  
Keyword(s):  
Home Environment ◽  
Sleep Stages

Catheters at home: managing urinary catheters in the home environment

2021 ◽  
Vol 26 (8) ◽  
pp. 370-376
Author(s):  
Drew Payne
Keyword(s):  
Emergency Department ◽  
Health Service ◽  
Literature Review ◽  
Home Environment ◽  
Negative Impact ◽  
Community Settings ◽  
Urinary Catheters ◽  
Factors Affecting ◽  
The Common ◽  
At Home

In England, there are some 90000 people with catheters in the community, and community nurses often have to manage catheter-related problems. This article looks at these common catheter problems found in the community, for example, blockage, infections and positioning problems. These problems were identified by a literature review and from the author's experience, from many years working in the community. It has been found that education, knowledge, empowerment and communication are vital factors affecting patients' ability to manager their catheters themselves. The article begins with a discussion about how patients can be involved in and manage many aspects of care for their own catheters. It goes on to talk about the common catheter-associated problems and how these can be avoided or addressed. It is hoped that better management of catheter-associated complications in the community settings can prevent unnecessary visits to the emergency department, which will save time and costs for the health service, as well as avoid the negative impact of these on patient lives.

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