scholarly journals Cough Sounds Recorded via Smart Devices as Useful Non-Invasive Digital Biomarkers of Aspiration Risk: A Case Report

Sensors ◽  
2021 ◽  
Vol 21 (23) ◽  
pp. 8056
Author(s):  
Hye-Seon Kang ◽  
Eung-Gu Lee ◽  
Cheol-Ki Kim ◽  
Andy Jung ◽  
Catherine Song ◽  
...  
Keyword(s):  
Oral Feeding ◽  
Smart Devices ◽  
Special Equipment ◽  
Digital Device ◽  
Non Invasive ◽  
Aspiration Risk ◽  
Cough Strength ◽  
Maximum Root ◽  
Digital Biomarkers ◽  
Cough Sound

Spirometer measurements can reflect cough strength but might not be routinely available for patients with severe neurological or medical conditions. A digital device that can record and help track abnormal cough sound changes serially in a noninvasive but reliable manner would be beneficial for monitoring such individuals. This report includes two cases of respiratory distress whose cough changes were monitored via assessments performed using recordings made with a digital device. The cough sounds were recorded using an iPad (Apple, Cupertino, CA, USA) through an embedded microphone. Cough sounds were recorded at the bedside, with no additional special equipment. The two patients were able to complete the recordings with no complications. The maximum root mean square values obtained from the cough sounds were significantly reduced when both cases were diagnosed with aspiration pneumonia. In contrast, higher values became apparent when the patients demonstrated a less severe status. Based on an analysis of our two cases, the patients’ cough sounds recorded with a commercial digital device show promise as potential digital biomarkers that may reflect aspiration risk related to attenuated cough force. Serial monitoring aided the decision making to resume oral feeding. Future studies should further explore the clinical utility of this technique.

scholarly journals P056: Gastric ultrasound in stable patients with decreased level of consciousness and recreational substance use -- are presumed full stomachs full?

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S84-S84
Author(s):  
M. Munn ◽  
C. Phillips ◽  
J. Laraya ◽  
G. Boivin-Arcouette
Keyword(s):  
Substance Use ◽  
Pilot Study ◽  
Usual Care ◽  
Clinical Decision Making ◽  
Additional Patient ◽  
Full Stomach ◽  
Music Festival ◽  
Non Invasive ◽  
Polysubstance Use ◽  
Aspiration Risk

Introduction: Intoxicated patients with decreased Glasgow Coma Scale (GCS) are common presentations to emergency departments. These patients are often intubated due to presumed full stomachs and perceived aspiration risk. Gastric ultrasound (GUS) -- a simple, non-invasive and objective option -- could be applied to this problem. This pilot study uses GUS alongside usual care at a music festival; a bounded, intoxication-dense environment where airways are often managed using non-invasive airway strategies. We aim to (1) clarify the gastric contents of any intubated patients, and (2) assess if patients managed without intubation go on to have a lack of aspiration sequelae because of empty stomachs or in spite of full stomachs. Methods: A prospective cohort study was conducted at a multi-day music festival. Patients presenting to on-site medical services with GCS ≤ 13 and known or suspected substance use were included. Patients with trauma, instability, metabolic derangements or additional aspiration risk factors (eg morbid obesity, pregnancy) were excluded. Standard GUS was performed by a trained provider and results were categorized according to convention as FS (full stomach, ie solids or liquids >1.5mL/kg) or ES (empty stomach, ie empty or liquids <1.5mL/kg). Additional patient data were extracted from linked medical records post event. Results: 33 patients met inclusion criteria and 27 remained after exclusions were applied and consent obtained. 25 patients reported substance use and 19 polysubstance use. The FS group had 15 patients (7 solid & 8 liquid > 1.5), and the ES group had 12 patients (5 empty & 12 liquid < 1.5). The median low GCS documented for FS and ES was 7 and 11 respectively, and 10 patients total had a GCS of 8 or less (6 FS & 4 ES). No patients were intubated and all were managed conservatively according to usual care. 3 patients (2 FS, 1 ES) were transferred to hospital. No patients re-registered at medical for clinically significant aspiration. Conclusion: This pilot study demonstrates the potential utility of GUS in stratifying aspiration risk in intoxicated patients with decreased GCS. “Empty” stomachs might avoid intubation, while the implications and true risks of “full” stomachs for aspiration sequelae in the absence of intubation remain unclear. Due to the small numbers in this pilot study and the quoted GUS sensitivity (only 95%), further research is needed to evaluate the safe application of this modality to clinical decision-making in intoxicated patients.

scholarly journals Descriptive characteristics of continuous oximetry measurement in moderate to severe COVID-19 patients

2021 ◽  
Author(s):  
Jonathan Aryeh Sobel ◽  
Jeremy Levy ◽  
Ronit Almog ◽  
Anat Reiner Benaim ◽  
Asaf Miller ◽  
...  
Keyword(s):  
Health Care ◽  
Mechanical Ventilation ◽  
High Resolution ◽  
Oxygen Saturation ◽  
Treatment Response ◽  
Vital Sign ◽  
Critical Group ◽  
Non Invasive ◽  
Critical Patients ◽  
Digital Biomarkers

Background: Non-invasive oxygen saturation (SpO2) measurement is a central vital sign that supports the management of COVID-19 patients. However, reports on SpO2 characteristics (patterns and dynamics) are scarce and none, to our knowledge, has analysed high resolution continuous SpO2 in COVID-19. Methods: SpO2 signal sampled at 1Hz and clinical data were collected from COVID-19 departments at the Rambam Health Care Campus (Haifa, Israel) between May 1st, 2020 and February 1st, 2021. Data from a total of 367 COVID-19 patients, totalling 27K hours of continuous SpO2 recording, could be retrieved, including 205 non-critical and 162 critical cases. Desaturations based on different SpO2 threshold definitions and oximetry derived digital biomarkers (OBMs) were extracted and compared across severity and support levels. Findings: An absolute SpO2 threshold at 93% was the most efficient in discriminating between critical and non-critical patients without support or under oxygen support. Under no support, the non-critical group depicted a fold change (FC) of 1,8 times more frequent desaturations compared to the critical group. However, the hypoxic burden was 1,6 times more important in critical versus non-critical patients. Other OBMs depicted significant differences, notably the percentage of time below 93% SpO2 (CT93) was the most discriminating OBM. Mechanical ventilation depicted a strong effect on SpO2 by significantly reducing the frequency (1,85 FC) and depth (1,21 FC) of desaturations. OBMs related to periodicity and hypoxic burden were markedly affected up to several hours before the initiation of the mechanical ventilation. Interpretation: This is the first report investigating continuous SpO2 measurements in hospitalized patients affected with COVID-19. SpO2 characteristics differ between critical and non-critical patients and are impacted by the level of support. OBMs from high resolution SpO2 signal may enable to anticipate clinically relevant events, monitoring of treatment response and may be indicative of future deterioration.

scholarly journals Factors associated with postmenstrual age at full oral feeding in very preterm infants

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241769
Author(s):  
Grégoire Brun ◽  
Céline J. Fischer Fumeaux ◽  
Eric Giannoni ◽  
Myriam Bickle Graz
Keyword(s):  
Patent Ductus Arteriosus ◽  
Bronchopulmonary Dysplasia ◽  
Ductus Arteriosus ◽  
Oral Feeding ◽  
Invasive Ventilation ◽  
Very Preterm Infants ◽  
Factors Associated ◽  
Very Preterm ◽  
Non Invasive ◽  
Patent Ductus

Aim We aimed to identify variables associated with gestational age at full oral feeding in a cohort of very preterm infants. Methods In this retrospective study, all infants born below 32 weeks of gestation and admitted to a level III neonatal unit in 2015 were included. We dichotomized our population of 122 infants through the median age at full oral feeding, and explored which variables were statistically different between the two groups. We then used linear regression analysis to study the association between variables known from the literature and variables we had identified and age at full oral feeding. Results The median postnatal age at full oral feeding was 36 6/7weeks post menstrual age (Q1-Q3 35 6/7-392/7), and was associated with the duration of hospital of stay. In the univariable linear regression, the variables significantly associated with full oral feeding were gestational age, socioeconomic status, sepsis, patent ductus arteriosus, duration of supplementary oxygen, of non-invasive and invasive ventilation, and bronchopulmonary dysplasia. In the multivariable regression analysis, duration of non-invasive ventilation and oxygen therapy, bronchopulmonary dysplasia, and patent ductus arteriosus were associated with an older age at full oral feeding, with bronchopulmonary dysplasia the single most potent predictor. Discussion Lung disease severity is a major determinant of age at full oral feeding and thus length of stay in this population. Other factors associated with FOF include socioeconomic status and patent ductus arteriosus, There is a need for research addressing evidence-based bundles of care for these infants at risk of long-lasting feeding and neurodevelopmental impairments.

scholarly journals Diagnosis of Pneumonia by Cough Sounds Analyzed with Statistical Features and AI

Sensors ◽  
2021 ◽  
Vol 21 (21) ◽  
pp. 7036
Author(s):  
Youngbeen Chung ◽  
Jie Jin ◽  
Hyun In Jo ◽  
Hyun Lee ◽  
Sang-Heon Kim ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Diagnostic Accuracy ◽  
Diagnostic Algorithm ◽  
The Other ◽  
Energy Ratio ◽  
Statistical Features ◽  
Non Invasive ◽  
Invasive Test ◽  
Serious Disease ◽  
Cough Sound

Pneumonia is a serious disease often accompanied by complications, sometimes leading to death. Unfortunately, diagnosis of pneumonia is frequently delayed until physical and radiologic examinations are performed. Diagnosing pneumonia with cough sounds would be advantageous as a non-invasive test that could be performed outside a hospital. We aimed to develop an artificial intelligence (AI)-based pneumonia diagnostic algorithm. We collected cough sounds from thirty adult patients with pneumonia or the other causative diseases of cough. To quantify the cough sounds, loudness and energy ratio were used to represent the level and its spectral variations. These two features were used for constructing the diagnostic algorithm. To estimate the performance of developed algorithm, we assessed the diagnostic accuracy by comparing with the diagnosis by pulmonologists based on cough sound alone. The algorithm showed 90.0% sensitivity, 78.6% specificity and 84.9% overall accuracy for the 70 cases of cough sound in pneumonia group and 56 cases in non-pneumonia group. For same cases, pulmonologists correctly diagnosed the cough sounds with 56.4% accuracy. These findings showed that the proposed AI algorithm has value as an effective assistant technology to diagnose adult pneumonia patients with significant reliability.

scholarly journals Next-Generation Digital Biomarkers for Tuberculosis and Antibiotic Stewardship: Perspective on Novel Molecular Digital Biomarkers in Sweat, Saliva, and Exhaled Breath

10.2196/25907 ◽  
2021 ◽  
Vol 23 (8) ◽  
pp. e25907
Author(s):  
Noe Brasier ◽  
Michael Osthoff ◽  
Fiorangelo De Ieso ◽  
Jens Eckstein
Keyword(s):  
Health Care ◽  
Infectious Diseases ◽  
Low Income ◽  
Health Care Professionals ◽  
Smart Devices ◽  
Therapeutic Drug ◽  
Exhaled Breath ◽  
Accelerometer Data ◽  
Next Generation ◽  
Digital Biomarkers

The internet of health care things enables a remote connection between health care professionals and patients wearing smart biosensors. Wearable smart devices are potentially affordable, sensitive, specific, user-friendly, rapid, robust, lab-independent, and deliverable to the end user for point-of-care testing. The datasets derived from these devices are known as digital biomarkers. They represent a novel patient-centered approach to collecting longitudinal, context-derived health insights. Adding automated, analytical smartphone applications will enable their use in high-, middle-, and low-income countries. So far, digital biomarkers have been focused primarily on accelerometer data and heart rate due to well-established sensors originating from the consumer market. Novel emerging smart biosensors will detect biomarkers (or compounds) independent of a lab and noninvasively in sweat, saliva, and exhaled breath. These molecular digital biomarkers are a promising novel approach to reduce the burden from 2 major infectious diseases with urgent unmet needs: tuberculosis and infections with multidrug resistant pathogens. Active tuberculosis (aTbc) is one of the deadliest diseases from an infectious agent. However, a simple and reliable test for its detection is still missing. Furthermore, inappropriate antimicrobial use leads to the development of antimicrobial resistance, which is associated with high mortality and health care costs. From this perspective, we discuss the innovative approach of a noninvasive and lab-independent collection of novel biomarkers to detect aTbc, which at the same time may additionally serve as a scalable therapeutic drug monitoring approach for antibiotics. These molecular digital biomarkers are next-generation digital biomarkers and have the potential to shape the future of infectious diseases.

scholarly journals MAJOR EMBRYONIC DEVELOPMENT VISUALIZATION METHODS REVIEW

2021 ◽  
Vol 9 (1) ◽  
pp. 121-135
Author(s):  
A.I. Trofimenko ◽  
◽  
D.A. Pevzner ◽  
V.V. Lazarev ◽  
E.E. Lysov ◽  
...  
Keyword(s):  
Embryonic Development ◽  
Developmental Disorders ◽  
Time Lapse ◽  
Scientific Data ◽  
Video Frame ◽  
Special Equipment ◽  
Non Invasive ◽  
Observation Process ◽  
Negative Effect ◽  
Static Images

Embryonic development is one of the most important stages in the formation of the animal organism, so its study never lost its relevance. However, today, the detailed process of embryo development remains behind the «screen» that nature created by itself, which in turn creates certain technical difficulties that can be coped with by various methods of visualization of the embryo that are presented in this article. These are not only relatively simple 2D techniques that permit to see the embryo in the plane, but also novel 3D techniques that permit observation of an embryo in its volumetric structure. Since invasive methods are associated with unfavourable consequences during observation of the embryo, which produce a negative effect on the obtained scientific data and can lead to their misinterpretation, recently, non-invasive methods are more often used that allow to preserve the integrity of the structures of the embryo and reduce the risk of developmental disorders that occur during the observation process. The time-lapse technology was an innovative discovery which permits to visualize real-time events during embryonic development. Time-lapse is a frame-by-frame shooting, which collects the obtained static images into one continuous video. Frame montage is carried out using special equipment. This system has found application in a large number of scientific experiments. High resolution of modern technical devices permits to observe the formation of embryonic structures, to make a real assessment of an embryo growth and development according to the established parameters, and to observe changes induced by different factors.

scholarly journals ALZUMERIC: A decision support system for diagnosis and monitoring of cognitive impairment

Loquens ◽  
2017 ◽  
Vol 4 (1) ◽  
pp. 037 ◽  
Author(s):  
Unai Martinez de Lizarduy ◽  
Pilar Calvo Salomón ◽  
Pedro Gómez Vilda ◽  
Mirian Ecay Torres ◽  
Karmele López de Ipiña
Keyword(s):  
Cognitive Impairment ◽  
Data Exchange ◽  
Complex Dynamics ◽  
Smart Cities ◽  
Low Cost ◽  
Developed Countries ◽  
Quality Analysis ◽  
Smart Devices ◽  
Non Invasive ◽  
Internet Connections

Internet of things and smart cities are becoming a reality. Nowadays, more and more devices are interconnected and in order to deal with this new situation, data processing speeds are increasing to keep the pace. Smart devices like tablets and smartphones are accessible to a wide part of society in developed countries, and Internet connections for data exchange make it possible to handle large volumes of information in less time. This new reality has opened up the possibility of developing client-server architectures focused on clinical diagnosis in real time and at a very low cost. This paper illustrates the design and implementation of the ALZUMERIC system that is oriented to the diagnosis of Alzheimer’s disease (AD). It is a platform where the medical specialist can gather voice samples through non-invasive methods from patients with and without mild cognitive impairment (MCI), and the system automatically parameterizes the input signal to make a diagnose proposal. Although this type of impairment produces a cognitive loss, it is not severe enough to interfere with daily life. The present approach is based on the description of speech pathologies with regard to the following profiles: phonation, articulation, speech quality, analysis of the emotional response, language perception, and complex dynamics of the system. Privacy, confidentiality and information security have also been taken into consideration, as well as possible threats that the system could suffer, so this first prototype of services offered by ALZUMERIC has been targeted to a predetermined number of medical specialists.

scholarly journals Digit Recognition from EEG Signals on Smart Devices a Novel Approach

2021 ◽  
Vol 9 (VII) ◽  
pp. 2342-2349
Author(s):  
Subodh Kumar Jha
Keyword(s):  
Neural Network ◽  
Human Brain ◽  
Communication System ◽  
Research Work ◽  
Smart Devices ◽  
Correct Classification ◽  
Eeg Signals ◽  
Digit Recognition ◽  
Non Invasive ◽  
Novel Approach

The Advancement of communication system has given us the freedom to think beyond traditional communication system and stage is set for thought oriented communication system. There are thousands of thoughts generated and vanished in a timeframe but out of these some prominent thoughts persist and we proceed with the same in our day to day activities. The advancement in Electroencephalogram has provided a chance to see the activity in the human brain in non-invasive manner. The proposed research work presents the method for Digit recognition using the EEG signals acquired and processed on smart devices. The results show the implementation of Computation neural network for the recognition of digits from EEG signals. It was seen that, the 90.64% correct classification was achieved.

Non-invasive Monitoring of Health Using Sensor-Rich Wearables and Smart Devices

2021 ◽  
pp. 153-179
Author(s):  
Vijay Narayan Tiwari ◽  
Ajit S. Bopardikar ◽  
Aloknath De
Keyword(s):  
Smart Devices ◽  
Invasive Monitoring ◽  
Non Invasive
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