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  1. Article ; Online: Wearable Respiration Monitoring: Interpretable Inference With Context and Sensor Biomarkers.

    Alam, Ridwan / Peden, David B / Lach, John C

    IEEE journal of biomedical and health informatics

    2021  Volume 25, Issue 6, Page(s) 1938–1948

    Abstract: Continuous monitoring of breathing rate (BR), minute ventilation (VE), and other respiratory parameters could transform care for and empower patients with chronic cardio-pulmonary conditions, such as asthma. However, the clinical standard for measuring ... ...

    Abstract Continuous monitoring of breathing rate (BR), minute ventilation (VE), and other respiratory parameters could transform care for and empower patients with chronic cardio-pulmonary conditions, such as asthma. However, the clinical standard for measuring respiration, namely Spirometry, is hardly suitable for continuous use. Wearables can track many physiological signals, like ECG and motion, yet respiration tracking faces many challenges. In this work, we infer respiratory parameters from wearable ECG and wrist motion signals. We propose a modular and generalizable classification-regression pipeline to utilize available context information, such as physical activity, in learning context-conditioned inference models. Novel morphological and power domain features from the wearable ECG are extracted to use with these models. Exploratory feature selection methods are incorporated in this pipeline to discover application-driven interpretable biomarkers. Using data from 15 subjects, we evaluate two implementations of the proposed inference pipeline: for BR and VE. Each implementation compares generalized linear model, random forest, support vector machine, Gaussian process regression, and neighborhood component analysis as regression models. Permutation, regularization, and relevance determination methods are used to rank the ECG features to identify robust ECG biomarkers across models and activities. This work demonstrates the potential of wearable sensors not only in continuous monitoring, but also in designing biomarker-driven preventive measures.
    MeSH term(s) Biomarkers ; Humans ; Monitoring, Physiologic ; Respiration ; Respiratory Rate ; Wearable Electronic Devices ; Wrist
    Chemical Substances Biomarkers
    Language English
    Publishing date 2021-06-04
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 2695320-1
    ISSN 2168-2208 ; 2168-2194
    ISSN (online) 2168-2208
    ISSN 2168-2194
    DOI 10.1109/JBHI.2020.3035776
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Book ; Online: Wearable Respiration Monitoring

    Alam, Ridwan / Peden, David B. / Lach, John C.

    Interpretable Inference with Context and Sensor Biomarkers

    2020  

    Abstract: Breathing rate (BR), minute ventilation (VE), and other respiratory parameters are essential for real-time patient monitoring in many acute health conditions, such as asthma. The clinical standard for measuring respiration, namely Spirometry, is hardly ... ...

    Abstract Breathing rate (BR), minute ventilation (VE), and other respiratory parameters are essential for real-time patient monitoring in many acute health conditions, such as asthma. The clinical standard for measuring respiration, namely Spirometry, is hardly suitable for continuous use. Wearables can track many physiological signals, like ECG and motion, yet not respiration. Deriving respiration from other modalities has become an area of active research. In this work, we infer respiratory parameters from wearable ECG and wrist motion signals. We propose a modular and generalizable classification-regression pipeline to utilize available context information, such as physical activity, in learning context-conditioned inference models. Morphological and power domain novel features from the wearable ECG are extracted to use with these models. Exploratory feature selection methods are incorporated in this pipeline to discover application-specific interpretable biomarkers. Using data from 15 subjects, we evaluate two implementations of the proposed pipeline: for inferring BR and VE. Each implementation compares generalized linear model, random forest, support vector machine, Gaussian process regression, and neighborhood component analysis as contextual regression models. Permutation, regularization, and relevance determination methods are used to rank the ECG features to identify robust ECG biomarkers across models and activities. This work demonstrates the potential of wearable sensors not only in continuous monitoring, but also in designing biomarker-driven preventive measures.

    Comment: 10 pages, 10 figures
    Keywords Electrical Engineering and Systems Science - Signal Processing ; Computer Science - Artificial Intelligence ; Computer Science - Computers and Society ; Computer Science - Human-Computer Interaction ; Computer Science - Machine Learning ; I.2.1
    Subject code 004 ; 006
    Publishing date 2020-07-02
    Publishing country us
    Document type Book ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Real-world walking in multiple sclerosis: Separating capacity from behavior.

    Engelhard, Matthew M / Patek, Stephen D / Lach, John C / Goldman, Myla D

    Gait & posture

    2017  Volume 59, Page(s) 211–216

    Abstract: Background: Habitual physical activity (HPA) measurement addresses the impact of MS on real-world walking, yet its interpretation is confounded by the competing influences of MS-associated walking capacity and physical activity behaviors.: Objective: ...

    Abstract Background: Habitual physical activity (HPA) measurement addresses the impact of MS on real-world walking, yet its interpretation is confounded by the competing influences of MS-associated walking capacity and physical activity behaviors.
    Objective: To develop specific measures of MS-associated walking capacity through statistically sophisticated HPA analysis, thereby more precisely defining the real-world impact of disease.
    Methods: Eighty-eight MS and 38 control subjects completed timed walks and patient-reported outcomes in clinic, then wore an accelerometer for 7days. HPA was analyzed with several new statistics, including the maximum step rate (MSR) and habitual walking step rate (HWSR), along with conventional methods, including average daily steps. HPA statistics were validated using clinical walking outcomes.
    Results: The six-minute walk (6MW) step rate correlated most strongly with MSR (r=0.863, p<10
    Conclusions: Conventional HPA statistics are poor measures of capacity due to variability in activity behaviors. The MSR and HWSR are valid, specific measures of real-world capacity which capture subjects' highest step rate and preferred step rate, respectively.
    MeSH term(s) Adult ; Disability Evaluation ; Exercise ; Female ; Humans ; Male ; Middle Aged ; Multiple Sclerosis/classification ; Multiple Sclerosis/diagnosis ; Walking ; Young Adult
    Language English
    Publishing date 2017-10-16
    Publishing country England
    Document type Journal Article
    ZDB-ID 1162323-8
    ISSN 1879-2219 ; 0966-6362
    ISSN (online) 1879-2219
    ISSN 0966-6362
    DOI 10.1016/j.gaitpost.2017.10.015
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Remotely engaged: Lessons from remote monitoring in multiple sclerosis.

    Engelhard, Matthew M / Patek, Stephen D / Sheridan, Kristina / Lach, John C / Goldman, Myla D

    International journal of medical informatics

    2017  Volume 100, Page(s) 26–31

    Abstract: Objectives: Evaluate web-based patient-reported outcome (wbPRO) collection in MS subjects in terms of feasibility, reliability, adherence, and subject-perceived benefits; and quantify the impact of MS-related symptoms on perceived well-being.: Methods! ...

    Abstract Objectives: Evaluate web-based patient-reported outcome (wbPRO) collection in MS subjects in terms of feasibility, reliability, adherence, and subject-perceived benefits; and quantify the impact of MS-related symptoms on perceived well-being.
    Methods: Thirty-one subjects with MS completed wbPROs targeting MS-related symptoms over six months using a customized web portal. Demographics and clinical outcomes were collected in person at baseline and six months.
    Results: Approximately 87% of subjects completed wbPROs without assistance, and wbPROs strongly correlated with standard PROs (r>0.91). All wbPROs were completed less frequently in the second three months (p<0.05). Frequent wbPRO completion was significantly correlated with higher step on the Expanded Disability Status Scale (EDSS) (p=0.026). Nearly 52% of subjects reported improved understanding of their disease, and approximately 16% wanted individualized wbPRO content. Over half (63.9%) of perceived well-being variance was explained by MS symptoms, notably depression (r
    Conclusions: wbPRO collection was feasible and reliable. More disabled subjects had higher completion rates, yet most subjects failed requirements in the second three months. Remote monitoring has potential to improve patient-centered care and communication between patient and provider, but tailored PRO content and other innovations are needed to combat declining adherence.
    Language English
    Publishing date 2017-04
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 1466296-6
    ISSN 1872-8243 ; 1386-5056
    ISSN (online) 1872-8243
    ISSN 1386-5056
    DOI 10.1016/j.ijmedinf.2017.01.006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Quantifying six-minute walk induced gait deterioration with inertial sensors in multiple sclerosis subjects.

    Engelhard, Matthew M / Dandu, Sriram Raju / Patek, Stephen D / Lach, John C / Goldman, Myla D

    Gait & posture

    2016  Volume 49, Page(s) 340–345

    Abstract: Background: The six-minute walk (6MW) is a common walking outcome in multiple sclerosis (MS) thought to measure fatigability in addition to overall walking disability. However, direct evidence of 6MW induced gait deterioration is limited by the ... ...

    Abstract Background: The six-minute walk (6MW) is a common walking outcome in multiple sclerosis (MS) thought to measure fatigability in addition to overall walking disability. However, direct evidence of 6MW induced gait deterioration is limited by the difficulty of measuring qualitative changes in walking.
    Objectives: This study aims to (1) define and validate a measure of fatigue-related gait deterioration based on data from body-worn sensors; and (2) use this measure to detect gait deterioration induced by the 6MW.
    Methods: Gait deterioration was assessed using the Warp Score, a measure of similarity between gait cycles based on dynamic time warping (DTW). Cycles from later minutes were compared to baseline cycles in 89 subjects with MS and 29 controls. Correlation, corrected (partial) correlation, and linear regression were used to quantify relationships to walking and fatigue outcomes.
    Results: Warp Scores rose between minute 3 and minute 6 in subjects with mild and moderate disability (p<0.001). Statistically significant correlations (p<0.001) to the MS walking scale (MSWS-12), modified fatigue impact scale (MFIS) physical subscale, and cerebellar and pyramidal functional system scores (FSS) were observed even after controlling for walking speed. Regression of MSWS-12 scores on Warp Scores and walking speed explained 73.9% of response variance. Correlations to individual MSWS-12 and MFIS items strongly suggest a relationship to fatigability.
    Conclusion: The Warp Score has been validated in MS subjects as an objective measure of fatigue-related gait deterioration. Progressive changes to gait cycles induced by the 6MW often appeared in later minutes, supporting the importance of sustained walking in clinical assessment.
    Language English
    Publishing date 2016-09
    Publishing country England
    Document type Journal Article
    ZDB-ID 1162323-8
    ISSN 1879-2219 ; 0966-6362
    ISSN (online) 1879-2219
    ISSN 0966-6362
    DOI 10.1016/j.gaitpost.2016.07.184
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Understanding the Physiological Significance of Four Inertial Gait Features in Multiple Sclerosis.

    Dandu, Sriram Raju / Engelhard, Matthew M / Qureshi, Asma / Gong, Jiaqi / Lach, John C / Brandt-Pearce, Maite / Goldman, Myla D

    IEEE journal of biomedical and health informatics

    2018  Volume 22, Issue 1, Page(s) 40–46

    Abstract: Gait impairment in multiple sclerosis (MS) can result from muscle weakness, physical fatigue, lack of coordination, and other symptoms. Walking speed, as measured by a number of clinician-administered walking tests, is the primary measure of gait ... ...

    Abstract Gait impairment in multiple sclerosis (MS) can result from muscle weakness, physical fatigue, lack of coordination, and other symptoms. Walking speed, as measured by a number of clinician-administered walking tests, is the primary measure of gait impairment used by clinical researchers, but inertial gait features from body-worn sensors have been proven to add clinical value. This paper seeks to understand and differentiate the physiological significance of four such features with proven value in MS to facilitate adoption by clinical researchers and incorporation in gait monitoring and analysis systems. In addition, this information can be used to select features that might be appropriate in other forms of disability. Two of the four features are computed using the dynamic time warping (DTW) algorithm: The "DTW Score" is based on the usual DTW distance, and the "Warp Score" is based on the warping length. The third feature, based on kernel density estimation (KDE), is the "KDE Peak" value. Finally, the "Causality Index" is based on the phase slope index between inertial signals from different body parts. Relationships between these measures and the aforementioned gait-related symptoms are determined by applying factor analysis to three common, clinical walking outcomes, then correlating the inertial measures as well as walking speed to each extracted factor. Statistically significant differences in correlation coefficients to the three extracted clinical factors support their distinct physiological meaning and suggest they may have complimentary roles in the analysis of MS-related walking disability.
    MeSH term(s) Accelerometry/methods ; Adolescent ; Adult ; Algorithms ; Biomechanical Phenomena/physiology ; Gait/physiology ; Humans ; Middle Aged ; Multiple Sclerosis/physiopathology ; Signal Processing, Computer-Assisted ; Walking/physiology ; Young Adult
    Language English
    Publishing date 2018-01-03
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 2695320-1
    ISSN 2168-2208 ; 2168-2194
    ISSN (online) 2168-2208
    ISSN 2168-2194
    DOI 10.1109/JBHI.2017.2773629
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Book ; Online: MFED

    Mondol, Md Abu Sayeed / Bell, Brooke / Ma, Meiyi / Alam, Ridwan / Emi, Ifat / Preum, Sarah Masud / de la Haye, Kayla / Spruijt-Metz, Donna / Lach, John C. / Stankovic, John A.

    A System for Monitoring Family Eating Dynamics

    2020  

    Abstract: Obesity is a risk factor for many health issues, including heart disease, diabetes, osteoarthritis, and certain cancers. One of the primary behavioral causes, dietary intake, has proven particularly challenging to measure and track. Current behavioral ... ...

    Abstract Obesity is a risk factor for many health issues, including heart disease, diabetes, osteoarthritis, and certain cancers. One of the primary behavioral causes, dietary intake, has proven particularly challenging to measure and track. Current behavioral science suggests that family eating dynamics (FED) have high potential to impact child and parent dietary intake, and ultimately the risk of obesity. Monitoring FED requires information about when and where eating events are occurring, the presence or absence of family members during eating events, and some person-level states such as stress, mood, and hunger. To date, there exists no system for real-time monitoring of FED. This paper presents MFED, the first of its kind of system for monitoring FED in the wild in real-time. Smart wearables and Bluetooth beacons are used to monitor and detect eating activities and the location of the users at home. A smartphone is used for the Ecological Momentary Assessment (EMA) of a number of behaviors, states, and situations. While the system itself is novel, we also present a novel and efficient algorithm for detecting eating events from wrist-worn accelerometer data. The algorithm improves eating gesture detection F1-score by 19% with less than 20% computation compared to the state-of-the-art methods. To date, the MFED system has been deployed in 20 homes with a total of 74 participants, and responses from 4750 EMA surveys have been collected. This paper describes the system components, reports on the eating detection results from the deployments, proposes two techniques for improving ground truth collection after the system is deployed, and provides an overview of the FED data, generated from the multi-component system, that can be used to model and more comprehensively understand insights into the monitoring of family eating dynamics.
    Keywords Computer Science - Computers and Society
    Subject code 006
    Publishing date 2020-07-11
    Publishing country us
    Document type Book ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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