JMIR Biomedical Engineering
Engineering for health technologies, medical devices, and innovative medical treatments and procedures
Editor-in-Chief: Gunther Eysenbach, MD, MPH, FACMI
Gunther Eysenbach, MD, MPH, FACMI
Due to the COVID-19 pandemic, the demand for remote electrocardiogram (ECG) monitoring has increased drastically in an attempt to prevent the spread of the virus and keep vulnerable individuals with less severe cases out of hospitals. Enabling clinicians to set up remote patient ECG monitoring easily and determining how to classify the ECG signals accurately so relevant alerts are sent in a timely fashion is an urgent problem to be addressed for remote patient monitoring (RPM) to be adopted widely. Hence, a new technique is required to enable routine and widespread use of RPM, as is needed due to COVID-19.
Maturity-onset diabetes of the young (MODY) is a group of dominantly inherited monogenic diabetes, with HNF4A-MODY, GCK-MODY, and HNF1A-MODY as the three most common forms based on the causal genes. Molecular diagnosis of MODY is important for precise treatment. Although a DNA variant causing MODY can be assessed based on the criteria of the American College of Medical Genetics and Genomics (ACMG) guidelines, gene-specific assessment of disease-causing mutations is important to differentiate among MODY subtypes. As the ACMG criteria were not originally designed for machine-learning algorithms, they are not true independent variables.
Physical activity has been shown to decrease cardiovascular mortality and morbidity. Walking, a simple physical activity which is an integral part of daily life, is a feasible and safe activity for patients with heart failure (HF). A step counter, measuring daily walking activity, might be a motivational factor for increased activity.
Rhythm, brain, and body are closely linked. Humans can synchronize their movement to auditory rhythms in ways that can improve the regularity of movement while reducing perceived effort. However, the ability to perform rhythmic movement may be disrupted by various neurological conditions. Many such conditions impair mechanisms that control movement, such as gait, but typically without rhythmic perception being affected. This paper focuses on hemiparetic stroke, a neurological condition that affects one side of the body. Hemiparetic stroke can cause severe asymmetries in gait, leading to numerous physical problems ranging from muscle degeneration to bone fractures. Movement synchronization via entrainment to auditory metronomes is known to improve asymmetry and related gait problems; this paper presents the first systematic study of entrainment for gait rehabilitation via the haptic modality.
Heart rate variability (HRV) is used to assess cardiac health and autonomic nervous system capabilities. With the growing popularity of commercially available wearable technologies, the opportunity to unobtrusively measure HRV via photoplethysmography (PPG) is an attractive alternative to electrocardiogram (ECG), which serves as the gold standard. PPG measures blood flow within the vasculature using color intensity. However, PPG does not directly measure HRV; it measures pulse rate variability (PRV). Previous studies comparing consumer-grade PRV with HRV have demonstrated mixed results in short durations of activity under controlled conditions. Further research is required to determine the efficacy of PRV to estimate HRV under free-living conditions.
Electrogastrography is a noninvasive electrophysiological procedure used to measure gastric myoelectrical activity. EGG methods have been used to investigate the mechanisms of the human digestive system and as a clinical tool. Abnormalities in gastric myoelectrical activity have been observed in subjects with diabetes.
Electroconvulsive therapy (ECT) is one of the oldest, most effective, and potentially life-saving noninvasive brain stimulation treatments for psychiatric illnesses such as severe depression, mania, and catatonia. The decision-making process to use ECT involves well-informed discussion between the clinician and the client. A platform, like an app, which provides this information in an easy-to-understand format may be of benefit to various stakeholders in making an informed decision. Apps developed by clinicians/hospitals taking into consideration user perspectives will filter and provide trustworthy information to the users. In this regard, the ECT app, an app which is freely available for download at the Apple Store, was developed by the Leicestershire Partnership National Health Service (NHS) Trust and Leicestershire Health Informatics Service (LHIS).
Biometric systems use scanners to verify the identity of human beings by measuring the patterns of their behavioral or physiological characteristics. Some biometric systems are contactless and do not require direct touch to perform these measurements; others, such as fingerprint verification systems, require the user to make direct physical contact with the scanner for a specified duration for the biometric pattern of the user to be properly read and measured. This may increase the possibility of contamination with harmful microbial pathogens or of cross-contamination of food and water by subsequent users. Physical contact also increases the likelihood of inoculation of harmful microbial pathogens into the respiratory tract, thereby triggering infectious diseases. In this viewpoint, we establish the likelihood of infectious disease transmission through touch-based fingerprint biometric devices and discuss control measures to curb the spread of infectious diseases, including COVID-19.
Sleep is essential for human health. Considerable effort has been put into academic and industrial research and in the development of wireless body area networks for sleep monitoring in terms of nonintrusiveness, portability, and autonomy. With the help of rapid advances in smart sensing and communication technologies, various sleep monitoring systems (hereafter, sleep monitoring systems) have been developed with advantages such as being low cost, accessible, discreet, contactless, unmanned, and suitable for long-term monitoring.
The amount of medical video data that has to be securely stored has been growing exponentially. This rapid expansion is mainly caused by the introduction of higher video resolution such as 4K and 8K to medical devices and the growing usage of telemedicine services, along with a general trend toward increasing transparency with respect to medical treatment, resulting in more and more medical procedures being recorded. Such video data, as medical data, must be maintained for many years, resulting in datasets at the exabytes scale that each hospital must be able to store in the future. Currently, hospitals do not have the required information and communications technology infrastructure to handle such large amounts of data in the long run. In this paper, we discuss the challenges and possible solutions to this problem. We propose a generic architecture for a holistic, end-to-end recording and storage platform for hospitals, define crucial components, and identify existing and future solutions to address all parts of the system. This paper focuses mostly on the recording part of the system by introducing the major challenges in the area of bioinformatics, with particular focus on three major areas: video encoding, video quality, and video metadata.
Parkinson disease (PD) is a common neurodegenerative disorder that affects between 7 and 10 million people worldwide. No objective test for PD currently exists, and studies suggest misdiagnosis rates of up to 34%. Machine learning (ML) presents an opportunity to improve diagnosis; however, the size and nature of data sets make it difficult to generalize the performance of ML models to real-world applications.