Electroencephalography (EEG) emerged in the second decade of the 20th century as a technique for recording the neurophysiological response. Since then, there has been little variation in the physical principles that sustain the signal acquisition probes, otherwise called electrodes. Currently, new advances in technology have brought new unexpected fields of applications apart from the clinical, for which new aspects such as usability and gel-free operation are first order priorities. Thanks to new advances in materials and integrated electronic systems technologies, a new generation of dry electrodes has been developed to fulfill the need. In this manuscript, we review current approaches to develop dry EEG electrodes for clinical and other applications, including information about measurement methods and evaluation reports. We conclude that, although a broad and non-homogeneous diversity of approaches has been evaluated without a consensus in procedures and methodology, their performances are not far from those obtained with wet electrodes, which are considered the gold standard, thus enabling the former to be a useful tool in a variety of novel applications.
Major reported factors associated with the limited effectiveness of home telemonitoring interventions in chronic respiratory conditions include the lack of useful early predictors, poor patient compliance and the poor performance of conventional algorithms for detecting deteriorations. This article provides a systematic review of existing algorithms and the factors associated with their performance in detecting exacerbations and supporting clinical decisions in patients with chronic obstructive pulmonary disease (COPD) or asthma. An electronic literature search in Medline, Scopus, Web of Science and Cochrane library was conducted to identify relevant articles published between 2005 and July 2015. A total of 20 studies (16 COPD, 4 asthma) that included research about the use of algorithms in telemonitoring interventions in asthma and COPD were selected. Differences on the applied definition of exacerbation, telemonitoring duration, acquired physiological signals and symptoms, type of technology deployed and algorithms used were found. Predictive models with good clinically reliability have yet to be defined, and are an important goal for the future development of telehealth in chronic respiratory conditions. New predictive models incorporating both symptoms and physiological signals are being tested in telemonitoring interventions with positive outcomes. However, the underpinning algorithms behind these models need be validated in larger samples of patients, for longer periods of time and with wellestablished protocols. In addition, further research is needed to identify novel predictors that enable the early detection of deteriorations, especially in COPD. Only then will telemonitoring achieve the aim of preventing hospital admissions, contributing to the reduction of health resource utilization and improving the quality of life of patients.
This paper presents a body-fixed-sensor-based approach to assess potential sleep apnea patients. A trial involving 15 patients at a sleep unit was undertaken. Vibration sounds were acquired from an accelerometer sensor fixed with a noninvasive mounting on the suprasternal notch of subjects resting in supine position. Respiratory, cardiac, and snoring components were extracted by means of digital signal processing techniques. Mainly, the following biomedical parameters used in new sleep apnea diagnosis strategies were calculated: heart rate, heart rate variability, sympathetic and parasympathetic activity, respiratory rate, snoring rate, pitch associated with snores, and airflow indirect quantification. These parameters were compared to those obtained by means of polysomnography and an accurate microphone. Results demonstrated the feasibility of implementing an accelerometry-based portable device as a simple and cost-effective solution for contributing to the screening of sleep apnea-hypopnea syndrome and other breathing disorders.
COPD places an enormous burden on the healthcare systems and causes diminished health-related quality of life. The highest proportion of human and economic cost is associated with admissions for acute exacerbation of respiratory symptoms (AECOPD). Since prompt detection and treatment of exacerbations may improve outcomes, early detection of AECOPD is a critical issue. This pilot study was aimed to determine whether a mobile health system could enable early detection of AECOPD on a day-to-day basis. A novel electronic questionnaire for the early detection of COPD exacerbations was evaluated during a 6-months field trial in a group of 16 patients. Pattern recognition techniques were applied. A k-means clustering algorithm was trained and validated, and its accuracy in detecting AECOPD was assessed. Sensitivity and specificity were 74.6 and 89.7 %, respectively, and area under the receiver operating characteristic curve was 0.84. 31 out of 33 AECOPD were early identified with an average of 4.5 ± 2.1 days prior to the onset of the exacerbation that was considered the day of medical attendance. Based on the findings of this preliminary pilot study, the proposed electronic questionnaire and the applied methodology could help to early detect COPD exacerbations on a day-to-day basis and therefore could provide support to patients and physicians.
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