| 1. |
- Abtahi, Farhad, 1981-, et al.
(författare)
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An Affordable ECG and Respiration Monitoring System Based on Raspberry PI and ADAS1000 : First Step towards Homecare Applications
- 2015
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Ingår i: 16th Nordic-Baltic Conference on Biomedical Engineering. - Cham : Springer. - 9783319129662 ; , s. 5-8, s. 5-8
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Konferensbidrag (refereegranskat)abstract
- Homecare is a potential solution for problems associated with an aging population. This may involve several physiological measurements, and hence a flexible but affordable measurement device is needed. In this work, we have designed an ADAS1000-based four-lead electrocardiogram (ECG) and respiration monitoring system. It has been implemented using Raspberry PI as a platform for homecare applications. ADuM chips based on iCoupler technology have been used to achieve electrical isolation as required by IEC 60601 and IEC 60950 for patient safety. The result proved the potential of Raspberry PI for the design of a compact, affordable, and medically safe measurement device. Further work involves developing a more flexible software for collecting measurements from different devices (measuring, e.g., blood pressure, weight, impedance spectroscopy, blood glucose) through Bluetooth or user input and integrating them into a cloud-based homecare system.
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| 2. |
- Abtahi, Farhad, 1981-
(författare)
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Aspects of Electrical Bioimpedance Spectrum Estimation
- 2014
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Electrical bioimpedance spectroscopy (EBIS) has been used to assess the status or composition of various types of tissue, and examples of EBIS include body composition analysis (BCA) and tissue characterisation for skin cancer detection. EBIS is a non-invasive method that has the potential to provide a large amount of information for diagnosis or monitoring purposes, such as the monitoring of pulmonary oedema, i.e., fluid accumulation in the lungs. However, in many cases, systems based on EBIS have not become generally accepted in clinical practice. Possible reasons behind the low acceptance of EBIS could involve inaccurate models; artefacts, such as those from movements; measurement errors; and estimation errors. Previous thoracic EBIS measurements aimed at pulmonary oedema have shown some uncertainties in their results, making it difficult to produce trustworthy monitoring methods. The current research hypothesis was that these uncertainties mostly originate from estimation errors. In particular, time-varying behaviours of the thorax, e.g., respiratory and cardiac activity, can cause estimation errors, which make it tricky to detect the slowly varying behaviour of this system, i.e., pulmonary oedema.The aim of this thesis is to investigate potential sources of estimation error in transthoracic impedance spectroscopy (TIS) for pulmonary oedema detection and to propose methods to prevent or compensate for these errors. This work is mainly focused on two aspects of impedance spectrum estimation: first, the problems associated with the delay between estimations of spectrum samples in the frequency-sweep technique and second, the influence of undersampling (a result of impedance estimation times) when estimating an EBIS spectrum. The delay between frequency sweeps can produce huge errors when analysing EBIS spectra, but its effect decreases with averaging or low-pass filtering, which is a common and simple method for monitoring the time-invariant behaviour of a system. The results show the importance of the undersampling effect as the main estimation error that can cause uncertainty in TIS measurements. The best time for dealing with this error is during the design process, when the system can be designed to avoid this error or with the possibility to compensate for the error during analysis. A case study of monitoring pulmonary oedema is used to assess the effect of these two estimation errors. However, the results can be generalised to any case for identifying the slowly varying behaviour of physiological systems that also display higher frequency variations. Finally, some suggestions for designing an EBIS measurement system and analysis methods to avoid or compensate for these estimation errors are discussed.
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| 3. |
- Abtahi, Farhad, et al.
(författare)
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Association of drivers’ sleepiness with heart rate variability : A pilot study with drivers on real roads
- 2018
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Ingår i: IFMBE Proceedings. - Singapore : Springer Verlag. - 9789811051210 ; , s. 149-152
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Konferensbidrag (refereegranskat)abstract
- Vehicle crashes lead to huge economic and social consequences, and one non-negligible cause of accident is driver sleepiness. Driver sleepiness analysis based on the monitoring of vehicle acceleration, steering and deviation from the road or physiological and behavioral monitoring of the driver, e.g., monitoring of yawning, head pose, eye blinks and eye closures, electroencephalogram, electrooculogram, electromyogram and electrocardiogram (ECG), have been used as a part of sleepiness alert systems.Heart rate variability (HRV) is a potential method for monitoring of driver sleepiness. Despite previous positive reports from the use of HRV for sleepiness detection, results are often inconsistent between studies. In this work, we have re-evaluated the feasibility of using HRV for detecting drivers’ sleepiness during real road driving. A database consists of ECG measurements from 10 drivers, driving during morning, afternoon and night sessions on real road were used. Drivers have reported their average sleepiness level by using the Karolinska sleepiness scale once every five minutes. Statistical analysis was performed to evaluate the potential of HRV indexes to distinguish between alert, first signs of sleepiness and severe sleepiness states. The results suggest that individual subjects show different reactions to sleepiness, which produces an individual change in HRV indicators. The results motivate future work for more personalized approaches in sleepiness detection.
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| 4. |
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| 5. |
- Abtahi, Farhad, 1981-, et al.
(författare)
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Big Data & Wearable Sensors Ensuring Safety and Health @Work
- 2017
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Ingår i: GLOBAL HEALTH 2017, The Sixth International Conference on Global Health Challenges. - 9781612086040
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Konferensbidrag (refereegranskat)abstract
- —Work-related injuries and disorders constitute a major burden and cost for employers, society in general and workers in particular. We@Work is a project that aims to develop an integrated solution for promoting and supporting a safe and healthy working life by combining wearable technologies, Big Data analytics, ergonomics, and information and communication technologies. The We@Work solution aims to support the worker and employer to ensure a healthy working life through pervasive monitoring for early warnings, prompt detection of capacity-loss and accurate risk assessments at workplace as well as self-management of a healthy working life. A multiservice platform will allow unobtrusive data collection at workplaces. Big Data analytics will provide real-time information useful to prevent work injuries and support healthy working life
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| 6. |
- Abtahi, Farhad, et al.
(författare)
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Biosignal PI, an Affordable Open-Source ECG and Respiration Measurement System
- 2014
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Ingår i: Sensors. - : MDPI AG. - 1424-8220. ; 15:1, s. 93-109
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Tidskriftsartikel (refereegranskat)abstract
- Bioimedical pilot projects e.g., telemedicine, homecare, animal and human trials usually involve several physiological measurements. Technical development of these projects is time consuming and in particular costly. A versatile but affordable biosignal measurement platform can help to reduce time and risk while keeping the focus on the important goal and making an efficient use of resources. In this work, an affordable and open source platform for development of physiological signals is proposed. As a first step an 8–12 leads electrocardiogram (ECG) and respiration monitoring system is developed. Chips based on iCoupler technology have been used to achieve electrical isolation as required by IEC 60601 for patient safety. The result shows the potential of this platform as a base for prototyping compact, affordable, and medically safe measurement systems. Further work involves both hardware and software development to develop modules. These modules may require development of front-ends for other biosignals or just collect data wirelessly from different devices e.g., blood pressure, weight, bioimpedance spectrum, blood glucose, e.g., through Bluetooth. All design and development documents, files and source codes will be available for non-commercial use through project website, BiosignalPI.org.
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| 7. |
- Abtahi, Farhad, 1981-, et al.
(författare)
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Development and preliminary evaluation of an Android based heart rate variability biofeedback system
- 2014
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Ingår i: Engineering in Medicine and Biology Society (EMBC), 2014 36th Annual International Conference of the IEEE. - : IEEE. - 9781424479290 ; 2014, s. 3382-5
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Konferensbidrag (refereegranskat)abstract
- The reduced Heart Rate Variability (HRV) is believed to be associated with several diseases such as congestive heart failure, diabetes and chronic kidney diseases (CKD). In these cases, HRV biofeedback may be a potential intervention method to increase HRV which in turn is beneficial to these patients. In this work, a real-time Android biofeedback application based on a Bluetooth enabled ECG and thoracic electrical bioimpedance (respiration) measurement device has been developed. The system performance and usability have been evaluated in a brief study with eight healthy volunteers. The result demonstrates real-time performance of system and positive effects of biofeedback training session by increased HRV and reduced heart rate. Further development of the application and training protocol is ongoing to investigate duration of training session to find an optimum length and interval of biofeedback sessions to use in potential interventions.
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| 8. |
- Abtahi, Farhad, et al.
(författare)
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Electrical bioimpedance spectroscopy in time-variant systems : Is undersampling always a problem?
- 2014
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Ingår i: Journal of Electrical Bioimpedance. - : Walter de Gruyter GmbH. - 1891-5469. ; 5:1, s. 28-33
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Tidskriftsartikel (refereegranskat)abstract
- During the last decades, Electrical Bioimpedance Spectroscopy (EBIS) has been applied mainly by using the frequency-sweep technique, across a range of many different applications. Traditionally, the tissue under study is considered to be time-invariant and dynamic changes of tissue activity are ignored by treating the changes as a noise source. A new trend in EBIS is simultaneous electrical stimulation with several frequencies, through the application of a multi-sine, rectangular or other waveform. This method can provide measurements fast enough to sample dynamic changes of different tissues, such as cardiac muscle. This high sampling rate comes at a price of reduction in SNR and the increase in complexity of devices. Although the frequency-sweep technique is often inadequate for monitoring the dynamic changes in a variant system, it can be used successfully in applications focused on the time-invariant or slowly-variant part of a system. However, in order to successfully use frequency-sweep EBIS for monitoring time-variant systems, it is paramount to consider the effects of aliasing and especially the folding of higher frequencies, on the desired frequency e.g. DC level. This paper discusses sub-Nyquist sampling of thoracic EBIS measurements and its application in the case of monitoring pulmonary oedema. It is concluded that by considering aliasing, and with proper implementation of smoothing filters, as well as by using random sampling, frequency-sweep EBIS can be used for assessing time-invariant or slowly-variant properties of time-variant biological systems, even in the presence of aliasing. In general, undersampling is not always a problem, but does always require proper consideration.
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| 9. |
- Abtahi, Farhad, et al.
(författare)
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Elimination of ECG Artefacts in Foetal EEG Using Ensemble Average Subtraction and Wavelet Denoising Methods : A Simulation
- 2014
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Ingår i: XIII Mediterranean Conference on Medical and Biological Engineering and Computing 2013. - Cham : Springer. - 9783319008455 ; , s. 551-554
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Konferensbidrag (refereegranskat)abstract
- Biological signals recorded from surface electrodes contain interference from other signals which are not desired and should be considered as noise. Heart activity is especially present in EEG and EMG recordings as a noise. In this work, two ECG elimination methods are implemented; ensemble average subtraction (EAS) and wavelet denoising methods. Comparison of these methods has been done by use of simulated signals achieved by adding ECG to neonates EEG. The result shows successful elimination of ECG artifacts by using both methods. In general EAS method which remove estimate of all ECG components from signal is more trustable but it is also harder for implementation due to sensitivity to noise. It is also concluded that EAS behaves like a high-pass filter while wavelet denoising method acts as low-pass filter and hence the choice of one method depends on application.
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| 10. |
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| 11. |
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| 12. |
- Abtahi, Farhad, 1981-, et al.
(författare)
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Pro-inflammatory Blood Markers and Heart Rate Variability in Apnoea as a Reflection of Basal Vagal Tone
-
Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Pro-inflammatory cytokines play a crucial role in inflammatory response, which istightly regulated by the nervous system to avoid the damage caused by inflammation. There isevidence for a cholinergic anti-inflammatory pathway that includes afferent and efferent vagalnerves that sense the inflammation and stimulate the anti-inflammatory response. Non-functionalanti-inflammatory response might lead to excessive and chronic inflammation e.g., rheumatoidarthritis (RA), inflammatory bowel disease (IBD), and poor outcome. Heart rate variability(HRV) has been proposed as a potential tool to monitor the level of anti-inflammatory activitythrough the monitoring of vagal activity. In this paper, the association of pro-inflammatorymarkers with HRV indices is evaluated. We used a database called “Heart Biomarker Evaluationin Apnea Treatment (HeartBEAT)” that consists of 6±2 hours of Electrocardiogram (ECG)recordings during nocturnal sleep from 318 patients at baseline and 301of them at 3 monthsfollow-up. HRV indices are calculated from ECG recordings of 5-360 minutes. The results showa statistically significant correlation between heart rate (HR) and pro-inflammatory cytokines,independent of duration of ECG analysis. HRV indices e.g., standard deviation of all RRintervals (SDNN) show an inverse relation to the pro-inflammatory cytokines. Longer ECGrecordings show a higher potential to reflect the level of anti-inflammatory response. In light oftheories for the cholinergic anti-inflammatory pathway, a combination of HR and HRV as areflection of basal vagal activity might be a potential prognostic tool for interventional guidance.
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| 13. |
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| 14. |
- Abtahi, Farhad, et al.
(författare)
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Software tool for analysis of breathing-related errors in transthoracic electrical bioimpedance spectroscopy measurements
- 2012
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Ingår i: Journal of Physics, Conference Series. - : IOP Publishing. - 1742-6588 .- 1742-6596. ; 407:1, s. 012028-
-
Tidskriftsartikel (refereegranskat)abstract
- During the last decades, Electrical Bioimpedance Spectroscopy (EBIS) has been applied in a range of different applications and mainly using the frequency sweep-technique. Traditionally the tissue under study is considered to be timeinvariant and dynamic changes of tissue activity are ignored and instead treated as a noise source. This assumption has not been adequately tested and could have a negative impact and limit the accuracy for impedance monitoring systems. In order to successfully use frequency-sweeping EBIS for monitoring time-variant systems, it is paramount to study the effect of frequency-sweep delay on Cole Model-based analysis. In this work, we present a software tool that can be used to simulate the influence of respiration activity in frequency-sweep EBIS measurements of the human thorax and analyse the effects of the different error sources. Preliminary results indicate that the deviation on the EBIS measurement might be significant at any frequency, and especially in the impedance plane. Therefore the impact on Cole-model analysis might be different depending on method applied for Cole parameter estimation.
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| 15. |
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| 16. |
- Abtahi, Farhad, 1981-
(författare)
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Towards Heart Rate Variability Tools in P-Health : Pervasive, Preventive, Predictive and Personalized
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Heart rate variability (HRV) has received much attention lately. It has been shown that HRV can be used to monitor the autonomic nervous system and to detect autonomic dysfunction, especially vagal dysfunction. Reduced HRV is associated with several diseases and has also been suggested as a predictor of poor outcomes and sudden cardiac death. HRV is, however, not yet widely accepted as a clinical tool and is mostly used for research. Advances in neuroimmunity with an improved understanding of the link between the nervous and immune systems have opened a new potential arena for HRV applications. An example is when systemic inflammation and autoimmune disease are primarily caused by low vagal activity; it can be detected and prognosticated by reduced HRV. This thesis is the result of several technical development steps and exploratory research where HRV is applied as a prognostic diagnostic tool with preventive potential. The main objectives were 1) to develop an affordable tool for the effective analysis of HRV, 2) to study the correlation between HRV and pro-inflammatory markers and the potential degree of activity in the cholinergic anti-inflammatory pathway, and 3) to develop a biofeedback application intended for support of personal capability to increase the vagal activity as reflected in increased HRV. Written as a compilation thesis, the methodology and the results of each study are presented in each appended paper. In the thesis frame/summary chapter, a summary of each of the included papers is presented, grouped by topic and with their connections. The summary of the results shows that the developed tools may accurately register and properly analyse and potentially influence HRV through the designed biofeedback game. HRV can be used as a prognostic tool, not just in traditional healthcare with a focus on illness but also in wellness. By using these tools for the early detection of decreased HRV, prompt intervention may be possible, enabling the prevention of disease. Gamification and serious gaming is a potential platform to motivate people to follow a routine of exercise that might, through biofeedback, improve HRV and thereby health.
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| 17. |
- Abtahi, Farhad, 1981-, et al.
(författare)
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Wearable Sensors Enabling Personalized Occupational Healthcare
- 2018
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Ingår i: Intelligent Environments 2018. - Amsterdam : IOS Press. - 9781614998730 - 9781614998747 ; , s. 371-376
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- This paper presents needs and potentials for wearable sensors inoccupational healthcare. In addition, it presents ongoing European and Swedishprojects for developing personalized, and pervasive wearable systems for assessingrisks of developing musculoskeletal disorders and cardiovascular diseases at work.Occupational healthcare should benefit in preventing diseases and disorders byproviding the right feedback at the right time to the right person. Collected datafrom workers can provide evidence supporting the ergonomic and industrial tasksof redesigning the working environment to reduce the risks.
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| 18. |
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| 19. |
- Atefi, Seyed Reza, 1985-, et al.
(författare)
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Cole Function and Conductance-Based Parasitic Capacitance Compensation for Cerebral Electrical Bioimpedance Measurements
- 2012
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Ingår i: Engineering in Medicine and Biology Society (EMBC), 2012 Annual International Conference of the IEEE. - San Diego : IEEE press. ; 2012, s. 3368-71
-
Konferensbidrag (refereegranskat)abstract
- One of the most common measurement artifacts present in Electrical Bioimpedance Spectroscopy measurements (EBIS) comes from the capacitive leakage effect resulting from parasitic stray capacitances. This artifact produces a deviation in the measured impedance spectrum that is most noticeable at higher frequencies. The artifact taints the spectroscopy measurement increasing the difficulty of producing reliable EBIS measurements at high frequencies. In this work, an approach for removing such capacitive influence from the spectral measurement is presented making use of a novel method to estimate the value of the parasitic capacitance equivalent that causes the measurement artifact. The proposed method has been tested and validated theoretically and experimentally and it gives a more accurate estimation of the value of the parasitic capacitance than the previous methods. Once a reliable value of parasitic capacitance has been estimated the capacitive influence can be easily compensated in the EBIS measured data. Thus enabling analysis of EBIS data at higher frequencies, i.e. in the range of 300-500 kHz like measurements intended for cerebral monitoring, where the characteristic frequency is remarkably higher than EBIS measurements i.e. within the range 30 to 50 kHz, intended for body composition assessment.
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| 20. |
- Atefi, Seyed Reza, 1985-
(författare)
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Electrical Bioimpedance Cerebral Monitoring : From Hypothesis and Simulation to First Experimental Evidence in Stroke Patients
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Stroke is amongthe leading causes of death worldwide and requires immediate care to prevent death or permanent disability. Unfortunately, the current stateof stroke diagnosis is limited to fixed neuroimaging facilities that do not allow rapid stroke diagnosis. Hence, a portable stroke-diagnosis device could assist in the pre-hospital triage of patients. Moreover, such a portable device could also be useful for bedside stroke monitoring of patients in the Neuro Intensive Care Unit (Neuro-ICU) to avoid unnecessary neuroimaging. Recent animal studies and numerical simulations have supported the idea of implementing Electrical Bioimpedance (EBI) in a portable device, allowing non-invasive assessment as a useful tool for the pre-hospital triage of stroke and Traumatic Brain Injury (TBI) patients. Unfortunately, these studies have not reported any results from human subjects in the acute phase of the stroke. The numerical simulations are also based on simple models that sometimes lack necessary details.Finite Element Method (FEM) simulations on a realistic numerical head model as well as experimental Bioimpedance Spectroscopy (BIS) measurements from human subjectsin the acute, subacute and chronic phasesof stroke were used to answer the following research questions: (i) Does stroke modify the electrical properties of brain tissue in a way that is detectable via EBI? (ii) Would it be possible to detect stroke via EBI as early as in the acute and sub-acute phase?(iii) Is EBI sensitive enough to monitor changes caused by stroke pathogenesis?Using FEM to simulate electrical current injection on the head and study the resulting distribution of electrical potential on the scalp, it was shown that Intra-Cranial Hemorrhage (ICH) affects the quasi-symmetric scalp potential distribution,creating larger left-right potential asymmetry when compared to the healthy head model. Proof-of-concept FEM simulations were also tested in a small cohort of 6ICH patients and 10 healthy controls, showing that the left-right potential difference in the patients is significantly (p<0.05) larger than in the controls. Using bioimpedance measurements in the acute, subacute and chronic phasesof stroke and examining simple features, it was also shown that the head EBI measurements of patients suffering stroke are different from controls, enabling the discrimination of healthy controls and stroke patients at any stage of the stroke. The absolute change in test-retest resistance measurements of the control group (~5.33%) was also found to be significantly (p<0.05) smaller than the EBI measurements of patients obtained 24 hours and 72 hours after stroke onset (20.44%). These results suggested that scalp EBI is sensitive to stroke pathogenesis changesand thususeful for bedside monitoring in the Neuro-ICU. These results suggested that EBI is a potentially useful tool for stroke diagnosis and monitoring.Finally, the initial observations based on a small number of patients, addressing the proposed future work of this thesis, suggested that the average head resistance amplitude of hemorrhagic stroke patients is smaller than in healthy controls, while ischemic stroke patients show a larger resistance amplitude than the controls. Scalp potential asymmetry analysis of healthy, hemorrhagic and ischemic stroke subjects also suggests that these three groups can be separated. However, these results are based on a small number of patients and need to be validated using a larger cohort. Initial observations also showed that the resistance of the EBI measurements of controls is robust between test and retest measurements, showing no significant difference (less than 2% and p>0.05). Subject position during EBI recording (supine or sitting) did not seem to affect the resistance of the EBI measurements (p>0.05). However, age, sex and head size showed significant effects on the resistance measurements. These initial observations are encouraging for further research on EBI for cerebral monitoring and stroke diagnosis. However, at this stage, considering the uncertainties in stroke type differentiation, EBI cannot replace CT but has the potential to be used as a consultation tool.
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| 21. |
- Atefi, Seyed Reza, 1985-, et al.
(författare)
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Electrical Bioimpedance cerebral monitoring. Preliminary results from measurements on stroke patients
- 2012
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Ingår i: Engineering in Medicine and Biology Society (EMBC), 2012 Annual International Conference of the IEEE. - : IEEE. - 9781424441198 ; 2012, s. 126-9
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Konferensbidrag (refereegranskat)abstract
- Electrical Bioimpedance Spectroscopy (EBIS) is currently used in different tissue characterization applications. In this work we aim to use EBIS to study changes in electrical properties of the cerebral tissues after an incident of hemorrhage/ischemic stroke. To do so a case-control study was conducted using six controls and three stroke cases. The preliminary results of this study show that by using Cole-based analysis on EBIS measurements and analyzing the Cole parameters R0 and R∞, it is possible to detect changes on electrical properties of cerebral tissue after stroke.
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| 22. |
- Atefi, Seyed Reza, et al.
(författare)
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Stroke Damage Detection Using Classification Trees on Electrical Bioimpedance Cerebral Spectroscopy Measurements
- 2013
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Ingår i: Sensors. - : MDPI AG. - 1424-8220. ; 13:8, s. 10074-10086
-
Tidskriftsartikel (refereegranskat)abstract
- After cancer and cardio-vascular disease, stroke is the third greatest cause of death worldwide. Given the limitations of the current imaging technologies used for stroke diagnosis, the need for portable non-invasive and less expensive diagnostic tools is crucial. Previous studies have suggested that electrical bioimpedance (EBI) measurements from the head might contain useful clinical information related to changes produced in the cerebral tissue after the onset of stroke. In this study, we recorded 720 EBI Spectroscopy (EBIS) measurements from two different head regions of 18 hemispheres of nine subjects. Three of these subjects had suffered a unilateral haemorrhagic stroke. A number of features based on structural and intrinsic frequency-dependent properties of the cerebral tissue were extracted. These features were then fed into a classification tree. The results show that a full classification of damaged and undamaged cerebral tissue was achieved after three hierarchical classification steps. Lastly, the performance of the classification tree was assessed using Leave-One-Out Cross Validation (LOO-CV). Despite the fact that the results of this study are limited to a small database, and the observations obtained must be verified further with a larger cohort of patients, these findings confirm that EBI measurements contain useful information for assessing on the health of brain tissue after stroke and supports the hypothesis that classification features based on Cole parameters, spectral information and the geometry of EBIS measurements are useful to differentiate between healthy and stroke damaged brain tissue.
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| 23. |
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| 24. |
- Atefi, Seyed Reza, et al.
(författare)
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Study of the dynamics of transcephalic cerebral impedance data during cardio-vascular surgery
- 2013
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Ingår i: XV International Conference on Electrical Bio-Impedance (ICEBI) & XIV Conference on Electrical Impedance Tomography (EIT). - : Institute of Physics (IOP). ; , s. 012045-
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Konferensbidrag (refereegranskat)abstract
- Postoperative neurological deficits are one of the risks associated with cardio vascular surgery, necessitating development of new techniques for cerebral monitoring. In this study an experimental observation regarding the dynamics of transcephalic Electrical Bioimpedance (EBI) in patients undergoing cardiac surgery with and without extracorporeal circulation (ECC) was conducted to investigate the potential use of electrical Bioimpedance for cerebral monitoring in cardio vascular surgery. Tetrapolar transcephalic EBI measurements at single frequency of 50 kHz were recorded prior to and during cardio vascular surgery. The obtained results show that the transcephalic impedance decreases in both groups of patients as operation starts, however slight differences in these two groups were also observed with the cerebral impedance reduction in patients having no ECC being less common and not as pronounced as in the ECC group. Changes in the cerebral impedance were in agreement with changes of haematocrit and temperature. The origin of EBI changes is still unexplained however these results encourage us to continue investigating the application of electrical bioimpedance cerebral monitoring clinically.
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| 25. |
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| 26. |
- Brante, Thomas, et al.
(författare)
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Profession och vetenskap : idéer och strategier för ett professionslärosäte
- 2009
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Förord av Björn Brorström, Prorektor Högskolan i Borås Ett professionslärosäte bedriver utbildning och forskning på vetenskaplig grund. Vetenskapliga metoder tillämpas och framkomna resultat prövas för att säkra tillförlitlighet och relevans. Förmågan att problematisera, formulera frågor och välja lämpliga metoder för att besvara frågor är egenskaper för god forskning och utmärkande för en stark utbildnings- och forskningsmiljö. Vid ett professionslärosäte finns samtidigt en stark strävan efter att i utbildning och forskning ta till vara den kunskap och de erfarenheter som professioner besitter och därigenom säkra en hög grad av praktisk relevans. Växelverkan mellan teori och praktik och erfarenhetsutbyte mellan forskare och praktiker är ständigt pågående. Det finns ingen avslutning på processen utan den pågår utan avbrott. En nödvändig förutsättning för ett fruktbart samarbete är en ömsesidig respekt och vilja att stödja och ifrågasätta varandra. Forskaren måste vara beredd på kritik för bristen på praktisk relevans och professionsföreträdaren måste vara beredd på att förtrogenhetskunskapens lämplighet ifrågasätts. Det är en fråga om med- och mothåll från båda håll i syfte att långsiktigt utveckla teori och praktik. Det är en utmaning att utveckla, etablera och därefter kontinuerligt försvara och förbättra professionslärosätet. Ett led i utvecklingen är att inom ramen för Högskolan i Borås föra en debatt om innebörden av ett professionslärosäte och vad vi behöver göra för att förbättra verksamheten. På uppdrag av rektor Lena Nordholm har medarbetare vid Bibliotekshögskolan utvecklat och ansvarat för en seminarieserie benämnd Profession och vetenskap. Seminarierna spände över ett brett fält. En av många viktiga frågor som diskuterades flitigt var huruvida vi ska forska om professioner, i för eller med, eller kanske alltihop samtidigt. Bidragen publiceras nu i denna antologi som ges ut inom ramen för Högskolan i Borås rapportserie Vetenskap för profession. Rapporten Profession och vetenskap – idéer och strategier för ett professionslärosäte, som redigerats av universitetsadjunkt Maria Lindh, kommer att få stor betydelse inom lärosätet och i vårt samarbete med företrädare för näringsliv, kulturliv och offentlig verksamhet. Jag ser det som en intressant fortsättning att anordna ett antal seminarier med inbjudna representanter för professioner där artiklarna i denna rapport kan ligga till grund för erfarenhetsutbyte och diskussioner.
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| 27. |
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| 28. |
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| 29. |
- Buendía López, Rubén, 1982-
(författare)
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Model Based Enhancement of Bioimpedance Spectroscopy Analysis : Towards Textile Enabled Applications
- 2011
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Several signal processing approaches have been developed to overcome the effect of stray capacitances in Electrical Bioimpedance Spectroscopy (EBIS) measurements. EBIS measurements obtained with textile-enabled instrumentation are more vulnerable to stray capacitances. Currently, the most widespread approach for correcting the effect of stray capacitances in EBIS is the time delay ( Td) compensation method, which also has several drawbacks. In this study, the Td method is revisited and its limitations and its lack of a scientific basis are demonstrated. To determine better ways to overcome the effect of stray capacitances, a simplified measurement model is proposed that is based on previous models of artefacts in EBIS measurements described in the literature. The model consists of a current divider with a parasitic capacitance (Cpar) in parallel with the load. Cpar creates a pathway for the measurement current to leak away from the load, provoking a capacitive leakage effect. In this thesis, three approaches with different limitations are proposed to overcome the capacitive leakage effect. The first approach estimates Cpar and subtracts it from the measurements, thus finding the load. Cpar can be estimated because the susceptance of biological tissue is null at infinite frequency. Therefore, at high frequencies, the susceptance of the tissue can be neglected, and the slope of the susceptance of the measurement is Cpar. The accuracy of Cpar depends on the maximum frequency measured and the value of Cpar. Therefore, it may not be possible to accurately estimate small values of Cpar in the typical frequency ranges used in EBIS. The second and third approaches use the Cole fitting process to estimate the Cole parameters, which form the basis for most EBIS applications. Because the conductance of the measurement is free from the effect of Cpar, performing Cole fitting on the conductance avoids the effect of Cpar in the fitting process. With a poor skin-electrode contact, this approach may not be sufficiently accurate. The third approach would be to perform the Cole fitting on the modulus with a reduced upper frequency limit because the modulus and the low-medium frequencies are very robust against the effect of artefacts. In this approach, a slight capacitive leakage effect is unavoidable. Since it is common to find tainted measurements, especially among those obtained with textile-enabled instrumentation, it is important to find viable methods to avoid their effect. The three methods studied showed that they could reduce the effect of tainted measurements.
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| 30. |
- Buendia, Ruben, 1982, et al.
(författare)
-
Estimation of body fluids with bioimpedance spectroscopy: state of the art methods and proposal of novel methods
- 2015
-
Ingår i: Physiological Measurement. - : IOP Publishing. - 0967-3334 .- 1361-6579. ; 36:10
-
Tidskriftsartikel (refereegranskat)abstract
- Determination of body fluids is a useful common practice in determination of disease mechanisms and treatments. Bioimpedance spectroscopy (BIS) methods are non-invasive, inexpensive and rapid alternatives to reference methods such as tracer dilution. However, they are indirect and their robustness and validity are unclear. In this article, state of the art methods are reviewed, their drawbacks identified and new methods are proposed. All methods were tested on a clinical database of patients receiving growth hormone replacement therapy. Results indicated that most BIS methods are similarly accurate (e.g. < 0.5 +/- 3.0% mean percentage difference for total body water) for estimation of body fluids. A new model for calculation is proposed that performs equally well for all fluid compartments (total body water, extra-and intracellular water). It is suggested that the main source of error in extracellular water estimation is due to anisotropy, in total body water estimation to the uncertainty associated with intracellular resistivity and in determination of intracellular water a combination of both.
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| 31. |
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| 32. |
- Buendia, Rubén, et al.
(författare)
-
Robustness study of the different immittance spectra and frequency ranges in bioimpedance spectroscopy analysis for assessment of total body composition.
- 2014
-
Ingår i: Physiological measurement. - : IOP Publishing. - 1361-6579 .- 0967-3334. ; 35:7, s. 1373-95
-
Tidskriftsartikel (refereegranskat)abstract
- The estimation of body fluids is a useful and common practice for assessment of disease status and therapy outcomes. Electrical bioimpedance spectroscopy (EBIS) methods are noninvasive, inexpensive and efficient alternatives for determination of body fluids. One of the main source of errors in EBIS measurements in the estimation of body fluids is capacitive coupling. In this paper an analysis of capacitive coupling in EBIS measurements was performed and the robustness of the different immittance spectra against it tested. On simulations the conductance (G) spectrum presented the smallest overall error, among all immittance spectra, in the estimation of the impedance parameters used to estimate body fluids. Afterwards the frequency range of 10-500kHz showed to be the most robust band of the G spectrum. The accuracy of body fluid estimations from the resulting parameters that utilized G spectrum and parameters provided by the measuring device were tested on EBIS clinical measurements from growth hormone replacement therapy patients against estimations performed with dilution methods. Regarding extracellular fluid, the correlation between each EBIS method and dilution was 0.93 with limits of agreement of 1.06 ± 2.95 l for the device, 1.10 ± 2.94 l for G [10-500kHz] and 1.04 ± 2.94 l for G [5-1000kHz]. Regarding intracellular fluid, the correlation between dilution and the device was 0.91, same as for G [10-500kHz] and 0.92 for G [5-1000kHz]. Limits of agreement were 0.12 ± 4.46 l for the device, 0.09 ± 4.45 for G [10-500kHz] and 0.04 ± 4.58 for G [5-1000kHz]. Such close results between the EBIS methods validate the proposed approach of using G spectrum for initial Cole characterization and posterior clinical estimation of body fluids status.
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| 33. |
- Bäcklund, Tomas, 1958-
(författare)
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Wearable systems and sensors for the assessment of motor control : Development and validation of methods for clinical assessment of idiopathic normal pressure hydrocephalus
- 2021
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Human gait and balance are controlled by automatic processes in the central nervous system, and in sensory and proprioceptive systems. If a disturbance occurs in any of these complex structures, it may lead to balance and gait problems. Equally important are the systems controlling the upper extremity functions where reach, grasp and manipulation skills may be affected. For the neurodegenerative disease idiopathic normal pressure hydrocephalus (iNPH), balance and gait disturbances are cardinal symptoms. Motor control of the upper extremities is also affected. In clinic today, physical impairment of persons with iNPH is commonly visually assessed using subjective, course tests with ordinal scales with the risk of missing minor changes. There is a lack of objective and quantitative ways to measure motor control in daily patient care. The aim of this thesis was to develop and validate tools for objective assessment of parameters that affect motor control in persons with iNPH.Postural stability in stance and walking was assessed using gyroscopes in patients with iNPH, healthy elderly (HE) and patients with ventriculomegaly (VM). Compared to HE, patients with iNPH had reduced postural stability and relied less on vision. iNPH patients also had a lower trunk sway velocity than VM during walking. The gyroscopic system could quantitatively assess postural deficits in iNPH, making it a potentially useful tool for diagnosis and for clinical follow-up. The differences found during gait also suggests that walking, rather than quiet stance, should be further investigated for facilitating differential diagnosis compared to other patient groups with ventriculomegaly.The gait in patients with iNPH is according to guidelines defined as slow, shuffling with a low foot-lift, and wide based. To objectively quantify the latter two features, a system (Striton) was developed in-house to assess the increased distance between the feet and the peak heel-height at the push-off phase of the gait cycle. It was validated in experimental setups, compared to gold standard motion capture systems (MCS), on healthy elderly (HE), through test-retest and day-to-day evaluations, and in four patients with iNPH. Striton demonstrated high correlations, in step-width and in heel-height, compared with the MCS. The mean step-width in the HE was 5.2 ± 0.9 cm (mean±Standard Deviation) and the heel-height 16.7±0.6 cm. Test-retest and day-to-day variations were small, ±0.5 cm in step-width and ±1.2 cm in heel-height, and differences in the parameters were seen between HE and iNPH both before and after surgery. Thus, Striton has the potential of quantitatively assessing gait parameters in HE and iNPH in a valuable manner.
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| 34. |
- Cuba-Gyllensten, Illapha, et al.
(författare)
-
Removing respiratory artefacts from transthoracic bioimpedance spectroscopy measurements
- 2013
-
Ingår i: XV International Conference on Electrical Bio-Impedance (ICEBI) & XIV Conference on Electrical Impedance Tomography (EIT). - : Institute of Physics Publishing (IOPP).
-
Konferensbidrag (refereegranskat)abstract
- Transthoracic impedance spectroscopy (TIS) measurements from wearable textile electrodes provide a tool to remotely and non-invasively monitor patient health. However, breathing and cardiac processes inevitably affect TIS measurements, since they are sensitive to changes in geometry and air or fluid volumes in the thorax. This study aimed at investigating the effect of respiration on Cole parameters extracted from TIS measurements and developing a method to suppress artifacts. TIS data were collected from 10 participants at 16 frequencies (range: 10 kHz - 1 MHz) using a textile electrode system (Philips Technologie Gmbh). Simultaneously, breathing volumes and frequency were logged using an electronic spirometer augmented with data from a breathing belt. The effect of respiration on TIS measurements was studied at paced (10 and 16 bpm) deep and shallow breathing. These measurements were repeated for each subject in three different postures (lying down, reclining and sitting). Cole parameter estimation was improved by assessing the tidal expiration point thus removing breathing artifacts. This leads to lower intra-subject variability between sessions and a need for less measurements points to accurately assess the spectra. Future work should explore algorithmic artifacts compensation models using breathing and posture or patient contextual information to improve ambulatory transthoracic impedance measurements.
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| 35. |
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| 36. |
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| 37. |
- Ferreira Gonzalez, Javier, 1982-
(författare)
-
Textile-enabled Bioimpedance Instrumentation for Personalised Health Monitoring Applications
- 2013
-
Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- A growing number of factors, including the costs, technological advancements, an ageing population, and medical errors are leading industrialised countries to invest in research on alternative solutions to improving their health care systems and increasing patients’ life quality. Personal Health System (PHS) solutions envision the use of information and communication technologies that enable a paradigm shift from the traditional hospital-centred healthcare delivery model toward a preventive and person-centred approach. PHS offers the means to follow patient health using wearable, portable or implantable systems that offer ubiquitous, unobtrusive bio-data acquisition, allowing remote access to patient status and treatment monitoring.Electrical Bioimpedance (EBI) technology is a non-invasive, quick and relatively affordable technique that can be used for assessing and monitoring different health conditions, e.g., body composition assessments for nutrition. EBI technology combined with state-of-the-art advances in sensor and textile technology are fostering the implementation of wearable bioimpedance monitors that use functional garments for the implementation of personalised healthcare applications.This research studies the development of a portable EBI spectrometer that can use dry textile electrodes for the assessment of body composition for the purposes of clinical uses. The portable bioimpedance monitor has been developed using the latest advances in system-on-chip technology for bioimpedance spectroscopy instrumentation. The obtained portable spectrometer has been validated against commercial spectrometer that performs total body composition assessment using functional textrode garments.The development of a portable Bioimpedance spectrometer using functional garments and dry textile electrodes for body composition assessment has been shown to be a feasible option. The availability of such measurement systems bring closer the real implementation of personalised healthcare systems.
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| 38. |
- Ferreira, Javier, 1982-, et al.
(författare)
-
A handheld and textile-enabled bioimpedance system for ubiquitous body composition analysis. : An initial functional validation
- 2016
-
Ingår i: IEEE journal of biomedical and health informatics. - : Institute of Electrical and Electronics Engineers (IEEE). - 2168-2194 .- 2168-2208. ; 21:5
-
Tidskriftsartikel (refereegranskat)abstract
- In recent years, many efforts have been made to promote a healthcare paradigm shift from the traditional reactive hospital-centered healthcare approach towards a proactive, patient-oriented and self-managed approach that could improve service quality and help reduce costs while contributing to sustainability. Managing and caring for patients with chronic diseases accounts over 75% of healthcare costs in developed countries. One of the most resource demanding diseases is chronic kidney disease (CKD), which often leads to a gradual and irreparable loss of renal function, with up to 12% of the population showing signs of different stages of this disease. Peritoneal dialysis and home haemodialysis are life-saving home-based renal replacement treatments that, compared to conventional in-center hemodialysis, provide similar long-term patient survival, less restrictions of life-style, such as a more flexible diet, and better flexibility in terms of treatment options and locations. Bioimpedance has been largely used clinically for decades in nutrition for assessing body fluid distributions. Moreover, bioimpedance methods are used to assess the overhydratation state of CKD patients, allowing clinicians to estimate the amount of fluid that should be removed by ultrafiltration. In this work, the initial validation of a handheld bioimpedance system for the assessment of body fluid status that could be used to assist the patient in home-based CKD treatments is presented. The body fluid monitoring system comprises a custom-made handheld tetrapolar bioimpedance spectrometer and a textile-based electrode garment for total body fluid assessment. The system performance was evaluated against the same measurements acquired using a commercial bioimpedance spectrometer for medical use on several voluntary subjects. The analysis of the measurement results and the comparison of the fluid estimations indicated that both devices are equivalent from a measurement performance perspective, allowing for its use on ubiquitous e-healthcare dialysis solutions.
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| 39. |
- Ferreira, Javier, 1982-
(författare)
-
Modular textile-enabled bioimpedance system for personalized health monitoring applications
- 2017
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- A growing number of factors, including costs, technological advancements, ageing populations, and medical errors, are leading industrialized countries to invest in research on alternative solutions to improve their health-care systems and increase patients’ quality of life. Personal health systems (PHS) examplify the use of information and communication technologies that enable a paradigm shift from the traditional hospital-centered healthcare delivery model toward a preventive and person-centered approach. PHS offer the means to monitor a patient’s health using wearable, portable or implantable systems that offer ubiquitous, unobtrusive biodataacquisition, allowing remote monitoring of treatment and access to the patient’s status. Electrical bioimpedance (EBI) technology is non-invasive, quick and relatively affordable technique that can be used for assessing and monitoring different health conditions, e.g., body composition assessments for nutrition. When combined with state-of-the-art advances in sensors and textiles, EBI technologies are fostering the implementation of wearable bioimpedance monitors that use functional garments for personalized healthcare applications. This research work isfocused on the development of wearable EBI-based monitoring systems for ubiquitous health monitoring applications. The monitoring systems are built upon portable monitoring instrumentation and custom-made textile electrode garments.Portable EBI-based monitors have been developed using the latest material technology and advances in system-on-chip technology. For instance, a portable EBI spectrometer has been validated against a commercial spectrometer for total body composition assessment using functional textile electrode garments. The development of wearable EBI-based monitoring units using functional garments and dry textile electrodes for body composition assessment and respiratory monitoring has been shown to be a feasible approach. The availability of these measurement systems indicates progress toward the real implementation of personalized healthcare systems.
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| 40. |
- Ferreira, J., et al.
(författare)
-
Portable bioimpedance monitor evaluation for continuous impedance measurements : Towards wearable plethysmography applications
- 2013
-
Ingår i: Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS. - 9781457702167 ; 2013, s. 559-62
-
Konferensbidrag (refereegranskat)abstract
- Personalised Health Systems (PHS) that could benefit the life quality of the patients as well as decreasing the health care costs for society among other factors are arisen. The purpose of this paper is to study the capabilities of the System-on-Chip Impedance Network Analyser AD5933 performing high speed single frequency continuous bioimpedance measurements. From a theoretical analysis, the minimum continuous impedance estimation time was determined, and the AD5933 with a custom 4-Electrode Analog Front-End (AFE) was used to experimentally determine the maximum continuous impedance estimation frequency as well as the system impedance estimation error when measuring a 2R1C electrical circuit model. Transthoracic Electrical Bioimpedance (TEB) measurements in a healthy subject were obtained using 3M gel electrodes in a tetrapolar lateral spot electrode configuration. The obtained TEB raw signal was filtered in MATLAB to obtain the respiration and cardiogenic signals, and from the cardiogenic signal the impedance derivative signal (dZ/dt) was also calculated. The results have shown that the maximum continuous impedance estimation rate was approximately 550 measurements per second with a magnitude estimation error below 1% on 2R1C-parallel bridge measurements. The displayed respiration and cardiac signals exhibited good performance, and they could be used to obtain valuable information in some plethysmography monitoring applications. The obtained results suggest that the AD5933-based monitor could be used for the implementation of a portable and wearable Bioimpedance plethysmograph that could be used in applications such as Impedance Cardiography. These results combined with the research done in functional garments and textile electrodes might enable the implementation of PHS applications in a relatively short time from now.
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| 41. |
- Flisberg, Anders, 1958, et al.
(författare)
-
Does indomethacin for closure of patent ductus arteriosus affect cerebral function?
- 2010
-
Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 99:10, s. 1493-1497
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To study whether indomethacin used in conventional dose for closure of patent ductus arteriosus affects cerebral function measured by Electroencephalograms (EEG) evaluated by quantitative measures. Study design: Seven premature neonates with haemodynamically significant persistent ductus arteriosus were recruited. EEG were recorded before, during and after an intravenous infusion of 0.2 mg/kg indomethacin over 10 min. The EEG was analysed by two methods with different degrees of complexity for the amount of low-activity periods (LAP, "suppressions") as an indicator of affection of cerebral function. Results: Neither of the two methods identified any change in the amount of LAPs in the EEG as compared to before the indomethacin infusion. Conclusion: Indomethacin in conventional dose for closure of patent ductus arteriosus does not affect cerebral function as evaluated by quantitative EEG.
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| 42. |
- Flisberg, Anders, 1958, et al.
(författare)
-
EEG and spectral edge frequency : analysis in posthypoxic newborn piglets
- 2010
-
Ingår i: Neuro - endocrinology letters. - : Brain Research Promotion. - 0172-780X. ; 31:2, s. 181-186
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate the frequency content of the electroencephalogram (EEG) during recovery after a severe hypoxic insult in newborn piglets. METHODS: EEG was continuously monitored in nine newborn piglets exposed to a severe hypoxic period. Power spectra in five frequency bands were calculated using Fourier transformation. Spectral edge frequency 90 (SEF90) was defined as the frequency below which 90% of the power in the EEG was located. The piglets were divided into two groups; Group 1 represented piglets with some EEG recovery and Group 2 represented piglets without any EEG recovery. RESULTS: The recovery of the EEG in Group 1 had the same time course in all frequency bands. SEF90 indicates recovery earlier than the value of total power. But SEF90 also signals activity in the EEGs that were almost completely suppressed. When SEF90 was calculated during periods of periodic EEG activity during the very early phase of recovery, the values fell within the same range as during the control period. CONCLUSION: Spectral analysis of continuous EEG in newborn piglets exposed to very severe hypoxia showed that no specific frequency band of the EEG preceded the other ones during recovery. The results of the SEF90 measure, demonstrates the need for critical analysis of the raw EEG before any reliable estimation of cerebral function can be made.
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| 43. |
- Flisberg, A., et al.
(författare)
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Prognostic capacity of automated quantification of suppression time in the EEG of post-asphyctic full-term neonates
- 2011
-
Ingår i: Acta Paediatrica. - : Wiley-Blackwell. - 0803-5253 .- 1651-2227. ; 100:10, s. 1338-1343
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: To evaluate the prognostic capacity of a new method for automatic quantification of the length of suppression time in the electroencephalogram (EEG) of a group of asphyxiated newborn infants. Methods: Twenty-one full-term newborn infants who had been resuscitated for severe birth asphyxia were studied. Eight channel continuous EEG was recorded for prolonged time periods during the first days of life. Artefact detection or rejection was not applied to the signals. The signals were fed through a pretrained classifier and then segmented into burst and suppression periods. Total suppression length per hour was calculated. All surviving patients were followed with structured neurodevelopmental assessments to at least 18 months of age. Results: The patients who developed neurodevelopmental disability or died had significant suppression periods in their EEG during the first days of life while the patients who had a normal follow-up had no or negligible amount of suppression. Conclusions: This new method for automatic quantification of suppression periods in the raw, neonatal EEG discriminates infants with good from those with poor outcome.
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| 44. |
- Gund, Anna, 1980, et al.
(författare)
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A randomized controlled study about the use of eHealth in the home health care of premature infants
- 2013
-
Ingår i: BMC Medical Informatics and Decision Making. - : Springer Science and Business Media LLC. - 1472-6947. ; 13
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: One area where the use of information and communication technology (ICT), or eHealth, could be developed is the home health care of premature infants. The aim of this randomized controlled study was to investigate whether the use of video conferencing or a web application improves parents' satisfaction in taking care of a premature infant at home and decreases the need of home visits. In addition, nurses' attitudes regarding the use of these tools were examined. METHOD: Thirty-four families were randomized to one of three groups before their premature infant was discharged from the hospital to home health care: a control group receiving standard home health care (13 families); a web group receiving home health care supplemented with the use of a web application (12 families); a video group with home health care supplemented with video conferencing using Skype (9 families). Families and nursing staff answered questionnaires about the usefulness of ICT. In addition, semi-structured interviews were conducted with 16 families. RESULTS: All the parents in the web group found the web application easy to use. 83% of the families thought it was good to have access to their child's data through the application. All the families in the video group found Skype easy to use and were satisfied with the video calls. 88% of the families thought that video calls were better than ordinary phone calls. 33% of the families in the web group and 75% of those in the video group thought the need for home visits was decreased by the web application or Skype. 50% of the families in the web group and 100% of those in the video group thought the web application or the video calls had helped them feel more confident in caring for their child. Most of the nurses were motivated to use ICT but some were reluctant and avoided using the web application and video conferencing. CONCLUSION: The families were satisfied with both the web application and video conferencing. The families readily embraced the use of ICT, whereas motivating some of the nurses to accept and use ICT was a major challenge.
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| 45. |
- Gund, Anna, 1980, et al.
(författare)
-
Attitudes among healthcare professionals towards ICT and home follow-up in chronic heart failure care
- 2012
-
Ingår i: BMC Medical Informatics and Decision Making. - : Springer Science and Business Media LLC. - 1472-6947. ; 12:1, s. 138-
-
Tidskriftsartikel (refereegranskat)abstract
- Background: eHealth applications for out-of-hospital monitoring and treatment follow-up have been advocated for many years as a promising tool to improve treatment compliance, promote individualized care and obtain a person-centred care. Despite these benefits and a large number of promising projects, a major breakthrough in everyday care is generally still lacking. Inappropriate organization for eHealth technology, reluctance from users in the introduction of new working methods, and resistance to information and communication technology (ICT) in general could be reasons for this. Another reason may be attitudes towards the potential in out-of-hospital eHealth applications. It is therefore of interest to study the general opinions among healthcare professionals to ICT in healthcare, as well as the attitudes towards using ICT as a tool for patient monitoring and follow-up at home. One specific area of interest is in-home follow-up of elderly patients with chronic heart failure (CHF). The aim of this paper is to investigate the attitudes towards ICT, as well as distance monitoring and follow-up, among healthcare professionals working with this patient group. Method: This paper covers an attitude survey study based on responses from 139 healthcare professionals working with CHF care in Swedish hospital departments, i.e. cardiology and medicine departments. Comparisons between physicians and nurses, and in some cases between genders, on attitudes towards ICT tools and follow-up at home were performed. Results: Out of the 425 forms sent out, 139 were collected, and 17 out of 21 counties and regions were covered in the replies. Among the respondents, 66% were nurses, 30% physicians and 4% others. As for gender, 90% of nurses were female and 60% of physicians were male. Internet was used daily by 67% of the respondents. Attitudes towards healthcare ICT were found positive as 74% were positive concerning healthcare ICT today, 96% were positive regarding the future of healthcare ICT, and 54% had high confidence in healthcare ICT. Possibilities for distance monitoring/follow-up are good according to 63% of the respondents, 78% thought that this leads to increased patient involvement, and 80% thought it would improve possibilities to deliver better care. Finally, 72% of the respondents said CHF patients would benefit from home monitoring/follow-up to some extent, and 19% to a large extent. However, the best method of follow-up was considered to be home visits by nurse, or phone contact. Conclusion: The results indicate that a majority of the healthcare professionals in this study are positive to both current and future use of ICT tools in healthcare and home follow-up. Consequently other factors have to play an important role in the slow penetration of out-of-hospital eHealth applications in daily healthcare practice.
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| 46. |
- Gund, Anna, 1980, et al.
(författare)
-
Care@Distance – Disease Management för hjärtsviktspatienter i hemmet
- 2007
-
Ingår i: Medicinteknikdagarna, 2-3 October 2007, Örebro, Sweden. - : Svensk förening för medicinsk teknik och fysik, Örebro Läns Landsting, Örebro Universitet, Stiftelsen för strategisk forskning, Vetenskapsrådet, Vinnova.
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Antalet äldre i samhället ökar, och med det kostnaderna p.g.a. kroniska åldersrelaterade sjukdomstillstånd. Ett sådant tillstånd är hjärtsvikt vilket drabbar ca 2 % av västvärldens befolkning. Forskning har visat att IT-baserad hemvård för s.k. Disease Management kan resultera i minskade kostnader så väl som ökad livskvalitet hos patienterna. Inom projektet Care@Distance är avsikten att utforma ett sådant system där tyngden ligger dels på regelbundna dagliga enkla mätningar av fysiologiskt relaterade parametrar såsom vikt och blodtryck, och dels på formulär där patienten svarar på några enkla frågor om det upplevda tillståndet. Syftet är att få med både objektiv och subjektiv information som sedan kan ligga till grund för en förbättrad vård av den enskilde patienten. Systemet utformas främst för att skapa underlag för en bättre långsiktig behandling, terapi och för uppföljning av Treatment Compliance, men även för att hantera akuta situationer genom t.ex. larm till vårdgivaren. Under projektets tid har ett samarbete med DAGA-kliniken på Östra sjukhuset upprättats, genom bl.a. diskussioner om frågeformulärets utformning. Under våren 2007 har även två förstudier genomförts på kliniken, den första med inriktning mot patientdelen av systemet, och den andra mot vårdgivarsidan. Studien visar att patientdelen är lätthanterad ur patientsynpunkt samt att intresse för systemet finns. Även på vårdgivarsidan är resultaten positiva när det gäller design, funktioner och intresse, men utrymme för förbättringar finns. Fortsatta studier i form av ett längre försök i hemmet hos patienter är planerat under sommaren och hösten 2007. Under sommaren kommer även patientdelen att vidareutvecklas med ny programvara. Ett framtida projekt innefattar att utveckla en metod för att utnyttja EBI (Elektrisk Bio-Impedans). Med relativt enkla och robusta mätningar förväntas mycket användbar och relevant information om sjukdomstillståndet kunna erhållas med denna metod, men detta kräver att ny sensorteknik utvecklas för hemmiljön.
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| 47. |
- Gund, Anna, 1980, et al.
(författare)
-
Care@Distance - Home Monitoring System for CHF Patients
- 2007
-
Ingår i: Tromsø Telemedicine and eHealth Conference, 11-13 June, 2007, Tromsø, Norway.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The number of elderly people in the society is increasing, and with that the expected the health care costs. One reason for this is that the probability of contracting a chronic illness increases with age. Congestive heart failure (CHF) is a typical such illness and it affects approximately 2 % of the population in the western world. Most of the patients are over 60 years of age. By using IT-based home care solutions for follow-up, disease management and treatment compliance these costs can potentially be reduced at the same time as the care of the patient can be improved. It is a matter of patient quality as well as reduced costs. Many CHF patients tend to return to hospitals with acute conditions where they are admitted for care, only to be discharged a couple of days later. This results in considerable costs for the health care sector, and suffering and insecurity for the patient. Studies have shown that using tele-care, or eHealth, symptoms can be discovered earlier than with traditional care. There is also a better possibility to study and improve patient treatment compliance. Within Care@Distance the intention is to develop a system that can support in acute situations as well as in the long term disease management. Regular daily measurements of physiological data, such as body weight and blood pressure will be done, together with questionnaires where the patients describe their actual medical situation. The combined objective and subjective information can then form a foundation for improving the care of the individual patient. In this project the type of physiological data to be collected and the questionnaire have been defined in collaboration with the DAGA-clinic at Östra Hospital, and Institute of Health and Care Sciences at Sahlgrenska Academy, both situated in Gothenburg, Sweden. The system is build up of two parts. One is the home client and the other the system server consisting of a web portal for medical personnel together with a central database. The home client is currently a portable Tablet PC combined with a scale and a blood pressure monitor. The computer program is designed to assist the patient carrying out the different measurements and questionnaires. The results are initially stored on a local database in the home client. Measurements will be made of body weight and blood pressure and questions of the current health status of the patient will be asked. These surveys will typically be performed one or several times a day depending on the patient's health status. When the measurement session is over the local database is synchronized with a central database. Measured data and results are sent to the central database, and the home client checks for updates, new configurations, etc. Health care personnel access the information on the central database when needed through the web portal. Besides examining the patient's physiological data and questionnaire results the personnel can also administrate the home client i.e. define measurements, measurement intervals, questionnaire forms etc. Currently a first generation of the system is out on trial on healthy volunteers in order to verify the functionality of the system. So far the results are promising, and have also led to a number of improvements of both the home client and the web portal. The first clinical trial will begin in the spring of 2007 where a small trial group, identified by the DAGA-clinic, will participate. The focus of this trial is to establish and evaluate interdisciplinary work procedures and technical infrastructure. Following this the system will be stepwise developed regarding measurements and increased functionality. Of special interest in the future of this project is to develop and verify sensors based on the use of Electric Bio Impedance (EBI). This technique allows for a robust, cheap and relatively simple way to acquire physiological information of large clinical value in relation to CHF treatment e.g. heart function and fluid balance. The ambition is to develop and verify different designs of this kind of sensors, suitable for the home care environment, where user-friendliness is one important factor.
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| 48. |
- Gund, Anna, 1980, et al.
(författare)
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Care@Distance, Home Monitoring System for Patients with Congestive Heart Failure
- 2006
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Ingår i: Medicinteknikdagarna, 3-4 October 2006, Uppsala, Sweden.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Allt eftersom antalet äldre och långtidssjuka ökar i samhället, förväntas också kostnaderna för sjuk- och hälsovård att öka. Hjärtsvikt är en sjukdom som drabbar omkring 2 % av befolkningen i västvärden, och de flesta patienter är över 60 år. Denna sjukdom spelar därför tillsammans med ett antal andra vanliga åldersrelaterade sjukdomar en stor roll i denna ökning. Med hjälp av IT-baserad hemövervakning och behandlingsuppföljning av hjärtsviktspatienter kan vi potentiellt både minska sjukvårdskostnaderna och förbättra vården för den enskilda individen. Inom Care@Distance är avsikten att utforma ett sådant system där tyngden ligger dels på regelbundna dagliga enkla mätningar av fysiologiskt relaterade parametrar såsom t.ex. vikt, blodtryck och puls, och dels formulär där patienten själv beskriver sin situation. Syftet är att få med både objektiva och subjektiva resultat vilka sedan kan ligga till grund för en förbättrad vård av den enskilde patienten. Systemet utformas för att hantera såväl akuta situationer, t.ex. genom att larma vårdpersonal vid avvikelser utifrån uppsatta gränser, samt skapa underlag för en bättre långsiktig behandling och terapi. Sjukvårdskostnaderna förväntas härigenom reduceras i och med att sjukdomen kan behandlas bättre och färre akutsituationer uppstår. Dessutom, och minst lika viktigt, förväntas patientens livssituation förbättras. Både typen av mätdata samt frågeformulär utarbetas i samarbete med DAGA-kliniken på Östra sjukhuset i Göteborg och Vårdvetenskapliga fakulteten vid Sahlgrenska Akademien. Behandlingsmässigt innebär Care@Distance att patienten kommer att erbjudas likartade mätningar och frågor hemma som vid återbesök på kliniken. Skillnaden är att hemmet kan dessa frågor ställas, och mätningar göras, flera gånger om dagen, medan de på kliniken kanske bara görs varannan månad. Detta ger bl.a. vårdgivaren en större informationsmängd att fatta vårdrelaterade beslut på. De första fältförsöken kommer att ske i början av hösten 2006. En liten försöksgrupp på ca 3-5 personer, identifierade med hjälp av DAGA-kliniken på Östra sjukhuset, kommer att medverka initialt. Fokus i dessa första test är att etablera och utvärdera arbetssätt och teknisk infrastruktur. Generellt är systemet utformat för att vara mycket användarvänligt i alla delar. I ett nästa steg skall EBI (Elektrisk Bio-Impedans) testas för att om möjligt inkluderas i mätmodaliteterna. Med relativt enkla och robusta mätningar förväntas mycket användbar och relevant information om sjukdomstillståndet hos de aktuella patienterna kunna erhållas med denna metod.
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| 49. |
- Gund, Anna, 1980, et al.
(författare)
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Care@Distance – IT-baserad hemvård av hjärtsviktspatienter
- 2006
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Ingår i: Svenska Läkaresällskapets Riksstämman, 29 November - 1 December, Gothenburg, Sweden.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Allt eftersom antalet äldre och långtidssjuka ökar i samhället, förväntas också kostnaderna för sjuk- och hälsovård att öka. Hjärtsvikt är en sjukdom som drabbar omkring 2 % av befolkningen i västvärden, och de flesta patienter är över 60 år. Denna sjukdom spelar därför tillsammans med ett antal andra vanliga åldersrelaterade sjukdomar en stor roll i denna ökning. Med hjälp av IT-baserad hemövervakning och behandlingsuppföljning av hjärtsviktspatienter kan vi potentiellt både minska sjukvårdskostnaderna och förbättra vården för den enskilda individen. Inom Care@Distance är avsikten att utforma ett sådant system där tyngden ligger dels på regelbundna dagliga enkla mätningar av fysiologiskt relaterade parametrar såsom t.ex. vikt, blodtryck och puls, och dels formulär där patienten själv beskriver sin situation. Syftet är att få med både objektiva och subjektiva resultat vilka sedan kan ligga till grund för en förbättrad vård av den enskilde patienten. Systemet utformas för att hantera såväl akuta situationer, t.ex. genom att larma vårdpersonal vid avvikelser utifrån uppsatta gränser, samt skapa underlag för en bättre långsiktig behandling och terapi. Sjukvårdskostnaderna förväntas härigenom reduceras i och med att sjukdomen kan behandlas bättre och färre akutsituationer uppstår. Dessutom, och minst lika viktigt, förväntas patientens livssituation förbättras. Både typen av mätdata samt frågeformulär utarbetas i samarbete med DAGA-kliniken på Östra sjukhuset i Göteborg och Vårdvetenskapliga fakulteten vid Sahlgrenska Akademien. Behandlingsmässigt innebär Care@Distance att patienten kommer att erbjudas likartade mätningar och frågor hemma som vid återbesök på kliniken. Skillnaden är att hemmet kan dessa frågor ställas, och mätningar göras, flera gånger om dagen, medan de på kliniken kanske bara görs varannan månad. Detta ger bl.a. vårdgivaren en större informationsmängd att fatta vårdrelaterade beslut på. De första fältförsöken kommer att ske under hösten 2006. En liten försöksgrupp på ca 3-5 personer, identifierade med hjälp av DAGA-kliniken på Östra sjukhuset, kommer att medverka initialt. Fokus i dessa första test är att etablera och utvärdera arbetssätt och teknisk infrastruktur. Generellt är systemet utformat för att vara mycket användarvänligt i alla delar. I ett nästa steg skall EBI (Elektrisk Bio-Impedans) testas för att om möjligt inkluderas i mätmodaliteterna. Med relativt enkla och robusta mätningar förväntas mycket användbar och relevant information om sjukdomstillståndet hos de aktuella patienterna kunna erhållas med denna metod.
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| 50. |
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