Continuous Activity Monitoring Research Articles

Bridging experimental and monitoring research for visible foliar injury as bio-indicator of ozone impacts on forests

ABSTRACT Tropospheric ozone (O3) is a phytotoxic air pollutant and the O3-induced visible foliar injury (O3 VFI) is a biomarker. A recently developed Free-air O3 eXposure (FO3X) is a promising facility to verify field-observed “O3-like” VFIs and to establish a flux-based threshold for the O3 VFI onset. The present study compared O3-like VFI registered in the southern European forest sites with actual O3 VFI observed in a FO3X experiment. The O3-like VFIs were evaluated by eye in forests and thus it was subjective. According to the imaging analysis, we firstly demonstrated that major parts of the colors were similar in the field and the FO3X. The color pallets for O3 VFI was species-specific and considered a advanced tool for the O3 VFI diagnosis. In addition, we calculated a flux-based threshold for the O3 VFI onset at the FO3X based on a Phytotoxic Ozone Dose (POD1), which ranged from 4.9 to 18.1 mmol m−2 POD1. This FO3X-derived threshold partly explained but did not necessarily match with the observation for several tree species in actual forests. The multivariate analysis showed that O3 VFI was decreased by the presence of various species and suggested the importance of continuous monitoring activities in the field for the further analysis.

When to set anticoagulant therapy in asymptomatic AF? looking for a cut-off duration.

The incidence of atrial fibrillation (AF) is progressively increasing, in line with the aging of the population and with the increase in chronic diseases. The care burden of the disease and above all to its consequences (i.e. ischaemic stroke and heart failure) significantly impacts the various health systems with forecasts of exponential increase in the near future. Clinical forms of AF, i.e. those diagnosed with electrocardiogram, have a clear correlation with systemic embolic events and also with a reduction in survival. Thromboembolic prophylaxis in these patients, with anticoagulant drugs, has in fact been shown to greatly reduce the incidence of ischaemic stroke and improve survival. In recent decades, the widespread use of therapeutic intra-cardiac devices, which allow constant and continuous monitoring of myocardial electrical activity, is bringing to light a large number of atrial high rate episodes (AHREs), which are not associated with clinical manifestation. The incidence of these findings grows linearly with the duration of the observation. More independent studies have shown that AHREs are associated with a risk of stroke that is higher (about double) than controls but significantly lower than in patients with manifest AF. However, taking into consideration patients with ischaemic stroke and wearers of implantable devices, no temporal correlation emerged between the incidence of the ischaemic episode and arrhythmia. The presence of AHRE is associated with an approximately six-fold increase in the incidence of clinical AF but only a minority of these patients meet the criteria for prescribing anticoagulation. Pending the publication of the studies still in progress, the European Society of Cardiology guidelines for the treatment of AF recommend considering the initiation of anticoagulant therapy in patients with long-lasting AHRE (> 24 h) associated with a high embolic risk. In patients with episodes of shorter duration (1-24 h), especially if with high burden, anticoagulant therapy can be considered in case of very high embolic risk (e.g. secondary prevention, CHADVASc ≥ 3).

Searching for the Sun cosmic shadow with a ground-based, portable muon telescope: The TRIPHON experiment

Objects of the Solar System can screen the cosmic rays as seen from the Earth. In particular, the cosmic shadows of the Moon and of the Sun have been observed in the last years by very large observatories. The latter can reveal details on the solar activity and magnetic field, an information which can be of high interest to better understand its internal dynamics. We report here on the possibility to perform such a study with much smaller and portable instruments. A compact muon telescope of active area 50 × 50cm2 was mounted on a motorized platform and followed the Sun during more than 7 months. By selecting muons close to the horizon, the data exhibit a small muon deficit in the direction of the Sun. These results suggest that a network of muon telescopes may be an interesting tool in the future for the continuous monitoring of the solar activity.

Effectiveness of smart wrist wearables for distinguishing physical and cognitive demands

Wrist-worn wearables, with sensors to measure physiological responses such as heart rate variability (HRV) and electrodermal activity (EDA), have been increasing and have the potential to be used for continuous monitoring. These devices have been used to detect responses in workers’ physical and cognitive demands; however, the accuracy of wrist wearables for distinguishing these demands is unknown, especially since many every day and work activities frequently require motion. The objective of this study was to evaluate the effectiveness of a wrist-worn wearable in measuring physiological changes during different demand conditions. Participants (n = 20 college students) completed a multi-factor laboratory study that considered task (cognitive/physical), difficulty (easy/hard), and motion (motion/no motion). N-back tasks and stationary bike tasks were used to represent cognitive and physical demands, respectively. Metrics of HRV and EDA were measured using reference-standard devices and a validated wrist-wearable. Significant differences between task, motion, and difficulty were observed from HRV measurements from the reference-standard and wrist-worn devices. Wrist wearables are sensitive to detecting workplace demands and may be used as an alternative to reference-standard sensors for continuous health and activity monitoring for worker health and wellness. Findings in this study can provide guidelines on task and conditions that affect the use and interpretation of wrist-worn devices for measuring cognitive and physical demands in healthcare systems. HIGHLIGHTS Applications for noninvasive, wrist-worn sensors can be used for continuous health and exercise monitoring HRV and EDA metrics obtained from wrist-worn device are sensitivity in detecting changes in task, difficulty, and motion HRV metric from wrist-worn device had agreement with reference-standard device Wrist-wearables has potential for ubiquitous health monitoring of individuals

Non-invasive brain-spine interface: Continuous control of trans-spinal magnetic stimulation using EEG.

Brain-controlled neuromodulation has emerged as a promising tool to promote functional recovery in patients with motor disorders. Brain-machine interfaces exploit this neuromodulatory strategy and could be used for restoring voluntary control of lower limbs. In this work, we propose a non-invasive brain-spine interface (BSI) that processes electroencephalographic (EEG) activity to volitionally control trans-spinal magnetic stimulation (ts-MS), as an approach for lower-limb neurorehabilitation. This novel platform allows to contingently connect motor cortical activation during leg motor imagery with the activation of leg muscles via ts-MS. We tested this closed-loop system in 10 healthy participants using different stimulation conditions. This BSI efficiently removed stimulation artifacts from EEG regardless of ts-MS intensity used, allowing continuous monitoring of cortical activity and real-time closed-loop control of ts-MS. Our BSI induced afferent and efferent evoked responses, being this activation ts-MS intensity-dependent. We demonstrated the feasibility, safety and usability of this non-invasive BSI. The presented system represents a novel non-invasive means of brain-controlled neuromodulation and opens the door towards its integration as a therapeutic tool for lower-limb rehabilitation.

Assessment of sleep and circadian rhythms of endocrine and immune function among women With advanced breast cancer

Background Previous findings indicate important effects of stress, disrupted sleep, and dysregulated circadian rhythms on the progression of cancer. Our understanding of these relationships, however, has been limited by the absence of data from 24-h continuous physiologic monitoring of hormonal and immune activity with simultaneous collection of objective sleep data. The present study successfully employed such an intensive protocol among women with advanced breast cancer. Purpose In this paper we describe our protocol in detail. We provide methodological and practical suggestions for assessing sleep and circadian rhythms in the medically ill. Finally, we offer psychological and physical safety guidelines for future studies that aim to utilize similar protocols. Results We enrolled 123 women with advanced breast cancer; 18 dropped out, 105 participated (6 provided incomplete data, and 99 completed the protocol). The protocol included: (1) psychological/medical screenings and assessments; (2) a 2-week at-home sleep study, including wrist actigraphy and two nights of polysomnography (PSG); and (3) 28 h in-hospital collection of measures of hormones and immune function, in conjunction with one night of PSG for assessing sleep stages, respiration, and leg movement. Based on the implementation challenges we faced, protocol adjustments were made to address feasibility limitations and to accommodate participant preferences and medical/physiological needs. Conclusions By combining and modifying the gold standard protocols for sleep and circadian assessments, researchers can compassionately optimize participant enrollment and protocol compliance, and minimize attrition.

Continuous Long-Term Physical Activity Monitoring in Hemodialysis Patients.

Physical inactivity is common in patients receiving hemodialysis, but activity patterns throughout the day and in relation to dialysis are largely unknown. This knowledge gap can be addressed by long-term continuous activity monitoring, but this has not been attempted and may not be acceptable to patients receiving dialysis. Ambulatory patients with end-stage kidney disease receiving thrice-weekly hemodialysis wore commercially available wrist-worn activity monitors for 6 months. Step counts were collected every 15 minutes and were linked to dialysis treatments. Physical function was assessed using the Short Physical Performance Battery (SPPB). Fast time to recovery from dialysis was defined as ≤2 hours. Mixed effects models were created to estimate step counts over time. Of 52 patients enrolled, 48 were included in the final cohort. The mean age was 60 years, and 75% were Black or Hispanic. Comorbidity burden was high, 38% were transported to and from dialysis by paratransit, and 79% had SPPB <10. Median accelerometer use (199 days) and adherence (95%) were high. Forty-two patients (of 43 responders) reported wearing the accelerometer every day, and few barriers to adherence were noted. Step counts were lower on dialysis days (3991 [95% CI, 3187 to 4796] versus 4561 [95% CI, 3757 to 5365]), but step-count intensity was significantly higher during the hour immediately after dialysis than during the corresponding time on nondialysis days (188 steps per hour increase [95% CI, 171 to 205]); these levels were the highest noted at any time. Postdialysis increases were more pronounced among patients with fast recovery time (225 [95% CI, 203 to 248] versus 134 [95% CI, 107 to 161] steps per hour) or those with SPPB ≥7. Estimates were unchanged after adjustment for demographics, diabetes status, and ultrafiltration rate. Long-term continuous monitoring of physical activity is feasible in patients receiving hemodialysis. Highly granular data collection and analysis yielded new insights into patterns of activity after dialysis treatments.

Continuous Glucose Monitoring and Physical Activity.

Continuous glucose monitoring (CGM) use has several potential positive effects on diabetes management. These benefits are, e.g., increased time in range (TIR), optimized therapy, and developed documentation. Physical activity is a recommended intervention tool in diabetes management, especially for people with type 2 diabetes (T2D). The benefits of physical activity for people with diabetes can be seen as an improvement of glycemic control, glycemic variability, and the reduction of insulin resistance. In relation to the physical activity of people with T2D, the benefits of CGM use can even be increased, and CGM can be a helpful tool to prevent adverse events due to physical activity of people with diabetes, such as hypoglycemic events and nocturnal hypoglycemia after sports. This narrative review aims to provide solid recommendations for the use of CGM in everyday life physical activities based on the noted benefits and to give a general overview of the guidelines on physical activity and CGM use for people with diabetes.

Accuracy of gait and posture classification using movement sensors in individuals with mobility impairment after stroke.

Background: Stroke leads to motor impairment which reduces physical activity, negatively affects social participation, and increases the risk of secondary cardiovascular events. Continuous monitoring of physical activity with motion sensors is promising to allow the prescription of tailored treatments in a timely manner. Accurate classification of gait activities and body posture is necessary to extract actionable information for outcome measures from unstructured motion data. We here develop and validate a solution for various sensor configurations specifically for a stroke population. Methods: Video and movement sensor data (locations: wrists, ankles, and chest) were collected from fourteen stroke survivors with motor impairment who performed real-life activities in their home environment. Video data were labeled for five classes of gait and body postures and three classes of transitions that served as ground truth. We trained support vector machine (SVM), logistic regression (LR), and k-nearest neighbor (kNN) models to identify gait bouts only or gait and posture. Model performance was assessed by the nested leave-one-subject-out protocol and compared across five different sensor placement configurations. Results: Our method achieved very good performance when predicting real-life gait versus non-gait (Gait classification) with an accuracy between 85% and 93% across sensor configurations, using SVM and LR modeling. On the much more challenging task of discriminating between the body postures lying, sitting, and standing as well as walking, and stair ascent/descent (Gait and postures classification), our method achieves accuracies between 80% and 86% with at least one ankle and wrist sensor attached unilaterally. The Gait and postures classification performance between SVM and LR was equivalent but superior to kNN. Conclusion: This work presents a comparison of performance when classifying Gait and body postures in post-stroke individuals with different sensor configurations, which provide options for subsequent outcome evaluation. We achieved accurate classification of gait and postures performed in a real-life setting by individuals with a wide range of motor impairments due to stroke. This validated classifier will hopefully prove a useful resource to researchers and clinicians in the increasingly important field of digital health in the form of remote movement monitoring using motion sensors.

Activity monitoring and patient-reported outcome measures in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome patients.

IntroductionMyalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a disease with no validated specific and sensitive biomarker, and no standard approved treatment. In this observational study with no intervention, participants used a Fitbit activity tracker. The aims were to explore natural symptom variation, feasibility of continuous activity monitoring, and to compare activity data with patient reported outcome measures (PROMs).Materials and methodsIn this pilot study, 27 patients with mild to severe ME/CFS, of mean age 42.3 years, used the Fitbit Charge 3 continuously for six months. Patients wore a SenseWear activity bracelet for 7 days at baseline, at 3 and 6 months. At baseline and follow-up they completed the Short Form 36 Health Survey (SF-36) and the DePaul Symptom Questionnaire–Short Form (DSQ-SF).ResultsThe mean number of steps per day decreased with increasing ME/CFS severity; mild 5566, moderate 4991 and severe 1998. The day-by-day variation was mean 47% (range 25%–79%). Mean steps per day increased from the first to the second three-month period, 4341 vs 4781 steps, p = 0.022. The maximum differences in outcome measures between 4-week periods (highest vs lowest), were more evident in a group of eight patients with milder disease (baseline SF-36 PF > 50 or DSQ-SF < 55) as compared to 19 patients with higher symptom burden (SF-36 PF < 50 and DSQ-SF > 55), for SF-36 PF raw scores: 16.9 vs 3.4 points, and for steps per day: 958 versus 479 steps. The correlations between steps per day and self-reported SF-36 Physical function, SF-36 Social function, and DSQ-SF were significant. Fitbit recorded significantly higher number of steps than SenseWear. Resting heart rates were stable during six months.ConclusionContinuous activity registration with Fitbit Charge 3 trackers is feasible and useful in studies with ME/CFS patients to monitor steps and resting heart rate, in addition to self-reported outcome measures.Clinical trial registrationClinicaltrials.gov: NCT04195815.

Investigating Stroke Effects on Respiratory Parameters Using a Wearable Device: A Pilot Study on Hemiplegic Patients.

Quantitatively assessing personal health status is gaining increasing attention due to the improvement of diagnostic technology and the increasing occurrence of chronic pathologies. Monitoring physiological parameters allows for retrieving a general overview of the personal health status. Respiratory activity can provide relevant information, especially when pathologies affect the muscles and organs involved in breathing. Among many technologies, wearables may represent a valid solution for continuous and remote monitoring of respiratory activity, thus reducing healthcare costs. The most popular wearables used in this arena are based on detecting the breathing-induced movement of the chest wall. Therefore, their use in patients with impaired chest wall motion and abnormal respiratory kinematics can be challenging, but literature is still in its infancy. This study investigates the performance of a custom wearable device for respiratory monitoring in post-stroke patients. We tested the device on six hemiplegic patients under different respiratory regimes. The estimated respiratory parameters (i.e., respiratory frequency and the timing of the respiratory phase) demonstrated good agreement with the ones provided by a gold standard device. The promising results of this pilot study encourage the exploitation of wearables on these patients that may strongly impact the treatment of chronic diseases, such as hemiplegia.

Long-term management of multiple sclerosis patients treated with cladribine tablets beyond year 4

ABSTRACT Introduction Oral cladribine is a highly effective pulsed selective immune reconstitution therapy licensed for relapsing multiple sclerosis (RMS) since 2017. A full treatment course comprises two treatment cycles given 1 year apart, followed by two treatment-free years. The management of cladribine-treated patients beyond year 4 needs to be addressed as patients have now passed the initial 4 years since European Medical Agency approval. Areas covered A panel of neurologists and a neuroradiologist experienced in MS treatment/monitoring evaluated clinical trial data and real-world evidence and proposed recommendations for the management of cladribine-treated patients beyond year 4. Expert opinion Continuous monitoring of disease activity during the treatment-free period is important. Subsequent management depends on the presence or absence of inflammatory disease activity, determined in the absence of consistent guidelines via practice-driven neurological decision criteria. Persisting or newly occurring inflammatory disease activity is an indication for further treatment, i.e. either re-initiation of cladribine or switching to another highly effective disease-modifying therapy. The decision to retreat or switch should be based on clinical and radiological evaluation considering disease course, treatment history, and safety aspects. In the absence of disease activity, either retreatment can be offered, or the treatment-free period can be extended under structured monitoring.

Coastal radar as a tool for continuous and fine-scale monitoring of vessel activities of interest in the vicinity of marine protected areas.

Marine protected areas (MPAs) are widely utilized for conservation of the world’s marine resources. Yet, compliance with MPA regulations remains difficult to measure because of limits to human resources and a lack of affordable technologies to automate monitoring over time. The Marine Monitor, an autonomous vessel monitoring, recording, and reporting system leveraging commercial off-the-shelf X-band marine radar to detect and track vessels, was used to monitor five nearshore California MPAs simultaneously and continuously to identify and compare site-specific use patterns over one year. Vessel tracks were classified into two movement patterns to capture likely fishing activity, “focal” or “linear”, that corresponded with local targeted species. Some illegal fishing potentially occurred at all sites (7–17% of tracks depending on site) most frequently on weekends and at mid-day, but the majority of activity occurred just outside the MPAs and in the near vicinity suggesting both a high level of compliance with regulations and awareness of MPA boundaries. Time spent engaged in potential fishing activity compared to track counts suggests that unique vessels may spend more time fishing inside area boundaries at some sites than others. The spatial distribution of activity shows distinct concentrations near MPA boundaries at all sites which strongly suggests vessels purposefully target the narrow area at the MPA boundary or “fish the line”, a potential acknowledgement of successful spillover. This activity increased significantly during some local fishing seasons. Concentration of activity at MPA boundaries highlights the importance of continuous monitoring at a high spatial and temporal resolution. Reporting of vessel behavior at a fine-scale using radar can help resource managers target enforcement efforts and understand human use patterns near coastal MPAs.

A Wearable Wideband Analog Bio-Impedance Analyzer for Real-Time Monitoring of Human Physiology.

Continuous monitoring of electrophysiological activities of the human body is a significant step toward the effective prognosis, diagnosis, and management of functional disorders and cardiovascular diseases. This paper presents the development of a wireless system for the real-time acquisition of hemodynamics data and ambulatory monitoring of body composition based on electrical bio-impedance (Bio-Z) analysis. The developed system is composed of a low-power wearable unit and a stationary unit connected to a computer. The system conducts the non-radiative non-invasive Bio-Z analysis over a wide bandwidth of 1 MHz through four independent channels. The proposed analog approach detects the physiological activity by extracting the magnitude of the mixed Bio-Z signal, in real-time. A graphical user interface was designed for monitoring, analysis, and storage of the processed data. Moreover, the amplitude and frequency of the electrical excitation signals can be instructed through the user interface, wirelessly. Bench-top validation of the system demonstrated the delivery of current signals over a wide frequency range of 1 kHz - 1 MHz and peak-to-peak amplitude of up to 20 mA. Besides, the system was able to detect the magnitude of the envelope of the mixed signal with amplitude modulation depths as low as 0.1 %. Clinical Relevance- The system provides the real-time monitoring of cardiac activity and blood pulsation in human arteries. In addition, due to the configurability of the frequency and amplitude of the current injection circuit, the system is an excellent candidate to be utilized for real-time medical imaging through electrical bio-impedance tomography as well as electrical bio-impedance spectroscopy.

Quantification of nitrogen and phosphorus inputs from farming activities into the water bodies in the Leningrad and Kaliningrad regions.

Agricultural intensification leads to higher diffuse environmental pollution. Successful pollution control requires the continuous monitoring of farming activities, reliable baseline data, and tested computational models for the quantitative assessment of diffuse loads. The study aimed to quantify the diffuse inputs of manure nitrogen (N) and phosphorus (P) to the marine environment from large livestock farms and to identify the lowering effect of the best available techniques of manure/organic fertiliser handling. The study area was the Leningrad and Kaliningrad regions, found in the Russian part of the Baltic Sea catchment area. The total diffuse load in 2017 was estimated by the Russian and Belarus methodologies based on the calculations of the livestock density and the total field application of nitrogen and phosphorus with organic fertilisers. In the Leningrad Region, it was 4571.53 t N year-1 and 280.01 t P year-1; in the Kaliningrad Region-6132.48 t N year-1 and 372.32 t P year-1. The introduction of relevant best available techniques and the supply of all farms with waterproof manure storages and pads could reduce the diffuse load on the catchment in the Leningrad region by 1078.07 t N year-1 and 55.5 t P year-1 and in the Kaliningrad Region-by 1060.43 t N year-1 and 40.5 t P year-1. Such a reduction would provide a marked contribution to fulfilling the nutrient input ceilings set for the Russian Federation under the Helsinki Commission (HELCOM) Baltic Sea Action Plan.

APPLICATION OF MODERN INFORMATION TECHNOLOGIES OF FEEDBACK IN IMPACT MARTIAL ARTS ON THE EXAMPLE OF TAEKWONDO WTF

The article deals with topical issues related to the use of feedback information technologies. Since there are not so many studies on this topic, the review includes information on the example of other sports where research is already being carried out, as well as preliminary own research obtained on the example of athletes of percussion martial arts, taekwondo WTF. The study examines the main parameters of the kinematics of the movement of athletes, the study of which allows us to evaluate their effectiveness, and the magnitude of the impact, primarily when assessing the external side of the load. Feedback information technologies for continuous monitoring of motor activity are currently informative, reliable tools in the work of coaches, the information from which helps to plan the training process and carry out the continuous process of training an athlete both in different periods of the annual cycle and during the recovery period.&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt; Article visualizations:&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;img src="/-counters-/edu_01/0933/a.php" alt="Hit counter" /&gt;&lt;/p&gt;

Monitoring of sedation in mechanically ventilated patients using remote technology.

Two years of coronavirus disease 2019 (COVID-19) pandemic highlighted that excessive sedation in the ICU leading to coma and other adverse outcomes remains pervasive. There is a need to improve monitoring and management of sedation in mechanically ventilated patients. Remote technologies that are based on automated analysis of electroencephalogram (EEG) could enhance standard care and alert clinicians real-time when severe EEG suppression or other abnormal brain states are detected. High rates of drug-induced coma as well as delirium were found in several large cohorts of mechanically ventilated patients with COVID-19 pneumonia. In patients with acute respiratory distress syndrome, high doses of sedatives comparable to general anesthesia have been commonly administered without defined EEG endpoints. Continuous limited-channel EEG can reveal pathologic brain states such as burst suppression, that cannot be diagnosed by neurological examination alone. Recent studies documented that machine learning-based analysis of continuous EEG signal is feasible and that this approach can identify burst suppression as well as delirium with high specificity. Preventing oversedation in the ICU remains a challenge. Continuous monitoring of EEG activity, automated EEG analysis, and generation of alerts to clinicians may reduce drug-induced coma and potentially improve patient outcomes.

Multi-level continuous monitoring of indoor radon activity

We present the results of an experiment taking place inside the geophysical museum of Rocca di Papa (Rome, Italy), where the high radon levels detected might pose a risk to the health of workers and of the public audience. As a first step towards the mitigation of potential exposure risk, four active sensors were installed at different floors of the building, in order to continuously monitor not only radon exhalation from the soil but also its transport from the ground up to elevated floors. Collecting more than three years of data of radon concentration enables us to identify fluctuations over both short and seasonal scales and to elucidate the relation between radon variations and changes of internal temperature and relative humidity. The analysis of such dataset reveals how the healthiness of indoor environments in terms of radon concentration is controlled by a number of factors, including the environmental conditions and the use of heating and ventilation systems. Finally, the continuous radon monitoring at different levels of the building provides a unique chance to trace the vertical radon diffusion, allowing to make a first-order estimate of upward radon velocity.

Interpolation Methods to Improve Data Quality of Indoor Positioning Data for Dairy Cattle

Position data from real-time indoor positioning systems are increasingly used for studying individual cow behavior and social behavior in dairy herds. However, missing data challenges achieving reliable continuous activity monitoring and behavior studies. This study investigates the pattern of missing data and alternative interpolation methods in ultra-wideband based real-time indoor positioning systems in a free-stall barn. We collected 3 months of position data from a Swedish farm with around 200 cows. Data sampled for 6 days from 69 cows were used in subsequent analyzes to determine the location and duration of missing data. Data from 20 cows with the most reliable tags were selected to compare the effects of four different interpolation methods (previous, linear interpolation, cubic spline data interpolation and modified Akima interpolation). By comparing the observed data with the interpolations of the simulated missing data, the mean error distance varied from around 55 cm, using the previously last observed position, to around 17 cm for modified Akima. Modified Akima interpolation has the lowest error distance for all investigated activities (rest, walking, standing, feeding). Larger error distances were found in areas where the cows walk and turn, such as the corner between feeding and cubicles. Modified Akima interpolation is expected to be useful in the subsequent analyses of data gathered using real-time indoor positioning systems.

Feasibility of Wearable-Based Remote Monitoring in Patients During Intensive Treatment for Aggressive Hematologic Malignancies.

Intensive treatment protocols for aggressive hematologic malignancies harbor a high risk of serious clinical complications, such as infections. Current techniques of monitoring vital signs to detect such complications are cumbersome and often fail to diagnose them early. Continuous monitoring of vital signs and physical activity by means of an upper arm medical wearable allowing 24/7 streaming of such parameters may be a promising alternative. This single-arm, single-center observational trial evaluated symptom-related patient-reported outcomes and feasibility of a wearable-based remote patient monitoring. All wearable data were reviewed retrospectively and were not available to the patient or clinical staff. A total of 79 patients (54 inpatients and 25 outpatients) participated and received standard-of-care treatment for a hematologic malignancy. In addition, the wearable was continuously worn and self-managed by the patient to record multiple parameters such as heart rate, oxygen saturation, and physical activity. Fifty-one patients (94.4%) in the inpatient cohort and 16 (64.0%) in the outpatient cohort reported gastrointestinal symptoms (diarrhea, nausea, and emesis), pain, dyspnea, or shivering in at least one visit. With the wearable, vital signs and physical activity were recorded for a total of 1,304.8 days. Recordings accounted for 78.0% (63.0-88.5; median [interquartile range]) of the potential recording time for the inpatient cohort and 84.6% (76.3-90.2) for the outpatient cohort. Adherence to the wearable was comparable in both cohorts, but decreased moderately over time during the trial. A high adherence to the wearable was observed in patients on intensive treatment protocols for a hematologic malignancy who experience high symptom burden. Remote patient monitoring of vital signs and physical activity was demonstrated to be feasible and of primarily sufficient quality.