Open Access
Formalize clinical processes into electronic health information systems: modelling a screening service for diabetic retinopathy
(Elsevier, 2015-06-14) Eguzkitza Diego, Aitor; Trigo Vilaseca, Jesús Daniel; Martínez de Espronceda Cámara, Miguel; Serrano Arriezu, Luis Javier; Andonegui Navarro, José; Ciencias de la Salud; Osasun Zientziak; Ingeniería Eléctrica, Electrónica y de Comunicación; Ingeniaritza Elektrikoa, Elektronikoa eta Telekomunikazio Ingeniaritza; Institute of Smart Cities - ISC; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Most healthcare services use information and communication technologies to reduce and redistribute the workload associated with follow-up of chronic conditions. However, the lack of normalization of the information handled in and exchanged between such services hinders the scalability and extendibility. The use of medical standards for modelling and exchanging information, especially dual-model based approaches, can enhance the features of screening services. Hence, the approach of this paper is twofold. First, this article presents a generic methodology to model patient-centered clinical processes. Second, a proof of concept of the proposed methodology was conducted within the diabetic retinopathy (DR) screening service of the Health Service of Navarre (Spain) in compliance with a specific dual-model norm (openEHR). As a result, a set of elements required for deploying a model-driven DR screening service has been established, namely: clinical concepts, archetypes, termsets, templates, guideline definition rules, and user interface definitions. This model fosters reusability, because those elements are available to be downloaded and integrated in any healthcare service, and interoperability, since from then on such services can share information seamlessly.
Open Access
Defining and scoping participatory health informatics - an eDelphi study
(Georg Thieme Verlag, 2023) Denecke, Kerstin; Rivera Romero, Octavio; Petersen, Carolyn; Benham-Hutchins, Marge; Cabrer, Miguel; Davies, Shauna; Grainger, Rebecca; Hussein, Rada; López-Campos, Guillermo; Martín-Sánchez, Fernando; Mckillop, Mollie; Merolli, Mark; Miron-Shatz, Talya; Trigo Vilaseca, Jesús Daniel; Wright, Graham; Wynn, Rolf; Hullin, Carol; Gabarron, Elia; Ingeniería Eléctrica, Electrónica y de Comunicación; Institute of Smart Cities - ISC; Ingeniaritza Elektrikoa, Elektronikoaren eta Telekomunikazio Ingeniaritzaren
Background Health care has evolved to support the involvement of individuals in decision making by, for example, using mobile apps and wearables that may help empower people to actively participate in their treatment and health monitoring. While the term “participatory health informatics” (PHI) has emerged in literature to describe these activities, along with the use of social media for health purposes, the scope of the research field of PHI is not yet well defined. Objective This article proposes a preliminary definition of PHI and defines the scope of the field. Methods We used an adapted Delphi study design to gain consensus from participants on a definition developed from a previous review of literature. From the literature we derived a set of attributes describing PHI as comprising 18 characteristics, 14 aims, and 4 relations. We invited researchers, health professionals, and health informaticians to score these characteristics and aims of PHI and their relations to other fields over three survey rounds. In the first round participants were able to offer additional attributes for voting. Results The first round had 44 participants, with 28 participants participating in all three rounds. These 28 participants were gender-balanced and comprised participants from industry, academia, and health sectors from all continents. Consensus was reached on 16 characteristics, 9 aims, and 6 related fields. Discussion The consensus reached on attributes of PHI describe PHI as a multidisciplinary field that uses information technology and delivers tools with a focus on individual-centered care. It studies various effects of the use of such tools and technology. Its aims address the individuals in the role of patients, but also the health of a society as a whole. There are relationships to the fields of health informatics, digital health, medical informatics, and consumer health informatics. Conclusion We have proposed a preliminary definition, aims, and relationships of PHI based on literature and expert consensus. These can begin to be used to support development of research priorities and outcomes measurements.
Open Access
Building standardized and secure mobile health services based on social media
(MDPI, 2020) Trigo Vilaseca, Jesús Daniel; Rubio, Óscar J.; Martínez de Espronceda Cámara, Miguel; Alesanco, Álvaro; Alenza García, José Francisco; Serrano Arriezu, Luis Javier; Ingeniaritza Elektrikoa, Elektronikoaren eta Telekomunikazio Ingeniaritzaren; Institute of Smart Cities - ISC; Ingeniería Eléctrica, Electrónica y de Comunicación; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa, PJUPNA29
Mobile devices and social media have been used to create empowering healthcare services. However, privacy and security concerns remain. Furthermore, the integration of interoperability biomedical standards is a strategic feature. Thus, the objective of this paper is to build enhanced healthcare services by merging all these components. Methodologically, the current mobile health telemonitoring architectures and their limitations are described, leading to the identification of new potentialities for a novel architecture. As a result, a standardized, secure/private, social-media-based mobile health architecture has been proposed and discussed. Additionally, a technical proof-of-concept (two Android applications) has been developed by selecting a social media (Twitter), a security envelope (open Pretty Good Privacy (openPGP)), a standard (Health Level 7 (HL7)) and an information-embedding algorithm (modifying the transparency channel, with two versions). The tests performed included a small-scale and a boundary scenario. For the former, two sizes of images were tested; for the latter, the two versions of the embedding algorithm were tested. The results show that the system is fast enough (less than 1 s) for most mHealth telemonitoring services. The architecture provides users with friendly (images shared via social media), straightforward (fast and inexpensive), secure/private and interoperable mHealth services.
Open Access
Multimodal minimally invasive wearable technology for epilepsy monitoring: a feasibility study of the periauricular area
(IEEE, 2023) Besné, Guillermo M.; López Iturri, Peio; Alegre, Manuel; Artieda, Julio; Trigo Vilaseca, Jesús Daniel; Serrano Arriezu, Luis Javier; Falcone Lanas, Francisco; Valencia Ustárroz, Miguel; Institute of Smart Cities - ISC
Ambulatory monitoring is of great interest in both clinical and domestic environments. Despite the technological advances, few monitoring solutions are suitable for medical application and diagnosis. Here, we investigate the feasibility of targeting the periauricular area (ear pavilion, ear canal, and the surrounding skin areas) to implement a multimodal system that fulfills the requirements of ergonomics and minimal obstructiveness in the context of epilepsy monitoring. Six physiological signals are selected and explored for their integration in the area of interest and a ¿proof-of-concept¿ prototype integrating the components in a single portable device targeting the selected location is implemented. Results show mixed results where some parameters are highly reliable, and others are impractical or require customized technology to provide clinically relevant information. To enable data acquisition, storage, and processing within the Internet of Medical Things paradigms, wireless body area transceiver integration is also analyzed in terms of coverage/capacity relations, showing feasibility for such device configuration.
Open Access
Development and validation of a smart system for medullation and diameter assessment of alpaca, llama and mohair fibres
(Elsevier, 2023) Quispe Bonilla, Max David; Quispe Bonilla, Christian; Serrano Arriezu, Luis Javier; Trigo Vilaseca, Jesús Daniel; Bengoechea, J. J.; Quispe Peña, Edgar; Institute of Smart Cities - ISC; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Medullated fibres, due to their higher resistance to bending and pressure, constitute a problem for the textile industry. Thus, having practical instruments to identify them is essential. Therefore, the aim of this research was to develop and validate a novel, swift, automatic system (referred to as S-Fiber Med) for medullation and diameter assessment of animal fibres based on artificial intelligence. The medullation of 88 samples of alpaca, llama and mohair fibres (41, 43 and 4, respectively) was evaluated. Additionally, 269 samples of alpacas were considered for average fibre diameter (AFD) and the results were compared with the Portable Fiber Tester (PFT) and Optical Fibre Diameter Analyser (OFDA) methods (72 and 197 samples, respectively). The preparation of each sample to be analysed followed the procedure described in IWTO-8-2011. Version 5 of “You Only Look Once” and DenseNet models were used to recognise the type of medullation and diameter of the fibres, respectively. Within each image (n = 661 for alpaca), all fibres were labelled (as Non-Medullated, Fragmented Medulla, Uncontinuous Medulla, Continuous Medulla and Strongly Medullated) using the LabelImg tool. Data augmentation technique was applied to obtain 3 966 images. Such data set was divided into 3 576 and 390 images for training and test data, respectively. For mohair samples (n = 321), a similar process was carried out. The data to train the model used to infer the diameter contained 16 446 fibres labelled with his respective AFD. A complementary hardware composed of three subsystems (mechanical, electronic, and optical) was developed for evaluation purposes. T-test, Pearson and Concordance correlation, Bland-Altman plot and linear regression analyses were used to validate and compare the S-Fiber Med with other methods. Results indicate that there was no significant difference between medullation percentage obtained with the projection microscope and the S-Fiber Med. The Pearson and Concordance correlation analysis shows a strong, high and significant relationship (P-value < 0.001). The AFDs of alpaca and llama fibre samples obtained with the two methods are very similar, because no significant difference was found at the t-test (P-value > 0.172), and they have a strong, high and significant relationship between them, given the high Pearson correlation value (r ≥ 0.96 with P-value < 0.001), high Concordance coefficient and bias correction factor. Similar results were found when PFT and OFDA100 were compared with S-Fiber Med. As a conclusion, this new system provides precise, accurate measurements of medullation and AFD in an expeditious fashion (40 seconds/sample).
Open Access
Smart cities, IoT y salud: retos de Internet of medical things (IoMT)
(Sociedad Española de Informática de la Salud, 2018) Trigo Vilaseca, Jesús Daniel; Serrano Arriezu, Luis Javier; Astrain Escola, José Javier; Falcone Lanas, Francisco; Institute of Smart Cities - ISC
La innovación tecnológica aplicada al ámbito de la salud está permitiendo el rápido desarrollo de la internet de los dispositivos médicos, o en su versión inglesa más aceptada internet of medical things (iomt). En este artículo se pretende dar una visión general de las posibilidades y retos de estas tecnologías, la cuales deben imbricarse como pilar fundamental en el desarrollo de estrategias locales, regionales y estatales de las ciudades inteligentes o smart cities.
Open Access
Future wireless communication systems to enable IoMT services and applications
(CRC Press, 2023) Trigo Vilaseca, Jesús Daniel; Astrain Escola, José Javier; Serrano Arriezu, Luis Javier; Falcone Lanas, Francisco; Ingeniería Eléctrica, Electrónica y de Comunicación; Ingeniaritza Elektrikoa, Elektronikoa eta Telekomunikazio Ingeniaritza; Estadística, Informática y Matemáticas; Estatistika, Informatika eta Matematika
Wireless communication systems play a key role in the adoption of IoMT services and applications, owing to inherent mobility capabilities, providing highly scalable and flexible deployments. In this chapter, the framework for IoMT wireless communication system evolution, from current LPWAN/5G connectivity to future B5G systems, focusing on sub THz (mainly in the 100 GHz to 300 GHz frequency range) and THz bands (up to 10 THz) is described. Further, the requirements in terms of device integration, node density, interference and energy handling is also discussed. The specific requirements in terms of wearable devices, considering intra-body, on-body and off-body communication links, coverage/capacity estimations for different case uses considering different communication link types are also presented. At last, different application scenarios, such as the evolution of current IoMT applications towards sensing networks, and security as well as interoperability and standardization aspects within the IoMT communication framework are discussed in detail.
Open Access
Implementation and operational analysis of an interactive intensive care unit within a smart health context
(MDPI, 2018) López Iturri, Peio; Aguirre Gallego, Erik; Trigo Vilaseca, Jesús Daniel; Astrain Escola, José Javier; Azpilicueta Fernández de las Heras, Leyre; Serrano Arriezu, Luis Javier; Villadangos Alonso, Jesús; Falcone Lanas, Francisco; Ingeniaritza Elektrikoa eta Elektronikoa; Matematika eta Informatika Ingeniaritza; Institute of Smart Cities - ISC; Ingeniería Eléctrica y Electrónica; Ingeniería Matemática e Informática
In the context of hospital management and operation, Intensive Care Units (ICU) are one of the most challenging in terms of time responsiveness and criticality, in which adequate resource management and signal processing play a key role in overall system performance. In this work, a context aware Intensive Care Unit is implemented and analyzed to provide scalable signal acquisition capabilities, as well as to provide tracking and access control. Wireless channel analysis is performed by means of hybrid optimized 3D Ray Launching deterministic simulation to assess potential interference impact as well as to provide required coverage/capacity thresholds for employed transceivers. Wireless system operation within the ICU scenario, considering conventional transceiver operation, is feasible in terms of quality of service for the complete scenario. Extensive measurements of overall interference levels have also been carried out, enabling subsequent adequate coverage/capacity estimations, for a set of Zigbee based nodes. Real system operation has been tested, with ad-hoc designed Zigbee wireless motes, employing lightweight communication protocols to minimize energy and bandwidth usage. An ICU information gathering application and software architecture for Visitor Access Control has been implemented, providing monitoring of the Boxes external doors and the identification of visitors via a RFID system. The results enable a solution to provide ICU access control and tracking capabilities previously not exploited, providing a step forward in the implementation of a Smart Health framework.
Open Access
Application of artificial intelligence and digital images analysis to automatically determine the percentage of fiber medullation in alpaca fleece samples
(Elsevier Science, 2022) Quispe Bonilla, Max David; Serrano Arriezu, Luis Javier; Trigo Vilaseca, Jesús Daniel; Quispe Bonilla, Christian; Poma Gutiérrez, Adolfo; Quispe Peña, Edgar; Ingeniaritza Elektrikoa, Elektronikoaren eta Telekomunikazio Ingeniaritzaren; Institute of Smart Cities - ISC; Ingeniería Eléctrica, Electrónica y de Comunicación; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
The aim of this research is to develop and validate two computer programs based on artificial intelligence (AI) and digital image analysis (DIA) in order to determine the incidence of medullation in white alpaca fibers. Two data sets were analyzed: 76 samples of Huacaya alpaca fibers obtained from Huancavelica, Peru, and 200 samples of white alpacas of two genotypes (Huacaya, n =100; Suri, n = 100), obtained from Arequipa, Peru. The preparation of each sample followed the procedure described in IWTO-8-2011. The Pytorch framework was used to generate several training models based on the You Only Look at Once (YOLO) architecture. Circa 4000 pictures of fibers were taken and 661 of them were selected as representative. Using the LabelImg software, the fibers present in each representative picture (approximately 10 fibers/picture) were labeled as one of these two classes: either medullated or non-medullated. Subsequently, the data augmentation technique was applied to expand the data set to 3966 photographs. Thus, 90 of them were used as initial validation data, while the reaming 3876 pictures (containing a total of 23,964 labeled fibers) were used as training data. Matlab was used to develop the DIA-based software. More specifically, algorithms of pre-processing, segmentation, smoothing, skeletonization and Hough transform were implemented to detect medullated and non-medullated fibers. Correlation and linear regression analyses were used to evaluate the models. The medullation percentage results show that there is no statistically significant difference between the AI-based method and the projection microscope method (p-value = 0.668 and 0.672 for the t-student and Wilcoxon tests, respectively). Moreover, the correlation of each of the developed computer methods with the projection microscope method is very strong (r = 0.99 and 0.97). This confirms the software ability to perform the recognition of fibers with and without medullation. Similar results (p-value = 0.357) were obtained when comparing the projection microscope method and DIA-based software method. Finally, using the proposed framework, the average time required to analyze a sample was 19.44 s. As a result, this software allows the implementation of practical, precise, and efficient methodologies to determine the incidence of medullation of alpaca fibers.
Open Access
Classification of south american camelid and goat fiber samples based on fourier transform infrared spectroscopy and machine learning
(Taylor and Francis Group, 2024) Quispe Bonilla, Max David; Trigo Vilaseca, Jesús Daniel; Serrano Arriezu, Luis Javier; Huere, Jorge; Quispe Peña, Edgar; Beruete Díaz, Miguel; Institute of Smart Cities - ISC; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa.
Some animal fibers are considerably cheaper than others. Hence the existence of counterfeit products, which are detrimental to legitimate producers and consumers alike. Fourier-Transform Infrared (FTIR) spectroscopy can extract a characteristic waveform from fibers that can be later used for classification. However, visually inspecting such waveforms is imprecise. Previous research has complemented FTIR with other mathematical or physical methods to improve accuracy. In parallel, Artificial Intelligence (AI) is an emerging field that could be helpful in this domain. The objective of this work is therefore to develop and validate two machine learning models, namely, Deep Neural Networks (DNN) and Support Vector Machine (SVM) to classify spectra of fibers by species. The spectra are acquired using an FTIR spectrometer in Attenuated Total Reflectance (ATR) mode (FTIR-ATR). Camelid (alpaca: n = 51, llama: n = 50, vicuña: n = 50) and goat (mohair: n = 35 and cashmere: n = 20) samples were evaluated, from which 1236 FTIR-ATR spectra were obtained. Some visual differences were observed between the spectra of the different species. Accuracies up to 96.75% and 95.12% were obtained when evaluating the DNN and SVM models. Furthermore, an accuracy of 97.8% was obtained when evaluating the FTIR-ATR spectra of South American Camelids (SAC) fibers with DNN, and 97.2% when evaluating them with SVM. A 100% accuracy was obtained when evaluating the FTIR-ATR spectra of vicuña fibers with both models. No significant differences were found (p-value = 0.368) by comparing the number of hits against the total number of alpaca, llama, vicuña, mohair and cashmere fibers using DNN. As per the results, it seems that DNN is more accurate than SVM. In conclusion, FTIR-ATR spectrometry techniques combined with machine learning models are a reliable alternative for the identification of SAC and goats through the spectrum of their fibers.