Emil Jovanov

Guest Editorial Introduction to the Special Section on M-Health: Beyond Seamless Mobility and Global Wireless Health-Care Connectivity

M-Health can be defined as “mobile computing, medical sensor, and communications technologies for health-care.” This emerging concept represents the evolution of e-health systems from traditional desktop “telemedicine” platforms to wireless and mobile configurations. Current and emerging developments in wireless communications integrated with developments in pervasive and wearable technologies will have a radical impact on future health-care delivery systems. This editorial paper presents a snapshot of recent developments in these areas and addresses some of the challenges and future implementation issues from the m-Health perspective. The contributions presented in this special section represent some of these recent developments and illustrate the multidisciplinary nature of this important and emerging concept.

Stress monitoring using a distributed wireless intelligent sensor system

We are developing personal health monitors based on a wireless body area network (BAN) of intelligent sensors. Individual monitors will be integrated into a distributed wireless system for synchronized monitoring of a group of subjects. This system could be used during the selection process and as part of a psychophysiological evaluation of military members undergoing intense training. We use measures of heart-rate variability to quantify stress level prior to and during training as well as to predict stress resistance. This task requires reliable, high-precision instrumentation and synchronized measurements from a group of individuals over prolonged periods (days of training).

Issues in wearable computing for medical monitoring applications: a case study of a wearable ECG monitoring device

In this paper we discuss issues surrounding wearable computers used as intelligent health monitors. Unlike existing health monitors (for example, ECG and EEG holters), that are used mainly for data acquisition, the devices we discuss provide real-time feedback to the patient, either as a warning of impending medical emergency or as a monitoring aid during exercise. These medical applications are to be distinguished from applications of wearable computing for medical personnel, e.g. doctors, nurses, and emergency medical technicians. Medical monitoring applications differ from other wearable applications in their I/O requirements, sensors, reliability, privacy issues, and user interface. The paper describes a prototype wearable ECG monitor based upon a high-performance, low-power digital signal processor and the development environment for its design.

Body Area Networks for Ubiquitous Healthcare Applications: Opportunities and Challenges

Body Area Networks integrated into mHealth systems are becoming a mature technology with unprecedented opportunities for personalized health monitoring and management. Potential applications include early detection of abnormal conditions, supervised rehabilitation, and wellness management. Such integrated mHealth systems can provide patients with increased confidence and a better quality of life, and promote healthy behavior and health awareness. Automatic integration of collected information and user’s inputs into research databases can provide medical community with opportunity to search for personalized trends and group patterns, allowing insights into disease evolution, the rehabilitation process, and the effects of drug therapy. A new generation of personalized monitoring systems will allow users to customize their systems and user interfaces and to interact with their social networks. With emergence of first commercial body area network systems, a number of system design issues are still to be resolved, such as seamless integration of information and ad-hoc interaction with ambient sensors and other networks, to enable their wider acceptance. In this paper we present state of technology, discuss promising new trends, opportunities and challenges of body area networks for ubiquitous health monitoring applications.

Medical Monitoring Applications for Wearable Computing

Medical monitors have benefited from technological advances in the field of wireless communication, processing and power sources. These advances have made possible miniaturization and prolonged operating times of medical monitors, as well as their global integration into telemedical systems. This allows patients to have real-time feedback about medical conditions while going about their normal daily activities. System designers are facing specific issues related to monitor acceptability, application requirements, power consumption and system connectivity. In this paper we discuss system design issues, present a survey of existing systems and sensors, and introduce two taxonomies of medical monitoring applications for wearable computing.

Closing of Venus Flytrap by Electrical Stimulation of Motor Cells

Electrical signaling and rapid closure of the carnivorous plant Dionaea muscipula Ellis (Venus flytrap) have been attracting the attention of researchers since XIX century, but the exact mechanism of Venus flytrap closure is still unknown. We found that the electrical stimulus between a midrib and a lobe closes the Venus flytrap leaf by activating motor cells without mechanical stimulation of trigger hairs. The closing time of Venus flytrap by electrical stimulation of motor cells is 0.3 s, the same as mechanically induced closing. The mean electrical charge required for the closure of the Venus flytrap leaf is 13.6 μC. Ion channel blockers such as Ba2+, TEACl as well as uncouplers such as FCCP, 2,4-dinitrophenol and pentachlorophenol dramatically decrease the speed of the trap closing. Using an ultra-fast data acquisition system with measurements in real time, we found that the action potential in the Venus flytrap has a s a duration time of about 1.5 ms. Our results demonstrate that electrical stimulation can be used to study mechanisms of fast activity in motor cells of the plant kingdom.

Wireless Technology and System Integration in Body Area Networks for m-Health Applications

m-Health integrates mobile computing, medical sensor, and communications technologies for mobile health-care applications. Wireless body area networks (WBANs) of intelligent sensors represent an emerging technology for system integration with great potentials for unobtrusive ambulatory health monitoring during extended periods of time. However, system designers will have to resolve a number of issues, such as severe limitations of sensor weight and size necessary to improve users compliance, sensor resource constraints, intermittent availability of uplink connectivity, reliability of transmission, security, and interoperability of different platforms. We present current and emerging wireless technologies and developments in pervasive and mobile technologies that are vital for implementation of WBAN-based monitors and m-Health system integration. We emphasize the problem of reliable system operation with extremely low power consumption and discontinuous connectivity, which are typical for ambulatory monitoring

Interoperability and Security in Wireless Body Area Network Infrastructures

Wireless body are networks (WBAN) and their supporting information infrastructures offer unprecedented opportunities to monitor state of health without constraining the activities of a wearer. These mobile point-of-care systems are now realizable due to the convergence of technologies such as low-power wireless communication standards, plug-and-play device buses, off-the-shelf development kits for low-power microcontrollers, handheld computers, electronic medical records, and the Internet. To increase acceptance of personal monitoring technology while lowering equipment cost, advances must be made in interoperability (at both the system and device levels) and security. This paper presents an overview of WBAN infrastructure work in these areas currently underway in the Medical Component Design Laboratory at Kansas State University (KSU) and at the University of Alabama in Huntsville (UAH). KSU efforts include the development of wearable health status monitoring systems that utilize ISO/IEE 11073, Bluetooth, Health Level 7, and OpenEMed. WBAN efforts at UAH include the development of wearable activity and health monitors that incorporate ZigBee-compliant wireless sensor platforms with hardware-level encryption and the TinyOS development environment. WBAN infrastructures are complex, requiring many functional support elements. To realize these infrastructures through collaborative efforts, organizations such as KSU and UAH must define and utilize standard interfaces, nomenclature, and security approaches

A WBAN-based System for Health Monitoring at Home

This paper describes a prototype system for continual health monitoring at home. The system consists of an unobtrusive wireless body area network (WBAN) and a home health server. The WBAN sensors monitor users heart rate and locomotive activity and periodically upload time-stamped information to the home server. The home server may integrate this information into a local database for users inspection or it may forward the information further to a medical server. The prototype may be used for ambulatory monitoring of patients undergoing cardiac rehabilitation or for monitoring of elderly at home by informal caregivers.

Time synchronization for ZigBee networks

Time synchronization is essential for most network applications. It is particularly important in a wireless sensor network (WSN) as a means to correlate diverse measurements from a set of distributed sensor elements and synchronize clocks for shared channel communication protocols. Wireless sensors are typically designed with very stringent constraints for size, cost, and especially power consumption. The flooding time synchronization protocol (FTSP) was developed explicitly for time synchronization of mesh-connected wireless sensor networks. However, ZigBee can also accommodate master-slave networks that can be more power-efficient. We optimized the FTSP for master-slave WSNs and implemented it using TinyOS 1.1.8 and ZigBee-compliant hardware. Our approach allows better synchronization and reduced power consumption of wireless nodes. In this paper we present implementation and experimental results.