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Computer Methods and Programs in... Jan 2022This paper presents an empirical study of a gamified mobile-based assessment approach that can be used to engage students and improve their educational performance.
BACKGROUND AND OBJECTIVE
This paper presents an empirical study of a gamified mobile-based assessment approach that can be used to engage students and improve their educational performance.
METHOD
A gamified audience response system called G-SIDRA was employed. Three gamification elements were used to motivate students in classroom activities: badges for achievements to increase engagement, points to indicate progression and performance in the subject and ranking for promoting competitiveness. A total of 90 medical students in a General and Descriptive Anatomy of the Locomotor System course were taught using G-SIDRA in the academic year 2019/2020. Smart bracelets were configured to collect heart rate measurements from 30 students with the aim of evaluating the impact of the gamification elements. The control group consisted of a sample of 110 students enrolled on the same course in the academic year 2016/2017 using non-gamified SIDRA.
RESULTS
Statistically significant differences were found between multiple choice questions (MCQ) scores obtained by using SIDRA and G-SIDRA in the four experiments (U = 1.621,50, p < 0,01 for Exp1; U = 1.950,00, p < 0,01 for Exp2; U = 955,00, p < 0,01 for Exp3; U = 2.335,00, p < 0,01 for Exp4). In the students' final exam grades, statistically significant differences between students that used G-SIDRA as opposed to SIDRA (T(157) = 3.992; p = 0.044) were obtained. Concerning gamification elements, statistically significantly differences were found in comparing the pulse increases after and before the badge event in the four experiments (U = 2.484,00, p = 0,038 for Exp1; U = 2.109,50, p = 0,046 for Exp2; U = 1.790,50, p = 0,025 for Exp3; U = 1.557,0, p = 0,048 for Exp4). However, there are not statistically significant differences between the pulse increases after and before the ranking event in the four experiments. In a 5-point Likert-type scale, the students expressed satisfaction with G-SIDRA (M = 4.552) and thought the system helped to better understand both theoretical and practical concepts (M = 4.092). Their global assessment of the G-SIDRA platform was 4.471.
CONCLUSIONS
Of the three gamification elements used in the study, only badge has an effect on heart rate. Better student responses and academic performance were achieved when using G-SIDRA. Nevertheless, more research is required to evaluate the impact of the gamification elements on the motivation, engagement and performance of students. Physiological measures are promising approaches for gamification elements evaluation.
Topics: Gamification; Heart Rate; Humans; Motivation
PubMed: 34768233
DOI: 10.1016/j.cmpb.2021.106459 -
BMC Infectious Diseases Oct 2023Pneumonia is the leading infectious cause of mortality worldwide and one of the most common lower respiratory tract infections that is contributing significantly to the...
BACKGROUND
Pneumonia is the leading infectious cause of mortality worldwide and one of the most common lower respiratory tract infections that is contributing significantly to the burden of antibiotic consumption. The study aims to identify the determinants of the progress of pulse rate, body temperature and time to recovery of pneumonia patients.
METHOD
A prospective cohort study design was used from Felege Hiwot referral hospital on 214 sampled pneumonia patients from March 01, 2022 up to May 31, 2022. The Kaplan-Meier survival estimate and Log-Rank test was used to compare the survival time. Joint model of bivariate longitudinal and time to event model was used to identify factors of longitudinal change of pulse rate and body temperature with time to recovery jointly.
RESULT
As the follow up time of pneumonia patient's increase by one hour the average longitudinal change of pulse rate and body temperature were decreased by 0.4236 bpm and 0.0119 [Formula: see text]. The average longitudinal change of pulse rate and body temperature of patients who lived in rural was 1.4602 bpm and 0.1550 [Formula: see text] times less as compared to urban residence. Patients who had dangerous signs are significantly increased the average longitudinal change of pulse rate and body temperature by 2.042 bpm and 0.6031 [Formula: see text] as compared to patients who had no dangerous signs. A patient from rural residence was 1.1336 times more likely to experience the event of recovery as compared to urban residence. The estimated values of the association parameter for pulse rate and body temperature were -0.4236 bpm and -0.0119 respectively, which means pulse rate and body temperature were negatively related with patients recovery time.
CONCLUSION
Pulse rate and body temperature significantly affect the time to the first recovery of pneumonia patients who are receiving treatment. Age, residence, danger sign, comorbidity, baseline symptom and visiting time were the joint determinant factors for the longitudinal change of pulse rate, body temperature and time to recovery of pneumonia patients. The joint model approach provides precise dynamic predictions, widespread information about the disease transitions, and better knowledge of disease etiology.
Topics: Humans; Body Temperature; Heart Rate; Prospective Studies; Pneumonia; Patients
PubMed: 37828463
DOI: 10.1186/s12879-023-08646-6 -
CMAJ : Canadian Medical Association... Feb 2024
Topics: Humans; COVID-19; Oximetry; Heart Rate
PubMed: 38346783
DOI: 10.1503/cmaj.230221 -
Annual International Conference of the... Jul 2022Continuous clinical grade measurement of SpO in out-of-hospital settings remains a challenge despite the widespread use of photoplethysmography (PPG) based wearable...
Continuous clinical grade measurement of SpO in out-of-hospital settings remains a challenge despite the widespread use of photoplethysmography (PPG) based wearable devices for health and wellness applications. This article presents two SpO algorithms: PRR (pulse rate derived ratio-of-ratios) and GPDR (green-assisted peak detection ratio-of-ratios), that utilize unique pulse rate frequency estimations to isolate the pulsatile (AC) component of red and infrared PPG signals and derive SpO measurements. The performance of the proposed SpO algorithms are evaluated using an upper-arm wearable device derived green, red, and infrared PPG signals, recorded in both controlled laboratory settings involving healthy subjects (n=36) and an uncontrolled clinic application involving COVID-19 patients (n=52). GPDR exhibits the lowest root mean square error (RMSE) of 1.6±0.6% for a respiratory exercise test, 3.6 ±1.0% for a standard hypoxia test, and 2.2±1.3% for an uncontrolled clinic use-case. In contrast, PRR provides relatively higher error but with greater coverage overall. Mean error across all combined datasets were 0.2±2.8% and 0.3±2.4% for PRR and GPDR respectively. Both SpO algorithms achieve great performance of low error with high coverage on both uncontrolled clinic and controlled laboratory conditions.
Topics: COVID-19; Heart Rate; Humans; Oximetry; Oxygen Saturation; Wearable Electronic Devices
PubMed: 36086022
DOI: 10.1109/EMBC48229.2022.9871461 -
Physiological Reports Jul 2022The present study aims to analyze the systemic response to auditory stimulation by means of hemodynamic (cephalic and peripheral) and autonomic responses in a broad...
The present study aims to analyze the systemic response to auditory stimulation by means of hemodynamic (cephalic and peripheral) and autonomic responses in a broad range of auditory intensities (70.9, 77.9, 84.5, 89.5, 94.5 dBA). This approach could help to understand the possible influence of the autonomic nervous system on the cephalic blood flow. Twenty-five subjects were exposed to auditory stimulation while electrodermal activity (EDA), photoplethysmography (PPG), electrocardiogram, and functional near-infrared spectroscopy signals were recorded. Seven trials with 20 individual tones, each for the five intensities, were presented. The results showed a differentiated response to the higher intensity (94.5 dBA) with a decrease in some peripheral signals such as the heart rate (HR), the pulse signal, the pulse transit time (PTT), an increase of the LFnu power in PPG, and at the head level a decrease in oxygenated and total hemoglobin concentration. After the regression of the visual channel activity from the auditory channels, a decrease in deoxyhemoglobin in the auditory cortex was obtained, indicating a likely active response at the highest intensity. Nevertheless, other measures, such as EDA (Phasic and Tonic), and heart rate variability (Frequency and time domain) showed no significant differences between intensities. Altogether, these results suggest a systemic and complex response to high-intensity auditory stimuli. The results obtained in the decrease of the PTT and the increase in LFnu power of PPG suggest a possible vasoconstriction reflex by a sympathetic control of vascular tone, which could be related to the decrease in blood oxygenation at the head level.
Topics: Acoustic Stimulation; Auditory Cortex; Heart Rate; Hemodynamics; Humans; Photoplethysmography
PubMed: 35785451
DOI: 10.14814/phy2.15372 -
Physics in Medicine and Biology Sep 2023. Commercial electron FLASH platforms deliver ultra-high dose rate doses at discrete combinations of pulse parameters including pulse width (PW), pulse repetition...
. Commercial electron FLASH platforms deliver ultra-high dose rate doses at discrete combinations of pulse parameters including pulse width (PW), pulse repetition frequency (PRF) and number of pulses (), which dictate unique combinations of dose and dose rates. Additionally, collimation, source to surface distance, and airgaps also vary the dose per pulse (DPP). Currently, obtaining pulse parameters for the desired dose and dose rate is a cumbersome manual process involving creating, updating, and looking up values in large spreadsheets for every treatment configuration. This work presents a pulse parameter optimizer application to match intended dose and dose rate precisely and efficiently.. Dose and dose rate calculation methods have been described for a commercial electron FLASH platform. A constrained optimization for the dose and dose rate cost function was modelled as a mixed integer problem in MATLAB (The MathWorks Inc., Version9.13.0 R2022b, Natick, Massachusetts). The beam and machine data required for the application were acquired using GafChromic film and alternating current current transformers (ACCTs). Variables for optimization included DPP for every collimator, PW and PRF measured using ACCT and airgap factors.. Using PW, PRF,and airgap factors as parameters, a software was created to optimize dose and dose rate, reaching the closest match if exact dose and dose rates are not achievable. Optimization took 20 s or less to converge to results. This software was validated for accuracy of dose calculation and precision in matching prescribed dose and dose rate.. A pulse parameter optimization application was built for a commercial electron FLASH platform to increase efficiency in dose, dose rate, and pulse parameter prescription process. Automating this process reduces safety concerns associated with manual look up and calculation of these parameters, especially when many subjects at different doses and dose rates are to be safely managed.
Topics: Humans; Electrons; Electricity; Heart Rate; Software
PubMed: 37735967
DOI: 10.1088/1361-6560/acf63e -
Journal of the American Geriatrics... Nov 2022Increasing evidence links obstructive sleep apnea (OSA) to cognitive decline. Autonomic dysfunction assessed by heart rate variability is a promising early biomarker of...
BACKGROUND
Increasing evidence links obstructive sleep apnea (OSA) to cognitive decline. Autonomic dysfunction assessed by heart rate variability is a promising early biomarker of cognitive impairment in populations without major neurocognitive disorder (MND). We aimed to determine whether nocturnal pulse rate variability (PRV) extracted from oximetry signal and OSA severity could predict MND onset among older OSA patients.
METHODS
This study relied on data collected within the multicenter longitudinal Pays de la Loire Sleep Cohort, linked to health administrative data to identify new-onset MND. We included patients ≥60 years with newly diagnosed OSA, and no history of MND or atrial fibrillation. Cox proportional-hazards models were used to evaluate the association of MND with indices of PRV and OSA severity generated from sleep recordings.
RESULTS
After a median follow-up of 6.8 [4.7-9.4] years, 70 of 3283 patients (2.1%) had been diagnosed with MND. In multivariable Cox models, MND incidence was associated with age (p < 0.0001), depression (p = 0.013), and PRV assessed by the root mean square of the successive normal-to-normal (NN) beat interval differences (RMSSD; p = 0.008) and standard deviation of NN beat intervals (SDNN; p = 0.02). Patients with the highest quartile of RMSSD had a 2.3-fold [95%CI 1.11-4.92] higher risk of being diagnosed with MND. Indices of OSA and nocturnal hypoxia severity were not associated with MND.
CONCLUSIONS
Within a large clinic-based cohort of older patients with OSA, we found an association between oximetry-based indices of PRV and the onset of MND. Nocturnal oximetry-derived PRV indices could allow the early identification of OSA patients at higher risk of MND.
Topics: Humans; Aged; Heart Rate; Polysomnography; Sleep Apnea, Obstructive; Oximetry; Neurocognitive Disorders
PubMed: 35726128
DOI: 10.1111/jgs.17933 -
Sensors (Basel, Switzerland) Sep 2022Heart rate (HR) and respiratory rate (RR) are two vital parameters of the body medically used for diagnosing short/long-term illness. Out-of-the-body, non-skin-contact...
Heart rate (HR) and respiratory rate (RR) are two vital parameters of the body medically used for diagnosing short/long-term illness. Out-of-the-body, non-skin-contact HR/RR measurement remains a challenge due to imprecise readings. "Invisible" wearables integrated into day-to-day garments have the potential to produce precise readings with a comfortable user experience. Sleep studies and patient monitoring benefit from "Invisibles" due to longer wearability without significant discomfort. This paper suggests a novel method to reduce the footprint of sleep monitoring devices. We use a single silver-coated nylon fabric band integrated into a substrate of a standard cotton/nylon garment as a resistive elastomer sensor to measure air and blood volume change across the chest. We introduce a novel event-based architecture to process data at the edge device and describe two algorithms to calculate real-time HR/RR on ARM Cortex-M3 and Cortex-M4F microcontrollers. RR estimations show a sensitivity of 99.03% and a precision of 99.03% for identifying individual respiratory peaks. The two algorithms used for HR calculation show a mean absolute error of 0.81 ± 0.97 and 0.86±0.61 beats/min compared with a gold standard ECG-based HR. The event-based algorithm converts the respiratory/pulse waveform into instantaneous events, therefore reducing the data size by 40-140 times and requiring 33% less power to process and transfer data. Furthermore, we show that events hold enough information to reconstruct the original waveform, retaining pulse and respiratory activity. We suggest fabric sensors and event-based algorithms would drastically reduce the device footprint and increase the performance for HR/RR estimations during sleep studies, providing a better user experience.
Topics: Heart Rate; Humans; Nylons; Polysomnography; Respiratory Rate; Sleep
PubMed: 36081149
DOI: 10.3390/s22176689 -
IEEE Transactions on Biomedical... Oct 2021Neonatal intensive care units provide vital medical support for premature infants. The key aspect in neonatal care is the continuous monitoring of vital signs measured...
Neonatal intensive care units provide vital medical support for premature infants. The key aspect in neonatal care is the continuous monitoring of vital signs measured using adhesive skin sensors. Since sensors can cause irritation of the skin and lead to infections, research focuses on contact-free, camera-based methods such as infrared thermography and photoplethysmography imaging. The development of image processing algorithms requires large datasets, but recording the necessary data from studies brings tremendous effort and costs. Therefore, realistic patient phantoms would be feasible to create a comprehensive dataset and validate image-based algorithms. This work describes the realization of a neonatal phantom which can simulate physiological vital parameters such as pulse rate and thermoregulation. It mimics the outer appearance of premature infants using a 3D printed base structure coated with several layers of modified, skin-colored silicone. A distribution of red and infrared LEDs in the scaffold enables the simulation of a PPG signal by mimicking pulsative light intensity changes on the skin. Additionally, the body temperature of the phantom is individually adjustable in several regions using heating elements. In the validation process for PPG simulation, the feasibility of setting different pulse frequencies and the variation of oxygen saturation levels was obtained. Furthermore, heating tests showed region-dependent temperature variations between 0.19 C and 0.81 C around the setpoint. In conclusion, the proposed neonatal phantom can be used to simulate a variety of vital parameters of preterm infants and, therefore, enables the implementation of image processing algorithms for the analysis of the medical state.
Topics: Heart Rate; Humans; Infant, Newborn; Infant, Premature; Oxygen Saturation; Phantoms, Imaging; Photoplethysmography; Vital Signs
PubMed: 34449392
DOI: 10.1109/TBCAS.2021.3108066 -
Medical & Biological Engineering &... Jul 2023Sample entropy is an effective nonlinear index for analyzing pulse rate variability (PRV) signal, but it has problems with a large amount of calculation and time...
Sample entropy is an effective nonlinear index for analyzing pulse rate variability (PRV) signal, but it has problems with a large amount of calculation and time consumption. Therefore, this study proposes a fast sample entropy calculation method to analyze the PRV signal according to the microprocessor process of data updating and the principle of sample entropy. The simulated data and PRV signal are employed as experimental data to verify the accuracy and time consumption of the proposed method. The experimental results on simulated data display that the proposed improved sample entropy can improve the operation rate of the entropy value by a maximum of 47.6 times and an average of 28.6 times and keep the entropy value unchanged. Experimental results on PRV signal display that the proposed improved sample entropy has great potential in the real-time processing of physiological signals, which can increase approximately 35 times.
Topics: Heart Rate; Pulse; Entropy; Signal Processing, Computer-Assisted
PubMed: 36826631
DOI: 10.1007/s11517-022-02766-y