Interprofessional Consensus Regarding Design Requirements for Liquid-Based Perinatal Life Support (PLS) Technology.

Liquid-based perinatal life support (PLS) technology will probably be applied in a first-in-human study within the next decade. Research and development of PLS technology should not only address technical issues, but also consider socio-ethical and legal aspects, its application area, and the corresponding design implications. This paper represents the consensus opinion of a group of healthcare professionals, designers, ethicists, researchers and patient representatives, who have expertise in tertiary obstetric and neonatal care, bio-ethics, experimental perinatal animal models for physiologic research, biomedical modeling, monitoring, and design.

Perceived Depth and Roughness of Virtual Buttons With Touchscreens.

With the rapidly increasing penetration of touchscreens in various application sectors, more sophisticated and configurable haptic effects can be rendered on touchscreens (e.g., buttons).

A Review of Digital Cognitive Behavioral Therapy for Insomnia (CBT-I Apps): Are They Designed for Engagement?

There are different ways to deliver Cognitive Behavioral Therapy for Insomnia (CBT-I), of which in-person (face to face) is the traditional delivery method. However, the scalability of in-person therapy is low. Digital Cognitive Behavioral Therapy for Insomnia (dCBT-I) is an alternative and there are tools on the market that are validated in clinical studies.

Predictive Monitoring of Critical Cardiorespiratory Alarms in Neonates Under Intensive Care.

We aimed at reducing alarm fatigue in neonatal intensive care units by developing a model using machine learning for the early prediction of critical cardiorespiratory alarms. During this study in over 34,000 patient monitoring hours in 55 infants 278,000 advisory (yellow) and 70,000 critical (red) alarms occurred. Vital signs including the heart rate, breathing rate, and oxygen saturation were obtained at a sampling frequency of 1 Hz while heart rate variability was calculated by processing the ECG - both were used for feature development and for predicting alarms.

Predicting Neonatal Sepsis Using Features of Heart Rate Variability, Respiratory Characteristics, and ECG-Derived Estimates of Infant Motion.

This study in preterm infants was designed to characterize the prognostic potential of several features of heart rate variability (HRV), respiration, and (infant) motion for the predictive monitoring of late-onset sepsis (LOS). In a neonatal intensive care setting, the cardiorespiratory waveforms of infants with blood-culture positive LOS were analyzed to characterize the prognostic potential of 22 features for discriminating control from sepsis-state, using the Naïve Bayes algorithm. Historical data of the subjects acquired from a period sufficiently before the clinical suspicion of LOS was used as control state, whereas data from the 24 h preceding the clinical suspicion of LOS were used as sepsis state (test data).

Statistical Modeling of Heart Rate Variability to Unravel the Factors Affecting Autonomic Regulation in Preterm Infants.

Analyzing heart rate variability (HRV) in preterm infants can help track maturational changes and subclinical signatures of disease. We conducted an observational study to characterize the effect of demographic and cardiorespiratory factors on three features of HRV using a linear mixed-effects model. HRV-features were tailored to capture the unique physiology of preterm infants, including the contribution of transient pathophysiological heart rate (HR) decelerations.

Monitoring the respiratory rate of preterm infants using an ultrathin film sensor embedded in the bedding: a comparative feasibility study.

Objective: To determine the feasibility of unobtrusively monitoring the respiratory rate (RR) in preterm infants by using a film-like pressure sensor placed between the mattress and the bedding.

Approach: The RR was simultaneously measured by processing the chest impedance (CI) and the ballistographic (BSG) signal acquired from the pressure sensor in 10 preterm infants of varying body weight. Nearly 27 h of data were analyzed from these infants while in different body positions including both spontaneously breathing infants and those receiving non-invasive respiratory support.

The effects of a bioresponse system on the joint attention behaviour of adults with visual and severe or profound intellectual disabilities and their affective mutuality with their caregivers.

Background: The subtle communicative behaviour of individuals with visual and severe/profound intellectual disabilities hinders the success of their interaction with professional caregivers. The bioresponse system, a tool to raise caregivers' awareness of the client's communicative behaviour, may improve the client's joint attention behaviour and the dyad's affective mutuality.

Method: Four client-caregiver dyads participated in a randomized multiple baseline study with repeated baseline, intervention and follow-up observations.

Anatomically Realistic Neonatal Heart Model for Use in Neonatal Patient Simulators.

Neonatal patient simulators (NPS) are artificial patient surrogates used in the context of medical simulation training. Neonatologists and nursing staff practice clinical interventions such as chest compressions to ensure patient survival in the case of bradycardia or cardiac arrest. The simulators used currently are of low physical fidelity and therefore cannot provide qualitative insight into the procedure of chest compressions.

Patient Perspectives on Health Data Privacy and Management: "Where Is My Data and Whose Is It?".

New technologies are increasingly evaluated for use within the clinical practice to monitor patients' medical and lifestyle data. This development could contribute to a more personalized approach to patient care and potentially improve health outcomes. To date, patient perspective on this development has mostly been neglected in the literature.

A Ballistographic Approach for Continuous and Non-Obtrusive Monitoring of Movement in Neonates.

Continuously monitoring body movement in preterm infants can have important clinical applications since changes in movement-patterns can be a significant marker for clinical deteriorations including the onset of sepsis, seizures, and apneas. This paper proposes a system and method to monitor body movement of preterm infants in a clinical environment using ballistography. The ballistographic signal (BSG) is acquired using a thin and a film-like sensor that is placed underneath an infant.

Cardiorespiratory coupling in preterm infants.

In preterm infants, a better understanding and quantification of cardiorespiratory coupling may help improve caregiving by enabling the tracking of maturational changes and subclinical signatures of disease. Therefore, in a study of 20 preterm infants admitted to a neonatal intensive care unit, we analyzed the cardiac and respiratory regulatory mechanisms as well as the coupling between them. In particular, we selectively analyzed coupling from changes in heart rate to respiratory oscillations as well as coupling from respiratory oscillations to the heart rate.

Do CHANGE platform: A service-based architecture for secure aggregation and distribution of health and wellbeing data.

Over the last decade, the adoption of open API standards offers new services meaningful in the domain of health informatics and behavior change. We present our privacy-oriented solution to support personal data collection, distribution, and usage. Given the new General Data Protection Regulations in Europe, the proposed platform is designed with requirements in mind to position citizens as the controllers of their data.

Changes in autonomic regulation due to Kangaroo care remain unaffected by using a swaddling device.

Aim: To investigate the effects of a swaddling device known as the Hugsy (Hugsy, Eindhoven, the Netherlands) towards improving autonomic regulation. This device can be used both in the incubator and during Kangaroo care to absorb parental scent and warmth. After Kangaroo care, these stimuli can continue to be experienced by infants, while in the incubator.

Unlike Kangaroo care, mechanically simulated Kangaroo care does not change heart rate variability in preterm neonates.

Background: While numerous positive effects of Kangaroo care (KC) have been reported, the duration that parents can spend kangarooing is often limited.

Aim: To investigate whether a mattress that aims to mimic breathing motion and the sounds of heartbeats (BabyBe GMBH, Stuttgart, Germany) can simulate aspects of KC in preterm infants as measured by features of heart rate variability (HRV).

Methods: A within-subject study design was employed in which every routine KC session was followed by a BabyBe (BB) session, with a washout period of at least 2 h in between.

A Strategy to Reduce Critical Cardiorespiratory Alarms due to Intermittent Enteral Feeding of Preterm Neonates in Intensive Care.

Background: Many preterm infants require enteral feeding as they cannot coordinate sucking, swallowing, and breathing. In enteral feeding, milk feeds are delivered through a small feeding tube passed via the nose or mouth into the stomach. Intermittent milk feeds may either be administered using a syringe to gently push milk into the infant's stomach (push feed) or milk can be poured into a syringe attached to the tube and allowed to drip in by gravity (gravity feed).

The heuristics of nurse responsiveness to critical patient monitor and ventilator alarms in a private room neonatal intensive care unit.

Aim: Alarm fatigue is a well-recognized patient safety concern in intensive care settings. Decreased nurse responsiveness and slow response times to alarms are the potentially dangerous consequences of alarm fatigue. The aim of this study was to determine the factors that modulate nurse responsiveness to critical patient monitor and ventilator alarms in the context of a private room neonatal intensive care setting.

An innovative design for cardiopulmonary resuscitation manikins based on a human-like thorax and embedded flow sensors.

Cardiopulmonary resuscitation manikins are used for training personnel in performing cardiopulmonary resuscitation. State-of-the-art cardiopulmonary resuscitation manikins are still anatomically and physiologically low-fidelity designs. The aim of this research was to design a manikin that offers high anatomical and physiological fidelity and has a cardiac and respiratory system along with integrated flow sensors to monitor cardiac output and air displacement in response to cardiopulmonary resuscitation.

Features of Heart Rate Variability Capture Regulatory Changes During Kangaroo Care in Preterm Infants.

Objective: To determine whether heart rate variability (HRV) can serve as a surrogate measure to track regulatory changes during kangaroo care, a period of parental coregulation distinct from regulation within the incubator.

Study Design: Nurses annotated the starting and ending times of kangaroo care for 3 months. The pre-kangaroo care, during-kangaroo care, and post-kangaroo care data were retrieved in infants with at least 10 accurately annotated kangaroo care sessions.

Pattern discovery in critical alarms originating from neonates under intensive care.

Patient monitoring generates a large number of alarms, the vast majority of which are false. Excessive non-actionable medical alarms lead to alarm fatigue, a well-recognized patient safety issue. While multiple approaches to reduce alarm fatigue have been explored, patterns in alarming and inter-alarm relationships, as they manifest in the clinical workspace, are largely a black-box and hamper research efforts towards reducing alarms.

Autonomic nervous system functioning associated with psychogenic nonepileptic seizures: Analysis of heart rate variability.

Objective: Psychogenic nonepileptic seizures (PNESs) resemble epileptic seizures but originate from psychogenic rather than organic causes. Patients with PNESs are often unable or unwilling to reflect on underlying emotions. To gain more insight into the internal states of patients during PNES episodes, this study explored the time course of heart rate variability (HRV) measures, which provide information about autonomic nervous system functioning and arousal.

Camera on Vessel: A Camera-Based System to Measure Change in Water Volume in a Drinking Glass.

A major problem related to chronic health is patients' "compliance" with new lifestyle changes, medical prescriptions, recommendations, or restrictions. Heart-failure and hemodialysis patients are usually placed on fluid restrictions due to their hemodynamic status. A holistic approach to managing fluid imbalance will incorporate the monitoring of salt-water intake, body-fluid retention, and fluid excretion in order to provide effective intervention at an early stage.

Neurophysiological correlates of dissociative symptoms.

Objective: Dissociation is a mental process with psychological and somatoform manifestations, which is closely related to hypnotic suggestibility and essentially shows the ability to obtain distance from reality. An increased tendency to dissociate is a frequently reported characteristic of patients with functional neurological symptoms and syndromes (FNSS), which account for a substantial part of all neurological admissions. This review aims to investigate what heart rate variability (HRV), EEG and neuroimaging data (MRI) reveal about the nature of dissociation and related conditions.

Efficacy of feed forward and feedback signaling for inflations and chest compression pressure during cardiopulmonary resuscitation in a newborn mannequin.

Background: The objective of the study was to evaluate a device that supports professionals during neonatal cardiopulmonary resuscitation (CPR). The device features a box that generates an audio-prompted rate guidance (feed forward) for inflations and compressions, and a transparent foil that is placed over the chest with marks for inter nipple line and sternum with LED's incorporated in the foil indicating the exerted force (feedback).

Methods: Ten pairs (nurse/doctor) performed CPR on a newborn resuscitation mannequin.

Rhythm of Life Aid (ROLA): an integrated sensor system for supporting medical staff during cardiopulmonary resuscitation (CPR) of newborn infants.

During the stress of cardiopulmonary resuscitation (CPR), it is difficult to maintain the right rhythm and correct ratio of insufflations to chest compressions and to exert the compressions at a constant pressure. In this paper, we propose and demonstrate an integrated sensor system-the "Rhythm of Life Aid" (ROLA) to support medical staff during CPR of newborn infants. The design concept is based on interactive audio and visual feedback with consideration of functionalities and user friendliness.