Wearable Devices for Environmental Monitoring in the Built Environment: A Systematic Review

Artificial intelligence in respiratory care: Current scenario and future perspective

BACKGROUND

This narrative review aims to explore the current state and future perspective of artificial intelligence (AI) in respiratory care. The objective is to provide insights into the potential impact of AI in this field.

METHODS

A comprehensive analysis of relevant literature and research studies was conducted to examine the applications of AI in respiratory care and identify areas of advancement. The analysis included studies on remote monitoring, early detection, smart ventilation systems, and collaborative decision-making.

RESULTS

The obtained results highlight the transformative potential of AI in respiratory care. AI algorithms have shown promising capabilities in enabling tailored treatment plans based on patient-specific data. Remote monitoring using AI-powered devices allows for real-time feedback to health-care providers, enhancing patient care. AI algorithms have also demonstrated the ability to detect respiratory conditions at an early stage, leading to timely interventions and improved outcomes. Moreover, AI can optimize mechanical ventilation through continuous monitoring, enhancing patient comfort and reducing complications. Collaborative AI systems have the potential to augment the expertise of health-care professionals, leading to more accurate diagnoses and effective treatment strategies.

CONCLUSION

By improving diagnosis, AI has the potential to revolutionize respiratory care, treatment planning, and patient monitoring. While challenges and ethical considerations remain, the transformative impact of AI in this domain cannot be overstated. By leveraging the advancements and insights from this narrative review, health-care professionals and researchers can continue to harness the power of AI to improve patient outcomes and enhance respiratory care practices.

IMPROVEMENTS

Based on the findings, future research should focus on refining AI algorithms to enhance their accuracy, reliability, and interpretability. In addition, attention should be given to addressing ethical considerations, ensuring data privacy, and establishing regulatory frameworks to govern the responsible implementation of AI in respiratory care.

Efficient and Accurate Analog Voltage Measurement Using a Direct Sensor-to-Digital Port Interface for Microcontrollers and Field-Programmable Gate Arrays

Portable sensor systems are usually based on microcontrollers and/or Field-Programmable Gate Arrays (FPGAs) that are interfaced with sensors by means of an Analog-to-Digital converter (ADC), either integrated in the computing device or external. An alternative solution is based on the direct connection of the sensors to the digital input port of the microcontroller or FPGA. This solution is particularly interesting in the case of devices not integrating an internal ADC or featuring a small number of ADC channels. In this paper, a technique is presented to directly interface sensors with analog voltage output to the digital input port of a microcontroller or FPGA. The proposed method requires only a few passive components and is based on the measurements of the duty cycle of a digital square-wave signal. This technique was investigated by means of circuit simulations using LTSpice and was implemented in a commercial low-cost FPGA device (Gowin GW1NR-9). The duty cycle of the square-wave signal features a good linear correlation with the analog voltage to be measured. Thus, a look-up table to map the analog voltage values to the measured duty cycle is not required with benefits in terms of memory occupation. The experimental results on the FPGA device have shown that the analog voltage can be measured with a maximum accuracy of 1.09 mV and a sampling rate of 9.75 Hz. The sampling rate can be increased to 31.35 Hz and 128.31 Hz with an accuracy of 1.61 mV and 2.68 mV, respectively.

Emerging Trends in Soft Electronics: Integrating Machine Intelligence with Soft Acoustic/Vibration Sensors

In the last decade, soft acoustic/vibration sensors have gained tremendous research interest due to their unique ability to detect broadband acoustic/vibration stimuli, potentializing futuristic applications including voice biometrics, voice-controlled human-machine-interfaces, electronic skin, and skin-mountable healthcare devices. Importantly, to benefit most from these sensors, it is inevitable to use machine learning (ML) to process their output signals; with ML, a more accurate and efficient interpretation of original data is possible. This paper is dedicated to offering an overview of recent advances empowering the development of soft acoustic/vibration sensors and their signal processing using ML. First, the key performance parameters of the sensors are discussed. Second, popular transduction mechanisms for the sensors are addressed, followed by an in-depth overview of each type, covering materials used, structural designs, and sensing performances. Third, potential applications of the sensors are elaborated and fourth, a thorough discussion on ML is conducted, exploring different types of ML, specific ML algorithms suitable for processing acoustic/vibration signals, and current trends in ML-assisted applications. Finally, the challenges and potential opportunities in soft acoustic/vibration sensor and ML research are revealed to offer new insights into future prospects in these fields.

Wearable-based accelerometer activity profile as digital biomarker of inflammation, biological age, and mortality using hierarchical clustering analysis in NHANES 2011-2014

Repeated disruptions in circadian rhythms are associated with implications for health outcomes and longevity. The utilization of wearable devices in quantifying circadian rhythm to elucidate its connection to longevity, through continuously collected data remains largely unstudied. In this work, we investigate a data-driven segmentation of the 24-h accelerometer activity profiles from wearables as a novel digital biomarker for longevity in 7,297 U.S. adults from the 2011-2014 National Health and Nutrition Examination Survey. Using hierarchical clustering, we identified five clusters and described them as follows: "High activity", "Low activity", "Mild circadian rhythm (CR) disruption", "Severe CR disruption", and "Very low activity". Young adults with extreme CR disturbance are seemingly healthy with few comorbid conditions, but in fact associated with higher white blood cell, neutrophils, and lymphocyte counts (0.05-0.07 log-unit, all p < 0.05) and accelerated biological aging (1.42 years, p < 0.001). Older adults with CR disruption are significantly associated with increased systemic inflammation indexes (0.09-0.12 log-unit, all p < 0.05), biological aging advance (1.28 years, p = 0.021), and all-cause mortality risk (HR = 1.58, p = 0.042). Our findings highlight the importance of circadian alignment on longevity across all ages and suggest that data from wearable accelerometers can help in identifying at-risk populations and personalize treatments for healthier aging.

Are Activity Wrist-Worn Devices Accurate for Determining Heart Rate during Intense Exercise?

The market for wrist-worn devices is growing at previously unheard-of speeds. A consequence of their fast commercialization is a lack of adequate studies testing their accuracy on varied populations and pursuits. To provide an understanding of wearable sensors for sports medicine, the present study examined heart rate (HR) measurements of four popular wrist-worn devices, the (Fitbit Charge (FB), Apple Watch (AW), Tomtom runner Cardio (TT), and Samsung G2 (G2)), and compared them with gold standard measurements derived by continuous electrocardiogram examination (ECG). Eight athletes participated in a comparative study undergoing maximal stress testing on a cycle ergometer or a treadmill. We analyzed 1,286 simultaneous HR data pairs between the tested devices and the ECG. The four devices were reasonably accurate at the lowest activity level. However, at higher levels of exercise intensity the FB and G2 tended to underestimate HR values during intense physical effort, while the TT and AW devices were fairly reliable. Our results suggest that HR estimations should be considered cautiously at specific intensities. Indeed, an effective intervention is required to register accurate HR readings at high-intensity levels (above 150 bpm). It is important to consider that even though none of these devices are certified or sold as medical or safety devices, researchers must nonetheless evaluate wrist-worn wearable technology in order to fully understand how HR affects psychological and physical health, especially under conditions of more intense exercise.

Long-Term Thermal Comfort Monitoring via Wearable Sensing Techniques: Correlation between Environmental Metrics and Subjective Perception

The improvement of comfort monitoring resources is pivotal for a better understanding of personal perception in indoor and outdoor environments and thus developing personalized comfort models maximizing occupants' well-being while minimizing energy consumption. Different daily routines and their relation to the thermal sensation remain a challenge in long-term monitoring campaigns. This paper presents a new methodology to investigate the correlation between individuals' daily Thermal Sensation Vote (TSV) and environmental exposure. Participants engaged in the long-term campaign were instructed to answer a daily survey about thermal comfort perception and wore a device continuously monitoring temperature and relative humidity in their surroundings. Normalized daily profiles of monitored variables and calculated heat index were clustered to identify common exposure profiles for each participant. The correlation between each cluster and expressed TSV was evaluated through the Kendall tau-b test. Most of the significant correlations were related to the heat index profiles, i.e., 49% of cases, suggesting that a more detailed description of physical boundaries better approximates expressed comfort. This research represents the first step towards personalized comfort models accounting for individual long-term environmental exposure. A longer campaign involving more participants should be organized in future studies, involving also physiological variables for energy-saving purposes.

Climate change, human health, and the exposome: Utilizing OMIC technologies to navigate an era of uncertainty

Climate change is an anthropogenic phenomenon that is alarming scientists and non-scientists alike. The emission of greenhouse gases is causing the temperature of the earth to rise and this increase is accompanied by a multitude of climate change-induced environmental exposures with potential health impacts. Tracking human exposure has been a major research interest of scientists worldwide. This has led to the development of exposome studies that examine internal and external individual exposures over their lifetime and correlate them to health. The monitoring of health has also benefited from significant technological advances in the field of "omics" technologies that analyze physiological changes on the nucleic acid, protein, and metabolism levels, among others. In this review, we discuss various climate change-induced environmental exposures and their potential health implications. We also highlight the potential integration of the technological advancements in the fields of exposome tracking, climate monitoring, and omics technologies shedding light on important questions that need to be answered.

Wearables for Measuring Health Effects of Climate Change–Induced Weather Extremes: Scoping Review

Background

Although climate change is one of the biggest global health threats, individual-level and short-term data on direct exposure and health impacts are still scarce. Wearable electronic devices (wearables) present a potential solution to this research gap. Wearables have become widely accepted in various areas of health research for ecological momentary assessment, and some studies have used wearables in the field of climate change and health. However, these studies vary in study design, demographics, and outcome variables, and existing research has not been mapped.

Objective

In this review, we aimed to map existing research on wearables used to detect direct health impacts and individual exposure during climate change–induced weather extremes, such as heat waves or wildfires.

Methods

We conducted a scoping review according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) framework and systematically searched 6 databases (PubMed [MEDLINE], IEEE Xplore, CINAHL [EBSCOhost], WoS, Scopus, Ovid [MEDLINE], and Google Scholar). The search yielded 1871 results. Abstracts and full texts were screened by 2 reviewers (MK and IM) independently using the inclusion and exclusion criteria. The inclusion criteria comprised studies published since 2010 that used off-the-shelf wearables that were neither invasive nor obtrusive to the user in the setting of climate change–related weather extremes. Data were charted using a structured form, and the study outcomes were narratively synthesized.

Results

The review included 55,284 study participants using wearables in 53 studies. Most studies were conducted in upper–middle-income and high-income countries (50/53, 94%) in urban environments (25/53, 47%) or in a climatic chamber (19/53, 36%) and assessed the health effects of heat exposure (52/53, 98%). The majority reported adverse health effects of heat exposure on sleep, physical activity, and heart rate. The remaining studies assessed occupational heat stress or compared individual- and area-level heat exposure. In total, 26% (14/53) of studies determined that all examined wearables were valid and reliable for measuring health parameters during heat exposure when compared with standard methods.

Conclusions

Wearables have been used successfully in large-scale research to measure the health implications of climate change–related weather extremes. More research is needed in low-income countries and vulnerable populations with pre-existing conditions. In addition, further research could focus on the health impacts of other climate change–related conditions and the effectiveness of adaptation measures at the individual level to such weather extremes.

Air pollution and mental health: associations, mechanisms and methods

PURPOSE OF REVIEW

There is increasing interest in the links between exposure to air pollution and a range of health outcomes. The association with mental health however is much less established. This article reviews developments in the field over the past 12 months, highlighting the evidence for causation, associations between multiple air pollutants and mental health outcomes, and assesses the challenges of researching this topic.

RECENT FINDINGS

Increasingly rigorous methods are being applied to the investigation of a broader range of mental health outcomes. These methods include basic science, neuroimaging, and observational studies representing diverse geographical locations. Cohort studies with linked high-resolution air pollutant exposure data are common, facilitating advanced analytic methods. To date, meta-analyses have demonstrated small and significant positive associations between long-term exposure to fine particulate matter and depressive symptoms and cognitive decline. Methodological complexities in measuring exposure and outcome pose ongoing difficulties for the field.

SUMMARY

Literature on this topic has recently seen an appreciable expansion. Work that better estimates daily exposure, controls for complex confounders, and is driven by hypotheses founded in candidate causal mechanisms would help clarify associations, and inform targeted interventions and policymakers.

Low-Cost Thermohygrometers to Assess Thermal Comfort in the Built Environment: A Laboratory Evaluation of Their Measurement Performance

A thermohygrometer is an instrument that is able to measure relative humidity and air temperature, which are two of the fundamental parameters to estimate human thermal comfort. To date, the market offers small and low-cost solutions for this instrument, providing the opportunity to bring electronics closer to the end-user and contributing to the proliferation of a variety of applications and open-source projects. One of the most critical aspects of using low-cost instruments is their measurement reliability. This study aims to determine the measurement performance of seven low-cost thermohygrometers throughout a 10-fold repeatability test in a climatic chamber with air temperatures ranging from about −10 to +40 °C and relative humidity from approximately 0 to 90%. Compared with reference sensors, their measurements show good linear behavior with some exceptions. A sub-dataset of the data collected is then used to calculate two of the most used indoor (PMV) and outdoor (UTCI) comfort indexes to define discrepancies between the indexes calculated with the data from the reference sensors and the low-cost sensors. The results suggest that although six of the seven low-cost sensors have accuracy that meets the requirements of ISO 7726, in some cases, they do not provide acceptable comfort indicators if the values are taken as they are. The linear regression analysis suggests that it is possible to correct the output to reduce the difference between reference and low-cost sensors, enabling the use of low-cost sensors to assess indoor thermal comfort in terms of PMV and outdoor thermal stress in UTCI and encouraging a more conscious use for environmental and human-centric research.

The Current State of Optical Sensors in Medical Wearables

Optical sensors play an increasingly important role in the development of medical diagnostic devices. They can be very widely used to measure the physiology of the human body. Optical methods include PPG, radiation, biochemical, and optical fiber sensors. Optical sensors offer excellent metrological properties, immunity to electromagnetic interference, electrical safety, simple miniaturization, the ability to capture volumes of nanometers, and non-invasive examination. In addition, they are cheap and resistant to water and corrosion. The use of optical sensors can bring better methods of continuous diagnostics in the comfort of the home and the development of telemedicine in the 21st century. This article offers a large overview of optical wearable methods and their modern use with an insight into the future years of technology in this field.

Relationship between exposure to ozone and exacerbation requiring hospital admission among patients with asthma: a case-control study in central Taiwan

OBJECTIVE

The convergence of asthma and air pollutants in ageing populations is currently a growing health issue worldwide, and hence there is an essential need to investigate the association between exposure to air pollution, particularly ozone (O₃), and exacerbation requiring admission in patients with asthma.

SETTING

A case-control study at a tertiary referral hospital in central Taiwan.

PARTICIPANTS

We used an asthma cohort, which included 11 400 patients with asthma, for the period 2006-2018 at Taichung Veterans General Hospital.

PRIMARY AND SECONDARY OUTCOME MEASURES

We identified patients who had admitted for exacerbation as cases and selected patients with asthma without exacerbation, matching (1:4) the cases for age, gender and season of exacerbation, as controls. Data on hourly level of air pollutants were obtained from the Taiwan Environmental Protection Administration. We used conditional logistic regression and calculated adjusted ORs (adjORs) with 95% CIs.

RESULTS

We enrolled 11 400 participants with asthma, and 4.4% (501) of them had been admitted for exacerbation. Participants with asthma with exacerbation requiring hospitalisation were exposed to a higher level of O₃ 8-hour daily maximum (adjOR 1.009, 95% CI 1.001 to 1.016) and were more likely to have high Charlson Comorbidity Index (CCI ≥3; adjOR 2.198, 95% CI 1.729 to 2.794) and asthma-chronic obstructive pulmonary disease overlap (adjOR 4.542, 95% CI 3.376 to 6.611) compared with those without exacerbation. The aforementioned associations between exacerbation of asthma requiring hospitalisation and exposure to O₃ were similar when defined by either O₃ 1-hour daily maximum or O₃ 24-hour average. Moreover, the O₃ relevant exacerbation of asthma mainly existed in those aged older than 65 years and patients with medical comorbidities, including gastrointestinal diseases, cardiovascular diseases, neurological diseases, diabetes and renal disease.

CONCLUSIONS

Our findings highlight the need for vigilance of exposure to O₃ among elderly with asthma, particularly those with medical comorbidities. Further studies are warranted to investigate the underlying mechanisms.

Monitoring Particulate Matter with Wearable Sensors and the Influence on Student Environmental Attitudes

The mobile monitoring of air pollution is a growing field, prospectively filling in spatial gaps while personalizing air-quality-based risk assessment. We developed wearable sensors to record particulate matter (PM), and through a community science approach, students of partnering Chicago high schools monitored PM concentrations during their commutes over a five- and thirteen-day period. Our main objective was to investigate how mobile monitoring influenced students' environmental attitudes and we did this by having the students explore the relationship between PM concentrations and urban vegetation. Urban vegetation was approximated with a normalized difference vegetation index (NDVI) using Landsat 8 satellite imagery. While the linear regression for one partner school indicated a negative correlation between PM and vegetation, the other indicated a positive correlation, contrary to our expectations. Survey responses were scored on the basis of their environmental affinity and knowledge. There were no significant differences between cumulative pre- and post-experiment survey responses at Josephinum Academy, and only one weakly significant difference in survey results at DePaul Prep in the Knowledge category. However, changes within certain attitudinal subscales may possibly suggest that students were inclined to practice more sustainable behaviors, but perhaps lacked the resources to do so.

A New Wearable System for Sensing Outdoor Environmental Conditions for Monitoring Hyper-Microclimate

The rapid urbanization process brings consequences to urban environments, such poor air quality and the urban heat island issues. Due to these effects, environmental monitoring is gaining attention with the aim of identifying local risks and improving cities’ liveability and resilience. However, these environments are very heterogeneous, and high-spatial-resolution data are needed to identify the intra-urban variations of physical parameters. Recently, wearable sensing techniques have been used to perform microscale monitoring, but they usually focus on one environmental physics domain. This paper presents a new wearable system developed to monitor key multidomain parameters related to the air quality, thermal, and visual domains, on a hyperlocal scale from a pedestrian’s perspective. The system consisted of a set of sensors connected to a control unit settled on a backpack and could be connected via Wi-Fi to any portable equipment. The device was prototyped to guarantee the easy sensors maintenance, and a user-friendly dashboard facilitated a real-time monitoring overview. Several tests were conducted to confirm the reliability of the sensors. The new device will allow comprehensive environmental monitoring and multidomain comfort investigations to be carried out, which can support urban planners to face the negative effects of urbanization and to crowd data sourcing in smart cities.