Automatic Classification of Anomalous ECG Heartbeats from Samples Acquired by Compressed Sensing.

In this paper, a method for the classification of anomalous heartbeats from compressed ECG signals is proposed. The method operating on signals acquired by compressed sensing is based on a feature extraction stage consisting of the evaluation of the Discrete Cosine Transform (DCT) coefficients of the compressed signal and a classification stage performed by means of a set of k-nearest neighbor ensemble classifiers. The method was preliminarily tested on five classes of anomalous heartbeats, and it achieved a classification accuracy of 99.40%.

Substantiation and Effectiveness of Remote Monitoring System Based on IoMT Using Portable ECG Device.

Cardiovascular disease is a major global health concern, with early detection being critical. This study assesses the effectiveness of a portable ECG device, based on Internet of Medical Things (IoMT) technology, for remote cardiovascular monitoring during daily activities. We conducted a clinical trial involving 2000 participants who wore the HiCardi device while engaging in hiking activities. The device monitored their ECG, heart rate, respiration, and body temperature in real-time. If an abnormal signal was detected while a physician was remotely monitoring the ECG at the IoMT monitoring center, he notified the clinical research coordinator (CRC) at the empirical research site, and the CRC advised the participant to visit a hospital. Follow-up calls were made to determine compliance and outcomes. Of the 2000 participants, 318 showed abnormal signals, and 182 were advised to visit a hospital. The follow-up revealed that 139 (76.37%) responded, and 30 (21.58% of those who responded) sought further medical examination. Most visits (80.00%) occurred within one month. Diagnostic approaches included ECG (56.67%), ECG and ultrasound (20.00%), ultrasound alone (16.67%), ECG and X-ray (3.33%), and general treatment (3.33%). Seven participants (23.33% of those who visited) were diagnosed with cardiovascular disease, including conditions such as arrhythmia, atrial fibrillation, and stent requirements. The portable ECG device using the patch-type electrocardiograph detected abnormal cardiovascular signals, leading to timely diagnoses and interventions, demonstrating its potential for broad applications in preventative healthcare.

BFLIDS: Blockchain-Driven Federated Learning for Intrusion Detection in IoMT Networks.

The Internet of Medical Things (IoMT) has significantly advanced healthcare, but it has also brought about critical security challenges. Traditional security solutions struggle to keep pace with the dynamic and interconnected nature of IoMT systems. Machine learning (ML)-based Intrusion Detection Systems (IDS) have been increasingly adopted to counter cyberattacks, but centralized ML approaches pose privacy risks due to the single points of failure (SPoFs). Federated Learning (FL) emerges as a promising solution, enabling model updates directly on end devices without sharing private data with a central server. This study introduces the BFLIDS, a Blockchain-empowered Federated Learning-based IDS designed to enhance security and intrusion detection in IoMT networks. Our approach leverages blockchain to secure transaction records, FL to maintain data privacy by training models locally, IPFS for decentralized storage, and MongoDB for efficient data management. Ethereum smart contracts (SCs) oversee and secure all interactions and transactions within the system. We modified the FedAvg algorithm with the Kullback-Leibler divergence estimation and adaptive weight calculation to boost model accuracy and robustness against adversarial attacks. For classification, we implemented an Adaptive Max Pooling-based Convolutional Neural Network (CNN) and a modified Bidirectional Long Short-Term Memory (BiLSTM) with attention and residual connections on Edge-IIoTSet and TON-IoT datasets. We achieved accuracies of 97.43% (for CNNs and Edge-IIoTSet), 96.02% (for BiLSTM and Edge-IIoTSet), 98.21% (for CNNs and TON-IoT), and 97.42% (for BiLSTM and TON-IoT) in FL scenarios, which are competitive with centralized methods. The proposed BFLIDS effectively detects intrusions, enhancing the security and privacy of IoMT networks.

Security Analysis for Smart Healthcare Systems.

The healthcare industry went through reformation by integrating the Internet of Medical Things (IoMT) to enable data harnessing by transmission mediums from different devices, about patients to healthcare staff devices, for further analysis through cloud-based servers for proper diagnosis of patients, yielding efficient and accurate results. However, IoMT technology is accompanied by a set of drawbacks in terms of security risks and vulnerabilities, such as violating and exposing patients' sensitive and confidential data. Further, the network traffic data is prone to interception attacks caused by a wireless type of communication and alteration of data, which could cause unwanted outcomes. The advocated scheme provides insight into a robust Intrusion Detection System (IDS) for IoMT networks. It leverages a honeypot to divert attackers away from critical systems, reducing the attack surface. Additionally, the IDS employs an ensemble method combining Logistic Regression and K-Nearest Neighbor algorithms. This approach harnesses the strengths of both algorithms to improve attack detection accuracy and robustness. This work analyzes the impact, performance, accuracy, and precision outcomes of the used model on two IoMT-related datasets which contain multiple attack types such as Man-In-The-Middle (MITM), Data Injection, and Distributed Denial of Services (DDOS). The yielded results showed that the proposed ensemble method was effective in detecting intrusion attempts and classifying them as attacks or normal network traffic, with a high accuracy of 92.5% for the first dataset and 99.54% for the second dataset and a precision of 96.74% for the first dataset and 99.228% for the second dataset.

An Optimal, Power Efficient, Internet of Medical Things Framework for Monitoring of Physiological Data Using Regression Models.

The sensors used in the Internet of Medical Things (IoMT) network run on batteries and need to be replaced, replenished or should use energy harvesting for continuous power needs. Additionally, there are mechanisms for better utilization of battery power for network longevity. IoMT networks pose a unique challenge with respect to sensor power replenishment as the sensors could be embedded inside the subject. A possible solution could be to reduce the amount of sensor data transmission and recreate the signal at the receiving end. This article builds upon previous physiological monitoring studies by applying new decision tree-based regression models to calculate the accuracy of reproducing data from two sets of physiological signals transmitted over cellular networks. These regression analyses are then executed over three different iteration varieties to assess the effect that the number of decision trees has on the efficiency of the regression model in question. The results indicate much lower errors as compared to other approaches indicating significant saving on the battery power and improvement in network longevity.

Developing a Novel Ontology for Cybersecurity in Internet of Medical Things-Enabled Remote Patient Monitoring.

IoT has seen remarkable growth, particularly in healthcare, leading to the rise of IoMT. IoMT integrates medical devices for real-time data analysis and transmission but faces challenges in data security and interoperability. This research identifies a significant gap in the existing literature regarding a comprehensive ontology for vulnerabilities in medical IoT devices. This paper proposes a fundamental domain ontology named MIoT (Medical Internet of Things) ontology, focusing on cybersecurity in IoMT (Internet of Medical Things), particularly in remote patient monitoring settings. This research will refer to similar-looking acronyms, IoMT and MIoT ontology. It is important to distinguish between the two. IoMT is a collection of various medical devices and their applications within the research domain. On the other hand, MIoT ontology refers to the proposed ontology that defines various concepts, roles, and individuals. MIoT ontology utilizes the knowledge engineering methodology outlined in Ontology Development 101, along with the structured life cycle, and establishes semantic interoperability among medical devices to secure IoMT assets from vulnerabilities and cyberattacks. By defining key concepts and relationships, it becomes easier to understand and analyze the complex network of information within the IoMT. The MIoT ontology captures essential key terms and security-related entities for future extensions. A conceptual model is derived from the MIoT ontology and validated through a case study. Furthermore, this paper outlines a roadmap for future research, highlighting potential impacts on security automation in healthcare applications.

A Deep Auto-Optimized Collaborative Learning (DACL) model for disease prognosis using AI-IoMT systems.

In modern healthcare, integrating Artificial Intelligence (AI) and Internet of Medical Things (IoMT) is highly beneficial and has made it possible to effectively control disease using networks of interconnected sensors worn by individuals. The purpose of this work is to develop an AI-IoMT framework for identifying several of chronic diseases form the patients' medical record. For that, the Deep Auto-Optimized Collaborative Learning (DACL) Model, a brand-new AI-IoMT framework, has been developed for rapid diagnosis of chronic diseases like heart disease, diabetes, and stroke. Then, a Deep Auto-Encoder Model (DAEM) is used in the proposed framework to formulate the imputed and preprocessed data by determining the fields of characteristics or information that are lacking. To speed up classification training and testing, the Golden Flower Search (GFS) approach is then utilized to choose the best features from the imputed data. In addition, the cutting-edge Collaborative Bias Integrated GAN (ColBGaN) model has been created for precisely recognizing and classifying the types of chronic diseases from the medical records of patients. The loss function is optimally estimated during classification using the Water Drop Optimization (WDO) technique, reducing the classifier's error rate. Using some of the well-known benchmarking datasets and performance measures, the proposed DACL's effectiveness and efficiency in identifying diseases is evaluated and compared.

Multirole of the internet of medical things (IoMT) in biomedical systems for managing smart healthcare systems: An overview of current and future innovative trends.

Internet of Medical Things (IoMT) is an emerging subset of Internet of Things (IoT), often called as IoT in healthcare, refers to medical devices and applications with internet connectivity, is exponentially gaining researchers' attention due to its wide-ranging applicability in biomedical systems for Smart Healthcare systems. IoMT facilitates remote health biomedical system and plays a crucial role within the healthcare industry to enhance precision, reliability, consistency and productivity of electronic devices used for various healthcare purposes. It comprises a conceptualized architecture for providing information retrieval strategies to extract the data from patient records using sensors for biomedical analysis and diagnostics against manifold diseases to provide cost-effective medical solutions, quick hospital treatments, and personalized healthcare. This article provides a comprehensive overview of IoMT with special emphasis on its current and future trends used in biomedical systems, such as deep learning, machine learning, blockchains, artificial intelligence, radio frequency identification, and industry 5.0.

An Optimized Model Based on Deep Learning and Gated Recurrent Unit for COVID-19 Death Prediction.

The COVID-19 epidemic poses a worldwide threat that transcends provincial, philosophical, spiritual, radical, social, and educational borders. By using a connected network, a healthcare system with the Internet of Things (IoT) functionality can effectively monitor COVID-19 cases. IoT helps a COVID-19 patient recognize symptoms and receive better therapy more quickly. A critical component in measuring, evaluating, and diagnosing the risk of infection is artificial intelligence (AI). It can be used to anticipate cases and forecast the alternate incidences number, retrieved instances, and injuries. In the context of COVID-19, IoT technologies are employed in specific patient monitoring and diagnosing processes to reduce COVID-19 exposure to others. This work uses an Indian dataset to create an enhanced convolutional neural network with a gated recurrent unit (CNN-GRU) model for COVID-19 death prediction via IoT. The data were also subjected to data normalization and data imputation. The 4692 cases and eight characteristics in the dataset were utilized in this research. The performance of the CNN-GRU model for COVID-19 death prediction was assessed using five evaluation metrics, including median absolute error (MedAE), mean absolute error (MAE), root mean squared error (RMSE), mean square error (MSE), and coefficient of determination (R2). ANOVA and Wilcoxon signed-rank tests were used to determine the statistical significance of the presented model. The experimental findings showed that the CNN-GRU model outperformed other models regarding COVID-19 death prediction.

Interoperable IoMT Approach for Remote Diagnosis with Privacy-Preservation Perspective in Edge Systems.

The emergence of the Internet of Medical Things (IoMT) has brought together developers from the Industrial Internet of Things (IIoT) and healthcare providers to enable remote patient diagnosis and treatment using mobile-device-collected data. However, the utilization of traditional AI systems raises concerns about patient privacy. To address this issue, we present a privacy-enhanced approach for illness diagnosis within the IoMT framework. Our proposed interoperable IoMT implementation focuses on optimizing IoT network performance, including throughput, energy consumption, latency, packet delivery ratio, and network longevity. We achieve these improvements using techniques such as device authentication, energy-efficient clustering, environmental monitoring using Circular-based Hidden Markov Model (C-HMM), data verification using Awad's Entropy-based Ten-Fold Cross Entropy Verification (TCEV), and data confidentiality using Twine-LiteNet-based encryption. We employ the Search and Rescue Optimization algorithm (SRO) for optimal route selection, and the encrypted data are securely stored in a cloud server. With extensive network simulations using ns-3, our approach demonstrates substantial enhancements in the specified performance metrics compared with previous works. Specifically, we observe a 20% increase in throughput, a 15% reduction in packet drop rate (PDR), a 35% improvement in network lifetime, and a 10% decrease in energy consumption and delay. These findings underscore the efficacy of our approach in enhancing IoT network interoperability and protection, fostering improved patient care and diagnostic capabilities.

A Novel 3D Reversible Data Hiding Scheme Based on Integer-Reversible Krawtchouk Transform for IoMT.

To avoid rounding errors associated with the limited representation of significant digits when applying the floating-point Krawtchouk transform in image processing, we present an integer and reversible version of the Krawtchouk transform (IRKT). This proposed IRKT generates integer-valued coefficients within the Krawtchouk domain, seamlessly aligning with the integer representation commonly utilized in lossless image applications. Building upon the IRKT, we introduce a novel 3D reversible data hiding (RDH) algorithm designed for the secure storage and transmission of extensive medical data within the IoMT (Internet of Medical Things) sector. Through the utilization of the IRKT-based 3D RDH method, a substantial amount of additional data can be embedded into 3D carrier medical images without augmenting their original size or compromising information integrity upon data extraction. Extensive experimental evaluations substantiate the effectiveness of the proposed algorithm, particularly regarding its high embedding capacity, imperceptibility, and resilience against statistical attacks. The integration of this proposed algorithm into the IoMT sector furnishes enhanced security measures for the safeguarded storage and transmission of massive medical data, thereby addressing the limitations of conventional 2D RDH algorithms for medical images.

Blockchain-enabled secure and efficient data sharing scheme for trust management in healthcare smartphone network.

The Internet of Medical Things (IoMT) is an extended genre of the Internet of Things (IoT) where the Things collaborate to provide remote patient health monitoring, also known as the Internet of Health (IoH). Smartphones and IoMTs are expected to maintain secure and trusted confidential patient record exchange while managing the patient remotely. Healthcare organizations deploy Healthcare Smartphone Networks (HSN) for personal patient data collection and sharing among smartphone users and IoMT nodes. However, attackers gain access to confidential patient data via infected IoMT nodes on the HSN. Additionally, attackers can compromise the entire network via malicious nodes. This article proposes a Hyperledger blockchain-based technique to identify compromised IoMT nodes and safeguard sensitive patient records. Furthermore, the paper presents a Clustered Hierarchical Trust Management System (CHTMS) to block malicious nodes. In addition, the proposal employs Elliptic Curve Cryptography (ECC) to protect sensitive health records and is resilient against Denial-Of-Service (DOS) attacks. Finally, the evaluation results show that integrating blockchains into the HSN system improved detection performance compared to the existing state of the art. Therefore, the simulation results indicate better security and reliability when compared to conventional databases.

3D printed biomedical devices and their applications: A review on state-of-the-art technologies, existing challenges, and future perspectives.

3D printing, also known as Additive manufacturing (AM), has emerged as a transformative technology with applications across various industries, including the medical sector. This review paper provides an overview of the current status of AM technology, its challenges, and its application in the medical industry. The paper covers the different types of AM technologies, such as fused deposition modeling, stereolithography, selective laser sintering, digital light processing, binder jetting, and electron beam melting, and their suitability for medical applications. The most commonly used biomedical materials in AM, such as plastic, metal, ceramic, composite, and bio-inks, are also viewed. The challenges of AM technology, such as material selection, accuracy, precision, regulatory compliance, cost and quality control, and standardization, are also discussed. The review also highlights the various applications of AM in the medical sector, including the production of patient-specific surgical guides, prosthetics, orthotics, and implants. Finally, the review highlights the Internet of Medical Things (IoMT) and artificial intelligence (AI) for regulatory frameworks and safety standards for 3D-printed biomedical devices. The review concludes that AM technology can transform the healthcare industry by enabling patients to access more personalized and reasonably priced treatment alternatives. Despite the challenges, integrating AI and IoMT with 3D printing technology is expected to play a vital role in the future of biomedical device applications, leading to further advancements and improvements in patient care. More research is needed to address the challenges and optimize its use for medical applications to utilize AM's potential in the medical industry fully.

An IoMT-Based Melanoma Lesion Segmentation Using Conditional Generative Adversarial Networks.

Currently, Internet of medical things-based technologies provide a foundation for remote data collection and medical assistance for various diseases. Along with developments in computer vision, the application of Artificial Intelligence and Deep Learning in IOMT devices aids in the design of effective CAD systems for various diseases such as melanoma cancer even in the absence of experts. However, accurate segmentation of melanoma skin lesions from images by CAD systems is necessary to carry out an effective diagnosis. Nevertheless, the visual similarity between normal and melanoma lesions is very high, which leads to less accuracy of various traditional, parametric, and deep learning-based methods. Hence, as a solution to the challenge of accurate segmentation, we propose an advanced generative deep learning model called the Conditional Generative Adversarial Network (cGAN) for lesion segmentation. In the suggested technique, the generation of segmented images is conditional on dermoscopic images of skin lesions to generate accurate segmentation. We assessed the proposed model using three distinct datasets including DermQuest, DermIS, and ISCI2016, and attained optimal segmentation results of 99%, 97%, and 95% performance accuracy, respectively.

Human Digital Twin for Personalized Elderly Type 2 Diabetes Management.

Managing Elderly type 2 diabetes (E-T2D) is challenging due to geriatric conditions (e.g., co-morbidity, multiple drug intake, etc.), and personalization becomes paramount for precision medicine. This paper presents a human digital twin (HDT) framework to manage E-T2D that exploits various patient-specific data and builds a suite of models exploiting the data for prediction and management to personalize diabetes treatment in E-T2D patients. These models include mathematical and deep-learning ones that capture different patient aspects. Consequently, the HDT virtualizes the patient from different viewpoints using an HDT that mimics the patient and has interfaces to update the virtual models simultaneously from measurements. Using these models the HDT obtains deeper insights about the patient. Further, an adaptive patient model fusing this information and a learning-based model predictive control (LB-MPC) algorithm are proposed. The geriatric conditions are captured as model parameters and constraints while solving the LB-MPC to personalize the insulin infusion for E-T2D management. The HDT is deployed on and illustrated with 15 patients using clinical trials and simulations. Our results show that HDT helps improve the time-in-range from 3-75% to 86-97% and reduces insulin infusion by 14-29%.

Designing Digital COVID-19 Screening: Insights and Deliberations.

Due to the global COVID-19 pandemic, public health control and screening measures have been introduced at healthcare facilities, including those housing our most vulnerable populations. These warning measures situated at hospital entrances are presently labour-intensive, requiring additional staff to conduct manual temperature checks and risk-assessment questionnaires of every individual entering the premises. To make this process more efficient, we present eGate, a digital COVID-19 health-screening smart Internet of Things system deployed at multiple entry points around a children's hospital. This paper reports on design insights based on the experiences of concierge screening staff stationed alongside the eGate system. Our work contributes towards social-technical deliberations on how to improve design and deploy of digital health-screening systems in hospitals. It specifically outlines a series of design recommendations for future health screening interventions, key considerations relevant to digital screening control systems and their implementation, and the plausible effects on the staff who work alongside them.

Smart Graphene-Based Electrochemical Nanobiosensor for Clinical Diagnosis: Review.

The technological improvement in the field of physics, chemistry, electronics, nanotechnology, biology, and molecular biology has contributed to the development of various electrochemical biosensors with a broad range of applications in healthcare settings, food control and monitoring, and environmental monitoring. In the past, conventional biosensors that have employed bioreceptors, such as enzymes, antibodies, Nucleic Acid (NA), etc., and used different transduction methods such as optical, thermal, electrochemical, electrical and magnetic detection, have been developed. Yet, with all the progresses made so far, these biosensors are clouded with many challenges, such as interference with undesirable compound, low sensitivity, specificity, selectivity, and longer processing time. In order to address these challenges, there is high need for developing novel, fast, highly sensitive biosensors with high accuracy and specificity. Scientists explore these gaps by incorporating nanoparticles (NPs) and nanocomposites (NCs) to enhance the desired properties. Graphene nanostructures have emerged as one of the ideal materials for biosensing technology due to their excellent dispersity, ease of functionalization, physiochemical properties, optical properties, good electrical conductivity, etc. The Integration of the Internet of Medical Things (IoMT) in the development of biosensors has the potential to improve diagnosis and treatment of diseases through early diagnosis and on time monitoring. The outcome of this comprehensive review will be useful to understand the significant role of graphene-based electrochemical biosensor integrated with Artificial Intelligence AI and IoMT for clinical diagnostics. The review is further extended to cover open research issues and future aspects of biosensing technology for diagnosis and management of clinical diseases and performance evaluation based on Linear Range (LR) and Limit of Detection (LOD) within the ranges of Micromolar µM (10-6), Nanomolar nM (10-9), Picomolar pM (10-12), femtomolar fM (10-15), and attomolar aM (10-18).

An Improved Lightweight User Authentication Scheme for the Internet of Medical Things.

The Internet of Medical Things (IoMT) is used in the medical ecosystem through medical IoT sensors, such as blood glucose, heart rate, temperature, and pulse sensors. To maintain a secure sensor network and a stable IoMT environment, it is important to protect the medical IoT sensors themselves and the patient medical data they collect from various security threats. Medical IoT sensors attached to the patient's body must be protected from security threats, such as being controlled by unauthorized persons or transmitting erroneous medical data. In IoMT authentication, it is necessary to be sensitive to the following attack techniques. (1) The offline password guessing attack easily predicts a healthcare administrator's password offline and allows for easy access to the healthcare worker's account. (2) Privileged-insider attacks executed through impersonation are an easy way for an attacker to gain access to a healthcare administrator's environment. Recently, previous research proposed a lightweight and anonymity preserving user authentication scheme for IoT-based healthcare. However, this scheme was vulnerable to offline password guessing, impersonation, and privileged insider attacks. These attacks expose not only the patients' medical data such as blood pressure, pulse, and body temperature but also the patients' registration number, phone number, and guardian. To overcome these weaknesses, in the present study we propose an improved lightweight user authentication scheme for the Internet of Medical Things (IoMT). In our scheme, the hash function and XOR operation are used for operation in low-spec healthcare IoT sensor. The automatic cryptographic protocol tool ProVerif confirmed the security of the proposed scheme. Finally, we show that the proposed scheme is more secure than other protocols and that it has 266.48% better performance than schemes that have been previously described in other studies.

A smart IoMT based architecture for E-healthcare patient monitoring system using artificial intelligence algorithms.

Generally, cloud computing is integrated with wireless sensor network to enable the monitoring systems and it improves the quality of service. The sensed patient data are monitored with biosensors without considering the patient datatype and this minimizes the work of hospitals and physicians. Wearable sensor devices and the Internet of Medical Things (IoMT) have changed the health service, resulting in faster monitoring, prediction, diagnosis, and treatment. Nevertheless, there have been difficulties that need to be resolved by the use of AI methods. The primary goal of this study is to introduce an AI-powered, IoMT telemedicine infrastructure for E-healthcare. In this paper, initially the data collection from the patient body is made using the sensed devices and the information are transmitted through the gateway/Wi-Fi and is stored in IoMT cloud repository. The stored information is then acquired, preprocessed to refine the collected data. The features from preprocessed data are extracted by means of high dimensional Linear Discriminant analysis (LDA) and the best optimal features are selected using reconfigured multi-objective cuckoo search algorithm (CSA). The prediction of abnormal/normal data is made by using Hybrid ResNet 18 and GoogleNet classifier (HRGC). The decision is then made whether to send alert to hospitals/healthcare personnel or not. If the expected results are satisfactory, the participant information is saved in the internet for later use. At last, the performance analysis is carried so as to validate the efficiency of proposed mechanism.