ECG Standards and Formats for Interoperability between mHealth and Healthcare Information Systems: A Scoping Review.

Interoperability is defined as the ability of a system or device to communicate between different technologies and software applications. This allows the exchange and use of data in an efficient, precise, and robust way. The present article gives researchers and healthcare information systems developers a qualitative and quantitative synthesis of the state of knowledge related to data formats and data standards proposed for mHealth devices interoperability in healthcare information systems that retrieve and store ECG data. We carry out a scoping review to answer to following questions: (1) What digital data formats or data standards have been proposed for the interoperability of electrocardiograph data between traditional healthcare information systems and mobile healthcare information systems? (2) What are the advantages and disadvantages of these data formats or data standards? The scoping review was conducted in four databases in accordance with the JBI methodology for scoping reviews, and in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). A total of 4018 studies were identified of which 30 studies met the inclusion criteria. Based on our findings, we identify four standards and nine formats for capturing and storing streaming ECG data in mobile health applications. The standards used were HL7, SCP-ECG, x73-PHD, and PDF/A. Formats include CSV, PDF-ECG, and seven XML-based formats. These are ECG-XML, HL7-XML, mPCG-XML, mECGML, JSON, SaECG, and CDA R2.

Applying Machine Learning to Finger Movements Using Electromyography and Visualization in Opensim.

Electromyographic signals have been used with low-degree-of-freedom prostheses, and recently with multifunctional prostheses. Currently, they are also being used as inputs in the human-computer interface that controls interaction through hand gestures. Although there is a gap between academic publications on the control of an upper-limb prosthesis developed in laboratories and its service in the natural environment, there are attempts to achieve easier control using multiple muscle signals. This work contributes to this, using a database and biomechanical simulation software, both open access, to seek simplicity in the classifiers, anticipating their implementation in microcontrollers and their execution in real time. Fifteen predefined finger movements of the hand were identified using classic classifiers such as Bayes, linear and quadratic discriminant analysis. The idealized movements of the database were modeled with Opensim for visualization. Combinations of two preprocessing methods-the forward sequential selection method and the feature normalization method-were evaluated to increase the efficiency of these classifiers. The statistical methods of cross-validation, analysis of variance (ANOVA) and Duncan were used to validate the results. Furthermore, the classifier with the best recognition result was redesigned into a new feature space using the sparse matrix algorithm to improve it, and to determine which features can be eliminated without degrading the classification. The classifiers yielded promising results-the quadratic discriminant being the best, achieving an average recognition rate for each individual considered of 96.16%, and with 78.36% for the total sample group of the eight subjects, in an independent test dataset. The study ends with the visual analysis under Opensim of the classified movements, in which the usefulness of this simulation tool is appreciated by revealing the muscular participation, which can be useful during the design of a multifunctional prosthesis.

Fabricating a Portable ECG Device Using AD823X Analog Front-End Microchips and Open-Source Development Validation.

Relevant to mobile health, the design of a portable electrocardiograph (ECG) device using AD823X microchips as the analog front-end is presented. Starting with the evaluation board of the chip, open-source hardware and software components were integrated into a breadboard prototype. This required modifying the microchip with the breadboard-friendly Arduino Nano board in addition to a data logger and a Bluetooth breakout board. The digitized ECG signal can be transmitted by serial cable, via Bluetooth to a PC, or to an Android smartphone system for visualization. The data logging shield provides gigabytes of storage, as the signal is recorded to a microSD card adapter. A menu incorporates the device's several operating modes. Simulation and testing assessed the system stability and performance parameters in terms of not losing any sample data throughout the length of the recording and finding the maximum sampling frequency; and validation determined and resolved problems that arose in open-source development. Ultimately, a custom printed circuit board was produced requiring advanced manufacturing options of 2.5 mils trace widths for the small package components. The fabricated device did not degrade the AD823X noise performance, and an ECG waveform with negligible distortion was obtained. The maximum number of samples/second was 2380 Hz in serial cable transmission, whereas in microSD recording mode, a continuous ECG signal for up to 36 h at 500 Hz was verified. A low-cost, high-quality portable ECG for long-term monitoring prototype that reasonably complies with electrical safety regulations and medical equipment design was realized.

QRS complex duration enhancement as ventricular late potential indicator by signal-averaged ECG using time-amplitude alignments.

Ventricular late potentials (VLPs) are small-amplitude waves with a short duration that appear at the end part of the QRS complex, making a QRS complex duration larger. The signal-averaged electrocardiography (ECG) technique enhances VLPs and beats, assuming noise as the only random variable. However, ECG signals are not completely stationary and different elongations appear in both time and amplitude in each beat. This research proposes to use piecewise linear approximation to segment each beat and performs the alignment of the beats using the technique known as derivative dynamic time-warping to have beats better aligned and consequently enhance the presence of VLPs. We recorded high-resolution ECGs (HRECGs) from 50 subjects in supine position with no heart-stroke antecedents. VLPs were created synthetically and added to the HRECGs. Two cases were evaluated: (i) duration of the QRS complexes with VLPs without beats alignment, and (ii) duration of QRS complexes with VLPs using beats alignment in time and amplitude. Considering QRS duration as an indicative of VLP presence, results show that when using beats alignment in time and amplitude it is possible to reach a sensitivity of 0.96 and a specificity of 0.52, as opposed to 0.72 and 0.40, respectively, when using only averaging without beats alignment in time and amplitude.

Dynamic autofocus for continuous-scanning time-delay-and-integration image acquisition in automated microscopy.

Efficient image cytometry of a conventional microscope slide means rapid acquisition and analysis of 20 gigapixels of image data (at 0.3-microm sampling). The voluminous data motivate increased acquisition speed to enable many biomedical applications. Continuous-motion time-delay-and-integrate (TDI) scanning has the potential to speed image acquisition while retaining sensitivity, but the challenge of implementing high-resolution autofocus operating simultaneously with acquisition has limited its adoption. We develop a dynamic autofocus system for this need using: 1. a "volume camera," consisting of nine fiber optic imaging conduits to charge-coupled device (CCD) sensors, that acquires images in parallel from different focal planes, 2. an array of mixed analog-digital processing circuits that measure the high spatial frequencies of the multiple image streams to create focus indices, and 3. a software system that reads and analyzes the focus data streams and calculates best focus for closed feedback loop control. Our system updates autofocus at 56 Hz (or once every 21 microm of stage travel) to collect sharply focused images sampled at 0.3x0.3 microm(2)/pixel at a stage speed of 2.3 mms. The system, tested by focusing in phase contrast and imaging long fluorescence strips, achieves high-performance closed-loop image-content-based autofocus in continuous scanning for the first time.