Search

Recent studies have shown the potential benefits of grid-forming (GFM) converters and their capability of stabilizing a power system with high penetration of power electronics-based generation. A crucial aspect of any GFM converter control strategy will be the handling of fault-ride through (FRT) scenarios, which converters for generation sources will face regularly in the field. In this article, an FRT strategy for GFM converters is proposed, which respects the converter hardware limitations (i.e., current limitations) while maintaining GFM behavior even during “protective” operating modes. The FRT strategy addresses both symmetrical and asymmetrical faults and is compliant with recently proposed draft grid codes requirements published by the British system operator NGESO. The issues related to FRT of GFM converters are first discussed in detail, then a proper strategy is presented and its effectiveness is demonstrated by means of an extensive power-hardware-in-the-loop measurement campaign, showing its efficacy even against severe fault conditions.

Grid inverters need a synchronization algorithm to connect with the grid which is often a phase-locked loop (PLL). Conventionally, small-signal models are used to tune such PLL and to assess stability in steady state; however, they can misjudge the dynamic behaviors, in particular, during large phase perturbation due to grid faults. To address this issue, a more accurate model of PLL-based synchronization of the grid inverter with second-order approximation terms valid not only for the steady state but also for phase transients has been developed in this paper. Stability criterion based on the developed model has been proposed to assess the harmonic stability during phase perturbations. The model accuracy and the effectiveness of the stability criterion have been comprehensively evaluated and validated by simulation and experiments.

State-of-the-art grid-connected converters can be classified as “grid-following,” meaning that they require a dedicated synchronization unit in order to inject active and reactive currents into the grid. Recently, other converter control concepts have been proposed in the literature, such as the synchronverter, which can instead achieve synchronization without a dedicated unit and, within its physical limitations, make the converter behave as an ideal voltage source. Since it should be expected that the grid-connected converters having different control philosophies will coexist for many years, in this article, the interaction among the converters operating nearby are addressed. First, the component connection method (CCM) technique is introduced, as a means for obtaining the state-space representation of a complex system with several units operating nearby. Due to the complexity of the grid and the difficulty in obtaining its exact representation, $\mu $ -analysis is adopted in this article for assessing the robust stability of the converter under different operating conditions, according to a defined set of plant uncertainties. Simulation results and experimental tests in a laboratory environment by means of a power hardware-in-the-loop (PHIL) test bench are performed to demonstrate the validity of the presented analysis.

The increasing penetration of converter-based generation in many power systems around the world has sparked a discussion about how to operate these power systems with the usual levels of efficiency, reliability and cost-effectiveness. Current grid-following converter-based generators have proven to run stably in parallel to one another, even if there are thousands of them connected in a power system, and even in very small isolated power systems with extremely low system inertia. Discussions around the necessity of additional converter performance, usually under the ‘grid-forming’ and ‘Virtual Synchronous Machines’ concepts, have recently been transferred from the academic sphere to national and international industry fora. Formal discussions have started in Great Britain, in Germany and at ENTSO-E level. However, there is still a lot of uncertainty about the real and not simulated performance of grid-forming converters, whilst the needs case for requiring this radically different control method has not been adequately justified. With the present paper we raise key questions that will serve towards an objective discussion about power system needs, grid infeed technologies and their interaction.

Neonatal subcutaneous fat necrosis (SCFN) is a transient, generally benign panniculitis that presents within several weeks of life and occurs mostly in term or post-term newborns who have a history of intrauterine or perinatal distress. It is usually a self-limited condition. Hypercalcemia is a rare but serious complication of SCFN and needs prolonged follow-up. The etiopathogenesis of both subcutaneous fat necrosis in newborn and the resultant hypercalcemia is poorly understood. We describe a classic presentation of SCFN that led to a severe hypercalcemia refractory to standard treatment. This case shows how a single dose of neridronic acid was safe and effective in managing severe hypercalcemia unresponsive to conventional therapy without hypocalcemic rebounds.

Recent studies have shown the importance of considering the synchronization mechanism of a grid-connected converter in its stability assessment. Moreover, it is often taken for granted that synchronization units of grid-connected converters operating nearby may interact with each other, but this topic has not yet been deeply investigated in the literature. In this paper, the interaction between synchronization units of grid-connected converters is investigated by means of impedance-based analysis. A multiple-inputs multiple-outputs analysis is required and a stability margin is introduced, based on the calculation of the norm of the equivalent grid impedance and equivalent output admittance of the converter. The sensitivity of the stability margin to parameter variations (e.g., grid impedance, bandwidth of the synchronization loop of each converter) is assessed by means of Monte Carlo simulations. Time-domain simulations as well as experimental results in a laboratory environment using a power hardware-in-the-loop test bench are performed so as to validate the presented frequency-domain analysis.

Recent studies have shown how synchronization units of converters operating nearby may interact with each other, affecting the stability of the system. Synchronverters are able to self-synchronize to the grid without the need of a dedicated unit because they can reproduce the power synchronization mechanism of synchronous machines. Recently, the robust stability of a synchronverter has been investigated by means of structured singular values (commonly called $\mu$ -analysis). In this paper, $\mu$ -analysis is performed to investigate how the robust stability of a synchronverter is affected by the presence of another converter of the same type operating in parallel. It is demonstrated that the parallel operation of synchronverters reduces their robust stability and a possible solution is proposed, based on the implementation of virtual impedances in the control algorithm. An accurate state-space model of the system under study is developed by adopting the component connection method and the robust stability analysis is validated against time-domain simulations in MATLAB/Simulink/PLECS and experimental results with a power-hardware-in-the-loop test bench.

Synchronverters have gained interest due to their capability of emulating synchronous machines, offering self-synchronization to the grid. Despite the simplicity of the control structure, the adoption of an LCL filter makes the overall model complex again, posing questions regarding the tuning of the synchronverter and its robustness. The multi-inputs multi-outputs (MIMO) formulation of the problem requires multivariable analysis. In this paper, the effects of control parameter and grid conditions on the stability of the system are investigated by means of structured singular values (or $\mu$ -analysis). A step-by-step design procedure for the control is introduced based on a linearized small-signal model of the system. Then, the design repercussions on the stability performance are evaluated through the performed robustness analysis. The developed linearized model is validated against time-domain simulations and laboratory experiments. These have been carried out using a power hardware-in-the-loop test bench, which allows as to test the synchronverter under different grid conditions. As a conclusion, this paper offers a simple guide to tune synchronverters but also a theoretical solid framework to assess the robustness of the adopted design.

The potentials of grid-forming (GFM) converters in stabilizing a power system with high penetration of power electronics-based generation have been recently investigated. Due to their intrinsic behaviour of voltage source behind impedance, a crucial aspect of any GFM converter control strategy will be the handling of fault-ride through (FRT) scenarios. This paper proposes a FRT strategy for GFM converters, which respects the converter hardware limitations (i.e. current limitations) even under sever fault conditions, while maintaining GFM behavior before, during, and after the fault. The presented strategy addresses both symmetrical and asymmetrical faults, and is compliant with recently proposed draft grid codes requirements published by the British system operator NGESO. The issues related to FRT of GFM converters are first discussed in detail, and a comprehensive overview on the solutions proposed in the literature is reported. Then a proper strategy is presented, and its effectiveness is demonstrated by means of simulations and Power-Hardware-in-the-Loop (PHIL) measurements in a laboratory environment.

Early detection of chronic obstructive pulmonary disease (COPD) exacerbations using telemonitoring of physiological variables might reduce the frequency of hospitalization.To evaluate the efficacy of home monitoring of lung mechanics by the forced oscillation technique and cardiac parameters in older patients with COPD and comorbidities.This multicenter, randomized clinical trial recruited 312 patients with Global Initiative for Chronic Obstructive Lung Disease grades II to IV COPD (median age, 71 yr [interquartile range, 66-76 yr]; 49.6% grade II, 50.4% grades III-IV), with a history of exacerbation in the previous year and at least one nonpulmonary comorbidity. Patients were randomized to usual care (n = 158) or telemonitoring (n = 154) and followed for 9 months. All telemonitoring patients self-assessed lung mechanics daily, and in a subgroup with congestive heart failure (n = 37) cardiac parameters were also monitored. An algorithm identified deterioration, triggering a telephone contact to determine appropriate interventions.Primary outcomes were time to first hospitalization (TTFH) and change in the EuroQoL EQ-5D utility index score. Secondary outcomes included: rate of antibiotic/corticosteroid prescription; hospitalization; the COPD Assessment Tool, Patient Health Questionnaire-9, and Minnesota Living with Heart Failure questionnaire scores; quality-adjusted life years; and healthcare costs. Telemonitoring did not affect TTFH, EQ-5D utility index score, antibiotic prescriptions, hospitalization rate, or questionnaire scores. In an exploratory analysis, telemedicine was associated with fewer repeat hospitalizations (-54%; P = 0.017).In older patients with COPD and comorbidities, remote monitoring of lung function by forced oscillation technique and cardiac parameters did not change TTFH and EQ-5D. Clinical trial registered with www.clinicaltrials.gov (NCT 01960907).

The stability of a converter synchronized to the grid voltage through a phase-locked loop (PLL) is negatively affected by the presence of another converter with the same synchronization principle operating nearby, especially under weak grid conditions. However, while weak grids are critical for PLL-based converters, virtual synchronous machines (VSMs) are instead suitable for such applications. In fact, it can be proven that the robust stability of a VSM is enhanced when it is connected to a weaker grid. Recent studies have investigated the parallel operation between VSMs, but the parallel operation between a VSM and a PLL-based converter has not yet been properly addressed in the literature. In this paper, this topic is investigated by means of eigenvalue analysis, showing the positive effects on the stability of a PLL-based converter due to the presence of a synchronverter operating nearby. The model of the system under study is obtained adopting the component connection method (CCM), and time-domain simulations as well as experimental results using a power hardware-in-the-loop (PHIL) test bench are reported to demonstrate the validity of the performed analysis.

The synchronization of grid converters through phase-locked loop (PLL) could cause stability issues especially when the penetration of grid converters is high. Most of the works in the literature consider all the grid converters with identical system parameters. In contrast, this paper aims at studying the stability issues of two PLL-synchronized grid converters with different PLL bandwidths and power injections and revealing the interactions between two converters caused by the band-width and power differences. Moreover, the relationship between power injection and PLL bandwidth of the grid converter is investigated. For these studies, a state-space model based on the component connection method (CCM) is developed, which is scalable for the power system with large numbers of grid converters. Eigenvalue-based analysis is carried out to study the grid converters’ interactions as well as power/bandwidth relation under various scenarios. Experimental results are given to validate the effectiveness of the model and theoretical analysis.

Early-onset sepsis (EOS) is responsible for an important fraction of neonatal morbidity and mortality all over the world. The aim of this study was to assess whether presepsin (P-SEP) can be a more accurate biomarker of EOS compared with pro-calcitonin (PCT) and C-reactive protein (CRP). Consecutive preterm neonates (

Virtual Synchronous Machines (VSMs) have been proposed during the last decade as possible solutions for integrating the increasing amount of power electronics-based grid connected converters in the utility grid. One of their main characteristics is the ability to self-synchronize themselves to the main grid without the need of a dedicated unit, since they can reproduce the power synchronization mechanism of a synchronous machine (SM). Different control strategies have been proposed in the literature based on the aforementioned principle. The aim of this work is to provide a generalized formulation of a power synchronization based (PSB) control algorithm, outlining the different loops constituting the control and to give an overview of the solutions proposed in the literature. Similarities along with advantages and drawbacks of each formulation are highlighted in the paper and time-domain simulation in MATLAB/SimulinkIPLECS are performed to compare the performance of the different solutions.

During the last decade virtual synchronous machines (VSMs) have been intensively investigated and plenty of control strategies have been proposed as possible implementations. Some of the proposed control strategies aim to reproduce the inertia of a synchronous machine (SM), but rely on a dedicated unit for the synchronization to the main grid. However, one of the most appealing features of a SM is its ability to self-synchronize itself to the grid thanks to the intrinsic power synchronization mechanism. The Synchronous Power Control (SPC) is among the control strategies proposed in the literature based on the power synchronization mechanism. In this paper, the aforementioned control is deeply investigated. Its concept is first introduced and a small-signal model of an SPC-based grid connected converter is developed. Subsequently, a comprehensive parameter sensitivity analysis is performed in order to identify the effects of control parameters variations on the eigenvalues of the system under different grid conditions. Time-domain simulations in MATLAB/Simulink/PLECS confirm the validity of the developed frequency-domain model.

It has been recently demonstrated that synchronization units of converters operating nearby may interact with each other affecting the stability of the system. Synchronverters have gained interest from the research community due to their capability of emulating the behaviour of synchronous machines (SMs), therefore being able to self-synchronize themselves to the grid without the need of a dedicated unit. However, parallel operation of synchronverters has not yet been properly investigated in literature. In this paper this topic is investigated by means of eigenvalue analysis. An accurate model of the system under study is developed by adopting the component connection method (CCM) technique, which allows to easily obtain the state-space representation of a complex system. It is demonstrated that the stability of the synchronverter could be negatively affected by the presence of another synchronverter operating in parallel, unless proper measures are taken. The developed frequency-domain model is validated against time-domain simulations in MATLAB/Simulink/PLECS and experimental results with a power-hardware in the loop (PHIL) test bench.

Aim: To assess the electrocardiography and echocardiography changes during therapeutic hypothermia and rewarming period in encephalopathic infants with long-term adverse neurological outcome. Methods: Prospective multicentre longitudinal study. We included 64 consecutive infants with moderate or severe hypoxic ischaemic encephalopathy undergoing therapeutic hypothermia who had 18–24 month-outcome data. We analysed electrocardiography and heart rate changes before, during and after therapeutic hypothermia. Superior vena cava flow, left ventricular cardiac output and stroke volume were studied using echocardiography during and immediately after therapeutic hypothermia. An abnormal outcome was defined as death or moderate/severe disability at 18–24 months. Results: Neonates with higher superior vena cava flow pre-rewarming had significantly higher odds of documented long-term adverse outcome when compared to newborns with good outcome (OR 1.57; 95%CI, 1.1–1.78; p = 0.01 after adjustment). QTc and RR intervals were significantly longer at 12, 24, 36 and 48 h in infants with good outcome compared with those with adverse outcome (p < 0.001). During therapeutic hypothermia, infants with poor outcome had a higher heart rate at 12, 24, 36, 48, 60 h after birth compared with those with good outcome (p < 0.001). From 36 h on, heart rate gradually increased and RR and QTc intervals progressively shortened with values back to normal after rewarming. Conclusions: Infants with hypoxic ischaemic encephalopathy who have adverse neurological outcome show a preferential cerebral blood flow redistribution during therapeutic hypothermia. Infants with poor outcome have higher heart rate and shorter RR and QTc intervals during therapeutic hypothermia.

Robots have the potential to support care and independence of older adults. The ENRICHME project is developing an integrated system composed of a robot, sensors and a networking care platform, aiming at assisting older adults with MCI in their home environment. This paper reports findings of the tests performed on a sample of MCI users and their caregivers, with the first version of the ENRICHME system, in a controlled environment.

Evidence of clinical benefit and cost-effectiveness from daily symptom and simple telemonitoring in COPD is unproven. The CHROMED study explored the effect of telemonitoring in older people with COPD and significant co-morbidity who performed daily forced oscillation measurements via RESMON PRO DIARY to identify early physiological change associated with an exacerbation. Six centres in 5 countries randomised 312 people to 9 months telemonitoring (154) or daily symptom questionnaires (158). Each day the monitored group recorded symptoms, pulse, BP, oxygen saturation and airway resistance and reactance. An alert was generated if results exceeded pre-determined parameters and the participant was contacted by their local clinical centre to consider additional treatment. Baseline characteristics were evenly matched: mean age 71 years, FEV1 1.3L (50% predicted) and SGRQ score 49. 61% of subjects had 2+ exacerbations and 42% had been hospitalised in the previous year. Time to first hospitalisation did not differ albeit the monitoring group had fewer hospitalisations (79 vs 103; p=ns) and days in hospital (329 vs. 650; p=ns). However, subjects hospitalized with an AE COPD in the previous year (n=128) had a lower hospitalisation rate (p

Mild cognitive impairment (MCI) is a state related to ageing, and sometimes evolves to dementia. As there is no pharmacological treatment for MCI, a non-pharmacological approach is very important. The use of Information and Communication Technologies (ICT) in care and assistance services for elderly people increases their chances of prolonging independence thanks to better cognitive efficiency. Robots are seen to have the potential to support the care and independence of elderly people. The project ENRICHME (funded by the EU H2020 Programme) focuses on developing and testing technologies for supporting elderly people with MCI in their living environment for a long time. This paper describes the results of the activities conducted during the first year of the ENRICHME project, in particular the definition of user needs and requirements and the resulting system architecture.

CHROMED (clinical trials for elderly people with multiple diseases, www.chromed.eu) is an EU-funded project involving 9 partners from 7 European countries aimed at evaluating the impact of a new home care approach to reduce costs and improve quality of life in elderly patients with COPD and comorbidity. The trial involves 300 patients with a prior history of exacerbations randomly assigned to a monitoring or observational arm. Monitored patients performed daily self-assessment of lung mechanics with a FOT (Forced Oscillation Technique) device (RESMON PRO DIARY, Restech srl, Italy) and completed a symptom diary card on touchscreen device (HOME PATIENT MONITOR, EBM srl, Italy). Any detected worsening in lung mechanics generated an alert triggering a phone interview directed at verifying the patient's status and optimizing treatment. By the end of March 2015, 70 monitored patients had completed the trial resulting in 16198 measurements with an adherence of 90.1%. Based on lung mechanics, 311 worsening events were detected, resulting in 0.65±0.3 alerts/patient/month. At least one major symptom (dyspnea, sputum purulence and volume) was reported in 70% of events and 41% were associated with an exacerbation according to diary cards (Seemungal et al., Am J Respir Crit Care Med 1998). A total of 77 exacerbations were confirmed during the phone interview and treated, but 48% of them were not associated with an exacerbation defined by diary cards only. These results suggest that a significant percentage of exacerbations cannot be identified by diary cards only. Self-assessment of lung mechanics using FOT provides complementary information which can be useful to manage COPD patients at home.

Characterize the trends in mortality from cancer in Chile according to differences in educational level in the period 2000-2010 in the population over 20 years of age.Calculation of specific mortality from cancer, age-adjusted for different educational levels, for the period 2000-2010. The obtained rates were analyzed using a Poisson regression model, calculating the relative inequality index and the slope index of inequality for each year.232 541 deaths from cancer were reported in the period 2000-2010. The most frequent types were breast, stomach, and gallbladder cancer in women; and stomach, prostate, and lung cancer in men. Age-standardized mortality from cancer was greater in the lower educational levels, except for breast cancer in woman and lung cancer in men. The greatest differences were found in gallbladder cancer in women and stomach cancer in men, with specific mortality rates up to 49 and 63 times higher, respectively, for low educational levels compared to higher ones. Between 2000 and 2010, the differences in mortality by educational level were smaller for all cancers combined in both genders, for breast cancer in women, and for lung and stomach in men.During the period studied, mortality from cancer in Chile was strongly associated with the educational level of the population. This information should be considered when designing national strategies to reduce specific mortality from cancer in the most vulnerable groups.

The CHRONIOUS system offers an integrated platform aiming at the effective management and real-time assessment of the health status of the patient suffering from chronic obstructive pulmonary disease (COPD). An intelligent system is developed for the analysis and the real-time evaluation of patient's condition. A hybrid classifier has been implemented on a personal digital assistant, combining a support vector machine, a random forest, and a rule-based system to provide a more advanced categorization scheme for the early and in real-time characterization of a COPD episode. This is followed by a severity estimation algorithm which classifies the identified pathological situation in different levels and triggers an alerting mechanism to provide an informative and instructive message/advice to the patient and the clinical supervisor. The system has been validated using data collected from 30 patients that have been annotated by experts indicating 1) the severity level of the current patient's health status, and 2) the COPD disease level of the recruited patients according to the GOLD guidelines. The achieved characterization accuracy has been found 94%.

The CHRONIOUS system defines a powerful and easy to use framework which has been designed to provide services to clinicians and their patients suffering from chronic diseases. The system is composed of a wearable shirt that integrate several body sensors, a portable smart device and a central sub-system that is responsible for the long term storage of the collected patient's data. A multi-parametric expert system is developed for the analysis of the collected data using intelligent algorithms and complex techniques. Apart for the vital signals, dietary habits, drug intake, activity data, environmental and biochemical parameters are recorded. The CHRONIOUS platform is validated through clinical trials in several medical centers and patient's home environments recruiting patients suffering from Chronic Obstructive pulmonary disease (COPD) and Chronic Kidney Disease (CKD) diseases. The clinical trials contribute in improving the system's accuracy, while Pulmonologists and Nephrologists experts utilized the CHRONIOUS platform to evaluate its efficiency and performance. The results of the utilization of the system were very encouraging. The CHRONIOUS system has been proven to be a well-validated real-time patient monitoring and supervision platform, providing a useful tool for the clinician and the patient that would contribute to the more effective management of chronic diseases.

To investigate whether creatine kinase-MB (CK-MB) and cardiac troponin I (cTnI) can be used to predict neurodevelopmental outcome at 18 months in infants with perinatal asphyxia (PA). The diagnostic value of cTnI to assess myocardial dysfunction was considered as well.Retrospective study of 178 neonates admitted with PA. cTnI concentrations measured within 12 h of birth were compared with medium-term outcome assessed with the Bayley Scales of Infant Development. cTnI concentrations measured within 12 h of birth were compared with clinical grade of hypoxic-ischemic encephalopathy (HIE) and with duration of inotropic support. Two-dimensional Doppler and color Doppler findings were recorded. Fractional shortening, tricuspid and mitral regurgitation were evaluated.A statistically significant correlation between cTnI concentration and BSID-II score was found (mental development index r -0.69, P0.05 and psychomotor development index r -0.39, P0.05). There was no statistically significant correlation between CK-MB and BSID-II score (P0.05).Serum cTnI concentrations and duration of inotropic support were significantly greater with increasing severity of PA. cTnI was negatively correlated with fraction shortening (r -0.64; P0.05). The severity of tricuspid regurgitation was correlated with the cTnI concentration (r 0.61; P0.05).In asphyxiated neonates, cTnI concentrations within 12 h of birth correlate with medium-term outcome. Early cTnI concentration correlates with severity of HIE, myocardial dysfunction and with Bayley II scores at 18 months.

The Chronic Obstructive Pulmonary Disease (COPD) is a chronic disease that causes airflow blockage and breathing-related problems. As a Chronic disease it requires specific treatment plan and patient management for a long period of time. Critical factor in the process is the realization of frequent and precise diagnostic tests that describes the health status of the patient. The CHRONIOUS system provides the required easy-to-use wearable platform aiming at the successful management of COPD patients. Several signals and patient's data are stored by the utilization of an ergonomic jacket and through the patient's platform interface. Hybrid techniques based on supervised and unsupervised methodologies were applied for the analysis of the patient's situation. The categorization of health level of the patient to discrete levels is achieved in a continuous base. Useful outcomes in the form of message or advice are extracted appeared on patient's and clinician's devices denoting his health status.

Intensity modulated radiotherapy (IMRT) is an important step forward in cancer treatment.To report the first experience in Chile with IMRT for prostate cancer and compare the results obtained with different doses.From January 1997 through June 2008, 156 patients with a mean age of 70 years, were treated with radiotherapy and 121 with IMRT. Patients were staged according to American Commission on Cancer Staging. Their biochemical relapse risk was classified according to the MD Anderson classification. Patients were routinely checked during and after therapy to evaluate side effects and relapse.Median follow up was 46 months (4-120). Overall five years survival was 85%. Biochemical relapse free five years survival for low, intermediate and high risk patients was 100, 82 and 70%, respectively. Biochemical relapse free survival for patients receiving radiotherapy doses over 76 Gy was 83%, compared to 30% for those receiving lower doses (p0.05). Urinary and gastrointestinal acute toxicity was low in 80% and 90% of patients respectively. Late toxicity developed in less than 3% of patients.IMRT for prostate cancer is readily available and safe in Chile. Biochemical disease free survival improved with higher doses with low toxicity rates.

The CHRONIOUS system has been developed based on an open architecture design that consists of a set of subsystems which interact in order to provide all the needed services to the chronic disease patients. An advanced multi-parametric expert system is being implemented that fuses information effectively from various sources using intelligent techniques. Data are collected by sensors of a body network controlling vital signals while additional tools record dietary habits and plans, drug intake, environmental and biochemical parameters and activity data. The CHRONIOUS platform provides guidelines and standards for the future generations of “chronic disease management systems” and facilitates sophisticated monitoring tools. In addition, an ontological information retrieval system is being delivered satisfying the necessities for up-to-date clinical information of Chronic Obstructive pulmonary disease (COPD) and Chronic Kidney Disease (CKD). Moreover, support tools are being embedded in the system, such as the Mental Tools for the monitoring of patient mental health status. The integrated platform provides real-time patient monitoring and supervision, both indoors and outdoors and represents a generic platform for the management of various chronic diseases.

The CHRONIOUS system is an open-architecture integrated platform aiming at the management of chronic disease patients. The system consists of a body sensor network collecting patient’s vital signals, a Personal Digital Assistance (PDA) for the real-time data analysis based on a Decision Support System (DSS) and a central system for the deeper analysis of patient’s status and data storing. The DSS combines several data sources to decide upon the severity of patient’s current health status. The first pilot study has been designed and carried out using patients suffering from Chronic Obstructive Pulmonary Disease(COPD). The DSS facilitates a one-against-all multi-class Support Vector Machine (SVM) classification system. The performance of the categorization scheme provides high classification results for most of the patient’s health status levels. The involvement of a larger number of patients might increase further the performance of the system.

CHRONIOUS system is an integrated platform aiming at the management of chronic disease patients. One of the most important components of the system is a Decision Support System (DSS) that has been developed in a Smart Device (SD). This component decides on patient's current health status by combining several data, which are acquired either by wearable sensors or manually inputted by the patient or retrieved from the specific database. In case no abnormal situation has been tracked, the DSS takes no action and remains deactivated until next abnormal situation pack of data are being acquired or next scheduled data being transmitted. The DSS that has been implemented is an integrated classification system with two parallel classifiers, combining an expert system (rule-based system) and a supervised classifier, such as Support Vector Machines (SVM), Random Forests, artificial Neural Networks (aNN like the Multi-Layer Perceptron), Decision Trees and Naïve Bayes. The above categorized system is useful for providing critical information about the health status of the patient.

The developed system aims to collect and analyze information valuable for estimating the severity of a health episode regarding patients suffering from chronic diseases. The system addresses a wearable platform, based on multi-parametric sensor data, a device which collects the data and a Smart Assistant Device, responsible for analyzing the collected multi-parametric data and facilitating the monitor of people suffering from chronic diseases in long-stay setting. The wearable platform integrates several sensors collecting information regarding motion, ECG, respiration, oxygen saturation (SpO 2 ), temperature and various other parameters. The Smart Assistant Device, after applying pre-processing and feature extraction techniques, fuses all sensor acquired data with information inserted by the patient. An Intelligent System is developed to analyze sensors' acquired and patient inputted data, facilitating data mining techniques, and decides upon the severity of a pathological episode that was appeared to the patient.

The CHRONIOUS system addresses a smart wearable platform, based on multi-parametric sensor data processing, for monitoring people suffering from chronic diseases in long-stay setting. Several signals are being recorded through wearable sensors and are stored together with additional information, entered by the patient. An Intelligent System, placed at a Smart Assistant Device, analyzes incoming data and facilitates data mining techniques resulting upon the severity of a health episode. Part of the Intelligent System is the Mental Support Tool, which calculates a Stress Index and classifies the mental condition and stress levels of the patient. An additional component aiming at the personalization of the Intelligent System's Decision is the Profiler which defines several patients profiles and facilitates clustering techniques in order to associate each patient's description with one of the predefined profiles.

CHRONIOUS project contributions supports the design and the development of an open architecture monitoring platform aiming on the detailed description of patient's health status focusing on people with chronic diseases. Essential modules of the CHRONIOUS system are the wearable platform responsible for the collection of several vital body signs, environmental, context and patient's activity signals. These data together with the description of patients' drug intake and dietary habits are analyzed by the CHRONIOUS intelligent module. The patient's history and his demographic data are processed along with the rest of the signals, concluding in the description of his recent health condition and the estimation of his severity status. As pilot studies for the development and the evaluation of the CHRONIOUS system, two of the most frequent chronic diseases have been selected: the Chronic Obstructive Pulmonary Disease (COPD) and the Chronic Kidney Disease (CKD). The architecture of the CHRONIOUS platform as well as some of the initial results are presented in this paper.

CHRONIOUS is a highly innovative Information and Communication Technologies (ICT) research initiative that aspires to implement its vision for ubiquitous health and lifestyle monitoring of people with chronic diseases at a European level.CHRONIOUS is funded by the European Union under its 7th Framework Program. The project started on February 1st, 2008 and has a planned duration of three years and half. The CHRONIOUS team is a consortium of internationally renowned research labs in Europe, universities and private companies, who collaborate to define a European framework for a generic health status monitoring platform addressing people with chronic health conditions. CHRONIOUS addresses a smart wearable platform, based on multi-parametric sensors processing, for monitoring people suffering from chronic diseases. In particular CHRONIOUS will be tested with chronic obstructive pulmonary disease (COPD) and chronic kidney disease (CKD) and renal insufficiency inpatients at their home.

This study shows preliminary results of the multicenter and international I-DONT-FALL (IDF) project, cofunded by the European Union, aiming to offer an integrated Information and Communication Technologies (ICT) solution for fall prevention and detection. Here we assessed the efficacy of a motor and a cognitive treatment delivered through the IDF ICT solution, aiming to reduce the risk of falls through a randomized controlled trial. The outcome was measured with the Falls Efficacy Scale-International (FES-I) and the subscales of the Tinetti Performance Oriented Mobility Assessment for balance (POMA-B) and gait (POMA-G). We compared the effect of a 24-sessions period of motor training delivered through an i-Walker vs. a comparable period of non-motor training in terms of frequency and duration of sessions. The same comparison was performed for a period of cognitive training delivered though a touch-screen computer interface vs. a comparable period of non-cognitive training in terms of frequency and duration of sessions. Results showed that motor treatment alone or mixed with cognitive training reduces significantly the fear of falling and the risk of falls. Both cognitive and motor treatments showed a nonspecific positive effect on balance performance of participants. These preliminary results are consistent with previous evidences.