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Background: Hypothesis-free signal detection (HFSD) methods such as tree-based scan statistics (TBSS) applied to longitudinal electronic healthcare data (EHD) are increasingly used in safety monitoring. However, challenges may arise in interpreting HFSD results alongside results from disproportionality analysis of spontaneous reporting., Research Design and Methods: Using the anti-diabetes drug insulin glargine (Lantus®) we apply two different tree-based scan designs using TreeScan™ software on retrospective EHD and compare the results to one another as well as to results from a disproportionality analysis using SRD., Results: The self-controlled tree temporal scan method produced the larger number of alerts relative to propensity-score matched approach; however, far fewer alerts were observed when analyses were limited to EHD in inpatient/emergency room settings only. Very few reference adverse events were observed using TBSS methods on EHD relative to disproportionality methods in SRD., Conclusion: Differences in detected alerts between TBSS methods and between TBSS and disproportionality analysis of SRD are likely attributable to differences in data, comparator, and study design. Our results suggest that HFDS methods like TBSS applied to EHD may complement more traditional approaches such as disproportionality analysis of SRD to provide a more complete picture of product safety in the post-approval setting.

Background: The move of cancer treatment into the outpatient setting can impact patient experience. Understanding how service delivery change impacts different people requires service feedback to inform future delivery development. The use of patient experience questionnaires often generates large amount of free-text data that are difficult to analyze., Objective: The aim of this study was to describe a proof-of-concept study exploring the experiences and perceptions of people undergoing cancer treatment, using novel analysis techniques to provide rapid free-text data analysis., Method: This was a mixed-methods qualitative analysis from qualitative questions gathered in Finland using the National Cancer Patient Experience Survey (n = 92 of 208 patients) and supplemented with 7 focus groups (31 people with cancer). Data were analyzed using natural language processing, via an automated sentiment analysis algorithm and supported with focus groups to inform the initial thematic analysis., Results: Participants were on average 65 years of age. Of the 196 free-text comments, 121 (73.6%) were positive about patient experiences and 75 (38.5%) negative with suggestions for improvement., Conclusion: Communication between patients and clinicians was an indicator of quality, and lack of psychological support was a barrier to quality care provision. The methodology of using sentiment analysis for free content to review quality was demonstrated through this study as a novel and feasible method to look at large-scale qualitative data., Implications for Practice: Using the free content on experience of care questionnaire to review gaps or needs in services is valuable in developing future practice., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)

Continual learning models allow them to learn and adapt to new changes and tasks over time. However, in continual and sequential learning scenarios, in which the models are trained using different data with various distributions, neural networks (NNs) tend to forget the previously learned knowledge. This phenomenon is often referred to as catastrophic forgetting. The catastrophic forgetting is an inevitable problem in continual learning models for dynamic environments. To address this issue, we propose a method, called continual Bayesian learning networks (CBLNs), which enables the networks to allocate additional resources to adapt to new tasks without forgetting the previously learned tasks. Using a Bayesian NN, CBLN maintains a mixture of Gaussian posterior distributions that are associated with different tasks. The proposed method tries to optimize the number of resources that are needed to learn each task and avoids an exponential increase in the number of resources that are involved in learning multiple tasks. The proposed method does not need to access the past training data and can choose suitable weights to classify the data points during the test time automatically based on an uncertainty criterion. We have evaluated the method on the MNIST and UCR time-series data sets. The evaluation results show that the method can address the catastrophic forgetting problem at a promising rate compared to the state-of-the-art models.

Sleep quality is an important determinant of human health and wellbeing. Novel technologies that can quantify sleep quality at scale are required to enable the diagnosis and epidemiology of poor sleep. One important indicator of sleep quality is body posture. In this paper, we present the design and implementation of a non-contact sleep monitoring system that analyses body posture and movement. Supervised machine learning strategies applied to noncontact vision-based infrared camera data using a transfer learning approach, successfully quantified sleep poses of participants covered by a blanket. This represents the first occasion that such a machine learning approach has been used to successfully detect four predefined poses and the empty bed state during 8-10 hour overnight sleep episodes representing a realistic domestic sleep situation. The methodology was evaluated against manually scored sleep poses and poses estimated using clinical polysomnography measurement technology. In a cohort of 12 healthy participants, we find that a ResNet-152 pre-trained network achieved the best performance compared with the standard de novo CNN network and other pre-trained networks. The performance of our approach was better than other video-based methods for sleep pose estimation and produced higher performance compared to the clinical standard for pose estimation using a polysomnography position sensor. It can be concluded that infrared video capture coupled with deep learning AI can be successfully used to quantify sleep poses as well as the transitions between poses in realistic nocturnal conditions, and that this non-contact approach provides superior pose estimation compared to currently accepted clinical methods.

With the proliferation of sensors and IoT technologies, stream data are increasingly stored and analyzed, but rarely combined, due to the heterogeneity of sources and technologies. Semantics are increasingly used to share sensory data, but not so much for annotating stream data. Semantic models for stream annotation are scarce, as generally semantics are heavy to process and not ideal for Internet of things (IoT) environments, where the data are frequently updated. We present a light model to semantically annotate streams, IoT-Stream. It takes advantage of common knowledge sharing of the semantics, but keeping the inferences and queries simple. Furthermore, we present a system architecture to demonstrate the adoption the semantic model, and provide examples of instantiation of the system for different use cases. The system architecture is based on commonly used architectures in the field of IoT, such as web services, microservices and middleware. Our system approach includes the semantic annotations that take place in the pipeline of IoT services and sensory data analytics. It includes modules needed to annotate, consume, and query data annotated with IoT-Stream. In addition to this, we present tools that could be used in conjunction to the IoT-Stream model and facilitate the use of semantics in IoT.

Dementia is a neurological and cognitive condition that affects millions of people around the world. At any given time in the United Kingdom, 1 in 4 hospital beds are occupied by a person with dementia, while about 22% of these hospital admissions are due to preventable causes. In this paper we discuss using Internet of Things (IoT) technologies and in-home sensory devices in combination with machine learning techniques to monitor health and well-being of people with dementia. This will allow us to provide more effective and preventative care and reduce preventable hospital admissions. One of the unique aspects of this work is combining environmental data with physiological data collected via low cost in-home sensory devices to extract actionable information regarding the health and well-being of people with dementia in their own home environment. We have worked with clinicians to design our machine learning algorithms where we focused on developing solutions for real-world settings. In our solutions, we avoid generating too many alerts/alarms to prevent increasing the monitoring and support workload. We have designed an algorithm to detect Urinary Tract Infections (UTI) which is one of the top five reasons of hospital admissions for people with dementia (around 9% of hospital admissions for people with dementia in the UK). To develop the UTI detection algorithm, we have used a Non-negative Matrix Factorisation (NMF) technique to extract latent factors from raw observation and use them for clustering and identifying the possible UTI cases. In addition, we have designed an algorithm for detecting changes in activity patterns to identify early symptoms of cognitive decline or health decline in order to provide personalised and preventative care services. For this purpose, we have used an Isolation Forest (iForest) technique to create a holistic view of the daily activity patterns. This paper describes the algorithms and discusses the evaluation of the work using a large set of real-world data collected from a trial with people with dementia and their caregivers., Competing Interests: This project is supported by a grant from the Department of Health in the UK and NHS England and led by Surrey and Borders Partnership NHS Foundation Trust. This project is also monitored by Innovate UK and IoT UK. Partners involved in the project include: Surrey and Borders Partnership, Alzheimers Society, University of Surrey, Royal Holloway University of London, Kent Surrey Sussex Academic Health Science Network, six local clinical commissioning groups and the following technology innovators: Intelesant, Safe Patient System, Sense.ly, Vision 360/Arqiva, Yecco, Docobo, and Halliday James. The industry partners are also partially funded by the Department of Health for their contribution in this project. There are no patents, products in development or marketed products to declare regarding the work reported in this paper. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

The number of people diagnosed with dementia is expected to rise in the coming years. Given that there is currently no definite cure for dementia and the cost of care for this condition soars dramatically, slowing the decline and maintaining independent living are important goals for supporting people with dementia. This paper discusses a study that is called Technology Integrated Health Management (TIHM). TIHM is a technology assisted monitoring system that uses Internet of Things (IoT) enabled solutions for continuous monitoring of people with dementia in their own homes. We have developed machine learning algorithms to analyse the correlation between environmental data collected by IoT technologies in TIHM in order to monitor and facilitate the physical well-being of people with dementia. The algorithms are developed with different temporal granularity to process the data for long-term and short-term analysis. We extract higher-level activity patterns which are then used to detect any change in patients' routines. We have also developed a hierarchical information fusion approach for detecting agitation, irritability and aggression. We have conducted evaluations using sensory data collected from homes of people with dementia. The proposed techniques are able to recognise agitation and unusual patterns with an accuracy of up to 80%.

A novel quaternion-valued singular spectrum analysis (SSA) is introduced for multichannel analysis of electroencephalogram (EEG). The analysis of EEG typically requires the decomposition of data channels into meaningful components despite the notoriously noisy nature of EEG--which is the aim of SSA. However, the singular value decomposition involved in SSA implies the strict orthogonality of the decomposed components, which may not reflect accurately the sources which exhibit similar neural activities. To allow for the modelling of such co-channel coupling, the quaternion domain is considered for the first time to formulate the SSA using the augmented statistics. As an application, we demonstrate how the augmented quaternion-valued SSA (AQSSA) can be used to extract the sources, even at a signal-to-noise ratio as low as -10 dB. To illustrate the usefulness of our quaternion-valued SSA in a rehabilitation setting, we employ the proposed SSA for sleep analysis to extract statistical descriptors for five-stage classification (Awake, N1, N2, N3 and REM). The level of agreement using these descriptors was 74% as quantified by the Cohen's kappa.

In this study, a single-channel electroencephalography (EEG) analysis method has been proposed for automated 3-state-sleep classification to discriminate Awake, NREM (non-rapid eye movement) and REM (rapid eye movement). For this purpose, singular spectrum analysis (SSA) is applied to automatically extract four brain rhythms: delta, theta, alpha, and beta. These subbands are then used to generate the appropriate features for sleep classification using a multi class support vector machine (M-SVM). The proposed method provided 0.79 agreement between the manual and automatic scores.

Complex tensor factorisation of correlated brain sources is addressed in this paper. The electrical brain responses due to motory, sensory, or cognitive stimuli, i.e. event related potentials (ERPs), particularly P300, have been used for cognitive information processing. P300 has two subcomponents, P3a and P3b which are correlated and therefore, the traditional blind source separation approaches cannot solve the problem. In this work, a complex-valued tensor factorisation of electroencephalography (EEG) signals is introduced with the aim of separating P300 subcomponents. The proposed method uses complex-valued statistics to exploit the data correlation. In this way, the variations of P3a and p3b can be tracked for the assessment of the brain state. The results of this work will be compared with those of spatial principal component analysis (SPCA) method.