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This article describes a new approach for quantitative evaluation of respiration in the pediatric intensive care unit (PICU). Video sequences of thorax movements are recorded by two depth cameras to cover the 3-D surface of the torso and its lateral sides. The breathing activity implies a frame-by-frame surface deformation, which can be described by the volume variation of reconstructed surfaces between the consecutive video frames. A quantitative evaluation of the breathing pattern is then performed through a subtraction technique, thereby detecting the volume variation between the subsequent frames. A high-fidelity simulation was performed in a realistic environment designed for critically ill children. The simulation was then followed by a real-world evaluation, involving two newborn babies (one female and one male) who required ventilator support. The breathing signal patterns resulting from our approach were compared to those measured by mechanical ventilation in terms of their waveforms, evaluating the most significant dynamic parameters: tidal volume, respiratory rate, and minute ventilation. Our experimental study showed a significant agreement between the proposed 3-D imaging system and the gold standard method in estimating respiratory waveforms and parameters. This article presents the following innovations. First, we suggest a 3-D imaging system specifically designed for PICUs based on a contactless design. Second, we propose an efficient positioning mechanism for the cameras, offering a very high spatial coverage of the thoracoabdominal zone and considering the PICU constraints. Finally, we propose an objective vision-based method to quantitatively measure respiration for spontaneous breathing patients in PICUs. [ABSTRACT FROM AUTHOR]

Highlights • A novel computer vision system for intensive care respiratory monitoring. • An efficient positioning for the cameras in an intensive care room is proposed. • Our system offers a very high spatial coverage of the thoraco-abdominal zone. • Our system is evaluated by comparison to a mechanical ventilator. • The experiments demonstrate a high performance in estimating breathing parameters. Abstract Assessment of respiratory activity in pediatric intensive care unit allows a comprehensive view of the patient's condition. This allows the identification of high-risk cases for prompt and appropriate medical treatment. Numerous research works on respiration monitoring have been conducted in recent years. However, most of them are unsuitable for clinical environment or require physical contact with the patient, which limits their efficiency. In this paper, we present a novel system for measuring the breathing pattern based on a computer vision method and contactless design. Our 3D imaging system is specifically designed for pediatric intensive care environment, which distinguishes it from the other imaging methods. Indeed, previous works are mostly limited to the use of conventional video acquisition devices, in addition to not considering the constraints imposed by intensive care environment. The proposed system uses depth information captured by two (Red Green Blue-Depth) RGB-D cameras at different view angles, by considering the intensive care unit constraints. Depth information is then exploited to reconstruct a 3D surface of a patient's torso with high temporal and spatial resolution and large spatial coverage. Our system captures the motion information for the top of the torso surface as well as for its both lateral sides. For each reconstruction, the volume is estimated through a recursive subdivision of the 3D space into cubic unit elements. The volume change is then calculated through a subtraction technique between successive reconstructions. We tested our system in the pediatric intensive care unit of the Sainte-Justine university hospital center, where it was compared to the gold standard method currently used in pediatric intensive care units. The performed experiments showed a very high accuracy and precision of the proposed imaging system in estimating respiratory rate and tidal volume. [ABSTRACT FROM AUTHOR]

Background: With the deployments of Electronic Health Records (EHR), interoperability testing in healthcare is becoming crucial. EHR enables access to prior diagnostic information in order to assist in health decisions. It is a virtual system that results from the cooperation of several heterogeneous distributed systems. Interoperability between peers is therefore essential. Achieving interoperability requires various types of testing. Implementations need to be tested using software that simulates communication partners, and that provides test data and test plans. Results: In this paper we describe a software that is used to test systems that are involved in sharing medical images within the EHR. Our software is used as part of the Integrating the Healthcare Enterprise (IHE) testing process to test the Cross Enterprise Document Sharing for imaging (XDS-I) integration profile. We describe its architecture and functionalities; we also expose the challenges encountered and discuss the elected design solutions. Conclusions: EHR is being deployed in several countries. The EHR infrastructure will be continuously evolving to embrace advances in the information technology domain. Our software is built on a web framework to allow for an easy evolution with web technology. The testing software is publicly available; it can be used by system implementers to test their implementations. It can also be used by site integrators to verify and test the interoperability of systems, or by developers to understand specifications ambiguities, or to resolve implementations difficulties. [ABSTRACT FROM AUTHOR]

Assessment of respiratory function allows early detection of potential disorders in the respiratory system and provides useful information for medical management. There is a wide range of applications for breathing assessment, from measurement systems in a clinical environment to applications involving athletes. Many studies on pulmonary function testing systems and breath monitoring have been conducted over the past few decades, and their results have the potential to broadly impact clinical practice. However, most of these works require physical contact with the patient to produce accurate and reliable measures of the respiratory function. There is still a significant shortcoming of non-contact measuring systems in their ability to fit into the clinical environment. The purpose of this paper is to provide a review of the current advances and systems in respiratory function assessment, particularly camera-based systems. A classification of the applicable research works is presented according to their techniques and recorded/quantified respiration parameters. In addition, the current solutions are discussed with regards to their direct applicability in different settings, such as clinical or home settings, highlighting their specific strengths and limitations in the different environments. [ABSTRACT FROM AUTHOR]

In the domain of human action recognition, existing works mainly focus on using RGB, depth, skeleton and infrared data for analysis. While these methods have the benefit of being non-invasive, they can only be used within limited setups, are prone to issues such as occlusion and often need substantial computational resources. In this work, we address human action recognition through inertial sensor signals, which have a vast quantity of practical applications in fields such as sports analysis and human-machine interfaces. For that purpose, we propose a new learning framework built around a 1D-CNN architecture, which we validated by achieving very competitive results on the publicly available UTD-MHAD dataset. Moreover, the proposed method provides some answers to two of the greatest challenges currently faced by action recognition algorithms, which are (1) the recognition of high-level activities and (2) the reduction of their computational cost in order to make them accessible to embedded devices. Finally, this paper also investigates the tractability of the features throughout the proposed framework, both in time and duration, as we believe it could play an important role in future works in order to make the solution more intelligible, hardware-friendly and accurate. [ABSTRACT FROM AUTHOR]

In children, vital distress events, particularly respiratory, go unrecognized. To develop a standard model for automated assessment of vital distress in children, we aimed to construct a prospective high-quality video database for critically ill children in a pediatric intensive care unit (PICU) setting. The videos were acquired automatically through a secure web application with an application programming interface (API). The purpose of this article is to describe the data acquisition process from each PICU room to the research electronic database. Using an Azure Kinect DK and a Flir Lepton 3.5 LWIR attached to a Jetson Xavier NX board and the network architecture of our PICU, we have implemented an ongoing high-fidelity prospectively collected video database for research, monitoring, and diagnostic purposes. This infrastructure offers the opportunity to develop algorithms (including computational models) to quantify vital distress in order to evaluate vital distress events. More than 290 RGB, thermographic, and point cloud videos of each 30 s have been recorded in the database. Each recording is linked to the patient's numerical phenotype, i.e., the electronic medical health record and high-resolution medical database of our research center. The ultimate goal is to develop and validate algorithms to detect vital distress in real time, both for inpatient care and outpatient management. [ABSTRACT FROM AUTHOR]

Background: In an intensive care units, experts in mechanical ventilation are not continuously at patient’s bedside to adjust ventilation settings and to analyze the impact of these adjustments on gas exchange. The development of clinical decision support systems analyzing patients’ data in real time offers an opportunity to fill this gap. Objective: The objective of this study was to determine whether a machine learning predictive model could be trained on a set of clinical data and used to predict transcutaneous hemoglobin oxygen saturation 5 min (5min SpO2) after a ventilator setting change. Data sources: Data of mechanically ventilated children admitted between May 2015 and April 2017 were included and extracted from a high-resolution research database. More than 776,727 data rows were obtained from 610 patients, discretized into 3 class labels (< 84%, 85% to 91% and c92% to 100%). Performance metrics of predictive models: Due to data imbalance, four different data balancing processes were applied. Then, two machine learning models (artificial neural network and Bootstrap aggregation of complex decision trees) were trained and tested on these four different balanced datasets. The best model predicted SpO2 with area under the curves < 0.75. Conclusion: This single center pilot study using machine learning predictive model resulted in an algorithm with poor accuracy. The comparison of machine learning models showed that bagged complex trees was a promising approach. However, there is a need to improve these models before incorporating them into a clinical decision support systems. One potentially solution for improving predictive model, would be to increase the amount of data available to limit over-fitting that is potentially one of the cause for poor classification performances for 2 of the three class labels. [ABSTRACT FROM AUTHOR]

Suicide by hanging is a sentinel event and a major cause of death in prisons, with an increasing frequency over recent years. The rapid detection of suicidal behavior can reduce the mortality rate and increase the odds of survival for the suicide victim. Significant efforts have been made to develop technologies for preventing hanging attempts, but most of them use cumbersome devices, or they are mainly depending on human attention and intervention. In this paper, we propose a vision-based method to automatically detect suicide by hanging. Our intelligent video surveillance system operates using depth streams provided by an RGB-D camera, regardless of illumination conditions. The proposed algorithm is based on the exploitation of the body joints’positions to model suicidal behavior. Both dynamic and static pose characteristics are calculated in order to efficiently capture the body joints’movement and model suicidal behavior. Results from the experiments on realistic video sequences, show that our system achieves a high accuracy in detecting suicide attempts, while meeting real-time requirements. [ABSTRACT FROM AUTHOR]

Higher plants are an integral part of strategies for sustained human presence in space. Space-based greenhouses have the potential to provide closed-loop recycling of oxygen, water and food. Plant monitoring systems with the capacity to remotely observe the condition of crops in real-time within these systems would permit operators to take immediate action to ensure optimum system yield and reliability. One such plant health monitoring technique involves the use of reporter genes driving fluorescent proteins as biological sensors of plant stress. In 2006 an initial prototype green fluorescent protein imager system was deployed at the Arthur Clarke Mars Greenhouse located in the Canadian High Arctic. This prototype demonstrated the advantageous of this biosensor technology and underscored the challenges in collecting and managing telemetric data from exigent environments. We present here the design and deployment of a second prototype imaging system deployed within and connected to the infrastructure of the Arthur Clarke Mars Greenhouse. This is the first imager to run autonomously for one year in the un-crewed greenhouse with command and control conducted through the greenhouse satellite control system. Images were saved locally in high resolution and sent telemetrically in low resolution. Imager hardware is described, including the custom designed LED growth light and fluorescent excitation light boards, filters, data acquisition and control system, and basic sensing and environmental control. Several critical lessons learned related to the hardware of small plant growth payloads are also elaborated. [ABSTRACT FROM AUTHOR]

Background: Reliable localization and tracking of the eye region in the pediatric hospital environment is a significant challenge for clinical decision support and patient monitoring applications. Existing work in eye localization achieves high performance on adult datasets but performs poorly in the busy pediatric hospital environment, where face appearance varies because of age, position and the presence of medical equipment.Methods: We developed two new datasets: a training dataset using public image data from internet searches, and a test dataset using 59 recordings of patients in a pediatric intensive care unit. We trained two eye localization models, using the Faster R-CNN algorithm to fine-tune a pre-trained ResNet base network, and evaluated them using the images from the pediatric ICU.Results: The convolutional neural network trained with a combination of adult and child data achieved an 79.7% eye localization rate, significantly higher than the model trained on adult data alone. With additional pre-processing to equalize image contrast, the localization rate rises to 84%.Conclusion: The results demonstrate the potential of convolutional neural networks for eye localization and tracking in a pediatric ICU setting, even when training data is limited. We obtained significant performance gains by adding task-specific images to the training dataset, highlighting the need for custom models and datasets for specialized applications like pediatric patient monitoring. The moderate size of our added training dataset shows that it is feasible to develop an internal training dataset for clinical computer vision applications, and apply it with transfer learning to fine-tune existing pre-trained models. [ABSTRACT FROM AUTHOR]