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Multimodal physiological monitoring during virtual reality piloting tasks

Summary

This dataset includes multimodal physiologic, flight performance, and user interaction data streams, collected as participants performed virtual flight tasks of varying difficulty. In virtual reality, individuals flew an "Instrument Landing System" (ILS) protocol, in which they had to land an aircraft mostly relying on the cockpit instrument readings. Participants were presented with four levels of difficulty, which were generated by varying wind speed, turbulence, and visibility. Each of the participants performed 12 runs, split into 3 blocks of four consecutive runs, one run at each difficulty, in a single experimental session. The sequence of difficulty levels was presented in a counterbalanced manner across blocks. Flight performance was quantified as a function of horizontal and vertical deviation from an ideal path towards the runway as well as deviation from the prescribed ideal speed of 115 knots. Multimodal physiological signals were aggregated and synchronized using Lab Streaming Layer. Descriptions of data quality are provided to assess each data stream. The starter code provides examples of loading and plotting the time synchronized data streams, extracting sample features from the eye tracking data, and building models to predict pilot performance from the physiology data streams.
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Summary

This dataset includes multimodal physiologic, flight performance, and user interaction data streams, collected as participants performed virtual flight tasks of varying difficulty. In virtual reality, individuals flew an "Instrument Landing System" (ILS) protocol, in which they had to land an aircraft mostly relying on the cockpit instrument readings. Participants were...

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Development and validation of the public-facing SimAEN web application

Summary

During a pandemic such as COVID-19, non-pharmaceutical interventions (NPIs) can help protect public health; however, it is not always clear which actions will have the greatest positive impact, or what the trade-offs are between different options. Exposure Notification (EN) was introduced as a prevention measure during the COVID-19 pandemic to supplement traditional contact tracing activities. To predict the estimated impacts of EN, a model for "simulation of automated exposure notification" (SimAEN) was developed by researchers at MIT Lincoln Laboratory (MIT LL) with CDC funding [2]. The model was published through an accessible web interface, available for use by the general public at https://SimAEN.philab.cdc.gov/.
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Summary

During a pandemic such as COVID-19, non-pharmaceutical interventions (NPIs) can help protect public health; however, it is not always clear which actions will have the greatest positive impact, or what the trade-offs are between different options. Exposure Notification (EN) was introduced as a prevention measure during the COVID-19 pandemic to...

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Transfer learning for automated COVID-19 B-line classification in lung ultrasound

Published in:
44th Annual Int. Conf. of IEEE Engineering in Medicine & Biology Society (EMBC), DOI: 10.1109/EMBC48229.2022.9871894.

Summary

Lung ultrasound (LUS) as a diagnostic tool is gaining support for its role in the diagnosis and management of COVID-19 and a number of other lung pathologies. B-lines are a predominant feature in COVID-19, however LUS requires a skilled clinician to interpret findings. To facilitate the interpretation, our main objective was to develop automated methods to classify B-lines as pathologic vs. normal. We developed transfer learning models based on ResNet networks to classify B-lines as pathologic (at least 3 B-lines per lung field) vs. normal using COVID-19 LUS data. Assessment of B-line severity on a 0-4 multi-class scale was also explored. For binary B-line classification, at the frame-level, all ResNet models pretrained with ImageNet yielded higher performance than the baseline nonpretrained ResNet-18. Pretrained ResNet-18 has the best Equal Error Rate (EER) of 9.1% vs the baseline of 11.9%. At the clip-level, all pretrained network models resulted in better Cohen's kappa agreement (linear-weighted) and clip score accuracy, with the pretrained ResNet-18 having the best Cohen's kappa of 0.815 [95% CI: 0.804-0.826], and ResNet-101 the best clip scoring accuracy of 93.6%. Similar results were shown for multi-class scoring, where pretrained network models outperformed the baseline model. A class activation map is also presented to guide clinicians in interpreting LUS findings. Future work aims to further improve the multi-class assessment for severity of B-lines with a more diverse LUS dataset.
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Summary

Lung ultrasound (LUS) as a diagnostic tool is gaining support for its role in the diagnosis and management of COVID-19 and a number of other lung pathologies. B-lines are a predominant feature in COVID-19, however LUS requires a skilled clinician to interpret findings. To facilitate the interpretation, our main objective...

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Feature importance analysis for compensatory reserve to predict hemorrhagic shock

Published in:
44th Annual Int. Conf. of IEEE Engineering in Medicine & Biology Society (EMBC), DOI: 10.1109/EMBC48229.2022.9871661.

Summary

Hemorrhage is the leading cause of preventable death from trauma. Traditionally, vital signs have been used to detect blood loss and possible hemorrhagic shock. However, vital signs are not sensitive for early detection because of physiological mechanisms that compensate for blood loss. As an alternative, machine learning algorithms that operate on an arterial blood pressure (ABP) waveform acquired via photoplethysmography have been shown to provide an effective early indicator. However, these machine learning approaches lack physiological interpretability. In this paper, we evaluate the importance of nine ABP-derived features that provide physiological insight, using a database of 40 human subjects from a lower-body negative pressure model of progressive central hypovolemia. One feature was found to be considerably more important than any other. That feature, the half-rise to dicrotic notch (HRDN), measures an approximate time delay between the ABP ejected and reflected wave components. This delay is an indication of compensatory mechanisms such as reduced arterial compliance and vasoconstriction. For a scale of 0% to 100%, with 100% representing normovolemia and 0% representing decompensation, linear regression of the HRDN feature results in root-mean-squared error of 16.9%, R2 of 0.72, and an area under the receiver operating curve for detecting decompensation of 0.88. These results are comparable to previously reported results from the more complex black box machine learning models. Clinical Relevance- A single physiologically interpretable feature measured from an arterial blood pressure waveform is shown to be effective in monitoring for blood loss and impending hemorrhagic shock based on data from a human lower-body negative pressure model of progressive central hypolemia.
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Summary

Hemorrhage is the leading cause of preventable death from trauma. Traditionally, vital signs have been used to detect blood loss and possible hemorrhagic shock. However, vital signs are not sensitive for early detection because of physiological mechanisms that compensate for blood loss. As an alternative, machine learning algorithms that operate...

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Toward improving EN adoption: Bridging the gap between stated intention and actual use

Summary

As the COVID-19 pandemic swept the globe in the spring of 2020, technologists looked to enlist technology to assist public health authorities (PHAs) and help stem the tide of infections. As part of this technology push, experts in health care, cryptography, and other related fields developed the Private Automated Contact Tracing (PACT) protocol and related projects to assist the public health objective of slowing the spread of SARS-CoV-2 through digital contact tracing. The joint Google and Apple deployed protocol (Google-Apple Exposure Notifications, also known as GAEN or EN), which became the de facto standard in the U.S., employs the same features as detailed by PACT. The protocol leverages smartphone Bluetooth communications to alert users of potential contact with those carrying the COVID-19 virus in a way that preserves the privacy of both the known-infected individual, and the users receiving the alert. Contact tracing and subsequent personal precautions are more effective at reducing disease spread when more of the population participates, but there are known difficulties with the adoption of novel technology. In order to help the U.S. Centers for Disease Control and Prevention (CDC) and U.S. state-level public health teams address these difficulties, a team of staff from MIT's Lincoln Laboratory (MIT LL) and Computer Science and Artificial Intelligence Laboratory (MIT CSAIL) focused on studying user perception and information needs.
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Summary

As the COVID-19 pandemic swept the globe in the spring of 2020, technologists looked to enlist technology to assist public health authorities (PHAs) and help stem the tide of infections. As part of this technology push, experts in health care, cryptography, and other related fields developed the Private Automated Contact...

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Modeling probability of alert of Bluetooth low energy-based automatic exposure notifications

Published in:
MIT Lincoln Laboratory Report ACTA-4

Summary

BLEMUR, or Bluetooth Low Energy Model of User Risk, is a model of the probability of alert at a given duration and distance of an index case for a specific configuration of settings for an Exposure Notification (EN) system.The Google-Apple EN framework operates in the duration and Bluetooth Low Energy (BLE) signal attenuation domains. However, many public health definitions of "exposure" to a disease are based upon the distance between an index case and another person. To bridge the conceptual gap for public health authorities (PHAs) from the familiar distance-and-duration space to the signal attenuation-and-duration space, BLEMUR uses BLE signal attenuation as a proxy for distance between people, albeit an imprecise one. This paper will discuss the EN settings that can be manipulated, the BLE data collected, how data support a model of the relationship between measured attenuation and distance between phones, and how BLEMUR calculates the probability of alert for a distance and duration based on the settings and data.
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Summary

BLEMUR, or Bluetooth Low Energy Model of User Risk, is a model of the probability of alert at a given duration and distance of an index case for a specific configuration of settings for an Exposure Notification (EN) system.The Google-Apple EN framework operates in the duration and Bluetooth Low Energy...

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The Simulation of Automated Exposure Notification (SimAEN) Model

Summary

Automated Exposure Notication (AEN) was implemented in 2020 to supplement traditional contact tracing for COVID-19 by estimating "too close for too long" proximities of people using the service. AEN uses Bluetooth messages to privately label and recall proximity events, so that persons who were likely exposed to SARS-CoV-2 can take the appropriate steps recommended by their health care authority. This paper describes an agent-based model that estimates the effects of AEN deployment on COVID-19 caseloads and public health workloads in the context of other critical public health measures available during the COVID-19 pandemic. We selected simulation variables pertinent to AEN deployment options, varied them in accord with the system dynamics available in 2020-2021, and calculated the outcomes of key metrics across repeated runs of the stochastic multi-week simulation. SimAEN's parameters were set to ranges of observed values in consultation with public health professionals and the rapidly accumulating literature on COVID-19 transmission; the model was validated against available population-level disease metrics. Estimates from SimAEN can help public health officials determine what AEN deployment decisions (e.g., configuration, workflow integration, and targeted adoption levels) can be most effective in their jurisdiction, in combination with other COVID-19 interventions (e.g., mask use, vaccination, quarantine and isolation periods).
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Summary

Automated Exposure Notication (AEN) was implemented in 2020 to supplement traditional contact tracing for COVID-19 by estimating "too close for too long" proximities of people using the service. AEN uses Bluetooth messages to privately label and recall proximity events, so that persons who were likely exposed to SARS-CoV-2 can take...

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Wearable technology in extreme environments

Published in:
Chapter 2 in: Cibis, T., McGregor AM, C. (eds) Engineering and Medicine in Extreme Environments. Springer, Cham. https://doi.org/10.1007/978-3-030-96921-9_2

Summary

Humans need to work in many types of extreme environments where there is a need to stay safe and even to improve performance. Examples include: medical providers treating infectious disease, people responding to other biological or chemical hazards, firefighters, astronauts, pilots, divers, and people working outdoors in extreme hot or cold temperatures. Wearable technology is ubiquitous in the consumer market but is still needed for extreme environments. For these applications, it is particularly challenging to meet requirements to be actionable, accurate, acceptable, integratable, and affordable. To provide insight into these needs and possible solutions and the technology trade-offs involved, several examples are provided. A physiological monitoring example is described for predicting and avoiding heat injury. A cognitive monitoring example is described for estimating cognitive workload, with broader applicability to a variety of conditions, such as cognitive fatigue and depression. Finally, eye tracking is considered as a promising wearable sensing modality with applications for both physiological and cognitive monitoring. Concluding thoughts are offered on the compelling need for wearable technology in the face of pandemics, wildfires, and climate change, but also for global projects that can uplift mankind, such as long-duration spaceflight and missions to Mars.
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Summary

Humans need to work in many types of extreme environments where there is a need to stay safe and even to improve performance. Examples include: medical providers treating infectious disease, people responding to other biological or chemical hazards, firefighters, astronauts, pilots, divers, and people working outdoors in extreme hot or...

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Detection of COVID-19 using multimodal data from a wearable device: results from the first TemPredict Study

Summary

Early detection of diseases such as COVID-19 could be a critical tool in reducing disease transmission by helping individuals recognize when they should self-isolate, seek testing, and obtain early medical intervention. Consumer wearable devices that continuously measure physiological metrics hold promise as tools for early illness detection. We gathered daily questionnaire data and physiological data using a consumer wearable (Oura Ring) from 63,153 participants, of whom 704 self-reported possible COVID-19 disease. We selected 73 of these 704 participants with reliable confirmation of COVID-19 by PCR testing and high-quality physiological data for algorithm training to identify onset of COVID-19 using machine learning classification. The algorithm identified COVID-19 an average of 2.75 days before participants sought diagnostic testing with a sensitivity of 82% and specificity of 63%. The receiving operating characteristic (ROC) area under the curve (AUC) was 0.819 (95% CI [0.809, 0.830]). Including continuous temperature yielded an AUC 4.9% higher than without this feature. For further validation, we obtained SARS CoV-2 antibody in a subset of participants and identified 10 additional participants who self-reported COVID-19 disease with antibody confirmation. The algorithm had an overall ROC AUC of 0.819 (95% CI [0.809, 0.830]), with a sensitivity of 90% and specificity of 80% in these additional participants. Finally, we observed substantial variation in accuracy based on age and biological sex. Findings highlight the importance of including temperature assessment, using continuous physiological features for alignment, and including diverse populations in algorithm development to optimize accuracy in COVID-19 detection from wearables.
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Summary

Early detection of diseases such as COVID-19 could be a critical tool in reducing disease transmission by helping individuals recognize when they should self-isolate, seek testing, and obtain early medical intervention. Consumer wearable devices that continuously measure physiological metrics hold promise as tools for early illness detection. We gathered daily...

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Artificial intelligence for detecting COVID-19 with the aid of human cough, breathing and speech signals: scoping review

Summary

Background: Official tests for COVID-19 are time consuming, costly, can produce high false negatives, use up vital chemicals and may violate social distancing laws. Therefore, a fast and reliable additional solution using recordings of cough, breathing and speech data forpreliminary screening may help alleviate these issues. Objective: This scoping review explores how Artificial Intelligence (AI) technology aims to detect COVID-19 disease by using cough, breathing and speech recordings, as reported in theliterature. Here, we describe and summarize attributes of the identified AI techniques and datasets used for their implementation. Methods: A scoping review was conducted following the guidelines of PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews). Electronic databases (Google Scholar, Science Direct, and IEEE Xplore) were searched between 1st April 2020 and 15st August 2021. Terms were selected based on thetarget intervention (i.e., AI), the target disease (i.e., COVID-19) and acoustic correlates of thedisease (i.e., speech, breathing and cough). A narrative approach was used to summarize the extracted data. Results: 24 studies and 8 Apps out of the 86 retrieved studies met the inclusion criteria. Halfof the publications and Apps were from the USA. The most prominent AI architecture used was a convolutional neural network, followed by a recurrent neural network. AI models were mainly trained, tested and run-on websites and personal computers, rather than on phone apps. More than half of the included studies reported area-under-the-curve performance of greater than 0.90 on symptomatic and negative datasets while one study achieved 100% sensitivity in predicting asymptomatic COVID-19 for cough-, breathing- or speech-based acoustic features. Conclusions: The included studies show that AI has the potential to help detect COVID-19 using cough, breathing and speech samples. However, the proposed methods with some time and appropriate clinical testing would prove to be an effective method in detecting various diseases related to respiratory and neurophysiological changes in human body.
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Summary

Background: Official tests for COVID-19 are time consuming, costly, can produce high false negatives, use up vital chemicals and may violate social distancing laws. Therefore, a fast and reliable additional solution using recordings of cough, breathing and speech data forpreliminary screening may help alleviate these issues. Objective: This scoping review...

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