Parkinson's Disease (PD) is the second most common neurodegenerative disease and prevalence is increasing as populations age. However, because it remains difficult to sensitively evaluate symptom progression, testing of therapies which change the disease course has been hampered (and no such therapy is yet licensed). The more recent use of home monitoring systems provides the potential for providing granular assessment of symptom progression, specifically, tremor evaluation, by continuous monitoring using inertial measurement units. A significant barrier remains in obtaining the ground truth information to assess inference models in these non-laboratory environments. Given these limitations, in this paper we propose a machine learning tremor regression model and classifier heuristic that uses minimal annotations. We use a real-world dataset of 12 participants, where pairs of participants, one with PD and a healthy control, are monitored over a four-day period in a home environment with wrist-worn devices. Our approach leverages the accelerometer frequency-time representation. We evaluate the classifier heuristic on the control participants. The tremor score regression model is trained on the self-assessments of the participants. We show that the tremor classifier can achieve false positive rates (FPR) less than 0.001 (on average one false positive every five hours) on control participants. For a particular participant, we show that the machine learning regression model achieves a mean absolute error (MAE) of 0.46 as compared to a polynomial regression model (degree=3) with MAE of 0.99. This research is the first to provide a semi-supervised machine learning approach using self-report of symptoms to continually predict tremor scores for individuals with PD.

Parkinson's disease (PD) is a slowly progressive, debilitating neurodegenerative disease which causes motor symptoms including gait dysfunction. Motor fluctuations are alterations between periods with a positive response to levodopa therapy ("on") and periods marked by re-emergency of PD symptoms ("off") as the response to medication wears off. These fluctuations often affect gait speed and they increase in their disabling impact as PD progresses. To improve the effectiveness of current indoor localisation methods, a transformer-based approach utilising dual modalities which provide complementary views of movement, Received Signal Strength Indicator (RSSI) and accelerometer data from wearable devices, is proposed. A sub-objective aims to evaluate whether indoor localisation, including its in-home gait speed features (i.e. the time taken to walk between rooms), could be used to evaluate motor fluctuations by detecting whether the person with PD is taking levodopa medications or withholding them. To properly evaluate our proposed method, we use a free-living dataset where the movements and mobility are greatly varied and unstructured as expected in real-world conditions. 24 participants lived in pairs (consisting of one person with PD, one control) for five days in a smart home with various sensors. Our evaluation on the resulting dataset demonstrates that our proposed network outperforms other methods for indoor localisation. The sub-objective evaluation shows that precise room-level localisation predictions, transformed into in-home gait speed features, produce accurate predictions on whether the PD participant is taking or withholding their medications.

Explaining health technology platforms to non-technical members of the public is an important part of the process of informed consent. Complex technology platforms that deal with safety-critical areas are particularly challenging, often operating within private domains (e.g. health services within the home) and used by individuals with various understandings of hardware, software, and algorithmic design. Through two studies, the first an interview and the second an observational study, we questioned how experts (e.g. those who designed, built, and installed a technology platform) supported provision of informed consent by participants. We identify a wide range of tools, techniques, and adaptations used by experts to explain the complex SPHERE sensor-based home health platform, provide implications for the design of tools to aid explanations, suggest opportunities for interactive explanations, present the range of information needed, and indicate future research possibilities in communicating technology platforms.

In interdisciplinary spaces such as digital health, datasets that are complex to collect, require specialist facilities, and/or are collected with specific populations have value in a range of different sectors. In this study we collected a simulated free-living dataset, in a smart home, with 12 participants (six people with Parkinson’s, six carers). We explored their initial perceptions of the sensors through interviews and then conducted two data exploration workshops, wherein we showed participants the collected data and discussed their views on how this data, and other data relating to their Parkinson’s symptoms, might be shared across different sectors. We provide recommendations around how participants might be better engaged in considering data sharing in the early stages of research, and guidance for how research might be configured to allow for more informed data sharing practices in the future.

A detailed understanding of the mental health needs of people from refugee backgrounds is crucial for the design of inclusive mental health technologies. We present a qualitative account of the digital mental health experiences of women from refugee backgrounds. Working with community members and community workers of a charitable organisation for refugee women in the UK, we identify social and structural challenges, including loneliness and access to mental health technologies. Participants' accounts document their collective agency in addressing these challenges and supporting social connectedness and personal wellbeing in daily life: participants reported taking part in community activities as volunteers, sharing technological expertise, and using a wide range of non-mental health-focused technologies to support their mental health, from playing games to supporting religious practices. Our findings suggest that, rather than focusing only on individual self-care, research also needs to leverage community-driven approaches to foster social mental health experiences, from altruism to connectedness and belonging.

This paper presents Vesta, a digital health platform composed of a smart home in a box for data collection and a machine learning based analytic system for deriving health indicators using activity recognition, sleep analysis and indoor localization. This system has been deployed in the homes of 40 patients undergoing a heart valve intervention in the United Kingdom (UK) as part of the EurValve project, measuring patients health and well-being before and after their operation. In this work a cohort of 20 patients are analyzed, and 2 patients are analyzed in detail as example case studies. A quantitative evaluation of the platform is provided using patient collected data, as well as a comparison using standardized Patient Reported Outcome Measures (PROMs) which are commonly used in hospitals, and a custom survey. It is shown how the ubiquitous in-home Vesta platform can increase clinical confidence in self-reported patient feedback. Demonstrating its suitability for digital health studies, Vesta provides deeper insight into the health, well-being and recovery of patients within their home.

Human activity recognition is progressing from automatically determining what a person is doing and when, to additionally analyzing the quality of these activities—typically referred to as skill assessment. In this chapter, we propose a new framework for skill assessment that generalizes across application domains and can be deployed for near-real-time applications. It is based on the notion of repeatability of activities defining skill. The analysis is based on two subsequent classification steps that analyze (1) movements or activities and (2) their qualities, that is, the actual skills of a human performing them. The first classifier is trained in either a supervised or unsupervised manner and provides confidence scores, which are then used for assessing skills. We evaluate the proposed method in two scenarios: gymnastics and surgical skill training of medical students. We demonstrate both the overall effectiveness and efficiency of the generalized assessment method, especially compared to previous work.

Deep clustering has increasingly been demonstrating superiority over conventional shallow clustering algorithms. Deep clustering algorithms usually combine representation learning with deep neural networks to achieve this performance, typically optimizing a clustering and non-clustering loss. In such cases, an autoencoder is typically connected with a clustering network, and the final clustering is jointly learned by both the autoencoder and clustering network. Instead, we propose to learn an autoencoded embedding and then search this further for the underlying manifold. For simplicity, we then cluster this with a shallow clustering algorithm, rather than a deeper network. We study a number of local and global manifold learning methods on both the raw data and autoencoded embedding, concluding that UMAP in our framework is able to find the best clusterable manifold of the embedding. This suggests that local manifold learning on an autoencoded embedding is effective for discovering higher quality clusters. We quantitatively show across a range of image and time-series datasets that our method has competitive performance against the latest deep clustering algorithms, including outperforming current state-of-the-art on several. We postulate that these results show a promising research direction for deep clustering. The code can be found at https://github.com/rymc/n2d.

The emerging Internet of Things has the potential to solve major societal challenges associated with healthcare provision. Low-power wireless protocols for residential Health Internet of Things applications are characterized by high reliability requirements, the need for energy-efficient operation, and the need to operate robustly in diverse environments in the presence of external interference. We enhance and experimentally evaluate the Time-Slotted Channel Hopping protocol from the IEEE 802.15.4 standard to address these challenges. Our contributions are a new schedule and an adaptive channel selection mechanism to increase the performance of time-slotted channel hopping in this domain. Evaluation in a test house shows that the enhanced system is suitable for our e-Health application and compares favorably with state-of-the-art options. The schedule provides higher reliability compared with the minimal scheduling function from the IETF 6TiSCH Working Group and has a better energy-efficiency/reliability tradeoff than the Orchestra scheduler. Results from 29 long-term residential deployments confirm the suitability for the application and show that the system is able to adapt and avoid channels used by WiFi. In these uncontrolled environments, the system achieves 99.96% average reliability for networks that generate 7.5 packets per second on average.

We are interested in hot and cold water flow detection in domestic kitchen and bathroom taps for smart home environments. Water flow monitoring is particularly valuable for long-term behavioural monitoring systems for health-related applications, as it enables the collection of long-term data on the hydration levels of the house residents, and it is associated with several activities of daily life, such as cooking and cleaning. This paper presents a water flow sensing device that is based on sensing the vibrations on the pipe when water is flowing through them. The proposed solution is noninvasive and energy efficient, as it does not require cutting the water pipes or altering the plumbing system, and consumes less then 2 uA in continuous operation. The proposed water flow sensor has been integrated to SPHERE, a sensing platform of non-medical sensors for healthcare monitoring and behavioural analytics in a home environment, and deployed to more than 15 residential properties.

Deriving a person's energy expenditure accurately forms the foundation for tracking physical activity levels across many health and lifestyle monitoring tasks. In this study, the authors present a method for estimating calorific expenditure from combined visual and accelerometer sensors by way of an RGB‐Depth camera and a wearable inertial sensor. The proposed individual‐independent framework fuses information from both modalities which leads to improved estimates beyond the accuracy of single modality and manual metabolic equivalents of task (MET) lookup table based methods. For evaluation, the authors introduce a new dataset called SPHERE_RGBD + Inertial_calorie , for which visual and inertial data are simultaneously obtained with indirect calorimetry ground truth measurements based on gas exchange. Experiments show that the fusion of visual and inertial data reduces the estimation error by 8 and 18% compared with the use of visual only and inertial sensor only, respectively, and by 33% compared with a MET‐based approach. The authors conclude from their results that the proposed approach is suitable for home monitoring in a controlled environment.

Networks deployed in real-world conditions have to cope with dynamic, unpredictable environmental temperature changes. These changes affect the clock rate on network nodes, and can cause faster clock de-synchronization compared to situations where devices are operating under stable temperature conditions. Wireless network protocols, such as time-slotted channel hopping (TSCH) from the IEEE 802.15.4-2015 standard, are affected by this problem, since they require tight clock synchronization among all nodes for the network to remain operational. This paper proposes a method for autonomously compensating temperature-dependent clock rate changes. After a calibration stage, nodes continuously perform temperature measurements to compensate for clock drifts at runtime. The method is implemented on low-power Internet of Things (IoT) nodes and evaluated through experiments in a temperature chamber, indoor and outdoor environments, as well as with numerical simulations. The results show that applying the method reduces the maximum synchronization error more than ten times. In this way, the method allows reduction in the total energy spent for time synchronization, which is practically relevant concern for low data rate, low energy budget TSCH networks, especially those exposed to environments with changing temperature.

The upcoming Internet of Things (IoT) applications include real-time human activity monitoring with wearable sensors. Compared to the traditional environmental sensing with low-power wireless nodes, these new applications generate a constant stream of a much higher rate. Nevertheless, the wearable devices remain battery powered and therefore restricted to low-power wireless standards such as IEEE 802.15.4 or Bluetooth Low Energy (BLE). Our work tackles the problem of building a reliable autonomous schedule for forwarding this kind of dynamic data in IEEE 802.15.4 TSCH networks. Due to the a priori unpredictability of these data source locations, the quality of the wireless links, and the routing topology of the forwarding network, it is wasteful to reserve the number of slots required for the worst-case scenario, under conditions of high expected datarate, it is downright impossible. The solution we propose is a hybrid approach where dedicated TSCH cells and shared TSCH slots coexist in the same schedule. We show that under realistic assumptions of wireless link diversity, adding shared slots to a TSCH schedule increases the overall packet delivery rate and the fairness of the system.

Physical activity envelope provides invaluable information in numerous pervasive health applications. Physical activity is traditionally gleaned using a range of wearable inertial sensors and/or video technology. This paper introduces a novel opportunistic and non-intrusive monitoring system which can quantify activity levels based on analysis of ambient WiFi signal scatter. A real-time signal processing framework is developed, and the proposed system is implemented in software defined radio platform. Experimental results corroborate the efficacy of the proposed system in long term ADL monitoring in residential healthcare applications.

Wearable technologies play a key role in the shift of traditional healthcare services towards eHealth and self-monitoring. Maintenance overheads, such as regular battery recharging, impose a limitation on the applicability of such technologies in some groups of the population. In this paper, we propose an activity monitoring system that is based on wearable sensors that are powered by textile inductive charging surfaces. By strategically positioning these surfaces on pieces of furniture that are routinely used, the system passively charges the wearable sensor whilst the user is present. As a proof-of-concept example, experiments conducted on a prototype implementation of the system suggest that 36 minutes of daily desktop computer usage are on average sufficient to maintain a wearable sensor energy neutral.

Quantitative assessment of the quality of motion is increasingly in demand by clinicians in healthcare and rehabilitation monitoring of patients. We study and compare the performances of different pose representations and HMM models of dynamics of movement for online quality assessment of human motion. In a general sense, our assessment framework builds a model of normal human motion from skeleton-based samples of healthy individuals. It encapsulates the dynamics of human body pose using robust manifold representation and a first-order Markovian assumption. We then assess deviations from it via a continuous online measure. We compare different feature representations, reduced dimensionality spaces, and HMM models on motions typically tested in clinical settings, such as gait on stairs and flat surfaces, and transitions between sitting and standing. Our dataset is manually labelled by a qualified physiotherapist. The continuous-state HMM, combined with pose representation based on body-joints’ location, outperforms standard discrete-state HMM approaches and other skeleton-based features in detecting gait abnormalities, as well as assessing deviations from the motion model on a frame-by-frame basis.

Monitoring actions at home can provide essential information for rehabilitation management. This paper presents a comparative study and a dataset for the fully automated, sample-accurate recognition of common home actions in the living room environment using commercial-grade, inexpensive inertial and visual sensors. We investigate the practical home-use of body-worn mobile phone inertial sensors together with an Asus Xmotion RGB-Depth camera to achieve monitoring of daily living scenarios. To test this setup against realistic data, we introduce the challenging SPHERE-H130 action dataset containing 130 sequences of 13 household actions recorded in a home environment. We report automatic recognition results at maximal temporal resolution, which indicate that a vision-based approach outperforms accelerometer provided by two phone-based inertial sensors by an average of 14.85% accuracy for home actions. Further, we report improved accuracy of a vision-based approach over accelerometry on particularly challenging actions as well as when generalising across subjects.