PowerPoint Presentation

Health MonitoringCarlotta Guiducci, EPFL ISyPeM II Qiuting Huang, ETHZ WearMeSoC Bradley Nelson, ETHZ FlusiTex Jean-Philippe Thiran, EPFL ObeSense Pierre Vandergheynst, EPFL NewbornCare Chair: Luca Fanucci, Universit di Pisa

Carlotta Guiducci, EPFLISyPeM II Therapeutic drug monitoring for personalized medicine

ISyPeM

Prof. C. Guiducci - ISyPeM

Prof. C. Guiducci - ISyPeMTHE RELEVANCE OF THERAPEUTIC DRUG MONITORINGtime after dose (hrs)

Prof. C. Guiducci - ISyPeMImatinib exposure (ng/ml)Pharmacokinetic targets for efficacy and safety (observational data from > 2000 EU patients)Courtesy of N. WidmerAfter selecting the correct patient and the correct drug, we need to determine the correct exposureModern anticancer agentsImmunosuppressantAntiretroviralsAntibioticsExposure is an excellent biomarker for responseMULTI-SCALE APPROACH FOR POINT-OF-CARE TDMProf. C. Guiducci - ISyPeMPOINT-OF-CARE TESTING

Low volume blood testingQuantitativeSpecificity towards metabolitesMiniaturized

INTERPRETATION AND DOSE ADJUSTMENT

Is the result expected?Is the drug still suitable?Prediction and dose adjustment

DATA EXCHANGE AND INTEROPERABILITY

Upload patients dataExtension of eHealth medical standardsData integrity

SUPPORT INTERPRETATION OF DRUG CONCENTRATION DATAProf. C. Guiducci - ISyPeM

ezeCHielEXPLOITATION PARTNERS Prof. C. Guiducci - ISyPeMDivision of Clinical PharmacologyCollect patient samples

Validation in field conditions

Elaborate a protocol for large-scale randomized clinical trials

Readers and prototyping

Contribution in the development of a demonstrator

Qiuting Huang, ETHZ WearMeSoC WearMeSoCKey Challenges and ApplicationsIntroductionObjective:Design of a matchbox sized system for physiological signal acquisitionMotivationHealth cost reduction due to telemedicine: Patient surveillance at home or in the ward.Enables new medical tests and researchChallengesDifferent applications have different needs FlexibilityIntegration & combination of hardware for the acquisition of different signals.

BatteryAntennaConnector:Electrodes/SensorsRadioMicro SD Card HolderMemoryPlanned SoC

Application: EOG-Based Fitness-to-Drive Test for Elderly DriversTest AcceptanceTest reflects exact demands of drivingCan be done in the examinees own car Saccadic Eye MovementsRecorded by EOGPhysiological marker of overall cognitive statusHead-Centered VideoSynchronized with EOGAllows to determine the point of gaze

Today, EEG electrodes are connected to an amplifier beside the bed

The wiring leads to an unnatural sleep situation

A small wireless device will improve the experimental setup and thus the results

13Application: EEG in Sleep Research

IntroductionWe further cooperate with medical researchers atThe university hospital and the university of Zurich

Wiring DISTURBS

In sleep research, there is indeed demand for more convenient to wear EEG (Electroencephalography)e.g. a small wireless device attached to a headband

13Challenge: Function Verification in Real WorldPrior to full system integration it is necessary to:Verify sensing circuits and algorithmsEstimate required computing resourcesTest the suitability of the chosen approach in real applications (e.g., medical research studies)

Modular Development and PrototypePlatformChallenge: Integrated PlatformRISC CPU: Heart of the platformSoftware based power and function optimizationHardware accelerators used for biomedical signal processingMixed-signal single chip solution

Bradley Nelson, ETHZ Michael Richter, EMPA

FlusiTex

Nano-Tera Annual Meeting: 20 May 2014

FlusiTexFlusiTex:Fabrication of Fluorescence Sensors Integrated in a Textile Dressing for Non-invasive Lifetime based Wound Monitoring

Nano-Tera Annual Meeting: 20 May 2014

FlusiTexCurrent MethodsFull or partial removal of wound padVisual ObservationSkin irritationIncreased chances of infectionOnly qualitative information

Collecting Biochemical InformationHighly invasiveExpensiveWound Monitoring

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Nano-Tera Annual Meeting: 20 May 2014

FlusiTexCommercial Opportunities in Wound Care

$12B worldwide market aimed solely at wound care Wound monitoring is currently less than 1% of this industry

19Frost and Sullivan, Medtech insights 2009

Nano-Tera Annual Meeting: 20 May 2014

FlusiTexEmerging Trends in Wound Care

As wound care moves towards active or physical theparies, quantitative data on wound healing becomes more critical

20Frost and Sullivan, Medtech insights 2009

Nano-Tera Annual Meeting: 20 May 2014

FlusiTexFluorescent Sensing Integrated into Medical Textiles

Biocompatible, non-invasive wound monitoring using optical methods

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Nano-Tera Annual Meeting: 20 May 2014

FlusiTexWork Packages and InteractionsMicrofabrication/System Integration (ETHZ/IRIS)Prof. Dr. Bradley NelsonFluorescence Lifetime Camera (CSEM)Dr. Stefano Cattaneoin vitro and in vivo testing (UZH/MSRU)Prof. Dr. med.vet. Brigitte von RechenbergSensing Chemistry (EMPA)Dr. Michael Richter22Immobilizing Matrices (EMPA)Dr. Lukas SchererLuciano Boesel

Jean-Philippe Thiran, EPFL ObeSense

ObeSenseMonitoring the Consequences of Obesity

24EMPA : Swiss Federal Laboratories for Materials, Science and TechnologyIRR : Institut de recherche en readaptationSFISM : Swiss Federal Institue of Sport MagglingenEPFL - ESL : Dr. Srinivasan Murali

MotivationsObesity is associated with multiple health problemsCardiovascular diseasesAtrial fibrillationHypertensionObstructive sleep apneaDiabetesCertain types of cancerHas been proven to reduce life expectancy : 10% of premature adult deathsIs reaching epidemic proportionsEx : Switzerland : 48.7% overweight, 8.3% obese7.3% of the total healthcare expensesGuidelines about identification, evaluation and treatment existThose guidelines require long-term monitoringSuch monitoring systems do not exist25Over the last 20 years, obesity has become the most prevalent nutritional problem in the world as the most significant contributor to morbidity and mortality25ObjectivesAnswer a clear medical need by joining research in physiological markers sensors with clinical end-usersDevelop innovative and non-invasive sensorsIntegrate them into single long-term monitoring systems adapted to obese patientsMulti-parametric, low-power, allergy-free, comfortable, with on-line feedback.Innovations in Sensors (including robustness & cost)Algorithms (in real-life conditions)Ultra-low power HW & SW designIntegration into smart textilesClinical practiceCentral involvement of end-usersThrough 3 clinical scenarios

26Robustness (capteur)Real-life : reduce false positives by multi-parametric appraches26MethodologySensors and algorithmsCardiac output & blood pressureEnergy consumption, respiratory rate and volumeECG : Smart t-shirts and signal analysisIntegration into a wireless body sensor network (WBSN)Flexible, scalable, power-efficient wireless node platform for WBSNSmart textiles

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27Clinical scenariosScenario 1: physical activity & lifestyle interventionsSupervised by Dr O. Driaz (IRR) and Dr U. Mder (SFISM) on patients following activity regimen in lab settings and at homeScenario 2: hospitalization monitoringObesity and atrial fibrillation, hypertension and type-2 diabetesSupervised by Dr E. Pruvot (CHUV)Scenario 3: ambulatory monitoringObesity and outpatient cardiovascular complicationsSupervised by Dr E. Pruvot (CHUV)

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Pierre Vandergheynst, EPFL

NewbornCare NewBornCareNewborn Monitoring based on Multiple Vision Sensors

Prof. Pierre Vandergheynst EPFLDr Jean-Marc Vesin EPFL Prof. Martin Wolf USZProf. MD Fauchre USZDr Mathieu Lemay CSEMDr Amina Chebira CSEMMr Damien Ferrario CSEM30MotivationsPremature births9% of the infants in Switzerland are born prematurely Crucial to continuously monitor vital signalsHeart and respiratory rates, arterial oxygen saturation (SpO2) Brain leasions lead to long-term disabilities in ~25% infantsLimitations of current monitoring systems: Current monitoring systems prone to frequent body motion artifactsInacceptable high rate of false alarms of 87.5% leading toDiscomfort, stress and cardiorespiratory instability of the neonatesDesensitized caregivers, also stressedDangerously long response times Slow application of sensors, while speed is important during resuscitationBrain, most sensitive organ, is NOT yet monitoredLack of accurate contactless technologyNegative impact on parents31

False alarmsCurrent monitoring systemsFalse alarms = useless warning sent out to nurses (machine actually beeps)Slow application of sensors = sensors need to be applied quickly to babies in some circumstances31ObjectivesTo improve the quality of the vital sign monitoringTo drastically reduce the false alarms By avoiding the physical presence of sensors on the chest and on the limbs of newborns

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Central component also acts as central node for the networks of sensors 32MethodologyNBC multi-optical sensor componentAim: monitor arterial & brain tissue oxygen saturationModalities:Near-infrared spectroscopy (NIRS)SpO2 dedicated systemImplementation: miniature multi-sensor device integrated into a headbandPartners involved:USZ: NIRS design, validation (task leader)CSEM: SpO2 design, system integrationLeverage NEOSENSE expertise33

NIRS prototype

SpO2

Mathieu: break la figure prcdente en trois et on les place en marge gauche des 3 prochains slides, please33MethodologyNBC central componentGoal: monitor of cardiac & respiratory activities, wireless central nodeModalities:Video-based estimation of blood diffusionVideo-based tracking of thoracic motionWireless communicationImplementation: visible + NIR camera, embedded system (algorithms, communication)Partners involved:EPFL: data processing (task leader) CSEM: system integration34

Respiratory rate

Heart rate

[REV COMMENT] Why proprietary camera ? Commercial cameras are not sensitive enough in the NIR range34

Health MonitoringCarlotta Guiducci, EPFL ISyPeM II Qiuting Huang, ETHZ WearMeSoC Bradley Nelson, ETHZ FlusiTex Jean-Philippe Thiran, EPFL ObeSense Pierre Vandergheynst, EPFL NewbornCare Chair: Luca Fanucci, Universit di Pisa