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Biomedical Signal Analysis for Connected Healthcare PDF

332 Pages·2021·15.616 MB·English
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BIOMEDICAL SIGNAL ANALYSIS FOR CONNECTED HEALTHCARE SRI KRISHNAN AcademicPressisanimprintofElsevier 125LondonWall,LondonEC2Y5AS,UnitedKingdom 525BStreet,Suite1650,SanDiego,CA92101,UnitedStates 50HampshireStreet,5thFloor,Cambridge,MA02139,UnitedStates TheBoulevard,LangfordLane,Kidlington,OxfordOX51GB,UnitedKingdom Copyright(cid:1)2021ElsevierInc.Allrightsreserved. Nopartofthispublicationmaybereproducedortransmittedinanyformorbyanymeans,electronicormechanical, includingphotocopying,recording,oranyinformationstorageandretrievalsystem,withoutpermissioninwritingfrom thepublisher.Detailsonhowtoseekpermission,furtherinformationaboutthePublisher’spermissionspoliciesandour arrangementswithorganizationssuchastheCopyrightClearanceCenterandtheCopyrightLicensingAgency,canbe foundatourwebsite:www.elsevier.com/permissions. ThisbookandtheindividualcontributionscontainedinitareprotectedundercopyrightbythePublisher(otherthanas maybenotedherein). Notices Knowledgeandbestpracticeinthisfieldareconstantlychanging.Asnewresearchandexperiencebroadenour understanding,changesinresearchmethods,professionalpractices,ormedicaltreatmentmaybecomenecessary. Practitionersandresearchersmustalwaysrelyontheirownexperienceandknowledgeinevaluatingandusingany information,methods,compounds,orexperimentsdescribedherein.Inusingsuchinformationormethodstheyshouldbe mindfuloftheirownsafetyandthesafetyofothers,includingpartiesforwhomtheyhaveaprofessionalresponsibility. Tothefullestextentofthelaw,neitherthePublishernortheauthors,contributors,oreditors,assumeanyliabilityforany injuryand/ordamagetopersonsorpropertyasamatterofproductsliability,negligenceorotherwise,orfromanyuseor operationofanymethods,products,instructions,orideascontainedinthematerialherein. LibraryofCongressCataloging-in-PublicationData AcatalogrecordforthisbookisavailablefromtheLibraryofCongress BritishLibraryCataloguing-in-PublicationData AcataloguerecordforthisbookisavailablefromtheBritishLibrary ISBN:978-0-12-813086-5 ForinformationonallAcademicPresspublicationsvisitour websiteathttps://www.elsevier.com/books-and-journals Publisher:MaraConner AcquisitionsEditor:ChrisKatsaropoulos EditorialProjectManager:IsabellaC.Silva ProductionProjectManager:PrasannaKalyanaraman CoverDesigner:MatthewLimbert TypesetbyTNQTechnologies DedicatedtotheloveandinspirationprovidedbymywifeMahi, and to our children, Sibi and Sarvi. Grateful for the constant support and encouragement of my parents, extended family, students, professors, and friends. About the author Sridhar (Sri) Krishnan received his B.E. degree in Electronics and Communication Engineering from the College of Engineer- ing, Guindy, Anna University, Chennai, India, in 1993 and M.Sc. andPh.D.degrees(withstudentfellowshipfromAlbertaHeritage Foundation for Medical Research) in Electrical and Computer Engineering from The University of Calgary, Calgary, Alberta, Canada, in 1996 and 1999, respectively. Sri Krishnan joined RyersonUniversityinJuly1999andiscurrentlyaprofessorinthe Department of Electrical, Computer, and Biomedical Engineer- ing. From 2011 to2021, he wasanAssociate Dean(Research and External Partnerships) for the Faculty of Engineering and Archi- tectural Science. He is also the Founding Co-director of the Institute for Biomedical Engineering, Science, and Technology (iBEST) and an Affiliate Scientist at the Keenan Research Centre in St. Michael’s Hospital, Toronto. Sri Krishnan’s research interests include biomedical signal processing, audio signal processing, wearable technology, and machinelearning.From2007to2017,SriKrishnanheldaCanada Research Chair position in Biomedical Signal Analysis. He has published more than 340 papers in refereed journals and conferences and has filed 15 invention disclosures/patents. He has presented keynote/plenary/invited talks in more than 60 international conferences and workshops. Sri Krishnan serves in the advisory boards of research institutes, innovation centers, incubator zones, and biomedical tech start-up organizations. Sri Krishnan is a registered Professional Engineer in the Province of Ontario. He was the Founding Chair (2005e2015) of IEEE Signal ProcessingSociety,TorontoSectionandRegion7(Canada),anda Founding Member of the IEEE Engineering in Medicine and Biology Society, Toronto Section. He currently serves as a Technical Committee Member (Biomedical Signal Processing) of IEEE EMBS. Sri Krishnan is a recipient/awarded Fellow of Canadian Academy of Engineering; Outstanding Canadian Biomedical Engineer Award from the Canadian Medical and Biological Engineering Society; Achievement in Innovation Award from Innovate Calgary; Ryerson University’s Sarwan Sahota Distin- guishedScholarAward;OntarioResearchInnovationAwardfrom Biodiscovery Toronto; Canadian Engineers’ Young Engineer Achievement Award from Engineers Canada; New Pioneers xii About theauthor Award in Science and Technology; South Asian Community Achiever Award; Exemplary Service Award and Best Chapter Chair Award from IEEE Toronto Section; and IEEE AESS Best Chapter Chair Award. Preface Pursuit of knowledge and contributions to research and innovationforthesocietalbenefitshavebeencoreaspectsofmy scientific journey. The interest in biomedical signal analysis started when I was in my undergraduate class on signals and systems and happen to visit my uncle in the emergency ward in which the monitor next to him displayed vital signals. The curi- osity of representing those vital signals with the mathematical concepts learnt in the signals and systems course led me to pursue fourth-yearcapstonedesign projectfollowedbygraduate studies in the area, and eventually as a professor investigating variousmodel-basedanddata-drivenapproachesforbiomedical signalprocessing,analysis,andinterpretation.Overthecourseof learning, the ideas from electronics, telecommunication, infor- mation theory, machine learning, and human-centered design have shaped my understanding of the domain of biomedical signal analysis for connected healthcare. In the past 10 years, through the various workshops and tutorials that we have con- ducted,the audience were more interestedto learn the concepts systematically so that the techniques could apply to any biomedical signal analysis. Followed by an IEEE Engineering in Medicine and Biology Society (EMBS) conference workshop on the same topic, the Elsevier team approached me to consider writing a book on this topic. During book writing, the pandemic stuck, and that also led to further strengthening certain topics of thebookontheaspectsofconnectedandtelehealthpossibilities. The book comprises seven chapters, and with a people- centered approach, biomedical signal analysis topic has the largestcoveragefollowedbywearablesdesign andthenmachine learningandconnectivitytopics.Thebookcoversthesetopicsin a logical flow as per the following sequence. The context of current global healthcare situation and the role of digital tech- nology in improving people’s lives are covered in Chapter 1. An understanding of the applicability of biomedical signals in real- world application can inspire hardware design considerations, and the topic of wearables design is covered in Chapter 2. Biomedical preprocessing techniques of sampling, quantization, and filtering are covered in Chapter 3. In Chapter 4, details of adaptive analysis of biomedical signal analysis are covered. xiv Preface Chapter 5 deals with various feature extraction and analysis techniques. The role of biomedical signals in decision-making applicationswillbenefitfromusingmachinelearningtechniques, and some requirements of those are covered in Chapter 6. Ap- proaches for digital transmission of biomedical signals for con- nected healthcare, telemedicine, and electronic medical records are covered in Chapter 7. The contents of the book clearly fit an undergraduate course in biomedical signal analysis, biomedical systems and signals, digital health technologies, telemedicine, and also for an advanced course at the graduate level. With the availability of a plethora of open datasets with various forms of biomedical sig- nals and computer programs for signal processing, feature analysis, machine learning, and embedded systems program- ming, the students can experience the concepts covered in the book in individual or collaborative laboratory exercises and projects. The book was possible because of the many help I received from my graduate students, clinical collaborators, international research collaborators, industry partners, and peers in the area. Specifically, I would like to thank my graduate students and research assistants, Yashodhan Athavale, Fayez Qureshi, Garima Sharma,and MagdaleenSingarajah, for helping withthecontent of various chapters in this book. I am also grateful to Ryerson University Signal Analysis Research (SAR) group members for theirresearchcontributionsonvariousaspectsofthebooktopic. Elsevierpublicationsteamhavebeendiligentintheirwork,andI thank them for their help and support throughout the book writing phase. I would like to place my gratitude for the uncon- ditional support provided by my family and friends throughout thisjourneyofknowledgedissemination.Mayweseeaconnected world with good health and happiness! Sri Krishnan Toronto, Canada June 2021 1 Opportunities for connected healthcare 1. Introduction Healthcare is an inevitable and core requirement of humanity and its very own existence and sustainability. In this ever resource constraint world, healthcare is under constant strain of lack of adequate and appropriate medical attention at various levels of the system. The requirements manifest in the form of long-term needs for chronic healthcare, care for aging popula- tion,remotedeliveryofvarioushealthservices,escalationofhos- pitalization costs, and increased chances of infection due to prolonged hospital stays. These challenges could be addressed if the healthcare is able to harness the technology connectivity we are all enjoying as part of the digital revolution and a consciousefforttobridgethedigitaldividegaptherebyproviding aplatform for anywhere, anytime connectivityand seamlessand timelyhealthservices.AsshowninFig.1.1,amongtheTop10dis- easesglobally,formostofthesediseases,ifnotall,theroleoftech- nologyindiagnosing, managing,andintervening ishuge.Inspite of the prevalence of these diseases worldwide, the good news is the fact that the average life expectancy of humans continues to increase worldwide. Fig. 1.2 shows the average life expectancy map of the countries, and it is obvious that socio-economic fac- tors and access to high-end technologies play a significant role in influencing these statistics. The ever-increasing prevalence ofaffordabledigitalhealthtechnologiesandthepenetrationofin- formationandcommunicationtechnologies(ICTs)havegreatpo- tential to bridge the digital divide and contribute to anequitable access of healthcare services. The idea of connecting human civilization on a global scale gave birth to telephony in the 1920s. This was also augmented by advancements in other communication modalities such as Morse code, telegraphy, radar, and sonar techniques. Though communication forms one aspect of human civilization, it is indeed the most primal medium of survival, and through the BiomedicalSignalAnalysisforConnectedHealthcare.https://doi.org/10.1016/B978-0-12-813086-5.00005-0 1 Copyright©2021ElsevierInc.Allrightsreserved. 2 Chapter 1 Opportunitiesforconnectedhealthcare Figure1.1 Top10diseasesgloballyin2017.Source:IHME,GlobalBurdenofDisease,OurWorldinData,BBC[1]. Figure1.2 Worldlifeexpectancymap(2016).Source:Wikipedia[2]. 20th and 21st centuries, communication technologies have boostedarapidgrowthinmostverticalsincludinginfrastructure, transportation, food, and healthcare. Up until the late 1960s, most communication methods which were applied for

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