Physical activity monitoring with wearable technology has the potential to support stroke rehabilitation. Little is known about how physical therapists use and value the use of wearable activity monitors. This cross-sectional study explores the use, perspectives, and barriers to wearable activity monitoring in day-to-day stroke care routines amongst physical therapists. Over 300 physical therapists in primary and geriatric care and rehabilitation centers in the Netherlands were invited to fill in an online survey that was developed based on previous studies and interviews with experts. In total, 103 complete surveys were analyzed. Out of the 103 surveys, 27% of the respondents were already using activity monitoring. Of the suggested treatment purposes of activity monitoring, 86% were perceived as useful by more than 55% of the therapists. The most recognized barriers to clinical implementation were lack of skills and knowledge of patients (65%) and not knowing what brand and type of monitor to choose (54%). Of the non-users, 79% were willing to use it in the future. In conclusion, although the concept of remote activity monitoring was perceived as useful, it was not widely adopted by physical therapists involved in stroke care. To date, skills, beliefs, and attitudes of individual therapists determine the current use of wearable technology.
Light intensity and spectral composition notably impact the human circadian rhythm. The human body is a physiological system that regulates its sleep-awake cycle through a constant rhythm of light and darkness. For a long time, the lighting research field has been concerned with understanding this circadian rhythm to improve people's quality of life. To better understand the influence of light on the human circadian rhythm, a remote monitoring device was developed that reliably measures the light spectrum and human circadian rhythm in different environments, including Antarctica and a tropical location study. The designed apparatus aims to facilitate the comprehension of the impact of light on the human circadian rhythm and provide accessible measurements through cost-effective tools. Results show that the developed monitoring prototype can collect and transmit environmental and human data. Therefore, the low-cost equipment developed can be reproduced and used by research institutions to collect data in different environments and improve the understanding of the influence of light on human activities. The cross-sectional analysis of the collected data revealed evidence of the significant influence of light on regulating the human circadian rhythm in tropical and Antarctica case studies. The collected information makes it possible to predict human reactions to the light environment, correlate these responses with seasonal periods, and comprehend how various forms of artificial and natural light interact with individuals and their living spaces. This prototype offers a non-invasive tool for assessing sleep quality and daytime activities, providing knowledge of how lighting conditions can impact overall well-being.
OBJECTIVES: to test the effects of an intervention involving sensor monitoring-informed occupational therapy on top of a cognitive behavioural treatment (CBT)-based coaching therapy on daily functioning in older patients after hip fracture.DESIGN, SETTING AND PATIENTS: three-armed randomised stepped wedge trial in six skilled nursing facilities, with assessments at baseline (during admission) and after 1, 4 and 6 months (at home). Eligible participants were hip fracture patients ≥ 65 years old.INTERVENTIONS: patients received care as usual, CBT-based occupational therapy or CBT-based occupational therapy with sensor monitoring. Interventions comprised a weekly session during institutionalisation, followed by four home visits and four telephone consultations over three months.MAIN OUTCOMES AND MEASURES: the primary outcome was patient-reported daily functioning at 6 months, assessed with the Canadian Occupational Performance Measure.RESULTS: a total of 240 patients (mean[SD] age, 83.8[6.9] years were enrolled. At baseline, the mean Canadian Occupational Performance Measure scores (range 1-10) were 2.92 (SE 0.20) and 3.09 (SE 0.21) for the care as usual and CBT-based occupational therapy with sensor monitoring groups, respectively. At six months, these values were 6.42 (SE 0.47) and 7.59 (SE 0.50). The mean patient-reported daily functioning in the CBT-based occupational therapy with sensor monitoring group was larger than that in the care as usual group (difference 1.17 [95% CI (0.47-1.87) P = 0.001]. We found no significant differences in daily functioning between CBT-based occupational therapy and care as usual.CONCLUSIONS AND RELEVANCE: among older patients recovering from hip fracture, a rehabilitation programme of sensor monitoring-informed occupational therapy was more effective in improving patient-reported daily functioning at six months than to care as usual.TRIAL REGISTRATION: Dutch National Trial Register, NTR 5716.
The integration of renewable energy resources, controllable devices and energy storage into electricity distribution grids requires Decentralized Energy Management to ensure a stable distribution process. This demands the full integration of information and communication technology into the control of distribution grids. Supervisory Control and Data Acquisition (SCADA) is used to communicate measurements and commands between individual components and the control server. In the future this control is especially needed at medium voltage and probably also at the low voltage. This leads to an increased connectivity and thereby makes the system more vulnerable to cyber-attacks. According to the research agenda NCSRA III, the energy domain is becoming a prime target for cyber-attacks, e.g., abusing control protocol vulnerabilities. Detection of such attacks in SCADA networks is challenging when only relying on existing network Intrusion Detection Systems (IDSs). Although these systems were designed specifically for SCADA, they do not necessarily detect malicious control commands sent in legitimate format. However, analyzing each command in the context of the physical system has the potential to reveal certain inconsistencies. We propose to use dedicated intrusion detection mechanisms, which are fundamentally different from existing techniques used in the Internet. Up to now distribution grids are monitored and controlled centrally, whereby measurements are taken at field stations and send to the control room, which then issues commands back to actuators. In future smart grids, communication with and remote control of field stations is required. Attackers, who gain access to the corresponding communication links to substations can intercept and even exchange commands, which would not be detected by central security mechanisms. We argue that centralized SCADA systems should be enhanced by a distributed intrusion-detection approach to meet the new security challenges. Recently, as a first step a process-aware monitoring approach has been proposed as an additional layer that can be applied directly at Remote Terminal Units (RTUs). However, this allows purely local consistency checks. Instead, we propose a distributed and integrated approach for process-aware monitoring, which includes knowledge about the grid topology and measurements from neighboring RTUs to detect malicious incoming commands. The proposed approach requires a near real-time model of the relevant physical process, direct and secure communication between adjacent RTUs, and synchronized sensor measurements in trustable real-time, labeled with accurate global time-stamps. We investigate, to which extend the grid topology can be integrated into the IDS, while maintaining near real-time performance. Based on topology information and efficient solving of power flow equation we aim to detect e.g. non-consistent voltage drops or the occurrence of over/under-voltage and -current. By this, centrally requested switching commands and transformer tap change commands can be checked on consistency and safety based on the current state of the physical system. The developed concepts are not only relevant to increase the security of the distribution grids but are also crucial to deal with future developments like e.g. the safe integration of microgrids in the distribution networks or the operation of decentralized heat or biogas networks.
Grid congestion has caused significant issues for many businesses and consumers, leading to pressing questions about potential expansion, the configuration of electrical infrastructure, opportunities to reduce energy usage, and the impacts of installing photovoltaic (PV) systems. This project is dedicated to developing a digital twin energy management system within an energy hub to enhance efficiency and sustainability. By integrating state-of-the-art digital twin technology with various energy systems, the project, led technically by HAN University of Applied Sciences and with security managed by Impact Iot Solutions, aims to optimize the management of diverse energy sources like solar panels, heat pumps, and storage systems. Central to our approach is ensuring that all data collected during the project, which includes system performance metrics but excludes any personal user information, is used responsibly and stored securely. Local storage at the energy hub allows real-time monitoring and data analysis, with secure remote access for project partners to facilitate collaboration. At the project's conclusion, non-sensitive data will be made publicly available on an open platform, promoting transparency and enabling further research and development by the broader community. This initiative not only seeks to improve energy management practices but also aims to serve as a model for future digital twin implementations in energy hubs worldwide. By focusing on innovation, privacy, and community engagement, the project represents a significant step forward in the integration of digital technologies into sustainable energy solutions.
