ComputingDOI 10.1007/s00607-012-0233-9

Application of SmartBox end-device for medical careusing JXTA-Overlay P2P system

Leonard Barolli · Evjola Spaho · Fatos Xhafa ·Muhammad Younas

Received: 15 June 2012 / Accepted: 29 October 2012© Springer-Verlag Wien 2013

Abstract During last decade more and more old people live alone and the num-ber of old people that need medical care is increased. The lack of doctors and theincrease of the medical cost is becoming a big problem. Therefore, IT-based infor-mation systems should be implemented to help solve this problem. In this paper, wepresent the experimental results and evaluation of the SmartBox stimulation devicefor medical applications using a P2P system which is based on JXTA-Overlay. TheSmartBox is integrated with our P2P system as a useful tool for monitoring and con-trolling patients activities. We found by experimental results that by SmartBox we cancheck the patient’s situation. We carried out experiments with a patient in the bed and

This work was carried out while Leonard Barolli was a visiting professor at Department of Computingand Communication Technologies, Oxford Brookes University, UK.

L. BarolliDepartment of Information and Communication Engineering, Fukuoka Institute of Technology (FIT),3-30-1 Wajiro-Higashi, Higashi-Ku, Fukuoka 811-0295, Japane-mail: barolli@fit.ac.jp

E. Spaho (B)Graduate School of Engineering, Fukuoka Institute of Technology (FIT),3-30-1 Wajiro-Higashi, Higashi-Ku, Fukuoka 811-0295, Japane-mail: evjolaspaho@hotmail.com

F. XhafaDepartment of Languages and Informatics Systems, Technical University of Catalonia,C/Jordi Girona 1-3, 08034 Barcelona, Spaine-mail: fatos@lsi.upc.edu

M. YounasDepartment of Computing and Communication Technologies, Oxford Brookes University,Oxford OX33 1HX, UKe-mail: m.younas@brookes.ac.uk

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changed the temperature of the room. From the experimental results, we conclude thatthe use of SmartBox is an effective way for medical applications.

Keywords P2P · JXTA-Overlay · SmartBox · Medical applications

Mathematics Subject Classification 94D05

1 Introduction

Recently, many new devices and networks are appearing and in the past few yearswe have observed an explosive growth of multimedia computing, communication andapplications. The Internet is growing every day and the performance of computers isincreased exponentially. However, the Internet architecture is based on Client/Server(C/S) topology, therefore cannot use efficiently the clients features.

In order to make the internet secure many security devices are used. The firewallsare used for checking the information between private and public networks. The infor-mation is transmitted according to some decided rules and it is very difficult to changethe network security policy. Therefore, recently many researchers are working onPeer-to-Peer (P2P) networks, which are able to overcome security devices withoutchanging the network policy.

Currently, because of the decline in birth-rate and the growth in the population ofelderly people, the aged population in the world and especially in Japan is increased. InJapan now 1 in 5 people are more than 65 years old. In 2055 is predicted that 1 among2.5 people will be more than 65 years old and 1 among 4 people will be more than 75years. Also, during last decade more and more old people live alone and the number ofold people that need medical care is increased. The lack of doctors and the increase ofthe medical cost is becoming a big problem. Therefore, IT-based information systemsshould be implemented to help solve this problem.

So far, in order to support the old people in their daily activities are proposed andimplemented many systems [1,2]. Most of these systems, use camera and other devicesin order to protect and help the elderly people. These devices in general are a little bitexpensive. Also, these systems are based on C/S approach.

In order to deal with these problems, we implemented a smart device that we callSmartBox. We have implemented in the SmartBox many functions and sensor such asbody sensor, infrared sensor, chair or bed vibration control, light control, smell controland sound control. The SmartBox is integrated in a P2P JXTA-Overlay platform, whichis able to overcome security devices without changing network security policy. TheSmartBox has a small size and is very cheap. By using SmartBox the implementedsystem is able to control the situation of patients.

In this paper, we present the experimental results and evaluation of SmartBox devicefor medical applications in P2P system which is based on JXTA-Overlay. We also showthe design and implementation of the SmartBox environment that is used for checkingthe situation of patients in the bed.

The structure of this paper is as follows. In Sect. 2, we introduce the related work.In Sect. 3, we introduce JXTA technology and JXTA-Overlay platform. In Sect. 4, we

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present the proposed P2P JXTA-Overlay system. In Sect. 5, we discuss the experi-mental results. Finally, conclusions and future work are given in Sect. 6.

2 Related work

In this section, we discuss the related work for P2P and medical care systems.Much of the initial research efforts and projects on P2P systems were concerned

with the investigation of overlay networks. It should be noted that each time more,this effort is oriented towards the design and implementation of libraries and plat-forms to support the development of real P2P applications, which could actually com-bine both Grid and P2P technologies. Bal et al. [3] motivated the need for researchfrom conceptual, algorithmic and application level tools to facilitate the applicationdevelopment task, that is, tools that enable writing, deploying and running Grid/P2Papplications.

Since in P2P applications file sharing plays an important role, a lot of research effortis being devoted to the development of reliable file sharing systems to be used in P2Papplications [4]. In particular, several studies are done for measuring the efficiency inP2P systems [5,6] as it is crucial.

In order to decrease the moving time of mental healthcare specialists, in [7], theauthors proposed and developed a WWW conference system, which can providethe communication between mental healthcare specialists and their students. Theyimplemented the prototype system in LAN environment and analyzed the perfor-mance by changing the frame rate, frame size and number of clients. The experi-mental results show that system has enough performance in the LAN environmentbut PCs need a high CPU power to send, receive and display the high quality livevideos.

In [8], the authors proposed and developed a remote medical care system to sup-port nurses, care managers and care helpers during their work. The proposed sys-tem has 3 functions: a multi-point communication function using video images andvoice, vital signs data auto-uploading and referencing function, and a drip infusionmonitoring function. They present the proposed remote medical care support systemand report the field experiment results using the system in a medical care supportcenter.

In [9,10], the authors use wearable devices to implement ubiquitous health monitor-ing systems. The biomedical data are collected by wearable health diagnostic devicesand permanent medical data of patients are kept in the corresponding databases. Bycombining the measured biomedical data and the permanent medical data is possibleto coordinate the needed actions and help the local medical teams to make quickly thebest decisions that could be crucial for the patient health, and that can reduce the costof health service. They also propose to use Inter Vehicle Communications as part of adistributed system for ubiquitous health monitoring of patients.

However, all these systems are based on C/S architecture. In such approachthe shared resources are centralized on servers and clients access them throughrequesting protocols. Among the most important limitations of server-mediatedapproaches, we could distinguish lack of scalability, lack of fault tolerance, usually low

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performance/bottlenecks as well as high costs in acquiring, developing and maintain-ing such applications.

For this reason, we propose and implement a P2P system called JXTA-Overlay.

3 JXTA technology and JXTA-Overlay

3.1 JXTA technology

JXTA [11] technology is a generalized group of protocols that allow different devicesto communicate and collaborate among them. JXTA offers a platform covering basicneeds in developing P2P networks.

By using the JXTA framework, it is possible that a peer in a private network canbe connected to a peer in the Internet by overcoming existing firewalls as shown inFig. 1.

In Fig. 1, the most important entity is the router peer. A router peer is any peerwhich supports the peer endpoint protocol and routing messages between peer in theJXTA networks. The procedure to overcome the firewall is as follows.

– In the Router Peer is stored the private address of Peer1 by using the HTTP protocolto pass the firewall from Peer1.

– The Router Peer receives the data from Peer2 and access the Private address ofPeer1 to transmit the data.

JXTA is an interesting alternative for developing P2P systems and group-ware tools.In particular, it is appropriate for file sharing given that the protocols allow to developeither pure or mixed P2P networks.

3.2 JXTA-Overlay

JXTA-Overlay project is an effort to use JXTA technology for building an overlayon top of JXTA offering a set of basic primitives (functionalities) that are most com-monly needed in JXTA-based applications. The proposed overlay comprises the fol-lowing primitives: peer discovery, peer’s resources discovery, resource allocation,task submission and execution, file/data sharing, discovery and transmission, instant

Fig. 1 P2P communication

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Fig. 2 Structure of JXTA-Overlay system

communication, peer group functionalities (groups, rooms etc.), monitoring of peers,groups and tasks.

The overlay is built on top of JXTA layer and provides a set of primitives that canbe used by other applications, which on their hand, will be built on top of the overlay,with complete independence. The JXTA-Overlay project has been developed using thever-2.3 JXTA libraries. In fact, the project offers several improvements of the originalJXTA protocols/services in order to increase the reliability of JXTA-based distributedapplications [12] and to support group management and file sharing.

The architecture of P2P distributed platform which we have developed using JXTAtechnology has 2 main peers: Broker and Client. Altogether these 2 peers form a newoverlay on top of JXTA. The structure of JXTA-Overlay system is shown in Fig. 2.

3.3 Internal architecture of JXTA-Overlay

Except Broker and Client peers, the JXTA-Overlay has also SimpleClient peers asshown in Fig. 3. The control layer interacts with the JXTA layer, and is divided into2 parts: a lower part with functionality common to any kind of peer, and a higher partwith functionality specific to Brokers and Clients.

– The common part provides functionality for doing JXTA messaging, discoveryand advertisement.

– The Broker specific part provides functionality for managing groups of Brokersand keeping broker statistics.

– The Client specific part provides functionality for managing groups of Clients,keeping client statistics, managing its shareable files, managing the user configu-ration and creating the connection with a Broker.

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Fig. 3 Internal architecture of JXTA-Overlay

The lower part enqueues the JXTA messages to be sent. Whenever a message arrives,the JXTA layer fires an event to the lower layer, which in turn fires a notifications tothe upper layers.

4 Proposed JXTA-Overlay P2P system

4.1 Transmission control and management in JXTA-Overlay

The most important part in a P2P system is the communication between peers. By usingthe proposed JXTA-Overlay, it is possible to overcome, firewalls, routers, NATs, andbridges in the private networks. We explain in following the message transmission bythe JXTA-Overlay.

JXTA-Overlay uses Universally Unique Identifier (UUID) in order to identify thepeers in the private network from the Internet. The UUID is a general unique identifier.It is generated by the NIC address of the computer, date and time. By knowing theUUID and TCP address, it is possible to make address translation.

We implemented a control system that is able to control a peer in a private networkfrom a peer in the Internet as showing in Fig. 4. The control targets are consideredthe network devices such as RS232C port, LPT port and USB port. By implementingthis kind of control system, we are able to collect data and control the peers in a WideArea Network (WAN). Thus, we will be able to control all devices that are connectedto the peers. We control the USB devices and RS232C equipment. This is becauseUSB devices are very popular and are used almost in every computer. Also, by usingUSB it is possible to control motors and LEDs. The RS232C is a legal interface andmany devices have implemented it.

4.2 Implementation of JXTA-Overlay P2P system

In our proposed system we combine P2P, Web and Sensor technologies. We imple-mented a P2P system based on JXTA-Overlay as shown in Fig. 5. The implementedsystem can be used for monitoring and control of different subjects.

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Fig. 4 Implementation of remote control in JXTA-Overlay

Fig. 5 Implemented JXTA-Overlay P2P system

Our goal is to check and control the health situation of patients. For this reason,we implemented a SmartBox as shown in Fig. 6. The SmartBox is integrated with ourP2P system as a useful tool for monitoring and controlling subjects activities.

Previously, we implemented a SmartBox device that was big in size and difficult tobe moved in different places. The size of previous SmartBox was 50 × 10 × 15 cm. Inorder to occupy a small space and to transport easily in different places we designedand implemented a new SmartBox. The size of the new SmartBox is 35 × 7 × 12 cm.The SmartBox has the following sensors and functions:

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Fig. 6 SmartBox functions

Fig. 7 New SmartBox (Front) and previous SmartBox (Back)

– Body Sensor for detecting body movement;– Chair or Bed Vibrator Control for vibrating the chair or bed;– Light Control for adjusting the room light;– Smell Control for controlling the room smell;– Sound Control to emit relaxing sounds; and– Remote Control Socket for controlling AC 100V socket (on-off control).

A snapshot of the previous SmartBox and new SmartBox is shown in Fig. 7.We carried out different experiments with SmartBox, which was controlled by 1

peer of JXTA-Overlay P2P system. In the experiments, SmartBox is used as an end-device connected to a peer.

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We used SmartBox for checking the situation of a patient in the bed. We set-up theinfrared sensor in the bed and checked the reaction time of the body when the patientis sleeping.

We pay attention to the reaction frequency of sensor. When the patient is sleeping,the number of body movements is small, so the infrared sensor do not respond whenthere are not movements. Based on the response time, the system made the decisionconsidering the following conditions.

– When there are more than 10 body movements for 30 min: the patient is notsleeping.

– When there are more than 10 body movements for 60 min (2 consecutive mea-surements): the patient is not sleeping, so he may be has some health problems.

– When there is not any body movement for 2 consecutive measurements: the patientis not in the bed or he fell down from the bed.

– When there are more than 6 body movements for 3 consecutive measurements:the patient is sleeping, but may be he has some health problems.

If the patient has health problem, then our system sends the information in real timeto the nurses or doctors.

We carried out extensive experiments with the patient sleeping considering 3 kindof beds: hard, normal and soft. The temperature of the room also effects the bodycondition. For this reason, we changed the temperature of room from 22 to 25 ◦C. Weobserved the situation of 1 patient for about 7 h during sleeping for 4 weeks. For theseexperiments we took in consideration the following.

– If the patient do not move for 4 min: the patient is sleeping.– If the patient is not moving for 20 min: the patient is not in the bed or he has fell

down from the bed.

In these experiments, we use only 1 patient, but our system can be used for checkingmany patients.

5 Experimental results

We observed the situation of 1 patient for about 7 h during sleeping for 2 weeks. Theexperimental results are shown in Figs. 8 and 9. In Fig. 8, the y-axis shows the timewhen the infrared sensor did not respond and x-axis show the time when the patientis sleeping. We recorded the values of the response time of the infrared sensor every5 s. We see that when the infrared sensor did not respond for a long time, the patientdoes not move the body, so he is sleeping well. In Fig. 9, we show the case when thepatient is not sleeping (abnormal case). So may be he has some health problems. Theresponse time of infrared sensor is very fast. This means that the body of patient ismoving. We can see from this figure that the patient is not sleeping for about 6 h, butafter that the infrared sensor did not respond that means that for the rest of time (about4 h) the patient was sleeping.

In Figs. 10 and 11, we show the number of body movements of the patient forsleeping (normal case) and not sleeping (abnormal case), respectively. We show thedata for about every 30 min. In Fig. 10, we can see that the patient body moved 34

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Fig. 8 Time when infrared sensor did not respond (during sleep)

Fig. 9 Time when infrared sensor did nod respond (abnormal case)

Fig. 10 Number of body movements (during sleep)

times. This means that the patient is not sleeping for about 30 min. But after that, thenumber of body movements for every 30 min is less than 5 times. This means that thepatient is sleeping. In Fig. 11, the patient is not sleeping for about 6 h, so the numberof body movements is about 15 times. After that, the number of body movements isless than 5 times, which shows that the patient is sleeping.

Extensive experimental results that take in consideration the bed type and the roomtemperature are shown in Figs. 12, 13, 14 and 15.

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Fig. 11 Number of body movements (abnormal case)

Fig. 12 Body not moving timefor hard bed and temperature22 ◦C

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Fig. 13 Body not moving timefor normal bed and temperature22 ◦C

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Fig. 14 Body not moving timefor soft bed and temperature22 ◦C

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Fig. 15 Body not moving timefor normal bed and temperature25 ◦C

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In Fig. 12 are shown the experimental results when the patient sleeps in a hard bedand the temperature of the room is 22 ◦C. The y-axis shows the time when the infraredsensor did not respond and x-axis shows the time when the patient is sleeping. Werecorded the values of the response time of the infrared sensor every 5 s. From thefigure, we can see that for the first 5,000 s the infrared sensor responds all the time, sothe patient is moving and not sleeping. After 5,000 s, we see that the infrared sensordid not respond for a long time. This means that the patient body was not moving,so he is sleeping well. During the period of time between 15,000 s and 20,000 sthe infrared sensor almost did not respond. This shows that the patient is in a deepsleep.

In Fig. 13, we show the case when the patient is sleeping in a normal bed and thetemperature of room is 22 ◦C. We can see from this figure that the infrared sensor isresponding faster than the case of hard bed. In Fig. 14, the patient is sleeping in a softbed and the temperature is 22 ◦C. We can see that the not moving time of the patientis higher than the case of normal bed. This means that the patient is sleeping better ina soft bed compared with the normal bed.

In Fig. 15 are shown the experimental results with a patient sleeping in a normalbed, but we increased the temperature of the room to 25 ◦C. Comparing Fig. 15 withFig. 13, we see that the response time of infrared sensor for 25 ◦C is faster than 22 ◦C.This means that the body of patient is moving, so he may be has some health problems.In this way, our system is able to check the health situation of the patient.

6 Conclusions and future work

In this work, we presented the application of SmartBox for medical application in aP2P System using JXTA-Overlay platform. The proposed system is able to check thepatients health situation.

We carried out many experiments to evaluate the effects of SmartBox for medicalcare. We took into consideration the movement of patients, bed type and room tem-perature. We found that when the infrared sensor did not respond for a long time, thepatient does not move the body, so he is sleeping well. In the case when the patientis not sleeping, the response time of infrared sensor is very fast. This means that the

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body of patient is moving. When patient sleep in a soft bed and the temperature of theroom is 22 ◦C, the patient state is better than in other scenarios.

From experimental results, we conclude that the use of SmartBox is an effectiveway to check the patients health situation.

In the future, we plan to evaluate the proposed system for many patients. We alsowould like to evaluate the proposed system for different scenarios.

Acknowledgements This work is supported by a Grant-in-Aid for scientific research of Japan Societyfor the Promotion of Science (JSPS). The authors would like to thank JSPS for the financial support.

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