Wireless Sensor Networks for

Home Health Care

Chris R. Baker∗ , Kenneth Armijo∗ , Simon Belka∗ , Merwan Benhabib∗ , Vikas Bhargava∗ , Nathan Burkhart∗ ,
Artin Der Minassians∗ , Gunes Dervisoglu∗ , Lilia Gutnik∗ , M. Brent Haick∗ , Christine Ho∗ , Mike Koplow∗ ,
Jennifer Mangold∗ , Stefanie Robinson∗ , Matt Rosa∗ , Miclas Schwartz∗ , Christo Sims∗ , Hanns Stoffregen∗ ,
Andrew Waterbury∗ , Eli S. Leland∗ , Trevor Pering† , and Paul K. Wright∗
∗ University of California, Berkeley, USA
† Intel
Corporation

Abstract— Sophisticated electronics are within reach of average based solutions for health care and patient monitoring. More
users. Cooperation between wireless sensor networks and existing specifically, this paper will discuss several of these projects,
consumer electronic infrastructures can assist in the areas of highlighting their need, design, implementation, and results.
health care and patient monitoring. This will improve the quality
of life of patients, provide early detection for certain ailments, and The contributions of this paper are the following:
improve doctor-patient efficiency. The goal of our work is to focus
• Identify opportunities for health monitoring applications
on health-related applications of wireless sensor networks. In this
paper we detail our experiences building several prototypes and utilizing wireless sensor network technology.
discuss the driving force behind home health monitoring and how • Demonstrate working prototypes with relatively simple
current (and future) technologies will enable automated home technology which make incremental, but important, steps
health monitoring. to toward ubiquitous deployment of health monitoring
I. I NTRODUCTION devices, as well as how they may be integrated into
existing infrastructures.
Various economic and technological factors (e.g. Moore’s
• Discussion of why heath care at home is important and
Law) have brought sophisticated electronics within the reach
how we believe future technology trends will continue to
of average users. These technologies, when complimented with
merge health care and smart home environments.
wireless sensor networks, promise to add a truly ambient intel-
ligent component to our daily lives. Today, these technologies This paper is organized as follows: §II will briefly dis-
may be integrated into existing consumer electronic and infras- cuss the base technologies with which we are working. §III
tructure already found in the home. The future home represents will discuss five prototype designs. These prototypes vary in
an opportunity for the convergence of these technologies far application from infant monitoring, alerting the deaf, blood-
beyond what we see today. This future “smart” home would pressure monitoring and tracking, and monitoring fire-fighter
be even more capable, providing an ambient awareness of vital signs (a generic monitoring technology). After a brief
the home’s occupants through an ecosystem of ubiquitous discussion of each prototype, §IV will reflect on the role of
connectivity, disappearing devices, highly-available services, technology in the convergence of health care and smart homes.
and multi-modal sensing. Finally, §V will conclude the paper.
One promising application is the area of health care and
patient monitoring. The integration of sensing and consumer
electronics technologies would allow people to be constantly II. T ECHNOLOGIES
monitored. One important benefit is to help stem rising health
care costs by increasing health observability and doctor-to- Our prototypes use two similar sensor network mote tech-
patient efficiency. Moreover, constant monitoring will increase nologies: Tmote Sky and SHIMMER. The Tmote Sky is the
early detection of adverse conditions and diseases for at- latest derivative of the Berkeley Telos motes from Moteiv
risk patients, potentially saving more lives. This ability is Corp. [1]. The other mote is Intel’s Digital Health Group’s
right around the corner and its beginning will be ushered in platform for Sensing Health with Intelligence, Modularity,
with incremental integration of wireless sensor networks and Mobility, and Experimental Re-usability, or SHIMMER. Sev-
consumer electronics. This is the focus of the paper: crossing eral of our prototypes use just Tmotes, while some use a
that barrier by introducing prototypes for health monitoring combination of Tmote and SHIMMER motes. Both are nearly
for smart home environments. identical with respect to processing and communication; each
At the University of California, Berkeley, a project-based have the Chipcon CC2420 802.15.4 radio and TI MSP430
graduate course on high-tech design and rapid prototyping has (with 10k RAM). However, the SHIMMER has additional
worked for the three months to develop prototype high-tech integrated sensors (e.g. 3-axis accelerometer) and has a smaller
products utilizing wireless sensor network technology. Several form factor by approximately 55%. For programming both
of the projects have focused on developing sensor network motes, we use the TinyOS environment [2].

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 Base Station
III. P ROTOTYPES Sensor Readings
Sensor Mote Infant on back.

We have developed several prototypes which demonstrate

wireless sensor network technologies for heath care at home. ZZZ

Each of these prototypes will be discussed in the following

sections.
(a) System architecture consisting of sensing mote and base station.
A. SleepSafe
g g g
Sudden Infant Death Syndrome (SIDS) strikes without Back Position Side Position Stomach Position
(Face Up) (Face Down)
warning causing unexplained death to infants one month to one
year of age. While experts cannot fully explain the causes of
SIDS, research shows there are several factors which increase
the incidence of SIDS. Foremost among the risks is allowing
the infant to sleep on their stomach. An infant sleeping on their Mattress Mattress Mattress

stomach is up to 12.9 times more likely to die from SIDS [3]. (b) The accelerometer detects the position of the infant in one of three
To reduce the likelihood of SIDS, doctors warn parents to put states relative to gravity (g).
their children to sleep on their backs. This has reduced the
incidence of SIDS by 40%. However, SIDS still remains the Fig. 1. SleepSafe baby monitor for detecting infant sleeping position.
leading cause of death for infants less than one year old, with
approximately 2,500 deaths per year in the United States [4].
Between the ages of 4 to 7 months, infants gain the ability
to roll onto their stomachs. Parents and other care givers
may be worried about this new ability. We have built a The base station is implemented using a Tmote and a laptop.
simple prototype (called SleepSafe) which detects the sleeping This mote is used to bridge the wireless to a serial port. A
position of the infant. It alerts the parents when the infant is Java program running on the laptop is listening for packets
detected to be lying on its stomach, offering them peace of from the SHIMMER mote. The Java program is very simple:
mind without having to constantly watch their child while it it detects the infant’s sleeping position given the sensor values
sleeps. Our prototype does this by attaching a sensor to the and sends an alert when infant is on its stomach. To adjust
infant’s clothing. This sensor detects if the infant is sleeping on the sensitivity of detection, the Java program keeps the last N
their back, side, or stomach. When the later two are detected, values in a buffer known as the sensing window (w, where
the parent is notified. The sensitivity and delay can be adjusted |w| = N). The values of the sensing window are averaged
to accommodate the user’s preferences (e.g. different risk to produce α: α ← ∑ wi /N. To determine the actual sleeping
levels and false-alarm frequency). position of the infant, α must be mapped to one of the three
Our prototype consists of two sensor network motes. One discreet sleeping positions si (back, side, and stomach) of set
sensor mote is attached to the infant’s clothing, while the other S . A threshold t (0 < t ≤ 1) is used to determine intervals Psi
acts as a wireless base station to receive and process sensor for mapping α to S: Psi ← (si − (1 − t), si + t]. For example,
readings. Depending on the SleepSafe settings, the base station suppose t = 0.5 and S = {−1, 0, 1} (i.e. the states are: stomach
will alert the parent. It is expected that this system could → −1, side → 0, and back → 1). Then the intervals for
be integrated into existing monitoring infrastructures, such as mapping α are: P−1 = −1.5 < α ≤ −0.5, P0 = −0.5 < α ≤ 0.5,
those for audio and video. Additionally, alerts could be sent to and P1 = 0.5 < α ≤ 1.5. If the average over the sensing window
a pager-like device or cell phone. This prototype architecture is 0.78, then the infant is on their back. The user’s preferences
is shown in Figure 1(a). determine the size of the sensing window and the threshold.
The mote attached to the infant’s clothing is a SHIMMER Think of this processing by the base station as an adjustable
mote. It is expected that with technology trends the reduction low-pass filter: a high-risk infant might have a smaller sensing
in physical size will allow it to be seamlessly integrated into window and higher threshold value, while to reduce false-
the fabric of the clothing. This mote has a 3-axis accelerome- alarms, a larger sensing window and lower threshold would
ter; a single axis is used to sense the infants position relative to be used.
gravity. With the mote oriented “face-up” on the infant’s chest,
3 discrete positions (back, side, and stomach) are measured Experimentation shows the infant can move very slowly
as anti-parallel, perpendicular, and parallel to the force of without loss of detection. Furthermore, the delay between the
gravity. Figure 1(b) illustrates how these positions are mea- infant changing positions and the base station issuing an alert
sured relative to gravity. The mote’s processor, running a small is not observable. Future work may be to integrate this into an
TinyOS program, reads the accelerometer values periodically existing commercial baby monitor, as well as adding additional
via the on-board analog-to-digital converter (ADC), packetizes sensing to the SleepSafe infrastructure. For example, adding
the values, and sends the packet wirelessly to the base station sensing for body temperature which is also correlated to SIDS
for processing. incidence rate [3].

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 Sensor Plates

operate using these same electrodes (with its own respective

circuitry) and calculates the childs hydration based on resis-
tivity measurements taken between them.
The Baby Gloves wireless feature allows it to monitor and
transmit vitals information to a variety of computing systems
such as PDAs, cell phones and laptops. As health condition
information is received by a computer, specialty software
analyzes the data and determines whether the childs vitals have
Base Station Mote Sensor Mote and
Circuitry Unit exceeded predefined health settings. If settings are exceeded,
(a) Experimental setup. (b) Baby glove swaddle. an alert is sent to a parent or nurse as to the condition
of the child. The Baby Glove device software also has the
Fig. 2. The Baby Glove prototype.
ability to send instructions to the environmental controls within
an incubator or thermostat to update the thermal conditions
autonomously.
B. Baby Glove
Due to their tiny nature, premature infants are susceptible C. FireLine
to a variety of health problems based on the lack of proper Note that while this prototype is geared toward monitoring
thermal regulation. Their underdeveloped state and low body firefighters, it can easily be adapted to monitor the same vital
mass limits their ability to sweat which makes them vulnerable signs of patients in the home environment.
to hypo- or hyperthermia, whereupon they become increas- In 2005, there were 1,136,650 firefighters (both career and
ingly susceptible to illness and death. Currently, children born volunteer) recorded protecting communities across the United
with a Low Body Weight (LWB) (weight < 5.5 lbs), which States. On average, U.S. fire departments respond to fire-
account for 7% of all US births, incur a 68% mortality related emergencies every 20 seconds. Though firefighting
rate [5]. As the weight of children decreases, the mortality technology, protective gear, and operation procedures have
rate increases. Many of these statistics are due in part to improved within the last three decades, the annual number
their extreme sensitivity to temperature fluctuations, which of on-duty firefighter deaths still remains around 100. Of
must stay within a consistent range of 36◦ C to 38◦ C. With those fatalities, 50% are determined to be caused by stress,
these very tight restrictions, very sensitive, bulky and rather with most firefighters experiencing sudden cardiac arrest.
expensive devices are implemented to closely monitor vitals. Furthermore, 24.1% of injuries occurring during fire-related
In turn, we have developed an integrated health monitoring emergencies have been attributed to strain [7]. The majority
device, contained within a swaddling baby wrap (called The of firefighter cardiac related complications can be traced to
Baby Glove). The wrap design provides a comfortable method the physical and psychological strain associated with having to
of securing the child, with strategically placed sensors that carry over 75 pounds worth of tools, equipment, and protective
monitor their temperature, hydration and pulse rate, three main gear [8]. Coupling labor intensive tasks with the heat stress
health considerations important to development [6]. developed from extreme, hostile environments, the heart rates
The Baby Glove prototype, as seen in Figure 2, encom- of firefighters often exceeds maximal “healthy” rates.
passes two integrated sensor plates, which contain a thermistor Because of these alarming statistics, there has been great
temperature sensor along with electrodes that monitor the interest in real-time monitoring of firefighter health. Any
childs pulse rate and hydration. The sensor plates are placed irregularities in a firefighters heart rate can signal imminent
posterior and anterior to the childs upper torso, which is the cardiac failure, so detecting these abnormalities immediately
bodys largest thermal mass. The device consists of two sensor and relieving the firefighter can prevent causalities. FireLine
network motes, one connected to the swaddling wrap and the is a wireless heart rate sensing system that can be used to
other to a base station computer. The first mote, connected decrease stress related fatalities and injuries through real-time
to the wrap, is a SHIMMER mote. It monitors the vitals firefighter health monitoring.
information coming from the sensors via an ADC, organizes FireLine, illustrated in Figure 3(a), includes a wireless
the measurements into packets and transmits them wirelessly sensor device (Tmote), a custom-made heart rate sensor board,
to the second mote, connected to the base station computer, and three reusable electrodes. All components have been
for processing. The mote’s sensitivity and sensor delays can integrated into a fire retardant shirt worn under the users
be adjusted based on user preferences. protective clothing and equipment. The wireless mote, sensor
The temperature sensor for the device calculates the baby’s board, and battery packs are housed in two slim cases that are
temperature (◦ C) based on thermistor input voltages and re- sewn into the inner right sleeve of the shirt. The case locations
sistances using a predefined equation: T = ((V /R)(100/(3.3 − were chosen to minimize any interference with equipment that
V )) − 1)(1/0.0039). The pulse rate electrode sensors operate a firefighter must wear, such as backpacks and the breathing
based on electrical signals that emanate from the heart as apparatus, and to minimize the wiring length. The electrodes
it pumps blood. To ensure accurate readings, electrodes are and wires were sewn inside the shirt such that the positive and
placed in two locations on the wrap. The hydration sensors, negative electrodes are attached to each side of the chest, and

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 health regime, and are comfortable with home PCs. It also
demonstrates integration of sensor network technology with
consumer electronics (i.e. an existing blood pressure monitor).
A SHIMMER mote is located inside the casing on the wrist
cuff connected to the electronic pressure sensor. When the start
button is pressed, it computes the user’s blood pressure and
heart rate using the oscillometric method. Initially, the wrist
cuff is inflated to restrict blood flow along the patient’s arm
(a) Diagram of FireLine shirt (b) EKG waveform measured using (pressure sensor reads a constant value). As it deflates, the
embedded with sensors, elec- FireLine. Each spike with an apex past
tronic hardware, and wiring. 1.8V represents one heart beat. pressure sensor value is monitored: the point at which its value
begins to oscillate is the pressure at which the blood flow is
Fig. 3. The FireLine prototype. no longer entirely restricted (systolic pressure), and the point
at which it returns to a constant value is the pressure at which
the blood flow is entirely unrestricted (diastolic pressure).
a ground electrode is attached to the stomach. The embedded Also, the user’s heart rate can be inferred by measuring the
electrodes sample a voltage signal from the heart every 10 time between pressure peaks while the blood flow is partially
ms, and these readings form an EKG waveform. An example restricted and the pressure sensor value is oscillating.
waveform is shown in Figure 3(b). These measurements are The SHIMMER mote then broadcasts these readings, along
wirelessly transmitted from the mote on the firefighter’s sleeve with a time-stamp, over the radio. This message is received
to a “base station” mote attached to a laptop monitored by an at the base station, which is plugged into the user’s computer
incident commander. The readings are recorded and processed through the USB port. This base station contains a Tmote
by custom software that calculates the firefighters beats per Sky, which forwards the received message through the USB
minute (bpm). The current bpm, EKG, and a graph of heart port to the user’s computer. The included software application,
rate over time are displayed in a Java based GUI. which is running on the user’s computer, monitors the specific
If the heart rate were to increase or decrease past certain USB port for traffic. When a message arrives, the values are
limits, dependent on the firefighters resting heart rate, an alert recorded along with the time-stamp. If the wrist cuff is unable
will appear on the laptop. For our test subject, a healthy heart to communicate with the base station, it will store the readings
rate was approximated to be between 50-140 bpm. In the and periodically broadcast them until it gets notification that
event that a firefighters heart rate has increased substantially, the base station received the message. Similarly, if the software
the commander (or patient’s doctor or care-giver) can use application is unable to retrieve the readings from the base
the readings to make an informed decision to remove the station, they will be stored locally until they are confirmed to
firefighter from the scene of the fire. have been received by the application.
The software application provides a graph of the user’s
D. Heart@Home
blood pressure and pulse rate over time (see Figure 4). The
Heart disease is the number one cause of death in America; software also offers helpful medical advice that is tailored to
as our population ages, people are getting more and more the individual’s physical profile, taken from a database filled
concerned about their high blood pressure as it leads to se- with medical tips collected from doctors. The user can enter
rious cardiovascular diseases. This increased health awareness their height and weight, along with any medications they are
pushes people to take their health into their own hands, into taking and other health problems they have, in order to better
their own home. Doctors nationwide agree that tracking blood provide health tips. If alarming anomalies appear in the user’s
pressure daily at home is one of the best ways to live with heart readings, such as a spike or steady increase in blood
high blood pressure and preventing more serious health issues. pressure, the software alerts the user. To easily communicate
Keeping track of blood pressure at home is already a booming the readings to a physician, a report of the user’s health can
business in the health care industry; millions of blood pressure be emailed to a doctor or printed out in an easily readable
monitors are sold every year with quick and accurate readings. format.
At the same time, hundreds of websites are popping up with
suggestions, tips, and isolated tracking services to help people E. LISTSENse
keep track of their health stats, especially their blood pressure. About 2 to 4 of every 1,000 people in the United States are
Furthermore, the user has to write down or manually enter functionally deaf. However, if people with a severe hearing
these stats into one of a dozen sites. impairment are included with those who are deaf, then the
To remedy this deficiency, we have developed a blood number is 4 to 10 times higher. That is, anywhere from 9 to
pressure monitor and tracking system we call Heart@Home 22 out of every 1,000 people have a severe hearing impairment
with a wireless sensor network as its core technology. The or are deaf. At least half of these people reported their hearing
Heart@Home blood pressure monitor is focused toward the loss after 64 years of age [9]. Age is not the only cause
aging baby boomer population who are concerned with their of hearing impairment. Recent studies show that one million
high blood pressure, are interested in maintaining a personal American children of school age have hearing impairments and

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 Encrypted Radio
Message
Transmitter Base Station
Sound

Sensor (microphone) LED

Signal Shaping Vibrator
Signal Processing LCD

(a) LISTENse’s simple communication scheme.

Fig. 4. Heart@Home prototype GUI output.

the figure is growing [10]. This is either genetic or due to the (b) Transmitter de- (c) Base Station with LCD, LEDs, and ac-
excessive use of personal electronic audio devices. Therefore, vice with micro- knowledge button.
phone.
hearing impaired people represent a growing percentage of the
nation’s population.
Fig. 5. LISTENse prototype.
LISTENse is a prototype that empowers the hearing im-
paired with the perception ability of critical audible informa-
tion in their environment (e.g. doorbell, smoke alarm, crying sound source has been activated. It will stop as soon as the
child.) It is comprised of at least two wireless sensor network user presses the acknowledge button or, to save power, after
motes. User carries one mote – the Base Station – on his wrist, a certain amount of time (e.g. one minute.). In addition, it
belt, etc. and each of the other motes – the Transmitters – is may display an appropriate text message on its LCD screen.
placed close to the sound source that it is to be “heard.” Figures 5(b) and 5(c) shows the manufactured Base Station
Form factor and cost are the two major shortcomings of and Transmitter prototype that were successfully tested and
the existing similar technologies compared to our prototype. evaluated. The prototype size currently follows the Tmote Sky
They have either a non-portable table-top Base Station or a sensor network mote dimensions that is expected to shrink
bulky pager-like device. Sensor mote technology and miniature substantially in a near future.
electronic parts enable us to shrink the form factor by a great
extent. We envision our product to be as small as a regular IV. D ISCUSSION
watch and very convenient to use. The deployment of mote Sophisticated, low-power, cheap, small, and mobile elec-
technology further reduces the cost of our prototype. tronics will continue to permeate the home environment for a
The prototype Transmitter consists of an omnidirectional variety of applications, ranging from multi-media entertain-
condenser microphone with flat frequency-domain character- ment to home automation. It is a natural step to augment
istics within the range of audible frequencies. It is connected or extend these technologies to enable a seamless patient
to the sensor network mote through signal shaping and pro- experience between home and the hospital or clinic.
cessing electronics. The prototype Base Station components Let us be clear why this must happen – cost. Health care in
such as the vibrator and LEDs are similarly interfaced to its the US, EU and much of Asia is now a significant part of the
mote through corresponding driver circuitry. economy. The US spends $2 trillion per year in health care,
Figure 5(a) depicts a simple communication scheme of approximately 16% of the GDP [11]. Figure 6 shows a major
the LISTENse basic network that consists of the Base Sta- concern for the future and the need for the products described
tion and one Transmitter. Transmitter periodically samples in this paper for maintaining health at home rather than care
the microphone signal at a rate of about 20 Hz (which is in a hospital. The figure can be explained with the following
adjustable) and compares the sample with a reference value points:
that is internally defined based on the user-defined Transmitter • The figure shows in the shaded region to the right, that the
sensitivity. Once the measured signal surpasses the reference age groups (in deciles) where the care-costs are greatest
value, an encrypted activation message is sent to the Base are between ages 55 and 95.
Station that incorporates the Transmitter address. The encryp- • Today, the current workforce shortages pose difficulty
tion is implemented to prevent the false alarms caused by with costs of care in this age range since 55-60% of
any similar existing wireless devices in the environment. As hospital health care is labor cost and hospital care of the
soon as the Base Station receives the activation message, it elderly poses proportionally higher costs.
extracts the Transmitter address, turns on the vibrator and • Given this graph is from the 2000 US Census, as todays
lights up the corresponding LEDs to warn the user that a baby-boomers grow into the regions on the right of the

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 Age groups where
care burden is greatest
some cases, the consumer electronic integration. We have
5e+07 demonstrated simple and generic technologies geared towards
real needs, while considering form-factor and the business
4e+07 Current workforce
shortages pose
difficulty with care
proposition (there must be always be monetary incentive for
burden at this level
this technology to transition from research to mainstream
Population

3e+07

consumers). For example, Heart@Home, LISTSENse, and

2e+07

1e+07
Population shift
will increase
demand for care } 2.5x
FireLine all demonstrate a generic sensing and display which
can be adapted to other applications.
0 V. C ONCLUSION
under 5

5 to 14

15 to 24

25 to 34

35 to 44

45 to 54

55 to 64

65 to 74

75 to 84

65 and over
Falling electronics prices and their increasing power, cou-
Age (in deciles) pled with sensing technologies, promise to make health moni-
toring in one’s home, rather than frequent trips to the hospital,
Fig. 6. The US age distributions from the year 2000 US Census. As the a reality. In this paper we have demonstrated several proto-
aging “baby-boomers” grow into the shaded region as shown by the horizontal
arrow, hospital costs will rise sharply prompting the need for products of the
types, including infant monitoring and heart-related monitor-
kind shown in this paper. ing. All the prototypes described in this paper address wireless
sensornet and monitoring applications that can prevent illness
and increase doctor-patient efficiency, thus reducing health
graph (shown by the horizontal arrow), the data indicate care costs. Reducing health care costs is a huge incentive for
that the US population in the “over 60” group is expected hospitals and patients; it will become even more important
to grow by 25% by the year 2030. for the US as today’s baby-boomers reach the age range
Therefore, this figure shows that hospital costs will rise sharply when health care costs sky-rocket. Each of the demonstrated
and health-care at home is one way of alleviating this problem. technologies are generic with respect to their sensing, notifi-
Furthermore, early detection of symptoms will allow doctors cation, and logging functions, and can easily be extended or
to treat diseases earlier, before they progress too far and more adapted to support a variety of applications. These prototypes
expensive to treat. represent incremental, but important steps towards ubiquitous
Several technologies will be important to this evolution: deployment of health monitoring devices for the betterment of
sensor networks, RFID, and mobile consumer electronics. human lives.
We have mainly addressed sensor networks in this paper. VI. ACKNOWLEDGMENTS
Sensor networks will make up the small, ubiquitous active
sensing and actuation components of future smart homes. For We thank the Ford Motor Company, Intel, and the Center for
example, measuring blood sugar and injecting insulin when it’s Information Technology in the Interests of Society (CITRIS)
needed. As battery and energy scavenging technologies con- for sponsorship and support of this class and the prototype
tinue to improve, these devices will be become more widely development.
available and cost effective. Radio Frequency Identification, R EFERENCES
RFID, will also play a major role to meet low-power needs
[1] Moteiv Corporation, http://www.moteiv.com/, 2006.
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know what drugs are currently being administered and a [4] Kids Health Website, http://www.kidshealth.org/parent/general/sleep/
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these problems by focusing on the sensor network and in

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