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Article history: This paper proposes a new indoor localization system, based on RFID technology and a hierarchical
Available online 6 August 2014 structure of classiers. This system has been specically designed to work in unfriendly scenarios, where
transmissions could be disturbed by other electronic devices or shielded walls. The infrastructure has
Keywords: been deployed and evaluated in the emergency unit of a large Italian hospital (48 rooms covering about
Indoor localization 4000 m2 ) to detect the room where lost or forgotten patients lie. Extensive experiments show the
Smart health potential of such technology for indoor localization applications in terms of accuracy, precision, complex-
Hospital
ity, robustness and scalability. In 98% of cases the system localizes the correct room (83%) or one of its
Emergency room
Random Forest
adjacency (15%).
2014 Elsevier Ltd. All rights reserved.
http://dx.doi.org/10.1016/j.eswa.2014.07.042
0957-4174/ 2014 Elsevier Ltd. All rights reserved.
126 L. Calderoni et al. / Expert Systems with Applications 42 (2015) 125134
1.1. Related works time constraint. To the best of our knowledge, this paper repre-
sents the rst comprehensive contribution completely dedicated
In recent years several system models concerning indoor posi- to indoor localization in hospital environment.
tioning were presented. For the purposes of this work it is mean-
ingful to focus on the system models for indoor localization 1.3. Outline
based on classiers, as the herein proposed method lies in this
eld. The paper is organized as follows: in Section 2 a description of
Honary, Mihaylova, and Xydeas (2012) provide a detailed the hospital context and its related indoor positioning issues are
performance analysis of a k-Nearest Neighbour based positioning provided, as well as the description of the sensors involved in this
system and also propose a positioning scheme based on Gaussian work and a detailed map representation of the hospital where the
Mixture Models in order to locate objects in a generic building. technical surveys were made. After a detailed description of the
An indoor positioning technique relying on bayesian classiers dataset (Section 3), the indoor classication system designed to
focusing on smart ofce and smart building scenarios is presented t the hospital scenario is introduced in Section 4 while in Section
by Kim, Ha, Lee, and Lee (2009). 5 a discussion on the results based on the previously proposed
A valuable study on the subject was proposed by Villarubia, system model is provided.
Rubio, Paz, Bajo, and Zato (2013); it consists of a practical experi-
ment which took place inside a University. Here a Wi-Fi based
system is used to gather signals and a wide range of classiers 2. Operating environment
are compared during the localization process. Shin and Han
(2010) suggest that a viable method to improve the classication In general, it is quite complicated to obtain satisfying results
process in the Wi-Fi indoor positioning context is to combine concerning indoor positioning inside a hospital or a medical facility
classiers, and provide subsequently some practical case studies using wireless techniques. In this specic scenario, several prob-
on the subject (Shin, Jung, Yoon, & Han, 2011). lems may occur due to location sensors installation. Frequently,
While Koyuncu and Yang (2010) provide a general survey on medical devices conict with installed sensors; moreover, these
indoor positioning methods, Gu, Lo, and Niemegeers (2009) focus buildings are often equipped with shielded walls. For instance,
on positioning systems for wireless personal networks. we could imagine an X-ray examination room equipped with thick
In another key-survey Liu et al. (2007) describe a wide range of leaded walls (Hentila, Taparungssanagorn, Viittala, & Hamalainen,
indoor localization systems and compare them on the basis of 2005). This leads to a tangible signal reduction or distortion during
some performance metrics (Accuracy, Precision, Complexity, the communication between transmitters and receivers. In the fol-
Robustness, Scalability, Cost). Within this paper a reference to some lowing a description of the adopted sensors and the operating
of these key-features is posed, in order to provide a helpful environment is proposed, in order to better understand both acqui-
comparison with other systems. The survey also describes several sition and localization steps of the designed system.
algorithm and mathematical techniques used for indoor positioning
purposes. 2.1. Sensors
Mathematical approaches for indoor localization are however
better described by Seco, Jimenez, Prieto, Roa, and Koutsou The deployed infrastructure relies on Radio Frequency Identica-
(2009) and divided in four main categories: geometry-based tion (RFID) technology and consists of three different sensors. Each
methods, cost function minimization methods, ngerprint methods sensor communicate in Ultra High Frequency (UHF) mode on fre-
and bayesian methods. According to this taxonomy, it is reasonable quencies LPD 433 MHz, 446 MHz and 860 MHz. Keeping the fre-
to include our system among the ngerprint based ones. Finger- quency range as conned as possible allows the infrastructure
print methods rely on two main steps. In the rst one, the signal not to conict with other WiFi and medical devices.
levels from the different base stations are recorded in order to form Patients are equipped with an active RFID transmitter (RFID
a training set and calibrate the system. In the localization step, the Tag). Each Tag lies inside a small hypoallergenic bracelet and sends
system tries to locate the source of a new signal classifying it a signal on an user-dened time interval basis. The duration of
against the previously recorded set. These methods are particularly each signal is limited to a few milliseconds, resulting in a total
robust in the non-line-of-sight (NLOS) context, where radio trans- effective transmission time of few hours per year. The irradiance
mission across a path is partially obstructed, usually by a physical at a point of the surface is near to 0. One of the main concerns in
object. dealing with active RFID tags is that of batteries and power con-
sumption. Active tags send signals to the receiver on their own
1.2. Contribution and thus need a local power source. As signals related to the
adopted tag are really short and energy-preserving, bracelets can
Most of the ICT (Information and Communication Technology) be equipped with a small battery which can although keep the
works in the Smart Health eld relate to the design of proper infor- tag alive for more than three months.
mation systems for medical purposes or to the innovative tech- Signals sent from tags are received from several antennas (RFID
niques adopted to cope with several known diseases (Zeng et al., Receiver) which store the Tag Identier (ID) and the strength of
2013). On the contrary, this work describes a novel technique to incoming signal. Specically, signal strength is expressed in deci-
track patients in an emergency room environment in order to nd bels and varies from 100 db (weak signal) to 30 db (strong sig-
them quickly as needed. Specically, in this context, it is important nal). Receivers stay idle until a signal from a tag occurs and, after
to know the room where the patient is located rather than his pre- its processing, which lasts for a few milliseconds, go back to sleep
cise position. The system proposed herein is aimed to locate mode. Thus, these antennas are energy-preserving as well and can
patients through RFID signals classication. In particular, signals be both plugged to the hospital power supply or equipped with
are processed combining several instances of decision-tree classi- batteries.
ers called Random Forest (Breiman, 2001). As assessed by Yim Each antenna sends the data to a central receiver (on the same
(2008) the off-line phase (training) of a ngerprint method is not frequency range) which is connected via an RS232-to-Ethernet
time critical whereas on-line phase (localization) is really time crit- adapter to the local server. This central receiver collects the signals,
ical. Decision-tree oriented classiers behave well according to this stores them and performs real-time localization.
L. Calderoni et al. / Expert Systems with Applications 42 (2015) 125134 127
Fig. 1. The detailed map of the hospitals emergency unit where the tests were made. Rooms are labeled with numbers (from 1 to 48) while the deployed antennas are labeled
with letters (from A to I). Openings between rooms are highlighted as well.
128 L. Calderoni et al. / Expert Systems with Applications 42 (2015) 125134
60%
40%
20%
A B C D E F G H I
Fig. 3. Percentage of valid observations received by each antenna. within the range 100; 70 in 75% of cases, resulting in a reduced
signals strength range.
Finally, A describes several charts useful for a further detailed
100% analysis of the collected data.
Overall, some conclusions can be drawn:
80%
The dataset is very difcult to handle due to the high percentage
of missing values (see Figs. 3 and 4);
60%
The localization task is rather difcult since, in several cases,
signals received from different rooms are very similar (e.g.,
rooms 40, 41 and 42 holds signatures close to each other, as
40% shown in Figures A120, A123, A126).
A future study on the rearrangement of certain antennas could
improve the system performance with respect to its robustness.
20% For instance, B; G and I could be moved in an area featuring
higher reception rates (see Fig. 3);
0%
1 2 3 4 5 6 7 8 9 4. Localization system
Fig. 4. Percentage of observations presenting at least w valid values; the result is The idea behind the proposed system is to organize rooms in a
reported for increasing values of w.
hierarchical structure through a partitioning into non-overlapping
macro-regions. Each macro-region contains rooms with similar
observations and is assigned separately to a specic sub-system,
customized to manage the data related to that macro-region.
30
Figs. 6 and 7 show the learning and localization activity
40 diagrams of the proposed system, respectively. In the following,
specic steps involved in training and localization procedures are
50 described in detail.
60
4.1. Training
70
has been replaced by the corresponding macro-region identier. 4.2.2. Macro-region classication
f idc , a
Moreover, for each cluster, a classier Clidc is trained using TS In this step, the classier ClMR is used to pre-select those macro-
f subset containing only the observations from rooms belonging
TS regions where, according to a given observation, the probability of
to cluster idc. Due to the high number of rooms, the chosen hierar- presence of the subject is higher than a prexed threshold. The
chical organization allows each sub-classier Clidc to focus on a normalized observation x ~ is used as input for the classier ClMR that
specic and smaller room subset, thus making easier the classica- returns a set of condences ConfMR fcMR MR
idc ; 1 6 idc 6 kg where c idc
tion problem. represents the likelihood that the subject is located in a room
Among the classiers suitable for the algorithm implementa- belonging to the macro-region idc.
tion, the Random Forest (Breiman, 2001) has been selected. This
choice was due to the classier convenient behavior both in terms
of accuracy and efciency, which are critical features of such an 4.2.3. Room classication
application. In fact, the training process of the whole proposed sys- In this step, the classiers, corresponding to pre-selected
tem requires about 2 s on the average. The localization task is macro-regions, are used to predict the rooms from which the signal
instead performed in real-time and its related execution time is could have been generated. The normalized observation x ~ is given
negligible. These values are referred to an Intel Core 2 Quad as input to each classier Clidc for which the corresponding macro-
Q9400 CPU at 2.66 Ghz, using a multithreaded C# implementation. region condence cMR idc is greater than or equal to a predened
Random Forest is an ensemble classier that consists of a set of threshold t. The result is a set of condences Confidc fcidr ;
decision trees. Let N be the number of samples in the training set idr 2 C idc g where C idc is the set of all identiers of rooms assigned
and P be the number of variables in the classier; let p be the input to the macro-region idc and cidr represents the likelihood that the
parameter denoting the number of input variables to be used to subject is located in room idr. Note that, this operation can be per-
determine the decision at a node of the tree (usually p P). Each formed in parallel since there are no dependencies between the
tree is grown as follows: different classiers.
The nal score of each room is calculated as:
Take a bootstrap sample by choosing n times with replacement
from all N available training samples; sidr cMR
M idr c idr ; 10
Use the remaining samples to estimate the error of the tree, by Midr idc; idr 2 C idc ; 11
predicting their classes;
For each node of the tree, randomly choose p variables on which where Midr returns the identier of the macro-region containing
to base the decision at that node. Calculate the best split based the room idr. In particular, the condence of the macro-region clas-
on these p variables in the training set; sier is combined to that of the selected classiers on the basis of
Each tree is fully grown and not pruned. the sum rule. Finally, the identiers of the r rooms with the highest
scores are returned. Note that, in the proposed Random Forest-
To classify a new object, the sample is given as input at each of based implementation, both condences cMR Midr and c idr are com-
the trees in the forest; each tree gives a classication and the nal puted as described in Section 4.1.3. The rst one is provided by
class is chosen on the basis of the majority vote rule. the classier ClMR , trained to distinguish among the different
On the basis of the distribution of votes among the different macro-regions while the second one is returned by the correspond-
classes, a condence is also computed for each class. Specically, ing room classier Clidc .
given a class i, the related condence ci corresponds to the percent- Fig. 9 shows the whole localization procedure over a sample
age of votes obtained through the set of trees composing the observation, using room grouping as reported in Fig. 8.
classier.
Data normalization;
5.1. Test protocol
Macro-region classication;
Room classication.
The localization system must be trained before it can be used to
localize the subjects (see Section 4.1). To this purpose, the dataset
4.2.1. Data normalization
described in Section 3 has been divided into two disjoint subsets:
The new observation x is rst normalized as described in Sec-
~. Since some feature values could be out of half of the observations belonging to each room is randomly
tion 4.1.1, obtaining x
selected as training data while the other half is used as test data.
the maximum and minimum bounds determined in the training
To assess the impact of invalid values on the system perfor-
phase, a clipping operation is performed to preserve values in the
mance, experiments have been carried out discarding (both in
range 0; 1:
8 training and test sets) those observations that present a number
< 0; v < 0
> of valid values less than w, with w 1; 2; 3. Moreover, the localiza-
~xij 1; v > 1 8 tion system has been evaluated for different values of the parame-
>
: ter r 1; 2; 3, representing the number of rooms returned by the
v ; o:w:
system (see Section 4.2.3). Finally, to reduce performance indica-
where tors variability the experiments have been repeated 20 times, each
time randomly choosing complementary training and test sets, and
xij mj
v : 9 the nal performance indicators have been calculated as results
Mj mj average.
L. Calderoni et al. / Expert Systems with Applications 42 (2015) 125134 131
Fig. 9. Example of localization process, given a valid observation. The room grouping proposed in Fig. 8 is used. Each ci represents the condence that the observation come
from room i.
di; j between the rooms is recursively calculated as follows: 1 0.76 0.02 0.55 0.01 0.47 0.01
2 0.40 0.01 0.25 0.01 0.20 0.01
( 3 0.27 0.01 0.16 0.01 0.12 0.01
0; ij
di; j mindk; j 1; o:w: 12
k2Ai
where Ai contains the identiers of all rooms adjacent to room i. that, when r > 1 the distance used to calculate the accuracy is the
Two rooms are adjacent if they share a wall or at least a part of it lowest one among the r distances calculated.
(e.g., in Fig. 1, rooms 1; 3; 4 and 5 are adjacent to room 2). The This chart shows that, as expected, better results in terms of
distance d represents the minimum number of walls that separate accuracy can be reached by applying more restrictive constraints
the true room and the estimated one (e.g., d4; 7 3). In other on the number of valid features required (w 2 or w 3); it is
words, a distance of zero means the system has located the right worth noting that the limits imposed in these experiments are
room, a distance of one means the real room and the located one rather low with respect to the number of receivers available. Sim-
are adjacent and, more in general, a distance of u means that ilarly, accuracy improves when a higher number of rooms (r 2 or
between the right room and the located one there are u walls. r 3) is retrieved by the localization system. According to the con-
Please note that the denition of accuracy used by Liu et al. straints applied to the problem discussed herein, a value of r 2 is
(2007) is here applied. This denition differs from the concept of acceptable; overall, the results provided using r 2; w 2 and
accuracy usually adopted in other contexts, since the lower is the r 2; w 3 are both satisfactory in terms of accuracy and suitable
value (lower distance), the more accurate is intended to be for a practical implementation.
the classication system. Table 1 reports the average accuracy of Fig. 10 depicts the confusion matrix where each row represents
the proposed system and the corresponding standard deviation a room identier (expected for classication) and each column
for different values of r and w, representing respectively the states the resulting localization. In other words, element i; j rep-
number of rooms retrieved by the localization system and the resents the percentage of signals transmitted from room i localized
minimum number of valid values used to select valid observations. as deriving from room j. This matrix helps to understand whether
As proved by standard deviation values, accuracys variability or not the system is confusing two rooms during localization. As
observed after the 20 tests have been carried out is very low. Note predictable, high values are mainly distributed along the diagonal;
132 L. Calderoni et al. / Expert Systems with Applications 42 (2015) 125134
1
48
47
46
45
44 0.9
43
42
41
40
39 0.8
38
37
36
35
34 0.7
33
32
31
30
29 0.6
28
27
26
25 0.5
24
23
22
21
20 0.4
19
18
17
16
15 0.3
14
13
12
11
10 0.2
9
8
7
6
5 0.1
4
3
2
1
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
Fig. 10. Confusion matrix. Blue values indicates a low percentage of localization while lighter ones indicates a higher localization rate.
it is thus conrmed that the system holds a high accuracy level. 5.5. Robustness
This matrix also conrms the frequent localization errors related
to rooms 40, 41 and 42, previously explained in Section 3, as the In general, robustness measures the capability of a localization
area around those room identiers presents a notable blur. system to work normally even if some signals are not available due
to receiver errors. The results in terms of precision (see Fig. 11)
5.3. Precision show that the proposed localization system holds good robustness
properties. The proposed algorithm was designed in order to oper-
Usually, the precision of a localization systems is dened as the ate with many missing values, allowing to reach satisfactory
distribution of distance error between the estimated location and results even with a limited number of valid features available
the real location. The precision of the proposed system is measured (for instance, an acceptable parameter could be w 2, meaning
using the Cumulative Distribution Function (CDF) of the distance that only two valid values, among 9, are required in order to accept
error. In particular, charts reported in Fig. 11 show CDFs of the pro- an observation as valid).
posed system for different values of r and w. Each chart represents
the percentage of correctly classied patterns as a function of the 5.6. Scalability
distance dened in (12)). According to this test, the behavior
observed in the previous experiment is conrmed. In particular, Further experiments have been carried out to evaluate the pos-
by selecting only observations with a minimum of two valid values sibility of scaling up the proposed localization system to larger
(w 2), localization is performed with a maximum distance of 1 in buildings with a higher number of rooms. Usually, the localization
more than the 90% of the tests that have been carried out (with performance degrades when the distance between the transmitter
respect to the real room). So, the localization system tends to iden- and the receiver increases. This evaluation relies on the analysis of
tify either the correct room or one of its adjacency. accuracy as a function of the ratio between the number of rooms in
the building and the number of receivers available, referred to as
5.4. Complexity rPr in the following. To this purpose, the localization system has
been tested on different datasets featuring an increasing number
Complexity of a localization system can be attributed to hard- of rooms per receiver (rPr):
ware, software and operation factors. For simplicity, it is usually
estimated as the computing time required to perform a localiza- DB1: 2840 observations acquired in a building with 19 rooms
tion. As reported in Section 4.1.3, the system performs a localiza- and 7 receivers installed (rPr 2:7);
tion in a negligible time, and it thus can be adopted in real-time DB2: 2130 observations acquired in the same building of DB1
applications. with 5 receivers installed (rPr 3:8);
L. Calderoni et al. / Expert Systems with Applications 42 (2015) 125134 133
w=1 1.2
1.1
100 1
0.9
0.8
Accuracy
90
0.7
0.6
0.5
80
0.4
0.3
70 0.2 r=1
0.1 r=2
r=1
0 r=3
r=2
60
r=3 0 1 2 3 4 5 6 7 8 9 10
0 1 2 3 4 5 6 7 8 9 10 rPr
w=2 Fig. 12. The accuracy of the localization system on three different datasets with
w 1; r 1; r 2 and r 3 (blue, red and green elements respectively). The
accuracy trends as a function of rPr (lines) is also shown. Finally, diamonds
100
highlight the accuracy measured on a dataset with rPr 9:6. (For interpretation of
the references to colour in this gure caption, the reader is referred to the web
version of this article.)
90
0.45, respectively. The measured results (diamonds) are extremely
close to those predicted by the trend function (1:14; 0:66 and 0.45),
80 thus making us condent that, at least for a reasonable range of rPr
values, the trend lines are rather reliable.
70
r=1 6. Conclusion
r=2
r=3 Indoor localization plays an important role in ambient intelli-
60
gence applications. In this work, an expert system for indoor local-
0 1 2 3 4 5 6 7 8 9 10 ization in a hospital environment is presented; the aim is to
w=3 estimate the room where the patients are located within the build-
ing. With respect to other scenarios where most of the state-of-
100 the-art work can be framed, the specic application imposes
important constraints mainly related to the presence of electronic
devices and shielded areas that signicantly affect the acquisition
90 process, with important implications on data quality.
The RFID technology was selected for data acquisition because
of its interesting properties in terms of cost, ease of use and com-
pliance to the Industrial, Scientic and Medical radio frequency
80
specications. The localization process, based on the data acquired
by different antennas positioned in the building, is performed by a
multi-classier system. One of the peculiarities characterizing the
70 r=1
indoor localization task addressed in this work is that the data
r=2
acquired present many missing values, in most cases less than
r=3
one third of the acquired signals are valid and can be used for local-
0 1 2 3 4 5 6 7 8 9 10 ization. The system was thus designed to deal with a high degree of
uncertainty and ad hoc feature extraction techniques have been
Fig. 11. Cumulative distribution functions of the distance error, reported for dened to this purpose. A very efcient implementation based on
different values of r and w.
Random Forest classiers has been proposed and tested on real
data, acquired in an emergency unit while it was fully operative.
DB3: the database described in Section 3 with 48 rooms and 9 Experimental results are very encouraging: the system is able to
receivers installed (rPr 5:3). work in real time and shows good behavior in terms of robustness,
accuracy and precision. As an additional contribution, an experi-
The results obtained are reported in Fig. 12, where accuracy mental study concerning scalability of the proposed approach to
obtained with w 1 is reported for each of the three databases larger buildings has been carried out to further support the feasi-
and different values of r (the markers in the chart). The chart also bility of the proposal.
reports trend functions (represented as lines) that could help to Despite of the systems performance and its suitability with
predict the system behavior at different values of rPr. To validate respect to the initial aims of the project, some important aspects
the observed model, an additional simulation has been carried deserve further investigations. A signicant aspect of the system
out by ignoring the signals from four of the nine receivers used design is antenna positioning; the receivers position should maxi-
in the experiments on DB3 (i.e., A, B, G and I in Fig. 1), thus increas- mize the coverage and consequently limit as much as possible
ing the value of rPr from 3.8 to 9.6 (48 rooms with 5 receivers). The missing data issues. It would be interesting to study the benets
accuracy measured with r equal to 1; 2, and 3 is: 1:15; 0:65 and introduced using different approaches for feature extraction and
134 L. Calderoni et al. / Expert Systems with Applications 42 (2015) 125134
signals management. For instance, the proposed system bases the Dixon, J. K. (1979). Pattern recognition with partly missing data. IEEE Transactions
on Systems, Man, and Cybernetics, 9, 617621.
localization process on each single signal received by antennas;
Gifnger, R., Fertner, C., Kramar, H., Kalasek, R., Pichler-Milanovic, N., & Meijers, E.
relying on signal sequences instead of single signals could improve (2007). Smart Cities: Ranking of European Medium-sized Cities. Centre of Regional
the system performances by reducing the effects of possible outli- Science, Vienna University of Technology.
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