scholarly journals Adopting MQTT for a multi protocols IoMT system

2022 ◽  
Vol 12 (1) ◽  
pp. 834
Author(s):  
Bilal Asaad Mubdir ◽  
Hassan Mohammed Ali Bayram
Keyword(s):  
Data Transfer ◽  
Experimental Tests ◽  
Raspberry Pi ◽  
Treatment Protocols ◽  
Data Packets ◽  
Trip Time ◽  
Remote Healthcare ◽  
Gsm Network ◽  
New Treatment

<span>Coronavirus disease (COVID-19) altered the way of caregiving and the new pandemic forced the health systems to adopt new treatment protocols in which remote follow-up is essential. This paper introduces a proposed system to link a remote healthcare unit as it is inside the hospital. Two different network protocols; a global system for mobile communication (GSM) and Wi-Fi were used to simulate the heath data transfer from the two different geographical locations, using Raspberry Pi development board and Microcontroller units. Message queuing telemetry transport (MQTT) protocol was employed to transfer the measured data from the healthcare unit to the hospital’s Gateway. The gateway is used to route the aggregated health data from healthcare units to the hospital server, doctors’ dashboards, and the further processing. The system was successfully implemented and tested, where the experimental tests show that the remote healthcare units using a GSM network consumed about 900 mWh. A high percentage of success data packets transfer was recorded within the network framework as it reaches 99.89% with an average round trip time (RTT) of 7.5 milliseconds and a data transfer rate up to 12.3 kbps.</span>

Centralization of Biliary Atresia: Has Germany Learned Its Lessons?

2021 ◽  
Author(s):  
Omid Madadi-Sanjani ◽  
David Fortmann ◽  
Udo Rolle ◽  
Burkhard Rodeck ◽  
Ekkehard Sturm ◽  
...  
Keyword(s):  
Biliary Atresia ◽  
Data Transfer ◽  
Previous Analysis ◽  
Outcome Data ◽  
Free Survival ◽  
Change In Practice ◽  
Native Liver ◽  
Survival With Native Liver ◽  
Pediatric Liver Transplant

Abstract Introduction The majority of pediatric surgeons and hepatologists recommend the centralization of biliary atresia (BA) treatment within experienced liver units. We aimed to investigate whether voluntary self-restriction and acceptance of the need for this change in practice changed the BA referral policy in Germany during the last decade. Materials and Methods In cooperation with pediatric surgeons, gastroenterologists or hepatologists, and pediatric liver transplant units, the 2-year follow-up data of infants with BA born in Germany between 2010 and 2014 were collected using www.bard-online.com or pseudonymized data transfer. Results were compared with our previous analysis of the outcome data of infants with BA born between 2001 and 2005 in Germany. Result Overall, 173 infants with BA were identified, of whom 160 underwent Kasai portoenterostomy (KPE; 92.5%) and 13 (7.5%) underwent primary liver transplantation at 21 German centers. At 2-year follow-up, overall survival was 87.7% (vs. 81.9% in 2001–2005 [p = 0.19]), survival with native liver post-KPE was 29.2% (vs. 22.8% in 2001–2005 [p = 0.24]), and jaundice-free survival with native liver post-KPE was 24.0% (vs. 20.1% in 2001–2005 [p = 0.5]). Compared with the 2001–2005 analysis, all criteria showed improvement but the differences are statistically not significant. Conclusion Our observation shows that KPE management requires improvement in Germany. Centralization of BA patients to German reference liver units is not yet mandatory. However, European and national efforts with regard to the centralization of rare diseases support our common endeavor in this direction.

scholarly journals Massachusetts’ Findings from Statewide Newborn Screening for Spinal Muscular Atrophy

2021 ◽  
Vol 7 (2) ◽  
pp. 26
Author(s):  
Jaime E. Hale ◽  
Basil T. Darras ◽  
Kathryn J. Swoboda ◽  
Elicia Estrella ◽  
Jin Yun Helen Chen ◽  
...  
Keyword(s):  
Spinal Muscular Atrophy ◽  
Newborn Screening ◽  
New England ◽  
Screening Program ◽  
Muscular Atrophy ◽  
Treatment Options ◽  
Newborn Screening Program ◽  
Treatment Protocols ◽  
Screening Algorithm ◽  
New Treatment

Massachusetts began newborn screening (NBS) for Spinal Muscular Atrophy (SMA) following the availability of new treatment options. The New England Newborn Screening Program developed, validated, and implemented a screening algorithm for the detection of SMA-affected infants who show absent SMN1 Exon 7 by Real-Time™ quantitative PCR (qPCR). We screened 179,467 neonates and identified 9 SMA-affected infants, all of whom were referred to a specialist by day of life 6 (average and median 4 days of life). Another ten SMN1 hybrids were observed but never referred. The nine referred infants who were confirmed to have SMA were entered into treatment protocols. Early data show that some SMA-affected children have remained asymptomatic and are meeting developmental milestones and some have mild to moderate delays. The Massachusetts experience demonstrates that SMA NBS is feasible, can be implemented on a population basis, and helps engage infants for early treatment to maximize benefit.

scholarly journals Effects of Non-thermal Ultrasound on a Fibroblast Monolayer Culture: Influence of Pulse Number and Pulse Repetition Frequency

Sensors ◽  
2021 ◽  
Vol 21 (15) ◽  
pp. 5040
Author(s):  
Silvia Ronda Peñacoba ◽  
Mar Fernández Gutiérrez ◽  
Julio San Román del Barrio ◽  
Francisco Montero de Espinosa
Keyword(s):  
Short Pulse ◽  
Pulse Repetition Frequency ◽  
Pulse Number ◽  
Repetition Frequency ◽  
Pulse Repetition ◽  
Treatment Protocols ◽  
Culture Plate ◽  
New Treatment ◽  
Long Pulse

Despite the use of therapeutic ultrasound in the treatment of soft tissue pathologies, there remains some controversy regarding its efficacy. In order to develop new treatment protocols, it is a common practice to carry out in vitro studies in cell cultures before conducting animal tests. The lack of reproducibility of the experimental results observed in the literature concerning in vitro experiments motivated us to establish a methodology for characterizing the acoustic field in culture plate wells. In this work, such acoustic fields are fully characterized in a real experimental configuration, with the transducer being placed in contact with the surface of a standard 12-well culture plate. To study the non-thermal effects of ultrasound on fibroblasts, two different treatment protocols are proposed: long pulse (200 cycles) signals, which give rise to a standing wave in the well with the presence of cavitation (ISPTP max = 19.25 W/cm2), and a short pulse (five cycles) of high acoustic pressure, which produces a number of echoes in the cavity (ISPTP = 33.1 W/cm2, with Pmax = 1.01 MPa). The influence of the acoustic intensity, the number of pulses, and the pulse repetition frequency was studied. We further analyzed the correlation of these acoustic parameters with cell viability, population, occupied surface, and cell morphology. Lytic effects when cavitation was present, as well as mechanotransduction reactions, were observed.

Accuracy and Efficacy for Robotic Assistance in Implanting Responsive Neurostimulation Device Electrodes in Bilateral Mesial Temporal Lobe Epilepsy

2017 ◽  
Vol 14 (3) ◽  
pp. 267-272 ◽  
Author(s):  
Alvin Y Chan ◽  
Lilit Mnatsakanyan ◽  
Mona Sazgar ◽  
Indranil Sen-Gupta ◽  
Jack J Lin ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Focal Epilepsy ◽  
Mesial Temporal Lobe Epilepsy ◽  
Advanced Technology ◽  
Robotic Assistance ◽  
Mesial Temporal Lobe ◽  
Robotic Devices ◽  
New Treatment

Abstract BACKGROUND Responsive neurostimulation (RNS) is a relatively new treatment option that has been shown to be effective for patients with medically refractory focal epilepsy when resection is not possible, especially in bilateral mesial temporal onset. Robotic devices are becoming increasingly popular for use in stereotactic procedures such as stereoelectroencephalography, but have yet to be used when implanting RNS devices. OBJECTIVE To show that these 2 forms of advanced technology were compatible and could be used effectively in patient care. METHODS We implanted RNS devices in 3 patients with bilateral mesial temporal lobe epilepsy. Each patient was placed in the prone position, and electrode trajectories were planned via the robotic navigation system via a transoccipital approach. One lead was placed along each amygdalohippocampal complex. A small craniectomy was then created in the parietal region for RNS generator implantation. Actual and expected target locations and distance were calculated for each depth. There were no complications in this group. RESULTS RNS devices with bilateral leads were successfully implanted in all 3 patients, with bilateral mesial temporal lobe onset. Follow-up ranged from 3 to 6 mo, and there were no complications in this group. The median distance between the estimate and actual targets was 2.18 (range = 1.11-3.27) mm. CONCLUSION We show that implanting RNS devices with robotic assistance is feasible with excellent precision and accuracy. The advantages of using robotic assistance include higher flexibility, accuracy, precision, and consistency.

Usefulness of Routine Urine Analysis in Medical Outpatients

1994 ◽  
Vol 1 (2) ◽  
pp. 84-87 ◽  
Author(s):  
Sigmund Rüttimann ◽  
Désirée Clémençon
Keyword(s):  
Urine Analysis ◽  
Protein A ◽  
Clinic Visit ◽  
Routine Test ◽  
General Internal ◽  
Outpatient Group ◽  
New Treatment ◽  
New Diagnosis ◽  
Medical Outpatients

Objective— To investigate prospectively the value of routine urine analysis in a university based, medical outpatient clinic providing primary (> 90%) and referral care (< 10%) in general internal medicine, as determined by whether it led to a new diagnosis requiring a change in medical management (new treatment; advice to patient; further follow up appointment). Methods— A dipstick urine analysis was performed in 610 consecutive patients (mean (SD) age 41 (16) years) making their first clinic visit. A urinary sediment of the same specimen was examined in those patients with abnormal results for haemoglobin, leucocytes, or protein. A urine analysis was defined as routine when it was not considered indicated for diagnostic or management purposes by the resident in charge at the patients' initial clinic visit. The main outcome measures were the number and nature of new diagnoses leading to a change in patient management. Results— In 183 patients (30%, 95% confidence interval (CI) 27% to 34%) the urine analysis was performed as an indicated test and in 427 (70%; 95% CI 64% to 73%) as a routine test. Urine analysis was abnormal in 71 of the 427 patients (17%) in whom it had been performed as a routine test. Abnormal findings led to a change in management in three patients only (0·7%; 95% CI 0·2% to 2·2%). Critical assessment makes the value of routine urine analysis debatable even in these three patients. Conclusions— In a middle aged medical outpatient group of a university based, teaching clinic providing predominantly primary care, urine analysis can be restricted to patients in whom it is clinically indicated.

scholarly journals Pipeline embolization device retraction and foreshortening after internal carotid artery blister aneurysm treatment

2017 ◽  
Vol 23 (6) ◽  
pp. 614-619 ◽  
Author(s):  
Jeremy J Heit ◽  
Nicholas A Telischak ◽  
Huy M Do ◽  
Robert L Dodd ◽  
Gary K Steinberg ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
High Morbidity ◽  
Case Description ◽  
Digital Subtraction ◽  
Pipeline Embolization Device ◽  
Aneurysm Occlusion ◽  
New Treatment

Background Subarachnoid hemorrhage (SAH) secondary to rupture of a blister aneurysm (BA) results in high morbidity and mortality. Endovascular treatment with the pipeline embolization device (PED) has been described as a new treatment strategy for these lesions. We present the first reported case of PED retraction and foreshortening after treatment of a ruptured internal carotid artery (ICA) BA. Case description A middle-aged patient presented with SAH secondary to ICA BA rupture. The patient was treated with telescoping PED placement across the BA. After 5 days from treatment, the patient developed a new SAH due to re-rupture of the BA. Digital subtraction angiography revealed an increase in caliber of the supraclinoid ICA with associated retraction and foreshortening of the PED that resulted in aneurysm uncovering and growth. Conclusions PED should be oversized during ruptured BA treatment to prevent device retraction and aneurysm regrowth. Frequent imaging follow up after BA treatment with PED is warranted to ensure aneurysm occlusion.

scholarly journals Febrile Neutropenia and Long-term Risk of Infection Among Patients Treated With Chemotherapy for Malignant Diseases

2018 ◽  
Vol 5 (10) ◽  
Author(s):  
Josefine Nordvig ◽  
Theis Aagaard ◽  
Gedske Daugaard ◽  
Peter Brown ◽  
Henrik Sengeløv ◽  
...  
Keyword(s):  
Febrile Neutropenia ◽  
Mortality Rates ◽  
Risk Of Infection ◽  
Increased Risk ◽  
Competing Events ◽  
Adjusted Incidence Rate ◽  
New Treatment ◽  
Rate Ratios

Abstract Background Febrile neutropenia (FN) is a common complication to chemotherapy, associated with increased short-term morbidity and mortality. However, the long-term outcomes after FN are poorly elucidated. We examined the long-term risk of infection and mortality rates in cancer patients with and without FN. Methods Patients aged &gt;16 years treated with firstline chemotherapy were followed from 180 days after initiating chemotherapy until first infection, a new treatment with chemotherapy, death, or end of follow-up. Risk factors for infections were analyzed by competing risks regression, with death or another treatment with chemotherapy as competing events. Adjusted incidence rate ratios (aIRRs) of infection and death were analyzed using Poisson regression. In analyses of mortality, infection was included as a time-updated variable. Results We included 7190 patients with a median follow-up (interquartile range) of 0.58 (0.20–1.71) year. A total of 1370 patients had an infection during follow-up. The aIRRs of infection were 1.86 (95% confidence interval [CI], 1.56–2.22) and 2.19 (95% CI, 1.54–3.11) for patients with 1 or &gt;1 episode of FN compared with those without FN. Mortality rate ratios were 7.52 (95% CI, 6.67–8.48) &lt;1 month after, 4.24 (95% CI, 3.80–4.75) 1–3 months after, 2.33 (95% CI, 1.63–3.35) 3–6 months after, and 1.09 (95% CI, 0.93–1.29) &gt;6 months after an infection, compared with the time before infection. Conclusions FN during chemotherapy is associated with a long-term increased risk of infection. Mortality rates are substantially increased for 6 months following an infection.

Retention rates in two naltrexone programmes for heroin addicts in Vitoria, Spain

1995 ◽  
Vol 10 (4) ◽  
pp. 183-188 ◽  
Author(s):  
M Gutiérrez ◽  
J Ballesteros ◽  
R González-Oliveros ◽  
J Ruíz de Apodaka
Keyword(s):  
Retention Rate ◽  
Time Lag ◽  
Total Sample ◽  
Retention Rates ◽  
Concomitant Treatment ◽  
Heroin Addicts ◽  
Opiate Addicts ◽  
New Treatment ◽  
Hospital Sample

SummaryThe main finding of a former Spanish multicenter study (SMS) on the effectiveness of naltrexone maintenance in heroin addicts, was the high retention rate achieved at 24 weeks of follow-up since naltrexone induction (40%). The authors claimed this rate was one of the highest ever reported in the literature for a non-selected sample of opiate addicts and discussed the possible relevance of a set of variables — like motivations and expectations due to a new treatment — on the findings. To assess the possible effects of these variables, we have compared the retention rates in two similar naltrexone programmes. The first programme (hospital sample) included 56 individuals who were also included in the SMS where they accounted for 37% of the total sample. That programme was developed formerly to the naltrexone marketing. The second sample (ambulatory sample) included 67 individuals who were recruited at least a year apart since naltrexone marketing was approved by the Spanish Health Boards. The time-lag between the beginnig of both studies was in the range of 15 to 25 months.The subjects in both programmes had similar distributions regarding age (p = 0.27), sex (p = 0.79), weeks on treatment after naltrexone induction (p = 0.20), and program compliance (p = 0.78). The retention rates evaluated over a period of 24 weeks were also similar (p = 0.45). The only difference appeared at 12 weeks of follow-up, showing in higher retention the hospital sample than the ambulatory sample (+23%; p < 0.05). The results are discussed according to other studies and it is concluded that findings reported in the former SMS and in this study are not unusual but compatible with recent research. Also underlined is the potential importance of naltrexone as a concomitant treatment for extinguishing high risk behaviours and the conditional stimuli associated with treatment relapse in heroin addicts.

scholarly journals Development of a Flexible Software Solution for Controlling Unmanned Air Vehicles via the Internet

2018 ◽  
Vol 6 (1) ◽  
pp. 37-43 ◽  
Author(s):  
Deniss Brodņevs
Keyword(s):  
Long Range ◽  
Data Transfer ◽  
Line Of Sight ◽  
Unmanned Air Vehicles ◽  
Raspberry Pi ◽  
Transmitter Power ◽  
Flexible System ◽  
Mobile Cellular ◽  
Transfer Services ◽  
Air Vehicles

Abstract Remotely piloted operations of lightweight Unmanned Air Vehicles (UAV) are limited by transmitter power consumption and are always restricted to Line-of-Sight (LOS) distance. The use of mobile cellular network data transfer services (e.g. 3G HSPA and LTE) as well as long-range terrestrial links (e.g. LoraWAN) makes it possible to significantly extend the operation range of the remotely piloted UAV. This paper describes the development of a long-range communication solution for the UAV telemetry system. The proposed solution is based on (but not restricted to) cellular data transfer service and is implemented on Raspberry Pi under Gentoo Linux control. The goal of the project is to develop a flexible system for implementing optimized redundant network solutions for the Non-LOS remote control of the UAV

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