Implementation of a Remote Activation Alarm System by the Citizens of the District of Carabayllo, Lima-Peru

Citizen insecurity is a reality with which we must coexist, the cities of Latin America are among the most violent and insecure in the world. According to the statistics of the National Police of Peru, they report that by 2017 the crimes of theft or robbery were the most common because they had a monthly average of 15348 complaints, equivalent to 66.9% of the total crimes nationwide. The INEI (National Institute of Statistics and Informatics) revealed that in the same year the district of Carabayllo obtained 1.85% of the total complaints in Metropolitan Lima, occupying the 17th place in the ranking of districts with the highest number of complaints for this crime. That is why in the present research work a way to counteract these criminal acts was proposed, the first thing is to be located within the operating range of the RF module, so that the remote transmission control can activate it, the RF module will be connected to the power outlet and the siren. The siren will oversee persuading the criminal, in addition to alerting the neighbors about the events that are happening. It was obtained as a result that the system fulfills its purpose, it can be alerted in real time about some attempted theft or at the instant of a threat situation, only by pressing the button of the remote control we can persuade the criminals either by scaring them with the sound or with the help of the neighbors. Keywords-- Citizen insecurity, RF Module, Siren, Remote Control

Reducing the Electrogram Review Burden Imposed by Insertable Cardiac Monitors

Background: Insertable cardiac monitors (ICMs) are essential for ambulatory arrhythmia diagnosis. However, definitive diagnoses still require time-consuming, manual adjudication of electrograms (EGMs). Objective: To evaluate the clinical impact of selecting only key EGMs for review. Methods: Retrospective analyses of randomly selected Abbott Confirm Rx devices with ≥90 days of remote transmission history was performed, with each EGM adjudicated as true or false positive (TP, FP). For each device, up to 3 “key EGMs” per arrhythmia type per day were prioritized for review based on ventricular rate and episode duration. The reduction in EGMs and TP days (patient-days with at least 1 TP EGM), and any diagnostic delay (from the first TP), were calculated vs. reviewing all EGMs. Results: In 1,000 ICMs over a median duration of 8.1 months, at least one atrial fibrillation (AF), tachycardia, bradycardia, or pause EGM was transmitted by 424, 343, 190, and 325 devices, respectively, with a total of 95716 EGMs. Approximately 90% of episodes were contributed by 25% of patients. Key EGM selection reduced EGM review burden by 43%, 66%, 77%, and 50% (55% overall), while reducing TP days by 0.8%, 2.1%, 0.2%, and 0.0%, respectively. Despite reviewing fewer EGMs, 99% of devices with a TP EGM were ultimately diagnosed on the same day vs. reviewing all EGMs. Conclusions: Key EGM selection reduced the EGM review substantially with no delay-to-diagnosis in 99% of patients exhibiting true arrhythmias. Implementing these rules in the Abbott patient care network may accelerate clinical workflow without compromising diagnostic timelines.

592 The growth of telehealth during SARS-CoV-2 time

Aims Improve the management of frail patients, particularly in times of pandemic, through an assistance based on a remote digitalized platform, which allows rapid interventions, able to reduce access to the emergency room, and decreased mortality from cardiovascular causes. Methods and results (i) Heart failure management—Enrollment in the digital platform. Use of devices: sphygmomanometer, scale, oximeter, single-track ECG. Daily analysis of the haemodynamic parameters on the platform. Communication by e-mail exchange and tele/videoconsultations, drug management, and therapeutic strategies. Possibility to perform echocardiogram at home. (ii) Remote monitoring management—Enrollment in the digital platform. Supply of transmitters for the management of thresholds, objectives, and alarms. Daily parametric check. (iii) Infarct network management—Integrated operating system for assistance between the in-hospital and out-of-hospital environment, in patients suffering from AMI. Execution, transmission, and reporting of the ecg-graphic trace on equipment provided with a remote transmission system. Allow to reduce the time of diagnosis and treatment. At our centers, over 1000 patients are followed on a digital platform, including those at risk of heart failure and device wearers. In addition, there is an annual trend of over 400 patients who are diagnosed electronically with AMI and relative percutaneous coronary treatment. The use of remote systems has allowed for some patients to early highlight threatening arrhythmias and/or device malfunctions, for others to prematurely intercept symptoms and signs of congestive heart failure. A clear improvement in prognosis and quality of life was therefore observed. Conclusions Cardiovascular diseases are the leading cause of death in Western countries. Therefore, the close follow-up and identification of haemodynamic and clinical parameters on digitized platforms, allows to: reduce access to the emergency room, guarantee the best therapeutic strategies, improve the quality of life, and decrease the mortality rate. In conclusion, we found a high approval rating as the patient reports feeling better, feeling constantly followed, and a clear improvement in compliance and adherence to the therapy.

Automated Medical Care: Bradycardia Detection and Cardiac Monitoring of Preterm Infants

Background and Objectives: Prematurity of birth occurs before the 37th week of gestation and affects up to 10% of births worldwide. It is correlated with critical outcomes; therefore, constant monitoring in neonatal intensive care units or home environments is required. The aim of this work was to develop solutions for remote neonatal intensive supervision systems, which should assist medical diagnosis of premature infants and raise alarm at cardiac abnormalities, such as bradycardia. Additionally, the COVID-19 pandemic has put a worldwide stress upon the medical staff and the management of healthcare units. Materials and Methods: A traditional medical diagnosing scheme was set up, implemented with the aid of powerful mathematical operators. The algorithm was tailored to the infants’ personal ECG characteristics and was tested on real ECG data from the publicly available PhysioNet database “Preterm Infant Cardio-Respiratory Signals Database”. Different processing problems were solved: noise filtering, baseline drift removal, event detection and compression of medical data using the à trous wavelet transform. Results: In all 10 available clinical cases, the bradycardia events annotated by the physicians were correctly detected using the RR intervals. Compressing the ECG signals for remote transmission, we obtained compression ratios (CR) varying from 1.72 to 7.42, with the median CR value around 3. Conclusions: We noticed that a significant amount of noise can be added to a signal while monitoring using standard clinical sensors. We tried to offer solutions for these technical problems. Recent studies have shown that persons infected with the COVID-19 disease are frequently reported to develop cardiovascular symptoms and cardiac arrhythmias. An automatic surveillance system (both for neonates and adults) has a practical medical application. The proposed algorithm is personalized, no fixed reference value being applied, and the algorithm follows the neonate’s cardiac rhythm changes. The performance depends on the characteristics of the input ECG. The signal-to-noise ratio of the processed ECG was improved, with a value of up to 10 dB.

Intelligent Control Optimization of Remote Transmission Quality of Communication Signals Based on 5G Network

With the rapid development of the information age, mobile communication networks have gradually entered people’s lives. The emergence of 5G networks has accelerated the convenience of people’s communication and contact, and has become an advanced information technology that has been widely used in various fields. Although the emergence of 5G networks is beneficial, the remote transmission quality of communication signals has also caused many problems. The optimization of remote transmission quality can effectively improve the operational stability of the communication network. There are many ways to optimize the transmission quality of communication signals. For example, when signal interference needs to be reduced, calculate the average value of signals in various places, set the interference reduction threshold function, and complete the remote transmission quality optimization of communication signals. The existing method is to use microblogs with hard and soft thresholds to decompose the signal quality through multiple scales to provide interference reduction thresholds, but ignore the calculation of the average value of the subband signals, so the signal transmission quality is optimized The effect is not satisfactory. It is recommended to reduce the interference in the network communication process based on the anti-window. First, the input communication signal is Pulley converted, the frequency domain interference detection is performed on the communication signal, a low-pass prototype filter is formed, the average value of the signal in each place is calculated, the interference reduction threshold is set, and the network communication process is completed. The weakening of interference realizes the optimization of transmission quality. This article conducts research and discussion on the optimization of the long-distance transmission quality of the communication signal of the 5G network. Experimental research results show that by demonstrating the optimization of the quality of the 5G communication signal transmission process, these demonstrations can ensure the quality of the communication signal, and people’s demand for the network is already indispensable.

Clinic time required to manage remote monitoring of cardiac implantable electronic devices: impact of outsourcing initial data review and triage

Funding Acknowledgements Type of funding sources: Private company. Main funding source(s): Medtronic Background Remote monitoring is guideline-recommended to manage cardiac implantable electronic device (CIED) patients. With the continuous growth of implanted patients, clinic workload to review transmissions is increasing. Outsourcing initial data review and triage to an external monitoring center could be a valuable option for more efficient allocation of staff time, as high-skilled healthcare professionals can focus on patients in need rather than non-actionable data. Purpose The objective was to estimate the potential clinic staff time saved when outsourcing part of remote transmission review. Methods A previous time and motion evaluation described workflow tasks and time required for remote transmission review (4 EU sites, 674 observations). From real-world experience with a third-party monitoring service, the steps that can be outsourced were determined considering existing clinic-driven protocols for triage and transmission escalation. Staff time required with and without the monitoring service was thus modeled and compared. Results Outsourcing to an external monitoring center can reduce clinic staff time between 77.4% and 84.7% depending on device type. Absolute time savings range from 32.7 to 82.6 hours per year per 100 patients for therapeutic devices, and 301.3 hours for insertable cardiac monitor (ICM) patients, due to the higher frequency of transmissions in diagnostic devices. Conclusion Time to review remote transmissions can become overwhelming for clinics as growing CIED population often outpaces available staffing resources. Outsourcing initial review and triage to an external monitoring center (ensuring quality and regulatory compliance) can be an efficient option to save dedicated staff and facility time for other crucial healthcare activities. Clinic Staff Time Savings Per YearPacemakerICDCRTICMTRANSMISSIONS PER PATIENT PER YEARGreen (no further review required when outsourcing)3.04.35.020.8Yellow/Red (medical action/decision required)0.60.80.93.8ANNUAL STAFF TIME PER PATIENT, minutesNo outsourcing25.346.658.5219.7Outsourcing to monitoring center5.77.78.938.9ANNUAL STAFF TIME PER 100 PATIENTS, hoursNo outsourcing42.277.697.4366.2Outsourcing to monitoring center9.612.914.964.8TIME SAVED PER 100 PATIENTS, hours (%)32.7 (77.4%)64.7 (83.4%)82.6 (84.7%)301.3 (82.3%)Abstract Figure. Outsourcing Remote Transmission Review

Reducing clinical review burden for insertable cardiac monitors

Funding Acknowledgements Type of funding sources: None. Background The insertable cardiac monitor (ICM) is an essential tool for the ambulatory diagnosis of arrhythmias. However, definitive diagnoses still rely on time-consuming, manual adjudication of electrograms (EGMs) transmitted to the patient care network. This EGM review burden may be minimized by automatically selecting a subset of EGMs for fast review without delaying the diagnosis. Purpose Develop EGM selection strategies to reduce the EGM review burden without delaying diagnoses. Methods A retrospective analysis of 1,000 randomly selected Abbott Confirm Rx devices with 90+ days of remote transmission history was performed, regardless of transmission frequency, and all EGMs were adjudicated as either true or false positive (TP, FP). Up to 3 EGMs per day per arrhythmia type were prioritized for review based on ventricular rate and episode duration, with rules specific to each arrhythmia type: atrial fibrillation (AF), tachycardia, bradycardia, and pause. The resulting reduction in EGM review burden and TP days (patient-days with at least 1 TP EGM), as well as any diagnostic delay from the first transmitted TP, were calculated relative to reviewing all transmitted EGMs. Results In this population and transmission period, at least one AF, tachycardia, bradycardia, and pause EGM was transmitted by 424, 343, 190, and 325 unique devices, respectively, with a total of 35,723, 12,239, 19,752, and 28,002 EGMs, and a total of 6,163, 1,572, 1,438, and 646 TP days. For these patients with ≥1 EGM, the median [IQR] EGM transmission rate was 2.6 [0.7, 11.6], 1.1 [0.4, 4.7], 2.1 [0.6, 10.7], and 3.4 [0.6, 29.9] EGMs/patient/month, respectively. The optimal EGM selection strategy reduced this EGM review burden by 43%, 67%, 76%, and 50%, while only missing 3.4%, 2.2%, 0.3%, and 0.2% of TP days, respectively. Ultimately, 97%, 99%, 99%, and 99% of devices with a TP AF, tachycardia, bradycardia, or pause EGM exhibited no diagnostic delay vs. reviewing all transmitted EGMs. Conclusion EGM prioritization rules for selecting up to 3 episodes/day significantly reduced EGM burden across all patients, not just "frequent fliers," with no delay-to-diagnosis in >97% of patients who exhibited a true arrhythmia. Implementing these rules on the patient care network may improve clinical workflow and ICM patient management. Abstract Figure.

TECHNICAL DIAGNOSTICS-GUARANTEE OF HIGH-QUALITY AND EFFECTIVE MAINTENANCE OF TIMBER ROLLING STOCK

A logging vehicle is a source of increased danger, and its serviceability affects road safety. Diagnostics of the technical condition of the car allows you to timely identify serious defects in components, mechanisms and aggregates without removing them and disassembling them, to have time to eliminate malfunctions in time and bring the technical characteristics to the standard. Analysis of the literature data has shown that diagnostics of the technical condition of a logging vehicle plays an important role in preventing accidents. Our task was to improve the reliability of the car and reduce the complexity of work during the next maintenance. In the article, we justify the criteria necessary for the organization of safe operation of logging vehicles when transporting timber on public roads. The age and technical condition of the timber rolling stock fleet is analyzed. The most frequent failures of forest transport vehicles on the example of cars of the KAMAZ family, affecting the organization of traffic safety, are determined. The necessity of pre-trip control inspections and Express diagnostics of vehicles is revealed. Taking into account the identified shortcomings, the scheme of post-trip removal of parameters from the built-in diagnostics system of a logging vehicle and subsequent remote transmission of data to the server of the control room of a motor transport enterprise has been developed. The conducted scientific research allowed us to find a solution to the problem, which is to allocate technical diagnostics in an independent type of technical impact. This measure will reduce the costs of premature technical impacts on the systems, components and aggregates of timber rolling stock without reducing the requirements for traffic safety