Internet of Things (IoT) based Health Monitor Device

Health is the centre of human enlightenment. Due to the recent Covid outbreak and several environmental pollutions, checking one's vitals regularly has become a necessity. Ours is an IoT-based device that measures a user's heart rate, blood oxygen level and body temperature. The device is compact and portable, making it easy for users to wear. The readings are measured and shown on an OLED display with the help of sensors. The data is also available on the cloud. A webpage and a mobile application were developed to view the data from the cloud. Individual graphs of the vitals with time are available on the mobile application. This can be used for progress measurement and statistical analyses. Authorized personnel can access the patient's vitals. This creates a scope for Tele-medication in rural and underdeveloped regions. Besides, one can also view his/her vitals for personal health routine. © 2022 IEEE.

How the Pandemic Crisis May Affect Economic Systems: A Study on the Nexus Between COVID-19 and Entrepreneurial Activities

The world has experienced several great crises that have had a significant economic impact. The global crisis of the COVID-19 pandemic has affected economies and production chains, harming millions of businesses and entrepreneurs. Economic resilience, an ability to adapt to change and responsiveness to exogenous shocks, is a scientific strategy in the business and economy sectors to analyze and deal with these crises. Undoubtedly, entrepreneurship is one of the important factors influencing the economy as a striking pillar of economic resilience. This study tries to identify factors for enhancing economic resilience that will help countries to be more viable when encountering exogenous or indigenous crises. In this study, the impact of some entrepreneurship indicators, which have been created by applying the Global Entrepreneurship Monitor (GEM) dataset, on the economic resilience index has been examined. Then, based on regression analysis, it was shown that some entrepreneurial indicators, such as the rate of total early-stage entrepreneurial activities (TEA), the rate of established business ownership (EB), the rate of entrepreneurship intention, and the rate of entrepreneurial innovation, can be useful in estimating and scrutinizing the global resilience index. Following this indirect method, the optimal range of some entrepreneurial indicators for achieving the maximum amount of economic resilience was determined. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Self-Tracking to Do Less: An Autoethnography of Long COVID That Informs the Design of Pacing Technologies

Long COVID is a post-viral illness where symptoms are still experienced more than three months after an infection of COVID 19. In line with a recent shift within HCI and research on self-tracking towards first-person methodologies, I present the results of an 18-month long autoethnographic study of using a Fitbit fitness tracker whilst having long COVID. In contrast to its designed intentions, I misused my Fitbit to do less in order to pace and manage my illness. My autoethnography illustrates three modes of using fitness tracking technologies to do less and points to the new design space of technologies for reducing, rather than increasing, activity in order to manage chronic illnesses where over-exertion would lead to a worsening of symptoms. I propose that these "pacing technologies"should acknowledge the interoceptive and fluctuating nature of the user's body and support user's decision-making when managing long-term illness and maintaining quality of life. © 2023 Owner/Author.

Cardioneuroablation in a Woman with Ictal-Induced Cardiac Asystole

Background: Ictal-induced cardiac bradyarrhythmia and asystole is a rare phenomenon. The exact mechanism of ictal-induced cardiac bradyarrhythmia and asystole remains unclear. It was postulated that stimulation of central autonomic network during ictal episode may trigger an abrupt burst of hypervagotonia. Prolonged episode of cardiac bradyarrhythmia and asystole may result in syncope or death due to impairment of cerebral perfusion. The role of cardioneuroablation (CNA) in this condition has not been well-described in the literature. Objective(s): To describe a case of successful CNA in a patient with ictal-induced bradyarrhythmia and asystole. Method(s): n/a Results: A 47-year-old female has a 1.5-year history of intractable focal epilepsy and COVID-19 infection. She started having multiple episodes of seizures following a mild COVID-19 infection. Electroencephalogram (EEG) and brain MRI revealed right temporal onset seizures without structural lesions. Due to ongoing uncontrolled seizures with multiple semiologies despite multiple anti-epileptic drugs, she was admitted to Epilepsy Monitoring Unit for seizure classification. Her ictal EEGs (Figure 1) showed onset of ictal rhythm in the right temporal region with episodes of severe sinus bradycardia (15-30 bpm) and sinus pauses (15-16 seconds). Telemetry tracings demonstrated PP interval slowing with PR interval prolongation prior to the pauses consistent with a vagally-mediated mechanism. Cardiac electrophysiology team recommended CNA for treating the episodes of ictal-induced bradyarrhythmia and asystole. 3D anatomic maps of the right atrium (RA) and left atrium (LA) were created using CARTO system (Biosense Webster). Right superior ganglionated plexus (RSGP) was localized with fractionation mapping and intracardiac echocardiography guidance. RSGP was targeted from the RA using an irrigated radiofrequency catheter with power limit of 25 W. Post-ablations of RSGP, her heart rate increased from 60 - 99 bpm. Additional lesions were delivered from the LA site but no additional heart rate increase was not seen. An implantable loop recorder was implanted post-ablation procedure. During follow-up of 8 months, she had recurrent focal epilepsy, but no bradyarrhythmias or asystole was noted on her loop recorder. Resting heart rates at long-term follow up were between 70 - 100 bpm. Conclusion(s): This case highlights the utility of CNA in patient with ictal-induced cardiac bradyarrhythmia and asystole. CNA may be an approach to avoid permanent pacemakers in this population. [Formula presented]Copyright © 2023

Using CO2 as a Ventilation Clue in Classrooms

In the era of COVID19, we need to quickly find and fix classrooms that have inadequate ventilation to reduce long-range airborne transmission of diseases. Historically, the limited available data has shown classrooms in the United States to be under ventilated in relation to consensus standard ventilation values that do not consider airborne infectious disease risk. Carbon dioxide (CO2) is a reasonable proxy of emissions from humans. This presentation will discuss the assumptions and uncertainties in using carbon dioxide concentrations as a proxy for ventilation in classrooms. Specifically, the influence of student density and activity level on carbon dioxide concentration will be modeled for a range of student ages and activities. This analysis shows classrooms with high carbon dioxide concentrations (above 2, 000 ppmv) are unlikely to be meeting United States ventilation standards. However, uncertainties mean conclusions cannot be easily made about ventilation rates in classrooms with lower carbon dioxide concentrations. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.

The Paths from Middle Class: Evaluation of the Poverty Risks for the Russian Middle Class

The middle class is usually perceived as a main supporter of innovations, source of political stability, and core consumer of goods and services. As a result, its members are traditionally supposed to have high human potential and make a significant contribution to economic growth both in certain country and all over the world, which permanently generates great interest in the issues concerning middle class. However, the main research questions have changed significantly over the last years. The experts both in Russia and abroad highlight the factors that negatively influence the position of the middle class. These are changes in labor market, price growth that outruns the growth of income, increase of tax burden and problems with access to public goods. During COVID-19 pandemic the income has fallen, the risks of unemployment have increased, and the costs of healthcare also have grown. The scholars in different countries underline similar tendencies: middle-class members, who already had to live in an ambiguous world, faced the risks of falling into poverty during the corona crisis. Using data from the Russian Longitudinal Monitor Survey, we evaluate the tracks of middle-class families during 2014-2020 and demonstrate that the problem of poverty affects a part of this social stratum every year. But the share of middle-class members with the income below the poverty line is relatively low and remains largely unaffected by the current corona crisis. © 2023 National Research University Higher School of Economics. All rights reserved.

Atrial Torsades De Pointes Post Covid Myocarditis

Background: Among patients with COVID-19 infection, the risk of adverse cardiovascular outcome, particularly myocarditis and dysrhythmias remain elevated at least up to one year after infection. We present a case of atrial tachycardia and atrial Torsades de Pointes from COVID myocarditis, persisted 6 months after infection, which was successfully managed by ablation. Objective(s): A 25-year-old female presented with mild COVID-19 infection, Omicron variant, in May 2022. One month after, her Covid infection resolved;she presented with symptomatic atrial tachycardia, paroxysmal atrial fibrillation and flutter. ECG showed multiple blocked premature atrial contractions (PAC) (Figure 1A). Holter monitor showed PAC triggered atrial tachycardia degenerating to paroxysmal atrial fibrillation, atrial Torsades de Pointes. She has mild persistent troponin elevation. Echocardiography was normal. Cardiac MRI showed evidence of mild myocarditis with subepicardial late Gadolinium enhancement (LEG) along the lateral mid-apical left ventricular wall and edema. (Figure 1B). She was treated with Colchicine for 2 months. Repeat cardiac MRI 4 months after COVID infection showed resolution of edema and LGE. However, her symptomatic PAC and atrial tachycardia did not respond to betablocker and amiodarone. She underwent electrophysiology study. Activation mapping of PAC using CARTO revealed earliest activation at the right anterior atrial wall, with close proximity to tricuspid valve;unipolar signal showed QS pattern, bipolar signal showed 16 msec pre-PAC (Figure 1C and 1D). Mechanical pressure from ThermoCool SmartTouch ablation catheter (Biosense Webster Inc.) at this site suppressed the PAC. Radiofrequency ablation resulted with an initial acceleration and then disappearance of the PAC. We did not isolate pulmonary veins or ablate cavotricuspid isthmus. Post ablation, PAC and atrial fibrillation were not inducible on Isoproterenol. Method(s): N/A Results: Covid myocarditis can result in dysrhythmia that lingers long after Covid myocarditis has resolved. Covid myocarditis can be caused by direct viral invasion of myocytes or more commonly is inflammatory related to cytokine release and edema. Our case demonstrates that dysrhythmias can persist despite resolution of myocarditis. Catheter ablation can successfully to treat these arrhythmias. Conclusion(s): This case highlights the importance of recognizing cardiac dysrhythmia as possible the long-term cardiac complications of COVID-19, requiring specific treatment such as catheter ablation. [Formula presented]Copyright © 2023

Supraclavicular regional anaesthesia affecting bispectral index as level of consciousness monitor (SUPRABLOC): a pilot randomised controlled trial

Background: Renewed interest in regional anaesthesia during the recent COVID-19 pandemic has inspired application of neuraxial anaesthesia for previously unconventional indications, such as awake abdominal surgeries. These patients needed little sedation, since studies demonstrate that neuraxial anaesthesia causes sedation as measured by the bispectral index (BIS). In contrast, no published study has investigated the possible sedative effects of non-neuraxial regional anaesthesia. This pilot randomised controlled trial (RCT) was designed as a template for, and to test the feasibility of, performing a definitive RCT to establish if non-neuraxial regional anaesthesia has any sedative effect. Method(s): Forty participants presenting for forearm surgery were randomly allocated to two treatment groups (supraclavicular block and control). Their level of sedation was monitored with BIS prior to surgery for 60 minutes. Specific feasibility outcomes were planned and data were collected according to CONSORT 2010 recommendations. Result(s): Out of 48 patients screened, 41 (85.42%) were invited to participate. Forty patients (97.56%) consented and 100% of these completed the study. In four participants (10%), BIS electrodes needed replacement, while inadequate contact was shown in three participants (7.50%). Data collection and form completion were deemed "easy" and block success rate was 100%. Differences in mean BIS between groups were < 5 and a difference of 10% between groups in incidence of BIS < 80 (85% block group, 75% control group) was shown. Conclusion(s): We propose that progression to formal RCT is feasible only with specific modifications to the study design. The decrease in BIS value from baseline should be measured per patient and a clinically significant decrease should be estimated;emergency patients should be excluded;the sample size should be 500 patients;and multiple trial sites should be used. Further consideration should be given to whether such a trial would provide clinically useful information, and would justify the risks, patient discomfort and the considerable financial cost.Copyright © 2023, Medpharm Publications. All rights reserved.

Some key aspects of telemedicine development to support human illness: a systematic review

The aim of this research is to describe the use of telemedicine applied to patients characterised by a particular state of illness, which often drives them toward a frail and chronic status, in a systematic manner. This work employed the Tranfield approach to carry out a systematic literature review (SLR), in order to provide an efficient and high-quality method for identifying and evaluating extensive studies. The methodology was pursued step by step, analysing keywords, topics, journal quality to arrive at a set of relevant open access papers that was analysed in detail. The same papers were compared to each other and then, they were categorised according to significant metrics, also evaluating technologies and methods employed. Through our systematic review we found that most of the patients involved in telemedicine programs agreed with this service model and the clinical results appeared encouraging. Findings suggested that telemedicine services were appreciated by patients, they increased the access to care and could be a better way to face emergencies and pandemics, lowering overall costs and promoting social inclusion.Copyright © 2022 Inderscience Enterprises Ltd.

Real-time remote audio-visual system versus standard buddy system to monitor the doffing of personal protective equipment during COVID-19 pandemic: an observational study

Introduction: Literature states a higher self-contamination rate among healthcare workers (HCWs) while doffing personal protective equipment (PPE). During the COVID-19 pandemic, onsite trained observers were not always available to monitor PPE compliance. The remote audio-visual doffing surveillance (RADS) system has the potential to overcome this limitation [1, 2]. We aimed to compare the efficacy of this real-time RADS system against the onsite buddy system for monitoring the doffing of PPE. Method(s): This prospective, observational study was conducted at our tertiary care centre in northern India. Study was registered in the clinical trial registry India (CTRI/2020/11/038172). 200 HCWs who cared for COVID-19 patients in the intensive care units were included. Group A included HCWs who performed doffing with the help of an onsite trained observer and group B included HCWs who performed doffing with the RADS system. An independent observer noted the error at any step using the CDC doffing checklist, in both groups. An online questionnaire to analyse the level of satisfaction post-doffing was also surveyed. Result(s): The proportion of errors committed during doffing was significantly lower in group B compared to group A with a low relative risk of 0.34 (95% CI 0.22-0.51) (p < 0.001) (Fig. 1). In both groups, there was no difference in HCWs feedback regarding the ease of the system and fear of committing an error. Though the perceived quality of monitoring was felt better with onsite buddy, the overall confidence rating of being safe after doffing was better with the RADS system. Conclusion(s): Real-time RADS system may be more effective than the onsite buddy system for ensuring the safety of HCWs during doffing PPE. HCWs level of satisfaction related to the ease and anxiety with the monitoring systems were comparable. RADS system can reduce reliance on HCW resources and can integrate well into existing healthcare systems.

Asymmetric Cerebral Perfusion in Comatose Extracorporeal Membrane Oxygenation Patients

Asymmetric cerebral perfusion can occur when extracorporeal membrane oxygenation (ECMO) flow competes with native cardiac circulation. It is unclear whether this phenomenon associates with brain injury. Diffuse correlation spectroscopy (DCS) provides continuous, laser-based, non-invasive, bedside monitoring of relative cerebral blood flow (rCBF). This study measured rCBF in ECMO patients via DCS to determine whether comatose patients experience asymmetric cerebral perfusion. Adults receiving ECMO for any indication were prospectively recruited from 12/2019-3/2021. Patients with prior neurologic injury, scalp/facial lacerations, and SARS-CoV-2 infection were excluded. DCS monitoring was performed daily during ECMO support with sensors placed on bilateral foreheads. Mean arterial pressure (MAP) was continuously recorded from the bedside monitor. The Glasgow Coma Scale (GCS) was assessed by clinical staff multiple times daily with sedation pauses, if possible, per standard of care. rCBF was calculated by comparing continuous cerebral blood flow (CBF) measurements to the daily median CBF, then averaged at each MAP value. Daily rCBF asymmetry was calculated by summing the absolute difference of rCBF between the two hemispheres at each MAP value, normalized for the total MAP range experienced by the patient that day. Twelve subjects were enrolled in this study (ages 21-78, 6 with cardiac arrest, 4 with acute heart failure, 2 with ARDS) and grouped by maximum GCS motor (GCS-M) score during ECMO, with 3 "comatose" subjects (GCS-M <= 4), and 9 "awake" subjects (GCS-M > 4). DCS was performed over 66 sessions with a mean duration of 131.83 +/- 1.13 minutes. Comatose subjects exhibited more rCBF asymmetry than awake subjects (0.28 +/- 0.06 mmHg-1 vs. 0.10 +/- 0.001 mmHg-1, p=0.045). No difference in asymmetry was noted between patients with or without cardiac arrest. We found that comatose ECMO subjects exhibited higher inter-hemispheric rCBF asymmetry over a range of blood pressures than awake subjects. Though our comatose sample is small, further validation of this finding and its causes, such as cerebrovascular dysregulation, is warranted.

Deep learning for embryo evaluation using time-lapse: a systematic review of diagnostic test accuracy.

OBJECTIVE: This study aimed to investigate the accuracy of convolutional neural network models in the assessment of embryos using time-lapse monitoring. DATA SOURCES: A systematic search was conducted in PubMed and Web of Science databases from January 2016 to December 2022. The search strategy was carried out by using key words and MeSH (Medical Subject Headings) terms. STUDY ELIGIBILITY CRITERIA: Studies were included if they reported the accuracy of convolutional neural network models for embryo evaluation using time-lapse monitoring. The review was registered with PROSPERO (International Prospective Register of Systematic Reviews; identification number CRD42021275916). METHODS: Two reviewer authors independently screened results using the Covidence systematic review software. The full-text articles were reviewed when studies met the inclusion criteria or in any uncertainty. Nonconsensus was resolved by a third reviewer. Risk of bias and applicability were evaluated using the QUADAS-2 tool and the modified Joanna Briggs Institute or JBI checklist. RESULTS: Following a systematic search of the literature, 22 studies were identified as eligible for inclusion. All studies were retrospective. A total of 522,516 images of 222,998 embryos were analyzed. Three main outcomes were evaluated: successful in vitro fertilization, blastocyst stage classification, and blastocyst quality. Most studies reported >80% accuracy, and embryologists were outperformed in some. Ten studies had a high risk of bias, mostly because of patient bias. CONCLUSION: The application of artificial intelligence in time-lapse monitoring has the potential to provide more efficient, accurate, and objective embryo evaluation. Models that examined blastocyst stage classification showed the best predictions. Models that predicted live birth had a low risk of bias, used the largest databases, and had external validation, which heightens their relevance to clinical application. Our systematic review is limited by the high heterogeneity among the included studies. Researchers should share databases and standardize reporting.

Monitored Anesthesia Care in Uterine Artery Embolization for Leiomyomas and Adenomyosis

Background: Patients undergoing an interventional radiology procedure report some degree of anxiety. Therefore, procedure-related anxiety needs to be managed. The aim of our study was to investigate patient satisfaction with monitored anesthesia care (MAC) for uterine artery embolization (UAE)-related procedural anxiety in symptomatic uterine fibroids or adenomyosis. Method(s): Between May 2021 and June 2022, 36 patients with symptomatic fibroids or adenomyosis underwent UAE with MAC. Follow-up evaluations consisted of clinical symptoms, degree of satisfaction with MAC in UAE, and complications. Result(s): MAC in UAE was successfully performed in all patients. UAE significantly reduced patients' complaints such as bleeding and pain: the scores for bleeding and pain were significantly reduced after 3 months of UAE compared with those before UAE, indicating the effectiveness of UAE. The mean score of satisfaction with MAC in UAE was 4.3 points, meaning that 94.4% of women were satisfied or very satisfied. No major complications were observed. Conclusion(s): MAC in UAE for symptomatic uterine fibroids or adenomyosis can be emotionally effective and safe for patients who are anxious about the procedure.Copyright © 2023 The Author(s).

Determining Typical Patient Effective Dose Levels Using a Dose Monitoring System for Optimization Studies: Application to Dental Cone Beam Ct Imaging

Purpose: To use a dose monitoring system for determining typical patient effective dose levels for optimization studies of x-ray exposures, with a focus on dental cone beam CT (CBCT) imaging. Material(s) and Method(s): A dose monitoring system (DOSE, Qaelum NV, Belgium) was used to collect radiation exposure data (i.e. the recorded Dose Area Product (DAP) value in dGy.cm2, Field Of View (FOV) selection in cm2, and the system operation mode), as well as the patient age for 5163 dental CBCT examinations performed in the university hospital of Leuven from January to December 2019, just prior to the Covid-19 pandemic. Examinations were performed on a 3D Accuitomo 170 (Morita, Japan) and a VGi EVO (NewTom, Italy) CBCT system. The extracted DAP values were corrected with an experimentally determined correction factor obtained during annual quality control tests. For each CBCT system, effective dose conversion factors (CFs) as a function of DAP and patient age were calculated and implemented in DOSE. CFs were determined for the following age groups: 4-6y, 7-11y, 12-14y, and >=15y. For the effective dose calculations, patient data was, for each system, further classified based on the selected FOV and operation mode. The FOV size was categorized into small (<=40 cm2), medium (>40 cm2 and <=100 cm2), or large (>100 cm2). Result(s): For the standard operation mode, average effective doses on the 3D Accuitomo 170 system as a function of age group were, from young to old: 77.7-300, 54.4-210, 39.9-154, 35.1-136 Sv, and for the VGi EVO system: 60.5-117, 12.1-97, 9.54-69.9, 9.26-61.5 Sv. For both systems, a decreasing trend in the effective dose with increasing age was observed. For each age group, the doses increased with increasing FOV size. The selected operation mode also influenced the dose to the patient (e.g. for the high-resolution mode on the VGi EVO system, 1.5-4 times higher effective doses were observed compared to the standard mode). The effective dose levels on the NewTom VGi evo system were significantly lower than on the 3D Accuitomo 170. For the VGi EVO system, the most frequently used system in clinical practice, the total radiation burden from the examinations was 0.22 manSv. Conclusion(s): This was one of the first studies providing a complete 1 year overview of dental CBCT effective doses in a university hospital dental department. The results could be used for optimization studies and/or to situate the exposures in comparison to multislice CT or panoramic examinations.Copyright © 2023 Southern Society for Clinical Investigation.

The framing of COVID-19 in Uganda's new vision and daily monitor newspapers

This chapter surveyed how the Daily Monitor and New Vision newspapers in Uganda framed discourse surrounding the COVID-19 pandemic. The pandemic was given massive media coverage in Uganda, as around the globe. It is of interest to examine the coverage and draw lessons for future reference. We considered Uganda as an interesting case due to its initial success in managing the spread of the pandemic (Sarki, Ezeh, & Stranges, 2020). This chapter aimed to analyse the coverage of the pandemic through the lens of framing theory. The chapter presents a content analysis of selected published material from their online sites in the two newspapers between 10 March and 2 June 2020. The dates start with lockdown in Uganda and end with lockdown's partial lifting. The study revealed several interesting news frames that included a western versus national frame, preparedness frame, economic frame, religious frame and other emerging news frames like solidarity, police enforcement and self-reflection. The main conclusion is that the two major dailies actively informed the public about COVID-19 and made some attempts to cover issues around the impact of COVID-19 on society. © 2022 by Emilly Comfort Maractho and Solveig Omland.

Continuous glucose monitor use in type 2 diabetes mellitus in pregnancy and perinatal outcomes: a systematic review and meta-analysis.

OBJECTIVE: This study aimed to assess whether continuous glucose monitor use in type 2 diabetes mellitus in pregnancy is associated with improved perinatal outcomes. DATA SOURCES: We searched Ovid MEDLINE, Scopus, ClinicalTrials.gov, and Cochrane library from inception through May 9, 2022. STUDY ELIGIBILITY CRITERIA: We included all studies that compared continuous glucose monitor use with fingerstick glucose monitoring in women with type 2 diabetes mellitus. METHODS: The initial search yielded 2463 unique citations that were screened in Covidence by 2 independent reviewers. Study types included randomized controlled trials, cohort studies, and cross-sectional studies. Our outcomes of interest were macrosomia or large-for-gestational-age infants, hemoglobin A1c, cesarean delivery, hypertensive disorders of pregnancy including preeclampsia, gestational age at delivery, and neonatal hypoglycemia. RESULTS: Three randomized controlled trials met the inclusion criteria. We performed random-effects meta-analyses of estimates from 2 studies without risk of significant bias and reported summary adjusted odds ratios and 95% confidence intervals. Meta-analysis of 56 women with continuous glucose monitor use and 53 control women without continuous glucose monitor use showed that there was no difference in the incidence of large-for-gestational-age infants between continuous glucose monitor users and standard-of-care controls (odds ratio, 0.78; 95% confidence interval, 0.34-1.78) with an I2 of 0%. In addition, there was no difference in the development of preeclampsia between continuous glucose monitor users and standard-of-care controls (odds ratio, 1.63; 95% confidence interval, 0.34-7.22) with an I2 of 0%. CONCLUSION: Continuous glucose monitor use was not associated with improved perinatal outcomes as assessed by large-for-gestational-age infants and preeclampsia. This review is limited by the small amount of data available for this population, and further research is needed.

Tracheal tube cuff pressure during anesthesia for robotic-assisted laparoscopic prostatectomy and the efficacy of an automatic cuff pressure controller (SmartCuff): observational studies of 1-sample paired data.

PURPOSE: The cuff pressure of a tracheal tube may increase during robot-assisted laparoscopic surgery for prostatectomy (RALP), which requires pneumoperitoneum in a steep head-down position, but there have been no studies which confirmed this. METHODS: In study 1, we studied how frequently the cuff pressure significantly increased during anesthesia for the RALP. In study 2, we studied if the SmartCuff (Smiths Medical Japan, Tokyo) automatic cuff pressure controller would minimize the changes in the intracuff pressure. With approval of the study by the research ethics committee (approved number: 20115), we measured the cuff pressures in anesthetized patients undergoing RALP and in those undergoing gynecological laparotomy (as a reference cohort), with and without the use of the SmartCuff. RESULTS: In 21 patients undergoing RALP, a clinically meaningful increase (5 cmH2O or greater) was observed in all the 21 patients (P = 0.00; 95% CI for difference: 86-100%), whereas in 23 patients undergoing gynecological laparotomy, a clinically meaningful decrease (5 cmH2O or greater) was observed in 21 of 23 patients (91%, P < 0.0001; 95% CI for difference: 72-99%). With the use of the SmartCuff, there was no significant increase in the incidence of a clinically meaningful change in the intracuff pressure in either cohort. CONCLUSION: The cuff pressure of a tracheal tube would frequently increase markedly in patients undergoing RALP, whereas it would frequently decrease markedly in patients undergoing gynecological laparotomy. The SmartCuff may inhibit the changes in the cuff pressure during anesthesia.

Self-monitoring using multimodal connected devices in patients with COVID-19 confined at home

Introduction: Covid-19 increased the burden on hospitals for patients with symptoms and potential vital complications. Patient home self-monitoring of clinical signs and physiological safety parameters using connected devices was assessed to better detect patients with indication of rehospitalization. Method(s): After clinical/PCR COVID confirmation, patients were given WITHINGS devices: Scanwatch, a thermometer, a blood pressure monitor, a Sleep analyzer and instructed to take measures twice a day with data retrieved on HealthMate app. Reports and questionnaires on clinical symptoms were sent daily to physicians. Result(s): Ten PCR positive patients were included (5 males): mean age 45.5years [31;67], BMI 26.9kg/m2 [19.7;43.2]. Main COVID symptoms were cough (33%), sore throat (27%), tiredness (36%), dyspnea (37%). Delay between COVID onset and self-monitoring start was 7.7days [0-37]. 8 patients had a good adherence to the protocol up to 30 days. SpO2 and Heart Rate (HR) were most frequently measured: 88 [5-177] and 58 [21-195] measures in average respectively. Five patients with polysomnography had Apnea-Hypopnea Index (AHI) equivalent to the Sleep analyzer averaged over several nights: AHISA: 8.53[-1;71.4] vs AHIPSG: 13.01[1.49;28.76]. Temperature remained within normal in 9/10 patients. In most patients Breathing rate (BR) decreased, HR decreased or remained steady, nigthtime HR/BR changed similarly. Daily steps increased throughout along with BR reduction. All patients had favorable outcomes without indication of hospitalization. Conclusion(s): Home self-monitoring during a pandemic is feasible. Safety parameters may be effectively monitored by patients and easily reported to their physicians.

Use of Accelerometers to Track Changes in Stepping Behavior With the Introduction of the 2020 COVID Pandemic Restrictions: A Case Study

Introduction: The COVID-19 lockdown introduced restrictions to free-living activities. Changes to these activities can be accurately quantified using combined measurement. Using activPAL3 and self-reports to collect activity data, the study aimed to quantify changes that occurred in physical activity and sedentary behavior between prelockdown and lockdown. The study also sought to determine changes in indoor and outdoor stepping. Methods: Using activPAL3, four participants recorded physical activity data prelockdown and during lockdown restrictions (February–June 2020). Single events (sitting, standing, stepping, lying) were recorded and analyzed by the CREA algorithm using an event-based approach. The analysis focused on step count, sedentary time, and lying (in bed) time;median and interquartile range were calculated. Daily steps classified as taking place indoors and outdoors were calculated separately. Results: 33 prelockdown and 92 in-lockdown days of valid data were captured. Median daily step count across all participants reduced by 14.8% (from 5,828 prelockdown to 4,963 in-lockdown), while sedentary and lying time increased by 4% and 8%, respectively (sedentary: 9.98–10.30 hr;lying: 9.33–10.05 hr). Individual variations were observed in hours spent sedentary (001: 8.44–8.66, 002: 7.41–8.66, 003: 11.97–10.59, 004: 6.29–7.94, and lying (001: 9.69–9.49, 002: 11.46–11.66, 003: 7.63–9.34, 004: 9.7–11.12) pre-and in-lockdown. Discrepancies in self-report versus algorithm classification of indoor/outdoor stepping were observed for three participants. Conclusion: The study quantitively showed lockdown restrictions negatively impacted physical activity and sedentary behavior;two variables closely linked to health outcomes. This has important implications for public health policies to help develop targeted interventions and mandates that encourage additional physical activity and lower sedentary behavior. © 2023 Human Kinetics, Inc.