78 research outputs found
Post-operative nausea and vomiting prophylaxis in adult day case surgery : did it justify a local protocol?
Background: Post-operative nausea and vomiting (PONV) is common following surgery and results in complications. The Society of Ambulatory Anaesthesia (SAMBA) published internationally established guidelinesfor its prophylaxis. Our aim was to investigate whether guidelines were being followed locally. We also assessed incidence of PONV, delay in discharge or unplanned admissions in adult surgical cases at Day Care Unit. This study was repeated after five yearsto assess the impact of establishing local guidelines in Mater Dei Hospital in the same year.Methods: In this retrospective study,we collected information between August and September 2012 and then in 2017. Data regarding vomiting, delayed discharge or unplanned admission due to PONV was documented. Local guidelines were implemented in 2013. Educational measures to raise awareness were carried out, followed by a re-audit in 2017.Results: 195 patients were eligible in the first study and 173 in the second cycle. No statistically significant decrease was found between patients having PONV (12.4%and 10% in the re-audit - p<0.01). One in ten patients (1%) had an unplanned admission due to PONV during the first audit with no admissions in the second study. Number of risk factors for PONV did not correlate with anti-emetics given.Conclusion: The incidence of PONV in adult day cases at our day care unit justifies the use of protocol for better prophylaxis. However, local protocols are not being followed. Education and emphasis of local guidelines can improve the compliance rate.peer-reviewe
Non-contact vital signs monitoring in paediatric anaesthesia – current challenges and future direction
Non-contact vital sign monitoring is an area of increasing interest in the clinical scenario since it offers advantages over traditional monitoring using leads and wires. These advantages include reduction in transmission of infection and more freedom of movement. Yet there is a paucity of studies available in the clinical setting particularly in paediatric anaesthesia. This scoping review aims to investigate why contactless monitoring, specifically with red-green-blue cameras, is not implemented in mainstream practise. The challenges, drawbacks and limitations of non-contact vital sign monitoring, will be outlined, together with future direction on how it can potentially be implemented in the setting of paediatric anaesthesia, and in the critical care scenario.peer-reviewe
Non–invasive vital signs monitoring in the adult population in clinical settings — current state of the art and beyond
The aim is to delineate the current state of the art in non-contact red-green-blue (RGB) camera-based heart rate and rhythm monitoring in adult populations in the clinical setting. In addition, the challenges that still exist for more widespread use of this technology are outlined, as well as potential ways to overcome them. A search using Boolean operators was carried out in PubMed, Google Scholar, IEEE Xplore, CINAHL and Cochrane databases using predefined inclusion and exclusion criteria. Studies within hospital settings that extract heart rate data from videos of adult patients were identified and their successes and limitations were analysed from a clinical perspective. Fifteen studies were identified that fit the inclusion criteria. Many of these studies took place in emergency department settings, with the postoperative care unit being another environment that was investigated. Although good correlation between gold standard measurements and camera-based values were obtained overall, there are still challenges related to patient movement, changes in illumination and standardisation of techniques. This may be the reason that the use of this technology is not yet commonplace. Although a lot of valuable work has been performed highlighting the advantages and feasibility of using camera-based photoplethysmography to extract heart rate data in clinical scenarios, challenges still need to be overcome before these systems can become more mainstream in clinical practise. Therefore more research needs to be conducted in the eld of non-invasive vital signs monitoring in the clinical setting.peer-reviewe
Exploring the diabesity characteristics and associated all‑cause mortality at a population level : results from a small European island state
Aim: Diabesity, the co-occurrence of diabetes and obesity, presents a global health crisis. Understanding its prevalence, associated
risk factors, and mortality outcomes is crucial for effective public health interventions. This study aims to investigate
the prevalence of diabesity and diabetes, assess associated risk factors, and analyze mortality outcomes over a 7-year period
in the diabetogenic country of Malta.
Subject and methods: A nationwide health examination survey (2014–16) was conducted involving 3947 adults aged
18–70 years. Sociodemographic data, anthropometric measurements, and blood samples were collected. Relationships
between different adiposity indices were explored. Mortality data was obtained by cross-referencing with the national
mortality register. Statistical analyses included chi-square tests, logistic regression, and Cox proportional hazard models.
Results: Prevalence of obesity was 34.08%, diabetes 10.31%, and diabesity 5.78%. Sociodemographic characteristics were
similar across all three cohorts. Multivariable regression identified increasing age (OR 1.10 CI95% 1.07–1.12; p≤ 0.001),
male gender (OR 0.53 CI95% 0.30–0.93; p = 0.03), and low educational level (OR 2.19 CI95% 1.39–3.45; p = 0.001) as
significant predictors of diabesity. Only diabetes showed a significant increase in mortality risk (HR 3.15 CI95% 1.31–7.62;
p = 0.02) after adjustment, with gender (HR 3.17 CI95% 1.20–8.37) and body adiposity index (HR 1.08 CI95% 1.01–1.16)
also significant (p ≤ 0.05).
Conclusion: Diabesity represents a substantial public health challenge in Malta, with implications for mortality outcomes.
Targeted interventions addressing sociodemographic disparities and promoting healthy lifestyles are essential to mitigate its
impact. The findings underscore the need for comprehensive healthcare strategies and policy initiatives to combat diabesity
and reduce associated mortality rates.peer-reviewe
State of the art of audio- and video based solutions for AAL
Working Group 3. Audio- and Video-based AAL ApplicationsIt is a matter of fact that Europe is facing more and more crucial challenges regarding health and social care due to the demographic change and the current economic context. The recent COVID-19 pandemic has stressed this situation even further, thus highlighting the need for taking action. Active and Assisted Living (AAL) technologies come as a viable approach to help facing these challenges, thanks to the high potential they have in enabling remote care and support. Broadly speaking, AAL can be referred to as the use of innovative and advanced Information and Communication Technologies to create supportive, inclusive and empowering applications and environments that enable older, impaired or frail people to live independently and stay active longer in society. AAL capitalizes on the growing pervasiveness and effectiveness of sensing and computing facilities to supply the persons in need with smart assistance, by responding to their necessities of autonomy, independence, comfort, security and safety. The application scenarios addressed by AAL are complex, due to the inherent heterogeneity of the end-user population, their living arrangements, and their physical conditions or impairment. Despite aiming at diverse goals, AAL systems should share some common characteristics. They are designed to provide support in daily life in an invisible, unobtrusive and user-friendly manner. Moreover, they are conceived to be intelligent, to be able to learn and adapt to the requirements and requests of the assisted people, and to synchronise with their specific needs. Nevertheless, to ensure the uptake of AAL in society, potential users must be willing to use AAL applications and to integrate them in their daily environments and lives. In this respect, video- and audio-based AAL applications have several advantages, in terms of unobtrusiveness and information richness. Indeed, cameras and microphones are far less obtrusive with respect to the hindrance other wearable sensors may cause to one’s activities. In addition, a single camera placed in a room can record most of the activities performed in the room, thus replacing many other non-visual sensors. Currently, video-based applications are effective in recognising and monitoring the activities, the movements, and the overall conditions of the assisted individuals as well as to assess their vital parameters (e.g., heart rate, respiratory rate). Similarly, audio sensors have the potential to become one of the most important modalities for interaction with AAL systems, as they can have a large range of sensing, do not require physical presence at a particular location and are physically intangible. Moreover, relevant information about individuals’ activities and health status can derive from processing audio signals (e.g., speech recordings). Nevertheless, as the other side of the coin, cameras and microphones are often perceived as the most intrusive technologies from the viewpoint of the privacy of the monitored individuals. This is due to the richness of the information these technologies convey and the intimate setting where they may be deployed. Solutions able to ensure privacy preservation by context and by design, as well as to ensure high legal and ethical standards are in high demand. After the review of the current state of play and the discussion in GoodBrother, we may claim that the first solutions in this direction are starting to appear in the literature. A multidisciplinary 4 debate among experts and stakeholders is paving the way towards AAL ensuring ergonomics, usability, acceptance and privacy preservation. The DIANA, PAAL, and VisuAAL projects are examples of this fresh approach.
This report provides the reader with a review of the most recent advances in audio- and video-based monitoring technologies for AAL. It has been drafted as a collective effort of WG3 to supply an introduction to AAL, its evolution over time and its main functional and technological underpinnings. In this respect, the report contributes to the field with the outline of a new generation of ethical-aware AAL technologies and a proposal for a novel comprehensive taxonomy of AAL systems and applications. Moreover, the report allows non-technical readers to gather an overview of the main components of an AAL system and how these function and interact with the end-users.
The report illustrates the state of the art of the most successful AAL applications and functions based on audio and video data, namely (i) lifelogging and self-monitoring, (ii) remote monitoring of vital signs, (iii) emotional state recognition, (iv) food intake monitoring, activity and behaviour recognition, (v) activity and personal assistance, (vi) gesture recognition, (vii) fall detection and prevention, (viii) mobility assessment and frailty recognition, and (ix) cognitive and motor rehabilitation. For these application scenarios, the report illustrates the state of play in terms of scientific advances, available products and research project. The open challenges are also highlighted.
The report ends with an overview of the challenges, the hindrances and the opportunities posed by the uptake in real world settings of AAL technologies. In this respect, the report illustrates the current procedural and technological approaches to cope with acceptability, usability and trust in the AAL technology, by surveying strategies and approaches to co-design, to privacy preservation in video and audio data, to transparency and explainability in data processing, and to data transmission and communication. User acceptance and ethical considerations are also debated. Finally, the potentials coming from the silver economy are overviewed.publishedVersio
The impact of the COVID-19 pandemic on the Mediterranean region over 18 months : bridging the health outcomes and sustainable development goals
Background: The COVID-19 pandemic spread across the globe, including across the Mediterranean basin. This region presents diversity in economy, culture, and societal affairs. We attempted to evaluate the impact of COVID-19 on the population and on the Sustainable Development Goals (SDGs), our aim being to aid in the development of COVID-19 national plans. Methods: Epidemiological data was obtained from ‘Our World in Data’ databases (January 2020 – July 2021). Case, mortality, and vaccination incidence comparisons were made across neighbouring countries. The SDG index, universal health coverage (UHC) and health workforce targets were collected for each country. Correlations between SDG targets and COVID-19 outcomes were analysed. Results: Similarities in morbidity and mortality outcomes were present across neighbouring countries, with a bidirectional relationship between cumulative fully vaccinated population and infectivity fatality rates. Positive relationships were present between SDG indexes, UHC and health workforces and COVID-19 cases, deaths, and vaccinations. Conclusion: At prima face, high-income countries seem to have sustained worse morbidity and mortality outcomes, despite having had better UHC and a greater health workforce in the pre-COVID-19 era however, one must also consider that factors such as health-seeking behaviour and underdiagnosis may have influenced this. Cross-border infectivity was, however, evident. Pan-Mediterranean action must therefore be taken to ensure COVID-19 transmissibility and mortality are reduced across borders, while ensuring an equitable health outcome across populations.peer-reviewe
State of the Art of Audio- and Video-Based Solutions for AAL
It is a matter of fact that Europe is facing more and more crucial challenges regarding health and social care due to the demographic change and the current economic context. The recent COVID-19 pandemic has stressed this situation even further, thus highlighting the need for taking action. Active and Assisted Living technologies come as a viable approach to help facing these challenges, thanks to the high potential they have in enabling remote care and support. Broadly speaking, AAL can be referred to as the use of innovative and advanced Information and Communication Technologies to create supportive, inclusive and empowering applications and environments that enable older, impaired or frail people to live independently and stay active longer in society. AAL capitalizes on the growing pervasiveness and effectiveness of sensing and computing facilities to supply the persons in need with smart assistance, by responding to their necessities of autonomy, independence, comfort, security and safety. The application scenarios addressed by AAL are complex, due to the inherent heterogeneity of the end-user population, their living arrangements, and their physical conditions or impairment. Despite aiming at diverse goals, AAL systems should share some common characteristics. They are designed to provide support in daily life in an invisible, unobtrusive and user-friendly manner. Moreover, they are conceived to be intelligent, to be able to learn and adapt to the requirements and requests of the assisted people, and to synchronise with their specific needs. Nevertheless, to ensure the uptake of AAL in society, potential users must be willing to use AAL applications and to integrate them in their daily environments and lives. In this respect, video- and audio-based AAL applications have several advantages, in terms of unobtrusiveness and information richness. Indeed, cameras and microphones are far less obtrusive with respect to the hindrance other wearable sensors may cause to one’s activities. In addition, a single camera placed in a room can record most of the activities performed in the room, thus replacing many other non-visual sensors. Currently, video-based applications are effective in recognising and monitoring the activities, the movements, and the overall conditions of the assisted individuals as well as to assess their vital parameters. Similarly, audio sensors have the potential to become one of the most important modalities for interaction with AAL systems, as they can have a large range of sensing, do not require physical presence at a particular location and are physically intangible. Moreover, relevant information about individuals’ activities and health status can derive from processing audio signals. Nevertheless, as the other side of the coin, cameras and microphones are often perceived as the most intrusive technologies from the viewpoint of the privacy of the monitored individuals. This is due to the richness of the information these technologies convey and the intimate setting where they may be deployed. Solutions able to ensure privacy preservation by context and by design, as well as to ensure high legal and ethical standards are in high demand. After the review of the current state of play and the discussion in GoodBrother, we may claim that the first solutions in this direction are starting to appear in the literature. A multidisciplinary debate among experts and stakeholders is paving the way towards AAL ensuring ergonomics, usability, acceptance and privacy preservation. The DIANA, PAAL, and VisuAAL projects are examples of this fresh approach. This report provides the reader with a review of the most recent advances in audio- and video-based monitoring technologies for AAL. It has been drafted as a collective effort of WG3 to supply an introduction to AAL, its evolution over time and its main functional and technological underpinnings. In this respect, the report contributes to the field with the outline of a new generation of ethical-aware AAL technologies and a proposal for a novel comprehensive taxonomy of AAL systems and applications. Moreover, the report allows non-technical readers to gather an overview of the main components of an AAL system and how these function and interact with the end-users. The report illustrates the state of the art of the most successful AAL applications and functions based on audio and video data, namely lifelogging and self-monitoring, remote monitoring of vital signs, emotional state recognition, food intake monitoring, activity and behaviour recognition, activity and personal assistance, gesture recognition, fall detection and prevention, mobility assessment and frailty recognition, and cognitive and motor rehabilitation. For these application scenarios, the report illustrates the state of play in terms of scientific advances, available products and research project. The open challenges are also highlighted. The report ends with an overview of the challenges, the hindrances and the opportunities posed by the uptake in real world settings of AAL technologies. In this respect, the report illustrates the current procedural and technological approaches to cope with acceptability, usability and trust in the AAL technology, by surveying strategies and approaches to co-design, to privacy preservation in video and audio data, to transparency and explainability in data processing, and to data transmission and communication. User acceptance and ethical considerations are also debated. Finally, the potentials coming from the silver economy are overviewed
Minimal information for studies of extracellular vesicles (MISEV2023): From basic to advanced approaches
Extracellular vesicles (EVs), through their complex cargo, can reflect the state of their cell of origin and change the functions and phenotypes of other cells. These features indicate strong biomarker and therapeutic potential and have generated broad interest, as evidenced by the steady year-on-year increase in the numbers of scientific publications about EVs. Important advances have been made in EV metrology and in understanding and applying EV biology. However, hurdles remain to realising the potential of EVs in domains ranging from basic biology to clinical applications due to challenges in EV nomenclature, separation from non-vesicular extracellular particles, characterisation and functional studies. To address the challenges and opportunities in this rapidly evolving field, the International Society for Extracellular Vesicles (ISEV) updates its 'Minimal Information for Studies of Extracellular Vesicles', which was first published in 2014 and then in 2018 as MISEV2014 and MISEV2018, respectively. The goal of the current document, MISEV2023, is to provide researchers with an updated snapshot of available approaches and their advantages and limitations for production, separation and characterisation of EVs from multiple sources, including cell culture, body fluids and solid tissues. In addition to presenting the latest state of the art in basic principles of EV research, this document also covers advanced techniques and approaches that are currently expanding the boundaries of the field. MISEV2023 also includes new sections on EV release and uptake and a brief discussion of in vivo approaches to study EVs. Compiling feedback from ISEV expert task forces and more than 1000 researchers, this document conveys the current state of EV research to facilitate robust scientific discoveries and move the field forward even more rapidly
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