Recognition of false alarms in fall detection systems

Falls are a major cause of hospitalization and injury-related deaths among the elderly population. The detrimental effects of falls, as well as the negative impact on health services costs, have led to a great interest on fall detection systems by the health-care industry. The most promising approaches are those based on a wearable device that monitors the movements of the patient, recognizes a fall and triggers an alarm. Unfortunately such techniques suffer from the problem of false alarms: some activities of daily living are erroneously reported as falls, thus reducing the confidence of the user. This paper presents a novel approach for improving the detection accuracy which is based on the idea of identifying specific movement patterns into the acceleration data. Using a single accelerometer, our system can recognize these patterns and use them to distinguish activities of daily living from real falls; thus the number of false alarms is reduced

Usability study of a wireless monitoring system among Alzheimer's Disease elderly population

Healthcare technologies are slowly entering into our daily lives, replacing old devices and techniques with newer intelligent ones. Although they are meant to help people, the reaction and willingness to use such new devices by the people can be unexpected, especially among the elderly. We conducted a usability study of a fall monitoring system in a long-term nursing home. The subjects were the elderly with advanced Alzheimer’s disease. The study presented here highlights some of the challenges faced in the use of wearable devices and the lessons learned. The results gave us useful insights, leading to ergonomics and aesthetics modifications to our wearable systems that significantly improved their usability and acceptance. New evaluating metrics were designed for the performance evaluation of usability and acceptability

Interleukin-1 regulates multiple atherogenic mechanisms in response to fat feeding

Background: Atherosclerosis is an inflammatory process that develops in individuals with known risk factors that include hypertension and hyperlipidaemia, influenced by diet. However, the interplay between diet, inflammatory mechanisms and vascular risk factors requires further research. We hypothesised that interleukin-1 (IL-1) signaling in the vessel wall would raise arterial blood pressure and promote atheroma. Methodology/Principal Findings: Apoe(-/-) and Apoe(-/-)/IL-1R1(-/-) mice were fed high fat diets for 8 weeks, and their blood pressure and atherosclerosis development measured. Apoe(-/-)/IL-R1(-/-) mice had a reduced blood pressure and significantly less atheroma than Apoe(-/-) mice. Selective loss of IL-1 signaling in the vessel wall by bone marrow transplantation also reduced plaque burden (p<0.05). This was associated with an IL-1 mediated loss of endothelium-dependent relaxation and an increase in vessel wall Nox 4. Inhibition of IL-1 restored endothelium-dependent vasodilatation and reduced levels of arterial oxidative stress. Conclusions/Significance: The IL-1 cytokine system links atherogenic environmental stimuli with arterial inflammation, oxidative stress, increased blood pressure and atherosclerosis. This is the first demonstration that inhibition of a single cytokine can block the rise in blood pressure in response to an environmental stimulus. IL-1 inhibition may have profound beneficial effects on atherogenesis in man

Ethical Criteria for the Admission and Management of Patients in the ICU Under Conditions of Limited Medical Resources: A Shared International Proposal in View of the COVID-19 Pandemic

Introduction The present pandemic has exposed us to unprecedented challenges that need to be addressed not just for the current state, but also for possible future similar occurrences. It is worth pointing out that discussions on the allocation of medical resources may not necessarily refer to an exception, but, unfortunately, to a regular condition for a large part of humanity (1). The criteria for admission to an Intensive Care Unit (ICU) setting generally take into account multiple factors. There must be a diagnostic and prognostic basis for the decisions made, considering both biological factors and patient values and wishes. Furthermore, the decision-making process should, whenever possible, respect the patient's advance directives as well as the relationship with the patient's family or attorney. Therapeutic neglect should be avoided. Having applied standard clinical evaluation criteria for the appropriate treatment of patients with COVID-19, including consideration of prognosis, if a hospital then finds itself unable to provide optimal treatment (e.g., due to a disproportion between the number of patients and the availability of beds, healthcare providers, ventilators, and drugs in the ICU), it becomes necessary to evaluate, case by case, how to achieve justice and the best possible good for the greatest number of patients. It is therefore mandatory to explore alternative solutions; these include increasing available beds and healthcare providers, implementing alternative, though suboptimal, approaches (where appropriate), transferring patients to other clinical units, etc. Making these decisions properly also involves the recovery of the political role of medicine and science (2). If the imbalance between needs and resources reaches a critical level, an emergency triage protocol, following the operational and ethical indications of “disaster medicine,” should be activated. These have been deployed in major and serious natural (earthquakes or tsunamis for example) and technological (factory explosions, public transport accidents for example) disasters, as well as following terrorist attacks (3, 4). The question of the feasibility of developing a clinical evaluation algorithm to support the decision-making of the triage team remains open, though many such protocols have been written. According to the above, we propose the following five ethical criteria for the triage of patients in conditions of limited resources, such as the COVID pandemic. They are the result of an interdisciplinary and intercultural dialogue between specialists from different disciplines. Several of the authors are working in the main epicenters of the crisis and currently are playing a central role in the bioethical, clinical, social and legal aspects of the management of the COVID-19 pandemic

Pathways to eating disorder care: a European multicenter study

Background: The aim of this study was to assess barriers and facilitators in the pathways toward specialist care for eating disorders (EDs). Methods: Eleven ED services located in seven European countries recruited patients with an ED. Clinicians administered an adapted version of the World Health Organization "Encounter Form," a standardized tool to assess the pathways to care. The unadjusted overall time needed to access the ED unit was described using the Kaplan-Meier curve. Results: Four-hundred-nine patients were recruited. The median time between the onset of the current ED episode and the access to a specialized ED care was 2 years. Most of the participants did not directly access the specialist ED unit: primary "points of access" to care were mental health professionals and general practitioners. The involvement of different health professionals in the pathway, seeking help for general psychiatric symptoms, and lack of support from family members were associated with delayed access to ED units. Conclusions: Educational programs aiming to promote early diagnosis and treatment for EDs should pay particular attention to general practitioners, in addition to mental health professionals, and family members to increase awareness of these illnesses and of their treatment initiation process

From ARPANET to Internet: A history of ARPA-sponsored computer networks, 1966-1988

The ARPANET and Internet were pioneering computer networks that established the technical groundwork and social expectations for wide-area networking in the United States today. Created by the U.S. Defense Advanced Research Projects Agency (ARPA), the ARPANET was a testing ground for innovative concepts such as packet switching, distributed topology and routing, and the connection of heterogeneous computer systems. ARPA dealt with the complexities of this project using a management style that fostered collegial interaction and a technical strategy known as layering that allowed network components to be developed independently. The highly visible success of the ARPANET brought its techniques into the computer science mainstream and made it an influential model for subsequent research and commercial networks. ARPA followed the ARPANET with experimental packet radio and satellite networks; the need to connect these diverse systems led ARPA to begin its Internet Program, which developed techniques for interconnecting networks. These techniques were used to connect other research networks to the ARPANET, forming the basis for today\u27s Internet, a worldwide network of networks. The ARPANET and Internet were socially constructed artifacts whose design was shaped by the interests and worldviews of their creators. Different networking techniques had different implications for the performance, economics, and social dynamics of the resulting system, so that technical choices can be understood as trade-offs between competing values. Analysis of the ARPANET design decisions reveals how the network was shaped by social considerations such as a preference for decentralized organization and a concern for military survivability. Network users were also instrumental in constructing the ARPANET\u27s identity: their unexpected enthusiasm for electronic mail turned a system intended primarily for remote computing into a medium for communication between people. The social values embodied in the ARPANET and Internet are further illuminated by contrast with alternative networking systems representing different social aims and interests that were introduced in the 1970s by international standards organizations

From ARPANET to Internet: A history of ARPA-sponsored computer networks, 1966-1988

The ARPANET and Internet were pioneering computer networks that established the technical groundwork and social expectations for wide-area networking in the United States today. Created by the U.S. Defense Advanced Research Projects Agency (ARPA), the ARPANET was a testing ground for innovative concepts such as packet switching, distributed topology and routing, and the connection of heterogeneous computer systems. ARPA dealt with the complexities of this project using a management style that fostered collegial interaction and a technical strategy known as layering that allowed network components to be developed independently. The highly visible success of the ARPANET brought its techniques into the computer science mainstream and made it an influential model for subsequent research and commercial networks. ARPA followed the ARPANET with experimental packet radio and satellite networks; the need to connect these diverse systems led ARPA to begin its Internet Program, which developed techniques for interconnecting networks. These techniques were used to connect other research networks to the ARPANET, forming the basis for today\u27s Internet, a worldwide network of networks. The ARPANET and Internet were socially constructed artifacts whose design was shaped by the interests and worldviews of their creators. Different networking techniques had different implications for the performance, economics, and social dynamics of the resulting system, so that technical choices can be understood as trade-offs between competing values. Analysis of the ARPANET design decisions reveals how the network was shaped by social considerations such as a preference for decentralized organization and a concern for military survivability. Network users were also instrumental in constructing the ARPANET\u27s identity: their unexpected enthusiasm for electronic mail turned a system intended primarily for remote computing into a medium for communication between people. The social values embodied in the ARPANET and Internet are further illuminated by contrast with alternative networking systems representing different social aims and interests that were introduced in the 1970s by international standards organizations

MIMS: A Minimally Invasive Monitoring Sensor Platform

This paper describes a minimally invasive sensor platform for active and passive monitoring of human movements and physiological signals. Such a system is needed in cases where 24 #x00D7; 7 monitoring is required, as in older adults with cognitive impairment, dementia and Alzheimer's disease. The passive monitoring systems used today are useful only in detecting events after they happen; the accuracy and speed of detection is questionable. The noninvasive nature of such systems does not bring trade off benefits to early detection and prevention of emergency incidents. We compare some existing sensor platforms and present our monitoring approach using minimally invasive wearable sensor device(s). With a Minimally Invasive Monitoring Sensor (MIMS), using advanced intelligent systems, we analyze the physiological signal data preceding potential emergency events in order to predict them quickly. The Virtual Hub is the core component of MIMS, which acts as a gateway between a monitored person and her/his caregivers, as well as a shared access point between active and passive sensing devices. Some preliminary results are presented here from our sleep-related fall study using two heterogeneous sensor systems