RFID Technology for Management and Tracking: e-Health Applications

Radio frequency identification (RFID) has become a key technology in the logistics and management industry, thanks to distinctive features such as the low cost of RFID tags, and the easiness of the RFID tags’ deployment and integration within the items to be tracked. In consequence, RFID plays a fundamental role in the so-called digital factory or 4.0 Industry, aiming to increase the level of automatization of industrial processes. In addition, RFID has also been found to be of great help in improving the tracking of patients, medicines, and medical assets in hospitals, where the digitalization of these operations improves their efficiency and safety. This contribution reviews the state-of-the-art of RFID for e-Health applications, describing the contributions to improve medical services and discussing the limitations. In particular, it has been found that a lot of effort has been put into software development, but in most of the cases a detailed study of the physical layer (that is, the characterization of the RFID signals within the area where the system is deployed) is not properly conducted. This contribution describes a basic RFID system for tracking and managing assets in hospitals, aiming to provide additional details about implementation aspects that must be considered to ensure proper functionality of the system. Although the scope of the RFID system described in this contribution is restricted to a small area of the hospital, the architecture is fully scalable to cover the needs of the different medical services in the hospital. Ultra high-frequency (UHF) RFID technology is selected over the most extended near-field communication (NFC) and high-frequency (HF) RFID technology to minimize hardware infrastructure. In particular, UHF RFID also makes the coverage/reading area conformation easier by using different kinds of antennas. Information is stored in a database, which is accessed from end-user mobile devices (tablets, smartphones) where the position and status of the assets to be tracked are displayed

Neuroimaging in Functional Neurological Disorder: State of the Field and Research Agenda.

Functional neurological disorder (FND) was of great interest to early clinical neuroscience leaders. During the 20th century, neurology and psychiatry grew apart - leaving FND a borderland condition. Fortunately, a renaissance has occurred in the last two decades, fostered by increased recognition that FND is prevalent and diagnosed using "rule-in" examination signs. The parallel use of scientific tools to bridge brain structure - function relationships has helped refine an integrated biopsychosocial framework through which to conceptualize FND. In particular, a growing number of quality neuroimaging studies using a variety of methodologies have shed light on the emerging pathophysiology of FND. This renewed scientific interest has occurred in parallel with enhanced interdisciplinary collaborations, as illustrated by new care models combining psychological and physical therapies and the creation of a new multidisciplinary FND society supporting knowledge dissemination in the field. Within this context, this article summarizes the output of the first International FND Neuroimaging Workgroup meeting, held virtually, on June 17th, 2020 to appraise the state of neuroimaging research in the field and to catalyze large-scale collaborations. We first briefly summarize neural circuit models of FND, and then detail the research approaches used to date in FND within core content areas: cohort characterization; control group considerations; task-based functional neuroimaging; resting-state networks; structural neuroimaging; biomarkers of symptom severity and risk of illness; and predictors of treatment response and prognosis. Lastly, we outline a neuroimaging-focused research agenda to elucidate the pathophysiology of FND and aid the development of novel biologically and psychologically-informed treatments

Trasplante hepático en el Principado de Asturias en el Principado de Asturias en el período 2002-2017: análisis de indicaciones y resultados

Tesis realizada en la Universidad de OviedoEste trabajo doctoral estudió los trasplantes hepáticos en el HUCA entre 2002 y 2017 para conocer el perfil de los pacientes, así como las causas de las dolencias, las características de las cirugías y realizar un seguimiento de los resultados de las intervenciones.MINISTERIO DE ECONOMÍA, INDUSTRIA Y COMPETITIVIDAD * FECYT * UCC+

Trasplante hepático en el Principado de Asturias en el período 2002-2017: análisis de indicaciones y resultados

Se considera indicado el trasplante hepático (TH) en pacientes con hepatopatías agudas o crónicas cuando se hayan agotado otras alternativas terapéuticas y cuando la esperanza de vida estimada sea inferior al año a la que se prevea con el trasplante. Desde el desarrollo de las técnicas de cirugía vascular por Alexis Carrel, las cuales dieron lugar al comienzo de los trasplantes de órganos sólidos, pasando por los primeros TH experimentales en perros por Staudacher se realizaron los primeros trasplantes de hígado en humanos en 1963. A partir de este estudio ha sido posible extrapolar que los datos obtenidos a nivel autonómico coinciden con la media nacional, tanto en lo asimilable al receptor como al donante, en aspectos de edad, sexo, y causa de TH, así como causa de muerte encefálica que llevo a la donación. Otra conclusión de dicho estudio ha sido que la tasa de retrasplante de Asturias es ligeramente superior a la media nacional (8,1% frente a 5,5% de España)

Profile of Liver Transplant Recipient in a Tertiary Hospital in Northern Spain

Spain has the highest rates of liver transplantation (LT) per million inhabitants in the world, with the profiles of both donors and recipients in Asturias, a region in northern Spain, being different from the rest of the country. The main goal of this study was to carry out a preliminary analysis of the characteristics of LT recipients in Asturias, as well as of the basic characteristics of surgery and the postoperative period, and to discuss whether the results obtained in this study were comparable to what is described in the literature. This was a retrospective, descriptive, cross-sectional study, analyzing the LT carried out in a reference center of Asturias between 2002 and 2017. Relative and absolute frequency distributions for qualitative variables are provided, as are position and dispersion measures for quantitative variables. Using the multivariate Cox regression model, the prognostic factors associated with overall survival were determined. A total of 533 LTs were analyzed; 431 were men and 102 were women. The mean age was 55.1 years, concentrated between 40 and 69 years for both genders. LT was performed for chronic parenchymal liver disease (mostly of alcoholic etiology) and the recipients underwent surgery in an advanced stage of liver disease. Of these recipients, 8.1% (43 patients) were retransplantions, 65.1% in the first year due to primary graft dysfunction and complete hepatic artery thrombosis. Most patients had presented a grade II of Clavien−Dindo as the most frequent complication. Biliary complications were found in 12.3% of patients, with the main cause of death in the first 30 days being instability in the 24 h after LT. The median survival of the group was 13 years, with a 5-year survival probability of 79.3% and a 10-year survival probability of 61.9%. In view of the analyzed series, it can be concluded that the most frequent recipient profile was a male patient (mean age 55 years), with a significant alcohol habit, who was overweight, with chronic parenchymal liver disease of alcoholic or viral etiology, and who had reached the Child C stage before LT. This study could lay the foundations for future studies, to complete this analysis with the characteristics of LT surgery, its postoperative period, and the follow-up after discharge, to obtain a broader view of LT recipients in this region

Surgical site infection after gastrointestinal surgery in children : an international, multicentre, prospective cohort study

Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45 center dot 1%) children were from high HDI, 397 (34 center dot 2%) from middle HDI and 239 (20 center dot 6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12 center dot 8% (51/397) in middle HDI and 24 center dot 7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.Peer reviewe

Use of Telemedicine for Post-discharge Assessment of the Surgical Wound: International Cohort Study, and Systematic Review with Meta-analysis

Objective: This study aimed to determine whether remote wound reviews using telemedicine can be safely upscaled, and if standardised assessment tools are needed. Summary background data: Surgical site infection is the most common complication of surgery worldwide, and frequently occurs after hospital discharge. Evidence to support implementation of telemedicine during postoperative recovery will be an essential component of pandemic recovery. Methods: The primary outcome of this study was surgical site infection reported up to 30-days after surgery (SSI), comparing rates reported using telemedicine (telephone and/or video assessment) to those with in-person review. The first part of this study analysed primary data from an international cohort study of adult patients undergoing abdominal surgery who were discharged from hospital before 30-days after surgery. The second part combined this data with the results of a systematic review to perform a meta-analysis of all available data conducted in accordance with PRIMSA guidelines (PROSPERO:192596). Results: The cohort study included 15,358 patients from 66 countries (8069 high, 4448 middle, 1744 low income). Of these, 6907 (45.0%) were followed up using telemedicine. The SSI rate reported using telemedicine was slightly lower than with in-person follow-up (13.4% vs. 11.1%, P<0.001), which persisted after risk adjustment in a mixed-effects model (adjusted odds ratio: 0.73, 95% confidence interval 0.63-0.84, P<0.001). This association was consistent across sensitivity and subgroup analyses, including a propensity-score matched model. In nine eligible non-randomised studies identified, a pooled mean of 64% of patients underwent telemedicine follow-up. Upon meta-analysis, the SSI rate reported was lower with telemedicine (odds ratio: 0.67, 0.47-0.94) than in-person (reference) follow-up (I2=0.45, P=0.12), although there a high risk of bias in included studies. Conclusions: Use of telemedicine to assess the surgical wound post-discharge is feasible, but risks underreporting of SSI. Standardised tools for remote assessment of SSI must be evaluated and adopted as telemedicine is upscaled globally

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world