A Thermal and Energy Aware Framework with Physiological Safety Considerations for Internet of Things in Healthcare and Medical Applications

Healthcare, lifestyle, and medical applications of Internet of Things (IoT) involve the use of wearable technology that employs sensors of various kinds to sense human physiological parameters such as steps walked, body temperature, blood pressure, heart rate and other cardiac parameters. Such sensors and associated actuators can be worn as gadgets, embedded in clothing, worn as patches in contact with the body and could even be implanted inside the body. These sensors are electronic, and any electronic activity during their sensing, processing and wireless transmission is associated with the generation of heat. This dissipated heat can cause discomfort to the subject and has the potential of damaging healthy living tissue and cells. In the proposed work, the author does a performance check on the intrinsic safety aspects of an IoT healthcare network with respect to the functioning of the wireless sensors involved and routing of sensor data samples. The author also suggests an optimized thermal and energy aware framework to address the issue of temperature rise due to processing and data transmission from sensors through signal processing approaches that help in reducing thermal hazards and simultaneously enhancing the network lifetime through energy conservation

Delayed Treatment Response in a Neonate with Multisystem Langerhans Cell Histiocytosis : Case report and review of literature

Langerhans cell histiocytosis (LCH) is a rare proliferative disorder of the Langerhans cells, which are part of the mononuclear phagocytic system. The disorder varies in terms of the extent of the disease, its natural course and patient outcomes. While skin rashes are a common presentation of neonatal LCH, other systems or organs may also be involved. Delays in the diagnosis of neonatal LCH may occur due to its non-specific presentation and a lack of awareness of the condition among doctors. We report a two-month-old male neonate who presented to the Chacha Nehru Bal Chikitsalya hospital, New Delhi, India, in 2016 after the onset of pulmonary symptoms. He had been noted to have a generalised rash which had progressively worsened from 15 days of age. Following a skin biopsy and chest imaging, he was diagnosed with multisystem LCH with risk organ involvement. There was a delayed response to combined chemotherapy with no major side-effects

A Cross-Layer Design Approach to Enhance 802.15.4

The low-power communication in wireless sensor networks can be impacted by severe channel impairments. In this paper, to address this problem and achieve high network goodput, we propose that the medium access control protocol takes into consideration the error performance of the underlying wireless links. We combine a distributed back-off strategy regulated by the wireless link quality with Carrier Sense Multiple Access with Collision Avoidance. We integrate our cross-layer operational approach in the IEEE 802.15.4 standard, taking advantage of existing functionality and signaling to avoid network overhead and achieve simplicity in implementation. Our performance evaluation indicates that our scheme is more effective, achieving up to 69% higher goodput, and more efficient, delivering up to 154% more data bits per unit of energy consumed in the network, at the expense of an up to 18% degradation in fairness, compared to the basic 802.15.4

Enhancing Wireless Spectrum Utilization with a Cellular-Ad Hoc Overlay Architecture

The spectrum of deployed wireless cellular communication systems is found to be under-utilized, even though licensed spectrum is at a premium. In this paper, we design a system with an ad hoc overlay network, which we denote as the secondary system (SEC), to efficiently utilize the bandwidth left unused in a cellular system, which we denote as the primary system (PRI). The basic design principle is that the SEC operates in a non-intrusive manner and does not interact with the PRI. We develop the AS-MAC, an Ad hoc SEC Medium Access Control protocol to enable the interoperation of the PRI-SEC system. We address a number of technical challenges pertinent to this networking environment, and investigate a number of AS-MAC variants. Our performance evaluation results indicate that AS-MAC can transparently utilize up to 80% bandwidth left unused by the PRI

A Bandwidth Sharing Approach to Improve Licensed Spectrum Utilization

The spectrum of deployed wireless cellular communication systems is found to be under-utilized, even though licensed spectrum is at a premium. To efficiently utilize the bandwidth left unused in a cellular system, which we denote as the primary system (PRI), we design a system with an ad hoc overlay network, which we denote as the secondary system (SEC). The basic design principle is that the SEC operates in a nonintrusive manner and does not interact with the PRI. We develop the AS-MAC, an Ad hoc SEC Medium Access Control protocol to enable the interoperation of the PRI-SEC system. We address a number of technical challenges pertinent to this networking environment, and evaluate AS-MAC. Our performance evaluation results show that, in a single-hop ASN, the AS-MAC transparently utilizes 75% of the bandwidth left unused by the PRI, while, in multi-hop ASNs, due to spatial reuse, the AS-MAC can utilize up to 180% of the idle PRI resources

Iron therapy for preoperative anaemia

Preoperative anaemia is common and occurs in 5% to 76% of patients preoperatively. It is associated with an increased risk of perioperative allogeneic blood transfusion, longer hospital stay, and increased morbidity and mortality. Iron deficiency is one of the most common causes of anaemia. Oral and intravenous iron therapy can be used to treat anaemia. Parenteral iron preparations have been shown to be more effective in conditions such as inflammatory bowel disease, chronic heart failure and postpartum haemorrhage due to rapid correction of iron stores. A limited number of studies has investigated iron therapy for the treatment of preoperative anaemia. The aim of this Cochrane Review is to summarise the evidence for iron supplementation, both enteral and parenteral, for the management of preoperative anaemia. Objectives To evaluate the effects of preoperative iron therapy (enteral or parenteral) in reducing the need for allogeneic blood transfusions in anaemic patients undergoing surgery. Search methods We ran the search on 30 July 2018. We searched the Cochrane Injuries Group's Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL, the Cochrane Library), Ovid MEDLINE(R), Ovid MEDLINE(R) In‐Process & Other Non‐Indexed Citations, Ovid MEDLINE(R) Daily and Ovid OLDMEDLINE(R), Embase Classic and Embase (Ovid), CINAHL Plus (EBSCO), PubMed, and clinical trials registries, and we screened reference lists. We ran a top‐up search on 28 November 2019; one study is now awaiting classification. Selection criteria We included all randomised controlled trials (RCTs) that compared preoperative iron monotherapy to placebo, no treatment, standard care or another form of iron therapy for anaemic adults undergoing surgery. We defined anaemia as haemoglobin values less than 13 g/dL for males and 12 g/dL for non‐pregnant females. Data collection and analysis Two review authors collected data and a third review author checked all collected data. Data were collected on the proportion of patients who receive a blood transfusion, the amount of blood transfused per patient (units), quality of life, ferritin levels and haemoglobin levels, measured as continuous variables at the following predetermined time points: pretreatment (baseline), preoperatively but postintervention, and postoperatively. We performed statistical analysis using the Cochrane software, Review Manager 5. We summarised outcome data in tables and forest plots. We used the GRADE approach to describe the quality of the body of evidence. Main results Six RCTs, with a total of 372 participants, evaluated preoperative iron therapy to correct anaemia before planned surgery. Four studies compared iron therapy (either oral (one study) or intravenous (three studies)) with no treatment, placebo or usual care, and two studies compared intravenous iron therapy with oral iron therapy. Iron therapy was delivered over a range of periods that varied from 48 hours to three weeks prior to surgery. The 372 participants in our analysis fall far short of the 819 required ‐ as calculated by our information size calculation ‐ to detect a 30% reduction in blood transfusions. Five trials, involving 310 people, reported the proportion of participants who received allogeneic blood transfusions. Meta‐analysis of iron therapy versus placebo or standard care showed no difference in the proportion of participants who received a blood transfusion (risk ratio (RR) 1.21, 95% confidence interval (CI) 0.87 to 1.70; 4 studies, 200 participants; moderate‐quality evidence). Only one study that compared oral versus intravenous iron therapy measured this outcome, and reported no difference in risk of transfusion between groups. There was no difference between the iron therapy and placebo/standard care groups for haemoglobin level preoperatively at the end of the intervention (mean difference (MD) 0.63 g/dL, 95% CI ‐0.07 to 1.34; 2 studies, 83 participants; low‐quality evidence). However, intravenous iron therapy produced an increase in preoperative postintervention haemoglobin levels compared with oral iron (MD 1.23 g/dL, 95% CI 0.80 to 1.65; 2 studies, 172 participants; low‐quality evidence). Ferritin levels were increased by intravenous iron, both when compared to standard care ((MD 149.00, 95% CI 25.84 to 272.16; 1 study, 63 participants; low‐quality evidence) or to oral iron (MD 395.03 ng/mL, 95% CI 227.72 to 562.35; 2 studies, 151 participants; low‐quality evidence). Not all studies measured quality of life, short‐term mortality or postoperative morbidity. Some measured the outcomes, but did not report the data, and the studies which did report the data were underpowered. Therefore, uncertainty remains regarding these outcomes. The inclusion of new research in the future is very likely to change these results. Authors' conclusions The use of iron therapy for preoperative anaemia does not show a clinically significant reduction in the proportion of trial participants who received an allogeneic blood transfusion compared to no iron therapy. Results for intravenous iron are consistent with a greater increase in haemoglobin and ferritin when compared to oral iron, but do not provide reliable evidence. These conclusions are drawn from six studies, three of which included very small numbers of participants. Further, well‐designed, adequately powered, RCTs are required to determine the true effectiveness of iron therapy for preoperative anaemia. Two studies are currently in progress, and will include 1500 randomised participants.Published onlin