TV interaction as a non-invasive sensor for monitoring elderly well-being at home

The number of technical solutions to remotely monitoring elderly citizens and detecting hazard situations has been increasing in the last few years. These solutions have dual purposes: to provide a feeling of safety to the elderly and to inform their relatives about potential risky situations, such as falls, forgotten medication, and other unexpected deviations from daily routine. Most of these solutions are based on IoT (Internet of Things) and dedicated sensors that need to be installed at the elderly’s houses, hampering mass adoption. This justifies the search for non-invasive technical alternatives with smooth integration that relying only on existent devices, without the need for any additional installations. Therefore, this paper presents the SecurHome TV ecosystem, a technical solution based on the elderly’s interactions with their TV sets—one of the most used devices in their daily lives—acting as a non-invasive sensor enabling one to detect potential hazardous situations through an elaborated warning algorithm. Thus, this paper describes in detail the SecurHome TV ecosystem, with special emphasis on the warning algorithm, and reports on its validation process. We conclude that notwithstanding some constraints while setting the user’s pattern, either upon the cold start of the application or after an innocuous change in the user’s TV routine, the algorithm detects most hazardous situations contributing to monitor elderly well-being at home

Development of an anomaly alert system triggered by unusual behaviors at home

In many countries, the number of elderly people has grown due to the increase in the life expectancy of the population, many of whom currently live alone and are prone to having accidents that they cannot report, especially if they are immobilized. For this reason, we have developed a non-intrusive IoT device, which, through multiple integrated sensors, collects information on habitual user behavior patterns and uses it to generate unusual behavior rules. These rules are used by our SecurHome system to send alert messages to the dependent person's family members or caregivers if their behavior changes abruptly over the course of their daily life. This document describes in detail the design and development of the SecurHome system.SecurHome is a multidisciplinary research project on ageing in the framework of the International Centre on Ageing (CENIE). It is a project evaluated by the Spanish State Agency for Research and co-financed by the European Regional Development Fund in the framework of the Interreg V-A Spain–Portugal Cooperation Programme (POCTEP) 2014–2020

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Development of an Anomaly Alert System Triggered by Unusual Behaviors at Home

In many countries, the number of elderly people has grown due to the increase in the life expectancy of the population, many of whom currently live alone and are prone to having accidents that they cannot report, especially if they are immobilized. For this reason, we have developed a non-intrusive IoT device, which, through multiple integrated sensors, collects information on habitual user behavior patterns and uses it to generate unusual behavior rules. These rules are used by our SecurHome system to send alert messages to the dependent person’s family members or caregivers if their behavior changes abruptly over the course of their daily life. This document describes in detail the design and development of the SecurHome system

TV Interaction as a Non-Invasive Sensor for Monitoring Elderly Well-Being at Home

The number of technical solutions to remotely monitoring elderly citizens and detecting hazard situations has been increasing in the last few years. These solutions have dual purposes: to provide a feeling of safety to the elderly and to inform their relatives about potential risky situations, such as falls, forgotten medication, and other unexpected deviations from daily routine. Most of these solutions are based on IoT (Internet of Things) and dedicated sensors that need to be installed at the elderly’s houses, hampering mass adoption. This justifies the search for non-invasive technical alternatives with smooth integration that relying only on existent devices, without the need for any additional installations. Therefore, this paper presents the SecurHome TV ecosystem, a technical solution based on the elderly’s interactions with their TV sets—one of the most used devices in their daily lives—acting as a non-invasive sensor enabling one to detect potential hazardous situations through an elaborated warning algorithm. Thus, this paper describes in detail the SecurHome TV ecosystem, with special emphasis on the warning algorithm, and reports on its validation process. We conclude that notwithstanding some constraints while setting the user’s pattern, either upon the cold start of the application or after an innocuous change in the user’s TV routine, the algorithm detects most hazardous situations contributing to monitor elderly well-being at home

Characteristics and Outcomes in Patients With COVID-19 and Acute Ischemic Stroke The Global COVID-19 Stroke Registry

International audienceRecent case-series of small size implied a pathophysiological association between coronavirus disease 2019 (COVID-19) and severe large-vessel acute ischemic stroke. Given that severe strokes are typically associated with poor prognosis and can be very efficiently treated with recanalization techniques, confirmation of this putative association is urgently warranted in a large representative patient cohort to alert stroke clinicians, and inform pre- and in-hospital acute stroke patient pathways. We pooled all consecutive patients hospitalized with laboratory-confirmed COVID-19 and acute ischemic stroke in 28 sites from 16 countries. To assess whether stroke severity and outcomes (assessed at discharge or at the latest assessment for those patients still hospitalized) in patients with acute ischemic stroke are different between patients with COVID-19 and non-COVID-19, we performed 1:1 propensity score matching analyses of our COVID-19 patients with non-COVID-19 patients registered in the Acute Stroke Registry and Analysis of Lausanne Registry between 2003 and 2019. Between January 27, 2020, and May 19, 2020, 174 patients (median age 71.2 years; 37.9% females) with COVID-19 and acute ischemic stroke were hospitalized (median of 12 patients per site). The median National Institutes of Health Stroke Scale was 10 (interquartile range [IQR], 4-18). In the 1:1 matched sample of 336 patients with COVID-19 and non-COVID-19, the median National Institutes of Health Stroke Scale was higher in patients with COVID-19 (10 [IQR, 4-18] versus 6 [IQR, 3-14]), P=0.03; (odds ratio, 1.69 [95% CI, 1.08-2.65] for higher National Institutes of Health Stroke Scale score). There were 48 (27.6%) deaths, of which 22 were attributed to COVID-19 and 26 to stroke. Among 96 survivors with available information about disability status, 49 (51%) had severe disability at discharge. In the propensity score-matched population (n=330), patients with COVID-19 had higher risk for severe disability (median mRS 4 [IQR, 2-6] versus 2 [IQR, 1-4], P<0.001) and death (odds ratio, 4.3 [95% CI, 2.22-8.30]) compared with patients without COVID-19. Our findings suggest that COVID-19 associated ischemic strokes are more severe with worse functional outcome and higher mortality than non-COVID-19 ischemic strokes

Reduction of cardiac imaging tests during the COVID-19 pandemic: The case of Italy. Findings from the IAEA Non-invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID)

Background: In early 2020, COVID-19 massively hit Italy, earlier and harder than any other European country. This caused a series of strict containment measures, aimed at blocking the spread of the pandemic. Healthcare delivery was also affected when resources were diverted towards care of COVID-19 patients, including intensive care wards. Aim of the study: The aim is assessing the impact of COVID-19 on cardiac imaging in Italy, compare to the Rest of Europe (RoE) and the World (RoW). Methods: A global survey was conducted in May–June 2020 worldwide, through a questionnaire distributed online. The survey covered three periods: March and April 2020, and March 2019. Data from 52 Italian centres, a subset of the 909 participating centres from 108 countries, were analyzed. Results: In Italy, volumes decreased by 67% in March 2020, compared to March 2019, as opposed to a significantly lower decrease (p &lt; 0.001) in RoE and RoW (41% and 40%, respectively). A further decrease from March 2020 to April 2020 summed up to 76% for the North, 77% for the Centre and 86% for the South. When compared to the RoE and RoW, this further decrease from March 2020 to April 2020 in Italy was significantly less (p = 0.005), most likely reflecting the earlier effects of the containment measures in Italy, taken earlier than anywhere else in the West. Conclusions: The COVID-19 pandemic massively hit Italy and caused a disruption of healthcare services, including cardiac imaging studies. This raises concern about the medium- and long-term consequences for the high number of patients who were denied timely diagnoses and the subsequent lifesaving therapies and procedures

Impact of COVID-19 on Diagnostic Cardiac Procedural Volume in Oceania: The IAEA Non-Invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID)

Objectives: The INCAPS COVID Oceania study aimed to assess the impact caused by the COVID-19 pandemic on cardiac procedure volume provided in the Oceania region. Methods: A retrospective survey was performed comparing procedure volumes within March 2019 (pre-COVID-19) with April 2020 (during first wave of COVID-19 pandemic). Sixty-three (63) health care facilities within Oceania that perform cardiac diagnostic procedures were surveyed, including a mixture of metropolitan and regional, hospital and outpatient, public and private sites, and 846 facilities outside of Oceania. The percentage change in procedure volume was measured between March 2019 and April 2020, compared by test type and by facility. Results: In Oceania, the total cardiac diagnostic procedure volume was reduced by 52.2% from March 2019 to April 2020, compared to a reduction of 75.9% seen in the rest of the world (p&lt;0.001). Within Oceania sites, this reduction varied significantly between procedure types, but not between types of health care facility. All procedure types (other than stress cardiac magnetic resonance [CMR] and positron emission tomography [PET]) saw significant reductions in volume over this time period (p&lt;0.001). In Oceania, transthoracic echocardiography (TTE) decreased by 51.6%, transoesophageal echocardiography (TOE) by 74.0%, and stress tests by 65% overall, which was more pronounced for stress electrocardiograph (ECG) (81.8%) and stress echocardiography (76.7%) compared to stress single-photon emission computerised tomography (SPECT) (44.3%). Invasive coronary angiography decreased by 36.7% in Oceania. Conclusion: A significant reduction in cardiac diagnostic procedure volume was seen across all facility types in Oceania and was likely a function of recommendations from cardiac societies and directives from government to minimise spread of COVID-19 amongst patients and staff. Longer term evaluation is important to assess for negative patient outcomes which may relate to deferral of usual models of care within cardiology