Non-continuous Monitoring Research Articles

Key Fundamentals and Examples of Sensors for Human Health: Wearable, Non-Continuous, and Non-Contact Monitoring Devices.

The increasing demand for personalized healthcare, particularly among individuals requiring continuous health monitoring, has driven significant advancements in sensor technology. Wearable, non-continuous monitoring, and non-contact sensors are leading this innovation, providing novel methods for monitoring vital signs and physiological data in both clinical and home settings. However, there is a lack of comprehensive comparative studies assessing the overall functionality of these technologies. This paper aims to address this gap by presenting a detailed comparative analysis of selected wearable, non-continuous monitoring, and non-contact sensors used for health monitoring. To achieve this, we conducted a comprehensive evaluation of various sensors available on the market, utilizing key indicators such as sensor performance, usability, associated platforms functionality, data management, battery efficiency, and cost-effectiveness. Our findings highlight the strengths and limitations of each sensor type, thus offering valuable insights for the selection of the most appropriate technology based on specific healthcare needs. This study has the potential to serve as a valuable resource for researchers, healthcare providers, and policymakers, contributing to a deeper understanding of existing user-centered health monitoring solutions.

Assessment of Environmental-induced Degradation on Reinforced Concrete Tie Rods in a 70-Year-Old Arch Bridge

Given the present landscape of existing bridges in Italy, a significant portion of which dates back to the mid-20th century, the need to conduct detailed investigations on the current deterioration state and on the safety of these infrastructures becomes indispensable. This work, focusing on a case study involving reinforced concrete tie rods removed from a 70-year-old arch bridge and preserved for mini-invasive diagnostics, addresses the critical need of estimating the current condition of these elements while verifying whether the common non-destructive techniques can be used to monitor the progress of deterioration. Both electrochemical measurements (e.g. corrosion potential and electrical resistivity) were used to detect the current corrosion conditions of steel bars; small core samples were also extracted to assess the presence of carbonation. In addition, this study allowed to investigate the effectiveness of the past restoration interventions, determining whether they achieved the designed outcomes. This research questions the effectiveness of these diagnostic measures to propose their repetition in situ for reliable, non-continuous monitoring of the structural health of these elements over time. The next steps involve visual inspection and mechanical characterization of the reinforcement to demonstrate the effectiveness of the diagnostics presented.

Low-Cost GNSS Solution for Continuous Monitoring of Slope Instabilities Applied to Madonna Del Sasso Sanctuary (NW Italy).

In recent years, the development of low-cost GNSS sensors allowed monitoring in a continuous way movement related to natural processes like landslides with increasing accuracy and limited efforts. In this work, we present the first results of an experimental low-cost GNSS continuous monitoring applied to an unstable slope affecting the Madonna del Sasso Sanctuary (NW Italy). The courtyard of Sanctuary is built on two unstable blocks delimited by a high cliff. Previous studies and non-continuous monitoring showed that blocks suffer a seasonal cycle of thermal expansion and a long-term trend to downslope a few millimeters (2/3) per year. The presence of a continuous monitoring solution could be an essential help to better understand the kinematics of unstable slope. Continuous monitoring could help to forecast a possible paroxysm phase that could end with a failure of the unstable area. The first year of experimental measurements shows a millimetric accuracy of low-cost GNSS, and the long-term trend is in agreement with other monitoring data. We also propose a methodological approach that considers the use of semi-automatized procedures for the identification of anomalous trends and a risk communication strategy. Pro and cons of the proposed methodology are also discussed.

The potential risk of sick building syndrome of the emergency department areas in a medical center in Taiwan

Background: Indoor air pollution is a constant problem in the current society, especially in the emergency department (ED). Dirty and polluted air in hospitals will reduce work efficiency of healthcare staff and could ultimately cause diseases and illness; some serious acute respiratory diseases are liable to become epidemics in the hospital. A solution to organize the medical working environment and prevent the underlying threat of nosocomial infection is becoming an increasingly important issue; therefore, a research project is designed to study the air quality in the ED of a medical center in Taiwan. Methods: Air quality measuring instruments were used three times a day for a non-continuous monitoring in the ED of the Taipei Mackay Memorial Hospital, including temperature, oxygen, carbon dioxide, ozone, total volatile organic compounds, suspended particulates (PM10) with a particle size of 10 microns or less, and formaldehyde. The emergency areas were classified into four types according to whether medical procedures were performed or not, is there confined space or not. The data collected from different ER zones were analyzed and compared. Results: The results showed that the oxygen concentration was higher than that of the general environment (20.9%) in all areas of the ED, while carbon dioxide concentration (CO 2 ) is also higher. The oxygen concentration of most places in ER exceeded 30%. The CO 2 concentration of each unit exceeds 700 ppm, especially in the internal and surgical ED, as well as the negative pressure isolation room, for which the value was close to 800 ppm (P 0.12 ppm) was detected in the nursing station the observation room and the research office. The highest concentration of ozone was also detected in the nursing station the observation room. As for the suspended particles (PM10) having a particle diameter of 10 µm or less, the level of each zone was quite low. There was a much lower concentration of volatile organic substances (VOCs) in the triage station, research office as well as corridors; while all other areas have exceeded 150 ppb. Conclusions: Our research indicates that the current emergency environment could be harmful to healthcare staff, and poor air quality in the ER is observed especially during busy hours, in older buildings, at intensive medical disposal areas and also in confined spaces. Some confined medical treatment spaces were prone to higher carbon dioxide (CO 2 ) concentrations that may cause fatigue and decrease of work efficiency. Therefore, improvement of air quality in ER and maintenance of emergency environment at the ideal air condition is significantly important. The ventilation of outdoor airflow and filtration of particles of the air conditioning systems should be thoughtfully planned as early as when designing an ER construction in order to avoid “sick building syndrome (SBS)”. That said, a healthier working environment to the ER staffs could ultimately bring more effective work and promote better medical quality.

Methods, accuracy and clinical implications of atrial fibrillation detection by cardiac implantable electronic devices

Atrial fibrillation (AF) is the most common arrhythmia in the developed countries and is associated with an increased risk of thromboembolic events and heart failure. Episodes of AF are often asymptomatic and intermittent, eluding diagnosis with non-continuous monitoring techniques. Cardiac implantable electronic devices (CIEDs) represent the gold standard for detecting asymptomatic AF. Improper CIED programming may however increase the risk of false-positive detection of atrial tachyarrhythmias, leading to inappropriate clinical management of patients. A faster rate and a longer duration of the tachyarrhythmic episodes, in addition to a greater AT/AF burden, have been proposed as potential criteria for differentiating between CIED-detected atrial tachyarrhythmias and true AF. Nonetheless, manual overreading of intracardiac electrograms recorded by the CIED remains crucial for a correct diagnosis. Asymptomatic atrial tachyarrhythmias may carry a higher risk of systemic thromboembolism, though clinical thromboembolic risk factors seem to play a greater if not absolute role in prognostication. In addition, there is no clear temporal relationship between CIED-detected atrial tachyarrhythmias and stroke, and the anticoagulation strategy to be pursued in these patients is still a matter of debate and the focus of current prospective randomized studies.

PROCEDURES FOR STAGE PROCESSING OF IRON-ORE WASTES IN INDUSTRIAL MINING AREAS

Authors substantiate development of management procedures for the step-by-step processing of iron ore wastes of mining regions that provide a full cycle of rational nature management through the introduction of waste-free and low-waste technologies, followed by reclamation and creation of recreation areas for people. Procedure for operating enterprises has been developed, that consists of structure and sequence of operation stages, sump recovery scheme, technological preparation of equipment, calendar plan. Stages are carried out in parallel and consist of waste recycling, reclamation, search, analysis and selection of tenders for recreational areas development. Waste processing and land reclamation are carried out during operation of mining enterprise. Commissioning of the territories intended for recreation of mining areas population is carried out after enterprise liquidation. Management of step-by-step processing of iron ore wastes for closed enterprises consists of the following stages: search for finance support for technogenic resources utilization and reclamation of disturbed land through the sale of available fixed assets (buildings, structures and equipment) and call for investments, including the state ones. In case of insufficient financing, part of iron ore waste is used as construction or packing material for reclamation. Management of the step-by-step processing of iron ore wastes for the projects under implementation includes non-continuous monitoring of man-made resources formation and land disturbance. When wastes are generated, an analysis of existing technologies aimed at their utilization and reclamation of disturbed lands is carried out. Non-continuous monitoring helps to prevent potential environmental damage. During operation of enterprise, step-by-step development of recreation zones is carried out with its subsequent commissioning after the enterprise liquidation. Based on the proposed management of step-by-step processing of iron ore waste, scenarios for waste-free and low-waste technologies introduction in the Tashtagol District of the Kemerovo Region have been developed. Their simulation was carried out in SciLab. The problem of processing scenarios ranking has been stated and solved.

I nuovi anticoagulanti orali e la loro gestione nella pratica clinica odontoiatrica

ObjectivesThe aim of this study is to assess the implications of Novel Oral Anticoagulants (NOA) on dental treatments, on the basis of the most recent literature. Materials and methodsStudies from the last five years have been evaluated to compare the effects of NOA with those of traditional anticoagulants in dental treatment. ResultsRapidity of onset, less pharmacological interactions, non-continuous monitoring requirements would make NOA more beneficial as compared to traditional anticoagulants, although furtherinvestigations are needed. ConclusionsLiterature supports the possibility of maintaining the therapy with NOA during most dental procedures.It is however important to define specific clinical criteria.

Does Catheter Ablation Eliminate the Need for Oral Anticoagulation?

Stroke and thromboembolism are recognized as one of the most serious complications of atrial fibrillation (AF) because they are associated with a substantial risk of morbidity and mortality.1 Oral anticoagulation (OAC) with warfarin is highly effective in preventing thromboembolic events in patients with AF.2 However, treatment with OAC necessitates frequent monitoring and dietary and drug restrictions and may be associated with serious side effects, of which hemorrhagic stroke is the most devastating. Therefore, adequate risk stratification of AF patients and meticulous evaluation of benefits and risks are mandatory. Various risk factors have been identified as contributing to the risk for stroke in AF and risk stratification schemes such as the CHADS2 score have been established and validated.3 Although this score identifies patients who benefit most and least from anticoagulation, the threshold for use of anticoagulation is controversial, especially for those at intermediate risk (stroke rate, 3% to 5% per year).4 Updated guidelines tend to an earlier anticoagulation strategy withholding OAC only in patients who are truly low risk.5 Article see p 615 The optimal anticoagulation treatment of patients undergoing successful AF catheter ablation is even less well defined. Limited data are available regarding the risk of thromboembolism with and without warfarin after AF ablation. Challenges arise from the definition of success, with noncontinuous monitoring techniques underestimating true arrhythmia recurrence rates,6 an increasing amount of asymptomatic AF after ablation,7 controversial data on long-term efficacy of AF catheter ablation,8,9 and on how much AF is necessary to provoke thromboembolic events. For these reasons, current recommendations rely on the patient's individual baseline thromboembolic risk irrespective of a potentially curative ablation procedure to decide on long-term anticoagulation strategies.5,10 Patients having a CHADS2 score ≥2 are generally not recommended to …

Implantable Monitors – Recent Developments

For many years implantable cardiac monitors have proved to be helpful diagnostic tools for illuminating mechanisms of syncopes and documenting symptomatic arrhythmias in selected patients. With an increasing number of patients being treated interventionally for atrial fibrillation (AF), continuous rhythm monitoring with implantable devices can help to address several unsolved questions in this field, such as the true AF burden after an ablation procedure, the percentage of completely asymptomatic recidives and the long-term efficacy of catheter ablation, and can thereby influence the timing for discontinuation of antiarrhythmic drug treatment or even oral anticoagulation. The recently published Reveal® XT Performance Trial (XPECT) quantified the performance of the first implantable cardiac monitor with dedicated AF detection capabilities. In this validation study the AF detection algorithm was proved to deliver reliable detection of the presence or absence of AF. In addition, the AF burden could be reliably assessed and quantified. In the future, continuous monitoring strategies may be helpful to overcome the shortcomings of non-continuous monitoring and may be able to better document AF recurrence, identify the type of recurrence and document the burden of AF.

Correlation of Clinical Outcome with Pressure-, Oxygen-, and Flow-Related Indices of Cerebrovascular Reactivity in Patients Following Aneurysmal SAH

Impaired cerebrovascular reactivity (CR) has been reported to be associated with adverse outcome in patients with aneurysmal subarachnoid hemorrhage (aSAH). However, CR may be determined using different paradigms and it is unclear, which measurement method most suitable reflects the clinical course or is able to predict clinical deterioration. Twenty-one aSAH patients were included in this study. Following occlusion of the aneurysms with or without implantation of nicardipine prolonged release implants (NPRIs), mean arterial and mean intracranial pressure, regional tissue oxygenation, and regional cerebral blood flow was determined. Based on these data, pressure-, oxygen-, and flow-related autoregulatory indices (PRx, ORx, FRx) were simultaneously calculated and correlated with outcome parameters including the Glasgow outcome score (GOS) and the modified Rankin (mRankin) scale. Eight patients showed newly developed cerebral infarcts. Low values of GOS and mRankin scale highly correlated with the incidence of cerebral infarcts (GOS, P = 0.001; mRankin, P = 0.003). However, indices of CR did not differ significantly between the infarction (I) and the noninfarction group (NI) (PRx, I, 0.058 +/- 0.096, NI, 0.097 +/- 0.203, P = 0.538; ORx, I, 0.162 +/- 0.316, NI, 0.094 +/- 0.176, P = 0.690; FRx, I, 0.395 +/- 0.200, NI, 0.265 +/- 0.177, P = 0.119). No correlation was found between indices and clinical outcome parameters (all not significant). However, ORx and FRx correlated well (P = 0.016). Due to the low number of included subjects, the obtained results are preliminary. However, they indicate that either the present technique of index-determination is not sensitive enough or that there is no strong relation between the measured indices and clinical outcome. Future verification is required of continuous against already established non-continuous monitoring techniques of CR in order to relate both to clinical outcome.

Continuous EEG Monitoring in Patients With Subarachnoid Hemorrhage

Patients with subarachnoid hemorrhage (SAH) are at risk for seizures and delayed cerebral ischemia, both of which can be detected with continuous EEG monitoring (cEEG). Ischemia can be detected with EEG at a reversible stage. CEEG may be most useful in patients with poor grade SAH, as the neurological exam is of limited utility in these stuporous or comatose patients. Seizures have been detected in 19% of SAH patients undergoing cEEG, with the vast majority (95%) of these seizures being nonconvulsive and without any detectable clinical correlate. Applying quantitative analysis to the cEEG (relative alpha variability, post-stimulation alpha/delta ratio) allows reliable detection of ischemia from vasospasm, with EEG changes often preceding changes in the clinical exam and other non-continuous monitoring techniques by up to two days. In patients at risk for developing vasospasm, cEEG monitoring, preferably with quantitative EEG analysis, should be started as early as possible and carried out for up to 14 days after the SAH. CEEG findings may lead to therapeutic (e.g., antiepileptic medication, hypertensive therapy, angioplasty) or additional diagnostic interventions such as angiography, CT or MRI.

Potential bias from non-continuous monitoring of ambient ozone concentrations for characterizing hourly and daily 7- and 12-hour average concentrations

Researchers using chamber experiments to investigate O 3 effects on vegetation do not always monitor O 3 concentrations continuously. Errors introduced because of non-continuous monitoring during experimental treatments may result in the inadequate characterization of hourly average concentrations, with the consequence that summarized exposure indices may provide inaccurate linkages between experimental results and the standard-setting process. We have investigated the uncertainties associated with limited sampling to characterize (1) hourly average and (2) daily 7- and 12-h average O 3 concentrations. As expected, accuracy increased with increased sampling; over- and underestimation of hourly values was directly related to whether the actual concentrations were increasing, decreasing or stable from one hour to the next. When non-continuous sampling was used at sites experiencing small changes from one hour to the next, more than 85 and 60% of the estimated hourly average values were within ±5 and ±2.5 ppb of the actual values, respectively. For a site where average O 3 concentrations changed rapidly from one hour to the next, a greater error was observed. For the daily 7- and 12-h average values, when hourly average concentrations did not change rapidly from one hour to the next, 85% or more of the estimated values agreed within ±2 ppb, independent of sampling frequency. Greater uncertainty was experienced when hourly average concentrations changed at a faster rate. When considering the uncertainties associated with non-continuous sampling, investigators should specify the level of accuracy needed to characterize hourly average concentrations and then select the number of samples per hour required to meet that objective.