Effective healthcare relies on accurate and timely diagnosis; however, obtaining large amounts of training data while maintaining patient privacy remains challenging. This study introduces a novel approach utilizing federated learning (FL) and a cross-device multi-modal model for clin-ical event classification using vital signs data. Our architecture leverages FL to train machine learning models, including Random Forest, AdaBoost, and SGD ensemble model, on vital signs data from a diverse clientele at a Boston hospital (MIMIC-IV dataset). The FL structure preserves patient privacy by training directly on each client's device without transferring sensitive data. The study demonstrates the potential of FL in privacy-preserving clinical event classification, achieving an impressive accuracy of 98.9%. These findings underscore the significance of FL and cross-device ensemble technology in healthcare applications, enabling the analysis of large amounts of sensitive patient data while safeguarding privacy.

The radar sensor described realizes healthcare monitoring capable of detecting subject chest-wall movement caused by cardiopulmonary activities, and wirelessly estimating the respiration and heartbeat rates of the subject without attaching any devices to the body. Conventional single-tone Doppler radar can only capture Doppler signatures because of a lack of bandwidth information with noncontact sensors. In contrast, we take full advantage of impulse radio ultra-wideband (IR-UWB) radar to achieve low power consumption and convenient portability, with a flexible detection range and desirable accuracy. A noise reduction method based on improved ensemble empirical mode decomposition (EEMD) and a vital sign separation method based on the continuous-wavelet transform (CWT) are proposed jointly to improve the signal-to-noise ratio (SNR) in order to acquire accurate respiration and heartbeat rates. Experimental results illustrate that respiration and heartbeat signals can be extracted accurately under different conditions. This noncontact healthcare sensor system proves the commercial feasibility and considerable accessibility of using compact IR-UWB radar for emerging biomedical applications.

Continuous in-home monitoring of older adults living alone aims to improve their quality of life and independence, by detecting early signs of illness and functional decline or emergency conditions. To meet requirements for technology acceptance by seniors (unobtrusiveness, non-intrusiveness, privacy-preservation), this study presents and discusses a new smart sensor system for the detection of abnormalities during daily activities, based on ultra-wideband radar providing rich, not privacy-sensitive, information useful for sensing both cardiorespiratory and body movements, regardless of ambient lighting conditions and physical obstructions (through-wall sensing). The radar sensing is a very promising technology, enabling the measurement of vital signs and body movements at a distance, and thus meeting both requirements of unobtrusiveness and accuracy. In particular, impulse-radio ultra-wideband radar has attracted considerable attention in recent years thanks to many properties that make it useful for assisted living purposes. The proposed sensing system, evaluated in meaningful assisted living scenarios by involving 30 participants, exhibited the ability to detect vital signs, to discriminate among dangerous situations and activities of daily living, and to accommodate individual physical characteristics and habits. The reported results show that vital signs can be detected also while carrying out daily activities or after a fall event (post-fall phase), with accuracy varying according to the level of movements, reaching up to 95% and 91% in detecting respiration and heart rates, respectively. Similarly, good results were achieved in fall detection by using the micro-motion signature and unsupervised learning, with sensitivity and specificity greater than 97% and 90%, respectively.

Background: Our study aimed to assess the differences between domestic and international students in terms of social support, vital exhaustion, and depression during the time of COVID-19. Methods: The online cross-sectional survey was conducted via Google Forms® at three time intervals during the pandemic. Results: Respectively 1320, 246, and 139 students completed our questionnaires in the different time intervals. International students reported significantly lower values of perceived social support. Women reached higher scores regarding vital exhaustion in both samples. Concerning depression, international female students had higher values than their male counterparts but the difference diminished with time. No differences could be found in the comparison of depression between domestic female and male students. Significant correlations were found between depression, perceived social support, and vital exhaustion. Discussion: International students perceive diminished social support just when they need more. Decreased levels of perceived social support may contribute to the development of their psychological problems.

We know that living matter must behave in accordance with the universal laws of physics and chemistry. However, these laws are insufficient to explain the specific characteristics of the vital phenomenon and, therefore, we need new principles, intrinsic to biology, which are the basis for developing a theoretical framework for understanding life. Here I propose what I call the seven commandments of life (the Vital Order, the Principle of Inexorability, the Central Dogma, the Tyranny of Time, the Evolutionary Imperative, the Conservative Rule, the Cooperating Thrust) as a set of principles that help us explain the vital phenomenon from an evolutionary perspective. In a metaphorical way, we can consider life like an endless race in which living beings are the runners, who are changing as the race goes on (the evolutionary process), and the commandments the rules.

Background: Machine learning can analyze vast amounts of data and make predictions for events in the future. Our group created machine learning models for vital sign predictions. To transport the information of these predictions without numbers and numerical values and make them easily usable for human caregivers, we aimed to integrate them into the Philips Visual-Patient-avatar, an avatar-based visualization of patient monitoring. Methods: We conducted a computer-based simulation study with 70 participants in three European university hospitals. We validated the vital sign prediction visualizations by testing their identification by anesthesiologists and intensivists. Each prediction visualization consisted of a condition (e.g., blood pressure low) and an urgency (a visual indication of the timespan in which the condition is expected to occur). To obtain qualitative user feedback, we also conducted standardised interviews and derived statements that participants later rated in an online survey. Results: The mixed logistic regression model showed 77.9% (95%CI 73.2-82.0%) correct identification of prediction visualizations (i.e. condition and urgency both correctly identified) and 93.8% (95%CI 93.7-93.8%) for conditions only (i.e. without considering urgencies). Forty-nine of 70 participants completed the online survey. The online survey participants agreed that the prediction visualizations were fun to use (32/49, 65.3%), and that they could imagine working with them in the future (30/49, 61.2%). They also agreed that identifying the urgencies was difficult (32/49, 65.3%). Conclusions: This study found that care providers correctly identified >90% of the conditions (i.e. without considering urgencies). The accuracy of identification decreased when considering urgencies in addition to conditions. Therefore, in future development of the technology, we will focus on either only displaying conditions (without urgencies) or improve the visualizations of urgency to enhance usability for human users.

The aim of the study was to assess the adaptability of Polish Red cows to extensive housing and feeding conditions. The study was carried out using 22 cows together with their offspring, kept on a certified organic family farm, from 15 October 2017 – the start of the winter feeding season – to 30 October 2018 – the end of the pasture season. The animals were kept as beef suckler cows, which stayed in the pasture during the summer and were kept in buildings with permanent access to a large cattle run in winter. The following were determined in the study: changes in the cows’ weight and body condition, daily gains in calves, 210-day standardized body weight, and estimated milk yield of suckler cows. To evaluate the cows’ health, blood was collected from them twice and analysed for haematological and biochemical parameters. The results indicated that during the study period the Polish Red cows had adequate body condition, normal vital parameters, and a normal course and development of pregnancy despite the sparse winter diet. This definitively confirms the breed’s high capacity to adapt to an extensive system.

Respiratory therapist(RT)internet-supervised At-Home Telespirometry(AHT)was validated in pilot 22/95=23% ALS Clinic population. Erect, supine Vital Capacity(eFVC, sFVC)were measured longitudinally using ZephyRx smartphone interface and database recording in-clinic-conventional(Viaire-Vyasis-)and at-home-portable(MIR-Spirobank-Smart-)spirometers. Bland-Altman(BA)analysis supported content validity-precision and 7-day-test-re-test-validity [mean difference=0.15L(conventional–portable;95%CI -0.40L, 0.70L); = 2.7% predicted (conventional-portable;95%CI -12.1%, 17.5%) ]meeting ATS-ERS performance standards. RT Internet-supervised AHT measured sFVC was more frequently obtained[35/52=67.3 %]in-home-vs-in-clinic sFVC[9/21=42.9 %](Chi-Square;P=0.0533). Monthly mean eFVC slope decline for the eFVC > 60 % predicted baseline cohort was – 1.24% predicted per month[95% CI -2.15 ,-0.33% predicted]statistically significantly(P=0.015)less compared with the – 5.86% predicted per month[95% CI -9.44, -2.29 % predicted]decline for the eFVC < 60 % predicted baseline cohort and in this cohort was associated with statistically significant decreased survival(P=0.0219). RT Internet-supervised AHT facilitated initiation of non-invasive ventilation(NIV)in 5/22[23%]patients including 3/4[75%] homebound subjects. RT Internet-supervised AHT can be deployed for ALS patients stratified according to baseline eFVC for earlier detection of eFVC and sFVC decreases between clinic visits. A prospective research study[NCT05106569]is ongoing to further define the capability of online deployment of Respiratory therapist(RT)internet-supervised AHT in the timely initiation of NIV use to improve ALS respiratory care in larger numbers of ALS subjects.

A partial or complete pulpotomy is a type of vital pulp therapy (VPT) that aims to remove the in-flamed, infected pulp, leaving behind healthy, vital pulp that is capable of healing. VPT has gained renewed popularity as a treatment option in permanent mature posterior teeth with irre-versible/moderate-severe pulpitis, its high success rates matching that of root canal treatment (RCT). There is currently no consensus regarding diagnostic and prognostic predictors of success of pulpotomies for managing such cases. Therefore, we conducted a scoping review to identify and analyze how these factors affect the outcome of treatment. A literature search using the PRISMA guidelines was undertaken using PubMed and Scopus on July 7, 2023. A total of 22 studies met the inclusion criteria and were qualitatively analyzed by two reviewers. The follow-ing diagnostic and prognostic factors were recognized and discussed; presenting signs and symptoms, periapical diagnosis, bleeding time, indicators of inflammation (bleeding time, con-centration of inflammatory biomarkers), patient age and medical status, the depth, activity and location of caries, and restorative factors. Based on the studies assessed, there is limited evidence to support their prognostic value. Further research is necessary to identify solid predictors of outcome.

Background: Measuring vital signs has always been a central task for Critical Care Nurse´s (CCNs) and Registered Nurse Anesthetist`s (RNAs) providing care in the post-anesthesia care unit (PACU) and a prerequisite for their decision-making. Properly measuring and understanding pediatric vital signs is a challenge in younger pediatric patients up to 36 months old. Purpose: gain a greater understanding of CCNs' and RNAs' perceptions of decision-making regarding the level of vital sign monitoring children require in the PACU. Method: A qualitative study design involving the critical-incident technique was used. Interviews were carried out with a purposeful sample of CCNs and RNAs (n=17) from two different hospitals. Findings: According to the nurses' experience, grounds for decisions concerning children’s need of vital-sign monitoring were both adequate and inadequate. They used actions to adjust the monitoring of vital signs to optimise conditions for assessment and the prospects of a safe recovery for the child. Conclusions: Evidence-based care and safety are compromised when the technology has limitations and is not adapted for children. Its use means that experience and clinical assessment are relied on to a greater extent. This not only makes experience important for reliable assessment, but also means that greater risks are accepted.

Background: All Payer Claims Databases (APCD) are a rich source of health information, however, race and ethnicity (R&E) data are largely missing. Bayesian Improved Surname Geocoding (BISG) is a common R&E imputation method, yet, validation of BISG in APCDs is lacking. We used the BISG to impute missing R&E in the Oregon APCD. Methods: BISG imputed R&E for Asian Pacific Islanders (API), Blacks, Hispanics and Whites were contrasted to the gold standard (vital statistics) and sensitivity and specificity improvements were assessed. Logistic regression examined whether missing R&E was random across patient characteristics. Results: Among 85,857 individuals in the study, 32.1% (n=27,594) had missing R&E. Missing R&E was not randomly distributed. There were higher odds of missingness among males, Whites, those age 65 and older, and commercially insured individuals. Differences in the percent missing were also found by co-morbid conditions and mortality causes. Imputing the missing R&E with BISG method improved the sensitivity to identify White, Black, API, and Hispanics. Conclusions: APCDs can benefit from enhancing missing R&E with BISG imputation to perform more robust population-health level analyses and identify inequities according to R&E without losing power or dropping non-random records with missing R&E data.

Holographic subsurface radar (HSR) is currently not in widespread usage. This is due to an historical perspective in the ground penetrating radar (GPR) community that the high attenuation of electromagnetic waves in most media of interest, and the inability to apply time-varying gain to the continuous wave (CW) HSR signal precludes sufficient effective penetration depth. While it is true that the fundamental physics of HSR, with its use of a CW signal, does not allow amplification of later (i.e. deeper) arrivals in lossy media (as is possible with impulse subsurface radar — ISR), HSR has distinct some distinctive advantages. The most important of these is the ability to do shallow subsurface imaging with a resolution that is not possible with ISR. In addition, the design of an HSR system is simpler than for ISR due to the relatively low-tech transmitting and receiving antennae. This paper provides a review of the main principles of HSR through an optical analogy and describes possible algorithms for radar hologram reconstruction. We also present a review of the history of development of systems and applications for HSR of the “RASCAN” type which is possibly the only holographic subsurface radar that is produced in lots. Among the subsurface imaging and remote sensing applications considered are humanitarian demining, construction inspection, surveys of historic architecture and artworks, nondestructive testing of dielectric aerospace materials, security applications, paleontology, detection of wood-boring insect damage, and others. Each application is illustrated with relevant data acquired in laboratory and/or field experiments.

Holographic subsurface radar (HSR) is currently not in widespread usage. This is due to an historical perspective in the ground penetrating radar (GPR) community that the high attenuation of electromagnetic waves in most media of interest, and the inability to apply time-varying gain to the continuous wave (CW) HSR signal precludes sufficient effective penetration depth. While it is true that the fundamental physics of HSR, with its use of a CW signal, does not allow amplification of later (i.e. deeper) arrivals in lossy media (as is possible with impulse subsurface radar — ISR), HSR has distinct some distinctive advantages. The most important of these is the ability to do shallow subsurface imaging with a resolution that is not possible with ISR. In addition, the design of an HSR system is simpler than for ISR due to the relatively low-tech transmitting and receiving antennae. This paper provides a review of the main principles of HSR through an optical analogy and describes possible algorithms for radar hologram reconstruction. We also present a review of the history of development of systems and applications for HSR of the “RASCAN” type which is possibly the only holographic subsurface radar that is produced in lots. Among the subsurface imaging and remote sensing applications considered are humanitarian demining, construction inspection, surveys of historic architecture and artworks, nondestructive testing of dielectric aerospace materials, security applications, paleontology, detection of wood-boring insect damage, and others. Each application is illustrated with relevant data acquired in laboratory and/or field experiments.