Search

The article discusses sedation practices in gastrointestinal endoscopy, highlighting variations in sedation rates, preferred regimens, and patient monitoring practices among endoscopists. The European Society of Gastrointestinal Endoscopy (ESGE) conducted a survey among its members to gather information on sedation practices, training, and patient care during endoscopic procedures. The survey revealed a lack of standardized training in sedation administration, varied sedation options, and limited monitoring tools used post-procedure. Recommendations for new ESGE guidance include standardizing propofol use, improving training, and establishing discharge criteria. The survey emphasizes the need for continuous training, quality improvement initiatives, and standardized practices to enhance patient safety and procedural outcomes in GI endoscopy. [Extracted from the article]

In general in ICUs, operation theatres, post-operative critical care units, and even ambulatory monitors, the patients are continuously examined with ECG and pulse oximeters PPG. In these situations, where the ECG and/or PPG are afflicted by severe artifacts, the idea of extracting respiratory signal from both ECG and PPG signals rather than from any one of them is tested in this work. As respiratory trend is present in both ECG and PPG signals, the common respiratory trend present in simultaneously recorded ECG and PPG signals is extracted, using a bivariate vector autoregressive modeling (BVAR) technique. This technique effectively reduced the inevitable artifacts and resulted in better estimation of the respiratory activity. For further improving the performance of the BVAR method, in extracting respiratory activity from ECG and PPG signals corrupted with sever artifacts, and also works for broad range of breathing rates, an improved BVAR (IB-VAR) technique is proposed. This technique is robust in the sense that it, firstly, works well even in the presence of various artifacts present in either of the signals, and extracts the signal common to both i.e. respiratory information, with a greater accuracy. Secondly, it also works even for a broad range of breathing rates covering as low as 6 breaths per minute (bpm) to as high as 90 bpm. The novel part of the proposed IB-VAR method is that the respiratory pole lying in that broad breathing range is automatically selected from among all other possible poles, which also include the ones corresponding to noises like motion artifact (MA) and baseline wander (BLW), making use of kurtosis values of extracted signals. An analog front end is developed to record ECG, PPG and respiratory signals with different breathing rates and respiration patterns simultaneously from the volunteers. The method, applied on the recorded data of fifteen healthy subjects, performed extremely well even in the presence of MA and BLW, compared to the well known wavelet based approach. Correlation analysis, done in both frequency and time domains, has shown a high degree of acceptance for the extracted respiratory signal with respect to the original reference respiratory signal. Higher values of accuracy rate (EDR: 98.10 ± 1.45, PDR: 98.45 ± 1.30) and lower values of NRMSE calculations (EDR: − 6.47 ± 4.29, PDR: − 6.50 ± 4.17) clearly confirmed the validity of the extracted respiratory signal. An important finding of this work is that the PPG derived respiratory signal very closely matched with the original than the ECG derived signal. [ABSTRACT FROM AUTHOR]

Background: Peripherally measured oxygen saturation (SpO2) may often differ from arterial oxygen saturation (SaO2), measured by co‐oximetry, especially within the lower range of oxygen saturations. This can potentially impact clinical decisions and therapy in children with congenital heart disease, as critical hypoxemia might remain unnoticed. Aims: Our aim was to investigate the accuracy of two different pulse oximeters compared to SaO2 in infants with congenital heart diseases. Methods: Simultaneous recordings of SpO2, measured by two different pulse oximeters (Philips IntelliVue X3 Monitor and Nellcor™ OxiMax™), were compared to SaO2 obtained by arterial blood gas analysis. Results: A total of 153 measurements were performed in 44 infants with arterial oxygen saturation between 70 and 100%. We divided the measurements into 3 subgroups: group 1—SaO2 70.0%–85.0%, group 2—SaO2 85.1%–94.0%, group 3—SaO2 >94.1%. For Philipps, the median bias was 5.3 (IQR: 2.6–8.7) %, 2.3 (IQR: 0.9–6.0) % and 1.1 (IQR: −0.8–2.4) % in group 1, 2 and 3, respectively. For OxiMax™, the median bias was 2.7 (IQR: 0.5–5.1) %, 0.2 (IQR: −0.9–2.6) % and −0.5 (IQR: −1.3–0.6) % in group 1, 2 and 3, respectively. Regarding the accuracy of these oximeters, as evaluated with the Accuracy root mean squared index (Arms), it was 9.8 versus 4.5% in group 1, 4.5 versus 2.9% in group 2 and 2.4 versus 1.9% in group 3 for Philipps and OxiMax™, respectively. Conclusions: In lower range saturations between 70% and 85% the accuracy of both pulse oximeters exceeded the threshold of ≤3% recommended by the Food and Drug Administration (FDA). Therefore, peripheral pulse oximetry within the lower range of oxygen saturations should be interpreted with caution in infants with congenital heart diseases, taking into consideration its limitations. Direct co‐oximetry should be the preferred method to support clinical decisions in children with cyanotic congenital heart diseases. [ABSTRACT FROM AUTHOR]

Background: Pulse oximeters are vital for assessing blood oxygen levels but can produce inaccurate readings during patient motion, leading to false alarms and alarm fatigue. Analog SpO2 Technology, which uses analog waveforms to filter motion artifacts, may improve accuracy compared to digital sensors. However, the effectiveness of this technology in reducing false alarms in clinical settings remains unclear. This study assesses and compares the motion resistance of Analog SpO2 Technology of two devices in the market. Methods: Thirty healthy adults underwent controlled experiments (Control, Linear Motion, Angular Motion) using two pulse oximeters. Linear Motion tested hand displacement impact, while Angular Motion involved rhythmic hand motions at 120 bpm and 160 bpm. Results: Both devices performed similarly in Control, with no disruptions. In Linear Motion, mild disruptions occurred, but no significant differences in SpO2 readings or alarms. Angular Motion at 120 bpm showed stability with no alarms. At 160 bpm, Device B (Biolight Analog SpO2) had fewer technical alarms but more SpO2 alarms than Device A (Masimo Analog SpO2). Conclusions: Analog SpO2 exhibited motion resistance under static, linear and continuous waving angular motion up to 120 bpm and 160 bpm, but alarms occurred at 160 bpm with continuous tapping angular motion. These findings signify non-inferiority of either device in clinical settings. Further studies should include patients with cardiovascular and/or respiratory diseases. Trial Registration: The study was submitted to and approved by the Biolight Ethics Committee (S0723), and written informed consent from all participants was obtained. [ABSTRACT FROM AUTHOR]

Introduction: The pandemic saw widespread use of home pulse oximeters to patients diagnosed with COVID-19 to support early detection of low oxygen saturation levels and appropriate care. Rapid implementation made conventional evaluation challenging, highlighting the need for rigorous non-randomised methods to support decision-making about future use of these technologies. We used routine data to explore the benefits of pulse oximetry in Greater Manchester, under the 'COVID-19 oximetry at home' (CO@h) programme. Methods: We used data from the Greater Manchester Secure Data Environment and defined study parameters using a 'target trial' model to compare patients receiving pulse oximetry under the CO@h programme, with matched controls using various comparator groups. Primary outcomes were unplanned hospitalisation and all-cause mortality. This study is based on data from the Greater Manchester Care Record (GMCR), using anonymised, routinely collected data provided in a de-identified format for research. Informed written consent is needed for primary care patient data to be collected for service improvement and research, before data extraction to the GMCR. The study was approved under protocol GMCR RQ-048, on 12/05/2022. As indicated by the University of Manchester ethics decision tool, formal ethical approval was not required for this study. Results: The adjusted odds ratios for an unplanned hospitalisation were higher among patients receiving pulse oximetry: OR 1.86 (95% CI 1.54–2.25) at 28 days, 1.5 (95% CI 1.3–1.74) at 90 days and 1.63 (95% CI 1.44–1.83) at 1 year. Overall odds of mortality were lower among patients receiving pulse oximetry: adjusted ORs of 0.5 (95% CI 0.25–0.98) at 28 days, 0.5 (95% CI 0.32–0.78) at 90 days and 0.58 (95% CI 0.44–0.76) at 1 year. The results were robust to different comparison groups. Conclusion: Use of pulse oximetry at home under the CO@h programme, through the resulting prioritisation for appropriate care, was associated with a higher frequency of unplanned admissions and a reduction in the risk of mortality up to 1 year later. Therefore, it is likely effective for early detection of clinical deterioration and timely intervention among patients with COVID-19. Further research is needed to understand whether this is a cost-effective use of healthcare resources. [ABSTRACT FROM AUTHOR]

Background: Heart disease patients necessitate precise monitoring to ensure the safety and efficacy of their physical activities when managing conditions such as hypertension or heart failure. This study, therefore, aimed to evaluate the accuracy of photoplethysmography (PPG)-based monitoring of pulse rate (PR), interbeat-intervals (IB-I) and oxygen saturation (SpO2) during high-intensity interval training (HIIT). Methods: Between January and March 2024, healthy volunteers were subjected to a cycling HIIT workout with bike resistance increments to evaluate performance within different heart rate ranges. To determine the accuracy of PPG-based measurements for PR, IB-I, and SpO2 using the CardioWatch 287–2 (Corsano Health, the Netherlands), measurements throughout these ranges were compared to paired reference values from the Covidien Nellcor pulse oximeter (PM10N) and Vivalink's wearable ECG patch monitor. Subgroups were defined for Fitzpatrick skin type and gender. Results: In total, 35 healthy individuals participated, resulting in 7183 paired measurements for PR, 22,713 for IB-I, and 41,817 for SpO2. The PR algorithm showed an average root mean square (Arms) of 2.51 beats per minute (bpm), bias at 0.05 bpm, and limits of agreement (LoA) from −4.87 to 4.97 bpm. The IB-I algorithm achieved an Arms of 23.00 ms, a bias of 1.00 ms, and LoA from −43.82 to 46.21 ms. Finally, the SpO2 algorithm showed an Arms of 1.28%, a bias of 0.13%, and LoA from −2.37% to 2.62%. The results were consistent across different demographic subgroups. Conclusions: This study demonstrates that the PPG-based CardioWatch 287–2 can accurately monitor PR, IB-I, and SpO2 during HIIT. However, further research is recommended to evaluate the algorithm's performance in heart disease patients during demanding exercise. [ABSTRACT FROM AUTHOR]

Blood oxygen saturation (SpO2) is vital for patient monitoring, particularly in clinical settings. Traditional SpO2 estimation methods have limitations, which can be addressed by analyzing photoplethysmography (PPG) signals with artificial intelligence (AI) techniques. This systematic review, following PRISMA guidelines, analyzed 183 unique references from WOS, PubMed, and Scopus, with 26 studies meeting the inclusion criteria. The review examined AI models, key features, oximeters used, datasets, tested saturation intervals, and performance metrics while also assessing bias through the QUADAS-2 criteria. Linear regression models and deep neural networks (DNNs) emerged as the leading AI methodologies, utilizing features such as statistical metrics, signal-to-noise ratios, and intricate waveform morphology to enhance accuracy. Gaussian Process models, in particular, exhibited superior performance, achieving Mean Absolute Error (MAE) values as low as 0.57% and Root Mean Square Error (RMSE) as low as 0.69%. The bias analysis highlighted the need for better patient selection, reliable reference standards, and comprehensive SpO2 intervals to improve model generalizability. A persistent challenge is the reliance on non-invasive methods over the more accurate arterial blood gas analysis and the limited datasets representing diverse physiological conditions. Future research must focus on improving reference standards, test protocols, and addressing ethical considerations in clinical trials. Integrating AI with traditional physiological models can further enhance SpO2 estimation accuracy and robustness, offering significant advancements in patient care. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 38-year-old woman with methemoglobinemia and hypoxemic respiratory failure, focusing on the discrepancy between pulse oximetry (SpO2) and arterial blood gas (SaO2) readings. Topics discussed include noninvasive oxygen measurement via pulse oximetry, the impact of methemoglobinemia on oxygen delivery, and the differential diagnosis for an "SpO2–SaO2 gap."

Background: Consumer facing wearable devices capture significant amounts of biometric data. The primary aim of this study is to determine the accuracy of consumer-facing wearable technology for continuous monitoring compared to standard anesthesia monitoring during endoscopic procedures. Secondary aims were to assess patient and provider perceptions of these devices in clinical settings. Methods: Patients undergoing endoscopy with anesthesia support from June 2021 to June 2022 were provided a smartwatch (Apple Watch Series 7, Apple Inc., Cupertino, CA) and accessories including continuous ECG monitor and pulse oximeter (Qardio Inc., San Francisco, CA) for the duration of their procedure. Vital sign data from the wearable devices was compared to inroom anesthesia monitors. Concordance with anesthesia monitoring was assessed with interclass correlation coefficients (ICC). Surveys were then distributed to patients and clinicians to assess patient and provider preferences regarding the use of the wearable devices during procedures. Results: 292 unique procedures were enrolled with a median anesthesia duration of 34 min (IQR 25--47). High fidelity readings were successfully recorded with wearable devices for heart rate in 279 (95.5%) cases, oxygen in 203 (69.5%), and respiratory rate in 154 (52.7%). ICCs for watch and accessories were 0.54 (95% CI 0.46--0.62) for tachycardia, 0.03 (95% CI 0--0.14) for bradycardia, and 0.33 (0.22--0.43) for oxygen desaturation. Patients generally felt the devices were more accurate (56.3% vs. 20.0% agree, p < 0.001) and more permissible (53.9% vs. 33.3% agree, p < 0.001) to wear during a procedure than providers. Conclusion: Smartwatches perform poorly for continuous data collection compared to gold standard anesthesia monitoring. Refinement in software development is required if these devices are to be used for continuous, intensive vital sign monitoring. [ABSTRACT FROM AUTHOR]

Introduction: The incorporation of health-related sensors in wearable devices has increased their use as essential monitoring tools for a wide range of clinical applications. However, the signals obtained from these devices often present challenges such as artifacts, spikes, high-frequency noise, and data gaps, which impede their direct exploitation. Additionally, clinically relevant features are not always readily available. This problem is particularly critical within the H2020 BRAINTEASER project, funded by the European Community, which aims at developing models for the progression of Multiple Sclerosis (MS) and Amyotrophic Lateral Sclerosis (ALS) using data from wearable devices. Methods: The objective of this study is to present the automated pipeline developed to process signals and extract features from the Garmin Vivoactive 4 smartwatch, which has been chosen as the primary wearable device in the BRAINTEASER project. The proposed pipeline includes a signal processing step, which applies retiming, gap-filling, and denoising algorithms to enhance the quality of the data. The feature extraction step, on the other hand, utilizes clinical partners' knowledge and feedback to select the most relevant variables for analysis. Results: The performance and effectiveness of the proposed automated pipeline have been evaluated through pivotal beta testing sessions, which demonstrated the ability of the pipeline to improve the data quality and extract features from the data. Further clinical validation of the extracted features will be performed in the upcoming steps of the BRAINTEASER project. Discussion: Developed in Python, this pipeline can be used by researchers for automated signal processing and feature extraction from wearable devices. It can also be easily adapted or modified to suit the specific requirements of different scenarios. [ABSTRACT FROM AUTHOR]

Oximeters have significantly evolved since their invention and are essential for monitoring chronic diseases in home care. However, commercial models can present an economic barrier. Therefore, we conducted a review of the use of low-cost pulse oximeters in the home care of patients with respiratory diseases. Our review included studies addressing oxygen saturation and heart rate monitoring in adults, focusing on the use of portable devices. Our search identified advances in vital signs monitoring that could provide accessible solutions for non-clinical settings. Although there are challenges related to clinical validation and accuracy, these oximeters may improve medical care, particularly in resource-limited areas. As a result, the accessibility of these devices opens up new possibilities for patients with chronic respiratory diseases in home care, enabling regular self-monitoring and increasing control over their health. [ABSTRACT FROM AUTHOR]

Background: There is growing concern that pulse oximeters are routinely less accurate in hospitalized patients with darker skin pigmentation, in turn increasing risk of undetected (occult) hypoxemia and adverse clinical outcomes. The aim of this systematic review and meta-analysis was to synthesize evidence on racial and ethnic disparities in occult hypoxemia prevalence and clinical impacts of undetected hypoxemia. Methods: Ovid MEDLINE, Embase, and CINAHL databases were searched for relevant articles published through January 2024. Eligible studies must have been conducted among adults in inpatient or outpatient settings and report occult hypoxemia prevalence stratified by patient race or ethnicity, or clinical outcomes stratified by patient race or ethnicity and occult hypoxemia status. Screening for inclusion was conducted independently by two investigators. Data extraction and risk of bias assessment were conducted by one investigator then checked by a second. Outcome data were synthesized using random-effects meta-analyses. Results: Fifteen primary studies met eligibility criteria and reported occult hypoxemia prevalence in 732,505 paired oximetry measurements from 207,464 hospitalized patients. Compared with White patients, occult hypoxemia is likely more common among Black patients (pooled prevalence ratio = 1.67, 95% CI 1.47 to 1.90) and among patients identifying as Asian, Latinx, Indigenous, multiracial, or other race or ethnicity (pooled prevalence ratio = 1.39, 95% CI 1.19 to 1.64). Findings from studies reporting clinical outcomes suggest that Black patients with undetected hypoxemia may experience poorer treatment delivery outcomes than White patients with undetected hypoxemia. No evidence was found from outpatient settings. Discussion: This review and included primary studies rely on self-identified race or ethnicity, which may obscure variability in occult hypoxemia risk. Findings underscore that clinicians should be aware of the risk of occult hypoxemia in hospitalized patients with darker skin pigmentation. Moreover, oximetry data from included studies suggests that the accuracy of pulse oximeters could vary substantially from patient to patient and even within individual patients. Trial Registration: PROSPERO (CRD42023402152). [ABSTRACT FROM AUTHOR]

Background: Nuisance and false alarms distract clinicians from urgent alerts, raising patient safety risks. Local Problem: High alarm rates in a pediatric progressive care unit resulted in experiencing 180-250 alarms per day or 1 alarm every 3 to 4 minutes per clinician. Methods: Through Plan-Do-Study-Act cycles, environmental, policy, and technology changes were implemented to decrease the average alarms/day/bed and percentage of time in alarm. Interventions: Alarm settings tailored to patient needs using features embedded within the patient monitoring system were implemented and monitored with the assistance of alarm champions. Results: The average number of alarms/day/bed decreased from 177.69 to 96.94 over the course of 10 years, a 45.45% reduction. The percentage of time in alarm decreased from 7.52% to 2.83%, a 62.37% reduction. Conclusions: Arming clinicians with technology to analyze real-time clinical data made alarms meaningful and actionable, decreasing false alarms without compromising patient safety. [ABSTRACT FROM AUTHOR]

This document contains summaries of various research studies conducted in the field of veterinary medicine. The studies cover a wide range of topics, including the use of computed tomography in identifying surgical lesions in cats, injuries sustained by dogs in motor vehicle accidents, and the effects of mild hypothermia on fluid therapy in cats. The findings of these studies provide valuable insights into specific areas of veterinary emergency and critical care. The document also includes studies on topics such as the use of handheld ultrasound devices in dogs, the treatment of NSAID toxicosis in dogs, and the management of anemia in dogs using a rapid infuser device. These studies contribute to the understanding and improvement of veterinary medical practices. [Extracted from the article]

Purpose: The purpose of this study was to evaluate the accuracy of peripheral oxygen saturation (SpO2) measurements from Polar Elixir™ pulse oximetry technology compared with arterial oxygen saturation (SaO2) measurements during acute stepwise steady-state inspired hypoxia at rest. A post hoc objective was to determine if SpO2 measurements could be improved by recalibrating the Polar Elixir™ algorithm with SaO2 values from a random subset of participants. Methods: The International Organization for Standardization (ISO) protocol (ISO 80601-2-61:2017) for evaluating the SpO2 accuracy of pulse oximeter equipment was followed whereby five plateaus of SaO2 between 70% and 100%were achieved using stepwise reductions in inspired O2 during supine rest. Blood samples drawn through a radial arterial catheter from 25 participants were first used to compare SaO2 with SpO2 measurements from Polar Elixir™. Then the Polar Elixir™ algorithm was recalibrated using SaO2 data from 13 random participants, and SpO2 estimates were recalculated for the other 12 participants. For SaO2 values between 70%and 100%, root mean square error, intraclass correlation coefficients (ICC), Pearson correlations, and Bland--Altman plots were used to assess the accuracy, agreement, and strength of relationship between SaO2 values and SpO2 values from Polar Elixir™. Results: The initial root mean square error for Polar Elixir™ was 4.13%. After recalibrating the algorithm, the RMSE was improved to 2.67%. The ICC revealed excellent levels of agreement between SaO2 and Polar Elixir™SpO2 values both before (ICC(1,3) = 0.837, df = 574, P < 0.001) and after (ICC(1,3) = 0.942, df = 287, P < 0.001) recalibration. Conclusions: Relative to ISO standards, Polar Elixir™ yielded accurate SpO2 measurements during stepwise inspired hypoxia at restwhen comparedwith SaO2 values, which were improved by recalibrating the algorithm using a subset of the SaO2 data. [ABSTRACT FROM AUTHOR]

Background: The pulse oximeter is a simple, cost‐effective and reliable device for estimating arterial blood oxygen saturation. Nurses are required to be knowledgeable in pulse oximeter use. Little is known about nurses' knowledge of pulse oximetry in the Middle East region. Aim: To assess nurses' knowledge of pulse oximetry among emergency and critical care nurses and to explore predictors of nurses' knowledge of pulse oximetry. Study Design: This is the second part of data analysis that was first presented in the 'proficiency in ECG' study conducted in Jordan. The original data used for both parts of analysis included a questionnaire with two tests; a knowledge of pulse oximeter test and an ECG proficiency test. Participants were asked to take, alone without receiving assistance, both tests. In this study, the second part of analysis, the focus is on the pulse oximeter test. The test consisted of 21 items that emphasize knowledge of basic physiological principles as well as device limitations; whether technical or interpretation. The test administration procedure also included asking participants to provide socio‐demographic variables. In the original data collected in both parts of analysis, nurses working in the emergency department, cardiac care units or intensive care units from nine different hospitals (1 governmental, 6 private and 2 educational) and holding a bachelor degree or higher were asked to participate. Results: The total number of participating nurses was 210; out of 247 approached (response rate, 85%). The mean score in the nurses' knowledge of pulse oximetry test was 12.33 out of 21, corresponding to 58.7%. The clinical area currently working in predicted the knowledge of pulse oximetry test score after controlling for all other variables. Emergency department and intensive care unit nurses scored higher than cardiac care unit nurses by 1.86 and 1.63 points respectively (58.2% and 60% respectively). Conclusion: Nurses consistently report inadequate education and training concerning pulse oximeter use and interpretation. A revision to hospital in‐service education seminars and undergraduate nurses' curriculum to assure adequate preparation is needed. Relevance to Clinical Practice: Knowledge of pulse oximetry among emergency and critical care nurses is modest. This is a challenge worldwide. Predictors of nurses' knowledge of pulse oximetery are the clinical area currently working in (ICU and ED nurses are more knowledgeable than CCU nurses), proficiency in electrocardiography and taking an advanced cardiac life support course. [ABSTRACT FROM AUTHOR]

The aims of this article are to: • Recognise the role of accurate oxygen saturation readings in guiding oxygen therapy. • Identify the limitations of the use of pulse oximetry in measuring oxygen saturation. • Understand the basic principles of the mechanism by which pulse oximeters obtain saturation readings. • Have an understanding of the studies investigating the degree of bias of skin colour on pulse oximetry readings. • Interpret pulse oximetry readings in the clinical setting with the knowledge that readings may be less reliable in patients with pigmented skin. Pulse oximetry is widely used to non-invasively estimate the oxygen saturation of haemoglobin in arterial blood (SpO 2). It is used widely throughout healthcare and was used extensively during the Covid-19 pandemic to detect and treat hypoxic patients. Research has suggested that pulse oximetry is less accurate in patients with darker skin. This led the US Food and Drug Administration agency (FDA) to issue a safety statement warning that pulse oximeters may be inaccurate when patients have pigmented skin. Evidence suggests that the oxygen saturation of arterial blood (SaO 2) may be being overestimated by measuring SpO 2 in those with pigmented skin. The degree of overestimation increases as SaO 2 decreases especially when SpO 2 reads below 80%. We review how pulse oximetry works and consider the implications for a patient's health when interpreting SpO 2 in individuals with pigmented skin. [ABSTRACT FROM AUTHOR]

The article comments on a study which observed the implementation of an automated oxygen control system in a tertiary care hospital. Emphasis is given on the need of automated oxygen control systems for accurate calibration to arterial oxygen saturation given the possible occurrence of software bugs. The potential benefits and potential disadvantages of routine use of automated oxygen administration systems are highlighted.

The L-band vegetation optical depth data garners significant interest for its ability to effectively monitor vegetation, thanks to minimal saturation within this frequency range. However, the existing datasets have limited temporal coverage, constrained by the start of the respective satellite missions. Global L-band equivalent AI-Based Vegetation Optical Depth or GLAB-VOD is a global long-term consistent microwave vegetation optical depth dataset created using machine learning to expand the SMAP-IB VOD dataset temporal coverage from 2015-2020 to 2002-2020. The GLAB-VOD dataset has an 18-day temporal resolution and 25 km spatial resolution on the EASE2 grid and covers 2002-2020. An auxiliary consistent daily brightness temperature product, called GLAB-TB, is developed in parallel and ensures the consistency of the VOD product across time periods with different microwave satellites. As a result of its temporal consistency, this dataset can be used to study long-term global and regional trends in vegetation biomass and utilized in any other applications where long-term consistency is necessary. The GLAB-VOD dataset shows excellent spatial correlation globally when compared with biomass (up to R = 0.92) and canopy height (R = 0.93), outperforming its target dataset, SMAP-IB VOD. [ABSTRACT FROM AUTHOR]

Pulse oximeter is the most commonly used instrument for clinical diagnosis of human blood oxygen saturation, so whether the measurement of blood oxygen saturation is stable and reliable. Medical staff should calibrate the pulse oximeter regularly to ensure its safety and reliability. The pulse oximeter in use can be calibrated with an intelligent calibration device. The purpose of this article is to design an intelligent digital wearable smart pulse oximeter calibration device. The device uses advanced digital technology combined with programming technology to achieve accurate calibration of wearable smart pulse oximeter. Through the device, the accurate measurement of parameters such as blood oxygen saturation and heart rate is realized, and real-time feedback and adjustment function is provided to ensure the stability and accuracy of the device. The implementation of this design is expected to improve the application effect of wearable smart pulse oximeter in the field of clinical and personal health monitoring, and provide users with more reliable health data support. The experimental results show that under the same test period (24 hours), the voltage change of the photosensor is 7mV, and the deviation of blood oxygen saturation is 0.4%, which may mean that the performance of the device under this condition is more stable and accurate compared with other experiments. [ABSTRACT FROM AUTHOR]

Pulse oximetry is arguably the most impactful monitor ever introduced into respiratory care practice. Recently there has been increased attention to the problem of occult hypoxemia in which patients are hypoxemic despite an acceptable SpO2. Although occult hypoxemia might be greater in Black patients than white patients, it is not insignificant in whites. In a given population of patients, the bias between SpO2 and arterial oxygen saturation (SaO2) might be close to zero. However, the limits of agreement can be wide, meaning that SpO2 might overestimate SaO2 in many individual patients, which can result in occult hypoxemia in some. Manufactures report accuracy of SpO2 derived from normal individuals, which might differ from that in the clinical setting. That SpO2 overestimates SaO2 in an important number of individuals has caused some to recommend higher SpO2 targets to avoid occult hypoxemia. There is also evidence that suggests that SpO2 might not accurately trend SaO2. Additional research is needed to investigate strategies to mitigate the bias between SpO2 and SaO2. Clinicians must be cognizant of the limitations of pulse oximetry when clinically using SpO2. The aim of this paper is to provide an update on pulse oximetry. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Veterinary Journal / Revue Vétérinaire Canadienne is the property of Canadian Veterinary Medical Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Rationale: Data on risk factors for chronic hypoxemia in low- and middle-income countries are lacking. Objectives: We aimed to quantify the association between potential risk factors and chronic hypoxemia among adults hospitalized in Kenya. Methods: A hospital-based, case–control study was conducted at Moi Teaching and Referral Hospital in Eldoret, Kenya. Adult inpatients were screened on admission and enrolled in a 1:2 case-to-control ratio. Cases were patients with chronic hypoxemia, defined as resting oxygen saturation as measured by pulse oximetry (SpO2) ⩽ 88% on admission and either 1-month postdischarge SpO2 ⩽ 88% or, if they died before follow-up, documented SpO2 ⩽ 88% in the 6 months before enrollment. Control subjects were randomly selected, stratified by sex, among nonhypoxemic inpatients. Data were collected using questionnaires and structured chart review. Regression was used to assess the associations between chronic hypoxemia and age, sex, smoking status, biomass fuel use, elevation, and self-reported history of tuberculosis and human immunodeficiency virus diagnosis. Odds ratios (ORs) and 95% confidence intervals (CIs) are reported. Results: We enrolled 108 chronically hypoxemic cases and 240 nonhypoxemic control subjects into our Chronic Hypoxemia among Kenyan Adults (CHAKA) cohort. In multivariable analysis, compared with control subjects, chronically hypoxemic cases had significantly higher odds of older age (OR, 1.2 per 5-year increase [95% CI, 1.1–1.3]), female sex (OR, 3.6 [95% CI, 1.8–7.2]), current or former tobacco use (OR, 4.7 [95% CI, 2.3–9.6]), and prior tuberculosis (OR, 11.8 [95% CI, 4.7–29.6]) but no increase in the odds of human immunodeficiency virus diagnosis and biomass fuel use. Conclusions: These findings highlight the potential impact of prior tuberculosis on chronic lung disease in Kenya and the need for further studies on posttuberculosis lung disease. [ABSTRACT FROM AUTHOR]

Introduction: Mortality due to injuries disproportionately impact low income countries. Knowledge of who is at risk of poor outcomes is critical to guide resource allocation and prioritization of severely injured. Kampala Trauma Score (KTS), developed in 1996 and last modified in 2002 as KTS II, is still widely being used to predict injury outcomes in resource-limited settings with no further revisions in the past two decades, despite ongoing criticism of some of its parameters. The New Trauma Score (NTS), a recent development in 2017, has shown potential in mortality prediction, but a dearth of evidence exist regarding its performance in the African population. Objectives: To compare NTS to the modified Kampala Trauma Score (KTS II) in the prediction of 30-day mortality, and injury severity amongst patients sustaining road traffic crashes in Ugandan low-resource settings. Methods: Multi-center prospective cohort study of patients aged 15 years and above. Of the 194 participants, 85.1% were males with a mean age of 31.7 years. NTS and KTS II were determined for each participant within 30-minutes of admission and followed-up for 30 days to determine their injury outcomes. The sensitivity, specificity, and area under receiver operating characteristics curve (AUC) for predicting mortality were compared between the two trauma scores using SPSS version 22. Ethical clearance: Research and Ethics Committee of Kampala International University Western Campus (Ref No: KIU-2022-125). Results: The injury severity classifications based on NTS vs. KTS II were mild (55.7% vs. 25.8%), moderate (29.9% vs. 30.4%), and severe (14.4% vs. 43.8%). The mortality rates for each injury severity category based on NTS vs. KTS II were mild (0.9% v 0%), moderate (20.7% vs. 5.1%), and severe (50% vs. 28.2%). The AUC was 0.87 for NTS (95% CI 0.808–0.931) vs. 0.86 (95% CI 0.794–0.919) for KTS II respectively. The sensitivity of NTS vs. KTS II in predicting mortality was 92.6% (95% CI: 88.9–96.3) vs. 70.4% (95% CI: 63.0-77.8) while the specificity was 70.7% (95% CI: 64.2–77.2) vs. 78.4% (95% CI: 72.1–84.7) at cut off points of 17 for NTS and 6 for KTS II respectively. Conclusions: NTS was more sensitive but its specificity for purposes of 30-day mortality prediction was lower compared to KTS II. Thus, in low-resourced trauma environment where time constraints and pulse oximeters are of concern, KTS II remains superior to NTS. [ABSTRACT FROM AUTHOR]

Remote Patient Monitoring has enjoyed strong growth to new heights driven by several factors, such as the COVID-19 pandemic or advances in technology, allowing consumers and patients to continuously record health data by themselves. This does not come without its challenges, however. A literature review was completed and highlights usability gaps when using wearables or home use medical devices in a virtual environment. Based on these findings, the Pi-CON methodology was applied to close these gaps by utilizing a novel sensor that allows the acquisition of vital signs at a distance, without any sensors touching the patient. Pi-CON stands for passive, continuous and non-contact, and describes the ability to acquire vital signs continuously and passively, with limited user interaction. The preference of vital sign acquisition with a newly developed sensor was tested and compared to vital sign tests taken with patient generated health-data devices (ear thermometer, pulse oximeter) measuring heart rate, respiratory rate and body temperature. In addition, the amount of operator errors and the user interfaces were tested and compared. Results show that participants preferred vital signs acquisition with the novel sensor and the developed user interface of the sensor. Results also revealed that participants had a mean error of.85 per vital sign measurement with the patient-generated health data devices and.33 with the developed sensor, confirming the beneficial impact available when using the developed sensor based on the Pi-CON methodology. [ABSTRACT FROM AUTHOR]

Background: Monitoring blood oxygenation is essential in immobilised rhinoceros, which are susceptible to opioid-induced hypoxaemia. This study assessed the reliability, clinical performance and trending ability of the Nonin PalmSAT 2500 A pulse oximeter's and the Masimo Radical-7 pulse co-oximeter's dual-wavelength technology, with their probes placed at two measurement sites, the inner surface of the third-eyelid and the scarified ear pinna of immobilised white rhinoceroses. Eight white rhinoceros were immobilised with etorphine-based drug combinations and given butorphanol after 12 min, and oxygen after 40 min, of recumbency. The Nonin and Masimo devices, with dual-wavelength probes attached to the third-eyelid and ear recorded arterial peripheral oxygen-haemoglobin saturation (SpO2) at pre-determined time points, concurrently with measurements of arterial oxygen-haemoglobin saturation (SaO2), from drawn blood samples, by a benchtop AVOXimeter 4000 co-oximeter (reference method). Reliability of the Nonin and Masimo devices was evaluated using the Bland-Altman and the area root mean squares (ARMS) methods. Clinical performance of the devices was evaluated for their ability to accurately detect clinical hypoxemia using receiver operating characteristic (ROC) curves and measures of sensitivity, specificity, and positive and negative predictive values. Trending ability of the devices was assessed by calculating concordance rates from four-quadrant plots. Results: Only the Nonin device with transflectance probe attached to the third-eyelid provided reliable SpO2 measurements across the 70 to 100% saturation range (bias − 1%, precision 4%, ARMS 4%). Nonin and Masimo devices with transflectance probes attached to the third-eyelid both had high clinical performance at detecting clinical hypoxaemia [area under the ROC curves (AUC): 0.93 and 0.90, respectively]. However, the Nonin and Masimo devices with transmission probes attached to the ear were unreliable and provided only moderate clinical performance. Both Nonin and Masimo devices, at both measurement sites, had concordance rates lower than the recommended threshold of ≥ 90%, indicating poor trending ability. Conclusions: The overall assessment of reliability, clinical performance and trending ability indicate that the Nonin device with transflectance probe attached to the third-eyelid is best suited for monitoring of blood oxygenation in immobilised rhinoceros. The immobilisation procedure may have affected cardiovascular function to an extent that it limited the devices' performance. [ABSTRACT FROM AUTHOR]

Background: Sleep apnea syndrome, characterized by recurrent cessation (apnea) or reduction (hypopnea) of breathing during sleep, is a major risk factor for postoperative respiratory depression. Challenges in sleep apnea assessment have led to the proposal of alternative metrics derived from oxyhemoglobin saturation (SpO2), such as oxygen desaturation index (ODI) and percentage of cumulative sleep time spent with SpO2 below 90% (CT90), as predictors of postoperative respiratory depression. However, their performance has been limited with area under the curve of 0.60 for ODI and 0.59 for CT90. Our objective was to propose novel features from preoperative overnight SpO2 which are correlated with sleep apnea severity and predictive of postoperative respiratory depression. Methods: Preoperative SpO2 signals from 235 surgical patients were retrospectively analyzed to derive seven features to characterize the sleep apnea severity. The features included entropy and standard deviation of SpO2 signal; below average burden characterizing the area under the average SpO2; average, standard deviation, and entropy of desaturation burdens; and overall nocturnal desaturation burden. The association between the extracted features and sleep apnea severity was assessed using Pearson correlation analysis. Logistic regression was employed to evaluate the predictive performance of the features in identifying postoperative respiratory depression. Results: Our findings indicated a similar performance of the proposed features to the conventional apnea–hypopnea index (AHI) for assessing sleep apnea severity, with average area under the curve ranging from 0.77 to 0.81. Notably, entropy and standard deviation of overnight SpO2 signal and below average burden showed comparable predictive capability to AHI but with minimal computational requirements and individuals' burden, making them promising for screening purposes. Our sex-based analysis revealed that compared to entropy and standard deviation, below average burden exhibited higher sensitivity in detecting respiratory depression in women than men. Conclusion: This study underscores the potential of preoperative SpO2 features as alternative metrics to AHI in predicting postoperative respiratory. [ABSTRACT FROM AUTHOR]

This publication presents the effect of hypochlorous acid dry mist as a disinfectant on selected bacteria, viruses, spores, and fungi as well as on portable Microlife OXY 300 finger pulse oximeters and electronic systems of Raspberry Pi Zero microcomputers. The impact of hypochlorous acid on microbiological agents was assessed at concentrations of 300, 500, and 2000 ppm of HClO according to PN-EN 17272 (Variant I). Studies of the impact of hypochlorous acid fog on electronic components were carried out in an aerosol chamber at concentrations of 500 ppm and 2000 ppm according to two models consisting of 30 (Variant II) and 90 fogging cycles (Variant III). Each cycle included the process of generating a dry mist of hypochlorous acid (25 mL/m3), decontamination of the test elements, as well as cleaning the chamber of the disinfectant agent. The exposure of the materials examined on hypochlorous acid dry mist in all variants resulted in a decrease in the number of viruses, bacteria, spores, and fungi tested. In addition, the research showed that in the variants of hypochlorous acid fogging cycles analyzed, no changes in performance parameters and no penetration of dry fog of hypochlorous acid into the interior of the tested medical devices and electronic systems were observed. [ABSTRACT FROM AUTHOR]

Background:Spinal route of approach is the standard mode of regional anesthesia for conducting caesarean section is considered the standard mode of anaesthesia in caesarean section and it is considered safe, low cost with patient compliance. Spinal anesthesia induced sympathetic blockade, supine hypotension syndrome and low baseline vascular tone cause post spinal hypotension in the mothers. Perfusion index is a real time non-invasive parameter for early detection of this post spinal hypotension. Therefore the aim of this study was early prediction of anypost spinal hypotension and its degree of correlation withperfusion index. Materialsand Methods:A prospective observation study was conduct on200parturient, based on inclusion exclusion criteria devoid of any co-morbidities undergoing elective caesarean section subjected to spinal anesthesia. After routine investigations parturient were posted for elective caesarean section maintaining proper fasting guidelines. The perfusion index was measured with pulse oximeter at fixed time interval along with other vital parameters. The final data were analyzed with appropriate statistical software. Results:The parturient whose baseline finger perfusion index (P.I) is >3.5 have more chance of post spinal hypotension with a significance of p< 0.0001. Finger P.I with degree of decrease of SBP has positive correlation with highly significant value (r=0.7,p value<0.0001) whereas for MAP, it is highly significant but notpositively correlated(r=0.4, p value<0.0001). Conclusion:Finger perfusion index is an effective non- invasive predictor for the post spinal hypotension undergoing elective caesarean section. Additionally, the finger perfusion index is a reliable indicator of the extent to which systolic and mean arterial pressure decreases. [ABSTRACT FROM AUTHOR]

The main aims of the current work are to design, fabricate, and test a low-cost, easy-to-operate portable pulse oximeter device capable of providing immediate blood oxygen saturation and heart rate readings with high accuracy for various disease conditions and all age groups. It can be used in intensive care departments, operating rooms, and health centers as well as at homes. The obtained results were compared using a calibrated device produced by a reputable company. The clinical examination results were evaluated by using the Export System 13.0 statistical software program. The readings are close to each other, with an error rate of less than 1%. The obtained results show that, in the case of a respiratory disease such as chronic obstructive pulmonary or other lung diseases, the percentage of oxygen saturation decreased to between 73 to 88 %. For patients with heart disease, it was found that the oxygen saturation level changes significantly according to the type of disease. These obtained values decreased by 11.11 %, and 7.08% compared to healthy people, respectively. For the smokers, the blood oxygen saturation rate decreased by 10.47% and 8.06% compared to healthy people, respectively. For those infected with the COVID-19 epidemic, the rate of blood oxygen saturation and heart rates decreased sharply by 31.51 % and 27.03 %, and by 14.67% and 16.67 % compared to healthy people for males and females, respectively. For asthma patients, the rate of blood oxygen saturation and heart rate decreased by 2.50 %, and 4.65 %, and increased by 4.65 % and 4.76 % compared to healthy people for male and female, respectively. For physical activities, such as athletes, the rate of blood oxygen saturation and heart rate were increased by 1.05 %, 3.19 %, 23.26 %, and 28.57 % compared to healthy people for males and females, respectively. [ABSTRACT FROM AUTHOR]

The article discusses a corporate proxy battle involving Chief Executive Officer (CEO) Joe Kiani and Masimo, a medical technology company. It draws parallels to the historical Ides of March, warning stakeholders to be cautious of potential power struggles and conflicts within the company. It provides insights into the implications of the proxy battle for the company's future and its stakehoders.

The article discusses a case of a 30-year-old Chinese male who attempted suicide by ingesting sodium nitrite purchased online in Singapore, resulting in methaemoglobinemia. The patient had a history of anxiety and delusional disorder and was successfully treated with methylene blue as an antidote. The text highlights the emerging trend of using sodium nitrite for suicide in Asia and emphasizes the importance of prompt identification and treatment of such cases to reduce mortality. [Extracted from the article]

Background: The impact of closed-loop control systems to titrate oxygen flow in critically ill patients, including their effectiveness, efficacy, workload and safety, remains unclear. This systematic review investigated the utilization of closed-loop oxygen systems for critically ill patients in comparison to manual oxygen titration systems focusing on these topics. Methods and findings: A search was conducted across several databases including MEDLINE, CENTRAL, EMBASE, LILACS, CINAHL, LOVE, ClinicalTrials.gov, and the World Health Organization on March 3, 2022, with subsequent updates made on June 27, 2023. Evidence databases were searched for randomized clinical parallel or crossover studies investigating closed-loop oxygen control systems for critically ill patients. This systematic review and meta-analysis was performed following the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines. The analysis was conducted using Review Manager software, adopting the mean difference or standardized mean difference with a 95% confidence interval (95% CI) for continuous variables or risk ratio with 95% CI for dichotomous outcomes. The main outcome of interest was the percentage of time spent in the peripheral arterial oxygen saturation target. Secondary outcomes included time for supplemental oxygen weaning, length of stay, mortality, costs, adverse events, and workload of healthcare professional. A total of 37 records from 21 studies were included in this review with a total of 1,577 participants. Compared with manual oxygen titration, closed-loop oxygen control systems increased the percentage of time in the prescribed SpO2 target, mean difference (MD) 25.47; 95% CI 19.7, 30.0], with moderate certainty of evidence. Current evidence also shows that closed-loop oxygen control systems have the potential to reduce the percentage of time with hypoxemia (MD -0.98; 95% CI -1.68, -0.27) and healthcare workload (MD -4.94; 95% CI -7.28, -2.61) with low certainty of evidence. Conclusion: Closed-loop oxygen control systems increase the percentage of time in the preferred SpO2 targets and may reduce healthcare workload. Trial registration: PROSPERO: CRD42022306033. [ABSTRACT FROM AUTHOR]

Background: Pulse oximetry is a valuable tool for monitoring animals during anesthesia and assessing the adequacy of administered oxygen therapy. Aims: To compare the pulse oximeter readings obtained by the Garmin Fenix 5X plus (GF5Xp) smartwatch and transmittance pulse oximetry (TPO) in anesthetized dogs. Methods: Twelve clinical canine patients requiring anesthesia for castration were prospectively enrolled in this study. The animals were premedicated with intramuscular dexmedetomidine at a dose of 5 µg/kg. Anesthesia was induced through intravenous administration of propofol and maintained using sevoflurane. The arterial hemoglobin oxygen saturation (SpO2) readings obtained from the tongue using TPO (238 readings) were compared with measurements taken over the lateral side of the tibia using a GF5Xp smart wearable device (238 readings). This comparison was performed using a Bland-Altman plot, where the differences (%) between the methods were plotted against their mean SpO2 (Gold standard - Device), and the limits of agreement were represented as the mean ± 1.96 times the standard deviation. Results: The SpO2 levels in dogs were overestimated by the GF5Xp relative to the readings obtained by the TPO, with the bias of - 0.3% (95% CI: -3.1%-2.5%). Conclusion: GF5Xp may be interchangeable with TPO in dogs. Further studies are required to validate the accuracy of the GF5Xp in non-anesthetized dogs or dogs outside the physiological range. [ABSTRACT FROM AUTHOR]

Purpose: The goal of this work was to compare pO2 measured using both continuous wave (CW) and pulse electron paramagnetic resonance (EPR) spectroscopy. The Oxychip particle spin probe enabled longitudinal monitoring of pO2 in murine pancreatic tumor treated with gemcitabine during the course of therapy. Procedures: Pancreatic PanO2 tumors were growing in the syngeneic mice, in the leg. Five doses of saline in control animals or gemcitabine were administered every 3 days, and pO2 was measured after each dose at several time points. Oxygen partial pressure was determined from the linewidth of the CW EPR signal (Bruker E540L) or from the T2 measured using the electron spin echo sequence (Jiva-25™). Results: The oxygen sensitivity was determined from a calibration curve as 6.1 mG/mm Hg in CW EPR and 68.5 ms−1/mm Hg in pulse EPR. A slight increase in pO2 of up to 20 mm Hg was observed after the third dose of gemcitabine compared to the control. The maximum delta pO2 during the therapy correlated with better survival. Conclusions: Both techniques offer fast and reliable oximetry in vivo, allowing to follow the effects of pharmaceutic intervention. [ABSTRACT FROM AUTHOR]

Birth asphyxia is a potential cause of death that is also associated with acute and chronic morbidities. The traditional and immediate approach for monitoring birth asphyxia (i.e., arterial blood gas analysis) is highly invasive and intermittent. Additionally, alternative noninvasive approaches such as pulse oximeters can be problematic, due to the possibility of false and erroneous measurements. Therefore, further research is needed to explore alternative noninvasive and accurate monitoring methods for asphyxiated neonates. This study aims to investigate the prominent ECG features based on pH estimation that could potentially be used to explore the noninvasive, accurate, and continuous monitoring of asphyxiated neonates. The dataset used contained 274 segments of ECG and pH values recorded simultaneously. After preprocessing the data, principal component analysis and the Pan–Tompkins algorithm were used for each segment to determine the most significant ECG cycle and to compute the ECG features. Descriptive statistics were performed to describe the main properties of the processed dataset. A Kruskal–Wallis nonparametric test was then used to analyze differences between the asphyxiated and non-asphyxiated groups. Finally, a Dunn–Šidák post hoc test was used for individual comparison among the mean ranks of all groups. The findings of this study showed that ECG features (T/QRS, T Amplitude, Tslope, Tslope/T, Tslope/|T|, HR, QT, and QTc) based on pH estimation differed significantly (p < 0.05) in asphyxiated neonates. All these key ECG features were also found to be significantly different between the two groups. [ABSTRACT FROM AUTHOR]

Pulse oximeters are widely used in hospitals and homes for measurement of blood oxygen saturation level (SpO2) and heart rate (HR). Concern has been raised regarding a possible bias in obtaining pulse oximeter measurements from different fingertips and the potential effect of skin pigmentation (white, brown, and dark). In this study, we obtained 600 SpO2 measurements from 20 volunteers using three UK NHS-approved commercial pulse oximeters alongside our custom-developed sensor, and used the Munsell colour system (5YR and 7.5YR cards) to classify the participants' skin pigmentation into three distinct categories (white, brown, and dark). The statistical analysis using ANOVA post hoc tests (Bonferroni correction), a Bland–Altman plot, and a correlation test were then carried out to determine if there was clinical significance in measuring the SpO2 from different fingertips and to highlight if skin pigmentation affects the accuracy of SpO2 measurement. The results indicate that although the three commercial pulse oximeters had different means and standard deviations, these differences had no clinical significance. [ABSTRACT FROM AUTHOR]

Background: During the coronavirus disease 2019 (COVID-19) pandemic, hospitals and healthcare systems launched innovative responses to emerging needs. The creation and use of programs to remotely follow patient clinical status and recovery after COVID-19 hospitalization has not been thoroughly described. Objective: To characterize deployment of remote post-hospital discharge monitoring programs during the COVID-19 pandemic Methods: Electronic surveys were administered to leaders of 83 US academic hospitals in the Hospital Medicine Re-engineering Network (HOMERuN). An initial survey was completed in March 2021 with follow-up survey completed in July 2022. Results: There were 35 responses to the initial survey (42%) and 15 responses to the follow-up survey (43%). Twenty-two (63%) sites reported a post-discharge monitoring program, 16 of which were newly developed for COVID-19. Physiologic monitoring devices such as pulse oximeters were often provided. Communication with medical teams was often via telephone, with moderate use of apps or electronic medical record integration. Programs launched most commonly between January and June 2020. Only three programs were still active at the time of follow-up survey. Conclusions: Our findings demonstrate rapid, ad hoc development of post-hospital discharge monitoring programs during the COVID-19 pandemic but with little standardization or evaluation. Additional study could identify the benefits of these programs, instruct their potential application to other disease processes, and inform further development as part of emergency preparedness for upcoming crises. [ABSTRACT FROM AUTHOR]

The reader will come to appreciate that: • Race-based disparities in pulse oximetry have been reported in large retrospective database studies involving adults and recently in pediatric populations. • Pulse oximeters overestimate oxygen saturation in Black compared to other races, particularly in hypoxic states. • Role of skin pigmentation and other dermatological factors that may vary between racial groups has not been evaluated. • Defining mechanisms of this inaccuracy is critical to addressing this disparity in pulse oximeter performance. Race-based and skin pigmentation-related inaccuracies in pulse oximetry have recently been highlighted in several large electronic health record-based retrospective cohort studies across diverse patient populations and healthcare settings. Overestimation of oxygen saturation by pulse oximeters, particularly in hypoxic states, is disparately higher in Black compared to other racial groups. Compared to adult literature, pediatric studies are relatively few and mostly reliant on birth certificates or maternal race-based classification of comparison groups. Neonates, infants, and young children are particularly susceptible to the adverse life-long consequences of hypoxia and hyperoxia. Successful neonatal resuscitation, precise monitoring of preterm and term neonates with predominantly lung pathology, screening for congenital heart defects, and critical decisions on home oxygen, ventilator support and medication therapies, are only a few examples of situations that are highly reliant on the accuracy of pulse oximetry. Undetected hypoxia, especially if systematically different in certain racial groups may delay appropriate therapies and may further perpetuate health care disparities. The role of biological factors that may differ between racial groups, particularly skin pigmentation that may contribute to biased pulse oximeter readings needs further evaluation. Developmental and maturational changes in skin physiology and pigmentation, and its interaction with the operating principles of pulse oximetry need further study. Importantly, clinicians should recognize the limitations of pulse oximetry and use additional objective measures of oxygenation (like co-oximetry measured arterial oxygen saturation) where hypoxia is a concern. [ABSTRACT FROM AUTHOR]

The blood oxygen saturation, which indicates the ratio of oxygenated hemoglobin to total hemoglobin in the blood, is closely related to one's health status. Oxygen saturation is typically measured using a pulse oximeter. However, this method can cause skin irritation, and in situations where there is a risk of infectious diseases, the use of such contact-based oxygen saturation measurement devices can increase the risk of infection. Therefore, recently, methods for estimating oxygen saturation using facial or hand images have been proposed. In this paper, we propose a method for estimating oxygen saturation from facial images based on a convolutional neural network (CNN). Particularly, instead of arbitrarily calculating the AC and DC components, which are essential for measuring oxygen saturation, we directly utilized signals obtained from facial images to train the model and predict oxygen saturation. Moreover, to account for the time-consuming nature of accurately measuring oxygen saturation, we diversified the model inputs. As a result, for inputs of 10 s, the Pearson correlation coefficient was calculated as 0.570, the mean absolute error was 1.755%, the root mean square error was 2.284%, and the intraclass correlation coefficient was 0.574. For inputs of 20 s, these metrics were calculated as 0.630, 1.720%, 2.219%, and 0.681, respectively. For inputs of 30 s, they were calculated as 0.663, 2.142%, 2.612%, and 0.646, respectively. This confirms that it is possible to estimate oxygen saturation without calculating the AC and DC components, which heavily influence the prediction results. Furthermore, we analyzed how the trained model predicted oxygen saturation through 'SHapley Additive exPlanations' and found significant variations in the feature contributions among participants. This indicates that, for more accurate predictions of oxygen saturation, it may be necessary to individually select appropriate color channels for each participant. [ABSTRACT FROM AUTHOR]

Pulse oximeters measure peripheral arterial oxygen saturation (SpO2) noninvasively, while the gold standard (SaO2) involves arterial blood gas measurement. There are known racial and ethnic disparities in their performance. BOLD is a dataset that aims to underscore the importance of addressing biases in pulse oximetry accuracy, which disproportionately affect darker-skinned patients. The dataset was created by harmonizing three Electronic Health Record databases (MIMIC-III, MIMIC-IV, eICU-CRD) comprising Intensive Care Unit stays of US patients. Paired SpO2 and SaO2 measurements were time-aligned and combined with various other sociodemographic and parameters to provide a detailed representation of each patient. BOLD includes 49,099 paired measurements, within a 5-minute window and with oxygen saturation levels between 70–100%. Minority racial and ethnic groups account for ~25% of the data – a proportion seldom achieved in previous studies. The codebase is publicly available. Given the prevalent use of pulse oximeters in the hospital and at home, we hope that BOLD will be leveraged to develop debiasing algorithms that can result in more equitable healthcare solutions. [ABSTRACT FROM AUTHOR]

Dissolved Oxygen (DO) in water enables marine life. Measuring the prevalence of DO in a body of water is an important part of sustainability efforts because low oxygen levels are a primary indicator of contamination and distress in bodies of water. Therefore, aquariums and aquaculture of all types are in need of near real-time dissolved oxygen monitoring and spend a lot of money on purchasing and maintaining DO meters that are either expensive, inefficient, or manually operated—in which case they also need to ensure that manual readings are taken frequently which is time consuming. Hence a cost-effective and sustainable automated Internet of Things (IoT) system for this task is necessary and long overdue. DOxy, is such an IoT system under research and development at Santa Clara University's Ethical, Pragmatic, and Intelligent Computing (EPIC) Laboratory which utilizes cost-effective, accessible, and sustainable Sensing Units (SUs) for measuring the dissolved oxygen levels present in bodies of water which send their readings to a web based cloud infrastructure for storage, analysis, and visualization. DOxy's SUs are equipped with a High-sensitivity Pulse Oximeter meant for measuring dissolved oxygen levels in human blood, not water. Hence a number of parallel readings of water samples were gathered by both the High-sensitivity Pulse Oximeter and a standard dissolved oxygen meter. Then, two approaches for relating the readings were investigated. In the first, various machine learning models were trained and tested to produce a dynamic mapping of sensor readings to actual DO values. In the second, curve-fitting models were used to produce a successful conversion formula usable in the DOxy SUs offline. Both proved successful in producing accurate results. [ABSTRACT FROM AUTHOR]

Background: Self-efficacy is an important factor associated with healthy lifestyle changes in heart failure treatment. Functional capacity testing of heart failure patients (HFPs) can stratify prognosis. Reduced functional capacities in HFPs are linked to a poor heart failure prognosis. Limited research has examined the potential relationship between self-efficacy and functional capacity. Aim: The aims of this study were to assess self-efficacy level and functional capacity among HFPs after hospitalization, and examine whether there is a relationship between them. Methods: A descriptive correlational design was used. A convenience sample of 220 HFPs was recruited from 2 hospitals in Jordan. The Arabic version of Cardiac Self-Efficacy Questionnaire was used to assess self-efficacy, the 6-Minute Walking Test (6-MWT) was used to assess functional capacity, and the Borg rating of perceived exertion scale (Borg Scale) was used to assess exertion during 6-MWT. Result: The sample included 46.8% male (n = 103) and 53.2% female (n = 117). The mean age was 52.66 ± 8.91 years. Most of the HFPswere categorized based on New York Heart Association classification as class I, 35.9% (n = 79), and class II, 41.4% (n = 91). The mean ejection fraction was 41.46 ± 9.44. The global self-efficacy was moderate (32.98 ± 9.92), and the mean score for the 6-MWT was 494.35 ± 143. 37. The Borg Scale mean was 10.94 ± 3.34. In addition, there was a positive relationship between self-efficacy and 6-MWT (r = 0.63, n = 220, P = .01). Conclusion: This study provides baseline data for further research on treatment of HFPs, and the development of evidence-based tailored health interventions to maintain and improve self-efficacy and functional capacity among these service users. Moreover, replicated researches can test the study results considering different methodologies, such as using objective functional capacity tool and longer follow-up periods. [ABSTRACT FROM AUTHOR]

Arterial occlusion pressure (AOP) of the brachial artery was measured simultaneously using Doppler ultrasound (US), a hand-held Doppler (HHDOP), and a pulse oximeter (PO) in the dominant (DOM) and nondominant (NDOM) arms of males (n = 21) and females (n = 23) using continuous (CONT) and incremental (INCR) cuff inflation protocols. A mixed-model analysis of variance revealed significant (p, 0.05) overall main effects between AOP measured using a CONT (115.7 ± 10.9) or INCR (115.0 ± 11.5) cuff inflation protocol; between AOP measured using US (116.3 ± 11.2), HHDOP (115.4 ± 11.2), and PO (114.4 ± 11.2); and between males (120.7 6 10.6) and females (110.569.4). The small overall difference (1.8163.3) between US and PO measures of AOP was significant (p, 0.05), but the differences between US and HHDOP and between HHDOP and PO measures of AOP were not significant. There were no overall differences in AOP between the DOM and NDOM arms. Trial-to-trial variance in US measurements of AOP was not significant when using either cuff inflation protocol but was significant when using HHDOP and PO and a CONT cuff inflation protocol. Bland-Altman plots revealed reasonable limits of agreement for both HHDOP and PO measures of AOP. The small differences in US, HHDOP, and PO measurements of AOP when using CONT or INCR cuff inflation protocols are of minimal practical importance. The choice of cuff inflation protocol is one of personal preference. Hand-held Doppler of PO can be used to assess AOP before using blood flow restriction during exercise. [ABSTRACT FROM AUTHOR]

Background: Point-of-care (POC) technology aims to hasten diagnosis in the clinical setting. Reducing samples, especially invasive samples, for the same result will reduce the work volume, and potentially the cost. Faith in POC devices requires finding the most reliable POC device in the interest of cost and patient benefit, especially in an intensive care unit (ICU). Methods: This study assessed the haemoglobin (Hb) correlation between invasive and non-invasive POC devices at a quaternary trauma ICU. A non-invasive, continuous Hb pulse oximeter was compared with two invasive POC devices, as well as the laboratory reference measurement. A 10% variance was considered a clinically significant difference. Results: A total number of 48 arterial blood gas (ABG) measurements, 49 Mission haemoglobinometer measurements, 50 Masimo Radical-7 measurements, and 52 Inkosi Albert Luthuli Central Hospital (IALCH) laboratory Hb measurements were performed with a mean Hb of 8.8. The Masimo non-invasive haemoglobinometer failed to demonstrate interchangeability with the GEM blood gas analyser machine (p < 0.004), neither did it show interchangeability with the IALCH laboratory measurements (p < 0.001), or the Mission haemoglobinometer (p < 0.0014). Comparing the POC devices with the results from the laboratory revealed that the ABG machine (GEM 4000) was the closest to correlate with the laboratory measurements (mean device difference of 0.51, p < 0.007). The values for the Mission haemoglobinometer were the next closest, but both the devices slightly overestimate the Hb in the order of 6-7%. Conclusion: This study compared the equivalence of the Hb level measured by two currently used POC devices (the Gem 4000 and Mission haemoglobinometer) against a novel, continuous, non-invasive device (the Masimo device) and the reference standard laboratory Hb level. The study found that the novel device did not perform equivalent or better than the existing devices. [ABSTRACT FROM AUTHOR]