Background The digital age, with digital sensors, the Internet of Things (IoT), and big data tools, has opened new opportunities for improving the delivery of health care services, with remote monitoring systems playing a crucial role and improving access to patients. The versatility of these systems has been demonstrated during the current COVID-19 pandemic. Health remote monitoring systems (HRMS) present various advantages such as the reduction in patient load at hospitals and health centers. Patients that would most benefit from HRMS are those with chronic diseases, older adults, and patients that experience less severe symptoms recovering from SARS-CoV-2 viral infection. Objective This paper aimed to perform a systematic review of the literature of HRMS in primary health care (PHC) settings, identifying the current status of the digitalization of health processes, remote data acquisition, and interactions between health care personnel and patients. Methods A systematic literature review was conducted using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines to identify articles that explored interventions with HRMS in patients with chronic diseases in the PHC setting. Results The literature review yielded 123 publications, 18 of which met the predefined inclusion criteria. The selected articles highlighted that sensors and wearables are already being used in multiple scenarios related to chronic disease management at the PHC level. The studies focused mostly on patients with diabetes (9/26, 35%) and cardiovascular diseases (7/26, 27%). During the evaluation of the implementation of these interventions, the major difficulty that stood out was the integration of information into already existing systems in the PHC infrastructure and in changing working processes of PHC professionals (83%). Conclusions The PHC context integrates multidisciplinary teams and patients with often complex, chronic pathologies. Despite the theoretical framework, objective identification of problems, and involvement of stakeholders in the design and implementation processes, these interventions mostly fail to scale up. Despite the inherent limitations of conducting a systematic literature review, the small number of studies in the PHC context is a relevant limitation. This study aimed to demonstrate the importance of matching technological development to the working PHC processes in interventions regarding the use of sensors and wearables for remote monitoring as a source of information for chronic disease management, so that information with clinical value is not lost along the way.
The smart city concept, in which data from different systems are available, contains a multitude of critical infrastructures. This data availability opens new research opportunities in the study of the interdependency between those critical infrastructures and cascading effects solutions and focuses on the smart city as a network of critical infrastructures. This paper proposes an integrated resilience system linking interconnected critical infrastructures in a smart city to improve disaster resilience. A data-driven approach is considered, using artificial intelligence and methods to minimize cascading effects and the destruction of failing critical infrastructures and their components (at a city level). The proposed approach allows rapid recovery of infrastructures’ service performance levels after disasters while keeping the coverage of the assessment of risks, prevention, detection, response, and mitigation of consequences. The proposed approach has the originality and the practical implication of providing a decision support system that handles the infrastructures that will support the city disaster management system—make the city prepare, adapt, absorb, respond, and recover from disasters by taking advantage of the interconnections between its various critical infrastructures to increase the overall resilience capacity. The city of Lisbon (Portugal) is used as a case to show the practical application of the approach.
Data sharing in the health sector represents a big problem due to privacy and security issues. Health data have tremendous value for organisations and criminals. The European Commission has classified health data as a unique resource owing to their ability to enable both retrospective and prospective research at a low cost. Similarly, the Organisation for Economic Co-operation and Development (OECD) encourages member nations to create and implement health data governance systems that protect individual privacy while allowing data sharing. This paper proposes adopting a blockchain framework to enable the transparent sharing of medical information among health entities in a secure environment. We develop a laboratory-based prototype using a design science research methodology (DSRM). This approach has its roots in the sciences of engineering and artificial intelligence, and its primary goal is to create relevant artefacts that add value to the fields in which they are used. We adopt a patient-centric approach, according to which a patient is the owner of their data and may allow hospitals and health professionals access to their data.
Traffic accidents in urban areas lead to reduced quality of life and added pressure in the cities’ infra-structures. In the context of smart city data is becoming available that allows a deeper analysis of the phenomenon. We propose a data fusion process from different information sources like road accidents, weather conditions, local authority reports tools, traffic, fire brigade. These big data analytics allow the creation of knowledge for local municipalities using local data. Data visualizations allow big picture overview. This paper presents an approach to the geo-referenced accident-hotspots identification. Using ArcGIS Pro, we apply Kernel Density and Hot Spot Analysis (Getis-Ord Gi*) tools, identifying the existence of black spots in terms of location and context conditions, and evaluate the possible human, environmental and circumstantial factors that may influence the severity of accidents. The results were validated by an expert committee. This approach can be applied to other cites wherever this data is available.
Buildings in Lisbon are often the victim of several types of events (such as accidents, fires, collapses, etc.). This study aims to apply a data-driven approach towards knowledge extraction from past incident data, nowadays available in the context of a Smart City. We apply a Cross Industry Standard Process for Data Mining (CRISP-DM) approach to perform incident management of the city of Lisbon. From this data-driven process, a descriptive and predictive analysis of an events dataset provided by the Lisbon Municipality was possible, together with other data obtained from the public domain, such as the temperature and humidity on the day of the events. The dataset provided contains events from 2011 to 2018 for the municipality of Lisbon. This data mining approach over past data identified patterns that provide useful knowledge for city incident managers. Additionally, the forecasts can be used for better city planning, and data correlations of variables can provide information about the most important variables towards those incidents. This approach is fundamental in the context of smart cities, where sensors and data can be used to improve citizens’ quality of life. Smart Cities allow the collecting of data from different systems, and for the case of disruptive events, these data allow us to understand them and their cascading effects better.
Transportation contributes to more than 25% of the European Union’s (EU) Greenhouse Gas Emissions (GHG) emissions [...]
Currently, an echocardiography expert is needed to identify calcium in the aortic valve, and a cardiac CT-Scan image is needed for calcium quantification. When performing a CT-scan, the patient is subject to radiation, and therefore the number of CT-scans that can be performed should be limited, restricting the patient’s monitoring. Computer Vision (CV) has opened new opportunities for improved efficiency when extracting knowledge from an image. Applying CV techniques on echocardiography imaging may reduce the medical workload for identifying the calcium and quantifying it, helping doctors to maintain a better tracking of their patients. In our approach, a simple technique to identify and extract the calcium pixel count from echocardiography imaging, was developed by using CV. Based on anonymized real patient echocardiographic images, this approach enables semi-automatic calcium identification. As the brightness of echocardiography images (with the highest intensity corresponding to calcium) vary depending on the acquisition settings, echocardiographic adaptive image binarization has been performed. Given that blood maintains the same intensity on echocardiographic images—being always the darker region—blood areas in the image were used to create an adaptive threshold for binarization. After binarization, the region of interest (ROI) with calcium, was interactively selected by an echocardiography expert and extracted, allowing us to compute a calcium pixel count, corresponding to the spatial amount of calcium. The results obtained from these experiments are encouraging. With this technique, from echocardiographic images collected for the same patient with different acquisition settings and different brightness, obtaining a calcium pixel count, where pixel values show an absolute pixel value margin of error of 3 (on a scale from 0 to 255), achieving a Pearson Correlation of 0.92 indicating a strong correlation with the human expert assessment of calcium area for the same images.
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