The evolution of the Internet of Things (IoT) has augmented the necessity for Cloud, edge and fog platforms. The chief benefit of cloud-based schemes is they allow data to be collected from numerous services and sites, which is reachable from any place of the world. The organizations will be benefited by merging the cloud platform with the on-site fog networks and edge devices and as result, this will increase the utilization of the IoT devices and end users too. The network traffic will reduce as data will be distributed and this will also improve the operational efficiency. The impact of monitoring in edge and fog computing can play an important role to efficiently utilize the resources available at these layers. This paper discusses various techniques involved for monitoring for edge and fog computing and its advantages. The paper ends with a case study to demonstarte the need of monitoring in fog and edge in the healthcare system.

In the healthcare domain, a transformative shift is envisioned towards Healthcare 5.0. It expands the operational boundaries of Healthcare 4.0 and leverages patient-centric digital wellness. Healthcare 5.0 focuses on real-time patient monitoring, ambient control and wellness, and privacy compliance through assisted technologies like artificial intelligence (AI), Internet-of-Things (IoT), big data, and assisted networking channels. However, healthcare operational procedures, verifiability of prediction models, resilience, and lack of ethical and regulatory frameworks are potential hindrances to the realization of Healthcare 5.0. Recently, explainable AI (EXAI) has been a disruptive trend in AI that focuses on the explainability of traditional AI models by leveraging the decision-making of the models and prediction outputs. The explainability factor opens new opportunities to the black-box models and brings confidence in healthcare stakeholders to interpret the machine learning (ML) and deep learning (DL) models. EXAI is focused on improving clinical health practices and brings transparency to the predictive analysis, which is crucial in the healthcare domain. Recent surveys on EXAI in healthcare have not significantly focused on the data analysis and interpretation of models, which lowers its practical deployment opportunities. Owing to the gap, the proposed survey explicitly details the requirements of EXAI in Healthcare 5.0, the operational and data collection process. Based on the review method and presented research questions, systematically, the article unfolds a proposed architecture that presents an EXAI ensemble on the computerized tomography (CT) image classification and segmentation process. A solution taxonomy of EXAI in Healthcare 5.0 is proposed, and operational challenges are presented. A supported case study on electrocardiogram (ECG) monitoring is presented that preserves the privacy of local models via federated learning (FL) and EXAI for metric validation. The case-study is supported through experimental validation. The analysis proves the efficacy of EXAI in health setups that envisions real-life model deployments in a wide range of clinical applications.

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Recently, in healthcare organizations, real-time data have been collected from connected or implantable sensors, layered protocol stacks, lightweight communication frameworks, and end devices, named the Internet-of-Medical-Things (IoMT) ecosystems. IoMT is vital in driving healthcare analytics (HA) toward extracting meaningful data-driven insights. Recently, concerns have been raised over data sharing over IoMT, and stored electronic health records (EHRs) forms due to privacy regulations. Thus, with less data, the analytics model is deemed inaccurate. Thus, a transformative shift has started in HA from centralized learning paradigms towards distributed or edge-learning paradigms. In distributed learning, federated learning (FL) allows for training on local data without explicit data-sharing requirements. However, FL suffers from a high degree of statistical heterogeneity of learning models, level of data partitions, and fragmentation, which jeopardizes its accuracy during the learning and updating process. Recent surveys of FL in healthcare have yet to discuss the challenges of massive distributed datasets, sparsification, and scalability concerns. Because of this gap, the survey highlights the potential integration of FL in IoMT, the FL aggregation policies, reference architecture, and the use of distributed learning models to support FL in IoMT ecosystems. A case study of a trusted cross-cluster-based FL, named Cross-FL, is presented, highlighting the gradient aggregation policy over remotely connected and networked hospitals. Performance analysis is conducted regarding system latency, model accuracy, and the trust of consensus mechanism. The distributed FL outperforms the centralized FL approaches by a potential margin, which makes it viable for real-IoMT prototypes. As potential outcomes, the proposed survey addresses key solutions and the potential of FL in IoMT to support distributed networked healthcare organizations.

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