The effects of wireless devices on male reproductive health: A literature overview / Los efectos de los dispositivos inalámbricos en la salud reproductiva masculina: una descripción general de la literature

Purpose: The aim of this study was to summarize the evidence of radiofrequency electromagnetic radiation (RF-EMR) exposure from wireless devices on total motile sperm count (TMSC) and identify gaps in the literature that could help clarify this link.Materials and methods: A literature search was conducted using PubMed/MEDLINE to find relevant studies examining the effects of EMR on male fertility, with a specific focus on TMSC, published from 2000 to 2019. R was used for data analyses.Results: Motility was identified as the parameter linked to TMSC that was most negatively impacted by EMR exposure. Many gaps were found including geographic and lack of standardization with EMR factors such as exposure time and operating frequency.Conclusion: The EMR emitted by wireless devices may negatively affect TMSC, which is one of the better predictors of achieving pregnancies and impairs male fertility. Our findings highlight the need for clinicians to explore wireless device usage to help guide treatment decisions in men or couples with subfertility concerns. (AU)

Objetivo: El objetivo de este estudio fue resumir la evidencia de la exposición a la radiación electromagnética (EMR) por radiofrecuencia de dispositivos inalámbricos en el recuento total de espermatozoides móviles (TMSC) e identificar brechas en la literatura que podrían ayudar a aclarar este vínculo.Materiales y métodos: Se realizó una búsqueda de literatura en PubMed/MEDLINE para encontrar estudios relevantes que examinaran los efectos de la EMR en la fertilidad masculina, con un enfoque específico en el TMSC, publicados desde 2000 hasta 2019. Se utilizó el programa R para el análisis de datos.Resultados: La motilidad se identificó como el parámetro vinculado al TMSC que se vio más negativamente afectado por la exposición a EMR. Se encontraron muchas lagunas, incluyendo la estandarización geográfica y la falta de estandarización con factores EMR, como el tiempo de exposición y la frecuencia de funcionamiento.Conclusión: La EMR emitida por dispositivos inalámbricos puede afectar negativamente al TMSC, que es uno de los mejores predictores para lograr embarazos y afecta la fertilidad masculina. Nuestros hallazgos ponen de relieve la necesidad de que los médicos exploren el uso de dispositivos inalámbricos para ayudar a guiar las decisiones de tratamiento en hombres o parejas con problemas de subfertilidad. (AU)

Machine learning for DCO-OFDM based LiFi.

Light fidelity (LiFi) uses different forms of orthogonal frequency division multiplexing (OFDM), including DC biased optical OFDM (DCO-OFDM). In DCO-OFDM, the use of a large DC bias causes optical power inefficiency, while a small bias leads to higher clipping noise. Hence, finding an appropriate DC bias level for DCO-OFDM is important. This paper applies machine learning (ML) algorithms to find optimum DC-bias value for DCO-OFDM based LiFi systems. For this, a dataset is generated for DCO-OFDM using MATLAB tool. Next, ML algorithms are applied using Python programming language. ML is used to find the important attributes of DCO-OFDM that influence the optimum DC bias. It is shown here that the optimum DC bias is a function of several factors including, the minimum, the standard deviation, and the maximum value of the bipolar OFDM signal, and the constellation size. Next, linear and polynomial regression algorithms are successfully applied to predict the optimum DC bias value. Results show that polynomial regression of order 2 can predict the optimum DC bias value with a coefficient of determination of 96.77% which confirms the effectiveness of the prediction.

Preventing Medjacking.

ABSTRACT: Advances in medical device technology have led to greater connectivity with other devices, networks, and systems, raising concerns about associated security risks. Many clinicians, as well as the patients who rely on these lifesaving devices, are unaware of these risks and how they can be mitigated. This article describes several types of cyberattacks, including medjacking, hacking, and ransomware, and what nurses can do to guard against security threats and educate patients.

Fifth Generation Cellular Networks and Neurosurgery: A Narrative Review.

Connectivity is a driving force for productivity across a wide variety of sectors in the 21st century, with health care being no exception. Fifth generation cellular technology (5G) is frequently alluded to in the mainstream media but understanding of the technology and its potential impact is not widespread in clinical communities. It promises unprecedented improvement in speed, bandwidth, reliability, and latency, all of which have significant implications for the way we use wireless data. 5G can be subdivided into 3 parallel technological architectures: extended mobile broadband (eMBB), ultra-reliable low latency communication (URLLC), and massive machine type communication (mMTC). These domains each present different and exciting prospects for the future of health care. This narrative review aims to elucidate the nature of 5G, its context within the development of telecommunications, and describe some of the notable opportunities it presents to the neurosurgical community. In many cases the requisite hardware has already been developed, but use has been limited by the requirements of a fast, reliable, and omnipresent network connection. Examples include telesurgical robots, remote supervision of procedures, integrated smart operating rooms, and clinician telepresence. The events of 2020 and the COVID-19 pandemic have brought the world's attention to digital transformation. The mechanics of 5G connectivity creates the capacity for these changes to be applied practically. An understanding of this technology is essential to appreciate the development and opportunities which will be part of our professional future.

Wireless and battery-free platforms for collection of biosignals.

Recent progress in biosensors have quantitively expanded current capabilities in exploratory research tools, diagnostics and therapeutics. This rapid pace in sensor development has been accentuated by vast improvements in data analysis methods in the form of machine learning and artificial intelligence that, together, promise fantastic opportunities in chronic sensing of biosignals to enable preventative screening, automated diagnosis, and tools for personalized treatment strategies. At the same time, the importance of widely accessible personal monitoring has become evident by recent events such as the COVID-19 pandemic. Progress in fully integrated and chronic sensing solutions is therefore increasingly important. Chronic operation, however, is not truly possible with tethered approaches or bulky, battery-powered systems that require frequent user interaction. A solution for this integration challenge is offered by wireless and battery-free platforms that enable continuous collection of biosignals. This review summarizes current approaches to realize such device architectures and discusses their building blocks. Specifically, power supplies, wireless communication methods and compatible sensing modalities in the context of most prevalent implementations in target organ systems. Additionally, we highlight examples of current embodiments that quantitively expand sensing capabilities because of their use of wireless and battery-free architectures.

Wireless Networking-Driven Healthcare Approaches in Combating COVID-19.

Since its outbreak, the coronavirus (COVID-19) pandemic has caused havoc on people's lives. All activities were paused due to the virus's spread across the continents. Researchers have been working hard to find new medication treatments for the COVID-19 pandemic. The World Health Organization (WHO) recommends that safety and self-measures play a major role in preventing the virus from spreading from one person to another. Wireless technology is playing a critical role in avoiding viral propagation. This technology mainly comprises of portable devices that assist self-isolated patients in adhering to safe precautionary measures. Government officials are currently using wireless technologies to identify infected people at large gatherings. In this research, we gave an overview of wireless technologies that assisted the general public and healthcare professionals in maintaining effective healthcare services during COVID-19. We also discussed the possible challenges faced by them for effective implementation in day-to-day life. In conclusion, wireless technologies are one of the best techniques in today's age to effectively combat the pandemic.

Wireless Laparoscopy in the 2020s: State-of-the-Art Technology in Surgery.

BACKGROUND: Wireless signal transduction is the future in the field of laparoscopic surgery. Cable-free endoscopic equipment would be the ideal surgical instrument for every laparoscopic surgeon. INSTRUMENT: Our department has developed a new cable-free laparoscopic setup that couples a rigid 0°, 10-mm laparoscope with a wireless camera modified with a special adapter. We used a portable and rechargeable LED cold light source. The signal was wirelessly transmitted from the camera to a tablet computer using the corresponding mobile application. EXPERIENCE: Our team has used this setup in 14 laparoscopic operations with excellent results. Two cases performed exclusively with the new setup are presented in the videos. The image quality obtained was comparable with the conventional laparoscopic setup, and the operations performed were unaffected. CONCLUSION: This report presents the use of a wireless camera throughout the course of a laparoscopic surgery, and the results are promising. The new systems' favorable characteristics, such as wireless signal transmission, cost, flexibility, and size, support this as a feasible new technique for performing laparoscopic surgery.

Multi-Cell LTE-U/Wi-Fi Coexistence Evaluation Using a Reinforcement Learning Framework.

Cellular broadband Internet of Things (IoT) applications are expected to keep growing year-by-year, generating demands from high throughput services. Since some of these applications are deployed over licensed mobile networks, as long term evolution (LTE), one already common problem is faced: the scarcity of licensed spectrum to cope with the increasing demand for data rate. The LTE-Unlicensed (LTE-U) forum, aiming to tackle this problem, proposed LTE-U to operate in the 5 GHz unlicensed spectrum. However, Wi-Fi is already the consolidated technology operating in this portion of the spectrum, besides the fact that new technologies for unlicensed band need mechanisms to promote fair coexistence with the legacy ones. In this work, we extend the literature by analyzing a multi-cell LTE-U/Wi-Fi coexistence scenario, with a high interference profile and data rates targeting a cellular broadband IoT deployment. Then, we propose a centralized, coordinated reinforcement learning framework to improve LTE-U/Wi-Fi aggregate data rates. The added value of the proposed solution is assessed by a ns-3 simulator, showing improvements not only in the overall system data rate but also in average user data rate, even with the high interference of a multi-cell environment.

Leveraging LoRaWAN Technology for Precision Agriculture in Greenhouses.

The technology development in wireless sensor network (WSN) offers a sustainable solution towards precision agriculture (PA) in greenhouses. It helps to effectively use the agricultural resources and management tools and monitors different parameters to attain better quality yield and production. WSN makes use of Low-Power Wide-Area Networks (LPWANs), a wireless technology to transmit data over long distances with minimal power consumption. LoRaWAN is one of the most successful LPWAN technologies despite its low data rate and because of its low deployment and management costs. Greenhouses are susceptible to different types of interference and diversification, demanding an improved WSN design scheme. In this paper, we contemplate the viable challenges for PA in greenhouses and propose the successive steps essential for effectual WSN deployment and facilitation. We performed a real-time, end-to-end deployment of a LoRaWAN-based sensor network in a greenhouse of the 'Proefcentrum Hoogstraten' research center in Belgium. We have designed a dashboard for better visualization and analysis of the data, analyzed the power consumption for the LoRaWAN communication, and tried three different enclosure types (commercial, simple box and airflow box, respectively). We validated the implications of real-word challenges on the end-to-end deployment and air circulation for the correct sensor readings. We found that temperature and humidity have a larger impact on the sensor readings inside the greenhouse than we initially thought, which we successfully solved through the airflow box design.

An Ingenious Design of a High Performance-Low Complexity Image Compressor for Wireless Capsule Endoscopy.

Wireless Capsule Endoscopy is a state-of-the-art technology for medical diagnoses of gastrointestinal diseases. The amount of data produced by an endoscopic capsule camera is huge. These vast amounts of data are not practical to be saved internally due to power consumption and the available size. So, this data must be transmitted wirelessly outside the human body for further processing. The data should be compressed and transmitted efficiently in the domain of power consumption. In this paper, a new approach in the design and implementation of a low complexity, multiplier-less compression algorithm is proposed. Statistical analysis of capsule endoscopy images improved the performance of traditional lossless techniques, like Huffman coding and DPCM coding. Furthermore the Huffman implementation based on simple logic gates and without the use of memory tables increases more the speed and reduce the power consumption of the proposed system. Further analysis and comparison with existing state-of-the-art methods proved that the proposed method has better performance.

Medical device active surveillance of spontaneous reports: A literature review of signal detection methods.

PURPOSE: The collection and analysis of real-world data for the active monitoring of medical device performance and safety has become increasingly important. Spontaneous reports, such as those in the Food & Drug Administration's (FDA's) Manufacturer and User Facility Device Experience (MAUDE), provide early warning of potential issues with marketed devices. This review synthesizes the current literature on medical device surveillance signal detection and provides a framework for application of methods to active surveillance of spontaneous reports. METHODS: Ovid MEDLINE, Ovid Embase, Scopus, and PubMed databases were systematically searched up to January 2019. Additionally, five methods articles from pharmacovigilance were added that had potential applications to medical devices. RESULTS: Among 105 articles included, the most common source of data (84%) was registries; median time between data collection and publication was 8 years. Surgical procedure outcome signal detection articles comprised 83% while 14% were on device outcome signal detection. The most common family of methods cited (70%) was Sequential Probability Ratio. CONCLUSION: Application of any signal detection algorithm requires careful consideration of influential factors, data limitations, and algorithmic assumptions. We recommend approaches using disproportionality, statistical process control, and sequential probability tests and provide R packages to further development efforts. The small number of published examples suggest that further development of statistical methods and technological solutions to analyze large amounts of data for device safety and performance is needed. Fundamental differences in products, data infrastructure, and the regulatory landscape suggest that medical device vigilance requires its own body of research distinct from pharmacovigilance.

Brain state monitoring for the future prediction of migraine attacks.

BACKGROUND: Migraine attacks are unpredictable, precluding preemptive interventions and leading to lack of control over individuals' lives. Although there are neurophysiological changes 24-48 hours before migraine attacks, so far, they have not been used in patients' management. This study evaluates the applicability and the ability to identify pre-attack changes of daily "at home" electroencephalography obtained with a portable system for migraine patients. METHODS: Patients with episodic migraine fulfilling ICHD-3 beta criteria used a mobile system composed of a wireless EEG device (BrainStation®, Neuroverse®, Inc., USA) and mobile application (BrainVitalsM®, Neuroverse®, Inc., USA) to self-record their neural activity daily at home while resting and while performing an attention task, over the course of 2 weeks. Standard EEG spectral analysis and event-related brain potentials (ERP) methods were used and recordings were grouped by time from migraine attacks (i.e. "Interictal day", "24 h Before Migraine", "Migraine day" and "Post Migraine"). RESULTS: Twenty-four patients (22 women) recorded an average of 13.3 ± 1.9 days and had 2 ± 0.9 attacks. Twenty-four hours before attack onset, there was a statistically significant modulation of relative power in the delta (decrease) and beta (increase) frequency bands, at rest, and a significant reduction of the amplitude and inter-trial coherence measures of an attention event-related brain potential (P300). CONCLUSIONS: This proof-of-concept study shows that brain state monitoring, utilising an easy-to-use wearable EEG system to track neural modulations at home, can identify physiological changes preceding a migraine attack enabling valuable pre-symptom prediction and subsequent early intervention.

Redefining Spinal Cord Stimulation "Trials": A Randomized Controlled Trial Using Single-Stage Wireless Permanent Implantable Devices.

BACKGROUND: "Traditional" spinal cord stimulation (SCS) trials with percutaneous electrodes externalized to a pulse generator (PG) are typically limited in duration due to risk of infection. Newer miniaturized wireless SCS technology eliminates the percutaneous extension (as well as PGs implanted for chronic use), thus facilitating a single-stage implantation after which the device can remain indefinitely. OBJECTIVE: To evaluate fully implanted wireless SCS devices during a 30-day screening trial in subjects with chronic low back pain and leg pain and a history of lumbosacral spine surgery. METHODS: In a randomized controlled trial of single-stage wireless SCS using a wireless percutaneous system, 99 subjects received either 10 kHz high frequency stimulation (HFS) or lower frequency stimulation (LFS) below 1500 Hz (Bolash R, Creamer M, Rauck R, et al. Wireless high frequency spinal cord stimulation (10 kHz) compared to multi-waveform low frequency spinal cord stimulation in the management of chronic pain in failed back surgery syndrome subjects: preliminary results of a multicenter, prospective, randomized controlled study. Pain Med 2019, https://doi.org/10.1093/pm/pnz019). In this report, we assess the 30-day trial success rate (≥50% pain relief from baseline) and complications. RESULTS: The overall trial success rate was 88% (87/99): 92% (46/50) for HFS and 84% (41/49) for LFS (NS). The trial success rate in the 64 subjects with predominant low back pain was 92% (59/64) vs. 80% (28/35) in those with leg pain ≥ low back pain (NS). During the screening trial, one infection occurred (1%) and one subject withdrew and was explanted (1%). Electrode migrations were seen on routine follow-up x-rays in 10 cases (10%). CONCLUSION: Using wireless SCS devices that allow for an extended trial period and evaluation of various waveforms, we observed a high rate trial success rate with both HFS and LFS waveforms, with minimal incidence of infection. Long-term follow-up will address the cost-effectiveness and morbidity associated with this technology, which facilitates single-stage treatment.

Comparative analysis of computer-vision and BLE technology based indoor navigation systems for people with visual impairments.

BACKGROUND: Considerable number of indoor navigation systems has been proposed to augment people with visual impairments (VI) about their surroundings. These systems leverage several technologies, such as computer-vision, Bluetooth low energy (BLE), and other techniques to estimate the position of a user in indoor areas. Computer-vision based systems use several techniques including matching pictures, classifying captured images, recognizing visual objects or visual markers. BLE based system utilizes BLE beacons attached in the indoor areas as the source of the radio frequency signal to localize the position of the user. METHODS: In this paper, we examine the performance and usability of two computer-vision based systems and BLE-based system. The first system is computer-vision based system, called CamNav that uses a trained deep learning model to recognize locations, and the second system, called QRNav, that utilizes visual markers (QR codes) to determine locations. A field test with 10 blindfolded users has been conducted while using the three navigation systems. RESULTS: The obtained results from navigation experiment and feedback from blindfolded users show that QRNav and CamNav system is more efficient than BLE based system in terms of accuracy and usability. The error occurred in BLE based application is more than 30% compared to computer vision based systems including CamNav and QRNav. CONCLUSIONS: The developed navigation systems are able to provide reliable assistance for the participants during real time experiments. Some of the participants took minimal external assistance while moving through the junctions in the corridor areas. Computer vision technology demonstrated its superiority over BLE technology in assistive systems for people with visual impairments.

A Survey on LPWAN Technologies in WBAN for Remote Health-Care Monitoring.

In ubiquitous health-care monitoring (HCM), wireless body area networks (WBANs) are envisioned as appealing solutions that may offer reliable methods for real-time monitoring of patients' health conditions by employing the emerging communication technologies. This paper therefore focuses more on the state-of-the-art wireless communication systems that can be explored in the next-generation WBAN solutions for HCM. Also, this study addressed the critical issues confronted by the existing WBANs that are employed in HCM. Examples of such issues include wide-range health data communication constraint, health data delivery reliability concern, and energy efficiency, which are attributed to the limitations of the legacy short range, medium range, and the cellular technologies that are typically employed in WBAN systems. Since the WBAN sensor devices are usually configured with a finite battery power, they often get drained during prolonged operations. This phenomenon is technically exacerbated by the fact that the legacy communication systems, such as ZigBee, Bluetooth, 6LoWPAN, and so on, consume more energy during data communications. This unfortunate situation offers a scope for employing suitable communication systems identified in this study to improve the productivity of WBANs in HCM. For this to be achieved, the emerging communication systems such as the low-power wide-area networks (LPWANs) are investigated in this study based on their power transmission, data transmission rate, data reliability in the context of efficient data delivery, communication coverage, and latency, including their advantages, as well as disadvantages. As a consequence, the LPWAN solutions are presented for WBAN systems in remote HCM. Furthermore, this research work also points out future directions for the realization of the next-generation of WBANs, as well as how to improve the identified communication systems, to further enhance their productivity in WBAN solutions for HCM.

Registro Español de Marcapasos. XVI Informe Oficial de la Sección de Estimulación Cardiaca de la Sociedad Española de Cardiología (2018) / Spanish Pacemaker Registry. 16th Official Report of the Spanish Society of Cardiology Working Group on Cardiac Pacing (2018)

Introducción y objetivos: Se describe el resultado del análisis de los dispositivos de estimulación implantados y remitidos al Registro Español de Marcapasos en 2018. Métodos: Información que aporta la Tarjeta Europea del Paciente Portador de Marcapasos, así como los datos proporcionados por la industria sobre el número total de dispositivos implantados. Resultados: Se recibió información de 90 centros hospitalarios, con un total de 12.148 tarjetas, lo cual supone un 31% de la actividad total estimada. El consumo de generadores convencionales y de dispositivos de resincronización fue de 825 y 77 unidades por millón de habitantes respectivamente. La media de edad de los pacientes que recibieron un implante fue 78,3 años y un 54% de los dispositivos se implantaron en pacientes mayores de 80 años. El 77,1% de los procedimientos fueron primoimplantes y el 21,6%, recambios de generador. Aunque la estimulación secuencial bicameral sigue siendo mayoritaria, se utiliza menos en pacientes mayores de 80 años y en mujeres. Además, al 28% de los pacientes con enfermedad del nódulo sinusal y el 24,7% de aquellos con bloqueo auriculoventricular se los estimula en modo VVI/R pese a estar en ritmo sinusal. Conclusiones: El consumo total de generadores de marcapasos en España ha aumentado en un 1,2% con respecto al año 2017, fundamentalmente a expensas del aumento del consumo de generadores de terapia de resincronización cardiaca con marcapasos (8,7%). Los factores directamente relacionados con la elección del modo de estimulación son la edad y el sexo

Introduction and objectives: This report describes the result of the analysis of the implanted pacemakers reported to the Spanish Pacemaker Registry in 2018. Methods: The analysis is based on the information provided by the European Pacemaker Identification Card and supplier-reported data on the overall number of implanted pacemakers. Results: Information was received from 90 hospitals, with a total of 12 148 cards, representing 31% of the estimated activity. Use of conventional and resynchronization pacemakers was 825 and 77 units per million people, respectively. The mean age of the patients receiving an implant was 78.3 years, and 54% of the devices were implanted in people aged> 80 years. A total of 77.1% were first implants and 21.6% corresponded to generator exchanges. Bicameral sequential pacing was the most frequent pacing mode but was less frequently used in patients aged> 80 years and in women. Single chamber VVI/R pacing was used in 28% of patients with sick sinus syndrome and in 24.7% of those with atrioventricular block, despite being in sinus rhythm. Conclusions: The total consumption of pacemaker generators in Spain increased by 1.2% compared with 2017, mainly due to an 8.7% increase in cardiac resynchronization therapy with pacemaker generators. Selection of pacing mode was directly influenced by age and sex

Recent Progress in Wireless Sensors for Wearable Electronics.

The development of wearable electronics has emphasized user-comfort, convenience, security, and improved medical functionality. Several previous research studies transformed various types of sensors into a wearable form to more closely monitor body signals and enable real-time, continuous sensing. In order to realize these wearable sensing platforms, it is essential to integrate wireless power supplies and data communication systems with the wearable sensors. This review article discusses recent progress in wireless technologies and various types of wearable sensors. Also, state-of-the-art research related to the application of wearable sensor systems with wireless functionality is discussed, including electronic skin, smart contact lenses, neural interfaces, and retinal prostheses. Current challenges and prospects of wireless sensor systems are discussed.

Towards successful digital transformation through co-creation: a longitudinal study of a four-year implementation of digital monitoring technology in residential care for persons with dementia.

BACKGROUND: Implementation of digital monitoring technology systems is considered beneficial for increasing the safety and quality of care for residents in nursing homes and simultaneously improving care providers' workflow. Co-creation is a suitable approach for developing and implementing digital technologies and transforming the service accordingly. This study aimed to identify the facilitators and barriers for implementation of digital monitoring technology in residential care for persons with dementia and wandering behaviour, and explore co-creation as an implementation strategy and practice. METHODS: In this longitudinal case study, we observed and elicited the experiences of care providers and healthcare managers in eight nursing homes, in addition to those of the information technology (IT) support services and technology vendors, during a four-year implementation process. We were guided by theories on innovation, implementation and learning, as well as co-creation and design. The data were analysed deductively using a determinants of innovation framework, followed by an inductive content analysis of interview and observation data. RESULTS: The implementation represented radical innovation and required far more resources than the incremental changes anticipated by the participants. Five categories of facilitators and barriers were identified, including several subcategories for each category: 1) Pre-implementation preparations; 2) Implementation strategy; 3) Technology stability and usability; 4) Building competence and organisational learning; and 5) Service transformation and quality management. The combination of IT infrastructure instability and the reluctance of the IT support service to contribute in co-creating value with the healthcare services was the most persistent barrier. Overall, the co-creation methodology was the most prominent facilitator, resulting in a safer night monitoring service. CONCLUSION: Successful implementation of novel digital monitoring technologies in the care service is a complex and time-consuming process and even more so when the technology allows care providers to radically transform clinical practices at the point of care, which offers new affordances in the co-creation of value with their residents. From a long-term perspective, the digital transformation of municipal healthcare services requires more advanced IT competence to be integrated directly into the management and provision of healthcare and value co-creation with service users and their relatives.