At present, in pharmacology one of the most serious problems is counterfeit drugs. The Health Research Funding organization reported that in developing countries, nearly 10–30% of the drugs are fake. Counterfeiting is not the main issue itself, but, rather, the fact that, as compared to traditional drugs, these counterfeit drugs produce different side effects to human health. According to WHO, around 30% of the total medicine sold in Africa, Asia, and Latin America is counterfeit. This is the major worldwide problem, and the situation is worse in developing countries, where one out of every 10 medicines are either fake or do not follow drug regulations. The rise of Internet pharmacies has made it more difficult to standardize drug safety. It is difficult to detect counterfeits because these drugs pass through different complex distributed networks, thus forming opportunities for counterfeits to enter the authentic supply chain. The safety of the pharmaceutical supply chain has become a major concern for public health, which is a collective process. In this paper, we propose a novel drug supply chain management using Hyperledger Fabric based on blockchain technology to handle secure drug supply chain records. The proposed system solves this problem by conducting drug record transactions on a blockchain to create a smart healthcare ecosystem with a drug supply chain. A smart contract is launched to give time-limited access to electronic drug records and also patient electronic health records. We also carried out a number of experiments in order to demonstrate the usability and efficiency of the designed platform. Finally, we used Hyperledger Caliper as a benchmarking tool to conduct the performance of the designed system in terms of transactions per second, transaction latency, and resource utilization.

Intradialytic hypotension (IDH) is a common side effect that occurs during hemodialysis and poses a great risk for dialysis patients. Many studies have been conducted so far to predict IDH, but most of these could not be applied in real-time because they used only underlying patient information or static patient disease information. In this study, we propose a multilayer perceptron (MP)-based IDH prediction model using heart rate (HR) information corresponding to time-series information and static data of patients. This study aimed to validate whether HR differences and HR slope information affect real-time IDH prediction in patients undergoing hemodialysis. Clinical data were collected from 80 hemodialysis patients from 9 September to 17 October 2020, in the artificial kidney room at Yeungnam University Medical Center (YUMC), Daegu, South Korea. The patients typically underwent hemodialysis 12 times during this period, 1 to 2 h per session. Therefore, the HR difference and HR slope information within up to 1 h before IDH occurrence were used as time-series input data for the MP model. Among the MP models using the number and data length of different hidden layers, the model using 60 min of data before the occurrence of two layers and IDH showed maximum performance, with an accuracy of 81.5%, a true positive rate of 73.8%, and positive predictive value of 87.3%. This study aimed to predict IDH in real-time by continuously supplying HR information to MP models along with static data such as age, diabetes, hypertension, and ultrafiltration. The current MP model was implemented using relatively limited parameters; however, its performance may be further improved by adding additional parameters in the future, further enabling real-time IDH prediction to play a supporting role for medical staff.

An important function in the future healthcare system involves measuring a patient’s vital signs, transmitting the measured vital signs to a smart device or a management server, analyzing it in real-time, and informing the patient or medical staff. Internet of Medical Things (IoMT) incorporates information technology (IT) into patient monitoring device (PMD) and is developing traditional measurement devices into healthcare information systems. In the study, a portable ubiquitous-Vital (u-Vital) system is developed and consists of a Vital Block (VB), a small PMD, and Vital Sign Server (VSS), which stores and manages measured vital signs. Specifically, VBs collect a patient’s electrocardiogram (ECG), blood oxygen saturation (SpO2), non-invasive blood pressure (NiBP), body temperature (BT) in real-time, and the collected vital signs are transmitted to a VSS via wireless protocols such as WiFi and Bluetooth. Additionally, an efficient R-point detection algorithm was also proposed for real-time processing and long-term ECG analysis. Experiments demonstrated the effectiveness of measurement, transmission, and analysis of vital signs in the proposed portable u-Vital system.

Bae TW, et al. J Korean Med Sci. 2020 Jul;35(34):e317. https://doi.org/10.3346/jkms.2020.35.e317

The characteristics or aspects of important fiducial points (FPs) in the electrocardiogram (ECG) signal are complicated because of various factors, such as non-stationary effects and low signal-to-noise ratio. Due to the various noises caused by the ECG signal measurement environment and by typical ECG signal deformation due to heart diseases, detecting such FPs becomes a challenging task. In this study, we introduce a novel PQRST complex detector using a one-dimensional bilateral filter (1DBF) and the temporal characteristics of FPs. The 1DBF with noise suppression and edge preservation preserves the P- or T-wave whereas it suppresses the QRS-interval. The 1DBF acts as a background predictor for predicting the background corresponding to the P- and T-waves and the remaining flat interval excluding the QRS-interval. The R-peak and QRS-interval are founded by the difference of the original ECG signal and the predicted background signal. Then, the Q- and S-points and the FPs related to the P- and T-wave are sequentially detected using the determined searching range and detection order based on the detected R-peak. The detection performance of the proposed method is analyzed through the MIT-BIH database (MIT-DB) and the QT database (QT-DB).