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Background High adherence to remote monitoring (RM) in pacemaker (PM) patients improves outcomes; however, adherence remains suboptimal. Bluetooth low-energy (BLE) technology in newer-generation PMs enables communication directly with patient-owned smart devices using an app without a bedside console. Objective To evaluate the success rate of scheduled RM transmissions using the app compared to other RM methods. Methods The BlueSync Field Evaluation was a prospective, international cohort evaluation, measuring the success rate of scheduled RM transmissions using a BLE PM or cardiac resynchronization therapy PM coupled with the MyCareLink Heart app. App transmission success was compared to 3 historical “control” groups from the Medtronic de-identified CareLink database: (1) PM patients with manual communication using a wand with a bedside console (PM manual transmission), (2) PM patients with wireless automatic communication with the bedside console (PM wireless); (3) defibrillator patients with similar automatic communication (defibrillator wireless). Results Among 245 patients enrolled (age 64.8±15.6 years, 58.4% men), 953 transmissions were scheduled through 12 months, of which 902 (94.6%) were successfully completed. In comparison, transmission success rates were 56.3% for PM manual transmission patients, 77.0% for PM wireless patients, and 87.1% for defibrillator wireless patients. Transmission success with the app was superior across matched cohorts based on age, sex, and device type (single vs dual vs triple chamber). Conclusion The success rate of scheduled RM transmissions was higher among patients using the smart device app compared to patients using traditional RM using bedside consoles. This novel technology may improve patient engagement and adherence to RM., Graphical abstract

The purpose of this article is to help unify thoughts on adopting best practices for home automation. This article also analyzes why fully automated homes are not yet commonplace and what steps are necessary for consumers to feel comfortable making this transition in their lifestyles. This article calls for business to incorporate a standardized system of communication among not only their product offerings, but among other manufacturers’ products within the marketplace. It also calls for businesses to focus on their design schemes, ease of use, and potential for integration so that consumers will want to adopt these new automation technologies.

Background Traditional metrics for evaluating the severity of psoriasis are subjective, which complicates efforts to measure effective treatments in clinical trials. Methods We collected images of psoriasis plaques and calibrated the coloration of the images according to an included color card. Features were extracted from the images and used to train a linear discriminant analysis classifier with cross-validation to automatically classify the degree of erythema. The results were tested against numerical scores obtained by a panel of dermatologists using a standard rating system. Results Quantitative measures of erythema based on the digital color images showed good agreement with subjective assessment of erythema severity (κ = 0.4203). The color calibration process improved the agreement from κ = 0.2364 to κ = 0.4203. Conclusion We propose a method for the objective measurement of the psoriasis severity parameter of erythema and show that the calibration process improved the results.

Birt-Hogg-Dube syndrome (BHD) is an uncommon autosomal dominant genodermatosis characterized by fibrofolliculomas and trichodiscomas on the face and neck with acrochordons in flexural areas. These skin signs serve as markers for internal disease, most importantly spontaneous pneumothoraces and renal cancers. BHD is caused by a mutation in a tumor suppressor gene. This gene encodes the protein folliculin (FLCN), important for normal functioning of the mammalian target of rapamycin (mTOR) signaling pathway.1

Traditional metrics for evaluating the severity of psoriasis are highly subjective, which complicates efforts to identify effective treatments in clinical trials. We propose a method for the objective measurement of the psoriasis severity parameter of erythema (redness). This procedure is standardized for different camera systems and lighting environments through the usage of a color card with predetermined color values in order to calibrate the images. Quantitative measures based on the digital color images are shown to correlate well with subjective assessment of psoriasis severity collected using a standard numerical scale by a panel of dermatologists. Additionally, the color calibration process is shown to improve results.

A 36-year-old man developed extreme shortness of breath after injecting "freebase" cocaine intravenously. Clinical and radiographic evaluation confirmed acute pulmonary edema, and blood gas studies substantiated acute respiratory failure. Despite vigorous therapy, the patient died three hours after admission. When cocaine use causes death, generally it is by respiratory collapse. Although the post-mortem finding of pulmonary edema after cocaine use has been reported, to our knowledge, this is the first reported death due to clinical pulmonary edema after the intravenous use of freebase cocaine.

Alternative methods for rapidly producing accurate medical records, usually dictation-transcription systems or nurse-scribe methods, have been used in emergency departments. We now have more than five years of experience with a non-nurse scribe system. This system has proven effective in generating accurate and complete medical records while enhancing patient flow. We describe the system and its implementation.