Tsuyoshi Kobayashi

Many frail older patients with multiple comorbidities are hospitalized in long-term care hospitals and nursing facilities. Due to pre-existing conditions and immunosuppressive states, there are significant individual differences, such as weakness, sluggishness, and asymptomatic status. These differences make it challenging to find a patient’s exacerbation using a conventional threshold of vital signs. We developed a circadian rhythm anomaly-detection system designed for each patient, which compares each patient’s past 2 weeks average respiratory rate circadian rhythm with that of the last 24 hours. Respiratory rate was measured using a piezoelectric sensor located under the mattress. Prior to the doctor’s diagnosis of acute exacerbation of lobar pneumonia and heart failure, a bedridden 88-year-old female patient with multiple chronic diseases showed abnormal circadian rhythm status. However, there were no significant changes in vital signs. A circadian rhythm anomaly-detection system appears promising as a future tool to promote medical checkups for the older person.

In 2020, 20% of patients with COVID-19 developed severe complications, including life-threatening pneumonia with systemic inflammatory response syndrome (SIRS). We developed a preliminary SIRS monitor that does not require blood sampling, is noninvasive, and can collect data 24 h per day. The proposed monitor comprises a piezoelectric respiratory sensor located beneath the patient’s mattress and a fingertip pulse sensor that determines ultra-high accuracy respiratory rate (mode of a 40-min frequency distribution of respiratory rates (M40FD-RR)). We assessed the clinical performance of the M40FD-RR preliminary SIRS monitor in 29 patients (12 female, 17 male, aged 15–90 years) hospitalized at Suwa Central Hospital with COVID-19, which was confirmed by a positive polymerase chain reaction test. SIRS was evaluated by logistic regression analysis using M40FD-RR, heart rate, age, and sex as explanatory variables. We compared the results of 109 examinations of 29 COVID-19 inpatients with SIRS against those determined by the proposed monitor. The proposed monitor achieved 75% sensitivity and 83% negative predictive value, making it a promising candidate for future 24 h noninvasive preliminary SIRS tests.

(A) According to TNM stages, Kaplan-Meier analyses of the 5-year cumulative recurrence risk were performed for the 138 matched patients belonging to the highly and poorly licensed NK groups. Further subgroup analyses were performed for patients with (B) stage I, (C) stage II, and (D) stage IIIA HCC.