Abstract-Falls are a major cause of hospitalization and injuryrelated deaths among the elderly population. The detrimental effects of falls, as well as the negative impact on health services costs, have led to a great interest on fall detection systems by the health-care industry. The most promising approaches are those based on a wearable device that monitors the movements of the patient, recognizes a fall and triggers an alarm. Unfortunately such techniques suffer from the problem of false alarms: some activities of daily living are erroneously reported as falls, thus reducing the confidence of the user. This paper presents a novel approach for improving the detection accuracy which is based on the idea of identifying specific movement patterns into the acceleration data. Using a single accelerometer, our system can recognize these patterns and use them to distinguish activities of daily living from real falls; thus the number of false alarms is reduced.
Early reports from Asia suggested that increased serum levels of the muscular enzyme creatine-(phospho)-kinase (CK/CPK) could be associated with a more severe prognosis in COVID-19. The aim of this single-center retrospective cohort study of 331 consecutive COVID-19 patients who were hospitalized during Italy’s “first wave” was to verify this relationship, and to evaluate the role of possible confounding factors (age, body mass index, gender, and comorbidities). We subdivided our cohort in two groups, based on “severe” (n = 99) or “mild” (n = 232) outcomes. “Severe” disease is defined here as death and/or mechanical invasive ventilation, in contrast to “mild” patients, who were discharged alive with no need for invasive ventilation; this latter group could also include those patients who were treated with non-invasive ventilation. The CK levels at admission were higher in those subjects who later experienced more severe outcomes (median, 126; range, 10–1672 U/L, versus median, 82; range, 12–1499 U/L, p = 0.01), and hyperCKemia >200 U/L was associated with a worse prognosis. Regression analysis confirmed that increased CK acted as an independent predictor for a “severe” outcome. HyperCKemia was generally transient, returning to normal during hospitalization in the majority of both “severe” and “mild” patients. Although the direct infection of voluntary muscle is unproven, transient muscular dysfunction is common during the course of COVID-19. The influence of this novel coronavirus on voluntary muscle really needs to be clarified.
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