As Global Positioning System (GPS) cannot provide satisfying performance in indoor environments, indoor positioning technology, which utilizes indoor wireless signals instead of GPS signals, has ...grown rapidly in recent years. Meanwhile, visible light communication (VLC) using light devices such as light emitting diodes (LEDs) has been deemed to be a promising candidate in the heterogeneous wireless networks that may collaborate with radio frequencies (RF) wireless networks. In particular, light-fidelity has a great potential for deployment in future indoor environments because of its high throughput and security advantages. This paper provides a comprehensive study of a novel positioning technology based on visible white LED lights, which has attracted much attention from both academia and industry. The essential characteristics and principles of this system are deeply discussed, and relevant positioning algorithms and designs are classified and elaborated. This paper undertakes a thorough investigation into current LED-based indoor positioning systems and compares their performance through many aspects, such as test environment, accuracy, and cost. It presents indoor hybrid positioning systems among VLC and other systems (e.g., inertial sensors and RF systems). We also review and classify outdoor VLC positioning applications for the first time. Finally, this paper surveys major advances as well as open issues, challenges, and future research directions in VLC positioning systems.
Since the well-established navigation systems such as GPS are ineffective in indoor environments, research into developing novel indoor positioning technologies has emerged in recent years. While ...several technologies are being investigated, a practical and reliable indoor positioning system is yet to emerge. Indoor positioning using light signals holds a great potential to provide a reliable solution to the indoor positioning problem. This paper presents a comprehensive review of the available literature on light-based indoor positioning systems. The paper establishes a classification based on the design of various light-based indoor positioning (LIP) systems, and discusses their key components including hardware, software and algorithms. The limitations and challenges of the LIP systems are discussed in details, and current published solutions are presented. The review also provides a comparison between LIP systems and other optical positioning systems, and identifies the associated research gaps. Finally, based on the identified gaps, the future research directions in both LIP systems and other optical positioning systems are presented.
During the COVID-19 pandemic, several centers had independently reported extending prone positioning beyond 24 h. Most of these centers reported maintaining patients in prone position until ...significant clinical improvement was achieved. One center reported extending prone positioning for organizational reasons relying on a predetermined fixed duration. A recent study argued that a clinically driven extension of prone positioning beyond 24 h could be associated with reduced mortality. On a patient level, the main benefit of extending prone positioning beyond 24 h is to maintain a more homogenous distribution of the gas-tissue ratio, thus delaying the increase in overdistention observed when patients are returned to the supine position. On an organizational level, extending prone positioning reduces the workload for both doctors and nurses, which might significantly enhance the quality of care in an epidemic. It might also reduce the incidence of accidental catheter and tracheal tube removal, thereby convincing intensive care units with low incidence of ARDS to prone patients more systematically. The main risk associated with extended prone positioning is an increased incidence of pressure injuries. Up until now, retrospective studies are reassuring, but prospective evaluation is needed.
Research and development in Collaborative Indoor Positioning Systems (CIPSs) is growing steadily due to their potential to improve on the performance of their non-collaborative counterparts. In ...contrast to the outdoors scenario, where Global Navigation Satellite System is widely adopted, in (collaborative) indoor positioning systems a large variety of technologies, techniques, and methods is being used. Moreover, the diversity of evaluation procedures and scenarios hinders a direct comparison. This paper presents a systematic review that gives a general view of the current CIPSs. A total of 84 works, published between 2006 and 2020, have been identified. These articles were analyzed and classified according to the described system's architecture, infrastructure, technologies, techniques, methods, and evaluation. The results indicate a growing interest in collaborative positioning, and the trend tend to be towards the use of distributed architectures and infrastructure-less systems. Moreover, the most used technologies to determine the collaborative positioning between users are wireless communication technologies (Wi-Fi, Ultra-WideBand, and Bluetooth). The predominant collaborative positioning techniques are Received Signal Strength Indication, Fingerprinting, and Time of Arrival/Flight, and the collaborative methods are particle filters, Belief Propagation, Extended Kalman Filter, and Least Squares. Simulations are used as the main evaluation procedure. On the basis of the analysis and results, several promising future research avenues and gaps in research were identified.
Limited data are available on the use of prone position in intubated, invasively ventilated patients with Coronavirus disease-19 (COVID-19). Aim of this study is to investigate the use and effect of ...prone position in this population during the first 2020 pandemic wave.
Retrospective, multicentre, national cohort study conducted between February 24 and June 14, 2020, in 24 Italian Intensive Care Units (ICU) on adult patients needing invasive mechanical ventilation for respiratory failure caused by COVID-19. Clinical data were collected on the day of ICU admission. Information regarding the use of prone position was collected daily. Follow-up for patient outcomes was performed on July 15, 2020. The respiratory effects of the first prone position were studied in a subset of 78 patients. Patients were classified as Oxygen Responders if the PaO
/FiO
ratio increased ≥ 20 mmHg during prone position and as Carbon Dioxide Responders if the ventilatory ratio was reduced during prone position.
Of 1057 included patients, mild, moderate and severe ARDS was present in 15, 50 and 35% of patients, respectively, and had a resulting mortality of 25, 33 and 41%. Prone position was applied in 61% of the patients. Patients placed prone had a more severe disease and died significantly more (45% vs. 33%, p < 0.001). Overall, prone position induced a significant increase in PaO
/FiO
ratio, while no change in respiratory system compliance or ventilatory ratio was observed. Seventy-eight % of the subset of 78 patients were Oxygen Responders. Non-Responders had a more severe respiratory failure and died more often in the ICU (65% vs. 38%, p = 0.047). Forty-seven % of patients were defined as Carbon Dioxide Responders. These patients were older and had more comorbidities; however, no difference in terms of ICU mortality was observed (51% vs. 37%, p = 0.189 for Carbon Dioxide Responders and Non-Responders, respectively).
During the COVID-19 pandemic, prone position has been widely adopted to treat mechanically ventilated patients with respiratory failure. The majority of patients improved their oxygenation during prone position, most likely due to a better ventilation perfusion matching.
clinicaltrials.gov number: NCT04388670.
Previous studies suggest that prone positioning (PP) can increase PaO
/FiO
and reduce mortality in moderate to severe acute respiratory distress syndrome (ARDS). The aim of our study was to determine ...whether the early use of PP combined with non-invasive ventilation (NIV) or high-flow nasal cannula (HFNC) can avoid the need for intubation in moderate to severe ARDS patients.
This prospective observational cohort study was performed in two teaching hospitals. Non-intubated moderate to severe ARDS patients were included and were placed in PP with NIV or with HFNC. The efficacy in improving oxygenation with four support methods-HFNC, HFNC+PP, NIV, NIV+PP-were evaluated by blood gas analysis. The primary outcome was the rate of intubation.
Between January 2018 and April 2019, 20 ARDS patients were enrolled. The main causes of ARDS were pneumonia due to influenza (9 cases, 45%) and other viruses (2 cases, 10%). Ten cases were moderate ARDS and 10 cases were severe. Eleven patients avoided intubation (success group), and 9 patients were intubated (failure group). All 7 patients with a PaO
/FiO
< 100 mmHg on NIV required intubation. PaO
/FiO
in HFNC+PP were significantly higher in the success group than in the failure group (125 ± 41 mmHg vs 119 ± 19 mmHg, P = 0.043). PaO
/FiO
demonstrated an upward trend in patients with all four support strategies: HFNC < HFNC+PP ≤ NIV < NIV+PP. The average duration for PP was 2 h twice daily.
Early application of PP with HFNC, especially in patients with moderate ARDS and baseline SpO
> 95%, may help avoid intubation. The PP was well tolerated, and the efficacy on PaO
/FiO
of the four support strategies was HFNC < HFNC+PP ≤ NIV < NIV+PP. Severe ARDS patients were not appropriate candidates for HFNC/NIV+PP.
ChiCTR, ChiCTR1900023564. Registered 1 June 2019 (retrospectively registered).
With the rapid development of wireless communication technology, various indoor location-based services (ILBSs) have gradually penetrated into daily life. Although many other methods have been ...proposed to be applied to ILBS in the past decade, WiFi-based positioning techniques with a wide range of infrastructure have attracted attention in the field of wireless transmission. In this survey, the authors divide WiFi-based indoor positioning techniques into the active positioning technique and the passive positioning technique based on whether the target carries certain devices. After reviewing a large number of excellent papers in the related field, the authors make a detailed summary of these two types of positioning techniques. In addition, they also analyse the challenges and future development trends in the current technological environment.
In navigation, the Twice the Distance Root Mean Square (2DRMS) is commonly used as a position accuracy measure. Its determination, based on statistical methods, assumes that the position errors are ...normally distributed and are often not reflected in actual measurements. As a result of the widespread adoption of this measure, the positioning accuracy of navigation systems is overestimated by 10–15%. In this paper, a new method is presented for determining the navigation system positioning accuracy based on a reliability model where the system’s operation and failure statistics are referred to as life and failure times. Based on real measurements, the method proposed in this article will be compared with the classical method (based on the 2DRMS measure). Real (empirical) measurements made by the principal modern navigation positioning systems were used in the analyses: Global Positioning System (GPS) (168’286 fixes), Differential Global Positioning System (DGPS) (900’000 fixes) and European Geostationary Navigation Overlay Service (EGNOS) (900’000 fixes). Research performed on real data, many of which can be considered representative, have shown that the reliability method provides a better (compared to the 2DRMS measure) estimate of navigation system positioning accuracy. Thanks to its application, it is possible to determine the position error distribution of the navigation system more precisely when compared to the classical method, as well as to indicate those applications that can be used by this system, ensuring the safety of the navigation process.
Prone positioning (PP) has shown to improve survival in patients with severe acute respiratory distress syndrome (ARDS). To this point, it is unclear if PP is also beneficial for ARDS patients ...treated with veno-venous extracorporeal membrane oxygenation (VV ECMO) support.
We report retrospective data of a single-centre registry of patients with severe ARDS requiring VV ECMO support between October 2010 and May 2018. Patients were allocated to the PP group if PP was performed during VV ECMO treatment or the supine positioning group. VV ECMO weaning success and hospital survival were analysed before and after propensity score matching.
A total of 158 patients could be analysed, and 38 patients (24.1%) received PP. There were no significant differences in VV ECMO weaning rate (47.4% vs. 46.7%, p = 0.94) and hospital survival (36.8% vs. 36.7%, p = 0.98) between the prone and supine groups, respectively. The analysis of 38 propensity score matched pairs also showed no difference in hospital survival (36.8% vs. 36.8%, p = 1.0) or VV ECMO weaning rate (47.4% vs. 44.7%, p = 0.82). Hospital survival was superior in the subgroup of patients treated with early PP (cutoff < 17 h via Youden's Index) as compared to late or no PP (81.8% vs. 33.3%, p = 0.02).
In this propensity score matched cohort of severe ARDS patients requiring VV ECMO support, prone positioning at any time was not associated with improved weaning or survival. However, early initiation of prone positioning was linked to a significant reduction of hospital mortality.
A Survey on Fusion-Based Indoor Positioning Guo, Xiansheng; Ansari, Nirwan; Hu, Fangzi ...
IEEE Communications surveys and tutorials,
2020-Firstquarter, 2020-00-00, 20200101, Volume:
22, Issue:
1
Journal Article
Peer reviewed
Open access
Demands for indoor positioning based services (IPS) in commercial and military fields have spurred many positioning systems and techniques. Complex electromagnetic environments (CEEs) may, however, ...degenerate the accuracy and robustness of some existing single systems and techniques. To overcome this drawback, fusion-based positioning of multiple systems and/or techniques have been proposed to revamp the positioning performance in CEEs. In this paper, we survey the fusion-based indoor positioning techniques and systems from seminal works to elicit the state of the art within our proposed unified fusion-based positioning framework, which consists of three fusion characteristics: source, algorithm, and weight spaces. Different from other surveys, this survey summarizes and analyzes the existing fusion-based positioning systems and techniques from three characteristics. Meanwhile, discussions in terms of lessons, challenges, and countermeasures are also presented. This survey is invaluable for researchers to acquire a clear concept of indoor fusion-based positioning systems and techniques and also to gain insights from this survey to further develop other advanced fusion-based positioning systems and techniques in the future.