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La metodología Aprendizaje-Servicio ofrece una vivencia práctica plenamente competencial y genuina para una universidad que no puede existir ajena a la realidad social. El artículo revisa la relación entre el Aprendizaje-Servicio y los estudios de Ciencias de la Actividad Física y el Deporte, planteando una propuesta de intervención acorde con las fases ampliamente justificadas por la bibliografía reciente. Además, se ejemplifican intervenciones singulares de Educación Física en menores con riesgo de exclusión social y en adolescentes con discapacidad psíquica. En base a la relación biunívoca entre estudiantes e instituciones, dichas sesiones deberán adaptarse a las necesidades específicas de cada grupo social. Estas intervenciones se valoran como buenas prácticas de compromiso social universitario, ya que deben estar plenamente adaptadas a las condiciones de heterogeneidad de grupos poblacionales escasamente reconocibles en el currículum, desde la comprensión empática por parte de los estudiantes. No obstante, se plantean reflexiones de mejora basadas en la elegibilidad de las propuestas o en posibles planteamientos transversales entre diferentes estudios.

Enflicoxib is approved for the treatment of pain and inflammation in canine osteoarthritis. The objective of this work was to assess the mechanistic basis of enflicoxib therapy investigating the COX inhibitory activity of enflicoxib (racemate), its enantiomers and its main metabolites using the canine whole blood assay. The (R)-(+)-Enflicoxib enantiomer and metabolite M8 (hydroxylated pyrazoline) did not induce significant COX inhibition. Enflicoxib and its (S)-(-)-Enflicoxib enantiomer inhibited COX-1 and COX-2 with variable degree of preferential isoform inhibition, but no significant therapeutic effect is anticipated in vivo. The pyrazol metabolite showed the highest COX-2 inhibition and was the most selective (IC

El objetivo del presente estudio fue analizar la relación entre las capacidades físicas, el hábito de realizar actividad física y la capacidad de atención selectiva en una muestra de estudiantes de enseñanza secundaria. La muestra fue configurada por un total de 97 participantes, concretamente 51 estudiantes de género femenino (n= 51) y 46 de género masculino (n= 46) de Barcelona (Cataluña) con edades comprendidas entre los 13 y los 15 años (13,7 ± 1,17). Para analizar la capacidad de atención selectiva se utilizó el Test de Percepción de Semejanzas y Diferencias (CARAS-R). Referente a la condición física, se evaluó la velocidad lineal (30 metros lisos), la fuerza de tren inferior (test de salto horizontal), la agilidad (test de10x5 metros) y la resistencia aeróbica (test de Luc-Léger). Finalmente el hábito de realización de actividad física se calculó con el Cuestionario internacional de actividad física en su formato adaptado para adolescentes (IPAQ-A).Los resultados mostraron que los participantes con un mayor rendimiento en el test de Luc-Léger, obtuvieron mejores puntuaciones en el test CARAS-R. Asimismo se obtuvo una correlación alta entre los registros del test de Luc-Léger y el test CARAS-R tanto para el género masculino como el femenino y una correlación alta entre el cuestionario IPAQ-A y el test CARAS-R en el género masculino. Dichos hallazgos, ponen de manifiesto la relación entre la atención selectiva y el nivel de condición física en adolescentes. En este sentido, se refuerza la importancia depracticar actividad física a esta edad, sugiriendo que el incremento de la condición física puede tener implicaciones positiva sobre la atención selectiva. The aim of this study was to analyze the relationship between fitness, selective attention and the physical activity habit in high school students.The sample was configured by a total of 97 participants, 51 females (n= 51) and 46 males (n= 46)from Barcelona (Catalonia), aged between 13 and 15 years (13,7 ± 1,17). To analyze the selective attention capacity, it was used the Perception of Similarities and Differences Test (CARAS-R). Regarding physical fitness, linear velocity (30-meter dash test), lower body strength (board jump test), agility (10x5 meter test) and aerobic capacity (Luc-Léger test) were evaluated. Finally, the physical activity was calculated with the International Physical Activity Questionnaire adapted for adolescents (IPAQ-A).The results showed that the subjects with higher performance in the Luc-Léger test obtained better scores in the CARAS-R test. A high correlation was also obtained between the records of the Luc-Léger test and the CARAS-R test in both boys and girls and ahigh correlation between the IPAQ-A questionnaire and the CARAS-R test in boys. These findings highlight the relationship between selective attention and the fitness level in adolescents. In this sense, the importance of practicing physical activity at this age is reinforced, suggesting that the increase of physical condition may have positive implications on selective attention. O objetivo do presente estudo foi analisar a relação entre habilidades físicas, atenção seletiva e o hábito de praticar atividade físicanumaamostra de estudantes do ensino médio.A amostra foi composta por um total de 97 sujeitos, especificamente 51 estudantes do sexo feminino (n= 51) e 46 do sexo masculino (n= 46) de Barcelona (Catalunha) com idades entre 13 e 15 anos (13,7 ± 1,17). Para analisar a capacidade de atenção seletiva, foi utilizado o Teste de Percepção de Diferenças e Diferenças (CARAS-R). A condição física foi avaliada através do teste de 30 metros de velocidade suave (velocidade linear), do teste de salto horizontal (força do corpo inferior), do teste de 10x5 metros (agilidade) e do teste de Luc-Léger (resistência). Por fim, o hábito de realizar atividade física foi calculado com o Questionário Internacional de Atividade Física, em formato adaptado para adolescentes (IPAQ-A).Os resultados mostraram que os sujeitos com maior desempenho no teste Luc-Léger obtiveram melhores pontuações no teste CARAS-R. Da mesma forma, foi obtida uma alta correlação entre os registros do teste Luc-Léger e o teste CARAS-R em meninos e meninas e uma alta correlação entre o questionário IPAQ-A e o teste CARAS-R em meninos. Os resultados revelam a relação entre a atenção seletiva e o nível de aptidão física em adolescentes. Nesse sentido, a importância da prática de atividade física nessa faixa etária é reforçada, sugerindo que o aumento da condição física pode ter implicações positivas na atenção seletiva

Background: Enflicoxib is a non-steroidal anti-inflammatory drug of the coxib family characterized by a long-lasting pharmacological activity that has been attributed to its active metabolite E-6132. Objective: The aim of this work was to explore enflicoxib biotransformation in vitro in humans, rats and dogs, and to determine its metabolic pathways. Method: Different in vitro test systems were used, including hepatocytes and liver and non-hepatic microsomes. The samples were incubated with enflicoxib and/or any of its metabolites at 37°C for different times depending on the test system. The analyses were performed by liquid chromatography coupled with either radioactivity detection or high-resolution mass spectrometry. Results: Enflicoxib was efficiently metabolized by cytochrome P-450 into three main phase I metabolites: M8, E-6132, and M7. The non-active hydroxy-pyrazoline metabolite M8 accounted for most of the fraction metabolized in all the three species. The active pyrazol metabolite E-6132 showed a slow formation rate, especially in dogs, whereas metabolite M7 was a secondary metabolite formed by oxidation of M8. In hepatocytes, diverse phase II metabolite conjugates were formed, including enflicoxib glucuronide, M8 glucuronide, E-6132 glucuronide, M7 glucuronide, and M7 sulfate. Metabolite E-6132 was most probably eliminated by a unique glucuronidation reaction at a very low rate. Conclusion: The phase I metabolism of enflicoxib was qualitatively very similar among rats, humans and dogs. The low formation and glucuronidation rates of the active enflicoxib metabolite E-6132 in dogs are postulated as key factors underlying the mechanism of its long-lasting pharmacokinetics and enflicoxib's overall sustained efficacy.

The pharmacokinetics of enflicoxib were evaluated in both a bioavailability study and a multi-dose safety study in Beagle dogs. When administered at 8 mg/kg, the oral bioavailability (F) of enflicoxib was 44.1% in fasted dogs, but F increased to 63.4% under post prandial conditions. Enflicoxib is rapidly metabolised. After the first 48 h, the plasma levels of its pyrazol metabolite were much higher and persistent than those of the parent compound. Following intravenous administration, the total body plasma clearance of enflicoxib was of 140 ml/h/kg and the volume of distribution based on the terminal phase was 4 L/kg. Plasma protein binding for both compounds was approximately 99%. The blood to plasma ratio for the pyrazol metabolite showed saturable kinetics with higher blood cell affinity at lower total blood concentrations which ranged from 2.49 to 0.95 for concentrations from 1 to 15 µg/ml. Enflicoxib and its pyrazol metabolite exhibited dose-proportional pharmacokinetics for single oral doses of 8-40 mg⁄kg and for multiple oral doses of 4-20 mg⁄kg. After 7 months of repeated weekly administrations, pre-dose plasma concentrations (Cmin,ss ) remained constant throughout the study, with no trend to any significant over-accumulation. The mean terminal elimination half-life (t½ ) was 20 h for enflicoxib and 17 days for the pyrazol metabolite. The pharmacokinetic profile of enflicoxib and its pyrazol metabolite in dogs supports the proposed dosing regimen in which doses are separated by 1 week.

El artículo tiene por objetivo analizar la evolución de los currículos competenciales a través del estudio de la transversalidad de los conocimientos mediante el análisis documental de las principales regulaciones jurídicas educativas. El análisis de contenido permitirá un enfoque transversal sincrónico para comparar las leyes y RD estatales con los decretos y normativas autonómicas catalanas, y un enfoque longitudinal diacrónico para comparar la evolución de los currículos competenciales desde su aparición en la LOE hasta su consolidación en la LOMCE. Dicho análisis de contenido se fundamentará en las regulaciones para la Educación Secundaria Obligatoria (ESO) a través de la materia específica Educación Física, contrastando las ejemplificaciones prácticas con la materia troncal de matemáticas. Las conclusiones determinan el florecimiento de las competencias en los currículos y el asentamiento de la transversalidad como intervención necesaria para su logro. De una transversalidad centrada en los contenidos disciplinares como metodología competencial (conexiones con las otras materias) se evoluciona a la transversalidad basada en las competencias y en la transferibilidad de los conocimientos a contextos reales (tratamiento globalizado de los contenidos). Abstract. The article aims to analyse the evolution of competency-based curricula through the study of the transversality of knowledge of the main educational legal regulations. The content analysis will allow a synchronous transversal approach to compare the state laws with the decrees of the autonomous administration, and a diachronic longitudinal approach to compare the evolution of the competences curricula from its appearance in the LOE to its consolidation in the LOMCE. Physical Education, a specific subject, will support the exemplification, contrasting it with the core mathematics subject. The conclusions determine the flourishing of competencies in the curricula and the establishment of transversality as a methodological aspect necessary for its achievement. From a transversality focused on disciplinary contents as a competency methodology (connections with other subjects) it evolves to transversality based on competences and on the transferability of knowledge to real contexts (globalized treatment of content).

Performing the rehabilitation of a player on a surface different from the normally used by the athlete in her/his sport is beneficial. By recruiting more muscle fibers in the new surface, the rehabilitation process is enhanced. Here, we describe the electromyography (EMG) data of anterior and posterior chains during workouts on two different surfaces: sand and artificial turf. We recorded data using a Myontec EMG device of two anterior cruciate ligament (ACL) injured women's soccer players. Player 1 was injured on her left leg in the ACL and the patellar tendon, and player 2 was injured on her right leg in the ACL and semitendinosus plasty. The EMG results of player 1 showed an increase in the activation of the cross pattern (i.e. left hamstring and right gluteus) of the posterior chain. Similarly, the EMG data of player 2 showed an increase in the activation of the left quadriceps (the antagonist muscle of her injured leg) of the anterior chain. In conclusion, in both players the muscle group most activated during rehabilitation was the antagonist of the injured leg's muscle, regardless of the surface used.

OBJECTIVE The objective of this study was to compare the systolic (S) and diastolic (D) blood pressure (BP) estimations from a new optical device at the wrist with invasive measurements performed on patients scheduled for radial arterial catheterization in the ICU. Optical signals were automatically processed by a library of algorithms from Aktiia SA (OBPM - optical blood pressure monitoring algorithms). METHODS A total of 31 participants from both sexes, aged 32-87 years, were enrolled in the study (NCT03837769). The measurement protocol consisted of the simultaneous recording of reflective photoplethysmographic signals (PPG) from the cuffless optical device and the reference BP values recorded by a contralateral radial arterial catheter. From the 31 participants, 23 subjects whose reference data quality requirements were adequate were retained for further analysis. The PPG signals from these patients were then automatically processed by the Aktiia OBPM library of algorithms, which generated uncalibrated estimates of SBP and DBP. After the automatic assessment of optical signal quality, 326 pairs of uncalibrated SBP and DBP determinations from 16 patients were available for analysis. These values were finally transformed into calibrated estimations (in mmHg) using arterial catheter SBP and DBP values, respectively. RESULTS For SBP, a mean difference (±SD) of 0.0 ± 7.1 mmHg between the arterial catheter and the optical device values was found, with 95% limits of agreement in the Bland-Altman method of -11.9 to + 12.2 mmHg (correlation of r = 0.87, P < 0.001). For DBP, a mean difference (±SD) of 0.0 ± 2.9 mmHg between arterial catheter and the optical device values was found, with 95% limits of agreement in the Bland-Altman method of -4.8 to + 5.5 mmHg (correlation of r = 0.98, P < 0.001). CONCLUSION SBP and DBP values obtained by radial artery catheterization and those obtained from optical measurements at the wrist were compared. The new optical technique appears to be capable of replacing more traditional methods of BP estimation.

Enflicoxib is a non-steroidal anti-inflammatory drug of the coxib family characterized by a long-lasting pharmacological activity that has been attributed to its active metabolite E-6132.The aim of this work was to explore enflicoxib biotransformation In vitro in humans, rats and dogs, and to determine its metabolic pathways.Different In vitro test systems were used, including hepatocytes and liver and non-hepatic microsomes. The samples were incubated with enflicoxib and/or any of its metabolites at 37°C for different times depending on the test system. The analyses were performed by liquid chromatography coupled with either radioactivity detection or high-resolution mass spectrometry.Enflicoxib was efficiently metabolized by cytochrome P-450 into three main phase I metabolites: M8, E-6132, and M7. The non-active hydroxy-pyrazoline metabolite M8 accounted for most of the fraction metabolized in all the three species. The active pyrazol metabolite E-6132 showed a slow formation rate, especially in dogs, whereas metabolite M7 was a secondary metabolite formed by oxidation of M8. In hepatocytes, diverse phase II metabolite conjugates were formed, including enflicoxib glucuronide, M8 glucuronide, E-6132 glucuronide, M7 glucuronide, and M7 sulfate. Metabolite E-6132 was most probably eliminated by a unique glucuronidation reaction at a very low rate.The phase I metabolism of enflicoxib was qualitatively very similar among rats, humans and dogs. The low formation and glucuronidation rates of the active enflicoxib metabolite E-6132 in dogs are postulated as key factors underlying the mechanism of its long-lasting pharmacokinetics and enflicoxib's overall sustained efficacy.

Objective The objective of this study (NCT04027777) was to assess the accuracy and precision of the Aktiia Bracelet, a CE-marked noninvasive optical blood pressure (BP) monitor worn at the wrist, over a period of 1 month. Methods In this study, participants aged between 21 and 65 years were recruited. The clinical investigation extended the ISO81060-2:2013 standard to the specificities of cuffless devices. Each BP assessment consisted of the simultaneous recording of optical signals with Aktiia Bracelet and double-blinded auscultation by two trained observers in the standard sitting position. The algorithms of Aktiia Bracelet further processed the recorded optical signals to perform a signal quality check and to calculate uncalibrated estimates of systolic BP (SBP) and diastolic BP (DBP). These estimates were transformed into mmHg using a subject-dependent calibration parameter, which was calculated using the first two available reference measurements per subject. Results Eighty-six participants were included in the analysis. The mean and SD of the differences between Aktiia Bracelet estimates and the reference (ISO81060-2 criterion 1) were 0.46 ± 7.75 mmHg for SBP and 0.39 ± 6.86 mmHg for DBP. The SD of the averaged paired difference per subject (ISO81060-2 criterion 2) were 3.9 mmHg for SBP and 3.6 mmHg for DBP. Conclusion After initialization and during 1 month, the overall accuracy of Aktiia Bracelet satisfied validation criteria 1 and 2 of ISO81060-2 in the sitting position. The Aktiia Bracelet can be recommended for BP measurement in the adult population.

Previous animal experiments have suggested that electrical impedance tomography (EIT) has the ability to noninvasively track changes in cardiac stroke volume (SV). The present study intended to reproduce these findings in patients during a fluid challenge. In a prospective observational study including critically ill patients on mechanical ventilation, SV was estimated via ECG-gated EIT before and after a fluid challenge and compared to transpulmonary thermodilution reference measurements. Relative changes in EIT-derived cardiosynchronous impedance changes in the heart ( $$\Delta {\text{Z}}_{\text{H}}$$ ) and lung region ( $$\Delta {\text{Z}}_{\text{L}}$$ ) were compared to changes in reference SV by assessing the concordance rate (CR) and Pearson’s correlation coefficient (R). We compared 39 measurements of 20 patients. $$\Delta {\text{Z}}_{\text{H}}$$ did not show to be a reliable estimate for tracking changes of SV (CR = 52.6% and R = 0.13 with P = 0.44). In contrast, $$\Delta {\text{Z}}_{\text{L}}$$ showed an acceptable trending performance (CR = 94.4% and R = 0.72 with P

Background Perioperative fluid overload is an important modifiable risk factor for adverse outcomes after colorectal surgery. This study aimed to define critical thresholds for perioperative fluid management and postoperative weight gain for patients undergoing elective laparoscopic colorectal surgery. Methods This was an analysis of consecutive elective laparoscopic colorectal resections at Lausanne University Hospital from May 2011 to May 2017. Main outcomes were overall, major (Clavien–Dindo grade IIIb or above) and respiratory complications, and postoperative ileus. Thresholds regarding perioperative fluid management and postoperative weight gain were identified through receiver operating characteristic (ROC) analysis and clinical judgement. Independent risk factors for all four outcomes were assessed by multinominal logistic regression. Results Overall and major complications occurred in 210 (36·2 per cent) and 46 (7·9 per cent) of 580 patients respectively. Twenty‐three patients (4·0 per cent) had respiratory complications and 98 (16·9 per cent) had postoperative ileus. Median length of hospital stay was 5 (i.q.r. 3–9) days. Based on respiratory complications, thresholds for perioperative intravenous fluid administration (postoperative day (POD) 0) were set pragmatically at 3000 ml for colonic (calculated threshold 3120 ml (area under ROC curve (AUROC) 0·63)) and 4000 ml for rectal (AUROC 0·79) procedures. Postoperative weight gain of 2·5 kg at POD 2 was predictive of respiratory complications. Multivariable analysis retained perioperative intravenous fluid administration over the above thresholds as an independent risk factor for overall (odds ratio (OR) 2·25, 95 per cent c.i. 1·23 to 4·11), major (OR 2·49, 1·17 to 5·31) and respiratory (OR 4·71, 1·42 to 15·58) complications. Weight gain above 2·5 kg at POD 2 was identified as a risk factor for respiratory complications (OR 3·58, 1·10 to 11·70) and ileus (OR 1·82, 1·02 to 3·52). Conclusion Perioperative intravenous fluid and weight thresholds were associated with postoperative adverse outcomes. These thresholds need independent validation.

The purpose of the present study was to determine the relationship between physical fitness and academic achievement in a sample of primary-school children. Data of 116 sixth-grade primary-school students (68 girls, 48 boys) from Barcelona (Catalonia, Spain) with a mean (SD) age of 11.4 years (0.4) was analyzed. To determine academic achievement, proficiency scores in the subjects Catalan language, Spanish language, English language, and Maths were derived from the Test de Compètencies Bàsiques. Physical fitness was assessed using the Cooper test (aerobic capacity), 20-m sprint test (linear velocity), and 4 × 10-m test (agility). The results showed that participants with a higher performance in the Cooper and 20-m sprint tests had significantly better academic achievement in the assessed subjects (p < 0.05; d range = 0.93 to −2.98). The findings of this investigation are interesting from a curricular perspective since a positive association between academic achievement and physical fitness indicates a strong reason to raise the physical education status in educational systems, a subject that has traditionally been considered less important by the educational community.

This chapter is dedicated to a novel family of sensors used for cardiovascular monitoring. Based on the so-called photoplethysmographic technology, optical cardiovascular monitors open the door to the comfortable and continuous monitoring of health status during daily life. Either integrated within a wrist-worn device, an arm band, or a chest patch, optical cardiovascular monitors are capable of accurately measuring heart rate by assessing the arterial pulsatility of underlying skin vascular beds. After reviewing the physical and physiological background of the photoplethysmographic phenomenon, this chapter copes with the design of optical sensors and monitors in terms of optomechanical properties and signal processing and motion artifact issues. The performance of recently launched commercial optical cardiovascular monitors is briefly addressed in the context of sport activities, daily life periods, and clinical applications.

The diagnosis of hypertension and the adjustment of antihypertensive drugs are evolving from isolated measurements performed at the physician offices to the full phenotyping of patients in real-life conditions. Indeed, the strongest predictor of cardiovascular risk comes from night measurements. The aim of this study was to demonstrate that a wearable device (the Aktiia Bracelet) can accurately estimate BP in the most common body positions of daily life and thus become a candidate solution for the BP phenotyping of patients. We recruited 91 patients with BP ranging from low to hypertensive levels and compared BP values from the Aktiia Bracelet against auscultatory reference values for 4 weeks according to an extended ISO 81060-2 protocol. After initializing on day one, the observed means and standard deviations of differences for systolic BP were of 0.46 ± 7.75 mmHg in the sitting position, − 2.44 ± 10.15 mmHg in the lying, − 3.02 ± 6.10 mmHg in the sitting with the device on the lap, and − 0.62 ± 12.51 mmHg in the standing position. Differences for diastolic BP readings were respectively of 0.39 ± 6.86 mmHg, − 1.93 ± 7.65 mmHg, − 4.22 ± 6.56 mmHg and − 4.85 ± 9.11 mmHg. This study demonstrates that a wearable device can accurately estimate BP in the most common body positions compared to auscultation, although precision varies across positions. While wearable persistent BP monitors have the potential to facilitate the identification of individual BP phenotypes at scale, their prognostic value for cardiovascular events and its association with target organ damage will need cross-sectional and longitudinal studies. Deploying this technology at a community level may be also useful to drive public health interventions against the epidemy of hypertension.

The diagnosis and management of hypertension usually requires the estimation of blood pressure (BP) by means of an inflatable cuff. This procedure generates discomfort and limits patient compliance. Cuffless devices capture BP readings without performing any arterial occlusion. We believe that comfortable and cuffless BP monitoring devices can significantly aid in the fight against hypertension and support the expansion of ambulatory and remote patient monitoring programs, provided that these devices provide reliable BP readings. The purpose of this study was to compare the systolic (S) and diastolic (D) blood pressure (BP) estimations from a new optical device at the wrist (figure) against invasive measurements performed on patients scheduled for radial arterial catheterization. The first results from this study were recently published and demonstrated good agreement for the overall study population. Here we report expanded statistical analyses for different population subgroups such as gender, age, body mass index (BMI) and skin color. The study protocol consisted of the simultaneous recording of reflective photo-plethysmographic signals (PPG) from the optical device, and BP values recorded by a contralateral radial arterial catheter. The PPG signals were processed to generate estimates of SBP and DBP. Agreement of paired BP estimations was further calculated in terms of standard deviation (SD) of differences. The mean of differences were systematically zero because BP estimations from the optical device were calibrated for each patient. The table shows that, for the overall population, both SBP and DBP differences SDs were smaller than 8 mmHg (as already published). Furthermore, across different population groups, both genders, all BMIs and all skin colors also resulted in SDs smaller than 8 mmHg. Only patients whose age was above 65 years were associated with a higher SD. For the overall population and most subgroups the new optical technique appears to be capable of replacing more traditional methods of BP estimation. Only the SBP differences for the subgroup of older patients were larger. Additional studies are needed to confirm and expand these very encouraging results. Table 1. SD of measured BP differences Population N SD of SBP differences SD of DBP differences (mmHg) (mmHg) All 16 7.1 2.9 Gender Male 10 6.4 2.8 Female 6 8.0 3.1 Age (years) 65 9 *9.3 3.4 BMI (kg/m2) 26 6 5.7 2.8 Skin Color (Fitzpatrick) 2 13 7.7 3.0 3 3 4.5 2.6 *Only subgroup with a SD larger than 8mmHg. Figure 1. The investigational device Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Aktiia SA

The US and European guidelines for the diagnosis and management of hypertension recommend the introduction of systematic home and night Blood Pressure (BP) monitoring. Fully-automated wearable devices can address the needs of patients and clinicians by improving comfort while achieving measurement accuracy. Often located at the wrist and based on indirect BP measurements, these devices must address the challenges of ambulatory scenarios. New validation strategies are needed, but little guidance has been published so far.In this work, we propose an experimental protocol for the validation of cuffless wrist BP monitors that addresses ambulatory environment challenges in a controlled experimental setting. The protocol assesses the robustness of the measurement for different body postures, the ability of the device to track BP changes, and its ability to deal with hydrostatic pressure changes induced by different arm heights.Performance testing using Aktiia Bracelet is provided as an illustration. The results of this pilot study indicate that the Aktiia Bracelet can generate accurate BP estimates for sitting and lying positions and is not affected by hydrostatic pressure perturbations.Clinical Relevance— Automated cuffless BP monitoring is opening a new chapter in the way patients are being diagnosed and managed. This paper provides a guidance on how to assess the clinical utility of such devices when used in different body positions.

The present study aimed to define thresholds for perioperative fluids and weight gain after urgent colectomies. Consecutive urgent colonic resections within an enhanced recovery pathway (2011-2017) were included. Primary outcomes were postoperative complications, stratified as overall (I-V) and major (IIIb-V) according to Clavien scale. Fluid-management-related thresholds were identified through receiver operating characteristics (ROC) analysis. Outcomes were compared for patients above vs below threshold, and multivariable logistic regression was performed to identify risk factors for overall complications. Overall, complications were observed in 133 out of 224 patients (59%), severe complications in 43 patients (19%). For overall complications, area under ROC (AUROC) was 0.71, identifying a critical cut-off of 3 L of total IV fluid administration at the day of surgery (negative predictive value [NPV]: 90%). Further, a critical cut-off for postoperative weight gain of 2.3 kg at postoperative day (POD) 2 was identified (AUROC 0.7, NPV 92%). Multivariable analysis identified fluid administration of >3 L (OR 5.33; 95% CI, 2.36-12.02) and weight gain of >2.3 kg at POD 2 (OR 2.5; 95% CI, 1.13-5.53) as independent predictors for overall complications. Median length of stay was 7 (5-10) days in patients receiving 3 L (P < .001). Fluid administration of 3 L at the day of surgery and weight gain of 2.3 kg at POD 2 may represent critical thresholds for adverse outcomes after urgent colectomy. The suggested thresholds need to be confirmed through independent validation.

Current oxygen delivery modes lack monitoring and can be cumbersome for patients with chronic respiratory diseases. Integrating a pulse oximeter and nasal oxygen cannulas into eyeglasses would reduce the burden of current solutions. An ear pulse oximeter (OxyFrame) was evaluated on 16 healthy volunteers and 20 hypoxemic patients with chronic respiratory diseases undergoing a prespecified protocol simulating daily activities. Correlation, error, and accuracy root mean square error (ARMS) were calculated to compare SpO2 measured by OxyFrame, a standard pulse oximeter (MASIMO), and arterial blood gas analysis (aBGA). SpO2 measured by OxyFrame and MASIMO correlated strongly in volunteers, with low error and high accuracy (r = 0.85, error = 0.2 ± 2.9%, ARMS = 2.88%). Performances were similar in patients (r = 0.87, error 0 ± 2.5%, ARMS = 2.49% compared with MASIMO; and r = 0.93, error = 0.4 ± 1.9%, ARMS = 1.94% compared with aBGA). However, the percentage of rejected measurements was high (volunteers 77.2%, patients 46.9%). The OxyFrame cavum conchae pulse oximeter was successfully evaluated, and demonstrated accurate SpO2 measurements, compliant with ISO 80601-2-61:2017. Several reasons for the high rejection rate were identified, and potential solutions were proposed, which might be valuable for optimization of the sensor hardware.

The present study aimed to analyse fluid management and to define optimal fluid-related thresholds for elective open colorectal surgery. A retrospective analysis was made of all consecutive elective open colorectal resections performed in our tertiary centre between May 2011 and May 2017. The main outcomes were postoperative complications [overall (I-V) and severe (IIIB-V) according to the Clavien classification], respiratory complications and postoperative ileus (POI). Critical thresholds regarding perioperative fluid management and postoperative weight gain were identified by using receiver operator characteristic (ROC) analysis. Independent risk factors for overall complications were identified by multivariable logistic regression analysis. Of 121 patients who had open operations, 84 (69%) had some complication and 26 (21%) had severe complications. Respiratory complications and POI occurred in 15 (12%) and 46 patients (38%), respectively. The thresholds for intravenous fluids were 3.5 l at postoperative day (POD) 0 [area under ROC curve (AUROC) 0.7 for any 0.69 for respiratory complications] and 3.5 kg weight gain at POD 2 (AUROC 0.82 for respiratory complications). Multivariable analysis revealed weight gain of > 3.5 kg at POD 2 (OR 5.9; 95% CI 1.3-16.6) as a significant risk factor for overall complications. Acute kidney injury was observed in five patients (4%), three (5%) in the group with > 3.5 l at POD 0 and two (3%) in the group with < 3.5 l at POD 0 (P = 0.64). Creatinine increase was transitory and all patients regained baseline levels before discharge. A weight gain of > 3.5 kg at POD 2 has been identified as the critical threshold for overall and respiratory complications and prolonged length of stay after open elective colorectal surgery.