Are cuffless devices challenged enough? Design of a validation protocol for ambulatory blood pressure monitors at the wrist: the case of the Aktiia Bracelet.

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.

Combined effect of sourdough lactic acid bacteria and additives on bread firmness and staling.

The effect of various sourdoughs and additives on bread firmness and staling was studied. Compared to the bread produced with Saccharomyces cerevisiae 141, the chemical acidification of dough fermented by S. cerevisiae 141 or the use of sourdoughs increased the volume of the breads. Only sourdough fermentation was effective in delaying starch retrogradation. The effect depended on the level of acidification and on the lactic acid bacteria strain. The effect of sourdough made of S. cerevisiae 141-Lactobacillus sanfranciscensis 57-Lactobacillus plantarum 13 was improved when fungal alpha-amylase or amylolytic strains such as L. amylovorus CNBL1008 or engineered L. sanfranciscensis CB1 Amy were added. When pentosans or pentosans, endoxylanase enzyme, and L. hilgardii S32 were added to the same sourdough, a greater delay of the bread firmness and staling was found. When pentosans were in part hydrolyzed by the endoxylanase enzyme, the bread also had the highest titratable acidity, due to the fermentation of pentoses by L. hilgardii S32. The addition of the bacterial protease to the sourdough increased the bread firmness and staling.

Aqueous humor-borne factor upregulates Bcl-2 expression in corneal endothelial cells.

PURPOSE: To determine if factors present in the aqueous humor (AH) protect the corneal endothelium from apoptosis. METHODS: Mouse and human corneal endothelial cells were cultured in vitro, and apoptosis was induced by nutrient deprivation. AH and supernatant from iris/ciliary body (I/CB) cell cultures were tested for their effect on corneal endothelial cell apoptosis. The effect of I/CB supernatant on Fas, Bax, and Bcl-2 gene transcription was evaluated by Northern blotting. I/CB supernatant was subjected to proteinase analysis to identify the apoptosis inhibitory factor(s). RESULTS: Rabbit AH and supernatant from mouse I/CB cell cultures inhibited the apoptosis of mouse and human immortalized corneal endothelial cell lines. The inhibition of apoptosis was associated with an upregulation of Bcl-2 gene transcription and Bcl-2 protein expression. Bax gene expression was not significantly affected by I/CB cell supernatant. Induction of apoptosis by stimulation of the Fas receptor was unaffected by I/CB cell supernatant. Protease analyses indicated that the apoptosis inhibitory factor was a protein. CONCLUSIONS: The inability of corneal endothelial cells to undergo mitosis renders the corneal endothelium vulnerable to loss of physiological function through cellular attrition. However, a protein(s) produced by I/CB cells and present in the AH, upregulates Bcl-2 gene transcription and protects the corneal endothelial cells from apoptosis.

Cytological features of canine ovarian tumours: a retrospective study of 19 cases.

The cytological features of 19 histologically confirmed canine ovarian tumours were retrospectively examined. Seven cases were cytologically classified as papillary adenocarcinoma, eight cases as granulosa cell tumours, two cases as mature ovarian teratomas, one case as a dysgerminoma and one case as a mixed granulosa cell tumour/dysgerminoma. On cytology, papillary adenocarcinoma was characterised by a papillary glandular pattern and tight cohesiveness. Granulosa cell tumours showed monolayered clusters of loosely cohesive granulosa cells. Call-Exner-like bodies were found in five of seven cases. Granulosa cells appeared to be heterogeneous and usually contained several intracytoplasmic vacuoles. Teratoma was characterised cytologically by keratin debris (two cases) and a mixture of epithelial cells with sebaceous, basaloid, columnar/palisading or ciliated appearance (one case). The dysgerminoma contained severely atypical round cells admixed with small lymphocytes. The mixed dysgerminoma/granulosa cell tumour had a mixture of germinal and granulosa cells. Cytological diagnosis was in agreement with histopathology in 18 of 19 (94.7 per cent) cases.

[Retroperitoneal leiomyosarcoma]. / Leiomiosarcoma retroperitoneal.

We report a case of retroperitoneal leiomyosarcoma recurrence. This entity is rare, < 0.2% of all tumours in humans and 25-30% of retroperitoneal sarcomas. The diagnosis is usually delayed in relationship with scarce clinical signs which favorite the development of great tumour volume before diagnosis. The treatment is surgical, with wide margins excision. Radiotherapy and chemotherapy are not adequates for treatment of this pathological entity.

Active galaxies. A fast and long-lived outflow from the supermassive black hole in NGC 5548.

Supermassive black holes in the nuclei of active galaxies expel large amounts of matter through powerful winds of ionized gas. The archetypal active galaxy NGC 5548 has been studied for decades, and high-resolution x-ray and ultraviolet (UV) observations have previously shown a persistent ionized outflow. An observing campaign in 2013 with six space observatories shows the nucleus to be obscured by a long-lasting, clumpy stream of ionized gas not seen before. It blocks 90% of the soft x-ray emission and causes simultaneous deep, broad UV absorption troughs. The outflow velocities of this gas are up to five times faster than those in the persistent outflow, and, at a distance of only a few light days from the nucleus, it may likely originate from the accretion disk.

Lípidos séricos y evaluación antropométrica en adultos jóvenes / Serum lipids and anthropometric evaluation in young adults

Se estudiaron en forma consecutiva y bajo su consentimiento 76 sujetos aparentemente sanos (38 hombres y 38 mujeres no embarazadas), de 18 a 40 años de edad (media 26,7 ñ 4,7) que concurrieron a efectuar un examen prenupcial, para determinar los lípidos séricos y relacionarlos con el sexo, la edad y los resultados de mediciones antropométricas para la evaluación indirecta del estado nutricional. Se les realizó un cuestionario, se obtuvo el peso, la talla, se midieron los perímetros de la muñeca, el tórax, la cintura y la cadera, se obtuvo el pliegue subcutáneo tricipital y subescapular. Se calculó el Indice de Masa Corporal o "body mass index" (BMI), el peso ideal y el peso relativo, el índice cintura/tórax (C/T) y cintura/cadera (C/C), se dosaron la colesterolemia, el HDL-Colesterol y los Triglicéridos por métodos enzimáticos. Se calculó el LDL-Colesterol (Fórmula de Friedewal) y el índice Col/HDL-col. Resultados: 1) Promedios: Col: 180,7 ñ 43,4 mg/dl, HDL-Col: 47,3 ñ 14,3 mg/dl, TG: 81,1 ñ 61,0 mg/dl, LDL-Col: 116,7 ñ 38,0 mg/dl, IR: 4,03 ñ 1,7, BMI: 23,5 ñ 3,5, PR: 102,4 ñ 10,5, C/T: 0,92 ñ 0,07, C/C: 0,80 ñ 0,08, Tri: 17,7 ñ 7,0 mn y Esc: 15,3 ñ 5,5 mn. Se detectó un 18,42 por ciento de los sujetos que tenían criterios BMI y de peso relativo de obesidad. El 30,26 por ciento de la muestra presentó un aumento del Col, un descenso de HDL-Col y un índice Col/HDL-Col elevado, en este último con un franco predominio de los varones. La frecuencia de hipertrigliceridemia fue baja (13,15 por ciento). Los índices antropométricos utilizados (BMI, PR, C/T, C/C) excepto con el Colesterol (que sólo se vinculó al C/C), mostraron una buena correlación con los lípidos séricos. La edad presentó una fuerte asociación con la colesterolemia pero no con el HDL-Col. Hubo diferencias entre sexos para las variables estudiadas, menos para el C/T y el pliegue escapular. No se detectó ninguna persona con C/C bajo (biotipo "fémoro-glúteo o ginoide) e IR elevado, lo cual plantea el interrogante si esta disposición de la grasa del cuerpo no representa una manifestación de "protección" para que no se desarrolle una dislipemia