Accuracy testing of a new optical device for noninvasive estimation of systolic and diastolic blood pressure compared to intra-arterial measurements.

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.

Impact of global change on karst groundwater mineralization in the Jura Mountains.

Chemistry of karst groundwater is related to conditions prevailing within the karst underground as well as at the land-surface within the recharge area. It is dominated by the dissolution of calcite and/or dolomite, which is strongly triggered by the presence of high pCO2 in soils at the top of the bedrock. Dissolution (water mineralization) is clearly influenced by soil pCO2, i.e. by global changes such as land-use, agriculture practices and climate change. However, the dissolution of carbonates is considered as a quite significant carbon sink for the Earth Atmosphere. Assessing the evolution of carbonate water mineralization can thus help characterizing the evolution of the carbon sink related to carbonate dissolution. The main goal of the study is to check the presence of trends with a high statistical relevance in groundwater quality data along the past 20 years. Causes potentially explaining the observed trends, such as land-use, agriculture practices and global warming are analyzed and discussed. The long term evolution of parameters related to carbonate dissolution are discussed and extrapolated as they may have consequences for the Global Carbon Cycle. The analysis is based on three independent data-sets stretching over more than 20 years each, coming from more than 40 sources. Statistical tests (Mann-Kendall trend test) indicate clear trends for compounds related to groundwater mineralization: increase in temperature (by about 0.5 °C/25 years), decrease in pH, increase in bicarbonate (by about 5%), and positive or negative trends for major ions directly related to human practices. Data and analysis suggest that carbonate dissolution is quickly increasing as a consequence of climate warming. Considering the largely accepted fact that carbonate dissolution acts as carbon sink for the atmosphere, it can be postulated that the observed increase could act as a negative feedback mechanism, tending to slow down the atmospheric increase in CO2.