scholarly journals Monitoring of Cardiac Output Using a New Smartphone Application (Capstesia) vs. Vigileo FloTrac System

Surgeries ◽  
2021 ◽  
Vol 2 (4) ◽  
pp. 347-356
Author(s):  
Fulvio Nisi ◽  
Chiara Melchiorri ◽  
Paola Di Grigoli ◽  
Enrico Giustiniano ◽  
Elisabetta Cerutti ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Vascular Surgery ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Cost Effective ◽  
Smartphone Application ◽  
Percentage Error ◽  
Strong Impact ◽  
And Performance ◽  
High Level

(1) Background: We tested Capstesia against a reference system, Vigileo FloTrac, in patients undergoing major vascular surgery procedures. (2) Methods: Twenty-two adult patients (236 data pairs) were enrolled. Cardiac output (CO), stroke volume (SV), systemic vascular resistance (SVR), and related indexed parameters from the two monitoring systems were collected and compared at eleven time points during surgery. Intraclass correlation coefficients with 95% confidence intervals (CIs) and Bland–Altman plots with percentages of error were used. (3) Results: The interclass correlation coefficients for CO, SV, and SVR were 0.527 (95%CI 0.387 to 0.634), 0.580 (95%CI 0.454 to 0.676), and 0.609 (95%CI 0.495 to 0.698), respectively. In the Bland–Altman analysis, bias (and limits of agreement) of CO was 0.33 L min−1 (−2.44; 3.10), resulting in a percentage error of 61.91% for CO. For SV, it was 5.02 mL (−36.42; 46.45), with 57.19% of error. Finally, the bias (and limit of agreement) of SVR was −75.99 dyne sec cm−5 (−870.04; 718.06), resulting in an error of 69.94%. (4) Conclusions: Although promising, cost-effective, and easy to use, the moderate level of agreement with Vigileo and the high level of error make Capstesia unsuitable for use in the intraoperative setting of vascular surgery. Critical errors in acquisition or digitalization of the snap might have a strong impact on the accuracy and performance. Further standardization of the acquisition technique and improvements in the processing algorithm are needed.

Intersession reliability of GPS-based and accelerometer-based physical variables in small-sided games with and without the offside rule

2021 ◽  
pp. 175433712098764
Author(s):  
Igor Junio de Oliveira Custódio ◽  
Gibson Moreira Praça ◽  
Leandro Vinhas de Paula ◽  
Sarah da Glória Teles Bredt ◽  
Fabio Yuzo Nakamura ◽  
...  
Keyword(s):  
Root Mean Square ◽  
Global Positioning System ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Mean Square ◽  
Physical Demands ◽  
Intraclass Correlation Coefficients ◽  
Total Distance ◽  
Global Positioning ◽  
High Level

This study aimed to analyze the intersession reliability of global positioning system (GPS-based) distances and accelerometer-based (acceleration) variables in small-sided soccer games (SSG) with and without the offside rule, as well as compare variables between the tasks. Twenty-four high-level U-17 soccer athletes played 3 versus 3 (plus goalkeepers) SSG in two formats (with and without the offside rule). SSG were performed on eight consecutive weeks (4 weeks for each group), twice a week. The physical demands were recorded using a GPS with an embedded triaxial accelerometer. GPS-based variables (total distance, average speed, and distances covered at different speeds) and accelerometer-based variables (Player Load™, root mean square of the acceleration recorded in each movement axis, and the root mean square of resultant acceleration) were calculated. Results showed that the inclusion of the offside rule reduced the total distance covered (large effect) and the distances covered at moderate speed zones (7–12.9 km/h – moderate effect; 13–17.9 km/h – large effect). In both SSG formats, GPS-based variables presented good to excellent reliability (intraclass correlation coefficients – ICC > 0.62) and accelerometer-based variables presented excellent reliability (ICC values > 0.89). Based on the results of this study, the offside rule decreases the physical demand of 3 versus 3 SSG and the physical demands required in these SSG present high intersession reliability.

Abstract 14288: Substantial Hospital-level Variation in Troponin Testing After Non-cardiac Surgery

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Paymon M Azizi ◽  
Lu Han ◽  
Maria Koh ◽  
Angela Jerath ◽  
Harindra C Wijeysundera ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cohort Study ◽  
Vascular Surgery ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Population Based ◽  
Level Variation ◽  
Hospital Level ◽  
Hospital Variation ◽  
Postoperative Myocardial Infarction

Introduction: There is an increasing emphasis in detecting postoperative myocardial infarction (PMI) using routine troponin testing after non-cardiac surgery. However, clinical practice guidelines vary considerably in their recommendations. We conducted a population-based cohort study in Ontario, Canada to assess the degree of hospital-level variation associated with troponin testing after three commonly performed surgeries. Methods: We conducted a retrospective cohort study of adults (40-105 y) undergoing major orthopedic, colorectal, or vascular surgery in Ontario, Canada from January 1, 2010 to December 31, 2017. Hierarchical logistic regression modeling was used to model the association of patient, surgery, and hospital factors with postoperative troponin testing, while accounting for clustering at the hospital level. Results: We identified 176,454 eligible patients. Canadian Cardiovascular Society guidelines recommended troponin testing for 73.5%, 90.8% and 95.6% of orthopedic, colorectal, and vascular surgery patients respectively, but only 6.7%, 16.6%, and 50.2% were actually tested. Inter hospital variation in testing rates was considerable for the three surgeries (Figure; 0-33%, 0-38% and 18-84%). Even after risk-adjustment, the median odds ratio for testing across hospitals was still 1.74, 1.63, and 2.65 for orthopedic, colorectal, and vascular surgery, respectively. This corresponded to intraclass correlation coefficients of 9.3%, 7.4%, and 24.2% respectively. Conclusion: Despite strong recommendations by Canadian guidelines for troponin testing after non-cardiac surgery, testing rates were low overall and varied significantly across hospitals.

Accuracy and precision of cardiac output estimation by an automated, brachial cuff-based oscillometric device in patients with shock

2019 ◽  
Vol 234 (11) ◽  
pp. 1330-1336 ◽  
Author(s):  
Theodore G Papaioannou ◽  
Dimitrios Xanthis ◽  
Antonis Argyris ◽  
Pavlos Vernikos ◽  
Georgia Mastakoura ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Output ◽  
Intensive Care ◽  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Intraclass Correlation ◽  
Percentage Error ◽  
Non Invasive ◽  
Oscillometric Device ◽  
Cardiac Output Measurements

Non-invasive monitoring of cardiac output is a technological and clinical challenge, especially for critically ill, surgically operated, or intensive care unit patients. A brachial cuff-based, automated, oscillometric device used for blood pressure and arterial stiffness ambulatory monitoring (Mobil-O-Graph) provides a non-invasive estimation of cardiac output values simultaneously with regular blood pressure measurement. The aim of the study was to evaluate the feasibility of this apparatus to estimate cardiac output in intensive care unit patients and to compare the non-invasive estimated cardiac output values with the respective gold standard method of thermodilution during pulmonary artery catheterization. Repeated sequential measurements of cardiac output were performed, in random order, by thermodilution (reference) and Mobil-O-Graph (test), in 24 patients hospitalized at intensive care unit. Reproducibility and accuracy of the test device were evaluated by Bland–Altman analysis, intraclass correlation coefficient, and percentage error. Mobil-O-Graph underestimated significantly the cardiac output by −1.12 ± 1.38 L/min ( p < 0.01) compared to thermodilution. However, intraclass correlation coefficient was >0.7 indicating a fair agreement between the test and the reference methods, while percentage error was approximately 39% which is considered to be within the acceptable limits. Cardiac output measurements were reproducible by both Mobil-O-Graph (intraclass correlation coefficient = 0.73 and percentage error = 27.9%) and thermodilution (intraclass correlation coefficient = 0.91 and percentage error = 26.7%). We showed for the first time that cardiac output estimation in intensive care unit patients using a non-invasive, automated, oscillometric, cuff-based apparatus is reproducible (by analyzing two repeated cardiac output measurements), exhibiting similar precision to thermodilution. However, the accuracy of Mobil-O-Graph (error compared to thermodilution) could be considered fairly acceptable. Future studies remain to further examine the reliability of this technology in monitoring cardiac output or stroke volume acute changes which is a more clinically relevant objective.

scholarly journals Effects of interobserver and interdisciplinary segmentation variabilities on CT-based radiomics for pancreatic cancer

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jeffrey Wong ◽  
Michael Baine ◽  
Sarah Wisnoskie ◽  
Nathan Bennion ◽  
Dechun Zheng ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Radiation Oncology ◽  
Quantitative Imaging ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Dice Similarity Coefficient ◽  
Imaging Features ◽  
Oncology Group ◽  
Radiation Oncology Group ◽  
And Performance

AbstractRadiomics is a method to mine large numbers of quantitative imaging features and develop predictive models. It has shown exciting promise for improved cancer decision support from early detection to personalized precision treatment, and therefore offers a desirable new direction for pancreatic cancer where the mortality remains high despite the current care and intense research. For radiomics, interobserver segmentation variability and its effect on radiomic feature stability is a crucial consideration. While investigations have been reported for high-contrast cancer sites such as lung cancer, no studies to date have investigated it on CT-based radiomics for pancreatic cancer. With three radiation oncology observers and three radiology observers independently contouring on the contrast CT of 21 pancreatic cancer patients, we conducted the first interobserver segmentation variability study on CT-based radiomics for pancreatic cancer. Moreover, our novel investigation assessed whether there exists an interdisciplinary difference between the two disciplines. For each patient, a consensus tumor volume was generated using the simultaneous truth and performance level expectation algorithm, using the dice similarity coefficient (DSC) to assess each observer’s delineation against the consensus volume. Radiation oncology observers showed a higher average DSC of 0.81 ± 0.06 than the radiology observers at 0.69 ± 0.16 (p = 0.002). On a panel of 1277 radiomic features, the intraclass correlation coefficients (ICC) was calculated for all observers and those of each discipline. Large variations of ICCs were observed for different radiomic features, but ICCs were generally higher for the radiation oncology group than for the radiology group. Applying a threshold of ICC > 0.75 for considering a feature as stable, 448 features (35%) were found stable for the radiation oncology group and 214 features (16%) were stable from the radiology group. Among them, 205 features were found stable for both groups. Our results provide information for interobserver segmentation variability and its effect on CT-based radiomics for pancreatic cancer. An interesting interdisciplinary variability found in this study also introduces new considerations for the deployment of radiomics models.

scholarly journals Prescribing Target Running Intensities for High-School Athletes: Can Forward and Backward Running Performance Be Autoregulated?

Sports ◽  
2018 ◽  
Vol 6 (3) ◽  
pp. 77 ◽  
Author(s):  
Aaron Uthoff ◽  
Jon Oliver ◽  
John Cronin ◽  
Paul Winwood ◽  
Craig Harrison
Keyword(s):  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Percentage Error ◽  
High School Athletes ◽  
Running Speed ◽  
Running Performance ◽  
Youth Athletes ◽  
Intraclass Correlation Coefficients ◽  
Relative Consistency ◽  
Maximum Effort

Target running intensities are prescribed to enhance sprint-running performance and progress injured athletes back into competition, yet is unknown whether running speed can be achieved using autoregulation. This study investigated the consistency of running intensities in adolescent athletes using autoregulation to self-select velocity. Thirty-four boys performed 20 m forward running (FR) and backward running (BR) trials at slow, moderate and fast intensities (40–55%, 60–75% and +90% maximum effort, respectively) on three occasions. Absolute and relative consistency was assessed using the coefficient of variation (CV) and intraclass correlation coefficients (ICC). Systematic changes in 10 and 20 m performance were identified between trials 1–2 for moderate and fast BR (p ≤ 0.01) and during moderate BR over 20 m across trials 2–3 (p ≤ 0.05). However, comparisons between trials 2–3 resulted in low typical percentage error (CV ≤ 4.3%) and very good to excellent relative consistency (ICC ≥ 0.87) for all running speeds and directions. Despite FR being significantly (p ≤ 0.01) faster than BR at slow (26%), moderate (28%) and fast intensities (26%), consistency was similar in both running directions and strongest at the fastest speeds. Following appropriate familiarization, youth athletes may use autoregulation to self-select prescribed FR and BR target running intensities.

scholarly journals Validity and reliability of intra-oral and plaster models’ photographs in the assessment of Little's Irregularity Index, tooth-size-arch-length discrepancy and Bolton's analysis

2020 ◽  
Author(s):  
Wael Al-Rasheed ◽  
Amer M Owayda ◽  
Mohammad Y Hajeer ◽  
Tarek Z Khattab ◽  
Rashad MT Murad ◽  
...  
Keyword(s):  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Repeated Measurements ◽  
Tooth Size ◽  
Validity And Reliability ◽  
Length Discrepancy ◽  
Irregularity Index ◽  
High Level ◽  
Plaster Models ◽  
Labor Consuming

Abstract Background Dental impressions have been required to obtain proper study models. This procedure is a time- and labor-consuming for the orthodontist and could be exhausting to the patient especially when braces are fitted in the context of a research project. This study aimed to assess the accuracy, reliability, and reproducibility of using intraoral photographs and plaster models’ photographs in measuring Little's Irregularity Index (LII), tooth-size-arch-length discrepancy (TSALD) and Bolton's ratios.Methods Fifty-two dental arches of 26 patients were included in this study. Plaster models, occlusal intraoral photographs and photographs of the collected plaster models were obtained for each patient. Then, LII, TSALD and Bolton’s ratios were measured using a manual caliper for plaster models’ measurements and a software-based on-screen method for the photographs.Results The intraclass correlation coefficients (ICCs) of measurements made on intraoral photographs and photographs of plaster models were high (ranging from 0.90 to 0.99 and from 0.88 to 0.99, respectively) indicating a high level of agreement with the gold standard measurements. In addition, the differences were insignificant. The intra-/inter-examiner ICCs ranged from 0.90 to 0.99/0.92 to 0.99 and from 0.85 to 0.99/0.88 to 0.98 for plaster models and intraoral photographs of the dental arches, respectively. The analysis of reproducibility of capturing intraoral photographs of the dental arches in two different occasions showed high ICCs ranging from 0.96 to 0.99 with almost no significant differences between repeated measurements (P>0.05).Conclusion LII, TSALD, and Bolton’s overall and partial ratios can be measured from intraoral photographs of the dental arches with high accuracy, reliability, and reproducibility. Therefore, this methodology can be suggested for use in research projects when multiple records of the dental arches are required instead of depending on time- and labor-consuming procedures of ordinary dental impressions.

scholarly journals Improving echographic monitoring of hemodynamics in critically ill patients: validation of right cardiac output measurements through the modified subcostal window

2020 ◽  
Author(s):  
Laura Colinas Fernández ◽  
Gonzalo Hernández Martínez ◽  
María B. Serna Gandía ◽  
Gaspar Tuero León ◽  
Pablo Cuesta-Montero ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Outflow Tract ◽  
Mechanically Ventilated ◽  
Severe Aortic Regurgitation ◽  
Time Integral ◽  
The Right

Abstract Background: The gold standard for echocardiographic monitoring of cardiac output in critically ill patients is measurements of the velocity-time integral (VTI) along the left ventricle outflow tract (LVOT). However, clinical circumstances such as severe aortic regurgitation or dynamic LVOT obstruction limit the use of LVOT VTI as a surrogate for stroke volume, and the transthoracic window is often unfeasible in mechanically ventilated patients. We aimed to assess the usefulness of using the right ventricle outflow tract (RVOT) VTI for echocardiographic monitoring of cardiac output. Methods: This prospective observational study included 100 consecutive patients admitted to a tertiary intensive care unit. We used intraclass correlation coefficients (ICC) to compare echocardiographic measurements of LVOT VTI through apical window with RVOT VTI through the parasternal and modified subcostal windows and to assess interobserver reproducibility. Preplanned post hoc analyses compared the ICC between ventilated and nonventilated patients. Results: At the time of echocardiography, 44 (44%) patients were mechanically ventilated and 28 (28%) were receiving vasoactive drugs. Good-quality measurements were obtained through the parasternal short-axis and/or apical views in 81 (81%) patients and in 100 (100%) patients through the subcostal window. Consistency with LVOT VTI was moderate for RVOT VTI measured from the modified subcostal view (ICC 0.727; 95%CI: 0.62–0.808) and for RVOT VTI measured from the transthoracic view (0.715; 95%CI: 0.59–0.807). Conclusions: Measurements of RVOT VTI are moderately consistent with measurements of LVOT VTI. Adding the modified subcostal window allows cardiac output to be monitored echocardiographically in practically all critically ill patients, even those under mechanical ventilation.

Maternal diabetes and fetal cardiac output

2021 ◽  
pp. 1-6
Author(s):  
S.L. Narasimhan ◽  
A. Eid ◽  
A. Bhatia ◽  
C. Davey ◽  
J. Steinberger
Keyword(s):  
Cardiac Output ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Maternal Diabetes ◽  
Left Ventricular ◽  
Chi Square ◽  
Intraclass Correlation Coefficients ◽  
Cardiac Adaptation ◽  
Diabetic Mothers

BACKGROUND: The intrauterine environment is a key determinant for long-term health outcomes. Adverse fetal environments, such as maternal diabetes, obesity and placental insufficiency are strongly associated with long-term health risks in children. Little is known about differences in fetal cardiac output hemodynamics of diabetic mothers (DM) vs. non-diabetic mothers (NDM). Our study aims to investigate the left-sided, right-sided, and combined cardiac output (CCO) in fetuses of DM vs. NDM. METHODS: Retrospective data were collected in fetuses of DM (N = 532) and NDM (103) at mean gestational age 24 weeks. Examination included 2D echo and pulse wave Doppler. Wilcoxon rank sum tests and Chi-square tests were used to test for distribution difference of maternal and fetal continuous and categorical measures respectively between DM and NDM. Intraclass correlation coefficients were calculated to assess intra-observer reliability of fetal cardiac measurements. RESULTS: DM mothers had higher mean weight (89.7±22.2 kg) than NDM (76.8±19.8 kg), p <  0.0001 and higher mean BMI (33.4±7.5) than NDM (28.3±5.8), p <  0.0001. C-section delivery occurred in 66% of DM vs. 35% of NDM fetuses. Fetuses of DM mothers had significantly larger semilunar valve diameter, higher left ventricular (LV) output, higher combined cardiac output and lower right ventricle /left ventricle ratio compared to NDM. CONCLUSION: The greater CCO (adjusted for fetal weight), left sided cardiac output in the fetuses of DM, compared to NDM, represent differences in cardiac adaptation to the diabetic environment.

Concurrent Validity of the Garmin Vivofit®4 to Accurately Record Step Count in Older Adults in Challenging Environments

2021 ◽  
pp. 1-9
Author(s):  
Jacinta I. Foster ◽  
Katrina L. Williams ◽  
Barbra H.B. Timmer ◽  
Sandra G. Brauer
Keyword(s):  
Older Adults ◽  
Concurrent Validity ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Error Rates ◽  
Percentage Error ◽  
Battery Life ◽  
Intraclass Correlation Coefficients ◽  
Outdoor Walking ◽  
Walking Speeds

There is little evidence of the concurrent validity of commercially available wrist-worn long battery life activity monitors to measure steps in older adults at slow speeds and with real-world challenges. Forty adults aged over 60 years performed a treadmill protocol at four speeds, a 50-m indoor circuit, and a 200-m outdoor circuit with environmental challenges while wearing a Garmin Vivofit®4, the activPAL3™, and a chest-worn camera angled at the feet. The Garmin Vivofit®4 showed high intraclass correlation coefficients2,1 (.98–.99) and low absolute percentage error rates (<2%) at the fastest treadmill speeds and the outdoor circuit. Step counts were underestimated at the slowest treadmill speed and the indoor circuit. The Garmin Vivofit®4 is accurate for older adults at higher walking speeds and during outdoor walking. However, it underestimates steps at slow speeds and when walking indoors with postural transitions.

scholarly journals The reliability of physiological and performance data obtained during a long distance simulated triathlon laboratory test

2019 ◽  
Vol 8 (3) ◽  
pp. 25-32
Author(s):  
Kate Margaret Luckin
Keyword(s):  
Blood Lactate ◽  
Perceived Exertion ◽  
Correlation Coefficients ◽  
Rating Of Perceived Exertion ◽  
Long Distance ◽  
Task Representation ◽  
Intra Class Correlation ◽  
Physiological Variables ◽  
And Performance ◽  
High Level

The aim of this study was to investigate the reliability of a newly developed long distance (LD) simulated triathlon for testing performance and physiological changes in LD triathletes. Ten trained LD triathletes (mean ± standard deviation: age 34.1 ± 5.0 years, body mass 69.07 ± 13.89 kg) completed two separate trials of a simulated LD triathlon consisting of a 1500 m swim, a 60 minute cycle at 60% of power at VO2max and a 20 minute run at 70% of velocity at VO2max. Performance (time, pace, power and rating of perceived exertion) and physiological (economy of movement (oxygen cost and energy consumption), blood lactate and heart rate)variables were measured throughout the simulated LD triathlon. Coefficient of variations (CV %) and intra class correlation coefficients (ICC) were calculated to determine reliability. The current study displayed a high level of reliability, with moderate to excellent ICC measurements for performance and physiological variables (ICC 0.62 – 0.99). All physiological variables, except blood lactate, demonstrated CV values < 10%. In conclusion, the newly developed LD simulated triathlon has a high level of task representation for LD triathletes and can accurately assess performance changes in a research setting.

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