Explore the vast range of titles available.

Heart and respiratory rate monitoring during sleep enables the detection of physiological irregularities through contact or contactless methods. Traditional approaches like polysomnography are accurate but costly, ergonomically limited, and often poorly accepted by patients. Smart Bedding® is a novel, flexible bedsheet equipped with a high-resolution sensor network that records movement, pressure, sound, temperature, and humidity throughout the night. This study aimed to estimate cardiorespiratory parameters using the Smart Bedding® IMU. Data from 30 participants sleeping on Smart Bedding® while undergoing simultaneous polysomnography were analyzed. A robust and low-cost preprocessing pipeline was developed; estimation was performed using zero-crossing, peak detection, and Burg’s method for comparison, and validation was conducted using polysomnography as the gold-standard reference. Respiratory and heart rates were accurately estimated, achieving overall accuracies of 93.9% and 88.7% using zero-crossing and peak detection, respectively. Respiratory rate estimation showed no significant limitations across the frequency spectrum or among sleeping positions. However, heart rate estimation accuracy decreased when the frequency was below 55 BPM or when participants slept in a lateral sleep position, likely due to reduced cardiac signal power. Overall, the proposed methodology accurately tracked respiratory and cardiac patterns throughout the night, supporting Smart Bedding® as a promising tool for future sleep tracking applications.

Wearable vital signs monitoring and specially the electrocardiogram have taken important role due to the information that provide about high-risk diseases, it has been evidenced by the needed to increase the health service coverage in home care as has been encouraged by World Health Organization. Some wearables devices have been developed to monitor the Electrocardiographic in which the location of the measurement electrodes is modified respect to the Einthoven model. However, mislocation of the electrodes on the torso can lead to the modification of acquired signals, diagnostic mistakes and misinterpretation of the information in the signal. This work presents a volume conductor evaluation and an Electrocardiographic signal waveform comparison when the location of electrodes is changed, to find a electrodes’ location that reduces distortion of interest signals. In addition, effects of motion artifacts and electrodes’ location on the signal acquisition are evaluated. A group of volunteers was recorded to obtain Electrocardiographic signals, the result was compared with a computational model of the heart behavior through the Ensemble Average Electrocardiographic, Dynamic Time Warping and Signal-to-Noise Ratio methods to quantitatively determine the signal distortion. It was found that while the Einthoven method is followed, it is possible to acquire the Electrocardiographic signal from the patient’s torso or back without a significant difference, and the electrodes position can be moved 6 cm at most from the suggested location by the Einthoven triangle in Mason–Likar’s method.

(1) Background and objectives: Parkinson’s disease (PD) is one of the most prevalent neurodegenerative diseases whose typical symptoms include bradykinesia, abnormal gait and posture, shortened strides, and other movement disorders. In this study, we present a novel framework to evaluate PD gait patterns using state of the art deep learning algorithms. A comparative analysis with three different approaches is presented and evaluated upon three groups of subjects: PD patients, Young Healthy Controls (YHC), and Elderly Healthy Controls (EHC). (2) Methods: The three approaches used in the study include: (i) The energy content of the gait signals in the frequency domain is captured with spectrograms that are used to feed a CNN model, (ii) Temporal information is incorporated by creating GRU networks, (iii) Temporal and spectral information is simultaneously captured by creating a new architecture based on CNNs and GRUs. (3) Results: Accuracies of up to 83.7% and 92.7% are found for the classification between PD vs. EHC and PD vs. YHC, respectively. According to our observations, the proposed approach based on the combination of temporal and spectral information, yields better results than others reported in the state of the art. (4) Conclusions: The results obtained in this study suggest that the combination of temporal and spectral information is more accurate than individual approaches used to classify and evaluate gait patterns in PD patients. To the best of our knowledge, this is the first study in gait analysis where temporal and spectral information is combined in an architecture of deep learning.

The Latin American and Caribbean (LAC) region faces persistent challenges of inequality, climate change vulnerability, and deteriorating air quality. The Aburrá Valley, where Medellín is located, is a narrow tropical valley with complex topography, strong thermal inversions, and unstable atmospheric conditions, all of which exacerbate the accumulation of pollutants. In Medellín, NO2 concentrations have remained nearly unchanged over the past eight years, consistently approaching critical thresholds, despite the implementation of air quality control strategies. These persistent high concentrations are closely linked to the variability of the atmospheric boundary layer (ABL) and are often intensified by prolonged dry periods. This study focuses on a representative street canyon in Medellín that has undergone recent urban interventions, including the construction of new public spaces and pedestrian areas, without explicitly considering their impact on NOx dispersion. Using Computational Fluid Dynamics (CFD) simulations, this work evaluates the influence of urban morphology on NOx accumulation. The results reveal that areas with high Aspect Ratios (AR > 0.65) and dense vegetation exhibit reduced wind speeds at the pedestrian level—up to 40% lower compared to open zones—and higher NO2 concentrations, with maximum simulated values exceeding 50 μg/m3. This study demonstrates that the design of pedestrian corridors in complex urban environments like Medellín can unintentionally create pollutant accumulation zones, underscoring the importance of integrating air quality considerations into urban planning. The findings provide actionable insights for policymakers, emphasizing the need for comprehensive modeling and field validation to ensure healthier urban spaces in cities affected by persistent air quality issues.

Although alcohol cessation is the only effective treatment for alcohol-related liver disease, few data exist concerning its influence on the risk of hepatocellular carcinoma (HCC). We aimed to evaluate the effect of alcohol abstinence on the incidence of HCC in patients with alcohol-related cirrhosis. We studied 727 patients with alcohol-related cirrhosis (247 with compensated disease and 480 with previous decompensation) who were included in a surveillance program for the early detection of HCC and prospectively followed. Baseline clinical and biological parameters and alcohol consumption during follow-up were recorded. Abstinence was defined as the absence of any alcohol use. During follow-up (median 54 months), 354 patients (48.7%) remained abstinent and 104 developed HCC (2.3 per 100 person-years). Factors independently associated with the risk of HCC among patients with previous decompensation were age, male gender, and aspartate aminotransferase, whereas abstinence was not linked to a reduced risk (hazard ratio 0.95; 95% confidence interval 0.59-1.52). However, among patients without previous decompensation, prothrombin activity and abstinence were independently associated with the risk of HCC. Abstinent patients had a significant decrease in the risk of developing tumor (hazard ratio 0.35; 95% confidence interval 0.13-0.94). These results did not change after applying a competing risk analysis where death and liver transplantation were considered as competing events. Alcohol abstinence reduced the risk of HCC in patients with alcohol-related cirrhosis, but only in those without a history of decompensated disease. This finding emphasizes the need for an early diagnosis of alcohol-related liver disease and for implementing strategies leading to an increase in the rate of achieving and maintaining abstinence among this population.

The quest for improved diagnosis and treatment in home health care models has led to the development of wearable medical devices for remote vital signs monitoring. An accurate signal and a high diagnostic yield are critical for the cost-effectiveness of wearable health care monitoring systems and their widespread application in resource-constrained environments. Despite technological advances, the information acquired by these devices can be contaminated by motion artifacts (MA) leading to misdiagnosis or repeated procedures with increases in associated costs. This makes it necessary to develop methods to improve the quality of the signal acquired by these devices. We aimed to present a novel method for electrocardiogram (ECG) signal denoising to reduce MA. We aimed to analyze the method's performance and to compare its performance to that of existing approaches. We present the novel Redundant denoising Independent Component Analysis method for ECG signal denoising based on the redundant and simultaneous acquisition of ECG signals and movement information, multichannel processing, and performance assessment considering the information contained in the signal waveform. The method is based on data including ECG signals from the patient's chest and back, the acquisition of triaxial movement signals from inertial measurement units, a reference signal synthesized from an autoregressive model, and the separation of interest and noise sources through multichannel independent component analysis. The proposed method significantly reduced MA, showing better performance and introducing a smaller distortion in the interest signal compared with other methods. Finally, the performance of the proposed method was compared to that of wavelet shrinkage and wavelet independent component analysis through the assessment of signal-to-noise ratio, dynamic time warping, and a proposed index based on the signal waveform evaluation with an ensemble average ECG. Our novel ECG denoising method is a contribution to converting wearable devices into medical monitoring tools that can be used to support the remote diagnosis and monitoring of cardiovascular diseases. A more accurate signal substantially improves the diagnostic yield of wearable devices. A better yield improves the devices' cost-effectiveness and contributes to their widespread application.

Introduction: Physical education (PE) has shifted toward active approaches that enhance engagement and promote healthy lifestyles. Gamification has emerged as a promising tool to boost student motivation and physical performance, positively impacting fitness, including cardiorespiratory fitness and body composition. However, comprehensive reviews on its effectiveness in PE are limited. Methodology: This systematic review and meta-analysis examined the effects of gamified PE interventions on physical fitness and motor coordination compared with traditional or non-gamified approaches. The protocol was registered in PROSPERO (CRD42025642780). Searches were conducted in PubMed/MEDLINE, Web of Science, ScienceDirect, and Scopus up to September 2024. Randomized controlled trials assessing physical fitness outcomes were included. Risk of bias was assessed using the Cochrane RoB 2 tool. Results: From 958 identified records, six studies met the inclusion criteria. Gamified PE interventions improved VO₂max (MD 4.05; 95% CI 2.54 to 5.57; p < 0.001; I² = 38%) and agility (MD 1.04; 95% CI 0.17 to 1.92; p = 0.02; I² = 99%). No beneficial effects were observed for horizontal jump performance (MD -0.01; 95% CI -0.06 to 0.04; p = 0.67; I² = 95%), and CMJ performance favored the control group (MD -2.39; 95% CI -3.76 to -1.02; p < 0.001; I² = 62%). Most studies showed low risk of bias in several domains, although some concerns were identified, mainly regarding randomization and deviations from intended interventions. Conclusion: Gamified PE interventions may improve VO₂max and agility, but evidence for strength-related outcomes is inconsistent. These findings should be interpreted cautiously due to the limited number of studies, high heterogeneity for several outcomes, and some methodological concerns. Introducción: La educación física (EF) ha evolucionado hacia enfoques activos que favorecen la participación del alumnado y promueven estilos de vida saludables. La gamificación ha surgido como una estrategia prometedora para incrementar la motivación del alumnado y mejorar el rendimiento físico, con efectos positivos sobre la condición física, incluida la capacidad cardiorrespiratoria y la composición corporal. Sin embargo, las revisiones exhaustivas sobre su eficacia en el contexto de la EF son todavía limitadas. Metodología: Esta revisión sistemática y metaanálisis examinó los efectos de las intervenciones basadas en gamificación en educación física sobre la condición física y la coordinación motriz, en comparación con enfoques tradicionales o no gamificados. El protocolo fue registrado en PROSPERO (CRD42025642780). Se realizaron búsquedas en PubMed/MEDLINE, Web of Science, ScienceDirect y Scopus hasta septiembre de 2024. Se incluyeron ensayos clínicos aleatorizados que evaluaban resultados relacionados con la condición física. El riesgo de sesgo se evaluó mediante la herramienta Cochrane RoB 2. Resultados: De los 958 registros identificados, seis estudios cumplieron los criterios de inclusión. Las intervenciones gamificadas en educación física mejoraron el VO₂máx (DM = 4,05; IC del 95%: 2,54 a 5,57; p < 0,001; I² = 38%) y la agilidad (DM = 1,04; IC del 95%: 0,17 a 1,92; p = 0,02; I² = 99%). No se observaron efectos beneficiosos sobre el rendimiento en el salto horizontal (DM = −0,01; IC del 95%: −0,06 a 0,04; p = 0,67; I² = 95%), mientras que el rendimiento en el salto con contramovimiento (CMJ) favoreció al grupo control (DM = −2,39; IC del 95%: −3,76 a −1,02; p < 0,001; I² = 62%). La mayoría de los estudios presentaron un bajo riesgo de sesgo en varios dominios, aunque se identificaron algunas preocupaciones, principalmente relacionadas con el proceso de aleatorización y las desviaciones de las intervenciones previstas. Conclusiones: Las intervenciones gamificadas en educación física pueden mejorar el VO₂máx y la agilidad; sin embargo, la evidencia sobre los resultados relacionados con la fuerza es inconsistente. Estos hallazgos deben interpretarse con cautela debido al reducido número de estudios incluidos, la elevada heterogeneidad observada en varios desenlaces y algunas limitaciones metodológicas. Introdução: A educação física (EF) evoluiu para abordagens ativas que incentivam a participação dos alunos e promovem estilos de vida saudáveis. A gamificação surgiu como uma estratégia promissora para aumentar a motivação dos alunos e melhorar o desempenho físico, com efeitos positivos na aptidão física, incluindo a aptidão cardiorrespiratória e a composição corporal. No entanto, as revisões abrangentes sobre a sua eficácia no contexto da EF são ainda limitadas. Metodologia: Esta revisão sistemática e meta-análise examinou os efeitos das intervenções baseadas na gamificação na educação física na aptidão física e na coordenação motora, em comparação com as abordagens tradicionais ou não gamificadas. O protocolo foi registado no PROSPERO (CRD42025642780). As pesquisas foram realizadas no PubMed/MEDLINE, Web of Science, ScienceDirect e Scopus até setembro de 2024. Foram incluídos ensaios clínicos randomizados que avaliaram desfechos relacionados com a aptidão física. O risco de viés foi avaliado através da ferramenta Cochrane RoB 2. Resultados: Dos 958 registos identificados, seis estudos cumpriram os critérios de inclusão. As intervenções gamificadas na educação física melhoraram o VO₂máx (DM = 4,05; IC 95%: 2,54 a 5,57; p < 0,001; I² = 38%) e a agilidade (DM = 1,04; IC 95%: 0,17 a 1,92; p = 0,02; I² = 99%). Não foram observados efeitos benéficos no desempenho do salto horizontal (DM = −0,01; IC 95%: −0,06 a 0,04; p = 0,67; I² = 95%), enquanto o desempenho do salto com contramovimento (CMJ) favoreceu o grupo controlo (DM = −2,39; IC 95%: −3,76 a −1,02; p < 0,001; I² = 62%). A maioria dos estudos apresentou um baixo risco de viés em diversos domínios, embora tenham sido identificadas algumas preocupações, principalmente relacionadas com o processo de randomização e com desvios das intervenções planeadas. Conclusões: As intervenções gamificadas na educação física podem melhorar o VO₂máx e a agilidade; no entanto, as evidências referentes aos desfechos relacionados com a força são inconsistentes. Estes achados devem ser interpretados com cautela devido ao pequeno número de estudos incluídos, à elevada heterogeneidade observada em vários desfechos e a algumas limitações metodológicas.

Background: The usefulness of thiopurines has been poorly explored in pouchitis and other pouch disorders. Objective: To evaluate the effectiveness and safety of azathioprine as maintenance therapy in inflammatory pouch disorders. Design: This was a retrospective and multicentre study. Methods: We included patients diagnosed with inflammatory pouch disorders treated with azathioprine in monotherapy. Effectiveness was evaluated at 1 year and in the long term based on normalization of stool frequency, absence of pain, faecal urgency or fistula discharge (clinical remission), or any improvement in these symptoms (clinical response). Endoscopic response was evaluated using the Pouchitis Disease Activity Index (PDAI). Results: In all, 63 patients were included [54% males; median age, 49 (28–77) years]. The therapy was used to treat pouchitis (n = 37) or Crohn’s disease of the pouch (n = 26). The rate of clinical response, remission and non-response at 12 months were 52%, 30% and 18%, respectively. After a median follow-up of 23 months (interquartile range 11–55), 19 patients (30%) were in clinical remission, and 45 (66%) stopped therapy. Endoscopic changes were evaluated in 19 cases. PDAI score decreased from 3 (range 2–4) to 1 (range 0–3). In all, 21 patients (33%) presented adverse events and 16 (25%) needed to stop therapy. Conclusion: Azathioprine may be effective in the long term for the treatment of inflammatory pouch disorders and could be included as a therapeutic option.

PurposeThis research examines the likelihood that Panamanian and Colombian banks listed on their respective stock exchanges voluntarily disclose intangible liabilities based on such variables as their size, profitability, indebtedness, age and growth. The presented findings concur with agency theory, signalling theory and the owner-cost theory.Design/methodology/approachThe authors propose a probabilistic model to test the influence of size, profitability, indebtedness, age and growth on the disclosure of intangible liabilities. The dependent variable, the disclosure index, was constructed from a dichotomous approach using Harvey and Lusch's (1999) model, which has 24 characteristics, plus six that we added in our research. These were grouped into four categories: procedures, human activity, information and organisational structure.FindingsBanks in Panama and Colombia with a larger size, higher profitability, lower age and higher growth are more likely to disclose more information about their intangible liabilities. However, indebtedness does not serve as a determinant of the disclosure of these liabilities, even though its relationship is negative.Research limitations/implicationsThe limitation of the research was the voluntary disclosure of information about these liabilities on firms' websites.Practical implicationsThe contributions of this research are as follows. First, we used an intangible asset disclosure methodology to verify the disclosure of intangible liabilities, in line with Harvey and Lusch's model, as well as providing another six indicators, thereby producing an extended model. Second, being the first empirical research to study the disclosure of intangible liabilities in Panama and Colombia opens a door to future research on this topic.Social implicationsThis research provides a significant practical contribution to society because banks listed on public stock markets, understanding that undisclosed intangible liabilities lead to opportunity costs in their profitability, might tend to disclose more information, thus promoting greater transparency in the market.Originality/valueThe main contribution of this research is applying an intangible asset disclosure methodology to the disclosure of intangible liabilities, following Harvey and Lusch's (1999) model, as well as the creation of an expanded model.

Background The National Nosocomial Infections Surveillance (NNIS) and Efficacy of Nosocomial Infection Control (SENIC) indexes are designed to develop control strategies and to reduce morbidity and mortality rates resulting from infections in surgical patients. We sought to assess the application of these indexes in patients under-going surgery for abdominal trauma and to develop an alternative model to predict surgical site infections (SSIs). Methods We conducted a prospective cohort study between November 2000 and March 2002. The main outcome measure was SSIs. We evaluated the variables included in the NNIS and SENIC indexes and some preoperative, intraoperative and postoperative variables that could be risk factors related to the development of SSIs. We performed multivariate analyses using a forward logistic regression method. Finally, we assessed infection risk prediction, comparing the estimated probabilities with actual occurrence using the areas under the receiver operating characteristic (ROC) curves. Results Overall, 614 patients underwent an exploratory laparotomy. Of these, 85 (13.8%) experienced deep incisional and organ/intra-abdominal SSIs. The independent variables associated with this complication were an Abdominal Trauma Index score greater than 24, abdominal contamination and admission to the intensive care unit. We proposed a model for predicting deep incisional and organ/intra-abdominal SSIs using these variables (alternative model). The areas under the ROC curves were compared using the estimated probabilities for this alternative model and for the NNIS and SENIC scores. The analysis revealed a greater area under the ROC curve for the alternative model. The NNIS and SENIC scores did not perform as well as the alternative model in patients with abdominal trauma. Conclusion The NNIS and SENIC indexes were inferior to the proposed alternative model for predicting SSIs in patients undergoing surgery for abdominal trauma.