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Wearable monitors continue to play a critical role in scientific assessments of physical activity. Recently, research-grade monitors have begun providing raw data from photoplethysmography (PPG) alongside standard raw data from inertial sensors (accelerometers and gyroscopes). Raw PPG enables granular and transparent estimation of cardiovascular parameters such as heart rate, thus presenting a valuable alternative to standard PPG methodologies (most of which rely on consumer-grade monitors that provide only coarse output from proprietary algorithms). The implications for physical activity assessment are tremendous, since it is now feasible to monitor granular and concurrent trends in both movement and cardiovascular physiology using a single noninvasive device. However, new users must also be aware of challenges and limitations that accompany the use of raw PPG data. This viewpoint paper therefore orients new users to the opportunities and challenges of raw PPG data by presenting its mechanics, pitfalls, and availability, as well as its parallels and synergies with inertial sensors. This includes discussion of specific applications to the prediction of energy expenditure, activity type, and 24-hour movement behaviors, with an emphasis on areas in which raw PPG data may help resolve known issues with inertial sensing (eg, measurement during cycling activities). We also discuss how the impact of raw PPG data can be maximized through the use of open-source tools when developing and disseminating new methods, similar to current standards for raw accelerometer and gyroscope data. Collectively, our comments show the strong potential of raw PPG data to enhance the use of research-grade wearable activity monitors in science over the coming years.

This double-blind study randomly assigned adults with obesity (or overweight and with one or more weight-related coexisting conditions) without diabetes to 68 weeks of once-weekly subcutaneous semaglutide (2.4 mg) or placebo, plus lifestyle intervention. Semaglutide therapy was associated with sustained, clinically relevant weight reduction.

Introduction and hypothesisSacrocolpopexy is the most durable surgical procedure for the treatment of symptomatic pelvic organ prolapse (Maher et al. Cochrane Database Syst Rev. 2013;(4):CD004014). The single port robotic platform has recently been approved in the USA for use in urological surgery. Innovation in robotic surgery continues to evolve, minimizing abdominal wall trauma while improving instrumentation and technical feasibility. Identifying the appropriate procedures to utilize novel technology is important to understand the role of new surgical tools. Sacrocolpopexy procedure, when performed with supracervical hysterectomy, requires extension of an incision for specimen retrieval, making it ideal for single port surgery. The technique and adaptation to new instrumentation is demonstrated in this video.MethodA surgical demonstration of single port robotic sacrocolpopexy is shown.ResultsSacrocolpopexy was successfully completed using the single port robotic platform.ConclusionsSacrocolpopexy is technically feasible with use of the single port robotic platform.

To determine the association of Lady Health Worker's role with immunization of children in Pakistan. Secondary analysis was conducted on data obtained from Pakistan's Demographic and Health Survey. Children who did not receive all doses of vaccines were considered incompletely immunized or vice versa. The association between determinants was assessed by simple and multivariable binary logistic regression. The mothers and fathers had a mean age of 32.7 (SD+8.6) years and 37.9 (SD +10.1) years, respectively. Age of mother greater than 35 (OR=0.93; 95% CI:0.70-1.25); born in Baluchistan (OR=3.47,95% CI:2.21-5.49); rural area dwellers (OR=2.04; 95% CI:1.65-2.51); female gender (OR=1.06; 95% CI:0.87-1.29); birth order (of last born child) greater than 7 (OR=2.21, 95% CI:1.60-3.06); delivered at home (OR=2.20, 95% CI:1.76-2.74); long distance to health care facility (OR=2.66, 95% CI:2.16-3.28); and no LHW visit in last 12 months (OR=1.91, CI:1.48-2.47) were significantly associated with incomplete immunization in bivariate analysis. In final model of multinomial regression analysis the absence of visit by LHW in last 12 months was the most significant factor when all risk factors were analyzed in last model. This study has concluded that visit of LHW in last 12 months was significantly associated with immunization.