Objective: In this study, it was aimed to investigate the function of high-resolution computed tomography (HRCT) densitometry in the diagnosis of otosclerosis by performing densitometric measurements on the foci around the cochlea. Materials and Methods: The HRCT images of 0.5 mm thin-slice axial-sections obtained from 30 patients with otosclerosis, who had been surgically confirmed and performed computed tomography of the temporal bone before the surgery, and 30 patients, who had undergone cochlear implant surgery and had been identified as the control group were examined. Densitometric measurements obtained from 7 different points of the otic capsule were recorded as the mean Hounsfield unit (HU) for each patient. Results: When we compared the patient and the control groups, a statistically significant difference was found in densitometric measurements in 6 of the 7 different regions (p<0.05). There was no statistically significant difference only in the HU 4 region (p>0.05). There was also a statistically significant difference between these two groups in the mean HU value obtained by measurements performed in 7 regions (p<0.05). In addition, no significant difference was found between both ears in all regions in the densitometric measurements at 7 different points of the otic capsule between the operated and non-operated ears of these patients (p> 0.05). Moreover, a negative and significant relationship was found between the bone conduction hearing threshold and HU4, HU5 and mean HU values according to the result of the Spearman correlation test. Conclusion: In our study, it was found that the density around the otic capsule was lower in patients with otosclerosis compared to normal patients. In addition, it was found that there was no statistically significant difference in density between the ear that was surgically confirmed to have otosclerosis and the non-operated ear in patients with otosclerosis

Aims and Objectives To develop a logic model that illustrates the steps needed to develop an effective intervention for diabetes management in a psychiatric inpatient setting, as the point of admission to a psychiatric inpatient unit may present as an opportune time for improving diabetes care. Methods We undertook (i) a survey of diabetes care among inpatients in a Mental Health Trust in England, comparing care to the National Health Service (NHS) Core National Diabetes Standards (ii) interviews with key clinical staff to understand challenges in delivering good diabetes care (iii) a review of current UK guidance on standards for diabetes care. On the basis of the findings we developed an initial logic model for service delivery. Results Among 163 inpatients reviewed, 44 (27%) had a diagnosis of diabetes, and only three (7%) had all three National Institute for Health and Care Excellence (NICE) treatment targets within range. Staff identified needs for regular training, better understanding of roles in shared care, and good quality IT support. We developed a logic model that illustrates the steps needed to develop an effective intervention for diabetes management in a psychiatric inpatient setting. Clinical Implications Admission to a psychiatric inpatient setting provides an opportunity in which diabetes care may be optimised. The quality and understanding of diabetes care will need to be enhanced if this opportunity is to be exploited.

Aims: Ticagrelor has become a new antiplatelet drug recommended by the acute coronary syndrome guidelines. Several studies have shown that high platelet reactivity occurs in ST-segment elevation myocardial infarction (STEMI) patients after taking ticagrelor. Here, we investigated whether gut microbiota play an important role in the change of platelet reactivity. Methods and Results: The rate of platelet aggregation (PA) was measured using light transmittance aggregometry. Pharmacokinetic assessment was used to analyze the plasma concentration of ticagrelor and its main active metabolite AR-C124910XX. Patients were classified into the normal platelet reactivity group (NPR) and high platelet reactivity group (HPR) according to PA at 2h after ticagrelor administration. High-throughput sequencing and 1H NMR profiling were used to investigate gut microbiota characteristics in patients. Finally, we transplanted the microbiota gut of patients into two groups of sterile mice to verify its effect on platelet reactivity. PA of HPR was higher than that of NPR at each time point after ticagrelor administration. The plasma concentrations of ticagrelor and AR-C124910XX were lower in HPR than in NPR. The diversity of gut microflora in HPR was greater than that in NPR. Through fecal transplantation high platelet reactivity could be transmitted to sterile mice. Conclusions: Gut microbiota variance and their metabolism between HPR and NPR may be an important mechanism for the difference in PA after ticagrelor administration. Gut microbiota could help improve our understanding of the pathogenesis of high platelet reactivity and support the potential therapeutic options that modify gut microbiota.

Mitral valve prolapse (MVP) is present in 2-3% of the general population. A small percentage of these patients develop sudden cardiac death. Although there have been several clinical, EKG, and imaging findings associated with sudden death in MVP patients, it is not yet known which of the risk factors should be weighed more heavily than other. More importantly, there is no consensus on which patients might benefit from a primary prevention defibrillator. We present a case of a young woman who sustained sudden cardiac arrest, and began recovering after a prolonged resuscitative effort. She ultimately succumbed to opportunistic infection. In hindsight, she had many of the concerning findings of arrhythmic mitral valve prolapse. Raising awareness of this condition can help to reduce risk of sudden death in these patients.

CD26/DPP4 is an exopeptidase that is expressed on the cell surface of many organs but is also present in a circulating soluble form. Beyond its enzymatic and co-stimulatory activity, CD26/DPP4 is involved in the pathogenesis of chronic fibrosis across many organ diseases such as liver cirrhosis, kidney failure, and lung fibrosis, but CD26/DPP4 has also impact on the epithelial-to-mesenchymal transition (EMT) pathway during cancer formation, chronic transplant rejection and autoimmune diseases. The morbidity and mortality caused by fibrotic disorders is high, and no effective therapies are available. Growing evidence suggests that the inhibition of CD26/DPP4 can attenuate the progress of fibrotic diseases via modulating the EMT milieu and other pathways. This review summarizes the role of CD26/DPP4 in fibrosis-associated diseases and highlight new opportunities of how CD26/DPP4-inhibitors may reduce or reverse fibrosis. As a major advantage, CD26/DPP4-inhibitors are in safe and routine clinical use against type 2 diabetes for many years with few side effects making them promising therapeutics for a novel clinical application in fibrotic disorders.

Objective: The aim of this study was to evaluate the relationship between apelin-36 and oxidative parameters and Generalized Anxiety Disorder (GAD). Apelin which prevents hippocampal neuron death is an endogenous ligand for G protein-bound APJ receptors in the central nervous system. Oxidative Stress occurred by free radicals which caused apoptosis in the hypothalamus, hippocampus and amygdala regions of the CNS. Methods: In this study, 61 patients diagnosed with generalized anxiety disorder at psychiatry polyclinic and 55 healthy subjects were enrolled. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and the Hamilton Anxiety Rating Scale (HARS) were used in this study and they were filled by the patients and healthy individuals. Serum apelin-36 level was measured by using an ELISA kit. TAS and TOS in the serum was measured by an automated system. The data wereanalyzed by using the SPSS. Results: It wasfound that serum apelin-36, TOS and OSI levels were significantly lower in patients group than controls. In addition, negative correlation was detected between apelin 36 levels and HARS scores, TOS and OSI values in patients group.TAS values were found as similar between the patient and control group.There was no correlation between TAS and Apelin 36 in the patient group. Conclusion: In this study it is found that serum apelin-36, TOS and OSI levels were low in GAD. According the results, Apelin-36 and oxidative stress may play a role in the etiopathogenesis of Generalized Anxiety Disorder.

Background: Sepsis is the most common health problem because of which an increased proportion of health resources are consumed. Tumour Necrosis factor alpha also plays an essential role in many diseased conditions like diabetes, cancer, etc. There have been findings suggesting a high level of correlation between TNF activity and sepsis susceptibility and mortality. Thus, the present meta-analysis was carried out to assess the role of Tumour Necrosis Factor-Alpha promoter 308A/G polymorphism in sepsis and sepsis mortality. Methods: The meta-analysis was carried out using the MOOSE guidelines. A total number of 782 articles were retrieved, out of which only 45 full-text articles were eligible. Out of that, 24 were used for meta-analysis after checking the quality of articles. The meta-analysis was carried out using MedCalc Software. The comparison of TNF factor alpha 1 and 2 among patients was calculated in the two groups. The odds ratio of these studies was used to construct the forest plot. Results: Eight studies evaluated the odds of having increased TNF1 in sepsis conditions. The plot shows that the cumulative statistics are significant at a 95% confidence level and have a p-value less than 0.05. The odds of increased TNF2 in sepsis conditions among Asians is more than in the case of TNF1. The odds ratio of 0.978 indicates that the odds of increased TNF1 in sepsis conditions among Caucasians are more than in the case of TNF2. Conclusion: The meta-analysis suggests an association between the G/A allele combination of TNF-α and sepsis risk in the Asian population compared to the Caucasian Population.

ABSTRACT Objective: The primary aim of this study was to determine whether PATET was altered in the fetuses whose mothers were complicated by intrahepatic cholestasis of pregnancy (IHCP). The secondary aim was to investigate the association between fetal pulmonary artery Doppler parameters with neonatal outcomes in pregnancies complicated by IHCP. Methods: This prospective case control study was conducted in a tertiary perinatal-neonatal center. A total of 18 fetuses whose mothers were complicated by IHCP were set as the study group and a total of 37 fetuses whose mothers were healthy were selected as the control group. Fetal pulmonary artery Doppler parameters (acceleration time -AT; ejection time -ET; AT/ET ratio) were assessed and neonatal outcomes were evaluated. Results: Mean pulmonary artery AT, ET, PATET were statistically significant different between the groups (p=0,001; p=0,024 and p=0,003, respectively). The mean PATET value in the IHCP group was 0,217 ± 0,029 while in the control group it was 0,180 ± 0,020 (p=0,003). While PATET values were correlated with gestational age at birth, respiratory distress and NICU admission were not correlated with PATET. Conclusions: Higher values of PATET may be helpful to understand fetal lung damage secondary to IHCP. Keywords: acceleration time; ejection time; intrahepatic cholestasis; pulmonary artery

Aβ42 peptides can form helix and sheet structure under different conditions. The conformational conversion is closely associated with Aβ peptides aggregation and their neurotoxicity. But the transition from helix to sheet is not be clearly understood. In this study we performed microsecond timescale MD simulations of Aβ42 peptides to investigate the conformation transition from α-helix to β-sheet. Markov state model (MSM) was built to facilitate identification of crucial intermediate states and possible transition pathway. Based on the analysis, we found that the region Y10-A21 in the middle of Aβ42 peptide plays an initial role in this transition. MSM model revealed that the collapse of helical structure in this region might trigger the formation of sheet structure. Moreover, we further simulated the aggregation of Aβ42 peptides with different conformations. We found that the Aβ42 peptides forming sheet structure have higher aggregation potential compared with peptides with helix structure. These results demonstrate that we can prevent the aggregation of Aβ42 peptides by stabilizing the helix structure in the region of Y10-A21. In addition, this study provides new insight into better understanding the conformational transition and aggregation of Aβ42 peptides.

Aims: The aim of the study is to examine the effectiveness of ShotBlocker and local vibration on the perceived pain and satisfaction during ventrogluteal intramuscular antibiotic injection. Background: In intramuscular injection applications different methods such as ShotBlocker and local vibration are used to reduce the pain caused by injection and increase the individual’s satisfaction. Design and Method: It is a randomized controlled experimental study. The sample of the study consisted of 100 patients (32 in vibration group, 35 in ShotBlocker group, 33 in control group) who applied to the adult emergency clinic for antibiotic (amoxicillin/cefuroxime sodium) injection between February-March 2021. Research data was collected using the Structured Information Form created by the researchers, VAS for Pain and VAS for Satisfaction. Data was analyzed using SPSS version 16.0. All results were considered meaningful at p <0.05 with a confidence interval of 95%. CONSORT statement was followed for reporting. Results: After the intramuscular antibiotic injection, a significant difference was found between the groups in terms of the mean scores of VAS for Pain and VAS for Injection Satisfaction (p <0.001). It was revealed that the lowest pain level was perceived by the patients who underwent local vibration (3.02±1.07) and the highest pain level was perceived by the control group (7.09±0.94). It was also determined that the highest satisfaction level was seen in the patients with local vibration (7.80±0.90) and the lowest one was in the control group (4.93±1.93). Conclusion: It was determined that local vibration application was more effective in reducing the pain that occurs during intramuscular antibiotic injection, and local vibration and ShotBlocker application were an effective methods in increasing satisfaction.

Abstract Fractional O-U process is a very classical stochastic process which is used to describe the time series of financial volatility. Three parameters need to be estimated in this process, and the estimation method based on discrete observations can be realized by machine learning optimization algorithm. In this study, the parameter estimation method of fractional O-U process is briefly described, and three optimization algorithms, Newton method, quasi Newton method and genetic algorithm, are used to estimate the parameters. The comparison shows that genetic algorithm is relatively accurate and efficient. Finally, the minute data of stock index futures are estimated based on fractional O-U process. The results show that the estimation of theta and Hurst index is relatively accurate, and the estimation error of volatility is large.

Wilms’ tumor is one of the most common childhood solid malignancies, which accounts for almost 95% of renal malignancies in pediatrics, and classically arises from primitive metanephric cells. Exceptionally it may occur at places other than kidneys. The estimated rate of nephroblastoma outside the kidneys is almost 0.5 to 1% of Wilms’ tumor cases. Extrarenal Wilms’ tumor occurs mostly in childhood. In this article, we report a 3-year-old girl who first presented with spinal dysraphism and a mass in the lumbar spinal cord with a histopathological diagnosis of nephrogenic rest, and after one year, a Wilms tumor arose in this location. When extrarenal wilms tumor located in the spine is unlikely to be suspected preoperatively because it is embryologically less intuitive. Thus, we report this case of a congenital Wilms tumor associated with spinal dysraphism to increase awareness and describe this malignant tumor’s clinical outcome.

Oncolytic viruses (OVs) are considered a promising therapeutic alternative for cancer. However, despite the development of novel OVs with improved efficacy and tumor selectivity, their limited efficacy as monotherapeutic agents remains a significant challenge. In this study, we explored the effect of propranolol, a nonselective β-blocker, on the antitumor efficacy of the T1012G virus in colorectal cancer models. A cell viability assay showed that cotreatment could induce synergistic killing effects on human and murine colorectal cell lines. Moreover, cotreatment caused sustained tumor regression compared with T1012G monotherapy or propranolol monotherapy in human HCT116 and murine MC38 tumor models. Additionally, propranolol treatment did not produce a positive effect on viral replication in vitro or in vivo. Western blotting showed that cotreatment significantly enhanced the expression of cleaved caspase-3 in HCT116 and MC38 cells compared with the propranolol or T1012G alone. In addition, propranolol or T1012G treatment induced a 35.06% ± 0.53% or 35.49% ± 2.68% reduction in VEGF secretion in HUVECs (P＜0.01/P＜0.01). Cotreatment further inhibited VEGF secretion compared with the monotherapies (compared with propranolol treatment: 75.06% ± 1.50% decrease, compared with T1012G treatment: 74.91% ± 0.68%; P＜0.001, P＜0.001). Consistent with the in vitro results, in vivo data showed that cotreatment could reduce Ki67 and enhance cleaved caspase 3 and CD31 expression in human HCT116 and murine MC38 xenografts. In summary, β-blockers could improve the therapeutic potential of OVs by enhancing oncolytic virus-mediated killing of colorectal cancer cells and antiangiogenic effects on colorectal tumors.

Objectives: To assesses the value of systemic inflammatory markers in evaluating the prognosis of threatened late miscarriage (TLM) patients. Design: Retrospective study. Setting: Single tertiary center. Population: A cohort of 220 TLM patients (128 remained pregnant until delivery and 92 developed into inevitable miscarriage (IM)) from January 2015 to August 2020, in addition to a control group of 200 normal pregnancies. Methods: Using routinely collected clinical data. Main Outcome Measures: Data of characteristics at baselines, complete blood counts and neonatal outcomes of live births. Predictive value of neutrophil:lymphocyte ratio (NLR) for the pregnancy outcome of TLM. Results: The mean counts for the total white blood cells (WBCs) and neutrophils in women with TLM increased and exceeded the reference ranges, resulting in a significant increase NLR. The counts for the total WBCs and neutrophils exceeding the upper limit were present in approximately 66% and 82% of TLM pregnancies, respectively. Besides, the prevalence of adverse neonatal outcomes was higher in the live-birth group of TLM. In TLM pregnancies, the NLR of the IM group was significantly higher than that of the live-birth group, and NLR showed considerable value in diagnosing IM (area under the curve = 0.67, sensitivity = 55.44%, specificity = 77.34%). A cutoff value of NLR > 6.05 indicated an increased risk of IM. Conclusion: Higher NLR in TLM pregnancies indicates that systemic inflammation may be involved in TLM progression, and the NLR value obtained at the initial stage of TLM has potential predictive value for the outcome of TLM.

This paper presents a pregnant woman successfully rescued in cardiac arrest (CA) using extracorporeal cardiopulmonary resuscitation (ECPR) for up to 5.5 hours. We reviewed the literature on the use of ECPR during pregnancy. Published data suggest that extracorporeal membrane oxygenation (ECMO) appears to be a viable treatment option for pregnant women who have experienced critical situations, such as a maternal CA or an amniotic fluid embolism.

AIM: This study was conducted to determine the correlation between thoughts and anxiety levels of the student nurses about the new type of coronavirus (COVID-19). METHOD: The descriptive study was conducted the sample was composed of 346 nursing students who were voluntary to participate in the study. While the study population consisted of all students, Before starting the study, necessary permissions were obtained from the Ministry of Health, Ethics Committee, and the relevant Institution. The data were collected online with the Questionnaire and State Anxiety Inventory (SAI). RESULTS: It was determined that 98.6% of the students knew about COVID-19, 87.3% knew the diagnostic methods, all of them knew the measures to be taken to protect from COVID-19 and obeyed these measures, 46.2% applied the social distance rule, 98.8% stayed away from crowded environments, and 98.6% comply with the call to “stay at home”. 73.1% of the students experienced stress due to this virus, 95.7% had concerns about the future, 82.7% believed that their education was affected negatively, and 67.9% believed that their quality of life was affected negatively. It was determined that SAI mean scores was 46.4±9.2 and there was a correlation between SAI mean scores with the gender, chronic disease in the family, taking disinfectant, keeping food stock, obeying the call to stay at home, having stress, and believing that education and quality of life were negatively affected (p<0.05). CONCLUSION: It was found that the students experienced “moderate” level anxiety, had sufficient knowledge about COVID-19 and complied with protection rules, but most of them had concerns about the future, and their education lives and quality of lives were negatively affected. In line with these results, it may be recommended to evaluate and support the anxiety levels of the students during online education process.

AbstractDespite the availability of effective biologics, rabies continues to impact several lower and middle-income countries. More than 50,000 people  succumb to rabies every year due to lack of timely and appropriate post-bite care. To combat this, integrating accurate information about availability of rabies biologics and prophylaxis into user-friendly apps can offer a simple, real-time, and local solution to prevent human rabies deaths following potentially rabid exposures like dog bites.Keywords: dog, prophylaxis, rabies, Shiny app, zoonosis

Aortic valve regurgitation complicating blunt chest trauma is rare. We describe a case of a 73-year-old male with history of car accident complicated by sternal fracture in 2002. In 2019 he was a candidate for liver metastasis resection complicating adenocarcinoma of the rectum but, for the finding of a holosystolic murmur, he underwent trans-esophageal echocardiography. This showed severe aortic regurgitation due to the fracture of the right coronary cusp. Heart Team decided upon the replacement of the aortic valve with biological prosthesis. Probably, the blunt chest trauma provoked an initial right cusp lesion and the regurgitation worsened over time.

Phytate represents an organic pool of phosphorus in soil that require hydrolysis by phytase enzymes produced by microorganisms prior to its bioavailability by plants. We hypothesize that in a greenhouse trail on soybean plants inoculated or non-inoculated with a microbial suspension made from an age-old maple forest’s undisturbed soil mineralize phytate. MiSeq Amplicon sequencing targeting bacterial 16S rRNA gene and fungal ITS was performed to assess microbial community changes following treatments. Our results showed that soybean nodulation and shoot dry weight biomass increased when phytate was applied to the nutrient-poor substrate mixture. Bacterial and fungal diversities of the root and rhizosphere biotopes were relatively resilient following inoculation by microbial suspension; however, bacterial community structure was significantly influenced. Interestingly, four arbuscular mycorrhizal fungi (AMF) were identified as indicator species, including Glomus sp., Claroideoglomus etunicatum, Funneliformis mosseae and an unidentified AMF taxon. We also observed that an ericoid mycorrhizal taxon Sebacina sp. and three Trichoderma spp. were among indicator species. Non-pathogenic Planctobacteria members highly dominated the bacterial community as core and hub taxa for over 80% of all bacterial datasets in root and rhizosphere biotopes. Overall, our study documented that inoculation with a microbial suspension and phytate amendment improved soybean plant growth.

The pitfalls in the enzymatic characterization of LwCas13a we encountered may trouble other colleagues in the future, and we hope to share this unpleasant experience regarding the issue of leakages in ion-exchange chromatography

Environmental DNA (eDNA) analysis allows non-invasive and cost-effective monitoring of species distribution and composition in aquatic ecosystems. Benzalkonium chloride (BAC) treatment is an inexpensive and simple method for preserving macrobial eDNA in water samples, which is suitable for maximizing both the number of sampling replicates and water volume. However, its preservation performance has been evaluated in a limited manner by species-specific assays, targeting short fragments of mitochondrial DNA in freshwater and brackish ecosystems. Here, we examined the performance of BAC in preserving eDNA in seawater samples, targeting different fragment lengths of mitochondrial and nuclear eDNA, and community information inferred by eDNA metabarcoding. First, we quantified the time-series changes of Japanese jack mackerel (Trachurus japonicus) eDNA concentrations in experimental tanks and inshore seawater to compare the yields and decay rates of eDNA between BAC treatments. As a result, BAC addition increased the eDNA yields at the start of the experiment and substantially suppressed the initial phase of rapid degradation but not the subsequent phase of slower degradation. In addition, we performed eDNA metabarcoding targeting fish community, showing that BAC addition suppressed the decrease in species richness, where the number of fish species hardly varied throughout the day. Findings of the present and previous studies indicate high versatility of BAC in preserving qualitative (species richness) and quantitative (copy number) information on aqueous eDNA under various environmental conditions. BAC should therefore be used to minimize the false-negative detection of eDNA, regardless of target genetic regions, fragment sizes, environmental conditions, and detection strategies.

This study was carried out to investigate the species diversity and habitat use of birds in the Menagesha Suba State forest and surrounding farmland. The study was conducted from July 2018 to January 2019 during the wet and dry seasons. The study area was stratified based on the dominant habitat types. A standardized survey technique was employed using systematically established point counts for all habitat types. EstimateS software (version 9.1) and Chi-square test were applied to analyze the data. A total of 122 bird species belonging to 14 orders and 49 families were identified in the study area during the two-season surveys. There was a statistically significant difference in the relative abundance of species among habitat types (χ2=81.928, df = 2, p<0.05). During both seasons, the highest bird diversity was observed in farmland (H’=3.65), followed by plantation forest (H’=3.52). The lowest and highest distributions were observed in natural forests (J=0.77) and plantation forests (J=0.89), respectively. Variations in the number of bird species were observed among the three habitats. Species similarity was highest between natural forests and plantation forests during both the dry and wet seasons. There was a statistically significant difference in habitat use of bird species among the three habitat types either when seasons were considered separately (dry season: χ2 = 22.825, df = 6, P<0.05; wet season: χ2 = 22.186, df = 6, P<0.05) or when combined (χ2 = 26.658, df = 6, P<0.05). The Menagesha Suba State forest is rich in endemic bird species to Ethiopia and shared with Eritrea, and more than 15% of bird species distributions are locally rare. There is a need for a detailed study of long duration on the diversity and other ecological aspects of forest bird species should be conducted to get exhaustive information.

SARS-CoV-2 real-time reverse-transcription PCR (rRT-PCR) is currently the only available yet effective testing system to fight COVID-19 epidemics as far as there’s not any treatment and vaccine. Moreover, many SARS-CoV-2 rRT-PCR kits are approved by the emergency-use-authorization (EUA) altogether over the world. In this article we’ve provided a comparison of important performance features of four commercial RT-PCR assays. A total of consecutive nasopharyngeal (NPS) samples and oropharyngeal (OP) swabs were collected from 50 COVID-19 patients for sensitivity and specificity analysis. Specificity of these assays were examined by using extractions of RNA from common human coronavirus cultures. All RT-PCR kits including in this study exhibited acceptable specificity over 90%, except for the Sansure and PowerCheck (88%). Pishtaz teb assays demonstrated a PPA of 95.24% (40/42), while the DaAn Gene, Sansure, Power check of SARS-CoV-2 panel showed the PPA of 85.7% (36/42), 66.66% (28/42), and 64.3% (27/42), respectively. An NPA of 100% (8/8) was observed for four molecular assays. This study gives a technical baseline of four distinct commercial PCR assays for detection of SARS-CoV-2, that can be practical and useful for laboratories interested in buying any of them for more clinical validation.

Introduction Photoplethysmography (PPG) in wearable sensors potentially plays an important role in accessible heart rhythm monitoring. We investigated the accuracy of a state-of-the-art bracelet (Corsano 287) for heartbeat detection in cardiac patients and evaluated the efficacy of a signal qualifier in identifying medically useful signals. Methods Patients from an outpatient cardiology clinic underwent a simultaneous resting ECG and PPG recording, which we compared to determine accuracy of the PPG sensor for detecting heartbeats within 100 and 50 ms of the ECG-detected heart beats and correlation and Limits of Agreement for heartrate (HR) and RR-intervals. We defined subgroups for skin type, hair density, age, BMI and gender and applied a previously described signal qualifier. Results In 180 patients 7,914 ECG-, and 7,880 (99%) PPG-heartbeats were recorded. The PPG-accuracy within 100 ms was 94.6% (95%CI 94.1-95.1) and 89.2% (95%CI 88.5-89.9) within 50 ms. Correlation was high for HR (R = 0.991 (95%CI 0.988-0.993), n = 180) and RR-intervals (R = 0.891 (95%CI 0.886-0.895), n = 7880). The 95% Limits of Agreement (LoA) were -3.89 to 3.77 (mean bias 0.06) beats per minute for HR and -173 to 171 (mean bias -1) for RR-intervals. Results were comparable across all subgroups. The signal qualifier led to a higher accuracy in a 100 ms range (98.2% (95%CI 97.9-98.5)) (n=143). Conclusion We showed that the Corsano 287 Bracelet with PPG-technology can determine HR and RR-intervals with high accuracy in cardiovascular at-risk patient population among different subgroups, especially with a signal quality indicator.