Comparison of Heart Rate Monitoring Accuracy between Chest Strap and Vest during Physical Training and Implications on Training Decisions.

Heart rate (HR) and heart rate variability (HRV) based physiological metrics such as Excess Post-exercise Oxygen Consumption (EPOC), Energy Expenditure (EE), and Training Impulse (TRIMP) are widely utilized in coaching to monitor and optimize an athlete's training load. Chest straps, and recently also dry electrodes integrated to special sports vests, are used to monitor HR during sports. Mechanical design, placement of electrodes, and ergonomics of the sensor affect the measured signal quality and artefacts. To evaluate the impact of the sensor mechanical design on the accuracy of the HR/HRV and further on to estimation of EPOC, EE, and TRIMP, we recorded HR and HRV from a chest strap and a vest with the same ECG sensor during supervised exercise protocol. A 3-lead clinical Holter ECG was used as a reference. Twenty-five healthy subjects (six females) participated. Mean absolute percentage error (MAPE) for HR was 0.76% with chest strap and 3.32% with vest. MAPE was 1.70% vs. 6.73% for EE, 0.38% vs. 8.99% for TRIMP and 3.90% vs. 54.15% for EPOC with chest strap and vest, respectively. Results suggest superior accuracy of chest strap over vest for HR and physiological metrics monitoring during sports.

Building Kidney Exchange Programmes in Europe-An Overview of Exchange Practice and Activities.

BACKGROUND: Considerable differences exist among the living donor Kidney Exchange Programmes (KEPs) that are in use and being built in Europe, contributing to a variation in the number of living donor transplants (Newsletter Transplant; International figures on donation and transplantation 2016). Efforts of European KEPs to exchange (best) practices and share approaches to address challenges have, however, been limited. METHODS: Experts from 23 European countries, collaborating on the European Network for Collaboration on Kidney Exchange Programmes Cooperation on Science and Technology Action, developed a questionnaire to collect detailed information on the functioning of all existing KEPs in Europe, as well as their opportunities and challenges. Following a comparative analysis, results were synthesized and interpreted by the same experts. RESULTS: The practices, opportunities and challenges reported by 17 European countries reveal that some of the 10 operating programs are mature, whereas others are in earlier stages of development. Over 1300 transplants were performed through existing KEPs up to the end of 2016, providing approximately 8% of their countries' living kidney donations in 2015. All countries report challenges to either initiating KEPs or increasing volumes. Some challenges are shared, whereas others differ because of differences in context (eg, country size, effectiveness of deceased donor program) and ethical and legal considerations (eg, regarding living donation as such, nonrelated donors, and altruistic donation). Transnational initiatives have started in Central Europe, Scandinavia, and Southern Europe. CONCLUSIONS: Exchange of best practices and shared advancement of national programs to address existing challenges, aided by transnational exchanges, may substantially improve access to the most (cost) effective treatment for the increasing number of patients suffering from kidney disease.