BACKGROUND The Apple Watch Series 4 (AW) can detect atrial fibrillation and perform a single-lead electrocardiogram (ECG), but the clinical accuracy of AW ECG waveforms compared to lead 1 of a 12-lead ECG is unclear. OBJECTIVE The purpose of this study was to assess the accuracy of interval measurements on AW ECG tracings in comparison to lead 1 on a 12-lead ECG. METHODS We obtained ECGs at a university hospital of healthy volunteers age .18 years. ECG waveforms were measured with calipers to the nearest 0.25 mm. When possible, 3 consecutive waveforms in lead 1 were measured. Waveform properties, including intervals, were recorded. Concordance correlation coefficients and Bland-Altman plots were used to assess level of agreement between devices. RESULTS Twelve-lead (n 5 113) and AW (n 5 129) ECG waveforms from 43 volunteers (mean age 31 years; 65% female) were analyzed. Sinus rhythm interpretation between devices was 100% concordant. No arrhythmias were recorded. Mean difference (d) for heart rate was 1.16 6 4.33 bpm (r 5 0.94); 3.83 6 113.54 ms for RR interval (r 5 0.79); 5.43 6 17 ms for PR interval (r 5 0.83);-6.89 6 14.81 ms for QRS interval (r 5 0.65);-11.27 6 22.9 ms for QT interval (r 5 0.79); and-11.67 6 27 ms for QTc interval (r 5 0.57). There was moderate (d ,40 ms) to strong (d ,20 ms or , 5 bpm) agreement between devices represented by Bland-Altman plots. CONCLUSION The AW produces accurate ECGs in healthy adults with moderate to strong agreement of basic ECG intervals.

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Thyrotoxic periodic paralysis is a life-threatening complication of hyperthyroidism characterized by transient episodes of muscle paralysis and hypokalemia, commonly seen in Asian men. We present a rare case of ventricular fibrillation as the initial presentation of thyrotoxic periodic paralysis. ( Level of Difficulty: Intermediate. )

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In the period of revolutionary change in information technology, the two developments that are most far-reaching have been cloud computing and the mobile Internet. These two information technology revolutions diverge in mobile cloud computing. There are already immense risks with data hosted in-house, so it's no secret that data offsite sits at even higher risk. With Data on offsite, higher avenues for attack and the fact that it will be traveling more makes it easier to be hijacked. With the technology regularly improving, there are ways to make sure of greater security. However with technology regularly improving, there are always people out there lifting their hacking skills.An effective methodology with prominent features of data integrity and confidentiality is proposed here to ensure the safety of offsite data or the data on cloud. In this paper we propose the mechanism which uses the concepts of ECC algorithm, Shamir's secret key sharing algorithm along with distinct cryptography tools such as threshold cryptography that enhances the security of data stored on clouds.