5-minute Recordings Research Articles

EEG differences in competitive female gymnastics, soccer, and esports athletes between resting states with eyes closed and open.

Athletes heavily rely on visual perception for performance. This study delves into electroencephalographic (EEG) brain activity among gymnastics, soccer, and esports athletes during resting states with eyes closed (REC) and open (REO) and compares differences in EEG alpha power from REC to REO (∆ EC-EO Alpha) across athlete groups. Forty-two female participants, including 14 from each athletic discipline, underwent two 5-minute EEG recordings, first during REC and then during REO conditions. Absolute EEG power was analyzed for delta (δ), theta (θ), alpha (α), and beta (β) frequency bands across various brain regions, and ∆ EC-EO Alpha values were computed. During REC, soccer players exhibited heightened α power at the midline frontopolar (Fpz) and β power at the midline occipital (Oz). Conversely, during REO, soccer players displayed increased δ power at Fpz and midline frontal (Fz) and reduced α power at the midline central (Cz) compared to gymnasts, along with elevated θ power at Fpz. Esports athletes demonstrated higher δ power and decreased α power at Fpz and Cz compared to gymnasts. Gymnasts exhibited distinct cortical activation patterns characterized by lower ∆ EC-EO Alpha at multiple electrode sites. These findings highlight sport-specific cortical activation patterns linked to visual attention among athletes. Understanding these neural adaptations could refine training methods and enhance performance outcomes in sports.

Implementing a new multidisciplinary, remote, dementia staff training program for Veterans affairs nursing homes

BackgroundPreventing Loss of Independence through Exercise (PLIÉ) is a group program for people living with dementia that combines movements to support daily function with present moment body awareness and social engagement that has been found to have physical, emotional, social, and cognitive benefits. The goal of this study was to develop and refine a PLIÉ remote training program for interdisciplinary Veterans Affairs (VA) nursing home staff members also known as community living center (CLC) staff.MethodsThis pre-implementation study used iterative Plan-Do-Study-Act (PDSA) cycles. The 10-week PDSA cycles occurred from June to September 2021 at 2 VA nursing home sites. Remote training was delivered via Microsoft Teams and included 1-hour live-streamed weekly didactic sessions (nursing staff with PLIÉ instructor) focused on PLIÉ principles and 1-hour weekly live-streamed experiential sessions for staff to apply PLIÉ principles with residents. We administered weekly feedback surveys to iteratively refine the training process.Results14 staff members participated (5 recreation therapists, 3 social workers, 2 registered nurses, 2 chaplains, 1 psychologist, and 1 speech pathologist). The experiential sessions were rated as most helpful overall. Key PDSA refinements included: (1) creating 10-minute video recording summaries to support learning, particularly for those unable to attend live training sessions due to clinical schedules; and (2) incorporating self-reflection and goal setting to support staff incorporation of PLIÉ principles into routine care and personal life. These refinements resulted in increased use of PLIÉ principles with the residents from 67 to 89% of the staff participants. 100% of regular attendees (11/11) rated their overall satisfaction with remote training as “very good” or “excellent.”ConclusionsIt was feasible to train interdisciplinary CLC staff participants to deliver an integrative group movement program for residents with dementia remotely. PDSA cycles supported refinement of the training process and improved uptake. A larger study of PLIÉ remote CLC staff training is needed to assess outcomes on residents and quality of care.

Resting Heart Rate Variability is Independently Associated with Visceral Fat Rating Scores in Saudi Adult Males.

Visceral adipose tissue (VAT) may be a specific modifiable contributor to body composition-related autonomic impairment. To compare heart rate variability (HRV) between groups stratified by visceral fat rating (VFR) and compare associations between HRV and body composition metrics. A cross-sectional study was conducted on healthy men (n=99,age=37.8±13.4 years, body mass index [BMI]=26.9±4.6 kg/m2). HRV was derived from 5-minute electrocardiographic recordings. Body composition (body fat percentage, VFR, and muscle mass to visceral fat ratio [MMVFR]) was estimated using tetrapolar bioelectrical impedance analysis. Participants were categorized into groups according to VFR: G1 (VFR=1-8); G2(VFR=9-12); and G3(VFR>12). Age-adjusted comparisons were made between groups. Independent associations were quantified with multiple linear regressions. P <0.05 was significant. Root-mean square of successive differences (RMSSD) and standard deviation of normal RR intervals (SDNN) were higher for G1 vs. G2 and G3 (p<0.05). Low-frequency power (LF) was higher in G1 than in G2 (p<0.05). VFR and MMVFR were negatively associated with SDNN, RMSSD, LF, and HF (p<0.05). After adjusting for age, BMI, and systolic and diastolic blood pressure, VFR was significantly predictive of RMSSD, SDNN, and HF (p=0.002,-0.027), and MMVFR was significantly predictive of RMSSD and SDNN (p=0.020,-0.023). Men in the lowest VFR category had the highest HRV. VFR was more strongly associated with HRV than body fat percentage and MMVR. Time domain parameters were more sensitive to VAT than frequency domain parameters. HRV parameters could be the primary parameters of interest in tracking cardiac-autonomic status in response to interventions targeting VAT reduction.

Characterizing acoustic dimensions of health-related urban greenspace

The association of urban greenspace and human health and well-being is widely recognised, but the underlying mechanisms are incompletely understood. The acoustic environment (AE) is frequently proposed as a mediator between greenspace and human health. While it is commonly viewed as a negative health factor (e.g. noise pollution), there is growing evidence that it also has positive effects on human health. However, a general problem is the lack of information on the AE for greenspaces in high spatial resolution. To provide evidence-based support for research on this issue, we identify and assess acoustic properties of health-related urban greenspace by estimating the association between urban green area and selected acoustic indices.The analysis is based on 5-minute audio recordings collected systematically from 730 locations, four times a year (n = 2,746) in Bochum, Germany. To quantify the acoustic properties, we use an indicator-set of 30 sound pressure levels, 11 eco-, 78 psychoacoustic indices and 3 complex network measures. Greenspace is defined, in alignment with various health studies, as the percentage of green area within three buffer sizes (50, 100, 300 m) around each recording location.Through cluster analysis, we identify eleven acoustic dimensions in our indicator-set, for which representative indices are derived using principal component analysis. Descriptive statistics and multi-level regression models are used to analyse the associations between representative indices and greenspace. We find the highest effect sizes for Link Density (representing “acoustic dominance”), Acoustic Richness (representing “persistent sound volume”) and the Articulation Index (representing “sound volume”). Thus, in addition to “sound volume”, the AE of urban greenspace is characterised to a similar extent by at least two additional acoustic dimensions. If properties of the AE act as mediators between urban greenspace and human health, these three acoustic dimensions hold the potential to reflect them. Studies on pathways between greenspace and human health could incorporate measures of these dimensions to extend the understanding of the AE’s relevance for Public Health.

Overdistention Accelerates Electrophysiological Changes in Uterine Muscle Towards Labour in Multiple Gestations

Background for the researchPremature birth and its associated complications are one of the biggest global health problems, since there is currently no effective screening method in clinical practice to accurately identify the true Preterm Birth (PTB) from the false threatened ones. Despite the high prevalence of PTB in multiple gestation (MG) women which amounted up to 60%, in the literature there is any work about their uterine myoelectric activities in vivo system. Electrohysterography (EHG) has been emerged as an alternative technique for predicting PTB in single gestation (SG) women. PurposeThe aim of this study was to characterize and compare the uterine myoelectrical activity in vivo system of SG and MG women in regular check-ups, to provide the basis for early detection and prevention of preterm labour in MG. Basic proceduresA prospective observational cohort study was conducted on 31 SG and 18 MG women between the 28th and 32th WoG who underwent regular check-ups in the Polytechnic and University Hospital La Fe (Valencia, Spain). The 30-minute bipolar recording was filtered in the 0.1-4 Hz bandwidth and downsampled to 20 Hz. Signal analysis was performed in 120-second moving windows with 50% overlap, after removing artefacts by a double- blind expert process. A set of 8 temporal, spectral and non-linear parameters were calculated: root mean square (RMS), kurtosis of the Hilbert envelope (KHE), median frequency (MDF), H/L ratio, and sample entropy (SampEn) and bubble entropy (BubbEn) calculated in the whole bandwidth (WBW) and the fast wave high (FWH). The 10th, 50th and 90th percentiles of all windows analysed were calculated to obtain representative values of the recordings. For each parameter and percentile, statistically significant differences between the SG and MG groups and their statistical power (SP) were analysed to determine both the existence of an effect and substantive significance, respectively. Main findingsIn comparison to SG, MG EHG exhibited significant higher impulsiveness and higher predictability than SG which was reflected in the KHE (SP10 = 85.2, p10 < 0.001) and entropy measures (SampEn FWH: SP50 = 62.0, p50 = 0.0.016; SP90 = 52.5, p90 = 0.059. BubbEn FWH: SP50 = 75.2, p50 < 0.001; SP90 = 60.3, p90 = 0.002), suggesting an accelerated evolution of uterine electrophysiological condition. In addition, several EHG parameters were found to significantly correlate with foetal weight such as amplitude (RMS: r90 = 0.311, p90 = 0.006), signal impulsiveness (KHE: r10 = 0.311, p10 = 0.006) and entropy measures (SampEn FWH: r50 = −0.317, p50 = 0.005*; r90 = −0.279, p90 = 0.013*. BubbEn FWH: r50 = −0.370, p50 = 0.001*; r90 = −0.313, p90 = 0.005*), suggesting an electromechanical coupling between uterine overdistension and contractile activity in vivo system. Principal conclusionsIn comparison to SG women, MG showed higher impulsiveness and predictability in early third gestational trimester, as reflected in KHE, SampEn and BubbEn, respectively. We found similar cell excitability between SG and MG women far from delivery. In addition, we confirmed the relationship between uterine overdistension and surface myoelectric activity, revealing the electromechanical coupling pathway in uterine smooth muscle. Therefore, contextualized EHG-biomarkers would provide valuable information for early detection of PTB risk, which would allow clinicians better PTB management through personalised therapeutic interventions.

Characterization of heart rate variability in end-stage renal disease patients after kidney transplantation with recurrence quantification analysis.

Heart rate variability (HRV) is a noninvasive approach to studying the autonomic modulation of heart rate in experimental settings, such as active standing sympathetic stimulation. It is known that patients with end-stage renal disease during active standing have few changes in HRV dynamics, which are improved after hemodialysis. However, it is unknown whether the response to active standing is recovered after definitive treatment with kidney transplantation. This work aims to assess the change in HRV dynamics in the supine position and active standing through time and frequency-based metrics, as well as recurrence plot quantitative analysis (RQA). We studied HRV dynamics by obtaining 5-minute electrocardiographic recordings from kidney transplant recipients who underwent an active standing test. The mean duration of heartbeats and their standard deviation diminished in active standing, compared with the supine position. Also, the low-frequency component of HRV and the presence of diagonal and vertical structures in RQA were predominant. A larger estimated glomerular filtration rate was significantly correlated with broader HRV in the supine position and during active standing. The narrower HRV during active standing may indicate a sympathetic response to external stimuli, which is expected in a functional cardiovascular system, and may be influenced by renal function.

Collaborative turn-construction practices of people with primary progressive aphasia and their family conversation partners

Background: Primary progressive aphasia describes a group of three rare language-led dementias: semantic, logopenic, and non-fluent. The small number of conversation analysis studies to date suggest that repair and turn-construction practices in primary progressive aphasia are similar to those seen in post-stroke aphasia. This study investigates the collaborative aspect of these practices between people with primary progressive aphasia and their conversation partners. Method: Conversation analysis was used to investigate collaboration in repair and turn-construction practices in 10-minute video recordings of natural conversation collected from two dyads, one with logopenic and one with mixed primary progressive aphasia. Results: This study demonstrates that people with primary progressive aphasia have a range of practices available to construct their turns, and that their conversation partners collaborate to co-construct talk. Discussion: Findings demonstrate that collaboration can support interaction or lead to further interactional trouble. Collaborative practices are important targets for speech and language therapy interventions.

Accuracy and clinical utility of heart rate variability derived from a wearable heart rate monitor in patients undergoing major abdominal surgery.

Low heart rate variability (HRV) can potentially identify patients at risk of intraoperative hypotension. However, it is unclear whether cheaper, readily accessible consumer heart rate (HR) monitors can provide similar utility to clinical Holter electrocardiograph (ECG) monitors. The objectives of this study were (1) to assess the validity of using the Polar H10 HR monitor as an alternative to a clinical Holter ECG and (2) to test total power (TP) as a predictor of intraoperative hypotension. The primary outcome was the level of agreement between Polar H10 and Holter ECG. Twenty-three patients undergoing major abdominal surgery with general anesthesia had 5-minute HR recordings taken concurrently with both devices during a pre-anesthetic consultation. Agreement between Polar H10 and Holter ECG was compared via Bland-Altman analysis and Lin's Concordance Correlation Coefficient. Patients were divided into groups based on TP < and TP > . Intraoperative hypotension was defined as MAP < 60 mmHg, systolic blood pressure < 80 mmHg, or 35% decrease in MAP from baseline.There was substantial agreement between Polar H10 and Holter ECG for average R-R interval, TP and other HRV indices. Reduced TP (< 500 ) had a high sensitivity (80%) and specificity (100%) in predicting intraoperative hypotension. Patients with reduced TP were significantly more likely to require vasoactive drugs to maintain blood pressure.The substantial agreement between Polar H10 and Holter ECG may justify its use clinically. The use of preoperative recordings of HRV has the potential to become part of routine preoperative assessment as a useful screening tool to predict hemodynamic instability in patients undergoing general anesthesia.

Hemodynamic responses to low-level transcutaneous auricular nerve stimulation in young volunteers.

The aim of this study was to characterize cardiovascular autonomic responses during two constant current intensities below sensory threshold of transcutaneous auricular nerve stimulation (taNS). On this basis, a protocol for taNS with autonomic modulatory potential could be proposed. We included 26 men and 24 women, mean age 26. Data were collected during three randomly allocated 20-minute right tragus stimulation sessions - a) no-stimulation (sham), b) 90µA (arbitrary), and c) 130µA (near the lowest sensory threshold in majority). Stimulation was 20Hz, rectangular pulse width of 2ms, duty cycle 2-second on/off. To assess autonomic responses, we continuously recorded ECG, non-invasive arterial blood pressure (BP) and thoracic impedance cardiography data. Ten-minute data were compared. Fast Fourier transform of RR intervals was performed on 10-minute recordings as well. Low frequency and high frequency power spectra were calculated. Friedman test or one-way ANOVA for repeated measurements and Mann-Whitney or Wilcoxon's signed-rank test, or t-test were carried out. P<0.05 was considered significant. At 130µA stimulation, cardiac output significantly decreased (p<0.05), driven by significant heart rate drop in women, and stroke volume and contractility drop in men, pointing to a gender-related autonomic responses. We observed no significant changes in BP, or variability parameters. Significantly higher body size and BP were found in men, as expected. It seems that tested taNS protocol has a potential for cardiac autonomic modulation in majority of young healthy men as well as women. Further studies are however needed to prove the therapeutic potential of this stimulation protocol in different patient groups.

Electroencephalography in young onset dementia

BackgroundYoung onset dementia (YOD) is a major diagnostic and management problem.MethodsWe set out to explore if electroencephalography (EEG) might be useful in the diagnosis of young onset Alzheimer’s disease (YOAD) and young onset frontotemporal dementia (YOFTD). The ARTEMIS project is a 25-year prospective study of YOD based in Perth, Western Australia. 231 participants were included: YOAD: n = 103, YOFTD: n = 28, controls: n = 100. EEGs were performed prospectively, with 30-minute recording time for each subject, without knowledge of diagnosis or other diagnostic data.Results80.9% of patients with YOD had abnormal EEGs (P < 0.00001). Slow wave changes were more frequent in YOAD that YOFTD (P < 0.00001), but no difference in the frequency of epileptiform activity (P = 0.32), with 38.8% of YOAD and 28.6% of YOFTD patients having epileptiform activity. Slow wave changes were more generalized in YOAD (P = 0.001). Slow wave changes and epileptiform activity were not sensitive to the diagnosis of YOD, but highly specific (97–99%). The absence of slow wave changes and epileptiform activity had a 100% negative predictive value and likelihood radio 0.14 and 0.62 respectively, meaning that those without slow wave changes or epileptiform activity had low probability of having YOD. No relationship was established between EEG findings and the patient’s presenting problem. Eleven patients with YOAD developed seizures during the study, and only one with YOFTD.ConclusionsThe EEG is highly specific for the diagnosis of YOD with the absence of slow wave changes and epileptiform phenomena making the diagnosis unlikely, with 100% negative predictive value and with low probability for the dementia diagnosis.

Dual-chamber leadless pacing: Atrioventricular synchrony in preclinical models of normal or blocked atrioventricular conduction

Dual-chamber leadless pacemakers (LPs) require robust communication between distinct right atrial (RA) and right ventricular (RV) LPs to achieve atrioventricular (AV) synchrony. The purpose of this preclinical study was to evaluate a novel, continuous implant-to-implant (i2i™) communication methodology for maintaining AV-synchronous, dual-chamber DDD(R) pacing by the 2 LPs. RA and RV LPs were implanted and paired in 7 ovine subjects (4 with induced complete heart block). AV synchrony (% AV intervals <300 ms) and i2i communication success (% successful i2i transmissions between LPs) were evaluated acutely and chronically. During acute testing, 12-lead electrocardiographic and LP diagnostic data were collected from 5-minute recordings, in 4 postures and 2 rhythms (AP-VP and AS-VP, or AP-VS and AS-VS) per subject. Chronic i2i performance was evaluated through 23 weeks postimplant (final i2i evaluation period: week 16-23). Acute AV synchrony and i2i communication success across multiple postures and rhythms were median [interquartile range] 100.0% [100.0%-100.0%] and 99.9% [99.9%-99.9%], respectively. AV synchrony and i2i success rates did not differ across postures (P = .59, P = .11) or rhythms (P = 1, P = .82). During the final i2i evaluation period, the overall i2i success was 98.9% [98.1%-99.0%]. Successful AV-synchronous, dual-chamber DDD(R) leadless pacing using a novel, continuous, wireless communication modality was demonstrated across variations in posture and rhythm in a preclinical model.

Preventable risk factors for type 2 diabetes can be detected using noninvasive spontaneous electroretinogram signals.

Given the ever-increasing prevalence of type 2 diabetes and obesity, the pressure on global healthcare is expected to be colossal, especially in terms of blindness. Electroretinogram (ERG) has long been perceived as a first-use technique for diagnosing eye diseases, and some studies suggested its use for preventable risk factors of type 2 diabetes and thereby diabetic retinopathy (DR). Here, we show that in a non-evoked mode, ERG signals contain spontaneous oscillations that predict disease cases in rodent models of obesity and in people with overweight, obesity, and metabolic syndrome but not yet diabetes, using one single random forest-based model. Classification performance was both internally and externally validated, and correlation analysis showed that the spontaneous oscillations of the non-evoked ERG are altered before oscillatory potentials, which are the current gold-standard for early DR. Principal component and discriminant analysis suggested that the slow frequency (0.4-0.7 Hz) components are the main discriminators for our predictive model. In addition, we established that the optimal conditions to record these informative signals, are 5-minute duration recordings under daylight conditions, using any ERG sensors, including ones working with portative, non-mydriatic devices. Our study provides an early warning system with promising applications for prevention, monitoring and even the development of new therapies against type 2 diabetes.

Advanced microstructural substrate detection in pre-hypertrophic HCM and its relationship to arrhythmogenesis; a hybrid CMR-ECG-Imaging study

Abstract Background Hypertrophic cardiomyopathy is defined in three domains; clinically by unexplained hypertrophy, genetically by sarcomeric gene mutations and histologically by disarray, small vessel disease and fibrosis. Both ischaemia and myocyte disarray have been implicated in arrhythmogenesis and sudden cardiac death but whether disarray occurs before hypertrophy and its relationship to ischaemia is unknown. Diffusion-tensor CMR, perfusion mapping &amp; ECG Imaging (ECGI) can measure disarray, ischaemia and electrical aberrance respectively in vivo. We aimed to investigate these in genotype positive (G+) subjects without hypertrophy (LVH−) to identify further subclinical manifestations of gene expression and whether these relate to ventricular arrhythmia formation. Methods Diffusion-tensor CMR (3-Tesla) using a motion-compensated spin-echo sequence was acquired in 3 short-axis slices. Quantitative adenosine stress perfusion mapping was performed using standard clinical protocols. A novel ECGI vest, containing 256 unipolar electrodes acquired a 5-minute recording of body-surface potentials to quantify conduction and repolarisation dynamics intervals. Results ECGI/CMR was performed on 68 mutation carriers from 64 families and 24 age sex and ethnicity matched healthy controls. Of the mutation carriers, median age was 33 (24–41 years), 57% (39) were female, and 79% (54) were white. Mutations were 39 (57%) MYBPC3, 19 (28%) MYH7, 1 (1%) MYL2 and 9 (12%) were thin filament/non-sarcomeric mutations. There was no significant difference in ejection fraction or LV mass, however G+LVH− had a higher maximum wall thickness (9 (9–10) vs 8 (7–9) mm p=0.003). Compared to healthy volunteers, G+LVH− individuals had more perfusion defects (18/64 (30%) vs 0, p=0.004), lower Fractional Anisotropy (FA) (suggestive of more disarray) (0.32±0.02 vs 0.34±0.02, p&amp;lt;0.0001) and more prolonged Activation–Recovery Intervals (ARI, a surrogate for action potential duration (259±40 vs 240±31 ms, p=0.03). In G+LVH−, patients with perfusion defects had more prolonged ARI (263 (248 vs 292) vs 246 (225–283) ms, p=0.03) and lower FA suggestive of more disarray (0.32±0.2 vs 0.31±0.1, p=0.04). Conclusion Ischaemia, myocyte disarray and electrical abnormalities occur even in the absence of hypertrophy in HCM. These abnormalities associate to form a complex a clinical phenotype. Funding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): British Heart FoundationBarts Charity

The Dangerous Discourse of “Us” vs. “Them:” Spain's VOX Discursive Practices

Abstract Since the entry of the far-right party VOX into the Spanish government administrations in 2018, Spain's political scene has gone through a deep transformation. The disparity in opinions among the different parties concerning migration seems to tear the country's democratic foundation apart. This paper is a study of the language and discursive strategies used by VOX's leader, Santiago Abascal, articulating the party's populist propaganda for a united country to “make Spain great again.” The analysis was grounded on the theoretical underpinnings of Wodak's (2001) discursive strategies and Van Dijk's (1993) “Us” vs. “Them” framework. The data were based on Abascal's closing political campaign speech during the Madridlenian elections, which was televised in May 2021. The 30-minute video recording was transcribed, annotated, coded, and analyzed. The findings suggest a pattern of discursive practices aimed at diminishing other political parties and their representatives, vilify immigrants, and impugn government measures that were against VOX's authoritarian conservatism and nationalism. There was a predominant use of predication strategies to positively present VOX while denigrating its political rivals. Referential/nomination strategies were also used to divide the society between in-groups and out-groups. Strongly embedded in these strategies were perlocutionary acts used to incite hate toward the out-groups and evoke fear and anxiety toward the in-group, strategically employed as tools to gain votes in the elections.

Prolonged diaphragm activation using closed loop optogenetic stimulation

Diaphragm dysfunction in individuals with late stage neuromuscular disease and cervical spinal cord injury is a substantial problem, often resulting in respiratory insufficiencies and ultimately respiratory failure. Therefore, there is a need to develop new methods that can improve diaphragm function in these clinical populations. Here we used an optogenetic method of activating diaphragm myofibers to assess the feasibility of prolonged photostimulation of the diaphragm. Our hypothesis was that closed loop photostimulation can pace the diaphragm over a prolonged period (1 hour) without a decrease in evoked response magnitude. Wild type mice (C57/bl6, n= 5) received an injection of AAV9‐CAG‐ChR2‐mVenus (34 µl, titer: 1.8x1013 vg/ml) to the intrapleural space between the lung and chest wall to target the diaphragm. After an 8‐18 week incubation period, diaphragm EMG and respiratory airflow were measured under isoflurane anesthesia. A light stimulus was delivered to the inferior diaphragm surface using a high‐power, 472 nm, micro‐LED. Photostimulation was delivered in a closed loop fashion using the onset of the inspiratory EMG burst recorded in intact hemi‐diaphragm to trigger the stimulus. The photostimulation paradigm consisted of a 250 ms, ramping/decrementing train of light pulses (pulse duration = 0.1 ms, interpulse interval = 0.1 ms). After a 10‐minute baseline recording, a unilateral right phrenicotomy was performed to paralyze the right diaphragm. The photostimulation paradigm immediately restored EMG activity to the paralyzed hemi‐diaphragm. Further, the magnitude of the evoked diaphragm EMG bursts stayed consistent over the sixty‐minute period of closed loop photostimulation, and there was no evidence of a decrement in EMG activation. Post‐mortem histology confirmed mVenus expression in diaphragm myofibers. We conclude that stimulation of the diaphragm using optogenetics is effective for up to one hour. This is a first demonstration of prolonged photostimulation of the diaphragm and provides evidence to support the feasibility of this method for the treatment of chronic diaphragm paralysis.

Perampanel enhances the cardiovagal tone and heart rate variability (HRV) in patients with drug-resistant temporal lobe epilepsy

ObjectiveThe temporal lobe plays a central role in the regulation of the "Central Autonomic Network" and cardiovascular functions. The blockade of glutamatergic pathways in the temporal lobe affects cardio-autonomic control. Perampanel (PER) is a non-competitive agonist of the AMPA receptor. This study evaluated PER effects on cardiac autonomic control in patients affected by drug-resistant TLE (DRTLE). MethodsWe enrolled 40 adults with DRTLE treated with PER as add-on therapy (PER group) and 32 DRTLE age, sex, and seizure-frequency matched controls treated with different additional anti-seizure medication (ASM) as add-on therapy (No-PER group). HRV analysis was performed on 5-minute EKG recording in resting state before and 6-months after the introduction of add-on ASM. Linear Mixed Models (LMM) were used to analyzed HRV variables according to time (baseline and 6-months follow-up) and groups. ResultsAt baseline no differences were detected between PER group and No-PER group according to time-domain and frequency-domain HRV parameters. At the follow-up, in PER group a multiplicative effect for the interaction between treatment and time was observed for MeanRR (ms) (p=0.03), LnRMSSD (ms) (p=0.04), LnHF (ms2) (p<0.001), HF n.u. (p=0.001), HF% (p=0.002) with increased values, and for LnLF (ms2) (p=0.001), LF n.u. (p=0.001), LF% (p=0.01), and LF/HF (p<0.001) with reduced values. The change in seizure frequency after add-on therapy was comparable between the two groups (p=0.81) ConclusionsOur data support the notion that PER increases the vagal tone in DRTLE. This activity may exert a cardioprotective effect by reducing the risk of developing cardiac arrhythmias. Furthermore, given the correlations between HRV modifications and the occurrence of SUDEP, future studies will need to test the protective effects of PER on SUDEP.

Improving Public Speaking: An English Speech Contest Case Study

This study explores how an English speech contest program integrates language learning over a 3-month non-regular course. Quantitative analyses were conducted, based on 5-minute video recordings of speeches with 6 participants for the final round of the speech contest program. Public Speaking (PS) courses were provided through the LMS and analyzed to identify speech improvement in various areas of public speaking anxiety (PSA) using a questionnaire, self-report, self-evaluation, and observation activity log. Based on the assessments noted above, the integration of language skills provides effective opportunities to speak. After taking a basic course and an in-depth coaching practicum, chunking-shadowing-windowing strategies had a positive effect on their PS skills strengthening their speaking progress. On the nonverbal side, students had a comparatively high level of PSA and did not feel engaged, or demonstrated a lack of confidence due to nonverbal communication skills they were unaccustomed to. However, participants felt less anxious, acquired the necessary techniques to boost confidence, and improved overall speech skills through participation in the program. Implications for better PS instruction and the importance of structured practice for speech preparation were suggested.

Mitigating Bias in the Measurement of Heart Rate Variability in Physiological Studies of Spinal Manipulation: A Comparison Between Authentic and Sham Manipulation

ObjectiveThe purpose of this study was to identify sources and strategies for the mitigation of bias in studies of spinal manipulation and heart rate variability. MethodsA small-scale study compared the effects of a single session of sham and authentic cervical manipulation on heart rate variability as measured by power spectrum analysis. The participants were a sample of 31 healthy young students from the Canadian Memorial Chiropractic College, randomized into 2 study arms. The effectiveness of blinding was evaluated, and 2 alternative methods of data analysis were explored to mitigate risk of bias. Following execution of the study, the stages of implementation and data processing were scored against version 2 of the Cochrane risk-of-bias tool for randomized trials for risk of bias. ResultsThe risk of bias arising from (1) the randomization process, (2) missing outcome data, and (3) selection of reported results was judged to be low. Risk of bias in (1) deviations from intended interventions (particularly due to the failure of masking) and (2) the measurement of the outcome, for example, through cleaning of the data, were judged to be high. ConclusionThe use of power spectrum analysis of heart rate variability based on 5-minute recordings of echocardiogram pre-and post-intervention contained multiple sources of bias that were challenging to mitigate. Based upon these findings, power spectrum analysis of heart rate variability using these parameters may be ill-suited to the study of physiological effects of spinal manipulative therapy.

Accuracy Assessment of Oura Ring Nocturnal Heart Rate and Heart Rate Variability in Comparison With Electrocardiography in Time and Frequency Domains: Comprehensive Analysis.

BackgroundPhotoplethysmography is a noninvasive and low-cost method to remotely and continuously track vital signs. The Oura Ring is a compact photoplethysmography-based smart ring, which has recently drawn attention to remote health monitoring and wellness applications. The ring is used to acquire nocturnal heart rate (HR) and HR variability (HRV) parameters ubiquitously. However, these parameters are highly susceptible to motion artifacts and environmental noise. Therefore, a validity assessment of the parameters is required in everyday settings.ObjectiveThis study aims to evaluate the accuracy of HR and time domain and frequency domain HRV parameters collected by the Oura Ring against a medical grade chest electrocardiogram monitor.MethodsWe conducted overnight home-based monitoring using an Oura Ring and a Shimmer3 electrocardiogram device. The nocturnal HR and HRV parameters of 35 healthy individuals were collected and assessed. We evaluated the parameters within 2 tests, that is, values collected from 5-minute recordings (ie, short-term HRV analysis) and the average values per night sleep. A linear regression method, the Pearson correlation coefficient, and the Bland–Altman plot were used to compare the measurements of the 2 devices.ResultsOur findings showed low mean biases of the HR and HRV parameters collected by the Oura Ring in both the 5-minute and average-per-night tests. In the 5-minute test, the error variances of the parameters were different. The parameters provided by the Oura Ring dashboard (ie, HR and root mean square of successive differences [RMSSD]) showed relatively low error variance compared with the HRV parameters extracted from the normal interbeat interval signals. The Pearson correlation coefficient tests (P<.001) indicated that HR, RMSSD, average of normal heart beat intervals (AVNN), and percentage of successive normal beat-to-beat intervals that differ by more than 50 ms (pNN50) had high positive correlations with the baseline values; SD of normal beat-to-beat intervals (SDNN) and high frequency (HF) had moderate positive correlations, and low frequency (LF) and LF:HF ratio had low positive correlations. The HR, RMSSD, AVNN, and pNN50 had narrow 95% CIs; however, SDNN, LF, HF, and LF:HF ratio had relatively wider 95% CIs. In contrast, the average-per-night test showed that the HR, RMSSD, SDNN, AVNN, pNN50, LF, and HF had high positive relationships (P<.001), and the LF:HF ratio had a moderate positive relationship (P<.001). The average-per-night test also indicated considerably lower error variances than the 5-minute test for the parameters.ConclusionsThe Oura Ring could accurately measure nocturnal HR and RMSSD in both the 5-minute and average-per-night tests. It provided acceptable nocturnal AVNN, pNN50, HF, and SDNN accuracy in the average-per-night test but not in the 5-minute test. In contrast, the LF and LF:HF ratio of the ring had high error rates in both tests.

Abstract 11481: Non-Invasive Electrocardiographic Mapping of the Human Heart Through a Novel 'Cardiac Magnetic Resonance-Electrocardiographic Imaging' Solution for High Throughput Use

Background: Electrocardiographic imaging (ECGI) non-invasively maps the heart’s electrical activity through multiple leads on the body surface. Cardiologists need a safe, quick, affordable and re-usable ECGI method to apply to patients undergoing cardiovascular magnetic resonance (CMR), but current solutions are not suitable for high-throughput use. We developed a CMR-ECGI vest for high-throughput use and report the first in vivo results. Methods: We designed and fabricated the CMR-ECGI vest from cotton, containing 256 square (2x2cm) dry textile electrodes each tagged with a localisation marker ( Fig 1 ). Body surface potentials were recorded and co-registered with heart-torso geometries obtained from CMR ( Fig 2 ). Epicardial unipolar potentials were reconstructed using state-of-the-art ECGI algorithms (YR Lab) and local activation and repolarization times were computed using standard methods. Results: Ten healthy volunteers with normal resting ECGs were recruited (34±10years; 60% male). A recumbent 5-minute ECGI recording was performed (preparation time ~15 minutes for montage and doffing). 3 Tesla CMR provided baseline parameters (left ventricular ejection fraction [LVEF] 75±5%, right ventricular [RV] EF 57±5%, native T1 1275±23ms, T2 42±1ms) and showed no clinically significant late gadolinium enhancement. ECGI showed that the sites of earliest and latest activation were the basal RV ( Fig 3A ) and basal-lateral LV respectively ( Fig 3B ). Total duration of epicardial activation and repolarization was 73.3±8.9ms and 195±35.2ms, respectively. These epicardial activation patterns in health are in line with previously described ECGI data. Conclusions: We have developed a re-usable and high-throughput CMR-ECGI solution that is safe and well-tolerated in vivo . This technology is now available for large-scale clinical research use to provide deeper insights into the pathophysiology of arrhythmogenesis, through seamless integration with CMR.