Pulse Rate Research Articles

Smartphone-based health monitoring in India: Data collection and evaluation for pulse rate estimation

ABSTRACT Introduction: Over the past decade, monitoring of body vitals has gained significant popularity, specifically during and post the recent COVID pandemic. Advancements in smartphones and wearables have been pivotal, providing accessible and cost-effective solutions for at-home health monitoring. Their development often requires a large corpus of labeled datasets, but such large and diverse datasets for developing smartphone-based vital estimation systems, particularly adapted to Indian context, are scarce. Aims and Objectives: This observational study focuses on development of such a dataset in a diverse Indian context and evaluation of smartphone-based pulse rate estimation based on this dataset. Methods: Data collection considered Indian patients with various medical conditions, body mass index profiles, blood pressure levels, ages, and smoking habits, reflecting a broad demographic spectrum. As part of this study, an algorithm was implemented to estimate the photoplethysmogram (PPG) signal from video recordings of fingers placed on the smartphone camera and subsequently to estimate pulse rate using the acquired PPG data. Smartphone-based pulse rate estimates were compared with readings from pulse oximeters to assess accuracy and feasibility. Results: The smartphone-based PPG algorithm provides reasonably accurate estimations of pulse rate when compared to traditional pulse oximeters under varied healthcare settings (mean absolute error < 5, intraclass correlation coefficient > 0.90). Conclusion: Results indicate that the smartphone-based PPG signal captures sufficient information of the cardiac cycle to reliably estimate the pulse rate. Furthermore, system accuracy is consistent across varied subjects and settings, highlighting the importance of tailored data collection for development and evaluation of vital estimation algorithms.

Effectiveness of the addition of visual aids to conversational preoperative education in glaucoma filtering surgery: A randomized controlled trial.

This study aimed to evaluate the impact of preoperative visual aids on anxiety and pain management in patients with low educational backgrounds undergoing glaucoma filtering surgery. A randomized, single-blinded, single-center clinical trial was conducted at a tertiary eye hospital in Shantou, China. Patients scheduled for glaucoma filtering surgery were randomly assigned to either a conventional oral education group or a visual aids group. Anxiety levels, pain scores, blood pressure, and pulse rates were measured at multiple time points. The visual aids group demonstrated significantly lower anxiety levels (HAMA score: 19.6±1.7 vs. 27.9±3.1; p<0.001) and pain scores (VAS: F=174.628; p<0.001) compared to the oral education group. Additionally, systolic blood pressure was significantly lower in the visual aids group (F=6.373; p=0.013). During the preoperative visit, patients in the oral education group asked significantly more questions (mean±SD: 4.0±1.3) compared to those in the visual aids group (mean±SD: 0.75±0.7; p<0.001). However, their understanding of the surgery was notably lower than that of the visual aids group. The requirement for additional anesthesia due to pain was markedly higher in the oral education group, with 66.2% (45/68) of patients needing extra anesthesia compared to only 4.6% (3/65) in the visual aids group (p<0.001). Furthermore, the ocular positioning compliance and cooperation during the surgery were significantly lower in the oral education group compared to the visual aids group (p<0.001). The inclusion of visual aids in preoperative education significantly improves patient outcomes in glaucoma filtering surgery by reducing anxiety and pain and stabilizing physiological parameters. This approach is particularly beneficial for patients with lower educational backgrounds.

Prediction of mortality and prioritisation to tertiary care using the 'OUR-ARCad' risk score gleaned from the second wave of COVID-19 pandemic-A retrospective cohort study from South India.

Judicious utilisation of tertiary care facilities through appropriate risk stratification assumes priority, in a raging pandemic, of the nature of delta variant-predominated second wave of COVID-19 pandemic in India. Prioritisation of tertiary care, through a scientifically validated risk score, would maximise recovery without compromising individual safety, but importantly without straining the health system. De-identified data of COVID-19 confirmed patients admitted to a tertiary care hospital in South India, between April 1, 2021 and July 31, 2021, corresponding to the peak of COVID-19 second wave, were analysed after segregating into 'survivors' or 'non-survivors' to evaluate the risk factors for COVID-19 mortality at admission and formulate a risk score with easily obtainable but clinically relevant parameters for accurate patient triaging. The predictive ability was ascertained by the area under the receiver operator characteristics (AUROC) and the goodness of fit by the Hosmer-Lemeshow test and validated using the bootstrap method. Of 617 COVID-19 patients (325 survivors, 292 non-survivors), treated as per prevailing national guidelines, with a slight male predilection (358/617 [58.0%]), fatalities in the age group above and below 50 years were (217/380 [57.1%]) and (75/237 [31.6%]), p<0.001. The relative distribution of the various parameters among survivors and non-survivors including self-reported comorbidities helped to derive the individual risk scores from parameters significant in the multivariable logistic regression. The 'OUR-ARCad' risk score components were-Oxygen saturation SaO2<94%-23, Urea > 40mg/dL-15, Neutrophil/Lymphocytic ratio >3-23, Age > 50 years-8, Pulse Rate >100-8 and Coronary Artery disease-15. A summated score above 50, mandated tertiary care management (sensitivity-90%, specificity-75%; AUC-0.89), validated in 2000 bootstrap dataset. The OUR-ARCad risk score, could potentially maximize recovery in a raging COVID-19 pandemic, through prioritisation of tertiary care services, neither straining the health system nor compromising patient's safety, delivering and diverting care to those who needed the most.

Driving under the influence of drugs - The failed quest of finding medical signs indicative to driving impairment.

Motor vehicle accidents (MVA) are the leading cause of death in childhood and young adult age. One of the most important factors behind MVA is driving under the influence of alcohol (DUIA) and drugs (DUID). The importance of DUID is rising together with the increasing drug abuse. The legal approaches to DUID are based on impairment, impairment per se or zero tolerance. In case of impairment, the negative effect of the substance on the driving abilities has to be proven by a forensic expert, which can be challenging. This study compares the medical signs registered during blood sampling with the concentrations of substances detected by toxicological examination to find medical signs indicative of impairment. Statistical analysis did not find a correlation between substance concentration and measured parameters (pupil diameter, blood pressure and pulse rate). No connection was found between substance concentrations and the appearance of medical signs. The results indicate that pupil dilation, heart rate, and blood pressure could not be used as indicators of possible driving impairment by drugs, and no medical sign could reliably indicate the driving impairment by substances other than ethanol.

External Validation of SHA2PE Score: A Score to Predict Low-Risk Lower Gastrointestinal Bleeding in the Emergency Department.

Introduction: Lower gastrointestinal bleeding (LGIB) frequently leads to emergency department (ED) visits and hospitalizations, encompassing a spectrum of outcomes from spontaneous resolution to intrahospital mortality. Aim: The purpose of this study was to validate a scoring system designed to identify cases of low-risk LGIB, allowing for safe discharge from the ED. Methods: A retrospective analysis of all gastrointestinal bleeding cases presented at three EDs in 2020 was conducted, focusing specifically on patients with LGIB. The SHA2PE score incorporates factors such as systolic blood pressure, hemoglobin levels, use of antiplatelet or anticoagulant medications, pulse rate, and episodes of bright blood per rectum. Results: Out of 1112 patients presenting with LGIB to the ED, 55 were hospitalized, 20 required blood transfusions, 15 underwent colonoscopies, one underwent interventional radiology procedures, and two patients died. Employing a SHA2PE score with a cutoff value of 1 yielded a specificity of 78.5% (95% CI (confidence interval) [75.8-81.0]), sensitivity of 76.8% (95% CI [63.6-87.0]), positive predictive value (PPV) of 17.0% (95% CI [12.6-22.2]), and negative predictive value (NPV) of 98.3% (95% CI [97.2-99.1]) for predicting the need for hospitalization and intrahospital intervention. When considering return visits to the ED within 7 days with the same presentation, the score demonstrated a specificity of 78.8% (95% CI [76.0-81.3]), sensitivity of 68.6% (95% CI [56.4-79.1]), PPV of 19% (95% CI [14.3-24.4]), and NPV of 97.2% (95% CI [95.8-98.2]). Conclusions: The SHA2PE score demonstrates potential in predicting cases of low-risk LGIB, offering a high NPV for hospitalization, the need for intrahospital intervention, and return visits to the ED. However, these findings should be interpreted cautiously given the low prevalence of interventions and limitations in the study's population and design.

Pregnancy and Postpartum Trends in Self-Measured Blood Pressure and Derived Indices: The BOSHI Study.

In this study, we aimed to reveal the trends of self-measured blood pressure (SMBP) and SMBP-derived indices during pregnancy and the postpartum period. The Babies and Their Parents Longitudinal Observation in Suzuki Memorial Hospital in the Intrauterine Period (BOSHI) Study is a prospective cohort study in Japan. Participants were instructed to measure SMBP daily during pregnancy and for 1 month after delivery. Among 237 participants with normotensive blood pressure (BP) during pregnancy and the postpartum period who were analyzed using mixed-effects models for repeated measures, the SMBP was measured, on average, 14.3 times from the day before delivery to 28 days postpartum. The systolic blood pressure (SBP) and diastolic blood pressure (DBP) on the day before delivery were 110.6±1.0 and 68.1±0.8mmHg (estimate ± standard error). Postpartum BP increased from postpartum Days 3-8 in SBP and from Days 3-22 in DBP, compared to that on the day before delivery. The SBP and DBP were 4.9 and 4.7mmHg higher on postpartum Days 8 and 7 than the day before pregnancy, respectively. During pregnancy, the pulse rate (PR) showed an inverted U-shaped trend and then sharply increased rapidly until the first postpartum day after delivery. The Shock Index showed a similar trend to that of the PR, decreased from labor until postpartum Day 8, and plateaued thereafter. The double product peaked during labor, remained higher than the prelabor levels for approximately 10 days, and then decreased in the postpartum period.

Effects of Intrauterine Isoproterenol Administration on Ovarian Follicular Development in Cows.

Isoproterenol (ISO) is a nonselective beta-adrenergic receptor agonist known for its vasodilatory effects. This experiment aims to investigate whether intrauterine ISO administration could alter vascular indices and follicular development in postpartum Holstein cows. The objectives are to evaluate the effects of intrauterine ISO administration on vascular changes and its impact on follicular development compared to placebo groups. This randomized controlled study was conducted on 36 Holstein cows selected based on their health status, including only those free from reproductive, metabolic and infectious disorders. The cows (n=36) were divided into two groups as control received distilled water alone (CON, n=18) and experiment received 4mg ISO in 40mL distilled water (ISO, n=18) and four subgroups as CON-I (n=9), CON-II (n=9), ISO-I (n=9) and ISO-II (n=9) according to days of intrauterine administration (I or II represents to 1 or 2days after ovulation, respectively). Uterine and ovarian artery blood flows were assessed before and after administration by Doppler ultrasonography. Blood samples were collected both before and after administration (on Day 1 or 2) and on Days 3, 6 and 9 post-ovulation for hormonal analysis. Antral follicle count (AFC) was recorded on the blood sampling days. Data were analysed via mixed model ANOVA. Intrauterine ISO administration significantly increased the pulse rate (PR) in the ovaries (89.4 vs. 65.5bpm, p<0.0001) and uterus (90.6 vs. 64.2bpm, p<0.0001). Early AFC (1-2.9mm) decreased, whereas small AFC (3-4.9mm) increased in the ISO groups. The weighted average antral follicle size (WAAFS) significantly increased in the ISO group but remained unchanged in the controls. Hormonal analysis revealed elevated levels of FSH (626 vs. 468mIU/mL), AMH (61.3 vs. 46.4ng/L), E2 (138 vs. 122ng/L), P4 (15.3 vs. 10.6ng/mL), IGF-1 (62.6 vs. 25.1ng/mL) and IGFBP-3 (28.4 vs. 16.5ng/mL) in the ISO groups (p<0.0001). The findings indicate that intrauterine administration of ISO on Day 1 post-ovulation could be a promising 'adjunct technique' for future research focussed on minimizing dependence on exogenous hormones or improving the sensitivity of follicles to endogenous hormonal signals, thereby potentially enhancing oocyte yield.

A Preliminary Study: The Effect of Slow Deep Breathing Exercise (SDBE) on Resting Heart Rate and Respiration Rate of Hypertension Patients

The prevalence of hypertension in Indonesia increases with age. Examination of vital signs such as resting pulse and respiratory rate are parameters of hypertension morbidity. One alternative therapy for hypertension is slow, deep breathing exercises. This study aimed to determine the effect of slow, deep breathing exercises on hypertensive patients' resting heart rate and respiratory rate. The research design used was pre-experimental with one group pretest and posttest on 26 hypertensive patients at Posyandu Lansia Waras Winangun, Banyumas. The sampling method used was the total sampling technique. Participants were treated with slow, deep breathing exercises three times a week for six weeks. Resting heart and respiratory rates were examined before and after the intervention of slow, deep breathing exercises. Data analysis of the results in this study used the Wilcoxon non-parametric test. Slow deep breathing exercises significantly decreased resting heart rate (p=0.001), but the respiratory rate was not found to decrease significantly (p=0.209). It can be concluded that the administration of slow, deep breathing exercises affected the resting heart rate but did not affect the respiration rate.

Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in hypertensive patients: A prospective cross-sectional study

Background: Long-term hypertension progresses to produce atherothrombotic disease. Chronic inflammation may contribute to epithelial dysfunction and atherogenesis and is associated with high blood pressure. Neutrophil-to-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) ratios are the predictors of the cardiovascular diseases. However, studies related to this context are sparse comparatively. Aims and Objectives: The current study explores the NLR and the PLR with hypertension as an indicator of cardiovascular risk. Materials and Methods: The present study is a cross-sectional study conducted at the Department of General Medicine outpatient department, from July 2024 to August 2024. Fifty willing male and female hypertensive patients age group between 40 and 60 years were part of the study. Fifty age and gender-matched normotensive individuals were also included in the study. Blood pressure was measured using a mercury sphygmomanometer. 3 mL of venous blood was collected for complete blood count analysis. Results: There was no significant difference in the demographic parameters among the cases and controls. Pulse rate blood pressure and mean arterial pressure were significantly high in hypertensive patients when compared with the normotensives. Neutrophil count was significantly higher in cases than controls. The NLR was significantly higher in cases than in controls. A positive correlation was observed between the parameters. Conclusion: The present study results support that the NLR and PLR can be used as markers for the diagnosis of cardiovascular diseases. These tests are cost-effective and accurate. Hence, this can be implemented in the diagnosis of cardiovascular diseases. The study recommends further studies involving multiple centers and increased sample size.

Prevalence, Risk Factors, and Haemato-Biochemical Changes Associated with Colic in Horses in Sana’a Province, Yemen

Background: Colic is a major health problem in controlled horse populations globally. It is a multifactorial and complex disorder. In Yemen, the prevalence, risk factors, and results of horse colic are unclear. Objectives: The current study aimed to determine the prevalence, risk factors, and haemato-biochemical changes associated with colic in horses in Sana’a, Yemen. Methods: A prospective study was conducted from September 2023 to February 2024. A total of 254 horses were examined under field conditions. Colic was identified based on physical examination, clinical symptoms, and rectal examination. A questionnaire was distributed to the horse owners to assess the risk factors while the clinical examination was performed, and blood samples were obtained to estimate the haemato biochemical parameters in horses with colic. Results: out of a total of 254 horses, the overall prevalence of colic in horses was found to be 11.81% (30 cases) and of these, 73.3% had spasmodic colic whereas 26.7% had impaction. The Means of respiration rate, pulse rate, and capillary refill time were significantly increased in horses affected with colic than healthy control animals (P&lt;0.05). The horses with colic showed a significant association between cases with age (p&lt;0.098), gender (p&lt;0.023), deworming frequency (p&lt;0.001), and previous exposure to colic (p&lt;0.001). In hematological indices, the mean packed cell volume in horses with colic was found to be dramatically increased (P&lt;0.0001), while the means of total platelet count, lymphocyte count, and neutrophil count were found to be significantly decreased (P&lt;0.001). Serum biochemical indices, including aspartate aminotransferase, alanine aminotransferase, blood urea nitrogen, creatinine, glucose, albumin, total protein, and alkaline phosphate, were significantly higher in horses with colic compared to healthy controls (P&lt;0.0001). Conclusions: This is the first study that documented the prevalence of colic in horses and identified risk factors and haemato-biochemical changes associated with colic in Sana’a province, Yemen. This information is a crucial first step in understanding the impact of colic in horses and developing ways to reduce the risk of colic.

Acute aortic regurgitation Physical examination and echocardiography

A 79 year old man presented with a 11 day history of dyspnea. His blood pressure was 149 61 mmHg, his pulse rate was 95 beats per minute, and his oxygen saturation level was 95% while breathing ambient air.

A novel and alternative treatment method for moderate diabetic foot ulcer: tibial periosteal distraction

ObjectiveResearchers have proposed a novel surgical treatment for moderate diabetic foot ulcer: tibial periosteal distraction (TPD) which could improve affected limb microcirculation. We aimed to describe the method and therapeutic effects of this technique.MethodsWe provided a technical guide to perform TPD surgery for the treatment of moderate diabetic foot ulcer of who had been treated in our department. The demographic information had been collected at the time of their admission. The patients were followed up at 3, 6, and 12 months after the operation with the ulcer area, skin temperature of the medial malleolus, transcutaneous oxygen pressure of the medial malleolus, ankle brachial index, dorsalis pedis artery pulsation, 12 item short form survey quality of life scale score, and visual analogue scale.ResultsA total of 35 patients with type 2 diabetes were included in this study, including 19 males and 16 females, with an average age of 62.49 ± 10.34 years and a maximum age of 87 years. The ulcers of all patients were cured, and the average healing time of ulcers was 8.09 ± 2.28 weeks, with no associated complications. The microcirculation indexes of the affected foot were significantly improved (p < 0.05). Three cases showed new vessels regeneration in the affected limbs according to their computed tomography angiography (CTA) results.ConclusionTPD surgery technique is a simple procedure that significantly increases the efficacy and reduces the complications of moderate diabetic foot ulcer patients, which could accelerate the formation of collateral circulation.

Psoriasis treatments in the stabilization of atherosclerosis: a systematic review

Abstract This systematic review explores the relationship between achieving minimal disease activity in psoriasis and the progression of atherosclerosis. It investigates how biologic therapies and other treatments impact atherosclerosis markers, offering insights into therapeutic strategies. A comprehensive search of PubMed, Embase, and Web of Science was conducted from January 1, 2000, to April 1, 2023, using terms such as psoriasis, psoriatic arthritis, atherosclerosis, biologic therapy, vascular stiffness, carotid intima-media thickness (CIMT), and coronary computed tomography angiography (CCTA). Eligible studies were those involving human subjects over 18, written in English, that provided quantitative atherosclerosis markers, including CIMT, CCTA, arterial pulse wave velocity (aPWV), fat attenuation index (FAI), and augmentation index (Aix). From an initial pool of 217 studies, 21 were included, grouped by treatments, including TNF-α inhibitors, IL-12/23 inhibitors, IL-17 inhibitors, DMARDs, phototherapy, and fumaric acid esters. The review found that TNF-α inhibitors significantly improved atherosclerosis markers such as CIMT, aPWV, FAI, and C-reactive protein (CRP), with reductions in these markers compared to no treatment, phototherapy, and IL-12/23 inhibitors. Additionally, IL-17 inhibitors demonstrated similar reductions in FAI compared to TNF-α inhibitors but showed a greater effect in reducing non-calcified plaque burden (12% vs. 5% for TNF-α inhibitors, p &lt; 0.001) and also decreased CRP levels. Fumaric acid improved cholesterol metabolism (p &lt; 0.04), and TNF-α inhibitors enhanced endothelial function (p &lt; 0.01). Mixed results were observed when compared to DMARDs, indicating that patient-specific factors should guide treatment choices. In conclusion, TNF-α inhibitors are highly effective in reducing atherosclerosis progression in psoriasis patients, consistently improving vascular health markers like CIMT, aPWV, FAI, and CRP. IL-17 inhibitors also show significant efficacy, particularly in reducing non-calcified plaque burden, making them a valuable alternative to TNF-α inhibitors. Fumaric acid’s role in cholesterol metabolism suggests its potential in combination therapies. These findings support integrating TNF-α and IL-17 inhibitors into treatment protocols for psoriasis patients with comorbid atherosclerosis, improving cardiovascular outcomes.

Real-time animal monitoring system using pulse, temperature, and GPS sensor

GPS tracking systems utilize the Global Positioning System (GPS) to monitor device movements and determine precise locations. In recent years, GPS technology has been extensively used in navigation applications, providing directions and creating digital maps. This technology has proven indispensable to various professionals, including pilots, surveyors, farmers, boat captains, military personnel, and scientists. Additionally, GPS systems are employed to track animals, offering insights into their behaviors, and locations, and helping to protect endangered species. Various tracking technologies, such as scale clapping, radar, acoustic telemetry, radio tags, Xirgo XT-200, geolocators, GSM mobile phone telemetry, and pop-up satellite archival tags, have been used. This paper focuses on a GPS-based tracking system that collects data through various sensors and processes it using an AVR microcontroller. We measure environmental parameters such as temperature and humidity (using the DTH11 sensor) and monitor pulse rates alongside GPS-derived location data of tracked animals. By scientifically collecting and analyzing this data, we can better understand the condition, movement patterns, and behaviors of wild animals, domestic animals, and pets, enhancing efforts to care for and protect them.

Resilience of Antibiotic Usage and Vital Signs in COVID-19 Patients: A Post-Pandemic Analysis in Pakistan

COVID-19 has had a profound global impact, wreaking havoc on economies and causing a significant loss of lives. Pakistan has also faced severe consequences from the pandemic. To combat the virus, antibiotics such as Azithromycin, Ceftriaxone, Cefixime, Clarithromycin, Levofloxacin, Moxifloxacin, Meropenem, Tazobactam, Tienam, and Vancomycin have been administered to COVID-19 patients. Various vital signs such as temperature, respiratory rate, oxygen saturation, pulse rate, and blood pressure have been closely linked to the symptoms of COVID-19. This study examines the impact of antibiotic usage and vital signs on the survival and mortality of COVID-19 patients using a dataset collected from four major hospitals in Pakistan. The analytical approach includes descriptive analysis, a t-test, and a chi-square test of independence. The originality of this research lies in its comprehensive exploration of the relationship between specific antibiotics and the monitoring of vital signs in the context of COVID-19. It offers a systematic analysis of existing information to derive meaningful insights. Azithromycin emerged as the predominant antibiotic used to treat COVID-19 patients in Pakistan, with other antibiotics showing varying usage patterns. Strong, significant associations were identified between Azithromycin, Tazobactam (Tanzo), and the binary response variable (died/alive). Regarding vital signs, significant relationships were observed for patient age, systolic blood pressure, and diastolic blood pressure when compared to the response variable. This study's findings underscore the importance of Azithromycin and Tazobactam in COVID-19 treatment and highlight the role of vital signs in predicting patient outcomes.

A Multi-Layered Origami Tactile Sensory Ring for Wearable Biomechanical Monitoring.

An origami-based tactile sensory ring utilizing multilayered conductive paper substrates presents an innovative approach to wearable health applications. By harnessing paper's flexibility and employing origami folding, the sensors integrate structural stability and self-packaging without added encapsulation layers. Knot-shaped designs create loop-based systems that secure conductive paper strips and protect sensing layers. Demonstrating a sensitivity of 3.8 kPa-1 at subtle pressures (0-0.05 kPa), the sensors detect both minimal stimuli and high-pressure inputs. Electrical modeling of various origami configurations identifies designs with optimized performance with a pentagon knot offering higher sensitivity to support high-sensitivity needs. Meanwhile a square knot provides greater precision and quicker recovery, balancing sensitivity and stability for real-time feedback devices. The enhanced elastic modulus from folds remains within human skin's elasticity range, ensuring comfort. Applications include grip strength monitoring and pulse rate detection from the thumb, capturing pulse transit time (PTT), an essential cardiovascular biomarker. This design shows the potential of origami-based tactile sensors in creating versatile, cost-effective wearable health monitoring systems.

Nocturnal sentry duty and cardiometabolic characteristics in armed forces personnel.

Sleep deprivation can lead to increased body weight and blood pressure (BP), but the latent effects of partial sleep deprivation related to required night sentry duties within a short-term period on cardiometabolic characteristic changes in military personnel are unclear. To investigate the association between night sentry duty frequency in the past 3 months and cardiometabolic characteristics in armed forces personnel. A total of 867 armed forces personnel who were aged 18-39 years and did not take any antihypertensive medications in Taiwan in 2020 were included. The frequency of night sentry duty was self-reported via a questionnaire (average number of night sentry shifts per month for the past 3 months). Hemodynamic status was assessed via the resting BP and pulse rate (PR). Cardiometabolic risk factors were defined according to the International Diabetes Federation criteria. Multivariable linear regression analyses of the associations between night sentry duties and PR, BP, and other metabolic syndrome (MetS) marker levels were performed, with adjustments for age, sex, substance use, body mass index and aerobic fitness. Multiple logistic regression analysis was carried out to determine the associations between night sentry duties and the prevalence of each MetS feature. There was an association between night sentry duties and PR [standardized β (standard error) = 0.505 (0.223), P =0.02], whereas there was no association with systolic and diastolic BP. In addition, there was an inverse association between night sentry duties and high-density lipoprotein cholesterol (HDL-C) levels [standardized β = -0.490 (0.213), P = 0.02], whereas there was no association with the other metabolic marker levels. Compared with personnel without night sentry duties, those with ≥ 1 night sentry shift/month had a greater risk of impaired fasting glucose (≥ 100 mg/dL) [odds ratio: 1.415 (confidence interval: 1.016-1.969)], whereas no associations with other MetS features were found. Among military personnel, the burden of night sentry duty was positively associated with the resting PR but inversely associated with HDL-C levels. In addition, personnel with partial sleep deprivation may have a greater risk of impaired fasting glucose than those without partial sleep deprivation.

Causal Associations with Arterial Stiffness and Sarcopenia: A Mendelian Randomization Analysis.

Observational studies and clinical trials indicate a link between arterial stiffness (AS) and sarcopenia (SAR), yet the causal relationship between these remains unclear. The study aims to investigate the causal connection from AS to SAR by Mendelian randomization (MR). We analyzed Genome-Wide Association Studies data for AS indicators: pulse wave arterial stiffness index (PWASI) and pulse wave peak-to-peak time (PPT), and SAR indicators: low hand grip strength (LHGS), usual walking pace (UWP), moderate-to-vigorous physical activity levels (MVPA), and walk or cycle unassisted for 10 minutes. The inverse variance-weighted, MR-Egger, weighted mode, and weighted median were applied to MR. There is a bidirectional causal relationship between the AS and SAR. The PWASI has a causation with UWP (odds ratio [OR] = 0.97, 95% confidence interval [CI] = 0.94-0.99). The PPT has a causal association with MVPA (OR = 1.08, 95% CI = 1.002-1.144) and UWP (OR = 1.05, 95% CI = 1.017-1.096). The LHGS is causally associated with PPT (OR = 0.95, 95% CI = 0.91-0.98) and UWP has a causal association with PWASI (OR = 0.77, 95% CI = 0.65-0.90) and PPT (OR = 1.37, 95% CI = 1.17-1.60). The increased AS could reduce the motor ability slightly and the lower upper and lower limb strength could lead to the higher AS. This bidirectional causal relationship of the two may offer novel perspectives for advancing the understanding of the underlying mechanisms related to AS and muscle pathophysiology.

Data analysis protocol for early autonomic dysfunction characterization after severe traumatic brain injury.

Traumatic brain injury (TBI) disrupts normal brain tissue and functions, leading to high mortality and disability. Severe TBI (sTBI) causes prolonged cognitive, functional, and multi-organ dysfunction. Dysfunction of the autonomic nervous system (ANS) after sTBI can induce abnormalities in multiple organ systems, contributing to cardiovascular dysregulation and increased mortality. Currently, detailed characterization of early autonomic dysfunction in the acute phase after sTBI is lacking. This study aims to use physiological waveform data collected from patients with sTBI to characterize early autonomic dysfunction and its association with clinical outcomes to prevent multi-organ dysfunction and improving patient outcomes. This data analysis protocol describes our pre-planned protocol using cardiac waveforms to evaluate early autonomic dysfunction and to inform multi-dimensional characterization of the autonomic nervous system (ANS) after sTBI. We will collect continuous cardiac waveform data from patients managed in an intensive care unit within a clinical trial. We will first assess the signal quality of the electrocardiogram (ECG) using a combination of the structural image similarity metric and signal quality index. Then, we will detect premature ventricular contractions (PVC) on good-quality ECG beats using a deep-learning model. For arterial blood pressure (ABP) data, we will employ a singular value decomposition (SVD)-based approach to assess the signal quality. Finally, we will compute multiple indices of ANS functions through heart rate turbulence (HRT) analysis, time/frequency-domain analysis of heart rate variability (HRV) and pulse rate variability, and quantification of baroreflex sensitivity (BRS) from high-quality continuous ECG and ABP signals. The early autonomic dysfunction will be characterized by comparing the values of calculated indices with their normal ranges. This study will provide a detailed characterization of acute changes in ANS function after sTBI through quantified indices from cardiac waveform data, thereby enhancing our understanding of the development and course of eAD post-sTBI.

Photonic-Assisted Multi-Tone Microwave Frequency Measurement Based on Pulse Identification

We report a photonic-assisted method for measuring the frequencies of a multi-tone microwave with high accuracy based on pulse identification. The unknown microwave signal and a linearly chirped signal are modulated to an optical carrier using a dual-polarization Mach–Zehnder modulator. Carrier-suppressed single-sideband modulation avoids the generation of undesired frequency components after photodetection. An electrical bandpass filter with a narrow bandwidth selects the beat signal between the unknown signal and the linearly chirped optical tone. A pulse, generated by the beat signal, can be observed using an oscilloscope (OSC). By identifying the beating pulse position, we can accurately determine the frequency of the unknown signal. The single-tone and multi-tone microwave signal ranges of 6–16 GHz and 26–36 GHz are successfully measured, respectively. The measurement errors for single-tone and multi-tone signals are both less than ±1 MHz.