Heart Rate Research Articles

Increased sound levels in the cardiac ICU are associated with an increase in heart rate, blood pressure, and sedation.

Several organizations including the Environmental Protection Agency, World Health Organization and American Academy of Pediatrics recommend that hospital sound levels not exceed 45 decibels. Yet, several studies across multiple age groups have observed higher than recommended levels in the intensive care setting. Elevated sound levels in hospitals have been associated with disturbances in sleep, patient discomfort, delayed recovery, and delirium. We measured sound levels in a pediatric cardiac intensive care unit and collected vital signs data, sedation dosing and delirium scores. During a 5-week study period, sound levels for 68 patients in 22 private and 4 semi-private rooms were monitored. Sound levels were consistently above stated recommendations with an average daytime level of 50.6 decibels (maximum, 76.9 decibels) and an average nighttime level of 49.5 decibels (maximum, 69.6 decibels). An increase in average and maximum sound levels increased the probability of sedation administration the following hour (p-value < 0.001 and 0.01, respectively) and was predictive of an increase in heart rate and blood pressure (p-value < 0.001). Sound levels in the CICU were consistently higher than recommended. An increase in heart rate, blood pressure and sedation utilization may suggest a stress response to persistent and sudden loud sounds. Given known negative impacts of excessive noise on stress, sleep, and brain development, as well as the similar adverse effects from the related use of sedative medications, reducing excessive and sudden noise may provide an opportunity to improve short- and long-term hemodynamic and neurodevelopmental outcomes in the pediatric cardiac intensive care unit.

Reassessing Ivabradine: Potential Benefits and Risks in Atrial Fibrillation Therapy.

Ivabradine has been identified as a funny current (If) inhibitor in the sinoatrial node (SAN) and is considered an advocated therapeutic agent in chronic heart failure and stable angina. This therapeutic agent has shown positive benefits in maintaining a reduction in heart rate while sustaining hemodynamic stability. Its clinical application is still evolving and the mechanism of action is becoming clearer daily. The use of this agent to manage atrial fibrillation (AF) has recently been brought under discussion. This study summarizes the mechanism of action of ivabradine and current evidence about the risk of new-onset AF and rate-lowering potential as a therapeutic option in patients suffering from AF. This review synthesizes findings from preclinical studies, case reports, and clinical trials that assess ivabradine's efficacy in controlling heart rate and its association with new-onset AF. Studies have shown that this medication may be beneficial in ventricular rate reduction in patients intolerant of first-line AF therapeutic options, including non-dihydropyridine calcium channel blockers and β-blockers. However, it is important to state that ivabradine-treated patients with cardiovascular diseases demonstrated an increased risk for new-onset AF compared with those patients who did not receive it. While ivabradine demonstrates promise as a therapeutic option for rate control in patients with AF, its use is accompanied by a notable risk of new-onset AF. Further studies should focus on optimal dosing strategies and long-term outcomes of ivabradine treatment in AF management.

Male rats emit aversive 44-kHz ultrasonic vocalizations during prolonged Pavlovian fear conditioning.

Rats are believed to communicate their emotional state by emitting two distinct types of ultrasonic vocalizations. The first is long '22-kHz' vocalizations (>300 ms, <32-kHz) with constant frequency, signaling aversive states, and the second is short '50-kHz' calls (<150 ms, >32 kHz), often frequency-modulated, in appetitive situations. Here, we describe aversive vocalizations emitted at a higher pitch by male Wistar and spontaneously hypertensive rats (SHR) in an intensified aversive state - prolonged fear conditioning. These calls, which we named '44-kHz' vocalizations, are long (>150 ms), generally at a constant frequency (usually within 35-50-kHz range) and have an overall spectrographic image similar to 22-kHz calls. Some 44-kHz vocalizations are comprised of both 22-kHz-like and 44-kHz-like elements. Furthermore, two separate clustering methods confirmed that these 44-kHz calls can be separated from other vocalizations. We observed 44-kHz calls to be associated with freezing behavior during fear conditioning training, during which they constituted up to 19.4% of all calls and most of them appeared next to each other forming uniform groups of vocalizations (bouts). We also show that some of rats' responses to the playback of 44-kHz calls were more akin to that of aversive calls, for example, heart rate changes, whereas other responses were at an intermediate level between aversive and appetitive calls. Our results suggest that rats have a wider vocal repertoire than previously believed, and current definitions of major call types may require reevaluation. We hope that future investigations of 44-kHz calls in rat models of human diseases will contribute to expanding our understanding and therapeutic strategies related to human psychiatric conditions.

Comparison of the Effect of Maternal Breast Milk Odor, Facilitated Tucking, and Nonnutritive Sucking Applied to Preterm Neonates During Heel Stick on Pain and Physiological Parameters: A Randomized Controlled Trial.

Background: Preterm infants in the neonatal intensive care unit (NICU) frequently undergo painful procedures, which can lead to both short-term and long-term complications, including potential mortality. Effective pain management is crucial in this context. Although numerous studies have explored non-pharmacological pain relief methods for preterm infants, no research has simultaneously compared the effects of maternal breast milk odor, facilitated tucking, and nonnutritive sucking. Aim: This study aims to comparatively investigate the efficacy of nonnutritive sucking, facilitated tucking, and maternal breast milk odor in reducing pain in preterm neonates during heel sticks. Methods: A randomized controlled trial was conducted in a tertiary-level NICU with 144 preterm neonates (gestational age 31-36 weeks) requiring heel sticks. The infants were randomly assigned to four groups: control, nonnutritive sucking, facilitated tucking, and maternal breast milk odor. Pain and physiological parameters were assessed through video recordings of the procedures and scored at 1-minute intervals using the Premature Infant Pain Profile and Data Evaluation Form. Data were collected at baseline and at 1, 2, and 3 minutes before, during, and after the heel stick. Results: The study found significant effects of the interventions on physiological parameters and pain (heart rate: F = 7.5, p < 0.001; oxygen saturation: F = 16.39, p < 0.001; respiratory rate: F = 6.56, p < 0.001; pain: F = 61.45, p < 0.001). Facilitated tucking resulted in significantly lower pain scores (6.61 ± 1.44) compared with the control group (14.22 ± 3.61), maternal breast milk odor (12.22 ± 3.08), and nonnutritive sucking (10.41 ± 1.71) (p < 0.001). Conclusions: All interventions demonstrated effectiveness in maintaining physiological stability and alleviating pain. Nevertheless, the intervention identified as most effective in reducing pain was facilitated tucking group.

Acute GLP-1 Agonism Induces Arrhythmogenic Electrical Activity in Aged Mice Heart Through Impaired Cellular Na+ and Ca2+ Handlings: TheRole of CK2 Hyperphosphorylation.

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are known for their benefits in conditions like cardiovascular diseases in type 2 diabetes and obesity. They also show promise for aging-related conditions with minimal side effects. However, their impact on cardiovascular risk is still debated. Notably, some long-acting GLP-1RAs cause a sustained increase in heart rate on the first day of use without a clear mechanism. To understand their short-term effects, we examined acute GLP-1R agonism on the electrical activity of elderly hearts. In this study, we utilized in vivo electrocardiography, in vitro cellular electrophysiology experiments, and biochemical measurements on heart preparations from 6-month-old (Adult) and 24-month-old (aged) BALB/c mice. A single liraglutide injection (0.3 mg/kg) induced repetitive, self-sustained arrhythmogenic electrocardiograms in aged mice (24 months old) but had no effect on adults (6 months old) within the first 10 minutes. Acute application of liraglutide to isolated ventricular cardiomyocytes from aged mice significantly prolonged the late phase of action potential repolarization (APR90). This was due to suppressed K+ currents and increased persistent Na+currents (Late-INa), primarily through delayed recovery from inactivation of Na+ currents. Additionally, liraglutide increased Ca2+ spark frequency and wave formation by enhancing Ca2+ release from the sarcoplasmic reticulum, affecting both Na+ and Ca2+ regulation in aging cells. Liraglutide also induced casein kinase 2 (CK2) hyperphosphorylation in aged cardiomyocytes, which a CK2 inhibitor could reverse, normalizing APR90 by reducing Late-INa and enhancing K+ currents. These findings reveal that acute GLP-1R agonism can disrupt electrical signaling and induce arrhythmia in aged mice through CK2 hyperphosphorylation, providing new insights into the cardiovascular effects of GLP-1RAs in the elderly.

Utilizing deep learning-based causal inference to explore vancomycin's impact on continuous kidney replacement therapy necessity in blood culture-positive intensive care unit patients.

Patients with positive blood cultures in the intensive care unit (ICU) are at high risk for septic acute kidney injury requiring continuous kidney replacement therapy (CKRT), especially when treated with vancomycin. This study developed a machine learning model to predict CKRT and examined vancomycin's impact using deep learning-based causal inference. We analyzed ICU patients with positive blood cultures, utilizing the Medical Information Mart for Intensive Care III data set. The primary outcome was defined as the initiation of CKRT during the ICU stay. The machine learning models were developed to predict the outcome. The deep learning-based causal inference model was utilized to quantitatively demonstrate the impact of vancomycin on the probability of CKRT initiation. Logistic regression was performed to analyze the relationship between the variables and the susceptibility of vancomycin. A total of 1,318 patients were included in the analysis, with 41 requiring CKRT. The Random Forest and Light Gradient Boosting Machine exhibited the best performance, with Area Under Curve of Receiver Operating Characteristic Curve values of 0.905 and 0.886, respectively. The deep learning-based causal inference model demonstrated an average 7.7% increase in the probability of CKRT occurrence when administrating vancomycin in total data set. Additionally, that younger age, lower diastolic blood pressure, higher heart rate, higher baseline creatinine, and lower bicarbonate levels sensitized the probability of CKRT application in response to vancomycin treatment. Deep learning-based causal inference models showed that vancomycin administration increases CKRT risk, identifying specific patient characteristics associated with higher susceptibility.IMPORTANCEThis study assesses the impact of vancomycin on the risk of continuous kidney replacement therapy (CKRT) in intensive care unit (ICU) patients with blood culture-positive infections. Utilizing deep learning-based causal inference and machine learning models, the research quantifies how vancomycin administration increases CKRT risk by an average of 7.7%. Key variables influencing susceptibility include baseline creatinine, diastolic blood pressure, heart rate, and bicarbonate levels. These findings offer insights into managing vancomycin-induced kidney risk and may inform patient-specific treatment strategies in ICU settings.

A Retrospective Study to Investigate the Relationship Between Body Mass Index and Hemodynamic Characteristics in Hypertensive Patients.

The relationship between hemodynamic parameters and body mass index (BMI) in the context of blood pressure regulation in hypertension is unclear. Here, we analyzed data from 1368 uncontrolled hypertensive patients, including key hemodynamic indicators such as heart rate (HR), cardiac index (CI), arterial stiffness (AS), systemic vascular resistance index (SVRI), and thoracic blood ratio (TBR). In this cohort, the average BMI across all hypertension patients was 26.859±3.897 (kg/m2), with obese patients (BMI≥28kg/m2) averaging 31.01±2.87kg/m2 and non-obese (BMI<28kg/m2) averaging 24.70±2.28kg/m2. Younger obese patients exhibited higher diastolic pressures than non-obese peers (p<0.01). Hemodynamic analysis showed obese patients had increased HR and SVRI but lower CI and AS (p<0.01). Hypertensive males aged under 60 with obesity displayed a more prominent peripheral vascular phenotype (p<0.05) and volemic phenotype (p<0.01) than non-obese males. Obese females aged under 60 showed a higher incidence of cardiac phenotype (p<0.01). Across genders, obese hypertensive patients aged over 60 had a greater prevalence of volemic phenotype than non-obese patients (p<0.05, p<0.01, respectively). BMI inversely correlated with CI and positively with SVRI across age and gender categories (p<0.01). Taken together, we find that patients with hypertension exhibit diverse hemodynamic profiles, and BMI significantly correlates with hemodynamic parameters such as SVRI and CI. Our research identifies BMI as a valuable target for personalized hypertension treatment.

The Assessment of Muscle Strength and Cardiorespiratory Parameters Using Simple Tests in Older Adults With Recovery From Mild COVID-19.

To evaluate muscle strength and cardiorespiratory parameters, this study uses simple tests in older adults, including those who have and have not recovered from mild coronavirus disease 2019 (COVID-19). Eighty older adults (age≥60 years old) were divided into two groups: those without previous COVID-19 (control group, n=40) and those with recovery from mild COVID-19 (recovered group, n=40). Muscle strength was assessed using a handgrip strength test and the sit-to-stand test (STS10). Cardiorespiratory parameters were evaluated with a 1-minute sitto- stand (1-min STS) test and a 6-minute walk test (6MWT). Both groups had normal values for body mass index, blood pressure, heart rate, and pulse oxygen saturation. The recovered group showed significant differences in handgrip strength test (24.73±6.99 vs. 22.03±4.36, p=0.041) and duration for the STS10 (25.15±6.11 vs. 33.40±7.56, p<0.001) when compared to the control group. Furthermore, the recovered group had significantly decreased repetitions of a 1-min STS (31.38±4.89 vs. 21.25±3.64, p<0.001) and increased the rate of perceived exertion (RPE) (7.43±1.20 vs. 8.95±1.01, p=0.01) and leg fatigue (1.49±1.13 vs. 3.00±1.04, p=0.03) after performing a 1-min STS when compared with the control group. Moreover, the recovered group had also significantly decreased distances for the 6MWT (421.68±8.28 vs. 384.35±6.17, p<0.001) and increased the post-test RPE (7.63±1.37 vs. 12.05±1.63, p<0.001) and the post-test leg fatigue (1.71±0.88 vs. 5.28±0.91, p<0.001) compared with the control group. Older adults with recovery from mild COVID-19 reported reduced muscle strength and exercise tolerance when compared with older adults without COVID-19.

A propensity score-adjusted HRV analysis of social avoidance and distress in patients with panic disorders.

Panic disorder (PD) may accompany elevated social avoidance and distress (SAD). Higher SAD in patients with PD predicts a poorer prognosis and response to treatment. As heart rate variability (HRV) reflects the self-regulatory capacity underlying SAD, applying HRV to distinguish PD heterogeneity would be clinically beneficial in formulating personalized treatment strategies. We hypothesized that HRV would be lower in patients with PD and severe SAD (PD-SAD group) than in those without SAD (PD group). A total of 288 patients met the eligibility criteria, with complete collection of variables of interest and HRV. The inverse probability of treatment weighting (IPTW) method was used to balance the groups for the baseline characteristics of patients. Following IPTW adjustment, the average treatment effects were computed using inverse propensity weighting with regression adjustment (IPW-RA). All characteristics were similar in both groups after IPTW adjustment. The PD-SAD group showed a decreased tendency in time domain parameters, including mean heart rate, SDNN, RMSSD, and pNN50 with a nonlinear domain of SD1. However, no significant intergroup differences were observed in the frequency domain. Higher SAD in PD was associated with reduced HRV, mainly in the time domain, which may be attributed to the shared neural networks between dysfunctional self-regulation statuses, as indexed by reduced HRV. As respiratory sinus arrhythmia is mainly reflected in the frequency domain, the time domain may be more reliable for identifying heterogeneity within patients with PD, who are frequently associated with respiratory pattern abnormalities.

Fetal death: Expert consensus of the French College of Obstetricians and Gynecologists.

Fetal death is defined as the spontaneous cessation of cardiac activity after 14 weeks gestational age (GA). Regarding prevention of fetal death in the general population, it is not recommended to counsel or prescribe rest, aspirin, vitamin A, vitamin D, or micronutrient supplementation; systematically look for nuchal cord during prenatal screening ultrasound; or perform systematic antepartum monitoring by cardiotocography for the sole purpose of reducing the risk of fetal death. It is recommended to offer vaccination against influenza in epidemic periods and against SARS-CoV-2. Regarding evaluation in the event of fetal death, it is recommended that a fetal autopsy and anatomopathologic examination of the placenta be performed; chromosomal analysis be performed by microarray testing, rather than by conventional karyotype (with postnatal sampling of the fetal placental surface preferred for genetic purposes); testing for antiphospholipid antibodies be performed, with systematic Kleihauer-Betke testing and for irregular agglutinins; and summary consultation to discuss these examination results be offered. Regarding announcement and support, it is recommended that fetal death be announced without ambiguity, using simple words adapted to each situation, after which the couple should be supported with empathy across the different stages of their care. Regarding patient management in cases of fetal death, it is recommended that: in the absence of risks for disseminated intravascular coagulation or maternal demise, the patient's wishes regarding the timing between the fetal death diagnosis and labor induction should be considered; return home is possible, according to the patient's wishes; in all situations except maternal life-threatening emergencies, the preferred mode of delivery is vaginal, regardless of previous cesarean section(s); mifepristone 200 mg be prescribed at least 24 h before induction; and perimedullary analgesia be initiated at the start of induction if requested by the patient, regardless of GA. Of note, there is insufficient evidence to recommend either the administration route (i.e., vaginal or oral) of misoprostol or prostaglandin type. Regarding the risk of recurrence after unexplained fetal death: the incidence does not appear to be increased in subsequent pregnancies; in cases with a history of fetal death due to vascular problems, low-dose aspirin is recommended to reduce perinatal morbidity (otherwise, evidence is insufficient to recommend the prescription of aspirin); no optimal delay in initiating another pregnancy should be recommended based solely on a history of fetal death; fetal heart rate monitoring is not indicated based solely on a history of fetal death; although systematic labor induction is not recommended, induction may be considered depending on the context and parental request, and considering fetal age, benefits, and risks, especially before 39 weeks GA. Note that if the cause of fetal death is identified, management should be adjusted on a case-by-case basis. Regarding fetal death in a twin pregnancy, it is recommended that the surviving twin be examined immediately upon fetal death diagnosis; in a dichorionic twin pregnancy, preterm delivery induction is not recommended; in a monochorionic twin pregnancy, the surviving twin should be immediately evaluated for signs of acute fetal anemia, with weekly ultrasound monitoring for the first month, though immediate labor induction is not recommended.

A prospective, self-controlled study of sub-plateau heart rate variability in healthy adults

BackgroundThe low-pressure, hypoxic environment characteristic of high-altitude regions significantly affects the cardiovascular and autonomic nervous system functions of individuals, consequently impairing their sleep quality. Heart rate variability, a non-invasive indicator of autonomic nervous system activity and balance within the cardiovascular system, has not been thoroughly investigated in terms of its patterns during acclimatization and de-acclimatization phases for individuals traveling to and residing in high-altitude areas and its relationship with sleep stability.MethodsData was collected from 22 medical staff members who traveled from Chengdu to Yecheng, with measurements taken before leaving Chengdu, 1 week in Yecheng, 3 months in Yecheng, and 1 week after returning to Chengdu. The study analyzed changes in heart rate variability during acclimatization and de-acclimatization at 1,400 m above sea level. It also examined arrhythmia and sleep disorders based on circadian groups.Results1. Following 1 week of acclimatization to the sub-plateau environment of Yecheng, significant decreases were observed in SDANN, SDNN and SD2 indices compared to departure from Chengdu (P &amp;lt; 0.05). After 3 months of sub-plateau acclimatization, these indices significantly increased (P &amp;lt; 0.05). Upon returning to Chengdu and undergoing de-acclimatization for 1 week, these indices further significantly increased (P &amp;lt; 0.05). 2. During the period of sub-plateau acclimatization and de-acclimatization, significant changes were noted in average heart rate and minimum heart rate (P &amp;lt; 0.05), with the average heart rate showing a continuous decrease and the minimum heart rate exhibiting an initial increase followed by a decrease. No significant changes were observed in maximum heart rate or the incidence of arrhythmias (P &amp;gt; 0.05). 3. When stratified by day and night, the trends for SDANN, RMSSD, and TP were consistent with the overall trend at night (P &amp;lt; 0.05), but opposite during the day (P &amp;lt; 0.05). 4. During the sub-plateau acclimatization period, stable sleep duration was significantly reduced, and increased markedly after de-acclimatization, although it did not return to pre-acclimatization levels (P &amp;lt; 0.05).ConclusionAcclimatization to the sub-plateau environment of Yecheng affects the autonomic nervous system, heart rate, and sleep in healthy adults. De-acclimatization can ameliorate these effects. Furthermore, the impact of sub-plateau acclimatization on the autonomic nervous system exhibits a distinct circadian rhythmicity.

Comparison of Hemodynamic Responses to Ketofol versus Etomidate During Anesthesia Induction in Elderly Patients

Background: Nausea While elderly patients are at an increased risk of perioperative morbidity and mortality; old age alone is not a contraindication for surgery. General factors that should be considered in preoperative risk assessments include age, functional status, cognition, nutritional status, and comorbidities, such as cardiac, pulmonary, renal, and endocrine disorders. Induction of anesthesia is a critical step in surgery, particularly for elderly patients and those with a high physical status. Commonly used drugs for this purpose include etomidate and propofol. Therefore, this study aimed to compare the impact of Ketofol versus etomidate alone on the hemodynamic status of patients who fall under the ASA class II or higher. Methods: The study was a prospective randomized double-blind clinical trial, with a study population of age of ≥65 years, ASA physical status class II or higher, that were randomized into two groups. Ketofol (n=45) and, Etomidate (n=45) groups. Patients followed for clinical outcomes including their hemodynamic status during the induction period. Results: The present study showed that, the examination of hemodynamic parameters up to 10 minute after laryngoscopy showed that none of these parameters were significantly different between the two groups, while immediately after anesthesia induction, heart rate and blood pressure were found to be significantly different. However, there was no significant difference in terms of SPO2 among the two groups in any given interval. Conclusion: The results of the present study revealed that Ketofol resulted in better regulation and stability of blood pressure and heart rate in patients undergoing endotracheal intubation, compared to etomidate alone.

Effects of Transcranial Electrical Stimulation on Physiological Responses to Acute Stress: A Systematic Review

AbstractPhysiological responses to acute stress generally proceed through two phases: first, a rapid and transient sympathetic and parasympathetic nervous system response, and second, a slow and relatively sustained hypothalamic-pituitary-adrenal (HPA) response. These responses are associated with changes in heart rate, heart rate variability, electrodermal responses, blood pressure, and salivary biomarkers such as alpha amylase and cortisol. Through the interactions of biochemical responses to stress and distributed brain regions including the amygdala, hippocampus, striatum, and prefrontal cortex, acute stress exposure can also adversely affect cognitive function. Transcranial electrical stimulation (tES), including transcranial direct, alternating, and random noise stimulation (tDCS, tACS, tRNS), has been examined for its potential ability to modulate physiological responses to stress and buffer negative impacts of stress on cognitive function. This systematic review surveyed research examining the effects of tES on physiological responses to acute stress in healthy neurotypical samples, examining cardiorespiratory (e.g., blood pressure, heart rate), peripheral (e.g., electrodermal), and biochemical (e.g., alpha amylase, salivary cortisol) outcomes. Sixteen reports were identified for inclusion. The articles showed low to high risk of bias, used a diverse set of acute stress induction techniques and tES methodologies, and examined a wide range of physiological outcomes. We found mixed evidence for the effectiveness of tES in reducing acute stress responses, and suggest that some tES methodologies may be more promising than others. Several directions for continuing research are proposed to help elucidate the mechanisms underlying tES effects on acute stress responses and clarify its potential for application to cognitive enhancement domains.

Effect of a Virtual Biophilic Residential Environment on the Perception and Responses of Seniors

This study investigates the effects of a virtual biophilic residential environment on seniors’ physiological and subjective responses to evaluate its potential to promote healing and recovery. Thirty seniors were exposed to three different scales (units, buildings, complexes) of virtual biophilic residential environments that combined both physical and digital biophilic elements. Physiological responses, including heart rate, heart rate variability, and galvanic skin response, were measured alongside self-reported levels of satisfaction and immersion. The primary objective was to assess the effectiveness of physical and digital design interventions at each residential scale. The findings revealed that the virtual biophilic residential environment reduced physiological stress in seniors, with the most significant impact observed at the unit scale. Digital design interventions further enhance stress relief benefits, indicating that integrating physical and digital elements in biophilic residential environments can positively influence seniors’ stress levels. Additionally, significant correlations were identified between physiological responses and subjective perceptions of immersion and satisfaction. This study is valuable as an initial comparative analysis of the effectiveness of physical and digital approaches in biophilic design. This paper is a preliminary study and is significant in that it systematizes virtual environment research from an age-friendly perspective and expands approaches to biophilic design.

Relationship Between Intensive Passive Data Signals and Patterns of Binge-Eating Behaviors: From a Dynamical-System Approach

In this study, we investigate using passive data, specifically heart rate and actigraphy, for individuals with binge-type eating disorders such as bulimia nervosa (BN) and binge-eating disorder (BED). By applying dynamical-system theory and incorporating advancements in technology-based health care, we explored the relationship between passive data patterns as potential indicators of binge-eating episodes. Over 30 days, 1,019 participants with BN or BED symptoms used the Recovery Record app on iPhone and Apple Watches for real-time eating-behavior logging. Apple Watches simultaneously recorded heart rate and actigraphy. Results show no marked difference in heart and step averages 2 hr before a binge versus a control period. However, significant momentum and stability differences emerged when examining the changing dynamics leading up to a binge event. These findings suggest that the stability of step, rather than their average value, may serve as a detectable indicator of approaching binge events.

Cardiac function monitoring during marathon training based on smart medical wearable sensor device

In recent years, intelligent wearable sensor devices have developed rapidly and can be seen everywhere in daily life. With the rapid development of electronic components and the continuous improvement of their performance, intelligent wearable intelligent products have gradually become possible and have shown explosive growth. In addition, intelligent wearable electronic devices have many advantages that traditional devices do not have. With the popularity of fitness wearable devices, intelligent wearable devices can also be used for real-time heart rate and dynamic electrocardiogram (ECG) monitoring during marathon sports. It can effectively prevent sudden death. During marathon training and other health services, it is very important to use intelligent wearable sensor devices to monitor heart function. This paper puts forward a heart function monitoring system for marathon training based on intelligent wearable sensor, expounds the origin of marathon sports and the importance of heart function monitoring for marathon athletes during training. This paper discusses the technology and construction method of heart rate monitoring system based on intelligent wearable sensor device. At the same time, relevant experiments are carried out to verify the relevant performance of the intelligent wearable sensor device in the algorithm. The results show that the R wave detection accuracy of wearable devices based on traditional algorithms is usually between 92% and 93%. The R wave detection accuracy of the intelligent wearable sensor device improved by the algorithm in this paper has been improved to more than 97%, and the R wave detection accuracy of the algorithm in this paper is much higher than that of the traditional algorithm. This also reflects the effectiveness of the intelligent wearable sensor device of the algorithm during the training of marathon athletes.

Synergistic Doping Strategy with Novel Multi-Carbonyl Conductive Polymer Enables Stable Self-Powered Perovskite Photodetectors.

Lead halide perovskites hold immense promise for optoelectronic applications but still suffer from instability caused by defects. The defects are mainly generated from the film fabrication processes and halide ion migration during long-term storage. Here, a synergistic doping strategy is proposed to enhance the stability of perovskites. A novel multi-carbonyl conductive polymer, poly(benzodifurandione) (PBFDO), is incorporated into the precursor solution to effectively passivate the unoccupied Pb2+ defects in perovskite films and promote the continuous growth of perovskites. An organic iodide, thiophene-2-ethylammonium iodide (TEAI), is doped in the transport layer to inhibit the halide ion migration and enhance the stability of perovskites synergistically. Self-powered photodetectors are constructed with improved stability, maintaining ≈90% of their initial photocurrents after being stored for ≈87 days in a humid atmosphere with 60% relative humidity. The optimized photodetectors show a high detectivity of 8.1×1012 Jones at 680 nm wavelength, wide linear dynamic range of 121.9 dB, and fast response with a rise/fall time of 1.92/1.17µs. A reflection-mode perovskite photoplethysmography testing system is developed, achieving high heart rate testing capabilities. This work suggests the great potential of perovskite photodetectors for noninvasive medical monitoring applications.

Clinical Outcomes of Using Dexmedetomidine, ProDex and Popfol for Sedation during Mechanical Ventilation in Patients Hospitalized in the Intensive Care Unit: A Triple Blinded Clinical Trial

Background: Sedation plays a crucial role in the care of intensive care unit (ICU) patients, addressing the challenges presented by factors such as agitation, anxiety, and delirium, particularly during mechanical ventilation (MV). Dexmedetomidine and propofol are commonly used sedatives, each with its unique characteristics and side effects. Combining these agents has been proposed to optimize effectiveness and minimize adverse effects. This study aims to compare the efficacy of the dexmedetomidine-propofol combination with dexmedetomidine alone and propofol alone for sedation during mechanical ventilation in ICU patients. Methods: A triple-blinded clinical trial was conducted in Isfahan, Iran, involving patients eligible for spinal fusion surgery and mechanical ventilation. Patients were randomized into three groups: dexmedetomidine alone (DO), propofol alone (PO), and a combination of both drugs (DP) dexmedetomidine-propofol (ProDex). Various dosages and infusion protocols were carefully administered, and patients were assessed for demographic and clinical variables. Hemodynamic parameters and sedation levels were monitored, and statistical analysis was performed. Results: The study involved 87 patients, with the ProDex group demonstrating the shortest mechanical ventilation duration. Hemodynamic stability was observed in the ProDex group, with significantly lower systolic blood pressure and heart rate compared to other groups. Sedation scores did not differ significantly among groups, suggesting similar sedative effects. The ProDex group exhibited favorable outcomes despite differences in hemodynamic variables. Conclusion: The dexmedetomidine-propofol combination appears effective in minimizing side effects associated with monotherapy sedation, leading to favorable clinical outcomes. This study contributes valuable insights into optimizing sedation strategies for mechanically ventilated ICU patients.

Differences in Network Functional Connectivity in Response to Sub-Symptomatic Exercise Between Elite Adult Athletes after Sport-Related Concussion and Healthy Matched Controls: A Pilot Study.

Resting-state electroencephalography (rsEEG) has developed as a method to explore functional network alterations related to sport-related concussion (SRC). Although exercise is an integral part of an athlete's return to sport (RTS) protocol, our understanding of the effects of exercise on (impaired) brain network activity in elite adult athletes is limited. However, this information may be beneficial to inform recovery and RTS progressions. Recording (128-channel) rsEEG datasets before and after a standardized moderate aerobic bike exercise test, this study aimed to explore functional connectivity patterns in whole brain and relevant functional networks in a group of elite adult athletes post-injury compared with healthy matched controls. The following networks were selected a priori: whole brain (68 regions of interest [ROIs]), default mode network (14 ROIs), central autonomic network (CAN, 24 ROIs), and visual network (8 ROIs). Twenty-one SRC athletes and 21 age-, sex-, sport type-, and skill level-matched healthy controls participated in this study. The SRC athletes were recruited during their RTS protocol (days since injury: 2-140 days). All athletes were able to achieve the exercise goal of reaching a moderate intensity (70% of their age-calculated maximum heart rate) while staying sub-symptomatic. Before and after exercise, functional connectivity was calculated by the phase locking value, in the alpha band (7-13 Hz). Mann-Whitney U and Wilcoxon signed rank tests were used to explore neurophysiological differences between and within groups, respectively. Whole-brain connectivity increased significantly from pre- to post-exercise within both groups (SRC: 0.264-0.284; p = 0.011 vs. controls: 0.253-0.257; p = 0.011). While CAN connectivity significantly increased only within the SRC group from pre-(0.298) to post-exercise (0.317; p = 0.003). Although all athletes reached their exercise goal without exacerbation of symptoms, the impact of exercise on the CAN appears to be greater for the SRC athletes, than matched healthy controls. The potential clinical significance of this finding is that it may have revealed an underlying mechanism for the cardiac autonomic alterations post-injury. This study merits further investigation into the CAN, as a network of interest more closely aligned with the clinical features (e.g., autonomic dysfunction) during athletes' RTS.

REM disruption and REM vagal activity predict extinction recall in trauma-exposed individuals.

Accumulating evidence suggests that rapid eye movement sleep (REM) supports the consolidation of extinction memory. REM is disrupted in posttraumatic stress disorder (PTSD), and REM abnormalities after traumatic events increase the risk of developing PTSD. Therefore, it was hypothesized that abnormal REM in trauma-exposed individuals may pave the way for PTSD by interfering with the processing of extinction memory. In addition, PTSD patients display reduced vagal activity. Vagal activity contributes to the strengthening of memories, including fear extinction memory, and recent studies show that the role of vagus in memory processing extends to memory consolidation during sleep. Therefore, it is plausible that reduced vagal activity during sleep in trauma-exposed individuals may be an additional mechanism that impairs extinction memory consolidation. However, to date, the contribution of sleep vagal activity to the consolidation of extinction memory or any emotional memory has not been investigated. Trauma-exposed individuals (n = 113) underwent a 2-day fear conditioning and extinction protocol. Conditioning and extinction learning phases were followed by extinction recall 24 h later. The association of extinction recall with REM characteristics and REM vagal activity (indexed as heart rate variability) during the intervening consolidation night was examined. Consistent with our hypotheses, REM disruption was associated with poorer physiological and explicit extinction memory. Furthermore, higher vagal activity during REM was associated with better explicit extinction memory, and physiological extinction memory in males. These findings support the notion that abnormal REM, including reduced REM vagal activity, may contribute to PTSD by impairing the consolidation of extinction memory.