Blood Heart Research Articles

Role of the peripheral chemoreceptors in cardiovascular and metabolic control in type 2 diabetes.

Preclinical work supports a role for the peripheral chemoreceptors in the progression of cardiovascular and metabolic pathologies. In the present study, we examined peripheral chemosensitivity in adults with type 2 diabetes (T2D) and the contribution of the peripheral chemoreceptors to resting cardiovascular and metabolic control. We hypothesized that: (1) adults with T2D exhibit exaggerated peripheral chemoreflex sensitivity; (2) the peripheral chemoreceptors contribute to cardiovascular dysfunction in T2D; and (3) attenuation of peripheral chemoreceptor activity improves glucose tolerance in T2D. Seventeen adults with diagnosed T2D [six males/11 females; aged 54±11years; glycated haemoglobin (HbA1c) 7.6±1.5%] and 20 controls without T2D (9 males/11 females; aged 49±13years, HbA1c 5.2±0.4%) participated in the study. The hypoxic ventilatory response (HVR) was assessed as an index of peripheral chemosensitivity. Resting heart rate, blood pressure and minute ventilation were measured when breathing normoxic followed by hyperoxic air (1.0 ) to acutely attenuate peripheral chemoreceptor activity. A subset of participants (n=9 per group) completed two additional visits [normoxia (0.21 ), hyperoxia (1.0 )] where glucose and insulin were measured for 2h following an oral glucose challenge. HVR was augmented in adults with T2D (-0.84±0.49Lmin-1/%) vs. control (-0.48±0.40Lmin-1/%, P=0.021). Attenuation of peripheral chemoreceptor activity decreased heart rate (P<0.001), mean blood pressure (P=0.009) and minute ventilation (P=0.002); any effect of hyperoxia did not differ between groups. There was no effect of hyperoxia on the glucose (control, P=0.864; T2D, P=0.982), nor insulin (control, P=0.763; T2D, P=0.189) response to the oral glucose challenge. Peripheral chemoreflex sensitivity is elevated in adults with T2D; however, acute attenuation of peripheral chemoreflex activity with hyperoxia does not restore cardiometabolic function. KEY POINTS: Preclinical work supports a role for the peripheral chemoreceptors in the progression of cardiovascular and metabolic pathologies. In the present study, we examined peripheral chemosensitivity in adults with type 2 diabetes and the contribution of the peripheral chemoreceptors to resting cardiovascular control and glucose tolerance. We observed elevated peripheral chemoreflex sensitivity in adults with diabetes which was associated with glycaemic control (i.e. glycated haemoglobin). Notably, acute attenuation of peripheral chemoreflex activity with hyperoxia did not restore cardiometabolic function in the individuals studied.

Non-Pharmacological Psychotropic Measures for Surgery Under Local Anaesthesia

Purpose surgery under local anaesthesia can be a stressful experience for patients. The aim of this study was to determine the influence of a non-pharmacological psychotropic measures (NPTM) on the anxiety and stress levels of individuals undergoing ophthalmic surgery. This is the first study to use a bilateral haptic NPTM for this purpose. Methods In this clinical interventional case-control study, we assessed objective and subjective stress parameters immediately pre- and postoperatively. We randomly assigned patients to one of two groups: an intervention group with NPTM (n = 70) and a control group (n = 68). Results When comparing objective parameters (heart rate, blood pressure, and sweat secretion), there were no significant differences between the two groups pre- and postoperatively (p ≥ 0.05). Subjectively, 79% of patients in the intervention group perceived a positive effect from the NPTM (p < 0.01). Patients undergoing eye surgery for the first time described a positive effect significantly more often (p = 0.027). Conclusions Our study results show that subjectively perceived anxiety and stress during eye surgery is significantly improved by using a bimanual NPTM. The majority of the patients experienced a positive effect on their wellbeing, particularly those undergoing eye surgery for the first time, although there was also a positive effect for patients who had previously undergone eye surgery. While the haptic NPTM used in this study has a positive impact on patients’ perception of ophthalmic surgery, all patients undergoing surgery under local anaesthesia may benefit from this approach.

A comparison of new cardiovascular endurance test using the 2-minute marching test vs. 6-minute walk test in healthy volunteers: A crossover randomized controlled trial.

This was a 2×2 randomized crossover control trial. To compare the cardiovascular endurance of healthy volunteers using a 2-minute marching test (2MMT) and a 6-minute walk test (6MWT). This study included 254 participants of both sexes, aged 20-50 years, with a height and body mass index (BMI) of ≥150 cm and ≤25 kg/m2, respectively. Participants were hospital staff who could perform activities independently and had normal annual chest radiographs and electrocardiograms. A group-randomized design was used to assign participants to Sequence 1 (AB) or 2 (BA). The tests were conducted over 2 consecutive days, with a 1-day washout period. On day 1, the participants randomly underwent either a 6MWT or 2MMT in a single-anonymized setup, and on day 2, the tests were performed in reverse order. We analyzed maximal oxygen consumption (VO2max) as the primary outcome and heart rate (HR), respiratory rate (RR), blood pressure (BP), oxygen saturation, dyspnea, and leg fatigue as secondary outcomes. Data were collected from 127 participants, categorized into two groups for different testing sequences. The first (AB) and second groups had 63 and 64 participants, respectively. The estimated VO2max was equivalent between both groups. The 2MMT and 6MWT estimated VO2max with a mean of 41.00 ± 3.95 mL/kg/min and 40.65 ± 3.98 mL/kg/min, respectively. The mean difference was -0.35 mL/kg/min (95% confidence interval: -1.09 to 0.38; p <0.001), and no treatment and carryover effect were observed. No significant changes were observed in HR, RR, and systolic BP (p = 0.295, p = 0.361 and p = 0.389, respectively). However, significant changes were found in the ratings of perceived exertion (p <0.001) and leg fatigue scale (p <0.001). The 2MMT is practical, simple, and equivalent to the 6MWT in estimating VO2max. TCTR20220528004 https://www.thaiclinicaltrials.org.

In vivo toxicity of upconversion nanoparticles (NaYF4:Yb, Er) in zebrafish during early life stages: Developmental toxicity, gut-microbiome disruption, and proinflammatory effects

Lanthanide-doped upconversion nanoparticles (Ln-UCNPs) have been considered promising materials for various fields, such as biomedical and industrial applications. However, data and reports regarding its toxicity and environmental risks are scarce. Under these circumstances, data must be obtained to fully understand potential toxicity and adverse outcome pathways. In the present study, the toxicity of uncoated Ln-UCNP cores (NaYF4:Yb, Er) was systematically assessed in zebrafish embryos during early developmental stages. Ln-UCNPs were found to have multiple toxic effects, such as effects on survival rates, delayed hatching times, shorter body lengths, altered heart rates and blood circulation (significantly reduced), and neurobehavioral impairments in response to photoperiod stimulation. Bioimaging showed that Ln-UCNPs were distributed on the chorion, eyes, and skin at 72 hpf. However, it accumulates in the pharynx, esophagus, and intestine after oral administration. Ln-UCNPs disrupt the diversity and abundance of host-associated microorganisms (gut microbiota) leading to an increase in the prevalence of harmful bacteria in zebrafish. Transcriptomic and Ingenuity Pathway Analysis (IPA) predicted Interleukin-8 (IL-8) signaling, neuroinflammation, cardiac hypertrophy signaling pathways, immune and inflammation-related response interferon-gamma (ifnγ), and miR-155 as key mediators in regulatory effects. Based on this, a causal network was built showing the strong links between the induced gene expression of differentially expressed genes (DEGs), such as nitric oxide synthase 2 (nos2) and tumor necrosis factor (tnf) upon Ln-UCNPs treatment, and with the downstream adverse outcomes, in particular, the promotion of apoptosis, liver damage, and inflammatory response. Finally, RT-qPCR analysis confirmed the up-regulated expression of nos2 and tnf in the exposed larvae, consistent with the observation of an increased number of fluorescence-labelled neutrophils and macrophages in lyz: DsRed transgenic zebrafish until 120 hpf exposure, which together demonstrated the proinflammatory effects of Ln-UCNPs on organisms. In conclusion, we illustrated the developmental toxicity, disruption of gut-microbiome, and proinflammatory effects of Ln-UCNP cores on zebrafish, and the causal network from IPA analysis may help further elucidate the adverse outcome pathway of Ln-UCNPs.

Development of a simple estimation method of serum caffeine concentration using a point-of-care test kit for urinary caffeine.

Serum caffeine concentration is an indicator of caffeine intoxication; however, it is difficult to measure it in most emergency departments. We developed a simple estimation method using a point-of-care test kit for urinary caffeine. Caffeine-spiked human serum (100, 50, 25, and 10µg/mL) was diluted 10-, 20-, 50-, and 100-fold with phosphate-buffered saline and applied to the kit. After 5min incubation, the kit was scanned by a flatbed scanner and the membrane image was processed with ImageJ. When the 20-fold diluted serum was applied, serum samples with initial caffeine concentration ≤ 25 and ≥ 50µg/mL were caffeine-negative and -positive, respectively. When the 100-fold diluted serum was applied, none of the caffeine-spiked serum samples gave positive results. Therefore, we proposed the following test procedure: (i) 20-fold diluted serum was initially tested and (ii) 100-fold diluted serum was additionally tested when the initial result was caffeine positive. Using this procedure, caffeine concentration is expected to be classified into three levels: ≤ 25, > 25- ≤ 100, and > 100µg/mL, which almost correspond to no or mild, severe, and potentially fatal intoxication, respectively. The test procedure was validated using postmortem heart blood from two cases of fatal caffeine intoxication (caffeine concentration: 276 and 175µg/mL) and two cases of other intoxication. Our developed method using point-of-care urinary caffeine test kits enabled simple estimation of serum caffeine concentration.

Does mental fatigue affect performance in racket sports? A systematic review

Mental fatigue impairs performance across several sports domains. However, a systematic review on its effects on racket sports performance has been lacking due to the previous scarcity of studies. This review aims to provide a comprehensive review the effects of mental fatigue on racket players’ performance, with a discussion of the underlying mechanisms. A thorough search was conducted across five databases, including Web of Science, PubMed, SCOPUS, SPORTDiscus (via EBSCOhost), and the Psychological and Behavioral Science Collection (via EBSCOhost). The PICOS framework established the inclusion criteria: (1) healthy racket sports players; (2) induction of mental fatigue in both field and laboratory settings; (3) comparison of mental fatigue interventions with a control group (e.g., watching a movie or reading a magazine); (4) assessment of performance outcomes, including physical performance, skilled performance, and perceptual-cognitive performance; and (5) randomized controlled trials (RCTs), non-randomized controlled trials (non-RCTs), and non-randomized non-controlled trials. Mental fatigue manipulation, subjective evaluation, and (neuro)physiological markers were synthesized to support the successful induction of mental fatigue. Performance was categorized into tennis, table tennis, badminton, and padel based on the characteristics of specific racket sports domains. Secondary outcomes, such as the rate perception of effort (RPE) and motivation, were synthesized to explain the mechanisms based on the prominent theory of the Psychobiological model of endurance performance. Six studies revealed that mental fatigue impacts stroke performance in table tennis, affecting speed, accuracy, faults, and only second-serve accuracy in tennis. The response time of psychomotor performance increased in table tennis, padel, and badminton. Meanwhile, mental fatigue increased the RPE and remained unchanged in heart rate, blood glucose, and lactate, consistent with the Psychobiological model of endurance performance. Additionally, attention is suggested as a significant underlying psychobiological factor.

Effect of Different Breathing Patterns on Heart Rate and Blood Pressure Response to Resisted Exercises in Females Within the Age Group of 25 to 35 Years

Introduction: Blood pressure and heart rate increases in individuals while performing heavy resisted exercises but acquiring different breathing patterns during exercise shows its effect on blood pressure and heart rate, it may or may not exaggerate. Inhalation or exhalation when coupled with concentric phase of resisted exercise may or may not show similar blood pressure response as compare to inhalation or exhalation when coupled with eccentric phase of resisted exercise whereas Valsalva maneuver can exaggerate the blood pressure response. Objective: To study the inhalation, exhalation and Valsalva maneuver on systolic, diastolic blood pressure and heart rate. Research Design: Quasi experimental. Methodology: 30 female subjects were taken which were asked to do a set of bicep curls with 3 different patterns of breathing with each pattern performed on a separate day. Then the recordings were taken and calculated to see in which pattern of breathing blood pressure and heart rate rises. Result: ANOVA was used and the result showed that diastolic blood pressure increases while exhalation coupled with the concentric phase and inhalation coupled with the eccentric Phase but there is a marked increase in diastolic blood pressure during Valsalva maneuver as compared to the inhalation coupled with the concentric phase and exhalation coupled with the eccentric phase. The result showed that the change in the blood pressure due to the different breathing patterns were significant p&gt;0.05 Conclusion: It is concluded that Valsalva maneuver exaggerates the blood pressure response. Keywords: resisted exercises, Valsalva maneuver, exhalation. breathing patterns.

Extracorporeal Cardiopulmonary Resuscitation Use Among Children With Cardiac Disease in the ICU: A Meta-Analysis and Meta-Regression of Data Through March 2024.

Epidemiologic data on extracorporeal cardiopulmonary resuscitation (ECPR) use in children with cardiac disease after in-hospital cardiac arrest (IHCA) are lacking. We aimed to investigate trends in ECPR use over time in critically ill children with cardiac disease. We performed a secondary analysis of a recent systematic review (PROSPERO CRD42020156247) to investigate trends in ECPR use in children with cardiac disease. PubMed, Web of Science, Embase, and Cumulative Index to Nursing and Allied Health Literature were screened (inception to September 2021). For completeness of this secondary analysis, PubMed was also rescreened (September 2021 to March 2024). Observational studies including epidemiologic data on ECPR use in children with cardiac disease admitted to an ICU. Data were extracted by two independent investigators. The risk of bias was assessed using the National Heart Lung and Blood Institutes Quality Assessment Tools. Random-effects meta-analysis was used to compute a pooled proportion of subjects undergoing ECPR; meta-regression was used to assess trends in ECPR use over time. Of the 2664 studies identified, 9 (17,669 patients) included data on ECPR use in children with cardiac disease. Eight were cohort studies, 1 was a case-control, 8 were retrospective, 1 was prospective, 6 were single-center, and 3 were multicenter. Seven studies were included in the meta-analysis; all were judged of good quality. By meta-analysis, we found that a pooled proportion of 21% (95% CI, 15-29%) of pediatric patients with cardiac disease experiencing IHCA were supported with ECPR. By meta-regression adjusted for category of patients (surgical vs. general cardiac), we found that the use of ECPR in critically ill children with cardiac disease significantly increased over time ( p = 0 .026). About one-fifth of critically ill pediatric cardiac patients experiencing IHCA were supported with ECPR, and its use significantly increased over time. This may partially explain the increased trends in survival demonstrated for this population.

PPG and Bioimpedance-Based Wearable Applications in Heart Rate Monitoring—A Comprehensive Review

The monitoring of hemodynamic parameters, such as heart rate and blood pressure, provides valuable indications of overall cardiovascular health. It is preferable that such monitoring is non-invasive and in real time via an affordable, compact and small-scale device for maximum convenience. Numerous literature sources have exploited derivations of these parameters from photoplethysmogram (PPG) and electrical bioimpedance (EBI) signal measurements through the use of calculation algorithms of varying complexity. Compared to electrocardiogram (ECG), these measurement techniques have a merit of well-established practices of designing a wearable device that could conveniently be put on a wrist. The current paper provides a comprehensive review on the use of PPG and EBI measurement techniques in the context of hemodynamic parameter monitoring using a wearable device. A special emphasis is placed on the most basic hemodynamic parameter—heart rate—describing different algorithms of heart rate detection and monitoring. The last section provides an overview of commercially available and in-home wearable device technologies based on PPG and EBI measurements, their design challenges, and future prospects.

Analysis of the Effects of Epidural Anesthesia on the Nociception Level Index (NOL®) during Abdominal Surgery.

Background: The NOL® system (PMD-200™ Nociception Level Monitor; Medasense Ltd., Ramat Gan, Israel) is used for the real-time detection of physiological nociception in anesthetized patients by assessing the parameters indicative of sympathetic activity, such as photoplethysmography, skin conductance, peripheral temperature, and accelerometry, which are quantified into the NOL®-Index. This index is more sensitive than traditional clinical parameters in estimating pain and stress responses. While its effectiveness in general anesthesia is well documented, its efficacy in epidural anesthesia needs further investigation. Methods: This retrospective study analyzed NOL®-Index dynamics compared to conventional parameters after epidural administration of bupivacaine. Following ethics committee approval, 119 NOL® measurements were retrospectively analyzed after thoracic epidural catheter administration in 40 patients undergoing abdominal and urological surgery. The NOL-Index® was assessed at 0, 1, 3, and 5 min post application and compared to heart rate, blood pressure, and bispectral index dynamics. Results: This study showed a significant decrease in the NOL®-Index post-local-anesthetic administration with better sensitivity than classical clinical parameters (0 min = 38 ± 11; 1 min = 22 ± 13*; 3 min = 17 ± 11*; 5 min = 12 ± 10*). Higher doses of local anesthetics led to a significant, dose-dependent decrease in NOL®-Index (low dose, 5 min = 15 ± 10*; high dose, 5 min = 8 ± 8*). Conclusions: This study is the first to demonstrate the effectiveness of the NOL®-Index in measuring nociceptive effects following epidural administration, highlighting its potential superiority over conventional parameters and its sensitivity to dose variations.

Implementation of electrical tomography in a medical measurement system for innovative imaging and area monitoring

LETS (Lung Electrical Tomography System) is an innovative medical system enabling comprehensive heart and lung function monitoring. It utilizes advanced techniques such as electrical impedance tomography (EIT), body surface potential mapping (BSPM), and electrical capacitance tomography (ECT) to provide accurate information about physiological parameters. The LETS system allows one-time examinations and continuous monitoring 24 hours a day. Remotely measuring and monitoring parameters such as the electrical activity of the heart muscle, blood flow, blood pressure, pulse, and lung aeration enables rapid identification and intervention in case of abnormalities. The system also allows for the detection of cardiac arrhythmias and other heart disorders, as well as the assessment of lung respiratory capacity and optimization of ventilation strategies. However, it's important to note that the LETS system has some limitations. For example, it may not be suitable for patients with certain pacemakers or other implanted devices. Overall, LETS represents a breakthrough in medical imaging, opening up new possibilities in diagnosing and monitoring heart and lung diseases. Its integration may contribute to improving patient care and increasing the effectiveness of medical interventions.

Randomized Crossover Trial of 2-Week Ketone Ester Treatment in Patients With Type 2 Diabetes and Heart Failure With Preserved Ejection Fraction.

Heart failure with preserved ejection fraction (HFpEF) is a major cause of morbidity and mortality in patients with type 2 diabetes (T2D). Acute increases in circulating levels of ketone body 3-hydroxybutyrate have beneficial acute hemodynamic effects in patients without T2D with chronic heart failure with reduced ejection fraction. However, the cardiovascular effects of prolonged oral ketone ester (KE) treatment in patients with T2D and HFpEF remain unknown. A total of 24 patients with T2D and HFpEF completed a 6-week randomized, double-blind crossover study. All patients received 2 weeks of KE treatment (25 g D-ß-hydroxybutyrate-(R)-1,3-butanediol × 4 daily) and isocaloric and isovolumic placebo, separated by a 2-week washout period. At the end of each treatment period, patients underwent right heart catheterization, echocardiography, and blood samples at trough levels of intervention, and then during a 4-hour resting period after a single dose. A subsequent second dose was administered, followed by an exercise test. The primary end point was cardiac output during the 4-hour rest period. During the 4-hour resting period, circulating 3-hydroxybutyrate levels were 10-fold higher after KE treatment (1010±56 µmol/L; P<0.001) compared with placebo (91±55 µmol/L). Compared with placebo, KE treatment increased cardiac output by 0.2 L/min (95% CI, 0.1 to 0.3) during the 4-hour period and decreased pulmonary capillary wedge pressure at rest by 1 mm Hg (95% CI, -2 to 0) and at peak exercise by 5 mm Hg (95% CI, -9 to -1). KE treatment decreased the pressure-flow relationship (∆ pulmonary capillary wedge pressure/∆ cardiac output) significantly during exercise (P<0.001) and increased stroke volume by 10 mL (95% CI, 0 to 20) at peak exercise. KE right-shifted the left ventricular end-diastolic pressure-volume relationship, suggestive of reduced left ventricular stiffness and improved compliance. Favorable hemodynamic responses of KE treatment were also observed in patients treated with sodium-glucose transporter-2 inhibitors and glucagon-like peptide-1 analogs. In patients with T2D and HFpEF, a 2-week oral KE treatment increased cardiac output and reduced cardiac filling pressures and ventricular stiffness. At peak exercise, KE treatment markedly decreased pulmonary capillary wedge pressure and improved pressure-flow relationship. Modulation of circulating ketone levels is a potential new treatment modality for patients with T2D and HFpEF. URL: https://www.clinicaltrials.gov; Unique Identifier: NCT05236335.

Towards assessing reliability of next‐generation Internet of Things dashboard for anxiety risk classification

AbstractThe ubiquitous Internet of Things (IoT) and sensing technologies provide an interesting opportunity of remote health monitoring and disease risk categorisation of populations. An end‐to‐end architecture is proposed to facilitate real‐time digital dashboards to visualise general anxiety risks of patients, especially during a pandemic, such as COVID‐19. To collect physiological data related to anxiety (heart rate, blood pressure, and saturation of peripheral oxygen [SPO2]) and communicate them to a centralised dashboard, dubbed ‘X‐DASH’, a hardware prototype of the proposed architecture was developed using Node‐MCU and diverse sensors. The dashboard presents a smart categorisation of users' data, assessing their anxiety risks, to provide medical professionals and state authorities a clear visualisation of health risks in populations belonging to different regions. We categorised the risk levels as Normal, Mild, Moderate, Elevated, Severe, and Extreme, based on the collected physiological data and pre‐defined threshold values. The developed hardware prototype in this work was used to collect data from about 500 patients present at cardiac clinic of a leading general hospital in Karachi (Pakistan) and the anxiety risk levels were assigned based on pre‐defined threshold values. To validate the reliability of the X‐DASH, the personal physician of each patient was consulted and was requested to identify each of their anxiety risk levels. It was found that the risk levels suggested by X‐DASH, (based on data of heart rate, blood pressure, and SPO2 were more than 90% accurate when compared with diagnoses of physicians. Subsequently, packet loss, delay and network overhead for the platform was compared when using MQTT, CoAP and Modbus. Although MQTT has shown higher delays, but it is still recommended due to having a higher reliability.

Human exposure to aerosol from indoor gas stove cooking and the resulting cardiovascular system responses

The effect of cooking aerosol on the human heart was investigated in this study. The heart rate and blood pressure of 33 healthy adults were monitored before, exactly after, and two hours post-exposure (30 minutes, 60 minutes, 90 minutes, and 120 minutes after cooking). One hundred twenty grams of ground beef was fried in sunflower oil for twenty minutes using a gas stove without ventilation. Ultrafine particles, indoor temperature, relative humidity, carbon dioxide, oil, and meat temperatures were monitored during the experiment. The average particle emission rate (S) and average decay rate (a+k) for meat frying were found to be 2.09×1013 (SD=3.94 ×1013, R2=0.98, P <0.0001) particles/min, and 0.055 (SD=0.019, R2=0.91, P <0.0001) particles/min, respectively. No statistically significant changes in diastolic blood pressure (DBP) and heart rate (HR) were observed. The average systolic blood pressure (SBP) statistically significantly increased from 98 mmHg (before the exposure) to 106 mmHg 60 minutes after the exposure. The results suggested that frying emission statistically significantly impacted blood pressure.

Association between physical activity and cardiovascular parameters in 7-year-old children: a Chinese cross-sectional study

IntroductionPhysical activity (PA) is believed to play an important part in many aspects during childhood and adolescence, especially cardiorespiratory fitness and cardiometabolic health. However, whether different levels of PA in daily life influence the structure or function of heart in school-aged children remains unknown. We aimed to investigate the association between PA and cardiovascular parameters in 7-year-old children.MethodsFollow-up data from the Shanghai Prenatal Cohort Study and the Shanghai Birth Cohort was analyzed. Perinatal information including both maternal and offspring datum was recorded. A refined questionnaire was used to evaluate the frequency and duration of children’s PA levels. Blood pressure, echocardiography, and anthropometry assessment were conducted during the follow-up of 7-year-old children.ResultsOverall, high PA level was associated with higher left ventricle posterior wall thickness in diastole (LVPWd, β coefficient: 0.36, 95% CI: 0.12, 0.61), higher left ventricle mass index (LVMI, β = 0.28, 95% CI: 0.07, 0.48), mitral E/a ratio (β = 0.47, 95% CI: 0.22, 0.71) and slower heart rate (β = -0.32, 95% CI: -0.57, -0.07), compared to low PA level. Medium PA level was associated with lower diastolic blood pressure (DBP, β = -0.18, 95% CI: -0.35, -0.01). In subgroup analysis, increased relative wall thickness (RWT) was found in high PA level boys (β = 0.36, 95% CI: 0.05, 0.67), and systolic blood pressure (SBP) showed a significant decrease in high PA level girls (β = -0.42, 95% CI: -0.78, -0.06).ConclusionsThis study suggested non-athlete children having higher PA level were associated with thicker left ventricle (LV) walls and better LV diastolic function, as well as slower heart rate and DBP at the age of 7. Furthermore, disparity in the association between PA level with morphological heart patterns and blood pressure existed in different sex category.

Co-exposure effect of different colour of LED lights and increasing temperature on zebrafish larvae (Danio rerio): Immunohistochemical, metabolomics, molecular and behaviour approaches

Although there are studies in the literature on the effects of different coloured light-emitting diodes (LEDs) on different organisms, there is limited information on how these effects change with temperature increase. In this study, the effects of blue, green, red and white LED lights on the early development process of zebrafish (Danio rerio (Hamilton, 1822)) were comprehensively investigated. In addition, to simulate global warming, it was examined how a one-degree temperature increase affects this process. For this purpose, zebrafish embryos, which were placed at 4 hpf (hours post fertilization) in an incubator whose interior was divided into four areas, were kept at three different temperatures (28, 29 and 30 °C) for 120 h. The group kept in a dark environment was chosen as the control. The temperature of the control group was also increased at the same rate as the other groups. The results showed that at the end of the exposure period, temperature and light colour caused an increase in body malformations. Histopathological damage and immunopositive signals of HSP 70 and 8-OHdG biomarkers in larval brains, increase in free oxygen radicals, apoptotic cells and lipid accumulation throughout the body, increase in locomotor activity, decrease in heart rate and blood flow, and significant changes in more than thirty metabolite levels were detected. In addition, it has been determined that many metabolic pathways are affected, especially glutathione, vitamin B6 and pyrimidine metabolism. Moreover, it has been observed that a one-degree temperature increase worsens this negative effect. It was concluded that blue light was the closest light to the control group and was less harmful than other light colours. The study revealed that blue light produced results that were most similar to those seen in the control group.

Effects of Exercise-Based Cardiac Rehabilitation in Patients After Myocardial Infarction

Background: Myocardial infarction (MI) is a leading cause of mortality and physical disability worldwide, particularly among the elderly. Despite advancements in percutaneous coronary intervention (PCI) and pharmacotherapy, many MI patients continue to experience health deterioration. Exercise-based cardiac rehabilitation has shown potential in improving myocardial perfusion, endothelial function, and reducing thrombotic activity, thereby enhancing patient outcomes. Objective: This study aimed to determine the effects of a supervised exercise-based cardiac rehabilitation program on quality of life, heart rate, and blood pressure in patients’ post-myocardial infarction. Methods: A randomized controlled trial was conducted with 36 participants aged 40 to 60 who experienced an MI within the previous three weeks. Participants were randomly assigned to Group A (exercise program) or Group B (educational interventions). Group A engaged in a 6-week supervised exercise program, including warm-up exercises, aerobic activities, and cool-down sessions. Quality of life was assessed using the CDC HRQOL-14 questionnaire, while heart rate and blood pressure were measured pre- and post-intervention. Data analysis was performed using SPSS 25, employing independent and paired sample t-tests. Results: Group A showed significant improvements in HRQOL scores: Module 1 (p=0.04), Module 2 (p=0.04), and Module 3 (p=0.02). Heart rate improved by 12 bpm (p=0.03), and systolic blood pressure reduced by 8.81 mmHg (p=0.01) in Group A compared to Group B. Conclusion: Exercise-based cardiac rehabilitation significantly improves quality of life, heart rate, and blood pressure in post-MI patients.

Circadian disruptions and their role in the development of hypertension.

Circadian fluctuations in physiological setpoints are determined by the suprachiasmatic nucleus (SCN) which exerts control over many target structures within and beyond the hypothalamus via projections. The SCN, or central pacemaker, orchestrates synchrony between the external environment and the internal circadian mechanism. The resulting cycles in hormone levels and autonomic nervous system (ANS) activity provide precise messages to specific organs, adjusting, for example, their sensitivity to approaching hormones or metabolites. The SCN responds to both photic (light) and non-photic input. Circadian patterns are found in both heart rate and blood pressure, which are linked to daily variations in activity and autonomic nervous system activity. Variations in blood pressure are of great interest as several cardiovascular diseases such as stroke, arrhythmias, and hypertension are linked to circadian rhythm dysregulation. The disruption of normal day-night cycles, such as in shift work, social jetlag, or eating outside of normal hours leads to desynchronization of the central and peripheral clocks. This desynchronization leads to disorganization of the cellular processes that are normally driven by the interactions of the SCN and photic input. Here, we review autonomic system function and dysfunction due to regulation and interaction between different cardiorespiratory brain centers and the SCN, as well as social, lifestyle, and external factors that may impact the circadian control of blood pressure.

The effect of clothing pressure of calf compression garments on human leg muscles during running

PurposeThe few previous researches on the impact of calf compression garments (CG) on running performance while assessing physiological and perceptual factors. Therefore, this study investigated how the clothing pressure of two types of Calf CG, CG1 and CG2, affects muscle fatigue and activation during running.Design/methodology/approachFive healthy amateur runners(three female and two male)were recruited for a 30-min running trial. They wear a Calf CG on their right leg (CG group), but not on their left leg(CON group). After obtaining the clothing pressure of Calf CG on the gastrocnemius lateral head (GL), gastrocnemius medial head (GM) and tibialis anterior(TA) of the right leg, surface electromyography (sEMG)of four muscles of GL, GM, TA and rectus femoris (RF) of the left and right legs were measured during running, and heart rate, cardiopulmonary rate, and human RPE were also measured. Blood bleed oxygen before and after the running trial were measured. The root mean square (RMS) of the characteristic values was selected as an index for the analysis of sEMG signals, and the data were analyzed using statistical and computational methods.FindingsThe results showed that the indexes of heart rate, blood oxygen, and RPE were significantly increased, indicating that the subjects had reached the fatigue level. The comparison of mean clothing pressure at GL, GM and TA locations reveals that the TA location consistently exhibits the highest pressure for both types of CG. When wearing CG1, the mean clothing pressure at the GL and GM test points is greater than that of CG2(CG1-GL = 0.2059 kPa > CG2-GL = 0.148 kPa; CG1-GM = 0.1633 kPa > CG2-GM = 0.127 kPa). This is attributed to the double-layered fabric on the sides of CG1, which precisely covers the GL and GM areas, thereby resulting in higher mean clothing pressure at these locations compared to CG2. Conversely, the mean clothing pressure at the TA location for CG1 is lower than that for CG2(CG1-TA = 0.3852 kPa < CG2-TA = 0.426 kPa). The pressure exerted by the CG1 on the lower limb test areas has both positive and negative effects, though neither are statistically significant. The pressure exerted by CG2 alleviates fatigue at the directly affected locations GL and GM, but exerts excessive pressure on TA, resulting in a negative effect. Additionally, CG2 pressure alleviates fatigue at the indirectly affected location RF on the same side. Based on the specific clothing pressure data, it is concluded that when the pressure at the GM location is 0.127 kPa, 30 min of running has a fatigue-relieving effect. However, the pressure should not be excessively high, at 0.1633 kPa it exhibits an insignificant adverse effect. At the TA location, a garment pressure mean between 0.3852 and 0.426 kPa does not alleviate fatigue after 30 min of running, and the negative effect becomes more pronounced as the pressure increases. The pressure exerted by the CG at GL, GM, TA and RF locations shows significant changes from the previous time period during the 15–18 min interval after running. Therefore, in the design of CG, attention should be paid to the changes in clothing pressure effects on muscles during this specific time period.Originality/valueThe few previous researches on the impact of calf compression garments (CG) on running performance while assessing physiological and perceptual factors. Therefore, this study investigated how the clothing pressure of two types of Calf CG, CG1 and CG2, affects muscle fatigue and activation during running.

Analytically Confirmed Intentional Overdose of the Antidepressant Vortioxetine

IntroductionVortioxetine is an antidepressant with a multimodal mechanism of action. It is used as a treatment option for patients with major depressive episodes. There have only been two previously reported non-fatal overdoses of vortioxetine; neither of these were analytically confirmed There has also been one case of serotonin syndrome potentially related to vortioxetine and two deaths where vortioxetine was detected. We report here a non-fatal analytically confirmed case of vortioxetine overdose.Case reportA 32-year-old male presented to the emergency department (ED) 12–13 h after oral ingestion of 1,260 mg of vortioxetine and 350 mg of diazepam. A family member reported that he had been drowsy after the overdose, but his level of consciousness and observations (heart rate, blood pressure and temperature) were normal on review by the pre-hospital emergency services and on arrival to the ED. During a period of observation, he did not develop any features of serotonin syndrome or any other significant toxicity. Toxicological analysis of a blood sample taken in the ED detected vortioxetine (plasma concentration 457 ng/mL 10 h after ingestion) and sub-therapeutic concentrations of diazepam and pregabalin.DiscussionDespite having a plasma vortioxetine concentration nearly 15-times therapeutic vortioxetine concentrations, this patient did not develop any significant toxicity. In particular he did not develop any clinical or biochemical features of serotonin toxicity that would be expected with this class of antidepressant. Additional reporting of analytically confirmed vortioxetine overdoses will allow clinicians and licensing authorities to further understand the safety of this medication in overdose.