Heart Rate Parameters Research Articles

Multidimensional Assessment of Orthorexia Nervosa: A Case-Control Study Comparing Eating Behavior, Adherence to the Mediterranean Diet, Body Mass Index, Psychological Symptoms, and Autonomic Arousal

Background: The research on orthorexia nervosa (ON) has thoroughly outlined the connection between it and various mental disorders, including obsessive-compulsive disorders and eating disorders, in addition to stress. However, research has not considered psychophysical stress and other measures of psychophysical health, such as adherence to the Mediterranean diet. Methods: This cross-sectional and case-control research involved 63 students from the University of Parma, aged between 18 and 49 years. The ORTO-15 questionnaire was utilized to categorize the entire sample into two groups: one without orthorexia (score > 35) and another with orthorexia (score < 35). All subjects were assessed with the Psychophysiological Stress Profile (PSP) and completed the Eating Disorder Inventory-3 (EDI-3) and the Symptom Checklist-90-Revised (SCL-90-R). In addition, they were interviewed using the PREDIMED questionnaire to assess adherence to the Mediterranean Diet, and their body mass index (BMI) was calculated. Results: Subjects with orthorexia represented 38.10% of the total sample and reported a higher BMI than controls, although the PREDIMED score did not show a difference in adherence to the Mediterranean diet. The EDI-3 highlighted emotional dysregulation and hypercontrol in students with orthorexia, and a dissociation between subjective and objective measures of stress emerged. Particularly, the psychophysiological parameters of skin conductance, heart rate, and heart rate variability showed greater reactivity to stressful stimuli, but no difference was noted in psychological symptoms. Conclusions: These findings confirmed the presence of alterations in eating behavior in people with orthorexia as well as a higher BMI. It was hypothesized that hypercontrol might favor the perception of psychological well-being at a subjective level, although inadequate management of stress emerged at an objective psychophysiological level. Further studies are needed to highlight the causality between ON, hypercontrol, diet, and psychophysical stress, given that students with orthorexia present a dysregulation of emotions associated with greater autonomic arousal.

Decreased risk-proneness with increasing age in equally raised and kept wolves and dogs.

A basic mechanism of domestication is the selection for fearlessness and acceptance of humans as social partners, which may affect risk-taking behavior and the ability to use humans as social support, both at the behavioural and physiological levels. We combined behavioural observations with heart rate parameters (i.e., HR and heart rate variability, HRV) in equally raised and housed wolves and dogs to assess the responses to food offered in the vicinity of a potential stressor (an unknown spinning object) with and without social support from a familiar human. Based on previous studies on neophobia in wolves and dogs, we expected dogs to be less scared of the object, approach more quickly, show less ambivalent behaviour, lower HR, and higher HRV, than wolves, especially at the presence of a human partner. However, we found that mainly age and the presence of a familiar human affected the behaviour of our subjects: older wolves and dogs were generally bolder and faster to approach the food and the familiar human's presence increased the likelihood of taking it. HR rate parameters were affected by age and the stage of the test. Wolves and dogs showed particularly high HRs at the beginning and end of the test sessions. We conclude that in our paradigm, wolves' and dogs' risk-proneness varied with age, rather than species. Additionally, the presence of a familiar human increased the motivation of both, dogs and wolves to take the food.

Design of stress detector with fuzzy logic method (GSR and heart rate parameters)

Stress is a condition of tension that affects emotions, thought processes, and the physical or psychological state of humans due to pressure from within or from outside a person, which can interfere with activities that can cause various diseases. Therefore, a tool is made to detect stress levels so that a person can monitor their condition and prevent stress from getting more severe and detrimental to the health of the body and mind. The stress level detection tool is designed using a galvanic skin response (GSR) sensor to detect skin response through a person's sweat glands and a heart rate sensor to detect heart rate. Furthermore, the reading results will be processed by microcontroller and then the stress level decision will be made using the fuzzy logic method and will be classified into Relax, Anxiety, Calm, and Stress. Based on the test results, the GSR parameter has the highest accuracy of 99.78%, and the heart rate parameter has the highest accuracy of 99.63%.

Sensor-Based Frailty Assessment Using Fitbit.

This study evaluated the reliability of Fitbit in assessing frailty based on motor and heart rate (HR) parameters through a validated upper extremity function (UEF) test, which involves 20 s of rapid elbow flexion. For motor performance, participants completed six trials of full elbow flexion using their right arm, with and without weight. Fitbit and a commercial motion sensor were worn on the right arm. For HR measurements, an ECG system was placed on the left chest alongside the Fitbit on the left wrist. Motor parameters assessing speed, flexibility, weakness, exhaustion, and HR before, during, and after UEF were measured. A total of 42 participants (age = 22 ± 3) were recruited. For motor parameters, excellent agreement was observed between the wearable sensor and Fitbit, except for flexibility (ICC = 0.87 ± 0.09). For HR parameters, ICC values showed weak agreement between ECG and Fitbit for HR increase and recovery (ICC = 0.24 ± 0.11), while moderate to stronger agreement was seen for mean HR during baseline, task, and post-task (ICC = 0.81 ± 0.13). Fitbit is a reliable tool for assessing frailty through motor parameters and provides reasonably accurate HR estimates during baseline, task, and recovery periods. However, Fitbit's ability to track rapid HR changes during activity is limited.

Health status and morphometrics of Galápagos magnificent frigatebirds (Fregata magnificens magnificens) determined by hematology, biochemistry, blood gas, and physical examination.

The magnificent frigatebird (Fregata magnificens; MFB) is a widely distributed seabird. It has breeding areas in the tropical Atlantic Ocean and the Pacific Ocean (extending along Central America up to Baja California) (Schreiber & Burger, 2001). The Fregata magnificens magnificens (MFB-Gal) subspecies is native to the Galápagos Islands. This is the first-time hematology and blood chemistry parameters have been published for the F. m. magnificens (MFB-Gal) from the Galápagos Islands. Analysis was run on blood samples drawn from n = 16 adult MFB-Gal captured by hand at their nests at North Seymour and Daphne Major Islands in the Galápagos Islands (n = 10 MFB-Gal in June 2017 and n = 6 MFB-Gal in July 2022). There were ten female birds and six male birds in total. A portable blood analyzer (iSTAT) was used to obtain near immediate field results for total carbon dioxide (TCO2), hematocrit (Hct), hemoglobin (Hb), sodium (Na), potassium (K), chloride (Cl), ionized calcium (iCa), total protein (TP), anion gap and glucose. Blood lactate was measured using a portable Lactate Plus™ analyzer. Average heart rate, respiratory rate, body weight, body temperature, biochemistry and hematology parameters were comparable to healthy individuals of other Fregatidae of the same species (magnificent frigatebird subspecies from Brazil, Fregata magnificens, likely F. m. rothschildi) or similar species (great frigatebird, Fregata minor, from the Galápagos Islands). There were some statistically significant differences between the males and females F. m. magnificens (MFB-Gal) in the Galápagos, including bill depth, bill width, wing length, weight, and chloride blood value. The reported results provide baseline data that can be used for comparisons among populations and in detecting changes in health status among Galápagos magnificent frigatebirds and other populations of magnificent frigatebirds.

Monitoring individualized glucose levels predicts risk for bradycardia in type 2 diabetes patients with chronic kidney disease: a pilot study

Patients with diabetes mellitus (DM) and chronic kidney disease (CKD) exhibit an elevated risk for cardiac arrhythmias, such as bradycardia, which may potentially lead to sudden cardiac death (SCD). While hypoglycemia, defined as a critical drop in glucose levels below the normal range, has long been associated with adverse cardiovascular events, recent studies have highlighted the need for a comprehensive reevaluation of its direct impact on cardiovascular outcomes, particularly in high-risk populations such as those with DM and CKD. In this study, we investigated the association between glucose levels and bradycardia by simultaneously monitoring interstitial glucose (IG) and ECG for 7 days in insulin-treated patients with DM and CKD. We identified bradycardia episodes in 19 of 85 patients (22%) and associated these episodes with personalized low, medium, and high relative glucose levels. Our analysis revealed a significant increase in bradycardia frequency during periods of lowest relative glucose, particularly between 06:00-09:00 and 12:00-15:00. Furthermore, leveraging a Random Forests classifier, we achieved a promising area under the curve (AUC) of 0.94 for predicting bradyarrhythmias using glucose levels and heart rate variability features. Contrary to previous findings, only 4% of bradycardia episodes in our study population occurred at glucose levels of 70 mg/dL or lower, with 28% observed at levels exceeding 180 mg/dL. Our findings not only highlight the strong correlation between relative glucose levels, heart rate parameters, and bradycardia onset but also emphasize the need for a more personalized definition of hypoglycemia to understand its relationship with bradyarrhythmias in high-risk DM and CKD patient populations.

Impact of a Three-Month Training Break on Swimming Performance in Athletes with Intellectual Disability.

This study aimed to ascertain whether there were any differences in anthropometrics, heart rate, and swimming performance parameters in athletes with intellectual disabilities (ID) before and after a three-month training break. A total of 21 athletes participated in the study, comprising 16 males and 5 females, with a mean age of 28.3 ± 8.7 years. All participants had ID, and six of them had Down syndrome. The study participants were classified as S14 athletes from a local swimming club. All participants had a minimum of four years of swimming experience and attended two to three one-hour sessions per week for eight consecutive months. All athletes completed two trials of 25 m freestyle swimming, one at the end of a training session and the other at the beginning of a new session. The measurements included weight, body mass index (BMI), handgrip strength (HGS), heart rate (pre- and post-trial), performance (T25), stroke count (SC), stroke length (SL), stroke rate, and the SWOLF efficiency index. The results demonstrated statistically significant elevations in weight (80.2 ± 16.1 to 81.7 ± 15.9), BMI (26.8 ± 5.5 to 27.2 ± 5.5), T25 (33.1 ± 17.1 to 35.6 ± 18), SC (19.3 ± 6.1 to 20.7 ± 7.2), and SWOLF (52.4 ± 22.0 to 56.3 ± 25.2) and a reduction in SL (1.39 ± 0.48 to 1.27 ± 0.42). However, no significant differences were observed in the remaining parameters. Significant correlations were found for body weight, BMI, HGS, and SWOLF with T25 throughout the study. It was concluded that individuals with ID experienced a decline in 25 m swimming performance due to technical rather than physiological factors after three months of detraining.

Cardioprotective effects of total and anthocyanin-rich extracts of Opuntia ficus-indica fruit on epinephrine-induced cardiac injury in rats

Objective: To examine the effect of fruit extracts of Opuntia ficus-indica on epinephrine-induced myocardial injury in rats. Methods: Rats were pre-treated with hydroalcoholic and anthocyanin-rich extracts (250, 500, and 1 000 mg/kg) orally for 16 days. Epinephrine (2 mg/kg) was injected subcutaneously on days 15 and 16. Then ECG, heart rate, RR interval, cardiac histopathology, and serum parameters of cardiac damage and oxidative stress were evaluated. Results: Pretreatment with the hydroalcoholic and anthocyanin-rich extracts of Opuntia ficus-indica at doses of 500 and 1 000 mg/kg reversed epinephrine-induced changes in ECG, heart rate, RR interval, and cardiac histopathology, and attenuated creatine phosphokinase-MB activity and malondialdehyde level. The extracts at all doses diminished heart weight, lactate dehydrogenase, and aspartate aminotransferase, and also elevated total antioxidant capacity. However, 1 000 mg/kg of the anthocyanin-rich extract was more effective than the hydroalcoholic extract. Conclusions: Supplementation with fruit extracts of Opuntia ficus-indica, especially anthocyanin-rich extract, could protect against epinephrine-induced cardiac injury in rats by alleviating electrocardiographic, biochemical, histopathological, and oxidative stress parameters, and may be used in the treatment of cardiovascular diseases.

Modeling the Dynamics of Blood Circulation in the Autonomous Cardiopulmonary Complex

The paper describes the development of computer modelling of hemodynamic systems, which helps to better understand physiology and to move from real experiments to simulation models. Using the object-oriented environment Modelica, an accurate model of the system "heart + lungs" was created. The performed numerical simulation confirmed the adequacy of the model and its applicability for more complex haemodynamic studies. Mathematical modelling of the "heart + lungs" system was carried out to create a digital twin. The main requirements to the model: reproduction of experimental data on animals and prediction of results in a wide range of parameters. The Modelica environment was used to create a circulatory model based on the quasi one-dimensional approximation. The modelling confirmed the adequacy of the digital twin for the key parameters of pressure and heart rate. The simulation results of two experiments showed good agreement with real data, which confirms the applicability of the model for complex haemodynamic problems.

Short-Term Safety of Nutri-Jelly in Adults Undergoing Hemodialysis.

Excessive water consumption from liquid or reconstituted oral nutrition supplements may increase risk of fluid overload in renal patients. Nutri-jelly, a ready-to-eat texture-modified diet with 52.8% water, some protein, low potassium, phosphorus, and sodium, could be an alternative. However, its safety is unknown for adults undergoing hemodialysis (HD). This study investigated the short-term physiological safety of Nutri-Jelly intake and its preliminary impact on renal outcomes. A randomized open-label, single-arm, two-sequence, two-period cross-over trial was conducted in 20 adults undergoing HD with inadequate protein intake (0.50 - 0.70 g/ kg body weight/day). Participants were randomly allocated into 2 groups (n =10 each) and assigned in random sequence into both Without-Jelly (HD 3 times during 7 days) and With-Jelly periods (100 g Nutri-Jelly twice daily along with HD 3 times during 7 days). A two-week washout was between the periods. Outcome measures included adverse symptoms, changes in body weight, heart rate, blood pressure, and blood biochemical parameters relevant to renal outcomes. The results showed no intervention-related adverse symptoms or significant changes in body weight, heart rate, systolic blood pressure, creatinine, albumin, and sodium. Potassium level and pre-HD diastolic blood pressure were better controlled during the With Jelly than the Without Jelly Periods (p < 0.01 and p < 0.05, respectively). The eGFR was improved with no significant difference between the periods. The findings suggest that continuous intake of 100 g Nutri-Jelly twice daily for 7 days is safe in adults undergoing hemodialysis. Its efficacy on renal-related parameters warrants further investigations in long-term studies.

Does exercise modality and posture influence cerebrovascular and cardiovascular systems similarly?

Cerebral hemodynamics have been quantified during exercise via transcranial Doppler ultrasound, as it has high-sensitivity to movement artifacts and displays temporal superiority. Currently, limited research exists regarding how different exercise modalities and postural changes impact the cerebrovasculature across the cardiac cycle. Ten participants (4 females and 6 males) ages 20-29 completed three exercise tests (treadmill, supine, and upright cycling) to volitional fatigue. Physiological data collected included middle cerebral artery velocity (MCAv), blood pressure (BP), heart rate, and respiratory parameters. Normalized data were analyzed for variance and effect sizes were calculated to examine differences between physiological measures across the three exercise modalities. Systolic MCAv was greater during treadmill compared to supine and upright cycling (p<0.001, (large) effect size), and greater during upright versus supine cycling (p<0.017, (large)). Diastolic MCAv was lower during treadmill versus cycling exercise only at 60% maximal effort (p<0.005, (moderate)) and no differences were observed between upright and supine cycling. No main effect was found for mean and diastolic BP (p>0.05, (negligible)). Systolic BP was lower during treadmill versus supine cycling at 40% and 60% intensity (p<0.05, (moderate-large)) and greater during supine versus upright at only 60% intensity (p<0.003, (moderate)). The above differences were not explained by partial pressure of end-tidal carbon dioxide levels (main effect: p=0.432). The current study demonstrates the cerebrovascular and cardiovascular systems respond heterogeneously to different exercise modalities and aspects of the cardiac cycle. As physiological data were largely similar between tests, differences associated with posture and modality are likely contributors.

Hemodynamic Disorders in Alcohol Withdrawal Syndrome

INTRODUCTION: The introduction of the study is determined by a high prevalence of alcoholism and a high incidence of complications from the cardiovascular system. AIM: To study the features of hemodynamics in patients with uncomplicated alcohol withdrawal syndrome (AWS) and in those with alcohol withdrawal delirium (delirium tremens). MATERIALS AND METHODS: The study enrolled 116 men, 58 of them with uncomplicated AWS, 78 with AWS and delirium. Basic hemodynamic parameters were studied: heart rate (HR), blood pressure (BP), and integral parameters — cardiac index (CI), total peripheral resistance (TPR), shock index (SI). Comparisons between the groups and correlation analysis were conducted to find relationships between hemodynamic parameters and clinical data. RESULTS: In patients with alcoholic delirium, hemodynamic parameters were statistically significantly higher than in patients with uncomplicated AWS: HR (р = 0.003), systolic BP (р = 0.02) and diastolic BP (р = 0.04), while no statistically significant differences in the integral parameters (CI, TPR, SI) were found between the groups. In patients of both groups, CI linearly decreased with age (p 0.0001). The same linearly CI decreased with increase in the duration of alcoholism (p = 0.02). With an increase in the amount of consumed alcohol during the binge period, a linear growth of CI was observed in withdrawal state (p = 0.001). The value of TPR increased with age (p = 0.005). Only in patients with delirium tremens, there was an inverse relationship between SI and partial tension of carbon dioxide in venous blood (r = -0.4; p = 0.014). Besides, only in patients with delirium tremens, by the 7th day of withdrawal, a direct relationship was established between the cardiac index and blood potassium level (r = 0.36; p = 0.03). CONCLUSIONS: There was no significant difference between hemodynamic parameters in uncomplicated AWS and in delirium tremens. CI in patients with uncomplicated AWS and in those with DT decreased with age and with increase in the alcohol load. The vessel tone was inversely proportional to CI throughout the entire period of observation. With the development of delirium, a correlation was noted between a decrease in the level of energy metabolism and the probability for decompensation of systemic circulation. At the stage of reduction of delirium tremens, a correlation was noted between CI and the blood potassium level that reflected the exhaustion of the cardiovascular system and reduction of its compensatory capacities.

Long-Term Differences in AutonomicAlterations After Cryoballoonvs Radiofrequency AtrialFibrillation Ablation.

The long-term natural history of autonomic alterations following catheter ablation of drug-refractory paroxysmal atrial fibrillation is poorly defined. The authors sought to define the long-term impact of thermal catheter ablation on the cardiac autonomic system. The study included 346 patients with drug-refractory paroxysmal atrial fibrillation undergoing pulmonary vein isolation using thermal ablation energy (radiofrequency or cryoballoon ablation). All patients underwent insertion of a Reveal LINQ implantable cardiac monitor prior to ablation. The implantable cardiac monitor continuously recorded physical activity, heart rate variability (HRV) (measured as the standard deviation of the average normal-to-normal), daytime heart rate, and nighttime heart rate (NHR). Longitudinal autonomic data in the 2-month period prior to the date of ablation were compared with the 3 years following ablation. Following ablation, there was a significant decrease in HRV (10-20ms; P< 0.0001) and significant increases in daytime heart rate and NHR (10 beats/min [P< 0.0001] and 7 beats/min [P< 0.0001], respectively). Changes in autonomic parameters were greatest in the first 3months following ablation but remained significantly different from baseline for 36months following ablation. Greater changes in NHR and HRV were associated with improved freedom from recurrent arrhythmia. The type of thermal ablation energy had no influence on the heart rate and autonomic parameters. Pulmonary vein isolation using thermal ablation energy results in significant sustained changes in the heart rate parameters related to autonomic function. These changes are independent of the ablation technology employed and are associated with procedural success. (Cryoballoon vs Irrigated Radiofrequency Catheter Ablation: Double Short vs Standard Exposure Duration [CIRCA-DOSE]; NCT01913522).

80 ЛЕТ НА СЛУЖБЕ ЗДОРОВЬЯ И РАЗВИТИЯ РЕБЁНКА В ОБРАЗОВАНИИ

The article discusses the history and mission of the Federal State Budgetary Scientific Institution "Institute of Child Development, Health and Adaptation" (Director – E.N. Pristupa, Doctor of Sciences in Pedagogy, Professor), which was founded in November 1944. The article describes the main stages of the Institute's development, its scientific achievements and contributions to the study of child physiology, school hygiene, preschool education, physical education and hospital pedagogy. The main areas of the Institute's research are presented, including studies of children's morphophysiological development, the development of methods and standards for assessing and improving children's physical and mental health, and the methodological support of innovative approaches to health protection and child development in the educational environment. The article presents in chronological order the main scientific and practical achievements of the Institute, including research on functional development of children, cognitive activity, telemetric recording of heart rate and respiratory parameters, physiological bases of pubertal stages of children, and the development of scientific bases of physical education in educational organizations. The article also highlights the modern research of the Institute. In conclusion, the article emphasizes the significance of the Institute of Child Development, Health and Adaptation as a recognized center of innovation that significantly contributes to the development of science and education, and the role of the Institute in the creation of a healthy and successful society.

Comparison of efficacy and safety of etomidate with other anesthesia induction drugs for patients undergoing cardiac surgery: A systematic review and meta-analysis of randomized controlled trials

IntroductionEtomidate is commonly used to induce anesthesia in cardiac surgery patients due to its favorable cardiovascular profile. Sedative-hypnotic effects are mediated by gammaaminobutyric acid (GABA) receptor complexes in the central nervous system. There are numerous studies in which etomidate and other drugs are compared in terms of their clinical outcomes. The relative efficacy and safety of etomidate, however, remains inconclusive. In this study, we performed a systematic analysis of randomized controlled trials to assess the impact of etomidate, on patients undergoing cardiac surgery, with respect to patient outcome and adverse events. MethodsA systematic review was conducted of all existing clinical trials exploring the safety and efficacy of etomidate in patients undergoing cardiac surgery. Randomized controlled trials (RCTs) that compared etomidate with other drugs during induction in adult cardiac surgery assessing hemodynamic parameters and clinical outcomes were included, while studies involving non-cardiac or pediatric surgery and those lacking relevant outcome data were excluded. Primary outcomes were all-cause 30-day mortality. Secondary outcomes included duration of tracheal intubation, duration of intensive care unit (ICU) stay, duration of hospital stay, systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR) and other hemodynamic parameters, vasopressor requirements after induction and intubation, cortisol levels, and incidence of myoclonus. ResultsSixteen randomized controlled trials involving 1162 patients were included. Etomidate did not affect the all-cause 30-day mortality of patients undergoing cardiac surgery compared to comparator drugs (RR, 0.96; 95 % CI, 0.26 to 3.49; P = 0.95). There were no significant differences in the duration of tracheal intubation (MD, −0.08 h; 95 % CI, −1.96 to 1.81; P = 0.94), the duration of ICU stay (MD, −2.07 h; 95 % CI, −8.09 to 3.96; P = 0.50) or the duration of hospital stay (MD, −0.62 d; 95 % CI, −2.25 to 1.00; P = 0.45) when etomidate was compared to comparator drugs. Patients receiving etomidate demonstrated a more stable hemodynamic profile after induction and intubation compared to those receiving comparator drugs. The requirement of a vasopressor after induction and intubation was significantly reduced with etomidate compared with those with comparator drugs (RR, 0.37; 95 % CI, 0.25 to 0.56; P < 0.00001). ConclusionsThis systematic meta-analysis found a significant heterogeneity among included studies. In addition, most studies focused only on the hemodynamic profile of etomidate. Thus, efficacy and safety of etomidate could not be answered within this context. Nevertheless, for patients undergoing cardiac surgery, etomidate seems to offer a minimal beneficial cardiovascular profile in comparison with other agents during induction and intubation. However, improved hemodynamics did not improve clinical outcomes as Etomidate did not affect mortality, duration of tracheal intubation, the length of stay in ICU and hospital. Finally, infectious side effects as one important trigger for increased mortality in ICU patients due to the use of Etomidate could not be analyzed as data were mostly missing.

Enhancing Caudal Analgesia in Pediatrics: A Comparison of Ropivacaine With and Without Clonidine for Infra-Umbilical Surgeries.

Introduction Regional anesthesia, particularly caudal blocks, is increasingly used in pediatric surgeries for effective post-operative pain management. However, the duration of analgesia with agents such as ropivacaine alone can be limited. This study investigates the effects of adding clonidine to ropivacaine in caudal blocks for pediatric patients undergoing infra-umbilical surgeries, with the purpose of enhancing the duration and quality of analgesia. Methods We conducted a randomized, double-blind study including 50 children aged one to eight years, divided equally into two groups: group R received 0.2% ropivacaine and group RC received 0.2% ropivacaine with 2 mcg/kg clonidine. Intraoperative and post-operative monitoring included heart rate, blood pressure, and respiratory parameters. Analgesia duration, sedation scores, and the need for rescue analgesia were assessed. Results Group RC exhibited significantly longer analgesia duration (18.4 ± 2.31 hours) compared to group R (10.56 ± 2.27 hours, P < 0.0001). Fewer patients in group RC required a second dose of rescue analgesia (4% vs. 32%, P = 0.023), with no significant differences in sedation scores or adverse effects between the groups. Conclusion Adding clonidine to ropivacaine in caudal blocks significantly prolongs analgesia and reduces the need for additional post-operative pain management in pediatric surgeries without increasing the risk of side effects. This study supports the use of clonidine as an effective adjuvant in pediatric pain management.

Using Multi-Layer Perceptron Driven Diagnosis to Compare Biomarkers for Primary Open Angle Glaucoma.

To use neural network machine learning (ML) models to identify the most relevant ocular biomarkers for the diagnosis of primary open-angle glaucoma (POAG). Neural network models, also known as multi-layer perceptrons (MLPs), were trained on a prospectively collected observational dataset comprised of 93 glaucoma patients confirmed by a glaucoma specialist and 113 control subjects. The base model used only intraocular pressure, blood pressure, heart rate, and visual field (VF) parameters to diagnose glaucoma. The following models were given the base parameters in addition to one of the following biomarkers: structural features (optic nerve parameters, retinal nerve fiber layer [RNFL], ganglion cell complex [GCC] and macular thickness), choroidal thickness, and RNFL and GCC thickness only, by optical coherence tomography (OCT); and vascular features by OCT angiography (OCTA). MLPs of three different structures were evaluated with tenfold cross validation. The testing area under the receiver operating characteristic curve (AUC) of the models were compared with independent samples t-tests. The vascular and structural models both had significantly higher accuracies than the base model, with the hemodynamic AUC (0.819) insignificantly outperforming the structural set AUC (0.816). The GCC + RNFL model and the model containing all structural and vascular features were also significantly more accurate than the base model. Neural network models indicate that OCTA optic nerve head vascular biomarkers are equally useful for ML diagnosis of POAG when compared to OCT structural biomarker features alone.

Smart watch for early heart attack detection and emergency assistance using IoT

This research introduces a Smart Watch equipped with advanced physiological monitoring capabilities for the early detection of heart attacks and automatic initiation of emergency assistance. Cardiovascular diseases, particularly heart attacks, are a leading cause of global mortality. Rapid response during a heart attack significantly improves patient outcomes, emphasizing the need for innovative solutions. The proposed Smart Watch integrates a combination of sensors, including ECG (Electrocardiogram) and PPG (Photoplethysmography), to continuously monitor the user's heart rate, rhythm, and other relevant physiological parameters. Machine learning (Time Series Analysis algorithm) is employed to analyse the collected data in real-time, identifying patterns indicative of a potential heart attack.Upon detecting abnormal cardiac activity, the Smart Watch triggers an immediate response by connecting to a dedicated mobile application. The application utilizes built-in communication features to establish a connection with emergency services, providing vital information about the user's condition, location, and medical history. Simultaneously, the Smart Watch alerts predefined emergency contacts, ensuring a swift response from friends or family members.

Methods for assessing the diastolic distensibility of the left ventricle

The most important property of the myocardium that determines the filling of the left ventricle (LV) of the heart is its distensibility. The simplest method of its assessment is the ratio of pressure and LV volume at the end of the diastole. Active relaxation of the myocardium is determined by the work of calcium pumps, and passive relaxation is determined by sarcomere proteins and, first of all, by connectin – titin. The paper compares 6 calculated indices of LV diastolic stiffness of the heart, compares their stability, variations and correlation coefficients from various parameters of hemodynamics. It is shown that only the diastolic stiffness index No. 4, which takes into account LV stiffness at the beginning and end of diastole, showed a weak dependence on LV, heart rate and other parameters of LV hemodynamics of the heart. Therefore, this index can be used in the future to assess the distensibility of the heart in various pathologies.

Unraveling the interplay between mental workload, occupational fatigue, physiological responses and cognitive performance in office workers

Recently, cognitive demands in workplaces have surged significantly. This study explored the intricate relationship among mental workload (MWL), occupational fatigue, physiological responses, and cognitive performance in office workers by using collective semi-parametric models. One hundred office workers were selected from twenty offices involved in cognitive performance. MWL was assessed through the NASA Task Load Index (NASA-TLX), and occupational fatigue was measured using the Persian version of the Swedish Occupational Fatigue Inventory. Physiological responses, including respiratory rate, the electrical conductivity of the skin (ECS), Heart Rate (HR), and other heart-related parameters, were recorded from the participants during a work shift. Selective and Divided Attention tests were chosen to evaluate workers' cognitive function based on cognitive task analysis. The mean of MWL and occupational fatigue scores were 66.28 ± 11.76 and 1.62 ± 1.07, respectively. There was a significant moderate correlation between two dimensions, mental demand (0.429) and frustration (0.409), with functional fatigue. Also, Significant and, of course, nonlinear relationships were observed between MWL and HR (R2 = 0.44, P-value < 0.001) and ECS (R2 = 0.45, P-value < 0.001) and reaction time in selected (R2 = 0.34, P-value < 0.001) and divided test (R2 = 0.48, P-value < 0.001). Similarly, nonlinear relationships were observed between physiological responses and cognitive performance with fatigue among participants who had experienced higher levels of occupational fatigue. The MWL and fatigue seem to have a significant and non-linear effect on physiological parameters such as HR and ECS and cognitive parameters such as reaction time. Moreover, MWL can influence the dimension of functional fatigue of workers.