Heart Rate Research Articles

Importance of Return to Usual and School Activities After Social Isolation in Recovering Vitamin D Concentrations, Physical Fitness, and Motor Performance in Adolescents

This study aimed to observe adolescents’ changes and individual responses regarding the anthropometry, cardiometabolic profile, vitamin D concentrations, physical fitness, and motor competence upon immediate return and three months of school activities after lockdown. Methods: The study included 28 adolescents (14.8 ± 0.8 years) of both sexes. Anthropometric measures, body composition, cardiometabolic parameters, physical fitness, and motor competence were assessed. A paired t-test was used to compare the frequencies of respondents and the effect size of the results, considering significant p < 0.05. Results: After three months of school activities, adolescents changed their body composition, reducing % fat mass (p = 0.008) and increasing fat-free mass (p = 0.008). In terms of physical fitness, there was increased abdominal resistance (p < 0.001; ES = −0.42) and motor performance, with reduction in supine-to-stand test time (p < 0.001; ES = 0.53). There were very beneficial effects in reducing resting heart rate (p ≤ 0.001; ES = 0.61) and increasing vitamin D concentrations (p < 0.001; ES = −0.61). After three months of a school routine, the proportions of change in respondents were similar between girls and boys and eutrophic individuals and overweight individuals. Conclusions: Returning to school activities after lockdown was important for the recovery of vitamin D concentrations, physical fitness, and motor competence, whose responses were independent of the level of adiposity and sex of the adolescents.

Mandibular Advancement Devices in Obstructive Sleep Apnea and Its Effects on the Cardiovascular System: A Comprehensive Literature Review

Background: Obstructive sleep apnea syndrome (OSA) is a chronic inflammatory disease characterized by endothelial dysfunction and cardiovascular complications. Continuous positive airway pressure (CPAP) is the standard treatment, hence poor adherence has prompted interest in mandibular advancement devices (MAD) as an alternative. This comprehensive review aimed to explore the effects of MAD therapy on oxidative stress, inflammation, endothelial function, and its impact on the cardiovascular risk in OSA patients. Results: MAD therapy significantly reduces the apnea-hypopnea index (AHI), improves serum nitric oxide (NOx) concentrations, reduces oxidative stress markers, and enhances endothelial function. Animal studies indicated that MAD reduces myocardial fibrosis and attenuates inflammatory markers. While both CPAP and MADs improve endothelial function and heart rate variability, CPAP is more effective in reducing OSA severity. Nevertheless, MAD has higher compliance, contributing to its positive impact on cardiovascular function. Moreover, CPAP and MADs have similar effectiveness in reducing cardiovascular risk. Conclusions: MAD therapy is an effective alternative to CPAP, particularly for patients with mild to moderate OSA as well as those intolerant to CPAP. It offers significant improvements in endothelial function and oxidative stress. Further studies are needed to assess MAD therapy in comprehensive OSA management.

Old and new equations for maximal and anaerobic threshold heart rate prediction in coronary heart disease in Chinese population

BackgroundThe prediction of maximal heart rate (MHR) and anaerobic threshold heart rate (HRAT) in patients with coronary heart disease (CHD), particularly among the Chinese population, remains a significant challenge. Existing equations for MHR prediction are primarily designed for healthy individuals not on medication for optimized β-blocker (BB) therapy, showing limited efficacy for individuals on various drug regimens. Moreover, the prediction of HRAT lacks established formulas. This study aims to develop equations for MHR and HRAT, assess the accuracy of historical MHR formulas, and examine their correlation with HR measurements at the anaerobic threshold (AT).MethodsAmong 2021 to 2023, 170 CHD patients were recruited. Patients were categorized into groups based on BB usage. BB dose was transformed into carvedilol dose. Multiple linear stepwise regression analysis was employed to identify predictors of MHR and HRAT, incorporating key patient variables according to prior studies (age, sex, height, weight, carvedilol dose, HRrest). The mean absolute percentage errors (MAPEs) were calculated and compared among abovementioned MHR and HRAT prediction formulas. Besides, the percentages of MHR in predicting HRAT among different formulas were calculated.ResultsFor the patients with BB medication, the simplified equations derived for MHR and HRAT were 176 − 1.2*age + 0.7*HRrest − 0.4*weight and 98 − 0.6*age + 0.7*HRrest − 0.3*weight, respectively. For those without BB medication, the derived equations for MHR and HRAT were 200 − 1.1*age and 91 − 0.5*age + 0.5*HRrest, respectively. There are significant differences between the results predicted by the new formula and the prior formulas. The new formulas are helpful for predicting the MHR of patients during exercise more accurately and guiding exercise training more scientifically.ConclusionsThe new equations for estimating MHR and HRAT in CHD patients enhance the accuracy of prior formulas. Given the BB impact on sympathetic nerve activity, the predictive formulas for MHR and HRAT were significantly improved.

Efficacy of high-flow nasal oxygen therapy in cancer patients with concurrent acute hypoxemic respiratory failure: a retrospective propensity score study.

Acute respiratory failure is the leading cause of intensive care unit (ICU) admission of cancer patients. Studies of the efficacy of high-flow nasal cannula (HFNC) therapy were rarely conducted in cancer populations. We here compared the clinical effects of HFNC therapy and conventional oxygen therapy (COT) in cancer patients with concurrent acute hypoxemic respiratory failure (AHRF). In this single-center retrospective study, cancer patients with concurrent acute hypoxic respiratory failure either received initial oxygen therapy via HFNC (HFNC group, 68 patients) or received initial oxygen therapy via a nasal cannula, simple mask, or mask with reservoir bag (COT group, 133 patients). Groups were propensity score matched. Differences in respiratory rate (RR), heart rate (HR), and PaO2/FiO2 ratio before and after treatment in the two groups were compared using a mixed-effects model. The 28-day mortality risk was explored using a Cox proportional hazards model. The 24-h and 48-h PaO2/FIO2 ratios were significantly higher in the HFNC than in the COT group (210.5mmHg vs. 178.5mmHg; P < 0.01; 217.1mm Hg vs. 181.6mm Hg; P < 0.01, respectively). Differences in RR and HR between the groups at each time point were nonsignificant. The 28-day mortality rate was 17.4% vs. 38.1% for the HFNC and COT groups, respectively (P < 0.01). Hazard ratio was significantly higher for COT group (HR 2.6, 95% confidence interval 1.3, 5.3). Compared with COT, HFNC use for initial oxygen therapy can improve PaO2/FIO2 ratio and survival rate in cancer patients with AHRF.

The impact of the type of playful massage movements on the perception of tactile stimulation in children: EEG study

Tactile play and playful massage are a normal interaction between adults and children in many cultures. Experimental data show that activation of the C-tactile system during such playful touches contributes to children’s socialization and the establishment of psychoemotional bonds in the parent-child dyad. However, comprehensive studies of the effects of different types of touch on perception of tactile stimulation in children have not been conducted before. Twenty-three children participated in the present study: 10 in the preschool age group and 13 in the elementary school age group. Children in both groups received play massage containing different types of touch with simultaneous recording of electroencephalogram (EEG) and heart rate. EEG processing included determination of spectral power, alpha rhythm peak frequency and fractal dimension. Analysis of the results showed that the relaxing effect of the procedure was more pronounced in children of primary school age, which can be explained both by the greater maturity of the CNS and the greater need for tactile contact, which is not realized in the school environment.

Effects of concentric and eccentric exercise regimens on bioenergetic efficiency of lymphocytes in sedentary males.

Eccentric exercise training (EET) increases physical performance while having lower metabolic demand than concentric exercise training (CET). Whether EET influences bioenergetic efficiency in peripheral blood mononuclear cells (PBMCs) remains unclear. This study investigates the effects of EET and CET on PBMC phenotypes and mitochondrial functions in blood. Thirty three sedentary healthy males were randomly assigned to either EET (n=11) or CET (n=11) that performed at progressively increased from 60% to 80% of maximal absolute workload for 30min/day, 5days/week for 6weeks, or a control group (n=11) that did not receive any exercise intervention. A graded exercise stress test (GXT) was performed before and after the intervention. PBMC phenotypes and mitochondrial respiratory capacity were analyzed using flowcytometry and high-resolution respirometry, respectively. In the same absolute workload, EET elicited lower heart rate and rating of perceived exertion than CET. However, EET as CET increased the VO2 level at the ventilatory threshold. Notably, both EET and CET increased central memory (CD45RO+/CD62+/CD3+) T cells and decreased effector memory T cells reexpressing CD45RA (CD45RA+/CD62-/CD3+). Moreover, the two exercise regimens diminished the loss of mitochondrial membrane potential (ΔΨm) caused by GXT, increased maximal/reserve O2 consumption rates (OCR), and bioenergetic health index in intact PBMCs and enhanced complex I-/II-related OCR in PBMCs with a substrate-rich environment. EET improves aerobic fitness with a lower cardiovascular response to exercise than CET. Moreover, EET as CET reduces senescent T-cell distribution in blood and improves PBMC bioenergetic efficiency by stabilizing ΔΨm and increasing capacity of oxidative phosphorylation.

The Impact of Yoga on Post-Exercise Fatigue among College Students

This study aims to evaluate the effects of yoga on subjective fatigue and heart rate recovery in college students following high-intensity exercise. By comparing groups of students practicing yoga and those resting statically, the study will explore whether yoga is a viable recovery method for reducing fatigue and accelerating heart rate recovery. The results will provide scientific evidence for designing university sports curricula and offer references for managing students' exercise health.

Is Greener Better? Quantifying the Impact of a Nature Walk on Stress Reduction Using HRV and Saliva Cortisol Biomarkers

The physiological impact of walking in nature was quantified via continuous heart rate variability (HRV), pre- and post-walk saliva cortisol measures, and self-reported mood and mindfulness scores for N = 17 participants who walked “The Green Road” at Walter Reed National Military Medical Center in Bethesda, Maryland. For N = 15 of the participants, HRV analysis revealed two main groups: group one individuals had a 104% increase (mean) in the root mean square standard deviation (RMSSD) and a 47% increase (mean) in the standard deviation of NN values (SDNN), indicating an overall reduction in physiological stress from walking the Green Road, and group two individuals had a decrease (mean) of 42% and 31% in these respective HRV metrics, signaling an increase in physiological stresses. Post-walk self-reported scores for vigor and mood disturbance were more robust for the Green Road than for a comparable urban road corridor and showed that a higher HRV during the walk was associated with improved overall mood. Saliva cortisol was lower after taking a walk for all participants, and it showed that walking the Green Road elicited a significantly larger reduction in cortisol of 53%, on average, when compared with 37% of walking along an urban road. It was also observed that the order in which individuals walked the Green Road and urban road also impacted their cortisol responses, with those walking the urban road before the Green Road showing a substantial reduction in cortisol, suggesting a possible attenuation effect of walking the Green Road first. These findings provide quantitative data demonstrating the stress-reducing effects of being in nature, thus supporting the health benefit value of providing access to nature more broadly in many settings.

The effects of methimazole combined with propranolol on heart rate, bone metabolism, and thyroid hormone levels in patients with hyperthyroidism: A systematic review and a meta-analysis of case-control studies.

The combination of methimazole and propranolol is considered an effective treatment regimen for hyperthyroidism in clinical practice; however, detrimental effects on the heart rate, bone metabolism and thyroid hormone levels have been reported. Therefore, the present study aimed to systematically review the efficacy and safety differences in patients with hyperthyroidism and the effects of treatment on heart rate, bone metabolism, cortisol, and adrenocorticotropic hormone levels using case-control studies. Clinical case-control trials of methimazole combined with propranolol for the treatment of hyperthyroidism were selected from Chinese and English databases, and data were collected from the establishment of the database until August 2024. Two independent researchers evaluated the quality of the literature using the Newcastle-Ottawa Scale (NOS). Meta-analysis of each effect index was performed using RevMan software (version 5.3), and the quality of the results was evaluated using the GRADE profiler system letter description method. Sixteen clinical case-control trials were included in this study. Of these, 2 trials exhibited NOS scores of 7, 6 trials exhibited NOS scores of 6, and 8 trials exhibited NOS scores of 5. These accounted for 12.5% of the high-quality literatures, and included 772 patients treated with methimazole combined with propranolol (observation group) and 771 patients treated with methimazole alone (control group). The results of the meta-analysis demonstrated that methimazole combined with propranolol improved the cure rate, the total effective rate, and heart rate, compared with the control group (P < .05). In addition, calcification, bone glutamate protein, free triiodothyronine, free tetraiodothyronine, thyroid-stimulating hormone, cortisol, and adrenocorticotropic hormone were significantly different between the 2 groups (P < .05). There were no significant differences in leukemia, headache, dizziness, skin pruritus, bone pain, arthralgia, or in improving parathyroid hormone or reducing gastrointestinal reactions between the 2 groups. The present study demonstrated that methimazole combined with propranolol may significantly improve the heart rate, bone metabolism and associated hormone levels in patients with hyperthyroidism, without significantly increasing the risk of adverse reactions. However, due to the impact of primary literature type, quality or research methods high-quality, multicenter, rigorously designed clinical trials are required for further verification.

Fatigue trajectories by wearable remote monitoring of breast cancer patients during radiotherapy

The aim of this pilot study was to assess the compliance of breast cancer (BC) patients with fitness tracker (FT) monitoring program during radiotherapy (RT) and to characterize radiation-induced fatigue (RIF) status through objective evaluation using FT-collected parameters. Thirty-six BC patients were invited to wear FT during their RT course for continuous monitoring of heart rate (HR) and step counts (STP). RIF assessment was performed weekly, according to CTCAE v5.0 and dichotomized into G0 vs. any-grade. A novel concept based on patient Repeated Activity Window (RAW) was introduced to evaluate HR and STP variations during RT. Several Machine Learning (ML) methods were trained to characterize RIF on the basis of HR and STP collected data. RIF of any grade was reported by 17 out of 36 patients (47%) included in the study. None of patient clinical variables were significantly correlated with RIF. All patients accepted the FT monitoring program, and for 32 patients FT collection efficiency was greater than 60%. For each patient, a distinct distribution of RAWs was identifiable over RT and across the entire patient cohort, with a total of 7950 RAWs processed. Six features related to RAWs, HR and STP were identified as associated with RIF. The best-performing classifier was the Bagged Trees model, showing a cross-validated ROC-AUC of 89% (95% CI 88–90%). This study confirms the feasibility of continuous biomedical monitoring of BC patients by FT. We successfully identify objective indicators of RIF through HR and STP variation measures within each patient’s RAW, thus providing a novel and practical approach to assess and manage RIF. This can significantly aid medical staff in evaluating RIF trajectories, potentially leading to better individualized care strategies and improved patient outcomes.

Changes in Negative Emotions Across Five Weeks of HRV Biofeedback Intervention were Mediated by Changes in Resting Heart Rate Variability.

Resting heart rate variability (HRV) is typically higher in those with better emotional well-being. In the current study, we examined whether changes in resting HRV mediated changes in negative emotions during a 7-week clinical trial of HRV biofeedback. Younger and older adults were randomly assigned to one of two daily biofeedback practices for 5weeks: (1) engage in slow-paced breathing to increase the amplitude of oscillations in heart rate at their breathing frequency (Osc+); or (2) engage in self-selected strategies to decrease heart rate oscillations (Osc-). We assessed negative emotion using the State Anxiety Inventory (SAI) and Profile of Mood States (POMS). Resting HRV at pre-intervention was significantly higher among those with lower negative emotion scores. Those participants showing greater increases in resting HRV showed greater decreases in negative emotion. In a mediation model with all participants, resting HRV changes significantly mediated the relationship between training performance (i.e., heart rate oscillation during practice sessions) and changes in negative emotion. However, additional analyses revealed this mediation effect was significantly moderated by condition and was only significant in the Osc+ condition. Thus, resting HRV changes mediated how biofeedback to increase amplitude of heart rate oscillations reduced negative emotion.

Associations of schizophrenia with arrhythmic disorders and electrocardiogram traits: genetic exploration of population samples.

An important contributor to the decreased life expectancy of individuals with schizophrenia is sudden cardiac death. Arrhythmic disorders may play an important role herein, but the nature of the relationship between schizophrenia and arrhythmia is unclear. To assess shared genetic liability and potential causal effects between schizophrenia and arrhythmic disorders and electrocardiogram (ECG) traits. We leveraged summary-level data of large-scale genome-wide association studies of schizophrenia (53 386 cases, 77 258 controls), arrhythmic disorders (atrial fibrillation, 55 114 cases, 482 295 controls; Brugada syndrome, 2820 cases, 10 001 controls) and ECG traits (heart rate (variability), PR interval, QT interval, JT interval and QRS duration, n = 46 952-293 051). We examined shared genetic liability by assessing global and local genetic correlations and conducting functional annotation. Bidirectional causal relations between schizophrenia and arrhythmic disorders and ECG traits were explored using Mendelian randomisation. There was no evidence for global genetic correlation, except between schizophrenia and Brugada syndrome (rg = 0.14, 95% CIs = 0.06-0.22, P = 4.0E-04). In contrast, strong positive and negative local correlations between schizophrenia and all cardiac traits were found across the genome. In the most strongly associated regions, genes related to immune and viral response mechanisms were overrepresented. Mendelian randomisation indicated that liability to schizophrenia causally increases Brugada syndrome risk (beta = 0.14, CIs = 0.03-0.25, P = 0.009) and heart rate during activity (beta = 0.25, CIs = 0.05-0.45, P = 0.015). Despite little evidence for global genetic correlation, specific genomic regions and biological pathways emerged that are important for both schizophrenia and arrhythmia. The putative causal effect of liability to schizophrenia on Brugada syndrome warrants increased cardiac monitoring and early medical intervention in people with schizophrenia.

A fuzzy-logic approach for longitudinal assessment of patients’ psychophysiological state: an application to upper-limb orthopedic robot-aided rehabilitation

Understanding the psychophysiological state during robot-aided rehabilitation is crucial for assessing the patient experience during treatments. This paper introduces a psychophysiological estimation approach using a Fuzzy Logic inference model to assess patients’ perception of robots during upper-limb robot-aided rehabilitation sessions. The patients were asked to perform nine cycles of 3D point-to-point trajectories toward different targets at varying heights with the assistance of an anthropomorphic robotic arm (i.e. KUKA LWR 4+). Physiological parameters, including galvanic skin response, heart rate, and respiration rate, were monitored across ten out of forty daily sessions. This data enabled the construction of an inference model to estimate patients’ perception states. Results expressed in terms of correlation coefficients between the patient state and the increasing number of sessions. Correlation coefficients showed statistically significant strong associations: a state of heightened engagement (formerly described as “Excited”) had ρ=-0.73\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\rho = -0.73$$\\end{document} (p-value=0.01), and a more calm and resting state (namely “Relaxed” state) had ρ=0.70\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\rho = 0.70$$\\end{document} (p-value=0.02) with the number of sessions completed. All patients had positive interaction with the robot, initially expressing curiosity and interest that gradually shifted to a more “Relaxed” state over time.

The influence of a walk in nature on human resting brain activity: a randomized controlled trial

Behavioral studies suggest that immersion in nature improves affect and executive attention. However, the neural mechanisms underlying these benefits remain unclear. This randomized controlled trial (N = 92) explored differences in self-reported affect and in frontal midline theta (FMθ), a neural oscillation linked to executive attention, between a 40-min, low-intensity nature walk and an urban walk of comparable time and distance—controlling for ambient temperature, humidity, elevation change, walking pace, heart rate, calories burned, and moving time between the two groups. While affect improved for both groups, the nature walkers showed a significantly greater boost in positive affect than the urban walkers. Electroencephalography (EEG) data revealed significantly greater FMθ activity following the urban walk compared to the nature walk, suggesting that the urban walk placed higher demands on executive attention. In contrast, the nature walk allowed executive attention to rest, as indicated by the lower FMθ activity observed after the walk. This study suggests that changes in FMθ may be a potential neural mechanism underlying the attentional strain of urban environments in contrast to the attentional rest in nature.

An Investigation of Indoor Environment Quality on Occupants’ Thermal Responses, Health, and Productivity: A Study Based on Physiological Data in Occupied Office Space

This study explores the impact of Indoor Environment Quality (IEQ) on the health and productivity of office workers in an office building in Fujisawa, Kanagawa, Japan. Previous studies have shown that IEQ can affect the physiological responses of occupants, such as of skin temperature, heart rate, and metabolic rate, which are indicators of health and productivity. However, most studies took place in controlled laboratory environments, which may not accurately represent real-life experiences. The study collected subjective and objective data from actual occupied office space, including on perceptions of IEQ, health, and productivity, and measurements of IEQ parameters such as on the thermal environment, light environment, indoor air quality, and acoustics. The study used correlation and linear regression methods to examine the relationship between IEQ, physiological data, and subjective responses to health and productivity. The stable thermal environment and low physical intensity of office work may contribute to the weak correlation between physiological data, thermal responses, and health–productivity variables. The results of this study can provide insights into how IEQ affects the psychological responses, well-being, and performance of office workers in real-world settings.

TO-LAB model: Real time Touchless Lung Abnormality detection model using USRP based machine learning algorithm.

Due to the increasing prevalence of respiratory diseases and the importance of early diagnosis. The need for non-invasive and touchless medical diagnostic solutions has become increasingly crucial in modern healthcare to detect lung abnormalities. Existing methods for lung abnormality detection often rely on invasive and time-consuming procedures limiting their effectiveness in real-time diagnosis. This work introduces a novel Touchless Lung Abnormality (TO-LAB) detection model utilizing universal software radio peripherals (USRP) and machine learning algorithms. The TO-LAB model integrates a blood pressure meter and an RGB-D depth-sensing camera to gather individual data without physical contact. Heart rate (HR) is analyzed through image conversion to IPPG signals, while blood pressure (BP) is obtained via analog conversion from the blood pressure meter. This touchless imaging setup facilitates the extraction of essential signal features crucial for respiratory pattern analysis. Advanced computer vision algorithms like Mel-frequency cepstral coefficients (MFCC) and Principal Component Analysis (PCA) process the acquired data to focus on breathing abnormalities. These features are then combined and inputted into a machine learning-based Multi-class SVM for breathing activity analysis. The Multi-class SVM categorizes breathing abnormalities as normal, shallow, or elevated based on the fused features. The efficiency of this TO-LAB model is evaluated with the simulated and real-time data. According to the findings, the proposed TO-LAB model attains the maximum accuracy of 96.15% for real time data; however, the accuracy increases to 99.54% for simulated data for the efficient classification of breathing abnormalities. From this analysis, our model attains better results in simulated data but it declines the accuracy while processing with real-time data. Moreover, this work has a significant medical impact since it presents a solution to the problem of gathering enough data during the epidemic to create a realistic model with a large dataset.

Variability of Loa loa microfilarial counts in successive blood smears and its potential implication in drug-related serious adverse events

BackgroundThe standard method to diagnose Loa loa infection and quantify microfilarial density (MFD) is the microscopic examination of calibrated thick blood smears (TBSs). In 1950, it was noticed that successive L. loa MFD samples from a single capillary puncture could exhibit up to 20% variation. Although loiasis treatment allocation is based on MFD to prevent serious adverse events (SAEs), data on this variability are scarce. There are also no guidelines supporting the collection and analysis of one or two TBSs.MethodsWe assessed the variability of two successive L. loa MFD samples (MFD1 and MFD2), collected from 255 patients. We analyzed the influence of sex, age, weight, heart rate, arterial pressure, body temperature, and sampling time on MFD variability, as well the impact of MFD variability on MFD thresholds relevant to loiasis treatment protocols.ResultsThe MFD2 was found to have increased in 63% (1145/1826) of TBS pairs and to have decreased in 37% (681/1826) of TBS pairs. The MFD2 were on average 28% higher than the MFD1. These variations drove a total of 333 (17.4%) changes in MFD classes according to loiasis treatment protocol, including 210 (11.3%) class increases. TBSs generated from blood samples from subjects with lower MFD (1–1000 mf/ml) or lower mean arterial pressure (MAP; 55–80 mmHg), or from blood samples collected at an earlier hour time-point (10:00–10:59 a.m.) were more subject to MFD2 variability in a multivariate analysis. The MFD relative change was not constant over time for a given person.ConclusionsWe observed a trend towards an increase in MFD2 with an important variability between samples that may impact loiasis treatment allocation. We suggest that systematically sampling at least two successive TBSs might allow better MFD assessments to prevent post-treatment SAEs. Further studies are needed to verify this variability in larger samples as well as confirm the potential explanatory variables identified.Graphical

Study on the clinical value of the wearable foetal electrocardiogram monitoring system.

Electronic foetal monitoring (EFM), a method to monitor foetal intrauterine conditions and foetal reserve capacity, is the most extensively used intrauterine monitoring technology in obstetrics. This study aims to compare the Thoth wearable foetal electrocardiogram (foetal ECG [FECG]) monitoring system with a traditional Doppler foetal heart monitoring system before labour to investigate their respective values in clinical application. A total of 393 pregnant women admitted to our hospital between 2020 and 2022 participated in this study. They were recruited using the convenience sampling method. We employed a paired design to assess the confusion rate, trend overlap, and foetal heart rate/ECG monitoring consistency, whereas a completely randomised design was used to measure pregnancy outcome indicators. The participants were divided into two groups using a random number table: the Thoth group (n= 196) and the traditional Doppler group (n= 197). Each group was monitored using the corresponding system. The Thoth monitor demonstrated a lower confusion rate compared with the traditional Doppler monitor (0.25% vs 2.04%; χ2= 5.508, P= 0.019). The trend overlap in foetal heart rates was consistently 100%, with 91.2% of readings showing a consistency rate of ⩾ 95%. Additionally, the Thoth monitor recorded a higher cumulative interruption time in the foetal heart rate curve (12.13 ± 2.22 vs 21.02 ± 2.34; t= 18.471, P< 0.001) and more abnormal ECGs (21.21 ± 4.32 vs 18.21 ± 2.91; t= 7.582, P< 0.001) than the traditional Doppler system. The Thoth wearable FECG monitor offers several advantages over the traditional Doppler foetal heart monitoring system. These include a reduced confusion rate, more accurate data collection, a lower rate of clinical misjudgement, reduced workload for medical staff, and enhanced comfort during vaginal delivery. The rates of emergency caesarean sections and neonatal asphyxia in the Thoth group were marginally lower than those in the Doppler group, which may be attributed to issues such as ECG disconnection or interference from the maternal heart rate.

Comparative efficacy of ciprofol and propofol in reducing respiratory depression during ERCP anesthesia: a randomized controlled trial

BackgroundPropofol is one of the important drug causes of respiratory depression in endoscopic retrograde cholangiopancreatography (ERCP) anesthesia. This study aims to clarify whether Ciprofol in ERCP anesthesia reduces the respiratory depression rate.MethodsIn this randomized controlled trial performed at the Surgical Endoscopy Center, the First Hospital of Lanzhou University between Jun 01, 2022 and Feb 20, 2024, patients undergoing ERCP anesthesia were randomly assigned into ciprofol (study group) or propofol (control group). Primary outcomes included respiratory depression rate during anesthesia, and secondary outcomes included body movement and hypoxemia, awakening time, mean arterial pressure and heart rate changes at key points during surgery.Results20 of the 306 patients had respiratory depression (6.5%). The frequency of respiratory depression was 3.3% in the group C and 9.8% in the group P, with a difference of 6.5% between the two groups (P = 0.035). Ciprofol anesthesia decreased the hyoxemia, injection pain, and circulation and heart rate fluctuations. Multivariable logistic regression analyses showed that Propofol (OR 1.970; 95% CI, 1.121–3.461, P = 0.018), mallampati classification>II (OR 1.594; 95% CI, 1.129–2.249, P = 0.008), and fasting time>10.5 h (OR 3.184; 95% CI, 1.531–6.621, P = 0.002) were independent risk factors for incidence of respiratory depression in ERCP anesthesia.ConclusionsFor patients undergoing anesthesia for ERCP, Ciprofol, compared to Propofol, has been shown to effectively reduce the incidence of intraoperative respiratory depression, thereby enhancing the safety of the anesthesia process.Trial registrationThis study was registered in the Chinese Clinical Trial Registry on 15/01/2022 (ChiCTR2200055629).

Obstetric Uterine Rupture of the Unscarred Uterus: A Case Series of Six

Objectives: Uterine rupture in an unscarred uterus is a reality. It is a rare obstetrical complication that requires prompt diagnosis and immediate management. The aim of our study is to describe and analyze the epidemiological characteristics, maternal and fetal prognostic elements, and different therapeutic modalities of uterine rupture in an unscarred uterus. Methods: This is a descriptive retrospective study spanning a 6-year period from 2017 to 2022. Results: The incidence was 1.7/10,000 deliveries, with a mean maternal age of 31.3 years. All patients were multiparous, and rupture occurred during labor in all cases. The main clinical presentation was a non-reassuring fetal heart rate tracing. Surgical treatment was conservative in 4 out of 6 cases. There were no maternal deaths, but the fetal prognosis was severe, with two fetal deaths. Conclusion: Unscarred uterine rupture is a rare but serious obstetric complication. In this series, maternal-fetal morbidity and mortality were high, consistent with the literature.