Blood Heart Research Articles

Health monitoring system using ECG and PPG techniques

The demand for portable health monitoring systems has grown rapidly in recent years due to the increasing prevalence of chronic diseases and the need for continuous health monitoring. This article introduces the development and implementation of a portable health monitoring system using photo plethysmography (PPG) and electrocardiogram (ECG) technologies. The system integrates the Node MCU ESP8266 microcontroller, AD8232 ECG sensor, and MAX30100 sensor to measure vital signs such as heart rate and blood oxygen saturation level. The proposed system provides a cost-effective and efficient solution for real-time health monitoring, enabling early detection of abnormalities and timely intervention. The feasibility and performance of the system were proven through experimental tests.

Dexmedetomidine versus remifentanil in nasal surgery: a systematic review and meta-analysis

BackgroundNasal surgeries, addressing anatomical variations for form and function, require careful anesthesia administration, including dexmedetomidine and remifentanil. This meta-analysis evaluates their safety and efficacy variations in nasal surgeries, emphasizing patient comfort and optimal outcomes.MethodsFour electronic databases (PubMed, Scopus, Web of Science, and CINAHL Complete) were searched for records in English. Studies that measure the effect of dexmedetomidine versus remifentanil on patients underwent nasal surgery were included. The Cochrane Collaboration’s tool was used to assess the quality of the included studies. A random-effect model was preferred and statistical analysis was performed by Stata software version 17.ResultsOut of an initial pool of 63 articles, five studies were selected for this analysis. All of these chosen studies were Randomized Controlled Trials (RCTs). The meta-analysis involved a total of 302 participants, with 152 in the remifentanil group and 150 in the dexmedetomidine group. The analysis aimed to compare the effects of Dexmedetomidine and Remifentanil on heart rate (HR) and mean arterial pressure (MAP) during surgery. Both groups exhibited similar MAP and HR, with the exception of a slightly lower HR in the remifentanil group at the 15th minute of surgery (Standardized Mean Difference: -0.24 [-0.83, 0.34]). Furthermore, when evaluating the impact of these medications on post-surgery outcomes, including pain levels, the use of pain relief medications, patient-surgeon satisfaction, agitation scores, and recovery time, no significant differences were observed between the two medications in any of these aspects.ConclusionIn summary, the study compared Dexmedetomidine and Remifentanil in nasal surgeries anesthesia. No significant differences were found in heart rate, blood pressure, satisfaction, pain, agitation, or recovery time. The study had limitations, and future research should establish standardized protocols and consider various surgical factors.

Effect of Maximal Exercise on the Heart Rate, Blood Pressure and Level of Cardiac Remolding in Elite Athletes

Aim / Objective: The purpose of this study was to determine how intense exercise effect the blood pressure, heart rate and the extent upto, which the cardiac remolding may occur in elite athletes. Location of Study: This study was conducted in the Department of Physiology, Army Medical College, along with the Armed Forces Institute of Cardiology (AFIC) in Rawalpindi. Methodology: There were 40 control participants and 40 elite endurance athletes. Clinical tests were performed on all the subjects to rule out an underlying medical condition or disease. Auscultatory method was used to measure the heart rate before exercise and immediately after exercise, Similarly the blood pressure was examined before and within 3 minutes after the physical activity. The left ventricular end-diastolic internal diameter (LVIDd), diastolic posterior wall thickness (PWTd), diastolic interventricular septal thickness (IVSTd), and left ventricular mass (LVM) were measured by echocardiography and determined using the Devereux formula. Before breakfast, the participants engaged in maximum physical activity on an electronic ergometer cycle until they were exhausted. Results: It was observed that when compared to the control group, the heart rates and blood pressure of athletes were noticeably lower. In contrast, LVIDd, IVSTd, PWTd, and LVM were higher in athletes than in healthy controls... Conclusion: The long term athletic training causes remodeling of the heart with increased dimensions of the left ventricle which reduces the heart rate and blood pressure in endurance trained athletes.

Blood Pressure Variability is Better Associated with Acute Relative Hyperglycemia Than the Heart Rate Variability in Healthy Young Adults.

Deranged cardiovascular autonomic functions are well-reported complications of diabetes mellitus, where chronic hyperglycemia is an important factor. The role of acute relative hyperglycemia on cardiovascular autonomic functions, particularly on blood pressure variability in healthy subjects, has been rarely explored. Therefore, this study aimed to examine the effect of acute relative hyperglycemia on cardiovascular autonomic functions in healthy young adults. Beat-to-beat blood pressure and electrocardiogram were recorded to assess the heart rate variability and blood pressure variability in 42 young, healthy subjects during fasting and relative hyperglycemic states. Recorded cardiovascular parameters were analyzed in time and frequency domains. Correlations among analyzed parameters of cardiovascular autonomic variabilities were explored during fasting and relative hyperglycemic state. A few of the systolic, mean, and diastolic blood-pressure-variability parameters were significantly altered during acute relative hyperglycemia when compared to the fasting state. However, no significant changes were observed in any of the heart-rate-variability parameters. Also, novel significant correlations were found among many of the parameters of cardiovascular autonomic variabilities during fasting and relative hyperglycemic states. The blood pressure variability is affected significantly during acute relative hyperglycemia in healthy young adults; however, the heart rate variability does not show such changes. Also, many blood pressure variability parameters show significant correlations with heart rate variability and baroreflex sensitivity. It may be hypothesized that although the variabilities in heart rate and blood pressure assess cardiovascular autonomic functions, blood pressure variability is a better indicator of cardiovascular autonomic effects of acute relative hyperglycemia.

Kinematic and Physiological Analysis of Medieval Combat Sport Using Motion Analysis, Blood Lactate Measurement, and Heart Rate Monitoring: A Case Study.

Medieval combat sport is a form of mixed martial art in which combatants engage in fighting using offensive and defensive equipment while dressed in full armor. The sport is considered extremely taxing, making it nearly impossible to maintain the same level of performance. However, this form of sport has not been thoroughly analyzed, and its impact on human physical response is largely unknown. To address this gap, the study reported here aimed to introduce and test a procedure for analyzing human physical responses within the framework of the sport. To accomplish this, two experienced combatants were asked to engage in a series of strikes, performed in the form of a set duel simulating a professional fight competition. The kinematic aspect of the procedure was examined using motion analysis with the help of an IMU suit, while the physiological aspect was evaluated based on blood lactate levels and heart rate measurements. Furthermore, an ergometer test conducted in a laboratory setting aimed to determine the lactate threshold. The duel results showed noticeable decreases in the kinematic aspects of the strikes, such as the velocity of impact, and a dramatic rise in physiological aspects, such as heart rate and blood lactate levels. During the duel sets, the blood lactate surpassed the threshold level, and at the end, the heart rate exceeded the maximum age-related level. Practicing medieval combat sport has been shown to impose an extreme physical load on the bodies of combatants, noticeably affecting their performance levels.

Clinical effects of epidurally administered lidocaine with or without dexmedetomidine in sheep

The study was designed as a randomized, prospective, blinded, clinical trial to compare the clinical effects of epidural lidocaine hydrochloride 2% (L2%) alone and in combination with dexmedetomidine (DL2%) in sheep. A total of 19 adult sheep, 14 females & 5 males were assigned to one of the two lumbosacral epidural treatments: L2% (4 mg kg –1) and DL2% (2.5 µg kg –1 + 4 mg kg –1) in a randomized order. The total volume of the drug combination was kept constant. Onset, analgesia, motor blockade, sedation and behaviour were determined before treatment, after effect of treatment and at recovery. Duration of epidural anesthesia and motor blockade were recorded. Heart rate, blood pressure, respiratory rate, rectal temperature and capillary refill time were recorded prior to treatments and every 15 minutes following epidural anesthesia for 60 minutes. Epidural anesthesia was produced with both the treatments effectively and was easily performed in all the studied animals. Both the treatments provided complete analgesia however no significant difference (p = 0.35) was recorded in onset time to analgesia. Duration of epidural anesthesia was significantly greater (p < 0.0001) with DL2% (239.56 ± 19.48 min) than L2% (69.30 ± 3.03 min). Significant extension (p < 0.0001) of motor blockade was recorded with DL2% (251.89 ± 22.18 min) than with L2% (88.30 ± 2.36 min) alone. The median analgesic scores were significantly higher in DL2% in comparison to the L2% alone. Rescue analgesia had to be given in 20% of L2% and 33.3% of DL2%.

Comparison of Logistic Regression, Random Forest and Adaboost Algorithms for Diabetes Mellitus Classification

Diabetes mellitus is a chronic disease that affects the way the body regulates sugar (glucose). High blood sugar levels can lead to health complications including heart problems, eye disorders, nerve damage, kidney and blood vessel disorders. It is important for early detection of diabetes by utilizing data mining technology. Data mining has various classification models that can be used to detect diabetes, including logistic regression, random forest and adaboost. The comparison of the three algorithms aims to find out which algorithm is most appropriate in the classification of diabetes. From the results obtained, the random forest algorithm has the best performance in the classification of diabetes mellitus compared to other algorithms.

Rehabilitation of cardiological patients with post-COVID syndrome: morphofunctional data report

INTRODUCTION. Post-COVID is a common complication of COVID-19, occurring in more than a third of patients, and condition will persist for more than 3 months after infection with the SARS-CoV-2. AIM. To evaluate impact and potential effectiveness of a comprehensive physical rehabilitation program on health of cardiac patients with complications of a previously suffered new coronavirus infection SARS-CoV-2 COVID-19. MATERIALS AND METHODS. The study involved 128 cardiology patients with post-COVID syndrome. The study participants comprised three groups depending on the 12-week physical rehabilitation program. The effectiveness of rehabilitation was assessed through parameters of cardiopulmonary testing, as well as the 6-minute walk exercise test and the degree of dyspnea according to modified mMRC dyspnea questionnaire. RESULTS. The mMCR index in CPR group was 1.0 [0.0–1.0] point, compared with 2.0 [1.0–2.0] in control and comparative groups (p 0.05); exercise tolerance VO2max increased by 8.3 ± 3.8 % (p 0.05); normalization of heart rate and blood pressure in response to physical activity after 12 weeks in intervention group was 5.0 ± 2.1 % compared to comparative and control groups; 6MWT test results 688 m, in the intervention group, versus 490 m, for participants in control group (p 0.05). DISCUSSION. A comparative analysis of previously conducted studies confirmed pattern between the inclusion of combined cardiorespiratory training in the protocol for 12-week rehabilitation of post-COVID complications among cardiac patients, and a decrease in the degree of shortness of breath, as well as an increase in exercise tolerance. CONCLUSIONS. Based on experimental data obtained, it is advisable to analyze the effects of Cardiopulmonary Physical Rehabilitation program in the framework of larger randomized clinical trials. This will allow a more detailed assessment of the clinical consequences, as well as the ability to adjust mode and dose of physical activity of proposed rehabilitation program.

Acute cardiovascular and muscular response to rowing ergometer exercise in artificial gravity – a pilot trial

Prolonged immobilization and spaceflight cause cardiovascular and musculoskeletal deconditioning. Combining artificial gravity through short-arm centrifugation with rowing exercise may serve as a countermeasure. We aimed to compare the tolerability, muscle force production, cardiovascular response, and power output of rowing on a short-arm centrifuge and under terrestrial gravity. Twelve rowing athletes (4 women, aged 27.2 ± 7.4 years, height 179 ± 0.1 cm, mass 73.7 ± 9.4 kg) participated in two rowing sessions, spaced at least six weeks apart. One session used a short-arm centrifuge with +0.5 Gz, while the other inclined the rowing ergometer by 26.6° to mimic centrifugal loading. Participants started self-paced rowing at 30 W, increasing by 15 W every three minutes until exhaustion. We measured rowing performance, heart rate, blood pressure, ground reaction forces, leg muscle activation, and blood lactate concentration. Rowing on the centrifuge was well-tolerated without adverse events. No significant differences in heart rate, blood pressure, or blood lactate concentration were observed between conditions. Inclined rowing under artificial gravity resulted in lower power output (−33%, p < 0.001) compared to natural gravity, but produced higher mean and peak ground reaction forces (p < 0.0001) and increased leg muscle activation. Muscle activation and ground reaction forces varied with rotational direction. Rowing in artificial gravity shows promise as a strategy against cardiovascular and muscular deconditioning during long-term spaceflight, but further investigation is required to understand its long-term effects.

Cold pressor stress effects on cardiac repolarization

The cold pressor test (CPT) elicits strong cardiovascular reactions via activation of the sympathetic nervous system (SNS), yielding subsequent increases in heart rate (HR) and blood pressure (BP). However, little is known on how exposure to the CPT affects cardiac ventricular repolarization. Twenty-eight healthy males underwent both a bilateral feet CPT and a warm water (WW) control condition on two separate days, one week apart. During pre-stress baseline and stress induction cardiovascular signals (ECG lead II, Finometer BP) were monitored continuously. Salivary cortisol and subjective stress ratings were assessed intermittently. Corrected QT (QTc) interval length and T-wave amplitude (TWA) were assessed for each heartbeat and subsequently aggregated individually over baseline and stress phases, respectively. CPT increases QTc interval length and elevates the TWA. Stress-induced changes in cardiac repolarization are only in part and weakly correlated with cardiovascular and cortisol stress-reactivity. Besides its already well-established effects on cardiovascular, endocrine, and subjective responses, CPT also impacts on cardiac repolarization by elongation of QTc interval length and elevation of TWA. CPT effects on cardiac repolarization share little variance with the other indices of stress reactivity, suggesting a potentially incremental value of this parameter for understanding psychobiological adaptation to acute CPT stress.

Stress Detection Based on Naïve Bayes Algorithm

Tension is a widespread concern impacting the mental and physical health of individuals, resulting in various health issues. Machine-based learning (ML) has emerged as a favored tool for identifying tension. ML strategies have displayed encouraging outcomes in recognizing trends and attributes from different physiological and behavioral data streams such as heart rate, blood pressure, and vocal signals. The main objective of utilizing ML for tension detection is to offer precise, non-invasive, and economical approaches for early tension identification and intervention. Overall, ML-based tension detection shows substantial potential for delivering an impartial, effective, and expandable strategy for tension monitoring and intervention. Additional exploration is needed to tackle the obstacles linked to data compilation, attribute extraction, and model adaptation to varied populations and scenarios. Keywords: Automated Learning, Simple-minded Bayes, Information, Gloom, Tension.

Implications of Race Adjustment in Lung-Function Equations.

Adjustment for race is discouraged in lung-function testing, but the implications of adopting race-neutral equations have not been comprehensively quantified. We obtained longitudinal data from 369,077 participants in the National Health and Nutrition Examination Survey, U.K. Biobank, the Multi-Ethnic Study of Atherosclerosis, and the Organ Procurement and Transplantation Network. Using these data, we compared the race-based 2012 Global Lung Function Initiative (GLI-2012) equations with race-neutral equations introduced in 2022 (GLI-Global). Evaluated outcomes included national projections of clinical, occupational, and financial reclassifications; individual lung-allocation scores for transplantation priority; and concordance statistics (C statistics) for clinical prediction tasks. Among the 249 million persons in the United States between 6 and 79 years of age who are able to produce high-quality spirometric results, the use of GLI-Global equations may reclassify ventilatory impairment for 12.5 million persons, medical impairment ratings for 8.16 million, occupational eligibility for 2.28 million, grading of chronic obstructive pulmonary disease for 2.05 million, and military disability compensation for 413,000. These potential changes differed according to race; for example, classifications of nonobstructive ventilatory impairment may change dramatically, increasing 141% (95% confidence interval [CI], 113 to 169) among Black persons and decreasing 69% (95% CI, 63 to 74) among White persons. Annual disability payments may increase by more than $1 billion among Black veterans and decrease by $0.5 billion among White veterans. GLI-2012 and GLI-Global equations had similar discriminative accuracy with regard to respiratory symptoms, health care utilization, new-onset disease, death from any cause, death related to respiratory disease, and death among persons on a transplant waiting list, with differences in C statistics ranging from -0.008 to 0.011. The use of race-based and race-neutral equations generated similarly accurate predictions of respiratory outcomes but assigned different disease classifications, occupational eligibility, and disability compensation for millions of persons, with effects diverging according to race. (Funded by the National Heart Lung and Blood Institute and the National Institute of Environmental Health Sciences.).

The surge in heart rate and blood pressure at respiratory event termination is dampened in children with down syndrome

BackgroundChildren with Down syndrome (DS) have a high prevalence of sleep disordered breathing (SDB) and altered cardiovascular autonomic control. We aimed to analyze the effect of DS on the surge in heart rate (HR) and pulse transit time (PTT, an inverse surrogate measure of blood pressure change) at respiratory event termination. Methods44 children (3–19 y) with DS and 44 typically developing (TD) children matched for SDB severity, age and sex underwent overnight polysomnography. Multilevel modelling determined the effect of DS on HR and PTT changes between a 10s pre-event to the latter half of each respiratory event (late-event) and 15s post-event during NREM and REM, accounting for SDB severity and event length. ResultsThe children with DS had a significantly smaller % change in HR late-event to post-event (NREM: DS 26.4 % ± 17.5 % (mean ± SD), TD 30.7 % ± 21.0 %; REM DS 16.9 % ± 15.3 %, TD 21.0 % ± 14.0 %; p < 0.05 for both) compared with TD children for obstructive events, and central events (13.2 % ± 17.0 %, TD 18.8 % ± 17.0 %; p < 0.01) during REM. %change in PTT was significantly smaller in the DS group during NREM and REM from pre-event and late-event to post-event compared with TD children for obstructive and central events. ConclusionThese results suggest children with DS have dampened HR and BP responses to respiratory events compared with TD children. Whether this is symptomatic of autonomic dysfunction or a protective factor for the cardiovascular system in children with DS remains to be elucidated.

Feasibility Study of Using the Integrated Telemedicine Platform “IS-cardio” for Outpatient Cardiological Rehabilitation: Single-Centered Cohort Study

INTRODUCTION. The implementation of remote cardiac rehabilitation (RCR) technology based on telemedicine platforms (TMP) requires a preliminary assessment of the feasibility of use. AIM. A preliminary study of the feasibility of using the integrated TMP “IS-cardio” to perform RCR in patients with cardiovascular diseases (CVD) in the context of need, feasibility and acceptability. MATERIALS AND METHODS. Single-center cohort study of patients (n = 33; 75 % men; mean age 56 ± 8 years) with CVD. Testing of the TMP «IS-cardio» was carried out during 12-week physical training (PT) programs with an intensity of 55 %. Feasibility was assessed according to the following criteria: need, feasibility, acceptability. Data on need and acceptability were obtained from a patient survey. Feasibility was assessed as the proportion of patients completing RCR. Remote monitoring was performed using heart rate, blood pressure, electrocardiogram and mobile application recorders. Feedback was provided in the form of electronic reports and delayed consultation. Patient satisfaction was assessed in points. RESULTS. 79.2 % of respondents were interested in telemedicine monitoring. 100 % of patients completed RCR; 12 patients (39.6 %) fully completed the PT program. The patients’ activity amounted to 2.4 ± 0.7 PT sessions per week; the average duration of PT was 56.5 ± 29.8 min/week. With a total satisfaction of 29.0 ± 3 points, the level of RCR was highly rated (3.85 ± 0.16 points) as a real solution to the problem associated with the presence of CVD (3.67 ± 0.34 points). DISCUSSION. The medical-technological solution TMP “IS-cardio”, combining the principles of traditional cardiac rehabilitation with telecardiology tools (monitoring based on digital recorders, automatic data transfer and feedback) met the criteria for the feasibility of using TMP with a similar concept. CONCLUSION. The high demand for remote monitoring, feasibility, and patient satisfaction of RCR may indicate the feasibility of its use for implementation of its programs.

A COMPARATIVE STUDY OF CLONIDINE VERSUS FENTANYL FOR INTRAOPERATIVE HEMODYNAMIC STABILITY IN PATIENTS UNDERGOING LAPAROSCOPIC CHOLECYSTECTOMY UNDER GENERAL ANESTHESIA: RANDOMIZED, DOUBLE-BLIND, INTERVENTIONAL STUDY

Objective: Laparoscopic cholecystectomy, though advantageous over traditional surgery, presents hemodynamic challenges due to pneumoperitoneum, systemic CO2 absorption, and patient positioning. Clonidine and Fentanyl are evaluated for their effectiveness in maintaining intraoperative hemodynamic stability, considering their different pharmacological actions. Methods: This randomized, double-blind interventional study involved 72 patients undergoing elective laparoscopic cholecystectomy under general anesthesia. Participants were allocated into two groups, receiving either IV Clonidine or IV Fentanyl. Hemodynamic parameters, including heart rate and blood pressure, were monitored and compared. Results: Clonidine demonstrated superior control over heart rate and blood pressure compared to Fentanyl, with statistically significant differences observed in the intraoperative period and post-intubation, indicating enhanced hemodynamic stability. Conclusion: Clonidine is more effective than Fentanyl in maintaining intraoperative hemodynamic stability in patients undergoing laparoscopic cholecystectomy. This suggests a potential preference for Clonidine as a premedicant in such surgical procedures, highlighting the need for tailored anesthetic techniques.

COMPARISON BETWEEN EFFECT OF TWO DIFFERENT DOSES OF INTRAVENOUS DEXMEDETOMIDINE IN ATTENUATING HEMODYNAMIC RESPONSE TO LARYNGOSCOPY AND ENDOTRACHEAL INTUBATION IN ELECTIVE GENERAL SURGERIES UNDER GENERAL ANAESTHESIA

Objective: The process of intubation is a noxious stimuli leading to a period of hemodynamic stress and is accompanied with intense sympathetic activity marked by tachycardia, hypertension and arrythmias. Methods: It was a randomised, prospective, double-blind study. After approval from the ethics committee 60 patients (ASA class 1 and II) were selected randomly, thirty in each group. Group A (n=30) received 0.5 µg/kg of inj. Dexmedetomidine and Group B received 0.75µg/kg of inj. Dexmedetomidine in 20 ml of normal saline as an infusion over 10 min. The patient was induced with inj Fentanyl 1µg/kg, inj. Propofol and inj. Succinylcholine administered and intubated. The primary outcome variables were heart rate and blood pressure at 1, 3, 5, 10, 15 min after intubation. The secondary outcome variables were the effect on the induction dose of propofol and any adverse effect associated with dexmedetomidine. The statistical package used was spss version 22. Results: The hemodynamic responses were attenuated in both groups after laryngoscopy and endotracheal intubation, with statistical significant difference between both groups and better obtundation of hemodynamic response in terms of heart rate, systolic, diastolic and mean arterial pressure at all points of time with dexmedetomidine 0.75µg/kg. Sedation scores were more with dexmedetomidine 0.75µg/kg. No significant side effects were there in both groups. Conclusion: Inj. dexmedetomidine 0.75µg/kg is more effective in attenuating the response to laryngoscopy and endotracheal intubation.

PPG-Hear: A Practical Eavesdropping Attack with Photoplethysmography Sensors

Photoplethysmography (PPG) sensors have become integral components of wearable and portable health devices in the current technological landscape. These sensors offer easy access to heart rate and blood oxygenation, facilitating continuous long-term health monitoring in clinic and non-clinic environments. While people understand that health-related information provided by PPG is private, no existing research has demonstrated that PPG sensors are dangerous devices capable of obtaining sensitive information other than health-related data. This work introduces PPG-Hear, a novel side-channel attack that exploits PPG sensors to intercept nearby audio information covertly. Specifically, PPG-Hear exploits low-frequency PPG measurements to discern and reconstruct human speech emitted from proximate speakers. This technology allows attackers to eavesdrop on sensitive conversations (e.g., audio passwords, business decisions, or intellectual properties) without being noticed. To achieve this non-trivial attack on commodity PPG-enabled devices, we employ differentiation and filtering techniques to mitigate the impact of temperature drift and user-specific gestures. We develop the first PPG-based speech reconstructor, which can identify speech patterns in the PPG spectrogram and establish the correlation between PPG and speech spectrograms. By integrating a MiniRocket-based classifier with a PixelGAN model, PPG-Hear can reconstruct human speech using low-sampling-rate PPG measurements. Through an array of real-world experiments, encompassing common eavesdropping scenarios such as surrounding speakers and the device's own speakers, we show that PPG-Hear can achieve remarkable accuracy of 90% for recognizing human speech, surpassing the current state-of-the-art side-channel eavesdropping attacks using motion sensors operating at equivalent sampling rates (i.e., 50Hz to 500Hz).

Cardiovascular Dysautonomy as a Sequel of SARS COV 2. Case Series

The impact of COVID-19, caused by the SARS-CoV-2 virus, a pandemic that originated in Wuhan, China, can lead to serious complications, in addition to mild symptoms, with special interest in the autonomic nervous system (ANS). Damage to the ANS by SARS-CoV-2 can cause dysautonomia, an imbalance between the sympathetic and parasympathetic system, with unclear mechanisms such as cytokine storm, excessive inflammation, and virus neurotropism. A significant sequelae of COVID-19 is cardiac dysautonomia, which affects heart rate, blood pressure and other autonomic reflexes, causing postural tachycardia, orthostatic hypotension, arrhythmias and fatigue. There is decreased heart rate variability (HRV) in patients, suggesting dysautonomia. Long COVID syndrome can also include cardiac dysautonomia. To diagnose cardiac autonomic neuropathy, at least two of six criteria must be met, such as an SDNN less than 50 ms and an RMSSD less than 15 ms. The cases of cardiac dysautonomia below present several of these criteria met. Methods to evaluate cardiac dysautonomia include the COMPASS 31 scale and the orthostatic hypotension questionnaire (OHQ), but more research is still needed, especially in Mexico. The case study shows that those who followed non-pharmacological recommendations such as cardiovascular exercise, increased water intake and BMI control had improvement, while cases that did not follow these recommendations did not show significant improvements. Cardiac dysautonomia is a post-COVID-19 sequelae with high prevalence, highlighting the importance of non-invasive methods for its diagnosis. Even without symptoms, people can have this sequelae, so it is important to suspect cardiovascular disorders. The need for early intervention and monitoring of hygienic-dietary measures is emphasized to avoid the worsening and chronicity of cardiac dysautonomia, with the hope of preventing the development of chronic diseases and fatal outcomes.

Effectiveness of Preoperative Alpha Wave Entrainment in Pediatric Dental Patients: A Randomized Controlled Trial.

Background Pediatric dental anxiety is a significant barrier to effective dental care, necessitating non-pharmacological interventions. Alpha wave entrainment has shown promise in adult studies for reducing procedural anxiety and pain perception, but its effectiveness in pediatric dental settings remains underexplored. Objective This study aims to evaluate the effectiveness of preoperative alpha wave entrainment in alleviating anxiety in gender-specific participants to the interventions. Methods We conducted a randomized controlled trial involving 252 pediatric patients (aged 7-12) with cooperative dispositions. Participants were randomly assigned to either an experimental group receiving alpha wave entrainment or a control group receiving conventional behavior management techniques. The experimental interventioninvolved 10-minute sessions of binaural beats with visualstimulation designed to induce alpha-wave synchronization. Anxiety levels were assessed using physiological measures (heart rate and blood pressure), both pre- and post-interventions. Results The intervention group demonstrated a significant reduction in heart rate and systolic blood pressure post-intervention compared to the control group. These changes indicate a decrease in anxiety levels, with no significant gender differences in the response to the intervention. Conclusion Alpha wave entrainment effectively reduces dental anxiety in pediatric patients, with similar efficacy observed across genders. This study supports the incorporation of alpha wave entrainment into pediatric dental practices as a viable alternative to traditional anxiety management techniques.

The impact of stress on the risk decision-making process.

The effect of stress on risk-taking or risk-averse behavior in decision-making has been inconclusive in previous research, with few studies revealing the underlying neural mechanisms. This study employed event-related potentials technique and combined a social cold pressor assessment test with a mental arithmetic task to induce stress responses, aiming to investigate the influence of exogenous stress on the risk decision-making process. Stress induction results indicated that, in addition to raising heart rate and blood pressure, stress responses were accompanied by enhanced negative emotions, diminished positive emotions, and alterations in neural activity. The outcomes of risk decision-making showed that stress did not significantly affect risk preference or time of choice but did reduce the feedback-related negativity/reward positivity, with a particularly significant effect observed for large outcomes. Stress also altered the amplitude of the P3 component, with stress decreasing the P3 value for winning outcomes relative to losing outcomes. The study suggests that understanding how stress affects risk preference should consider the emotional valence induced by stress. Contrary to the reward sensitivity hypothesis, stress weakened reward sensitivity. Stress led to changes in the allocation of cognitive resources for outcome evaluation: compared to negative outcomes, stress reduced cognitive resources for positive outcomes, which might be related to the enhanced negative emotions induced by stress. The study highlights the importance of focusing on the subjective emotional experience induced by stress in future research on stress and risk decision-making.