Physiological Coherence Research Articles

Resonating with the World: Thinking Critically about Brain Criticality in Consciousness and Cognition

Aim: Biofields combine many physiological levels, both spatially and temporally. These biofields reflect naturally resonant forms of synaptic energy reflected in growing and spreading waves of brain activity. This study aims to theoretically understand better how resonant continuum waves may be reflective of consciousness, cognition, memory, and thought. Background: The metabolic processes that maintain animal cellular and physiological functions are enhanced by physiological coherence. Internal biological-system coordination and sensitivity to particular stimuli and signal frequencies are two aspects of coherent physiology. There exists significant support for the notion that exogenous biologically and non-biologically generated energy entrains human physiological systems. All living things have resonant frequencies that are either comparable or coherent; therefore, eventually, all species will have a shared resonance. An organism’s biofield activity and resonance are what support its life and allow it to react to stimuli. Methods: As the naturally resonant forms of synaptic energy grow and spread waves of brain activity, the temporal and spatial frequency of the waves are effectively regulated by a time delay (T) in inter-layer signals in a layered structure that mimics the structure of the mammalian cortex. From ubiquitous noise, two different types of waves can arise as a function of T. One is coherent, and as T rises, so does its resonant spatial frequency. Results: Continued growth eventually causes both the wavelength and the temporal frequency to abruptly increase. Two waves expand simultaneously and randomly interfere in an area of T values as a result. Conclusion: We suggest that because of this extraordinary dualism, which has its roots in the phase relationships of amplified waves, coherent waves are essential for memory retrieval, whereas random waves represent original cognition.

Exploring the complexities of illness identity and symptom management in seeking a diagnostic label of postural orthostatic tachycardia syndrome (POTS): An inductive approach.

Postural orthostatic tachycardia syndrome (POTS) is a debilitating and under-recognized condition of the autonomic nervous system. This study applied Leventhal's Common-Sense Model of Illness Representations to explore the journey to a diagnosis of POTS and to understand its relevance to poorly understood conditions which have common comorbidities. An inductive qualitative approach was used to explore the processes by which patients formulate explanations and management of symptoms within the search for a diagnostic label and to investigate illness identity in the context of existing diagnoses or multimorbidity. Participants (n = 29) for this nested qualitative study were recruited from a larger longitudinal study of people who had been newly referred to a specialist POTS service. Semi-structured interviews were conducted via video call. Three researchers coded and analysed data using Reflexive Thematic Analysis and elements of Grounded Theory. The analysis resulted in three overarching themes: 'Seeking physiological coherence and validation', 'Individual persistence', and 'Navigating the cumulative burden'. 'Accessibility and disparities of health care' was noted as a contextual factor. Receiving a POTS diagnosis was regarded by participants as providing legitimacy and increased access to treatment. Overall, delays in the diagnostic journey and the lack of a clear diagnosis impacted negatively on patients through increased uncertainty and a lack of clear guidance on how to manage symptoms. Findings also suggested there were great complexities in assigning symptoms to labels in the context of multimorbidity. Participants' stories highlighted the urgent need for better recognition of POTS so that the self-regulatory process can be initiated from the early stages of symptom detection.

Three-dimensional electrical impedance tomography (EIT) to study regional ventilation/perfusion (V/Q̇) ratios in anesthetized pigs.

This study aimed to develop a 3D method for assessing ventilation/perfusion (V/Q̇) ratios in a pig model of hemodynamic perturbations using electrical impedance tomography (EIT). In order to evaluate the physiological coherence of changes in EIT-derived V/Q̇ ratios, global EIT-derived V/Q̇ mismatches were compared with global gold-standards. The study found regional heterogeneity in the distribution of V/Q̇ ratios in both the ventrodorsal and craniocaudal directions. Although global EIT-derived indices of V/Q̇ mismatch consistently underestimated both low and high V/Q̇ mismatch compared to global gold standards, the direction of the change was similar. We made the software available at no cost for other researchers to use. Future studies should compare regional V/Q̇ ratios determined by our method against other regional, high-resolution methods.

Physiological Signal-Based Real-Time Emotion Recognition Based on Exploiting Mutual Information with Physiologically Common Features

This paper proposes a real-time emotion recognition system that utilizes photoplethysmography (PPG) and electromyography (EMG) physiological signals. The proposed approach employs a complex-valued neural network to extract common features from the physiological signals, enabling successful emotion recognition without interference. The system comprises three stages: single-pulse extraction, a physiological coherence feature module, and a physiological common feature module. The experimental results demonstrate that the proposed method surpasses alternative approaches in terms of accuracy and the recognition interval. By extracting common features of the PPG and EMG signals, this approach achieves effective emotion recognition without mutual interference. The findings provide a significant advancement in real-time emotion analysis and offer a clear and concise framework for understanding individuals’ emotional states using physiological signals.

On brain criticality in the context of resonance

Biofields integrate several physiological levels temporally and spatially. Physiological coherence complements metabolic processes, which preserve animal cellular and physiological function. Coherent physiology involves internal biological system coordination and sensitivity to specific stimuli and signal frequencies. Current research shows that exogenous biologically and non-biologically generated energy entrains human physiological systems. Electrical and magnetic field measurements during physiological activity may occur from metabolic processes or unknown physiological actions. All living things resonate at similar or coherent frequencies; therefore, species will eventually share resonance. Resonance is a term closely related to awareness, interregional connections or disconnection in the brain, and the integratory function of the brain. It can describe synchrony, vibration, or harmony more broadly. The synchronized electrical cycles of the brain have similar resonance patterns. Resonance's significance in fostering integrated brain activity, awareness, awakeness and death are reviewed.

Perceived stress and physiological consistency during mental stress exercises and controlled breathing

IntroductionThe measurement of the physiological coherence, the order and the quality of the connection of complex systems such as the cardiac and the respiratory system, varies in situations of stress and relaxation.ObjectivesWe aim to assess changes in physiological coherence and perception of stress during mental stress and directed breathing exercises.MethodsRepeated-measures study in healthy adults without prior training in breathing techniques, aged between 18 and 65 years of both sexes who were evaluated in three situations: baseline, mental stress (Stroop test and successive subtractions), and directed breathing, during which were captured heart rate and respiratory signals to estimate physiological coherence and the participants rated the perceived stress at each moment.Results34 participants were analyzed, 59% women, with a median age of 36 years (Rq = 13). During mental stress tasks, the median for physiological coherence was similar to baseline coherence but increased significantly with five minutes of directed breathing exercises (38% vs. 63% p <0.0001). The highest perception of stress was during successive subtractions (Me 7, Rq = 4) and the lowest during directed breathing exercises (Me 2 Rq = 3.0). The correlation was sought between physiological coherence and perception of stress during each of the four moments of the study. Basal (Rho Spearman -0.05, p 0.54); Stroop (Rho -0.17, p 0.03); successive subtractions (Rho 0.50, p 0.77); and directed breathing (Rho -0.28, p 0.09).ConclusionsA correlation was found between physiological coherence and perception of stress during the Stroop test; however, no association was found.DisclosureNo significant relationships.

Effects of focus training on heart rate variability in post-stroke fatigue patients

ObjectiveThis study discusses the effects of focus training on heart rate variability (HRV) in post-stroke fatigue (PoSF) patients.MethodsSelf-generate physiological coherence system (SPCS) was used for the focus training of PoSF patients for 12 weeks. Then, fatigue severity scale (FSS), Hamilton depression scale (HAMD), HRV and satisfaction scale (SASC-19) before and after the training were assessed.ResultsCompared with the control group, FSS score, HAMD score, RMSSD, PNN50% were significantly lower in the research group at the end of the intervention (P < 0.05); SDNN, SDANN, LF, HF, LF/HF intervention satisfaction rate increased significantly in the research group at the end of the intervention (P < 0.05).ConclusionThe use of SPCS software during the focus training of PoSF patients reduced the fatigue and depression, meanwhile improved the HRV of the patients. Therefore, these patients were greatly satisfied with the intervention.

Interpersonal Emotion Dynamics in Couples With Somatic Symptom Disorder: Dyadic Coherence in Facial Temperature During Emotional Interactions.

Disturbances in emotional processes are commonly reported in patients with a somatic symptom disorder (SSD). Although emotions usually occur in social interactions, little is known about interpersonal emotion dynamics of SSD patients during their actual emotional encounters. This study examined physiological coherence (linkage) between SSD patients and their partners, and in healthy couples during their emotional interactions. Secondarily, we explored group-level relationships between participants' and their partners' subjective affect. Twenty-nine romantic couples (16 healthy and 13 SSD patient-couples) underwent a dyadic conversation task with neutral and anger-eliciting topics followed by a guided relaxation. Partners' cutaneous facial temperature was recorded simultaneously by functional infrared thermal imaging. Immediately after each condition, participants reported on their pain intensity, self-affect, and perceived partner-affect. Emotional conditions and having a partner with an SSD significantly affected coherence amplitude on the forehead (F(2,54) = 4.95, p = .011) and nose tip temperature (F(2,54) = 3.75, p = .030). From baseline to anger condition, coherence amplitude significantly increased in the patient-couples, whereas it decreased in the healthy couples. Correlation changes between partners' subjective affect comparably accompanied the changes in physiological coherence in healthy and patient-couples. Inability to reduce emotional interdependence in sympathetic activity and subjective affect during a mutual conflict observed in SSD patient-couples seems to capture emotion co-dysregulation. Interventions should frame patients' emotional experiences as embodied and social. Functional infrared thermal imaging confirms to be an ecological and reliable method for examining autonomic changes in interpersonal contexts.Registration Page: https://osf.io/8eyjr.

Effects of visual search task on attentional bias and stress response under pressure.

it has always been a problem for athletes that their performance is out of order due to pressure in major competitions. The change of attention pattern and the emergence of stress response (SR) caused by negative affect (NA) are the direct reasons for the greater impact on the performance of athletes. It is a hot topic to explore how to improve attention bias (AB) and SR of athletes in stressful situations. the study aimed to analyze the improvement effect of visual search task (VST) training on AB and SR of athletes under pressure situations. 62 male basketball players with national level 2 or above of Shenyang sports institute were divided into experimental group (EG) and control group (CG). Visual search task training program was used in the EG (happy, sad, disgusted, neutral faces) and sham training program was used in the CG (all faces with neutral expression) for two months. Under the stress situation, attention behavior of all subjects before and after training was tested. Physiological coherence and autonomic balance system were used to record heart rate variability synchronously. Parallel frequency domain analysis was divided into very low frequency band (VLF), low frequency (LF), high frequency (HF) and total spectrum (TP). The normalized treatment obtained indexes such as HFnorm, LFnorm, and LF/HF. The e-prime 2.0 software was adopted to obtain the attention bias score. The Positive and Negative Affect Scale (PANAS) and the self-rating stress scale were adopted for evaluation before and after training. the self-rating pressure in the two groups was lower than that before the training, and the pressure in the experimental group was lower than that in the control group (P < 0.05). After training, the positive emotion of the experimental group was higher than that of the control group, and the EG was lower than that of the CG (P < 0.05). After training, the score of attention bias of happy and neutral faces in the EG was higher than that of theCG, while the score of attention bias of sad and disgusted faces was lower than that of the CG (P < 0.05). After training, LF/HF and LFnorm in the EG were lower than those in the CG, and HFnorm was higher than those in the CG (P < 0.05). the training of visual search task can effectively improve the athletes' PA and AB of positive information, reduce the attention bias of negative information and psychological pressure, and relieve theSR.

Effect of Quick Coherence Technique on Psychophysiological Coherence, Heart Rate, Stress, Anxiety, Depression and Feeling State in Young Adults in India

HeartMath technology is an innovative technique to improving emotional mental health. A small-scale study was conducted to investigate the effect of quick coherence technique on psychophysiological coherence, stress, anxiety, depression and feeling state in young adults in India. Present study is in line with the past research done by S.D. Edwards (2016) on ‘Influence of Heartmath Quick Coherence Technique on Psychophysiological Coherence and Feeling States’. Six postgraduate students who complained of stress, anxiety and depression were included in the present study. There were 4 female and 2 males between the age group of 22-28 years. They were screened for stress, anxiety and depression using DAS 21 scale and their physiological coherence score was recorded using emWave system. They were asked to rate their feeling states (anger, sadness, happiness and calmness) before and after each session. Six (twice a week) sessions were conducted using quick coherence technique. In the initial session they were taught quick coherence technique. They were given heart focused breathing exercise and affirmation as a home plan. After six sessions their physiological coherence score was recorded using emWave system. Then they were screened for stress, anxiety and depression using DAS 21 scale. There was a significant improvement in psychophysiological coherence, anxiety, stress and feeling state after quick coherence training. The present study supports the past research done by S.D. Edwards (2016) where the results showed significant changes in psychophysiological coherence, negative feeling states and positive feeling state after five sessions.

Advanced echocardiographic phenotyping of critically ill patients with coronavirus-19 sepsis: a prospective cohort study

BackgroundSepsis is characterized by various hemodynamic alterations which could happen concomitantly in the heart, pulmonary and systemic circulations. A comprehensive demonstration of their interactions in the clinical setting of COVID-19 sepsis is lacking. This study aimed at evaluating the feasibility, clinical implications, and physiological coherence of the various indices of hemodynamic function and acute myocardial injury (AMI) in COVID-19 sepsis.MethodsHemodynamic and echocardiographic data of septic critically ill COVID-19 patients were prospectively recorded. A dozen hemodynamic indices exploring contractility and loading conditions were assessed. Several cardiac biomarkers were measured, and AMI was considered if serum concentration of high-sensitive troponin T (hs-TNT) was above the 99th percentile, upper reference.ResultsSixty-seven patients were assessed (55 males), with a median age of 61 [50–70] years. Overall, the feasibility of echocardiographic parameters was very good, ranging from 93 to 100%. Hierarchical clustering method identified four coherent clusters involving cardiac preload, left ventricle (LV) contractility, LV afterload, and right ventricle (RV) function. LV contractility indices were not associated with preload indices, but some of them were positively correlated with RV function parameters and negatively correlated with a single LV afterload parameter. In most cases (n = 36, 54%), echocardiography results prompted therapeutic changes. Mortality was not influenced by the echocardiographic variables in multivariable analysis. Cardiac biomarkers’ concentrations were most often increased with high incidence of AMI reaching 72%. hs-TNT was associated with mortality and inversely correlated with most of LV and RV contractility indices.ConclusionsIn this comprehensive hemodynamic evaluation in critically ill COVID-19 septic patients, we identified four homogeneous and coherent clusters with a good feasibility. AMI was common and associated with alteration of LV and RV functions. Echocardiographic assessment had a clinical impact on patient management in most cases.

Multimodal Stress-Management Intervention Improves Physiological, Psychological, and Productivity of Assembly-Line Workers

Stress-related problems experienced by blue collar workers have become one of the most prevalent health and safety risks and relate to loss of productivity or other poorer quality of work. Their inability to cope with the environmental demands leads to certain responses involving a complex interaction between physiological and psychological mechanism. This study aimed to evaluate the effect of multimodal stress management intervention at individual-level approach (biofeedback and work-life balance) on multiple outcome measures: physiological, physiological and productivity. A sample consisted of 18 female assembly-line operators who perceived extremely severe level of depression, anxiety, and stress, attended six-week heart rate variability (HRV) biofeedback and work-life balance training sessions. We found significantly improved physiological HRV physiological coherence, reduced negative emotional symptoms, and increased productivity (all p 0.53|). The possible mechanism of these parallel findings discussed as well as its practical implication. Nevertheless, our lack of sample and less rigorous research design limited us to infer generalizability and causality. Despite these drawbacks, our study demonstrates a potential use of combining HRV biofeedback and other stress management approach for improving worker’s overall well-being and work performance.

The Influence of Stress on Industrial Operator’s Physiology and Work Performance

Elevated stress has been widely associated with physical and physiological threats as well as reduced work performance. However, there is still a lack of studies that investigate whether stress influences concurrently physiological and objective work performance. The purpose of this study is to examine whether workers’ level of stress or negative emotional symptoms correlates with their physiological coherence and work performance. Eighteen female operators who reported high severity levels of stress, assessed using the Depression, Anxiety, and Stress Scale (DASS-42) were categorized as the risk group. The comparison group was formed by randomly selecting 18 of 99 female workers who had significantly lower DASS scores. Both participants attended one session of physiological measurement. Their work performance was observed by calculating their cycle time completing a product during five workdays. A significant difference in HRV between the two groups was also found in physiological and work performance measures. The results showed that workers in the risk group obtained significantly lower coherence levels and longer work cycle time than the control participants, indicating that negative emotional symptoms were parallel with physiological coherence and work performance. However, a weak correlation was found between work performance and negative emotional symptoms as well as physiological coherence. Despite the study limitations, our findings support to evidence the more complete picture of how stress affects female worker’s physiology and work performance, suggesting a need to implement effective workplace stress intervention. Further study is needed to be conducted among different group characteristics such as male and occupational settings.

Assessment of high coherent states using heart rate variability, pulse transit time and respiratory signals

Goal: the purpose of this study is to introduce a novel index, called Global Coherence Index (GCI), for the estimation of physiological coherence (PhyCoh), which includes the assessment of synchronization among signals. Methods: 34 volunteers (14 men) were randomly selected to be part of the study (84% sample power). Participants were asked to perform a 20-min test while electrocardiography, photoplethysmography and respiration signals were acquired. The test consisted of a basal measurement (stage 1), laboratory mental stress (stage 2 and 3), and controlled breathing (stage 4). PhyCoh was estimated in each of the stages using both GCI and the traditional estimation method based on HRV. The estimated PhyCoh values obtained in each stage were compared using repeated-measures analysis of variance, and the agreement between the measurements was assessed using the Bland-Altman analysis. Results: GCI behaves similarly to the traditional measurement of PhyCoh, while including more information regarding the synchronization of body systems; it has a moderate agreement with the traditional measurement. Conclusion: GCI reflects PhyCoh states and enables the assessment of signal synchronization and a broader revision of the PhyCoh state. An accurate evaluation of physiological coherence based on more than heart rate variability signals is feasible using the proposed index. Significance: The novel index allows for a more comprehensive and reliable estimation of physiological coherence states.

SNP-ChIP: a versatile and tag-free method to quantify changes in protein binding across the genome

BackgroundChromatin-immunoprecipitation followed by sequencing (ChIP-seq) is the method of choice for mapping genome-wide binding of chromatin-associated factors. However, broadly applicable methods for between-sample comparisons are lacking.ResultsHere, we introduce SNP-ChIP, a method that leverages small-scale intra-species polymorphisms, mainly SNPs, for quantitative spike-in normalization of ChIP-seq results. Sourcing spike-in material from the same species ensures antibody cross-reactivity and physiological coherence, thereby eliminating two central limitations of traditional spike-in approaches. We show that SNP-ChIP is robust to changes in sequencing depth and spike-in proportions, and reliably identifies changes in overall protein levels, irrespective of changes in binding distribution. Application of SNP-ChIP to test cases from budding yeast meiosis allowed discovery of novel regulators of the chromosomal protein Red1 and quantitative analysis of the DNA-damage associated histone modification γ-H2AX.ConclusionSNP-ChIP is fully compatible with the intra-species diversity of humans and most model organisms and thus offers a general method for normalizing ChIP-seq results.

Using a cost function based on kinematics and electromyographic data to quantify muscle forces

A reliable evaluation of muscle forces in the human body is highly desirable for several applications in both clinical and research contexts. Several models of muscle force distribution based on non-invasive measurements have been proposed since 1836 (Weber and Weber, 1836), amongst which Crowninshield’s model (Crowninshield and Brand, 1981), which maximizes a cost-function representing the muscle fiber endurance, is the most popular. It is worth noting that Crowninshield’s model is the most widely adopted notwithstanding its major limitations of physiological coherence. Forster et al. (2004) pointed out that “these (conventional) criteria however do not predict co-contraction adequately”. Besides, electromyographic (EMG)-driven models have been proposed to assess individual muscle forces, which have not been broadly adopted due to their complexity and the need for a calibration before each test. In this context, a cost function based on kinematic and electromyographic data could provide the advantage of being physiologically more coherent with muscle activations compared to conventional cost-functions based on kinematics solely, and easier to use than the EMG-driven models. The objective of this study is to propose the first cost-function based on kinematics and electromyographic data to quantify muscle forces. When applying this new cost-function on a database of upper limb motions data of 17 subjects, healthy or with cerebral palsy, the muscle force prediction of the proposed model was 17.74% more coherent with the EMG pattern than the prediction of Crowninshield’s model. And on average, these results were more consistent whether the subjects were healthy or with cerebral palsy. In conclusion, we propose this cost-function for the quantification of muscle forces.

Physiological coherence in healthy volunteers during laboratory-induced stress and controlled breathing.

Physiological coherence has been related with a general sense of well-being and improvements in health and physical, social, and cognitive performance. The aim of this study was to evaluate the relationship between acute stress, controlled breathing, and physiological coherence, and the degree of body systems synchronization during a coherence-generation exercise. Thirty-four university employees were evaluated during a 20-min test consisting of four stages of 5-min duration each, during which basal measurements were obtained (Stage 1), acute stress was induced using validated mental stressors (Stroop test and mental arithmetic task, during Stage 2 and 3, respectively), and coherence states were generated using a controlled breathing technique (Stage 4). Physiological coherence and cardiorespiratory synchronization were assessed during each stage from heart rate variability, pulse transit time, and respiration. Coherence measurements derived from the three analyzed variables increased during controlled respiration. Moreover, signals synchronized during the controlled breathing stage, implying a cardiorespiratory synchronization was achieved by most participants. Hence, physiological coherence and cardiopulmonary synchronization, which could lead to improvements in health and better life quality, can be achieved using slow, controlled breathing exercises. Meanwhile, coherence measured during basal state and stressful situations did not show relevant differences using heart rate variability and pulse transit time. More studies are needed to evaluate the ability of coherence ratio to reflect acute stress.

New Frontiers in Heart Rate Variability and Social Coherence Research: Techniques, Technologies, and Implications for Improving Group Dynamics and Outcomes.

Concepts embraced by the term coherence have been identified as central to fields such as quantum physics, physiology, and social science. There are different types of coherence, although the term always implies a harmonious relationship, correlations and connections between the various parts of a system. A specific measure derived from heart rate variability (HRV) provides a measure of physiological coherence. Another type of coherence, social coherence, relates to the harmonious alignment between couples or pairs, family units, small groups, or larger organizations in which a network of relationships exists among individuals who share common interests and objectives. A high degree of social coherence is reflected by stable and harmonious relationships, which allows for the efficient flow and utilization of energy and communication required for optimal collective cohesion and action. Social coherence requires that group members are attuned and are emotionally connected with each other, and that the group’s emotional energy is organized and regulated by the group as a whole. A number of studies are reviewed which have explored various types of synchronization in infants, pairs and groups, indicating that feelings of cooperation, trust, compassion and increased prosocial behaviors depends largely on the establishment of a spontaneous synchronization of various physiological rhythms between individuals. This article discusses a new application using HRV monitoring in social coherence research and the importance of physiological synchronization in group developmental processes and dynamics. Building on the extensive body of research showing that providing feedback of HRV coherence level at the individual level can improve self-regulation, we suggest the following hypotheses: (1) providing feedback of individual and collective HRV coherence and the degree of heart rhythm synchronization will increase group coherence, and heart rhythm synchronization among group members. (2) Training in techniques to increase group coherence and heart rhythm synchronization will correlate with increased prosocial behaviors, such as kindness and cooperation among individuals, improved communication, and decreases in social discord and adversarial interactions. (3) Biomagnetic fields produced by the heart may be a primary mechanism in mediating HRV synchronization among group members. Data supporting each of the hypothesis is discussed.

Left ventricular systolic dysfunction during septic shock: the role of loading conditions.

The clinical significance of septic myocardial dysfunction is controversial, a fact that may be explained by the influence of loading conditions. Many indices may be useful to characterize cardiac function during septic shock, but their feasibility and physiological coherence in the clinical setting are unknown. Hemodynamic and echocardiographic data with tissue Doppler and speckle tracking were prospectively recorded on the first 3days of human septic shock. Hypokinesia, normokinesia, and hyperkinesia were defined as a left ventricular ejection fraction (LVEF) of<45, 45-60, and>60%, respectively. Twelve hemodynamic indices exploring contractility and loading conditions were assessed and analyzed. Two hundred and ninety-seven echocardiographies were performed in 132 patients. During the first 24h (H1-24), 48 (36.4%) patients were hyperkinetic, 55 (41.7%) were normokinetic, and 29 (22.0%) patients were hypokinetic. Thirteen patients had a secondary hypokinesia absent at H1-24 but present at H25-48 or H49-72, for an overall incidence of 42 (31.8%) during the first 3days. Despite a limited feasibility (<50%), global LV longitudinal peak systolic strain was impaired in a majority (>70%) of the patients assessed, including all those with depressed LVEF, and declined early in patients whose LVEF secondarily deteriorated. Most contractility indices were inversely correlated with afterload indices. Hyperkinetic patients exhibited the worst reduction in afterload indices. Hospital mortality was significantly higher in patients with LV hyperkinesia than in their counterparts: 30 (62.5%) vs. 35 (41.7%), p=0.02. Speckle tracking-derived strain was reduced in the majority of patients with septic shock, revealing covert septic myocardial dysfunction, but had poor feasibility. We found an inverse correlation between most of the contractility and afterload indices. Precise evaluation of afterload is crucial for adequate interpretation of LV systolic function in this setting.

Biofeedback and the Illusion of Self-Control: A Functional Contextual Perspective

Physiological self-regulation through biofeedback may be seen as a metaphor for generalized self-control expectancies. Using a model based on functional contextualism and relational frames theory, self-control efforts are seen as a convenient fiction or illusion, with physiological coherence and the sense of coherence associated with improvements in health and behavior.