Physiological Patterns Research Articles

An improved biometric stress monitoring solution for working employees using heart rate variability data and Capsule Network model.

Biometric stress monitoring has become a critical area of research in understanding and managing health problems resulting from stress. One of the fields that emerged in this area is biometric stress monitoring, which provides continuous or real-time information about different anxiety levels among people by analyzing physiological signals and behavioral data. In this paper, we propose a new approach based on the CapsNets model for continuously monitoring psychophysiological stress. In the new model, streams of biometric data, including physiological signals and behavioral patterns, are taken up for analysis. In testing using the Swell multiclass dataset, it performed with an accuracy of 92.76%. Further testing of the WESAD dataset reveals an even better accuracy at 96.76%. The accuracy obtained for binary classification of stress and no stress class is applied to the Swell dataset, where this model obtained an outstanding accuracy of 98.52% in this study and on WESAD, 99.82%. Comparative analysis with other state-of-the-art models underlines the superior performance; it achieves better results than all of its competitors. The developed model is then rigorously subjected to 5-fold cross-validation, which proved very significant and proved that the proposed model could be effective and efficient in biometric stress monitoring.

Predictors of mortality for blunt trauma patients in intensive care: A retrospective cohort study

Background Major trauma places substantial demand on critical care services, is a leading cause of death in under 40-year-olds and causes significant morbidity and mortality across all age groups. Various factors influence patient outcome and predefining these could allow prognostication. The aim of this study was to identify predictors of mortality from major trauma in intensive care. Methods This was a retrospective study of adult trauma patients admitted to general intensive care between January 2018 and December 2019. We assessed the impact on mortality of patient demographics, patterns of injury, injury scores (Glasgow Coma Score (GCS), Charlson’s comorbidity index (CCI), Acute Physiology and Health Evaluation II (APACHE II), Injury Severity Score (ISS) and Probability of Survival Score (Ps19)), number of surgeries and mechanism of injury using logistic regression. Results A total of 414 patients were included with a median age of 54 years (IQR 34–72). Overall mortality was 18.6%. The most common mechanism of injury was traffic collision (46%). Non-survivors were older, had higher ISS scores with lower GCS on admission and lower probability of survival scores. Factors independently predictive of mortality were age 70-80 (OR 3.267, p = 0.029), age >80 (OR 27.043, p < 0.001) and GCS < 15 (OR 8.728, p < 0.001). Ps19 was the best predictor of mortality (p <0.001 for each score category), with an AUROC of 0.90. Conclusions The significant mortality predictors were age, fall from <2 metres, injury of head or limbs, GCS <15 and Ps19. Contrary to previous studies, CCI and APACHE II did not significantly predict mortality. Although Ps19 was found to be the best current prognostic score, trauma prognostication would benefit from a single validated scoring system incorporating both physiological variables and injury patterns.

On the role of visual feedback and physiotherapist-patient interaction in robot-assisted gait training: an eye-tracking and HD-EEG study

BackgroundTreadmill based Robotic-Assisted Gait Training (t-RAGT) provides for automated locomotor training to help the patient achieve a physiological gait pattern, reducing the physical effort required by therapist. By introducing the robot as a third agent to the traditional one-to-one physiotherapist-patient (Pht-Pt) relationship, the therapist might not be fully aware of the patient’s motor performance. This gap has been bridged by the integration in rehabilitation robots of a visual FeedBack (FB) that informs about patient’s performance. Despite the recognized importance of FB in t-RAGT, the optimal role of the therapist in the complex patient-robot interaction is still unclear. This study aimed to describe whether the type of FB combined with different modalities of Pht’s interaction toward Pt would affect the patients’ visual attention and emotional engagement during t-RAGT.MethodsTen individuals with incomplete Spinal Cord Injury (C or D ASIA Impairment Scale level) were assessed using eye-tracking (ET) and high-density EEG during seven t-RAGT sessions with Lokomat where (i) three types of visual FB (chart, emoticon and game) and (ii) three levels of Pht-Pt interaction (low, medium and high) were randomly combined. ET metrics (fixations and saccades) were extracted for each of the three defined areas of interest (AoI) (monitor, Pht and surrounding) and compared among the different experimental conditions (FB, Pht-Pt interaction level). The EEG spectral activations in theta and alpha bands were reconstructed for each FB type applying Welch periodogram to data localised in the whole grey matter volume using sLORETA.ResultsWe found an effect of FB type factor on all the ET metrics computed in the three AoIs while the factor Pht-Pt interaction level also combined with FB type showed an effect only on the ET metrics calculated in Pht and surrounding AoIs. Neural activation in brain regions crucial for social cognition resulted for high Pht-Pt interaction level, while activation of the insula was found during low interaction, independently on the FB used.ConclusionsThe type of FB and the way in which Pht supports the patients both have a strong impact on patients’ engagement and should be considered in the design of a t-RAGT-based rehabilitation session.

Continuous characterisation of exacerbation pathophysiology using wearable technologies in free-living outpatients with COPD: a prospective observational cohort study

The most recent exacerbation of COPD (ECOPD) classification criteria relies in part on changes in respiratory rate (RR), heart rate (HR) and oxygen saturation (SpO2). Despite this paradigm shift, a thorough understanding of exacerbation patterns is still lacking, as is the identification of physiological exacerbation biomarkers. Using a convenience sampling approach, this prospective observational cohort study was conducted between February 2023 and January 2024. Continuous measurements of daytime/overnight respiratory (primary outcome), cardiovascular, autonomic, activity and sleep-related parameters were collected by a wearable biometric wristband and ring over 21 consecutive days in free-living outpatients experiencing and receiving treatment (≤3 days) for a current exacerbation from the home environment. The EXACT-PRO questionnaire served as the validated reference for daily symptom burden and to identify 'recovered' versus 'persistent worsening' participants. Unadjusted and adjusted (for age, sex, FEV1) linear mixed-effects models were fitted to estimate associations between each physiological parameter with daily EXACT-PRO score (points, pts), in all, 'recovered', and 'persistent worsening' participants. Results are presented as point estimates with 95% CIs. In 21 participants with COPD (43% female, mean age 66.8, BMI 27.7kg/m2, FEV1 36.3% predicted; 85.7% with GOLD 3-4 disease), significant associations in unadjusted models with daily EXACT-PRO score included RR variability (-1.45 [-2.84,-0.073] pts/breath/min) but not RR, daily step count (-0.56 [-0.82,-0.31] pts/1000 steps), and sleep efficiency (-0.12 [-0.20,-0.037] pts/%asleep). In 'recovered' participants (n=10), significant associations included nighttime HR, movement intensity and nightly SpO2. In 'persistent worsening' participants (n=11), significant associations included HR variability, nightly RR variability, nightly SpO2, sleep efficiency, and skin temperature. Similar results were found in adjusted models. This study provides a prospective continuous characterisation of exacerbations of COPD using remotely collected, ambulatory/free-living data. The physiological patterns presented may contribute to the understanding of exacerbations and may enhance the development of effective remote monitoring solutions. University hospital (MUHC-CAS) grant.

Influence of physiological patterns of coronary disease on fractional flow reserve and instantaneous wave-free ratio changes in patients undergoing TAVI

BackgroundInconsistent variations of hyperaemic and resting physiology indexes have been reported between pre- and post-transcatheter aortic valve implantation (TAVI). AimsThis study aimed to evaluate the predominant physiological pattern of coronary artery disease (CAD) in patients with severe aortic stenosis (SAS) undergoing TAVI and assess its impact on fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) variations between pre- and post-TAVI. MethodsPatients with SAS and CAD undergoing FFR and iFR assessment before and after TAVI were included. Vessels were categorized based on FFR and iFR tertiles of change. Longitudinal vessel analysis using Murray's law-based quantitative flow ratio (μFR) was performed. Disease pattern was considered focal with μFR-pullback pressure gradient index (μFR-PPGi) ≥0.78, and local disease severity was stratified by instantaneous μFR gradient per unit length (dμFR/ds) with a value of 0.025/mm. ResultsIn total, 136 vessels (67 patients) were assessed with μFR, having paired pre- and post-TAVI FFR and iFR. μFR-PPGi was 0.73 ± 0.13, with 60.3 % showing diffuse CAD. dμFR/ds was 0.03 ± 0.03/mm, with 27.2 % having a major gradient. Vessels with decreased FFR post-TAVI had lower pre-TAVI FFR and higher dμFR/ds compared to stable or increased FFR vessels. iFR changes were unpredictable; both decreased and increased iFR vessels post-TAVI had lower pre-TAVI FFR and iFR values and showed major dμFR/ds gradients. ConclusionsIn SAS patients undergoing TAVI, diffuse CAD without major gradients was the predominant physiological pattern. Post-TAVI, FFR typically decreased in vessels with major focal gradients, while iFR changes were more unpredictable.

22. SEXUAL PROBLEMS AMONG OLDER ADULTS IN ASIA AND AFRICA: A REVIEW

The aim of this review was to explore the prevalence of sexual problems among older adults in Asia and Africa; and to analyze how difficult it was for them to seek help. Sexual problems are characterized by diminished or absent of sexual interests and by disturbances in the physiological or psychosocial patterns associated with sexual response cycle. Male sexual dysfunction (ED) and female sexual dysfunction increase with age. Studies show that about 33% of the elderly population has at least one complaint with their sexual functioning. Old people face shame and hesitancy when consulting health-care professionals for sexual problems due to the taboos surrounding sex, compounded by a lack of knowledge of older sexuality and ageism in healthcare. The General Practitioners (GP) on the other hand, tend to ignore older adult’s complaints due to lack of training, or just perceiving sexual problems is a norm at old age. However, GP should always give their clients’ opportunity to voice out their concerns with sexual function and offer them various health care regimen and alternatives for evaluation and treatments.

Spatiotemporal Gait Asymmetries Remain Unaffected by Increased Load Carriage in Professional Intervention Police Officers.

Although evidence indicates that load carriage may have an influence on walking patterns, the specific impacts of progressively increased loads on spatial and temporal gait asymmetries remain underexplored. Therefore, the primary aim of this study was to examine whether an increased load carriage had an effect on spatiotemporal gait asymmetries among intervention police officers. For the purpose of this study, 96 male intervention police officers were recruited and assessed under four load conditions: (i) "No load", (ii) "a 5 kg load", (iii) "a 25 kg load", and (iv) "a 45 kg load". Spatial and temporal gait parameters were measured using a pedobarographic platform (Zebris FDM). The spatial and temporal gait parameters, along with the ground reaction forces beneath different foot regions, were examined. The gait asymmetry for each parameter was calculated using the formula (xright - xleft)/0.5 × (xright + xleft)*100%, where "x" represents the numerical value of each parameter for the left and right sides of the body. The findings indicated no statistically significant differences in the spatiotemporal parameters, nor ground reaction force gait asymmetries between the left and right foot, during walking under a progressively increased load carriage. Additionally, the parameter values for both the left and right sides of the body remained consistent, with a high intercorrelation observed across all of the loading conditions. The gait speed and ground reaction forces, which served as covariates, did not significantly change the spatiotemporal gait asymmetries. In summary, this study demonstrates that an increased load carriage did not lead to a progressive rise in spatiotemporal gait asymmetries in professional intervention police officers. However, further examination using an advanced 3-D gait analysis and an assessment of physiological patterns and adaptations is recommended to identify and confirm the key factors influencing gait asymmetry.

High temperature stress induced changes in physiological, biochemical, hormonal and gene expression patterns in contrasting tomato genotypes

High temperature stress induced changes in physiological, biochemical, hormonal and gene expression patterns in contrasting tomato genotypes

Associations between milk infrared-predicted plasma biomarkers of stress resilience and fertility in dairy cattle: insights for enhancing breeding programs and herd management

Fertility is a crucial aspect of dairy herd efficiency and sustainability. Among factors influencing fertility in dairy cattle, metabolic stress and systemic inflammation of animals are of main relevance, especially in the postpartum stage when ovarian activity begins and cows are inseminated. Our study aimed to infer the associations between milk infrared-predicted blood biomarkers of stress resilience and fertility traits, namely the interval from calving to first service (iCF), days open (DO), and the pregnancy rate at first service (PRF) in a multi-breed population of 89,097 dairy cows. The blood metabolites (15 blood biomarkers related to hepatic damage and function, oxidative stress, and inflammation/innate immunity) were predicted using milk Fourier-transform mid-infrared (MIR) spectroscopy. A gradient boosting machine (GBM) approach with leave-one-batch-out cross-validation (R2 range from 0.45 to 0.82) was implemented to an independent calibration database of 1,367 lactating cows reared in 5 herds. Calibration equations were then applied to a population database of 1,799,186 MIR milk spectral data, that were then merged with fertility data collected by the Breeders Federation of Alto Adige (Bolzano province, Italy) generating a final database of 285,145 records. The 2 databases were merged according to the milk test day (and thus the MIR spectrum) closest to the date of insemination. The interval fertility traits were fitted as the hazard of either receiving the first service after calving at time t for iCF or becoming pregnant after calving at time t for DO in a Cox proportional-hazards model. Statistical analyses were performed including in the model the number of lactations, year of calving, and herd as fixed effects. The independent effect of the MIR-based predictions of metabolites was also included with each metabolite evaluated separately and discretized into 7 levels based on percentiles. Pregnancy rate at first service, on the other hand, was analyzed using logistic regression and the same explanatory variables. The metabolites linked to liver function and damage, such as aspartate aminotransferase, total bilirubin, and alkaline phosphatase, had a relevant influence on iCF and DO in terms of the hazard ratio (HR). Relevant results were also obtained for the biomarkers related to oxidative stress and inflammation/innate immunity. Specifically, increasing levels of ceruloplasmin, total reactive oxygen metabolites, and advanced oxidation protein products resulted in a relevant decrease in the HR of cows becoming pregnant. The logistic regression analysis did not reveal any significant effect of the aforementioned biomarkers on PRF, indicating that the effects of the stress response mainly concern the resumption of the ovarian cycle after calving. The results for the associations of the predicted biomarkers of the stress response with iCF and DO were consistent with expected physiological patterns. In conclusion, the predicted biomarkers investigated revealed to be promising novel phenotypes for assessing animal health and welfare, in the view of enhancing fertility in dairy cattle also through selective breeding, thus improving the overall efficiency of dairy herds.

Associations of Food Group Intakes with Serum Carbon Isotope Ratio Values in Youth: Results from 2 Prospective Pediatric Cohort Studies

BackgroundThe carbon isotope ratio (CIR) is a candidate biomarker for sugar-sweetened beverage (SSB) intake in the United States. However, research specific to youth, who differ in their physiology and dietary patterns compared with adults, is lacking. ObjectivesWe evaluated longitudinal associations of SSB intakes across childhood/adolescence with serum CIR. We also explored the relationship between other dietary intakes and serum CIR. MethodsData were from participants in two longitudinal, pediatric cohorts in Colorado: Exploring Perinatal Outcomes among CHildren (EPOCH) study (visits at median 10 and 16 y, n = 150) and Healthy Start Study (visits at median 5 and 9 y, n = 166). Serum CIR was measured using isotope ratio mass spectrometry. Diet was assessed by food-frequency questionnaires (EPOCH) or 24-h diet recalls (Healthy Start). We assessed associations of longitudinal dietary intakes (log2-transformed, standardized) with serum CIR using linear mixed models adjusted for age, sex, and energy intake, and associations of change values between visits using linear regression models. ResultsIn linear mixed models, higher SSB intake across visits was associated with higher serum CIR in both cohorts [β (95% confidence interval (CI)): 0.11 (0.06, 0.15) in EPOCH and 0.14 (0.07, 0.21) in Healthy Start]. Higher meat intake and a higher dietary animal protein ratio were also positively associated with serum CIR in both cohorts [β (95% CI): 0.08 (0.05, 0.12) and 0.18 (0.13, 0.23) in EPOCH; 0.08 (0.01, 0.16) and 0.28 (0.21, 0.35) in Healthy Start]. In change analyses, there were positive associations for changes in the dietary animal protein ratio between visits with changes in serum CIR in both cohorts, but not for changes in SSB intake. ConclusionsOur findings support serum CIR as a potential biomarker of SSB intake in youth cross-sectionally; however, there was not a strong link between change values over longer-term follow-up. Meat/animal protein intake was also consistently and, at times, more strongly associated with serum CIR.

The usefulness of His bundle pacing in a heterogeneous population of patients with impaired left ventricular systolic function.

His bundle pacing (HBP) maintains a physiological activation pattern of ventricular activation, and in patients with intraventricular conduction delay (IVCD) it can normalize wide QRS duration. A total of 181 patients from the HBP registry were enrolled into a the study, which was conducted at the Department of Electrocardiology in Katowice, Poland. The patients had left ventricular ejection fraction (LVEF) < 50% and were implanted between November 2015 and April 2019. The HBP indications were as follows: 1) bradycardia and atrioventricular conduction disturbances with expected high pacing burden, 2) IVCD, LVEF ≤ 35%, with an indication for resynchronization therapy, 3) the need to upgrade to resynchronization therapy due to pacing-induced cardiomyopathy. Pacing parameters and echocardiographic and clinical data were assessed for up to 2 years of follow-up (FU). His bundle pacing was successful in 154 (85.1%) patients. Eighty-two patients completed a 6-month FU. The mean age was 70.6 ± 9.23 years, and 79% were males. At 6 months FU LVEF improved from 35.3 ± 8.22% to 43.1 ± 10.14% (p < 0.0001), and indexed left ventricular end-systolic volume (LVESVi) decreased from 63.1 ± 25.21 mL/m² to 51.9 ± 22.79 mL/m² (p < 0.0001). In 53.1%, the LVESVi reduction was greater than 15%. The improvement in LVEF and LVESVi was also observed after 24 months of FU. His bundle pacing in permanently paced patients when LVEF is reduced below 50% is associated with improvement in LVEF and reverse left ventricle remodeling.

Physiological disease pattern as assessed by PPGI in vessels with FFR and iFR discordance

Abstract Background Fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) disagree on the hemodynamic significance of a coronary lesion in≈20% of cases. It is unclear whether the physiological pattern of disease is an influencing factor for this. This study assessed whether the physiological pattern of coronary artery disease (CAD) as assessed by angiography derived pullback pressure gradient index (PPGI) influences discordance between FFR and iFR measurement. Methods and results This study is a centralized off-line analysis by an independent academic core laboratory (CORRIB Core lab) of a prospective cohort of 444 vessels with both pressure wire-instantaneous wave free ratio (PW-iFR) and pressure wire-fractional flow reserve (PW-FFR) measurements. The study population consisted of a patients presenting with chronic coronary syndrome and having at least one epicardial coronary artery lesion with a 40% to 90% diameter stenosis by visual assessment on invasive coronary angiography. Three-hundred and ninety vessels (355 patients; mean age, 68±10 years; 70% men) with combined FFR, iFR, QFR and angiography derived PPGI were included. QFR was calculated using the QAngio XA 3D 2.1 software package (Medis Medical Imaging System BV, Leiden, The Netherlands). PPGI was calculated using the QFR 2.1.38.2 Research Edition software package. Cut points for hemodynamic significance were FFR ≤0.80 and iFR ≤0.89, respectively. Vessels were classified into FFR+/iFR+ (n=103; 26.4%), FFR-/iFR+ (n=27; 6.9%), FFR+/iFR- (n=38; 9.7%), and FFR-/iFR- (n=222; 57%) groups.. Median FFR, iFR, and QFR were 0.84 (0.77-0.90), 0.92 (0.88-0.97), and 0.83 (0.73-0.90) respectively. FFR disagreed with iFR in 16.7% (65 of 390). The Median PPGI was 0.75 (0.67-0.85). Vessels with PPGI ≥0.75 was considered to have predominantly focal disease pattern and vessels with PPGI &amp;lt;0.75 was considered to have predominantly diffuse disease pattern. The physiological pattern of disease was classified according to the angiography derived pullback pressure gradient index (PPGI) as predominantly physiologically focal (n=209; 53.6%) or predominantly physiologically diffuse (n=181; 46.4%). The median PPGI was significantly lower in FFR-/iFR+ vessels as compared to FFR+/iFR- vessels [0.65(0.60-0.69) vs 0.82(0.75-0.85), p&amp;lt;0.001). The physiological pattern of disease was the influencing factor relating to FFR/iFR discordance: predominantly physiologically focal was significantly associated with FFR+/iFR- (76.3% [29 of 38]), and predominantly physiologically diffuse was significantly associated with FFR-/iFR+ (96.3% [26 of 27]; P&amp;lt;0.001 for pattern of disease between FFR+/iFR- and FFR-/iFR+ groups). Conclusions The physiological pattern of coronary artery disease was an important influencing factor for FFR/iFR discordance.

Contaminant Exposure Profiles Demonstrate Similar Physiological Effects Across Environments Despite Unique Profile Composition in Formosa, Argentina, and Connecticut, USA.

Exposure to environmental contaminants is globally universal. However, communities vary in the specific combination of contaminants to which they are exposed, potentially contributing to variation in human health and creating "locally situated biologies." We investigated how environmental exposures differ across environments by comparing exposure profiles between two contexts that differ markedly across political, economic, and sociocultural factors-Namqom, Formosa, Argentina, and New Haven, Connecticut, United States. We collected infant urine, maternal urine, and human milk samples from mother-infant dyads in Formosa (n = 13) and New Haven (n = 21). We used untargeted liquid chromatography with high-resolution mass spectrometry (LC-HRMS) to annotate environmental contaminants and endogenous metabolites in these samples, and we analyzed the data using exposome-wide association studies (EWAS) followed by pathway enrichment. We found statistically significant differences between the chemical exposure profiles of the Argentinian and US mothers, mostly involving pesticides; however, we observed similarities in the infant urine and human milk environmental contaminant profiles, suggesting that the maternal body may buffer infant exposure through human milk. We also found that infants and mothers were exposed to contaminants that were associated with alterations in amino acid and carbohydrate metabolism. Infants additionally showed alterations in vitamin metabolism, including vitamins B1, B3, and B6. Differences in chemical exposure profiles may be related to structural factors. Despite variation in the composition of exposure profiles between the two study sites, environmental contaminant exposure was associated with similar patterns in human physiology when we considered contaminants comprehensively rather than individually, with implications for metabolic and cardiovascular disease risk as well as infant cognitive development.

A novel strain-based bone-fracture healing algorithm is able to predict a range of healing outcomes.

Fracture healing is a complex process which sometimes results in non-unions, leading to prolonged disability and high morbidity. Traditional methods of optimising fracture treatments, such as in vitro benchtop testing and in vivo randomised controlled trials, face limitations, particularly in evaluating the entire healing process. This study introduces a novel, strain-based fracture-healing algorithm designed to predict a wide range of healing outcomes, including both successful unions and non-unions. The algorithm uses principal strains as mechanical stimuli to simulate fracture healing in response to local mechanical environments within the callus region. The model demonstrates good agreement with experimental data from ovine metatarsal osteotomies across six fracture cases with varying gap widths and inter-fragmentary strains, replicates physiological bony growth patterns, and is independent of the initial callus geometry. This computational approach provides a framework for developing new fracture-fixation devices, aid in pre-surgical planning, and optimise rehabilitation strategies.

Pharmacological Management of Sleep-Wake Disturbances in Delirium.

Delirium is a heterogeneous syndrome primarily characterized by fluctuations in attention and awareness. Sleep-wake disturbances are a common and significant feature of delirium and can manifest as circadian rhythm inversion, sleep fragmentation, and reduced rapid eye movement (REM) and slow-wave sleep. Some literature suggests that the relationship between sleep disruption and delirium is reciprocal wherein the two reinforce one another and may share an underlying etiology. As there are no FDA-approved medications for delirium or delirium-related sleep disturbances, management is primarily focused on addressing underlying medical concerns and promoting physiologic circadian patterns with non-pharmacological behavioral interventions. In practice, however, medications are often used, albeit with limited evidence to support their use. This literature review explores the pharmacology and pharmacokinetics of several medications with literature investigating their use in delirium: melatonin, ramelteon, dual orexin receptor antagonists (DORAs), and dexmedetomidine. Current evidence suggests a possible benefit of ramelteon or melatonin, dexmedetomidine for patients in the ICU setting, and DORAs as therapeutic options for the re-regulation of sleep-wake cycle disruption in delirium. We discuss pertinent pharmacokinetic and pharmacodynamic factors that may influence clinical decision-making regarding these interventions.

Preliminary assessment of a robotic system for overground gait in children with cerebral palsy

PurposeCerebral palsy is one of the leading causes of chronic disability in children. The current pilot study investigated (1) whether an exoskeleton system enables physiological gait patterns and (2) whether the system is user-friendly enough to envision its use in a clinical setting.Design/methodology/approachParticipants included a convenience sample of six children with cerebral palsy. Following informed consent, study volunteers underwent baseline assessments, participated in eight sessions during which they used the exoskeleton system with the objective of achieving proficiency in use of the system, and underwent an end-of-study assessment of walking. Satisfaction and usability questionnaires were given to the family/caregiver.FindingsAll participants achieved a more regular gait pattern and improved their 6-Minute Walk Test scores. Overall satisfaction and usability were rated as good.Practical implicationsThe exoskeleton system enabled physiological gait patterns, and the system was user-friendly enough to envision its use in a clinical setting.Originality/valueThere is potential for guiding treatment plans for individuals with cerebral palsy.

Yield, cell structure and physiological and biochemical characteristics of rapeseed under waterlogging stress

Rapeseed (Brassica napus L.) is a major oilseed crop in the middle and lower reaches of the Yangtze River in China. However, it is susceptible to waterlogging stress. This study aimed to investigate the physiological characteristics, cellular changes, and gene expression patterns of rapeseed under waterlogging stress, with the goal of providing a foundation for breeding waterlogging-tolerant rapeseed. The results revealed that waterlogging-tolerant rapeseed exhibited higher levels of soluble sugars and antioxidant enzyme activity, particularly in the roots. Conversely, waterlogging-sensitive rapeseed displayed greater changes in malondialdehyde, proline, and hydrogen peroxide levels. Cellular observations showed that after experiencing waterlogging stress, the intercellular space of rapeseed leaf cells expanded, leading to disintegration of mitochondria and chloroplasts. Moreover, the area of the root xylem increased, the number of vessels grew, and there were signs of mitochondrial disintegration and vacuole shrinkage, with more pronounced changes observed in waterlogging-sensitive rapeseed. Furthermore, significant differences were found in the transcription levels of genes related to anaerobic respiration and flavonoid biosynthesis, and different varieties demonstrated varied responses to waterlogging stress. In conclusion, there are differences in the response of different varieties to waterlogging stress at the levels of morphology, physiological characteristics, cell structure, and gene transcription. Waterlogging-tolerant rapeseed responds to waterlogging stress by regulating its antioxidant defense system. This study provides valuable insights for the development of waterlogging-tolerant rapeseed varieties.

Analysis of Biomechanical Gait Parameters in Patients after Total Hip Replacement in the Early Recovery Period

INTRODUCTION. The widespread use of total hip arthroplasty (THA) places high demands on the restoration of a normal gait pattern and is one of the key goals of rehabilitation. AIM. Determination of key parameters of walking in patients after THA to assess the effectiveness of restoration of the physiological gait pattern. MATERIALS AND METHODS. In a control prospective study, the main group consisted of 23 patients (11 men, 12 women, aged from 41 to 75 years, mean age 63.9 ± 9.4 years), who in the first 8 weeks after planned THA, moved with the help of assistive devices. supports (two crutches or walkers) who underwent stage II of medical rehabilitation; control group — 27 healthy people (12 men and 15 women, aged from 42 to 73 years, average age 60.9 ± 9.9 years). Spatiotemporal and kinematic gait parameters were recorded before and after the rehabilitation course using a gait simulator with biofeedback equipped with three sensors. For each leg, spatiotemporal and kinematic biomechanical parameters were separately recorded. RESULTS. All spatiotemporal gait parameters on both limbs and pelvic mobility in the sagittal plane in patients in the early recovery period after THA before the start of the rehabilitation course are significantly different from healthy people. After a course of rehabilitation, the studied gait parameters approach physiological values. The main asymmetry is observed in the single support phase from 16 % at the beginning of the course, to 10 % at the end; sagittal pelvic mobility are 2 times higher than the physiological normal meaning at the beginning of the course, without significant changes in dynamics. DISCUSSION. Disturbances in the gait pattern are observed in the majority of patients undergoing THA. Step symmetry is one of the significant parameters of walking, according to which the primary global assessment of its quality is carried out. Asymmetry of the single support phase of the limbs is a natural development of compensatory motor reactions after endoprosthetics. CONCLUSION. The gait parameters “step frequency” and “step cycle” quickly change after a course of rehabilitation and can be used to assess the locomotor activity of patients during short courses of medical rehabilitation in the early recovery period. Indicators of stance and swing phases, their symmetry changes much more slowly, can serve as criteria for assessing the effectiveness of measures taken at the stages of rehabilitation in the dynamics of gait restoration.

Initiated Breastfeeding and Physiological Patterns in Newborn Infants When Reunited With Mother After Separation Due to Elective Cesarean Birth.

The purpose of this study was to compare the effects of two caregiving models on full-term healthy infants' wakefulness, rooting and sucking reflexes, initiation of breastfeeding, and physiological parameters when reunited with their mothers after a mother-infant separation of 130 min after elective cesarean birth. Ninety-five mother-infant pairs participated in a randomized controlled trial, in which full-term healthy infants were allocated to be either dressed in their mothers' arms (n = 56) or skin-to-skin with their mother (n = 39) when reunited with the mother within 130 min after cesarean birth. Data were collected by the Neonatal Behavioral Assessment Scale (NBAS) to assess the infants' wakefulness and prebreastfeeding behaviors. Physiological parameters were assessed at 15 min intervals, from 130 to 205 min after birth. Time to first breastfeed was measured in minutes from the reunion with the mother. The primary finding was that physiologic parameters did not differ but time for initiation of breastfeeding after the reunion with the mother was significantly faster in the skin-to-skin group compared to the infants in the mothers' arms group (p = 0.005). Over the full study period, a more relaxed state and drowsy were found in the skin-to-skin group compared to the infants in the mothers' arms group. Healthy full-term infants born by elective cesarean, who were cared for by their mothers when reunited within 130 min of separation and cared for by their fathers during the mother-infant separation, initiated breastfeeding successfully and showed stable physiological patterns.

Understanding Social Interaction and Physiological Patterns in Nonlean and Last Planner System–Based Project Teams: A Comparative Study Using Immersive Virtual Reality

Understanding Social Interaction and Physiological Patterns in Nonlean and Last Planner System–Based Project Teams: A Comparative Study Using Immersive Virtual Reality