Heart Rate Variability Research Articles

Comprehensive linear and nonlinear heart rate variability normative data in children.

The autonomic nervous system (ANS) is critical in regulating involuntary bodily functions, including heart rate. Heart rate variability (HRV) reflects the complex interplay between the ANS and humoral factors, making it a valuable noninvasive tool for assessing autonomic function. While HRV has been extensively studied in adults, normative data for HRV in children, primarily based on long-term rhythm recordings, are limited. This study aimed to establish comprehensive normative data for HRV in children. In this retrospective study, we examined 24-h Holter monitors of children aged 1day to 18years, divided into six age groups, at Nemours Children's Health in Orlando, Florida, spanning the years 2013-2023. HRV analysis encompassed time-domain, frequency-domain, and nonlinear indices. Holter data for a total of 247 patients in six age groups were included. An age-related uptrend was observed in all time- and frequency-domain variables except the normalized unit of low-frequency power. Entropy analysis revealed contradictory results among different entropy techniques. Sample and approximate entropy analyses were consistent and showed less complexity and more predictability of HRV with decreasing heart rate, while Shannon entropy analysis showed the opposite. Fractal detrended fluctuation analysis exhibited significant decreases across the age groups, suggestive of diminishing self-similarity of HRV patterns. Control of heart rate and HRV is a highly complex process and requires further study for a better understanding. It seems that no single parameter can fully elucidate the entire process. A combination of time-domain, frequency-domain, and nonlinear indices may be necessary to explain HRV behavior in the growing body.

Exploring the feasibility of heart rate variability biofeedback for individuals with tetraplegia: A pilot clinical trial.

This study aimed to determine the feasibility of using commercially available heart rate variability (HRV) biofeedback training to improve physiological and self-reported stress and anxiety among adults with tetraplegia. HRV biofeedback teaches individuals to effectively modify their HRV levels in synchronization with their respiration rate and amplitude. Thirty participants with tetraplegia were enrolled and allocated into one of two study arms: biofeedback or control. The study was conducted remotely from June 2022 through February 2023. Participants in the biofeedback arm received eight HRV training sessions with physiological monitoring, while participants in the control arm received physiological monitoring only. Outcome measures included feasibility, percentage of time spent in the low-frequency range, the Depression Anxiety Stress Scale-21, the Subjective Units of Distress Scale, and the State-Trait Anxiety Inventory-Y Form. Feasibility was demonstrated with 100% completion of the protocol and no participant withdrawals due to adverse events. The biofeedback arm showed a greater percentage of time spent in the low-frequency range and reported greater improvement in anxiety from baseline to Session 8 on the Subjective Units of Distress Scale compared to the control arm. However, no differences were found between study arms on the Depression Anxiety Stress Scale-21 and State-Trait Anxiety Inventory-Y Form. This study demonstrated that a remotely delivered, self-administered HRV biofeedback intervention could feasibly be delivered to individuals with tetraplegia who report moderate-to-high levels of anxiety. Trends in the reduction of physiological and self-reported anxiety were observed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Heart Rate Variability Estimation based on RFID Tag-Pair in Dynamic Environments

With the rapid development of smart healthcare, accurate Heart Rate Variability (HRV) estimation for the early detection of diseases has become a hot research topic. Advanced work uses the wireless signal to estimate the heartbeat in a contact-free way, which usually cannot separate multiple users or work in a dynamic environment. In this paper, we propose a lightweight heartbeat-sensing method based on RFID tag pairs, which focuses on HRV extraction in a more general sensing scenario. Based on the tag-pair design, we build a novel heartbeat and respiration model to describe the signal relationship between the two tags from the time and space domains. Based on the model, we propose a Calibrated Temporal-Spatial IQ-Shaping-based signal cancellation algorithm to cancel the respiration and extract the heartbeat. To remove the interference in dynamic measurement, we build an IQ-based signal model via a Principal Component Analysis-based interference estimation. To reduce the statistical error in HRV extraction, we further design a neural network to predict the HRV index. We have implemented a system prototype in a real environment with COTS RFID devices. Extensive experiments show that our system can achieve a median RMSSD error of 7.51ms, which satisfies the medical demand in HRV measurement.

An Evaluation of the Autonomic Nervous Activity and Psychomotor Vigilance Level for Smells in the Work Booth

In this study, we investigated the effects of the smell environment in the work booth on autonomic nervous activity (ANS) and psychomotor vigilance levels (PVLs) using linalool (LNL) and trans-2-nonenal (T2N). The subjects were six healthy males (31 ± 6 years old) and six healthy females (24 ± 5 years old). They sat in the work booth filled with the smells of LNL and T2N for 10 min, and their electrocardiograms (ECGs), skin conductance levels, pulse wave variabilities, skin temperatures, and seat pressure distributions were measured. In addition, the orthostatic load test (OLT) and psychomotor vigilance test (PVT) were performed before and after entering the work booth, and a subjective evaluation of the smell was also performed after the experiment. This paper focused on ECG and PVT data and analyzed changes in heart rate variability indices and PVT scores. Males felt slightly comfortable with the LNL smell and showed promoted sympathetic nerve activity in the OLT after the smell presentation. Females felt slightly uncomfortable with the T2N smell and showed promoted sympathetic nerve activity and a decrease in PVT scores in the OLT after the smell presentation. Gender differences were observed in ANS and PVLs, and it is possible that the comfort of LNL increased sympathetic nervous activity in males, while the uncomfortableness of T2N may have reduced work performance in females.

Investigation of Heart Rate Variability and Ventricular Repolarization Indexes in Brucella Patients with Palpitations

Investigation of Heart Rate Variability and Ventricular Repolarization Indexes in Brucella Patients with Palpitations

Fed-CL- an atrial fibrillation prediction system using ECG signals employing federated learning mechanism

Deep learning has shown great promise in predicting Atrial Fibrillation using ECG signals and other vital signs. However, a major hurdle lies in the privacy concerns surrounding these datasets, which often contain sensitive patient information. Balancing accurate AFib prediction with robust user privacy remains a critical challenge to address. We suggest Federated Learning , a privacy-preserving machine learning technique, to address this privacy barrier. Our approach makes use of FL by presenting Fed-CL, a advanced method that combines Long Short-Term Memory networks and Convolutional Neural Networks to accurately predict AFib. In addition, the article explores the importance of analysing mean heart rate variability to differentiate between healthy and abnormal heart rhythms. This combined approach within the proposed system aims to equip healthcare professionals with timely alerts and valuable insights. Ultimately, the goal is to facilitate early detection of AFib risk and enable preventive care for susceptible individuals.

Improved heart rate variability in postmenopausal women following short-term combined exercise training

Imbalances in cardiac autonomic nervous systems are associated with cardiovascular risk factors and poor cardiac outcomes. Heart rate variability (HRV) is a practical and reproducible measure of cardiac autonomic nervous system function. Exercise training promotes positive adjustments in HRV. However, previous studies have reported mixed results. Therefore, this study aimed to investigate the effects of short-term combined exercise training on heart rate variability in post-menopausal women. Thirty-four women aged 50-80 years, at least 12 months post-menopause, were divided into a control (CON) group and an exercise (EX) training group. The participants in the exercise group underwent a 2-week of combined exercise program consisting of aerobic, strength, flexibility, and balance exercises. HRV was recorded using an Actiheart device, before and after the final exercise intervention in a sitting position. The significant main effects of time and group were found in the parameter of SDNN (p time = 0.039; p group = 0.026). Post-hoc analysis showed a borderline increase in SDNN in the EX group (POST: 48.79 ± 17.88 VS 44.54 ± 17.39, p = 0.055). No significant change was observed in the CON group (POST: 35.55 ± 13.51 VS 33.17 ± 8.74, p = 0.288). Statistical analysis of other HRV components revealed no significant results (all P > 0.05). In conclusion, a 2-week of combined exercise training program, including aerobic, resistance, balance, and flexibility exercises improves global cardiac autonomic function in post-menopausal women. Keywords: combined exercise training, heart rate variability, blood pressure, menopause, and women

The effect of transcutaneous auricular vagus nerve stimulation on cardiovascular function in subarachnoid hemorrhage patients: a safety study.

Subarachnoid hemorrhage (SAH) is characterized by intense central inflammation, leading to substantial post-hemorrhagic complications such as vasospasm and delayed cerebral ischemia. Given the anti-inflammatory effect of transcutaneous auricular vagus nerve stimulation (taVNS) and its ability to promote brain plasticity, taVNS has emerged as a promising therapeutic option for SAH patients. However, the effects of taVNS on cardiovascular dynamics in critically ill patients, like those with SAH, have not yet been investigated. Given the association between cardiac complications and elevated risk of poor clinical outcomes after SAH, it is essential to characterize the cardiovascular effects of taVNS to ensure this approach is safe in this fragile population. Therefore, we assessed the impact of both acute taVNS and repetitive taVNS on cardiovascular function in this study. In this randomized clinical trial, 24 SAH patients were assigned to either a taVNS treatment or a Sham treatment group. During their stay in the intensive care unit, we monitored patient electrocardiogram (ECG) readings and vital signs. We compared long-term changes in heart rate, heart rate variability, QT interval, and blood pressure between the two groups. Additionally, we assessed the effects of acute taVNS by comparing cardiovascular metrics before, during, and after the intervention. We also explored acute cardiovascular biomarkers in patients exhibiting clinical improvement. We found that repetitive taVNS did not significantly alter heart rate, QT interval, blood pressure, or intracranial pressure. However, taVNS increased overall heart rate variability and parasympathetic activity compared to the sham treatment. The increase in parasympathetic activity was most pronounced from 2-4 days after initial treatment (Cohen's d = 0.50). Acutely, taVNS increased heart rate, blood pressure, and peripheral perfusion index without affecting the corrected QT interval, intracranial pressure, or heart rate variability. The acute post-treatment elevation in heart rate was more pronounced in patients who experienced a decrease of more than one point in their Modified Rankin Score at the time of discharge. Our study found that taVNS treatment did not induce adverse cardiovascular effects, such as bradycardia or QT prolongation, supporting its development as a safe immunomodulatory treatment approach for SAH patients. The observed acute increase in heart rate after taVNS treatment may serve as a biomarker for SAH patients who could derive greater benefit from this treatment. NCT04557618.

Influence of Night Shift Work on Heart Rate Variability in an Age- and Gender-Matched Study Group.

Regular and long-term shift work is associated with a number of chronic diseases. There is some evidence that shift work also has an influence on the autonomous nervous system. Studies that have examined the effect of shift work on heart rate variability (HRV) have not taken into account age and gender. Therefore, the aim of this study was to investigate the influence of night shift based on 24 h long-term analyses carried out on non-night shift days with a matched control group for age and gender. In total, 172 (128 male, 44 female) healthy shift night workers were compared with subjects from a non-night shift worker group at a ratio of 1:1, forming matched pairs based on the subjects' sex and age. HRV parameters were analyzed based on 24 h ECG recording. An analysis of the HRV parameters showed only a small difference but without statistical significance between the two groups with regard to all of the HRV parameters examined (SDNN, RMSSD, NN50, pNN50, VLF, LF, HF, LF/HF, DFA1, and DFA2). An analysis of the subgroup of subjects who had only worked night shifts for a minimum of 10 or 20 years, with the respective pairs matched by age and gender, did not reveal any significant differences between the HRV parameters of employees working night shifts and those not working night shifts. Taking into account qualitative aspects of HRV analysis, this study was thus able to show that working night shifts for many years may not have as big an influence on HRV as had been assumed so far.

Reduced heart rate variability is associated with altered clinical laboratory profile in people living with HIV

BackgroundWe compared heart rate variability (HRV) indices between people living with HIV (PLWH) and HIV-negative individuals to ascertain the independent association between HIV infection and reduced HRV, and further investigated whether distinct clinical laboratory profiles exist between PLWH with and without reduced HRV. MethodsThis cross-sectional analysis included 304 PLWH and 147 HIV-negative individuals with comparable age and sex. Thirty-two routine clinical laboratory indices (including hematology and biochemistry) closest to the survey were extracted from the Electronic Medical Record System. HRV indices were divided into two categories: low (lowest quartile, Q1) and moderate-to-high (combined, Q2‒Q4). ResultsThe time domain indices, ln(SDNN), ln(RMSSD), and ln(PNN50), as well as the frequency domain indices, ln(HF), ln(LF), and ln(VLF), were all significantly reduced in PLWH versus HIV-negative individuals (all p < 0.05). These associations remained for ln(SDNN), ln(PNN50), ln(HF) and ln(LF) even after adjusting for potential confounders in multivariable models. PLWH with low HRV indices exhibited distinct clinical laboratory profiles that were characterized by an elevation in fasting plasma glucose, white blood cell count, neutrophil count, neutrophil%, and a reduction in albumin, total protein, urine creatinine, lymphocyte%, red blood cell count (RBC) and nadir CD4 count. The final stepwise logistic regression models for low SDNN included older age, decreased total cholesterol levels, elevated neutrophil count, and the use of antidiabetic medications, whereas the final model for low LF included older age, reduced RBC and the use of antidiabetic medications. ConclusionPLWH exhibit impaired parasympathetic activity, as evidenced by reduced SDNN, PNN50, LF and HF. Furthermore, PLWH who have reduced HRV indices exhibits distinct clinical laboratory profiles that are related to systematic inflammatory response and diabetes.

Dysfunction of the autonomic nervous system in gastro-esophageal reflux disease: Consequences for the cardiovascular system

ObjectiveThe pathophysiology of gastro esophageal reflux disease (GERD) implicates autonomic dysregulation of the lower esophageal sphincter tone. Our goal is to investigate whether this dysregulation of the autonomic nervous system (ANS) function observed in isolated GERD cases can affect other systems, such as cardiovascular regulation.Methods: Twenty-five participants were included in the study, 11 patients with isolated GERD and 14 controls. All patients and 7 controls responded to a COMposite Autonomic Symptoms Score 31 (COMPASS 31) questionnaire and underwent functional explorations including EMLA test, sympathetic skin response (SSR), 24-hour heart rate recording and ambulatory blood pressure measurement (ABPM). Seven additional controls underwent a 24-hour heart rate recording only. ResultsGERD patients (Age: mean 36.81±7.82; SR= 0.22) showed high clinically dysautonomic scores (COMPASS 31) (p = 0.015), increased Heart rate variability (HRV) parameters (daytime, nighttime, 24-hour SDNN (standard deviation of the RR interval (NN)), respectively p = 0.003, p < 0.001, p = 0.001; daytime and nighttime very low frequencies (VLF) respectively p = 0.03 and p = 0.007), impaired nocturnal dipping of blood pressure (3/11 patients) and high positivity of EMLA test (7/11, p = 0.037). These outcomes were strongly correlated with clinical dysautonomic assessment. No difference was observed between patients and controls regarding SSR. ConclusionOur data suggests a high parasympathetic tone amongst patients with GERD and a dysregulation of parasympathetic and sympathetic balance in the cardiovascular system with an impairment of the peripheral sympathetic fibers of cutaneous microcirculation, assessed by the EMLA test. GERD may be an inaugural symptom of autonomic neuropathy. Further functional exploration of peripheral small fibers seems to be necessary.

Heart Rate Variability in Elite Team Sports: A Systematic Review

Background: Heart rate variability (HRV) is recognized as a crucial indicator of autonomic nervous system function and is valuable in sports science for monitoring athlete health and performance. This systematic review investigates the use of HRV in elite team sports to monitor training adaptations, athlete status, and overall health. The purpose is to consolidate recent findings and provide a comprehensive understanding of HRV's application in elite team sports. Methods: The review was conducted in accordance with PRISMA guidelines and registered in PROSPERO (CRD42023431208). A comprehensive search was performed across PubMed, Science Direct, Web of Science, and Google Scholar, covering studies from January 2013 to November 2023. Studies included involved elite team-sport athletes, with HRV measured immediately after waking. Exclusion criteria were underage athletes, injured athletes, and studies using HRV for different purposes. The review process involved screening titles, abstracts, and full texts, with a final inclusion of 12 studies. Results: Out of 277 identified articles, 12 studies met the inclusion criteria, involving sports such as water polo, rugby, football, basketball, volleyball, handball, futsal, hockey, and rowing. The studies highlighted HRV as a valuable tool for tracking training load adaptations, monitoring athlete readiness, recovery, and mental stress. Daily HRV measurements were commonly used, showing effectiveness in detecting overtraining and ensuring adequate recovery. Various HRV parameters and recording methods were discussed, emphasizing the need for individualized assessment. RMSSD and LnRMSSD were the most commonly used parameters, with variations in recording times and positions. Conclusions: HRV is an effective non-invasive marker for optimizing training regimens and improving athlete health, making it a significant tool in sports medicine. This review provides actionable insights for integrating HRV monitoring into daily training practices, ultimately enhancing athletic performance and preventing overtraining. Standardized protocols for HRV measurement are recommended to ensure consistency and reliability in data collection and interpretation. The findings highlight the need for further research to refine HRV applications and establish best practices in elite team sports

Analysis of heart rate variability in assessing the autonomic status of tuberculosis patients and in combination with HIV infection

In this study, a comprehensive instrumental assessment of the autonomic status of tuberculosis patients and those with concomitant HIV infection at the beginning and during treatment was conducted, revealing the structure of dysfunction through heart rate variability analysis. Correcting the identified disorders will enhance the effectiveness of treatment through a comprehensive individualized approach.The aim of the study: to assess the autonomic status of patients with tuberculosis and concomitant HIV infection during the course of treatment using spectral analysis of heart rate variability and to determine its clinical significance.Materials and methods. The study involved 195 participants. They were divided into two groups: a control group of 70 healthy individuals and an observation group of 125 newly diagnosed patients with infiltrative and disseminated pulmonary tuberculosis, further divided into two subgroups. The first subgroup included 64 patients with pulmonary tuberculosis, and the second subgroup included 61 patients with tuberculosis combined with HIV infection. The structure of the autonomic nervous system was studied using the computer complex «Varicard 2.51» for processing variocardiograms and analyzing heart rate variability (Registration certificate for medical device dated 10.12.2007 No. FSR 2007/01390). All patients were examined under identical conditions. Calculations were performed using SPSS Statistics v. 23.Results and discussion. The data on the assessment of the state and dynamics of the total power spectrum of RR intervals (TP) in the control group and in patients with tuberculosis and concomitant HIV infection in subgroups 1 and 2 of the observation group during treatment are presented. When comparing the frequency of TP above the «normal zone» in the control group and subgroup 1 of the observation group (t1= 3.30; p1&lt;0.01; t2=1.70; p2&gt;0.05), in the control group and subgroup 2 of the observation group (t1=3.51; p1&lt;0.01; t2=2.64; p2&lt;0.01), statistically significant differences were found in subgroup 1 before treatment and in subgroup 2 before and after treatment. The significant decrease in TP levels above the «normal zone» in patients of subgroups 1 and 2 before treatment indicated significant mobilization of the body’s regulatory system reserves needed to maintain vital functions. By the end of the hospital treatment stage, TP levels had not recovered in patients of subgroup 2, marking more pronounced regulatory disturbances in patients with pulmonary tuberculosis combined with HIV infection.Conclusion. The assessment of the state of regulatory systems and the body’s reserves based on heart rate variability indicators showed that in healthy individuals, these systems were at levels ensuring the body’s normal homeostatic balance with the regulatory systems functioning normally without excessive stress and high resource mobilization. In patients with pulmonary tuberculosis, the state of regulatory systems was at a lower level, especially in patients with concomitant HIV infection.

Effect of different anesthesia depths on perioperative heart rate variability and hemodynamics in middle-aged and elderly patients undergoing general anesthesia

BackgroundTo analyze the effects of different anesthesia depths on perioperative heart rate variability and hemodynamics in middle-aged and elderly patients undergoing general anesthesia, and to provide a basis for clinical application.MethodsA total of 111 patients with gastric cancer who were treated with epidural anesthesia combined with general anesthesia were selected as the study subjects, and the patients were randomly divided into group A, group B and group C. The bispectral index (BIS) was maintained by adjusting the infusion speed of anesthetics, the BIS of group A was maintained at 50 ~ 59, the BIS of group B was maintained at 40 ~ 49, and the BIS of group C was maintained at 30 ~ 39. The high-frequency power (HFP), low-frequency power (LFP), total power (TP), mean arterial pressure (MAP), heart rate (HR), diastolic blood pressure (DBP), and systolic blood pressure (SBP) were measured before anesthesia induction (T1), immediately after intubation (T2), 3 min after intubation (T3), and 6 min after extubation (T4). The cognitive function of the patients was evaluated before and 48 h after surgery.ResultsThe HFP, LFP/HFP, TP, HR, DBP and SBP between the three groups at T1 ~ T3 are significantly difference from each other (P < 0.05). There were significant differences in spontaneous breathing recovery time, eye opening time and extubation time among group A, B and C groups, and group B had the lowest spontaneous breathing recovery time, eye opening time and extubation time (P < 0.05). There was no significant difference in the incidence of adverse reactions during anesthesia between the three groups. The cognitive function score of group B was significantly higher than that of group A and group C (P < 0.05).ConclusionsBIS maintenance of 40 ~ 49 has little effect on perioperative heart rate variability and hemodynamics in middle-aged and elderly patients undergoing general anesthesia, which is helpful for postoperative recovery.

A framework for modeling performers' beat-to-beat heart intervals using music features and Interpretation Maps.

Music strongly modulates our autonomic nervous system. This modulation is evident in musicians' beat-to-beat heart (RR) intervals, a marker of heart rate variability (HRV), and can be related to music features and structures. We present a novel approach to modeling musicians' RR interval variations, analyzing detailed components within a music piece to extract continuous music features and annotations of musicians' performance decisions. A professional ensemble (violinist, cellist, and pianist) performs Schubert's Trio No. 2, Op. 100, Andante con moto nine times during rehearsals. RR interval series are collected from each musician using wireless ECG sensors. Linear mixed models are used to predict their RR intervals based on music features (tempo, loudness, note density), interpretive choices (Interpretation Map), and a starting factor. The models explain approximately half of the variability of the RR interval series for all musicians, with R-squared = 0.606 (violinist), 0.494 (cellist), and 0.540 (pianist). The features with the strongest predictive values were loudness, climax, moment of concern, and starting factor. The method revealed the relative effects of different music features on autonomic response. For the first time, we show a strong link between an interpretation map and RR interval changes. Modeling autonomic response to music stimuli is important for developing medical and non-medical interventions. Our models can serve as a framework for estimating performers' physiological reactions using only music information that could also apply to listeners.

Heart rate variability as a dynamic marker of surgeons' stress during vascular surgery.

A surgeon experiences elevated stress levels when operating. Acute stress is linked to cognitive overload, worsening surgical performance. Chronic stress poses a significant risk to a surgeon's health. Identifying intraoperative stress may allow for preventative strategies that reduce surgeons' stress and subsequently improve patient outcomes. The aim of this study was to assess the feasibility of using heart rate variability as a marker of stress during vascular surgery. A total of 11 senior surgeons were evaluated performing three different vascular surgery procedures. Heart rate variability metrics (low-frequency to high-frequency ratio and standard deviation of the normal-normal interval) were determined from single-lead ECG traces at predetermined procedural performance points. State-Trait Anxiety Inventory-6, a validated stress tool, was used to assess surgeon-reported stress. Subjective reports of procedural difficulty were also collected. One-way ANOVA compared heart rate variability at key performance points with baseline. Pearson's coefficient assessed correlation between heart rate variability and subjective stress. Data were collected for six carotid endarterectomies, six open abdominal aortic aneurysm repairs, and five lower limb bypasses. Heart rate variability metrics indicating markedly greater stress were observed at key performance points across all procedures. Peaks in stress were consistent across different surgeons performing the same procedure. A significant correlation was observed between heart rate variability metrics and subjective State-Trait Anxiety Inventory-6 stress reports (r = 0.768, P =<0.001). The most difficult procedural steps reported corresponded with heart rate variability metrics displaying the greatest stress. Heart rate variability may be a viable approach to assess intraoperative stress and cognitive load during vascular surgery and could be used to evaluate whether a theatre intervention (for example timeout) could reduce stress in areas of surgical difficulty.

Observational study of the effects of maximal oxygen uptake on cognitive function and performance during prolonged military exercise

IntroductionMilitary operations place high demands on many cognitive functions, and stressful events characterise the military work environment. The study aimed to examine the relationship between cardiorespiratory fitness, stress response, cognitive...

Effectiveness analysis of deceleration capacity and traditional heart rate variability in diagnosing vasovagal syncope.

Vasovagal syncope (VVS) is a prevalent medical condition with a lack of efficient methods for its detection. This study aimed to explore an objective clinical indicator in diagnosing VVS. The retrospective analysis involved clinical data of 243 syncope patients from 1 June 2020 to 31 July 2023. Among them, 108 patients had a negative result in the tilt test (TTT), while the remaining 135 patients had a positive result in the TTT. Relevant statistical methods were utilized to examine the correlation between VVS and different indicators of heart rate variability. After screening, 354 patients being considered for VVS were evaluated, resulting in a final sample size of 243. Sex, age, deceleration capacity (DC), and standard deviation of all normal-to-normal intervals (SDNNs) were the variables that showed statistical significance between the TTT(-) group and the TTT(+) group. Independent risk factors identified by multivariate logistic regression were DC [odds ratio (OR) 1.710, 95% confidence interval (CI) 1.388-2.106, P < 0.001] and SDNN (OR 1.033, 95% CI 1.018-1.049, P < 0.001). Comparing the groups, receiver operating characteristic analysis revealed a notable distinction in both DC and SDNN [the respective areas under the curve were 0.789 (95% CI 0.730-0.848) and 0.702 (95% CI 0.637-0.767); the cutoff values were 7.15 and 131.42; P < 0.001, respectively]. In summary, DC can function as an impartial and easily accessible clinical marker for differentiating VVS. A value exceeding 7.15 ms might suggest a higher likelihood of syncope.

Implementing Triage-Bot: Supporting the Current Practice for Triage Nurses.

In Canada, emergency departments (ED) have 15.1 million unscheduled visits every year; this has been suggested to indicate that patients rely on ED to address the gaps experienced by 6.5 million Canadians who lack a primary care provider. When this large number of visits is coupled with a predicted shortage of 100,000 nurses in Canada by 2030, ED can be expected to face resource limitations, which highlights the importance of triage systems as a source of immediate support. Technology that incorporates innovative analytical methods, automation of routine, and efficient processing can be leveraged to enhance patient outcomes, streamline clinical processes, and improve the overall quality and efficiency of healthcare delivery. This paper aims to highlight how the Triage-Bot, a proposed AI system, can assist ED nurses when triaging patients. The Triage-Bot system is based on the Canadian Triage and Acuity Scale (CTAS), which currently serves as a standardized and highly effective tool for prioritizing patient care in emergency departments across the country. Pre-set and open-ended questions are asked using voice and video, allowing patients to describe their health concerns and conditions. Triage-Bot automatically measures the following vital signs: heart rate (HR), heart rate variability (HRV), oxygen saturation (SpO2), respiratory rate (RR), blood pressure (BP), blood glucose (BG), and stress. The system uses artificial intelligence models, particularly those with a deep learning approach that simultaneously analyzes both the user's facial expression and voice tone. Implementation: A systematic review addressed the implications of AI in nursing and concluded that it could contribute to patient care by providing personalized instructions and/or remotely monitoring patients. The Triage-Bot system can be implemented in healthcare facilities, such as emergency department waiting rooms. The information it collects can then be added to a patient's health records to support nurses in assessing the severity of each patient's condition. Limitations: If the system is accessed without a nurse's guidance, it is imperative that the user receives information regarding when to visit a healthcare provider or ED. Continuous improvements in Triage-Bot's accessibility for patients with varying abilities are required to ensure that the system remains user-friendly during times of illness. The voice and text interaction can also be influenced by a user's understanding of language, culture, and age-related factors.

The relationship between cardiac activity, behaviour and endogenous oxytocin and vasopressin in Prader-Willi Syndrome: An exploratory study

This study aimed to increase our understanding of cardiac activity abnormalities in Prader-Willi Syndrome (PWS) and the relationship between cardiac activity, PWS behaviours thought to be associated with cardiac vagal tone and endogenous oxytocin and vasopressin levels. We compared cardiac activity (respiratory sinus arrhythmia (RSA), low-frequency heart rate variability (LF-HRV), heart period) in 30 adolescents and adults with PWS to 30 typically developing age-matched controls. RSA, LF-HRV, and heart period were lower in individuals with PWS than in the control group. In the control group, RSA was higher for females than males. However, for those with PWS, there was no difference between the sexes. Individuals with the mUPD genetic subtype had lower RSA and LF-HRV than participants with the PWS deletion subtype and compared to typically developing controls, no difference was found between the latter two groups. Heart period was also lower for those with mUPD compared to controls. Higher RSA reduced the odds of having temper outbursts and skin-picking. RSA was lower in those with PWS and psychosis compared to those with PWS without psychosis. Finally, we found RSA correlated with vasopressin for those with mUPD but not deletion. There was no relationship between RSA and oxytocin plasma or saliva levels. Our findings suggest autonomic dysfunction in PWS that is more marked in mUPD than deletion and potentially due to greater loss of parasympathetic activity in mUPD.