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While dual-task walking requires the ability to integrate sensory information from multiple ongoing sources, it remains unknown whether dual-task walking is more affected than single-task walking by the multisensory integration ability. How does the audiovisual temporal integration ability affect single-task and dual-task gaits in the aging population? One hundred and thirty healthy middle-aged and older adults (age = 64.7 ± 6.4 years) completed an audiovisual simultaneity judgment (AVSJ) task and underwent single-task, motor dual-task, and cognitive dual-task gait assessments. In the AVSJ task, participants judged whether a flash and an auditory stimulus presented at different stimulus onset asynchronies were simultaneous. The accuracy and precision of the AVSJ performance were assessed using the point of subjective simultaneity (PSS) and the temporal binding window (δ), respectively. A lower absolute PSS and δ indicated better performance. Participants held a cup of water and performed serial-7 subtraction for motor and cognitive dual-task gait assessments, respectively. The spatiotemporal gait parameters and their variability were calculated. The influences of PSS and δ on the gait parameters of the three gaits were examined with multiple hierarchical regressions. Only the cognitive dual-task gait was significantly affected by PSS and δ. Greater PSS predicted a longer single support time (β = 0.195, p = 0.024) and its variability (β = 0.224, p = 0.011). Greater δ predicted greater step time variability (β = 0.198, p = 0.022). Declined perception of audiovisual simultaneity particularly degrades temporal control of cognitive dual-task walking, highlighting the importance of assessing and training this ability after midlife. • Audiovisual (AV) temporal perception and dual-task gaits decline in midlife. • Impact of AV perception on aging gaits under cognitive loads remains unclear. • Poorer AV temporal perception impairs temporal control of cognitive dual-task gait. • Single- and motor dual-task gaits show no audiovisual sensitivity. • Findings stress multisensory perception's importance in cognitive dual-task gait. [ABSTRACT FROM AUTHOR]

Timing is an important interactional resource for coordinating mobile and digital interactions, and for signalling interest and involvement in an exchange. This article breaks new ground in exploring conversational rhythm as a 'disconnective' resource through which people suspend, or withdraw from, interactions as a way of asserting agency and autonomy. Focusing on mobile-messaging apps such as WhatsApp, it develops an innovative 'day-in-the-life' methodological approach for exploring how individuals manage multiple online and offline encounters through combining interviews, time-use diaries and messaging data. Interactional analysis of selected extracts involving British women in their 40s and 50s points to an emerging interactive practice of 'suspended alignment' which enables connection-building through alignment while simultaneously keeping interlocutors at a desired distance. Suspended alignment is an increasingly accepted pragmatic norm through which adults maintain key relationships while managing the multiple demands on their time. • Day-in-the-life approach enables insights into how people manage parallel online/offline encounters. • Desire to connect through mobile messaging while maintaining autonomy prompts practice of suspended alignment. • Suspended alignment involves harnessing conversational rhythm to suspend mobile conversations. [ABSTRACT FROM AUTHOR]

In people with Parkinson's disease, what is the effect of adding external cueing (ie, visual, auditory or somatosensorial cueing) to walking training compared with walking training alone in terms of walking, mobility, balance, fear of falling and freezing? Are any benefits carried over to participation or maintained beyond the intervention period? Systematic review of randomised trials with meta-analysis. Ambulatory adults with Parkinson's disease. Walking training with external cueing compared with walking training without external cueing. Walking (ie, speed, stride length and cadence), mobility, balance, fear of falling, freezing and participation. Ten trials involving a total of 309 participants were included. The mean PEDro score of the included trials was 5 (range 4 to 8). Walking training with auditory cueing improved walking speed by 0.09 m/s (95% CI 0.02 to 0.15) more than walking training alone. Although the best estimate was that auditory cueing may also improve stride length by 5 cm, this estimate was imprecise (95% CI –2 to 11). The addition of visual cueing to walking training did not improve walking speed or stride length. Results regarding cadence, mobility, balance, fear of falling, and freezing and maintenance of benefits beyond the intervention period remain uncertain. This systematic review provided low-quality evidence that walking training with auditory cueing is more effective than walking training alone for improving walking speed in Parkinson's disease. Cueing is an inexpensive and easy to implement intervention, so the mean estimate might be considered clinically worthwhile, although the confidence interval spans clinically trivial and worthwhile effects. PROSPERO CRD42021255065. [ABSTRACT FROM AUTHOR]

Newly formed memories require strengthening and reorganisation (consolidation) after learning. The sleeping brain is hallmarked by slow oscillations (SOs), spindles, and ripples. These rhythms drive neuronal firing rates with increasing efficacy and spatiotemporal precision. While SOs set global windows of excitability and inhibition, nested spindles serve as relays that partially reactivate cortical learning networks, facilitate hippocampal ripples, and bias the content of associated memory reactivation. Ripples activate local memory circuits and drive hippocampal–cortical pattern completion to strengthen and reorganise memory traces. SO–spindle–ripple coupling thus governs consolidation processes at the neuronal (synaptic) and brain-wide (systems) level. How do passing moments turn into lasting memories? Sheltered from external tasks and distractions, sleep constitutes an optimal state for the brain to reprocess and consolidate previous experiences. Recent work suggests that consolidation is governed by the intricate interaction of slow oscillations (SOs), spindles, and ripples – electrophysiological sleep rhythms that orchestrate neuronal processing and communication within and across memory circuits. This review describes how sequential SO–spindle–ripple coupling provides a temporally and spatially fine-tuned mechanism to selectively strengthen target memories across hippocampal and cortical networks. Coupled sleep rhythms might be harnessed not only to enhance overnight memory retention, but also to combat memory decline associated with healthy ageing and neurodegenerative diseases. [ABSTRACT FROM AUTHOR]

The reward/circadian rhythm model of bipolar spectrum disorders (BSDs) posits that when individuals with hypersensitive reward systems encounter reward-relevant events, they experience social and circadian rhythm disruption, leading to mood symptoms. The aim of the current study is to test an element of this theoretical model by investigating changes in social rhythms during and after an ecologically-valid reward-relevant event and evaluating whether the strength of these associations differ by trait reward sensitivity and BSD diagnostic group. Young adults from three groups (low BSD risk with moderate reward sensitivity [MRew], high BSD risk with high reward sensitivity [HRew], and high reward sensitivity with BSD [HRew+BSD]) completed a reward responsiveness task and 20-day ecological momentary assessment study structured around a participant-specific goal occurring on day 15. Social rhythm disruption (SRD) and social rhythm regularity (SRR) were assessed daily. Multilevel models examined whether reward sensitivity and group moderated associations between study phase (baseline [days 1–5], goal-striving [days 16–20], or outcome [days 16–20]) and social rhythms. Participants experienced greater SRD after the goal-striving event during the outcome phase, compared to the baseline phase. The HRew+BSD group had significant decreases in SRR during the outcome phase, and this pattern differed significantly from the low-risk and high-risk groups. Greater task reward responsiveness also was associated with significant decreases in SRR during the outcome phase. This study did not test whether social rhythm irregularity was associated with subsequent mood change. Participants exhibited social rhythm changes over the course of this ecologically valid goal-striving period, providing evidence for the interplay between reward-activating events and social rhythms. The HRew+BSD group showed a distinct pattern in which their social rhythms were more irregular after completing reward-relevant goal-striving that was not observed for the low-BSD risk or high-BSD risk groups. These findings provide additional support for Interpersonal and Social Rhythms Therapy. • Young adults exhibited changes in social rhythms over the course of an ecologically valid goal-striving period. • All participants had increased social rhythm disruptions in the days following a reward-relevant event. • Individuals with bipolar spectrum disorder had more social rhythm irregularity compared to the low-risk and high-risk groups. • High behavioral reward responsiveness also was associated with more social rhythm irregularity. [ABSTRACT FROM AUTHOR]

• The effects of exercise with groove rhythm (GREX) have varied in individuals. • GREX enhanced executive function and PFC activity in GrooveEx-familiar participants. • Psychological responses predicted GREX effecs on PFC activity and executive function. • Feelings of audiomotor entrainment and excitement to GREX were key factors. A positive affective response modulates the effects of aerobic exercise on prefrontal executive function (EF). Groove rhythm (GR), eliciting the feeling of wanting to move to music, is useful for inducing positive affective response during exercise. Three minutes of listening to GR activated the left dorsolateral prefrontal cortex (l-DLPFC) and enhanced EF in participants who had higher psychological responses to GR. This finding prompted us to test the hypothesis that the combination of GR and exercise (GREX) induces positive psychological responses that enhance PFC function through entrainment of body movements and musical beats. 41 participants were administered two experimental conditions: three min of very light-intensity (30% V ̇ O 2peak) exercise combined with GR and combined with a white-noise metronome (WMEX). Before and after exercise, participants performed a Stroop task and were monitored for l-DLPFC activity with functional near-infrared spectroscopy. GREX enhanced EF and l-DLPFC activity in participants who experienced greater subjective feelings of audiomotor entrainment and increased excitement with GREX. These psychological responses were predictive of the impact of GREX on l-DLPFC activity and EF. These findings, together with previous results, support the hypothesis that GR allows us to boost the cognitive benefits of exercise via l-DLPFC activity only in those who enjoy groove, and suggest that subjective audiomotor entrainment is a key mechanism of this boosting effect. [ABSTRACT FROM AUTHOR]

• Preschool teachers can deliver rhythm and movement interventions. • Rhythm and movement intervention effective for self-regulation growth in preschool. • Intervention showed marginal positive impact for executive function of inhibition. • Scaling up of music therapy informed preschool programs promising. Self-regulation skills are an important predictor of school readiness and early school achievement. Research identifies that experiences of early stress in disadvantaged households can affect young children's brain architecture, often manifested in poor self-regulatory functioning. While there are documented benefits of coordinated movement activities and music education to improve self-regulation, few interventions have focused exclusively on rhythmic movement activities within a universal preschool setting. This study investigated the effectiveness of a preschool intervention, delivered across eight weeks by generalist preschool teachers, which focused on coordinated rhythmic movement with music to improve self-regulation and executive function. The program is known as Rhythm and Movement for Self-Regulation (RAMSR). The study involved 213 children across eight preschools in disadvantaged communities. The intervention group received 16 to 20 sessions of a rhythm and movement program over eight weeks, while the control group undertook the usual preschool program. Primary outcome measures were executive function and self-regulation with secondary outcomes being school readiness and visual motor integration. Children across the study had baseline measures demonstrating substantial self-regulation and executive function challenges when compared to norms on these measures. Post intervention, significant intervention effects were found for self-regulation and importantly, fidelity and teacher report measures show that it is feasible for educators without any music background to deliver the program. These findings are important given that children from low socioeconomic backgrounds are both more likely to need support for self-regulation to support school transition and have inequitable access to quality music and movement programs. This study confirms that universal access to this beneficial approach can be created through building capacity in early childhood educators. This trial was registered pre-recruitment with the Australian New Zealand Clinical Trials Registry, ACTRN12619001342101. [ABSTRACT FROM AUTHOR]

Out-of-hospital cardiac arrest (OHCA) is a leading cause of death worldwide. Cardiac rhythms of OHCA patients can change during transportation and transfer from emergency medical services (EMS) to the emergency department (ED). Our objective was to study the prevalence of cardiac rhythm changes during transfer from the EMS to the ED in OHCA patients and the possible association with clinical outcomes. We retrospectively studied adult OHCA patients admitted to the ED between January 2017 and December 2019. The primary outcome was the incidence of cardiac rhythm changes during transfer from EMS to the ED. Secondary outcomes were: ED survival, intensive care unit survival, hospital survival, and maximum Glasgow Coma Scale score during admission. We included 625 patients, of whom there were 49 (7.8%) in the rhythm change group and 576 in the no rhythm change group. ED survival was significantly lower in the rhythm change group (26.5%) vs. the no rhythm change group (78.5%, p < 0.01). Cardiac rhythm changes can occur in OHCA patients during transfer from EMS to the ED. Our results showed some evidence that these changes are associated with a lower ED survival. [ABSTRACT FROM AUTHOR]

In this article, we analyze pupils' prosodic realizations of the apology sequence anteeksi–saat anteeksi "I apologize–apology accepted", focusing on pitch, rhythm, and loudness. Drawing on teacher-led mediations in which teachers settle pupils' peer conflicts in Finnish elementary schools as data, and conversation analysis as a method, we examine how the participants' orientation to the interaction of the mediation episode as unproblematic (i.e. contributing to the smooth progress of interaction) vs. problematic (i.e. long delays in turn-taking and explicit disagreements) is prosodically reflected in the apology sequence. We show that prosodic linking of pitch, rhythm, and loudness play a key role in this regard. The apology sequence was produced using complementary ascending–descending pitch patterns in the unproblematic cases, but the pupils deviated from this pattern in the problematic cases. The pupils also aligned their turns to co-construct an isochronous rhythmic pattern throughout the unproblematic apology sequences, while this did not happen in the problematic sequences. Moreover, the loudness levels were matched in the unproblematic cases but not in the problematic ones. We argue that a mutual apology sequence is highly conventionalized, and that prosody plays a major role in how it is received and treated as legitimate, sincere, and ritually correct. • In school mediation, pupils orient to the prosodic realization of an apology and its acceptance. • Prosody reflects the problematic vs. unproblematic nature of the situation. • In unproblematic situations, pupils complement and match pitch, rhythm, and loudness. • In problematic situations, there is no prosodic linking in the apology sequence. • Prosody aids the interpretation of the apologetic stance as sincere and legitimate. [ABSTRACT FROM AUTHOR]

Sociality and timing are tightly interrelated in human interaction as seen in turn-taking or synchronised dance movements. Sociality and timing also show in communicative acts of other species that might be pleasurable, but also necessary for survival. Sociality and timing often co-occur, but their shared phylogenetic trajectory is unknown: How, when, and why did they become so tightly linked? Answering these questions is complicated by several constraints; these include the use of divergent operational definitions across fields and species, the focus on diverse mechanistic explanations (e.g., physiological, neural, or cognitive), and the frequent adoption of anthropocentric theories and methodologies in comparative research. These limitations hinder the development of an integrative framework on the evolutionary trajectory of social timing and make comparative studies not as fruitful as they could be. Here, we outline a theoretical and empirical framework to test contrasting hypotheses on the evolution of social timing with species-appropriate paradigms and consistent definitions. To facilitate future research, we introduce an initial set of representative species and empirical hypotheses. The proposed framework aims at building and contrasting evolutionary trees of social timing toward and beyond the crucial branch represented by our own lineage. Given the integration of cross-species and quantitative approaches, this research line might lead to an integrated empirical-theoretical paradigm and, as a long-term goal, explain why humans are such socially coordinated animals. • Social timing refers to the dynamic and mutual adaptation in time between agents. • Social timing is crucial for communication in many species. • A comparative multi-methodological approach can track social timing's evolution. • Comparative research needs to consider each species' ecology. [ABSTRACT FROM AUTHOR]

Milk synthesis exhibits a daily rhythm that is modified by the timing of feed intake. However, it is unknown how specific nutrients entrain this daily rhythm. Amino acids have an important role in milk synthesis, and may have a role in entrainment of mammary circadian rhythms. The objective of this study was to determine the effects of intestinally absorbed protein on daily rhythms of milk and milk component synthesis and key plasma hormones and metabolites. Nine lactating Holstein cows were assigned to 1 of 3 treatment sequences in a 3 × 3 Latin square. Treatments included abomasal infusions of 500 g/d of sodium caseinate either continuously throughout the day (CON), for 8 h/d from 0900 to 1700 h (DAY), or for 8 h/d from 2100 to 0500 h (NGT). Cows were milked every 6 h during the final 8 d of each period. A 24-h rhythm was fit to data using cosine analysis and the amplitude and acrophase were determined. Night infusion of protein decreased the daily milk yield and milk protein yield by 8.2% and 9.2%, respectively. Milk fat yield was increased 5.5% by DAY and milk fat concentration was increased 8.8% by NGT. Milk yield exhibited a daily rhythm in all treatments, with NGT increasing the amplitude of the daily rhythm 33% compared with CON. Milk fat concentration fit a daily rhythm in CON and NGT, but not DAY, whereas milk protein concentration fit a daily rhythm in CON and DAY, but not NGT. Moreover, DAY abolished the daily rhythm of plasma glucose concentration, but induced rhythms of plasma insulin and nonesterified fatty acid concentrations. Results suggest that feeding increased protein levels during the early part of the day may increase milk fat yield and modify energy metabolism through increased daily variation in insulin-stimulated lipid release, but additional research focused on feeding multiple diets across the day is required. [ABSTRACT FROM AUTHOR]

Patients with hypertrophic cardiomyopathy (HCM) are at increased risk of stroke, but the incidence and factors associated with cardioembolic events in HCM patients without atrial fibrillation (AF) remain unresolved. We determined the incidence of stroke in patients in sinus rhythm (SR) monitored with a cardiac implantable electronic device (CIED). All consecutive patients diagnosed with HCM and referred to CIED implantation with >16 years at diagnosis and ≥ 1 year follow-up post CIED implantation were retrospectively reviewed. Severe LA dilatation was defined as ≥48 mm. Patients were stratified by rhythm as: Pre-existing AF (AF present prior to CIED); De novo AF (AF present after CIED implantation); SR : no episodes of AF. Of 1651 patients, 185 (11.2%) implanted with a CIED were included (57% men, age: 54 ± 17 years). Baseline, pre-existing AF was present in 73 (39%) patients. Ischemic stroke was reported in 19 (10.3%, 1.78%/year) patients and was similar across the three groups (2.3%/year vs 1.1%/year vs 0.6%/year in patients in SR vs pre-existing AF vs de novo AF , respectively, p = 0.235). In SR patients, a LAD≥48 mm posed the greatest risk of stroke (Hazard Ratio: 10.03,95% Confidence-Interval 2.79–16.01). At Cox multivariable analysis, after adjustment for oral anticoagulation, LA was independently associated with stroke while rhythm was not. in HCM patients with CIED long-term monitoring and no prior history of AF, stroke rates were similar in those with de novo AF or stable SR. Severe LA dilatation was a powerful risk factor, irrespective of AF. CIED: Cardiac Implantable Electronic Device, HCM: Hypertrophic Cardiomyopathy, HR: Hazard Ratio, P/LP pathogenic/likely pathogenic variant. [Display omitted] • Incidence of cardioembolic events in HCM patients with atrial fibrillation (AF) and sinus rhythm (SR) remains unresolved. • Whether left atrial (LA) disease could predispose to cardioembolic events in patients with SR is undetermined. • In patients with HCM and long-term monitoring stroke rates were similar in those with AF and SR. LA dilatation was a powerful risk factor. [ABSTRACT FROM AUTHOR]

This cross-sectional, observational study aimed to characterize and compare movement-based rest-activity rhythms (RARs) and sleep period variables of children with tactile hypersensitivities (SS) and non-sensitive peers (NSS) to expand the understanding of experienced differences in sleep. Children (ages 6–10) wore Actigraph GT9X watches for 2 weeks and caregivers completed daily sleep diaries. RARs and sleep period variables (e.g., sleep efficiency, duration, wake after sleep onset) were analyzed and localized means were plotted to visualize average rhythms for each group. Groups were compared using Student's t tests, or non-parametric alternatives, and Hedge's g effect sizes. Fifty-three children and their families participated in this study (n SS = 21 n NSS = 32). The groups had similar RARs and sleep period variables. In both groups, sleep efficiency was low (SE SS = 78%, SE NSS = 77%) and total sleep time was short (TST SS = 7 hrs 26 mins, TST NSS - 7 h, 33 min) compared to national recommendations. Despite these similarities, children with SS took noticeably longer to settle down and fall asleep (53 min) than children with NSS (26 min, p =.075, g = 0.95). This study provides preliminary data describing RAR and sleep period variables in children with and without tactile hypersensitivities. While overall RAR and sleep variables were similar between groups, there is evidence that children with SS spend a longer time transitioning to sleep. Evidence is provided that wrist-worn actigraphy is tolerable and acceptable for children with tactile sensitivities. Actigraphy provides important, movement-based data that should be used in tandem with other measures of sleep health for future studies. • We used rest-activity rhythm (RAR) analyses that have rarely been used in children. • RAR and traditional sleep variables characterize multidimensional sleep health. • Traditional sleep variables did not show a difference between groups. • We found that children with sensitivities take longer to settle down than peers. • RARs can pinpoint unique sleep difficulties experienced in novel populations. [ABSTRACT FROM AUTHOR]

Alterations in the electrocardiogram (ECG) have been associated with coronavirus disease 2019 (COVID-19) severity. ECG irregularities have been linked to death from any cause. However, in previous studies, different abnormalities have been shown to be associated with COVID-19 mortality. We aimed to evaluate the association between ECG abnormalities and COVID-19 clinical outcomes. This cross-sectional retrospectively evaluated patients with COVID-19 admitted to the emergency department of Shahid Mohammadi Hospital, Bandar Abbas, in 2021. Patients' data were extracted from their medical records, including demographics, smoking, underlying diseases, treatment, laboratory test results, and in-hospital parameters. Their admission ECGs were assessed for abnormalities. Of the 239 COVID-19 patients with a mean age of 55.18 ± 16.85 years, 126 (52.7%) were male. Fifty-seven patients (23.8%) died. Intensive care unit (ICU) admission and mechanical ventilation requirement were higher in patients who died (P < 0.001). Furthermore, mechanical ventilation duration and hospital and ICU length of stay were significantly longer in patients who died (P < 0.001). Multivariable logistic regression analysis revealed that a non-sinus rhythm in the admission ECG was associated with approximately eight times higher odds of mortality than a sinus rhythm (adjusted odds ratio = 7.961, 95% confidence interval 1.724; 36.759, P = 0.008). Among ECG findings, a non-sinus rhythm in the admission ECG appears to increase the odds of mortality in patients with COVID-19. Therefore, it is advised that COVID-19 patients be continuously monitored for ECG alterations, as this might provide crucial prognostic data. [ABSTRACT FROM AUTHOR]

Mid- and long-term rhythm outcomes of catheter ablation (CA) for atrial fibrillation (AF) are reported to be suboptimal. Minimally invasive surgical off-pump ablation (MISOA), including both thoracoscopic and trans-diaphragmatic approaches, has been developed to reduce surgical invasiveness and overcome on-pump surgery drawbacks. We sought to compare the efficacy and safety of MISOA and CA for AF treatment. A systematic review and meta-analysis of the literature was performed including studies comparing MISOA and CA. The primary endpoint was survival freedom from AF at follow-up after a 3-month blanking period. Subgroup analysis of the primary endpoint was performed according to the type of surgical incision and hybrid approach. Freedom from AF at 4 years was 52.1% ± 3.2% vs 29.1% ± 3.5%, between MISOA and CA respectively (log-rank p < 0.001; Hazard Ratio: 0.60 [95%Confidence Interval (CI):0.50–0.72], p < 0.001). At landmark analysis, a significant improvement in rhythm outcomes was observed in the MISOA group after the 5th month of follow-up (2 months from the blanking period). The Odds Ratio between MISOA and CA of postoperative cerebrovascular accident incidence and postoperative permanent pacemaker implant (PPM) were 2.00 (95%CI:0.91–4.40, p = 0.084) and 1.55 (95%CI:0.61–3.95, p = 0.358), respectively. The incidence rate ratio of late CVA between MISOA and CA was 0.86 (95%CI:0.28–2.65, p = 0.787), while for late PPM implant was 0.45 (95%CI:0.11–1.78, p = 0.256). The current meta-analysis suggests that MISOA provides superior rhythm outcomes when compared to CA in terms of sinus rhythm restoration. Despite the rhythm outcome superiority of MISOA, it is associated to higher postoperative complications compared to CA. • MISOA showed higher freedom from AF compared to CA at 4 years (log-rank p < 0.001). • The advantage of MISOA over CA was identified after the 5th month of follow-up. • MISOA was found to be a protective factor for AF at univariable Cox regression. • Despite the rhythm advantage, total postoperative adverse events were higher in MISOA. [ABSTRACT FROM AUTHOR]

Asthma often presents with a daily rhythm; however, the underlying mechanisms remain unclear. Circadian rhythm genes have been proposed to regulate inflammation and mucin expression. Here, ovalbumin (OVA)-induced mice and serum shock human bronchial epidermal cells (16HBE) were used in in vivo and in vitro models, respectively. We constructed a brain and muscle ARNT-like 1 (BMAL1) knockdown 16HBE cell line to analyze the effects of rhythmic fluctuations on mucin expression. Serum immunoglobulin E (IgE) and circadian rhythm genes in asthmatic mice showed rhythmic fluctuation amplitude. Mucin (MUC) 1 and MUC5AC expression was increased in the lung tissue of the asthmatic mice. MUC1 expression was negatively correlated with that of the circadian rhythm genes, particularly BMAL1 (r = −0.546, P = 0.006). There was also a negative correlation between BMAL1 and MUC1 expression (r = −0.507, P = 0.002) in the serum shock 16HBE cells. BMAL1 knockdown negated the rhythmic fluctuation amplitude of MUC1 expression and upregulated MUC1 expression in the 16HBE cells. These results indicate that the key circadian rhythm gene, BMAL1 , causes periodic changes in airway MUC1 expression in OVA-induced asthmatic mice. Targeting BMAL1 to regulate periodic changes in MUC1 expression may, therefore, improve asthma treatments. • Rhythm gene disorders in OVA asthmatic mice manifested by an increased amplitude of transcriptional oscillations. • MUC1 was accompanied by rhythmic oscillations in asthma due to BMAL1 regulation. • The serum IgE levels observed a rhythmic fluctuation in the OVA-challenged mice. [ABSTRACT FROM AUTHOR]

• Goal: identify regions of the spinal cord that are essential for locomotor rhythmogenesis. • Neurons in specific regions of the spinal cord were activated or inhibited pharmacologically. • Cells involved in rhythm generation were found to be clustered near the central canal. • Neurons in this region of the rostral cord were more rhythmogenic than those situated caudally. Locomotor movements in mammals are generated by neural networks, situated in the spinal cord, known as central pattern generators (CPGs). Recently, significant strides have been made in the genetic identification of interneuronal components of the locomotor CPG and their specific function. Despite this progress, a population of interneurons that is required for locomotor rhythmogenesis has yet to be identified, and it has been suggested that subsets of interneurons belonging to several genetically-defined populations may be involved. In this study, rather than hunt for rhythmogenic neurons, we take a different approach and attempt to identify the specific region of the spinal cord in which they are located. Focal application of 5-hydroxytryptamine creatine sulfate complex (5-HT) and N-methyl-D-aspartate (NMDA) to the central canal of the rostral lumbar segments of newborn male and female mouse spinal cords quickly generates a robust pattern of fictive locomotion, while inhibition or ablation of neurons in this region disrupts the locomotor rhythm in both rostral and caudal lumbar segments. When applied to the central canal at caudal lumbar levels a higher volume of 5-HT and NMDA are required to elicit fictive locomotion, while inhibition of neurons surrounding the central canal at caudal levels again interrupts rhythmic activity at local segmental levels with minimal effects rostrally. The results of this study indicate that interneurons in the most medial laminae of the neonatal mouse spinal cord are both necessary and sufficient for the generation of locomotor activity, and suggests that this is the region where the rhythm generating core of the locomotor CPG resides. [ABSTRACT FROM AUTHOR]

Testing the hypothesis that combined wake + light therapy improves mood in pregnant vs. postpartum depressed participants (DP) by differentially altering melatonin and sleep timing. Initially 89 women, 37 pregnant (21 normal controls-NC; 16 DP) and 52 postpartum (27 NCs; 25 DP), were randomized to a parallel trial of a phase-delay intervention (PDI): 1-night of early-night wake therapy (sleep 3-7 am) + 6-weeks of evening bright white light (Litebook Advantage) for 60 min starting 90 min before bedtime, vs. a Phase-advance intervention (PAI): 1-night of late-night wake therapy (sleep 9 pm-1 am) + 6-weeks of morning bright white light for 60 min within 30 min of wake time. Blinded clinicians assessed mood weekly by structured interview, and participants completed subjective ratings, a Morningness-Eveningness questionnaire, actigraphy, and collected 2 overnight urine samples for 6-sulphatoxy melatonin (6-SMT). In pregnant DP, mood improved more after the PDI vs. PAI (p =.016), whereas in postpartum DP, mood improved more after the PAI vs. PDI (p =.019). After wake therapy, 2 weeks of light treatment was as efficacious as 6 weeks (p >.05). In postpartum DP, PAI phase-advanced 6-SMT offset and acrophase (p <.05), which correlated positively with mood improvement magnitude (p =.003). Small N. Mood improved more after 2 weeks of the PDI in pregnant DP, but more after 2 weeks of PAI in postpartum DP in which improvement magnitude correlated with 6-SMT phase-advance. Thus, critically-timed Sleep + Light Interventions provide safe, efficacious, rapid-acting, well-tolerated, at-home, non-pharmaceutical treatments for peripartum DP. • Melatonin rhythms are phase-advanced in pregnancy depression; phase-delayed in postpartum depression • Sleep+light interventions that phase-delay rhythms improve mood in pregnancy depression • Sleep+light interventions that phase-advance rhythms improve mood in postpartum depression • Sleep+light interventions benefit mood within 2 weeks • Sleep+light interventions can be administered at home [ABSTRACT FROM AUTHOR]

Background: Impairment in gait domains such as pace, rhythm, and variability are associated with falls, cognitive decline, and dementia. However, the longitudinal changes in these gait domains are poorly understood. The aim of this study was to examine age-related changes in gait domains overall and in those with cognitive impairment and mobility disability.Methods: Participants were from the LonGenity study (n = 797; M Age=75.1 SD 6.5 years; 58.2% female) and were followed up to 12 years (Median=3.3; IQR: 1.1; 6.3). Gait speed and absolute values of step length, step time, cadence and, variability (standard deviation) of step length and step time during usual pace walking were assessed. Principal components analysis was used to obtain weighted combinations of three gait domains: pace (velocity, step length), variability (step length variability, step time variability) and rhythm (step time). Linear mixed effect models were used to examine age-related changes in gait domains overall, and in those with cognitive impairment and mobility disability at baseline.Results: Pace declined, and rhythm increased (worsened) in an accelerating non-linear fashion. Variability gradually increased with age. Those with cognitive impairment had faster rates of change in pace and rhythm. Those with mobility disability had faster increases in rhythm.Conclusions: Age-related changes in gait domains are not uniform. Individuals with cognitive and mobility impairments are particularly vulnerable to accelerated change in pace and or rhythm. [ABSTRACT FROM AUTHOR]

The development of atrial flutter and fibrillation (AFL/AF) in patients with pre-capillary pulmonary hypertension has been associated with an increased risk of morbidity and mortality. Rate and rhythm control strategies have not been directly compared. Eighty-four patients with pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension (CTEPH) with new-onset AFL/AF were identified in the ASPIRE registry. First, baseline characteristics and rates of sinus rhythm (SR) restoration of 3 arrhythmia management strategies (rate control, medical rhythm control and DC cardioversion, DCCV) in an early (2009–13) and later (2014–19) cohort were compared. Longer-term outcomes in patients who achieved SR versus those who did not were then explored. Sixty (71%) patients had AFL and 24 (29%) AF. Eighteen (22%) patients underwent rate control, 22 (26%) medical rhythm control and 44 (52%) DCCV. SR was restored in 33% treated by rate control, 59% medical rhythm control and 95% DCCV (p < 0.001). Restoration of SR was associated with greater improvement in functional class (FC) and Incremental Shuttle Walk Distance (p both <0.05). It also independently predicted superior survival (3-year survival 62% vs 23% in those remaining in AFL/AF, p < 0.0001). In addition, FC III/IV independently predicted higher mortality (HR 2.86, p = 0.007). Right atrial area independently predicted AFL/AF recurrence (OR 1.08, p = 0.01). DCCV was generally well tolerated with no immediate major complications. Restoration of SR is associated with superior functional improvement and survival in PAH/CTEPH compared with rate control. DCCV is generally safe and is more effective than medical therapy at achieving SR. • Atrial arrhythmias increase morbidity and mortality in pulmonary hypertension • Restoration of sinus rhythm leads to improved functional status and survival • DC cardioversion is a safe and effective initial strategy to achieve rhythm control [ABSTRACT FROM AUTHOR]

Jacoby and colleagues used an iterative rhythm reproduction paradigm with listeners from around the world to provide evidence for both rhythm universals (simple-integer ratios 1:1 and 2:1) and cross-cultural variation for specific rhythmic categories that can be linked to local music traditions in different regions of the world. [ABSTRACT FROM AUTHOR]

Non-24-hour sleep-wake rhythm disorder (N24SWD) typically presents in patients with visual impairments that disrupt the ability to entrain to the 24 hour solar cycle. We discuss a 43 year old sighted man who presented with periodic daytime hypersomnia and nighttime insomnia, occasionally leading to <3 hours of sleep per day. Previous polysomnography showed an apnea hypopnea index of 6.2 events per hour. A sleep log of 3 months showed irregular time of sleep onset, and an average of 3 hours of sleep per day. Wrist actigraphy confirmed N24SWD. A trial of tasimelteon 20 mg/day resulting in improved daytime hypersomnia (pre-Epworth Sleepiness Scale (ESS) = 21/24, post-ESS = 5/24; a score of > 10/24 is considered sleepy). Follow-up actigraphy showed marked resolution of phase delay with an average of five hours of sleep. The case demonstrates that tasimelteon is a possible treatment for N24SWD in sighted individuals. [ABSTRACT FROM AUTHOR]

The prognosis of refractory out-of-hospital cardiac arrest (OHCA) is generally poor. A recent Prague OHCA study has demonstrated that an invasive approach (including extracorporeal cardiopulmonary resuscitation, ECPR) is a feasible and effective treatment strategy in refractory OHCA. Here we present a post-hoc analysis of the role of initial rhythm on patient outcomes. The study enrolled patients who had a witnessed OHCA of presumed cardiac cause without early recovery of spontaneous circulation. The initial rhythm was classified as either a shockable or a non-shockable rhythm. The primary outcome was a composite of 180 day-survival with Cerebral Performance in Category 1 or 2. 256 (median age 58y, 17% females) patients were enrolled. The median (IQR) duration of resuscitation was 52 (33–68) minutes. 156 (61%) and 100 (39%) of patients manifested a shockable and non-shockable rhythm, respectively. The primary outcome was achieved in 63 (40%) patients with a shockable rhythm and in 5 (5%) patients with a non-shockable rhythm (p < 0.001). When patients were analyzed separately based on whether the treatment was invasive (n = 124) or standard (n = 132), the difference in the primary endpoint between shockable and non-shockable initial rhythms remained significant (35/72 (49%) vs 4/52 (8%) in the invasive arm and 28/84 (33%) vs 1/48 (2%) in the standard arm; p < 0.001). An initial shockable rhythm and treatment with an invasive approach is associated with a reasonable neurologically favorable survival for 180 days despite refractory OHCA. Non-shockable initial rhythms bear a poor prognosis in refractory OHCA even when ECPR is readily available. [ABSTRACT FROM AUTHOR]

Sleep-wake disturbances in individuals at clinical high risk (CHR) of psychosis may relate to increased symptom severity and contribute to disease progression. Here, we examined differences in rest-activity rhythms (RAR) measures, derived from actigraphy, and objective sleep outcomes, derived from electroencephalography (EEG), between 12 CHR and 16 healthy comparison (HC) individuals. Further, we examined the relationships between RAR disturbances, objective sleep outcomes and clinical psychosis symptoms (i.e., negative, positive, disorganized, general symptoms). Sleep-wake behaviors were monitored via actigraphy for 3–7 days (CHR: 5.7 ± 1.7 days; HC: 6.3 ± 1.2 days) prior to participants spending a night in the sleep laboratory, which was monitored with EEG. Separate regressions were used to examine the effect of clinical group on RAR measures and objective sleep outcomes after controlling for age and gender. CHR participants were found to be less active, specifically during the evening (17:00–20:00; β = 1.145, SE = 0.362, p =.004) and nighttime (21:00–24:00; β = 1.152, SE = 0.326, p =.002) relative to HC. Further, CHR participants had more fragmented sleep (wake after sleep onset: β = 0.888, SE = 0.395, p =.034) and more hyperarousal during sleep (NREM gamma activity: β = 1.087, SE = 0.348, p =.005), but these sleep disturbances were not related to reduced activity or clinical symptoms, whereas lower nighttime activity was related to more disorganized symptoms (ρ = −.640, p =.025). Thus, increasing activity through behavioral interventions may have additional beneficial effects on CHR clinical symptoms. [ABSTRACT FROM AUTHOR]

• Listeners benefit from visually guided cues for the timing of syllables in noise. • Visual cues are redundant when there are auditory temporal cues from speech rhythm. • Visual cues are more effective at reducing informational than energetic masking. This study examined the effect of visual cues that provide the timing information of syllables in nonsense target sentences on the recognition of target speech against either a speech-spectrum noise masker or a two-talker masker. When the target sentences with normally regular rhythm were used (Experiment 1), visual cues indicating the onset times of the target-sentence syllables did not significantly improve target-speech recognition against either the speech-spectrum noise masker or the two-talker masker. On the other hand, recognition of the last (third) keyword in these normal rhythmic sentences was significantly better than that of the first keyword against the two-talker masker, but not the noise masker. This word-position-related speech-recognition improvement indicates a beneficial role of regular speech rhythm in release from informational masking due to the temporal prediction of target-sentence syllables. When artificially irregular rhythms were introduced into target sentences (Experiment 2), visual cues indicating syllable onset times significantly improved target-speech recognition against both types of masker. Moreover, the visual-cue-induced improvement in speech recognition against the two-talker masker was significantly larger than that against the speech-spectrum noise masker. The results of this study suggested that visual cues indicating target-syllable timing information improve target-speech recognition against competing maskers only when the temporal rhythmic regularity of target speech sentences is reduced. [ABSTRACT FROM AUTHOR]

Aim: Treatment with certain drugs can augment the risk of developing malignant arrhythmias (e.g. torsades de pointes [TdP]). Hence, we examined the overall TdP risk drug use before out-of-hospital cardiac arrest (OHCA) and possible association with shockable rhythm and return of spontaneous circulation (ROSC).Methods: Patients ≥18 years with an OHCA of cardiac origin from the Danish Cardiac Arrest Registry (2001-2014) and TdP risk drug use according to www.CredibleMeds.org were identified. Factors associated with TdP risk drug use and secondly how use may affect shockable rhythm and ROSC were determined by multivariable logistic regression.Results: We identified 27,481 patients with an OHCA of cardiac origin (median age: 72 years [interquartile range 62.0, 80.0 years]). A total of 37% were in treatment with TdP risk drugs 0-30 days before OHCA compared with 33% 61-90 days before OHCA (p < 0.001). Most commonly used TdP risk drugs were citalopram (36.1%) and roxithromycin (10.7%). Patients in TdP risk drug treatment were older (75 vs 70 years) and more comorbid compared with those not in treatment. Subsequently, TdP risk drug use was associated with less likelihood of the presenting rhythm being shockable (odds ratio [OR] = 0.63, 95% confidence interval [CI]:0.58-0.69) and ROSC (OR = 0.73, 95% CI:0.66-0.80).Conclusion: TdP risk drug use increased in the time leading up to OHCA and was associated with reduced likelihood of presenting with a shockable rhythm and ROSC in an all-comer OHCA setting. However, patients in TdP risk drug treatment were older and more comorbid than patients not in treatment. [ABSTRACT FROM AUTHOR]

• The BeeBox automatically records feeding time and occurrence in insects. • This reveals circadian rhythm in feeding in bees. • This rhythm is lost in animals kept in constant light. • Constant light also induces higher mortality. In honey bees, most studies of circadian rhythms involve a locomotion test performed in a small tube, a tunnel, or at the hive entrance. However, despite feeding playing an important role in honey bee health or fitness, no demonstration of circadian rhythm on feeding has been performed until recently. Here, we present the BeeBox, a new laboratory platform for bees based on the concept of the Skinner box, which dispenses discrete controlled amounts of food (sucrose syrup) following entrance into an artificial flower. We compared caged groups of bees in 12 h-12 h light/dark cycles, constant darkness and constant light and measured average hourly syrup consumption per living bee. Food intake was higher in constant light and lower in constant darkness; mortality increased in constant light. We observed rhythmic consumption with a period longer than 24 h; this is maintained in darkness without environmental cues, but is damped in the constant light condition. The BeeBox offers many new research perspectives and numerous potential applications in the study of nectar foraging animals. [ABSTRACT FROM AUTHOR]

• In this paper, we proposed a multi-branch network for multi-label ECG classification and introduce a straightforward and effective lead grouping strategy. • The proposed method was evaluated on the PTB-XL dataset and the China Physiological Signal Challenge 2018 (CPSC2018) database for multi-label ECG classification task. • The average macro AUC score and sensitivity of the proposed model in these two ECG databases were 93.25 %, 74.87 %, and 96.49 %, 86.88 %, respectively. • The experimental results on multiple multi-label datasets demonstrated that our method outperformed state-of-the-art networks in multi-label classification tasks. The 12-lead electrocardiogram (ECG) is widely used for diagnosing cardiovascular diseases in clinical practice. Recently, deep learning methods have become increasingly effective for automatically classifying ECG signals. However, most current research simply combines the 12-lead ECG signals into a matrix without fully considering the intrinsic relationships between the leads and the heart's structure. To better utilize medical domain knowledge, we propose a multi-branch network for multi-label ECG classification and introduce an intuitive and effective lead grouping strategy. Correspondingly, we design multi-branch networks where each branch employs a multi-scale convolutional network structure to extract more comprehensive features, with each branch corresponding to a lead combination. To better integrate features from different leads, we propose a feature weighting fusion module. We evaluate our method on the PTB-XL dataset for classifying 4 arrhythmia types and normal rhythm, and on the China Physiological Signal Challenge 2018 (CPSC2018) database for classifying 8 arrhythmia types and normal rhythm. Experimental results on multiple multi-label datasets demonstrate that our proposed multi-branch network outperforms state-of-the-art networks in multi-label classification tasks [ABSTRACT FROM AUTHOR]

First, the RRI was transformed into a p -dimensional Poincaré plot representation, which reveals that the uniformity in the angular component of the Poincaré plot can depict the irregularity of the RRI, while the magnitude of the radial component represents the variability of the RRI. Then, the Shifted Spherical Projection (SSP) method was proposed to simultaneously quantify the irregularity and variability of the RRI. Furthermore, a learnable feature extraction module was devised to capture the irregularity and variability of the RRI, and it was integrated into the end-to-end model for AF detection. Finally, the effectiveness of the end-to-end model was validated through cross-dataset validation using a simulated RRI database (SIMU) and eight additional real-world databases. [Display omitted] Numerous algorithms designed for detecting atrial fibrillation (AF) often exhibit limitations in extracting essential rhythm features, leading to challenges in accurately discerning ectopic beats and consequently yielding suboptimal detection performance. In this study, we explored the distribution patterns of R-R intervals (RRIs) in both AF and specific rhythms, such as atrial premature beats (APBs) and normal sinus rhythm (NSR). For the first time, we employed the Sobolev test statistics, a method used in directional statistics to assess spherical uniformity, to quantify the irregularity and variability characteristics of RRIs. We developed an end-to-end learnable model for detecting AF by leveraging this approach. A cross-dataset validation method is employed to train and test the proposed model. This involved the use of a simulated dataset and eight distinct real-world databases. Notably, when trained on the Computing in Cardiology Challenge 2017 (C2017) and tested on the MIT-BIH Atrial Fibrillation Database (AFDB), our model, designed to take only a sequence of 32 RRIs as input, achieved a sensitivity of 96.2%, specificity of 98.2%, and accuracy of 97.3%. The results illustrate its competitive standing against the existing methods for AF detection and its enhanced resilience to ectopic beats. Unlike existing deep learning-based AF detection models, our model prioritizes interpretability, boasts lower computational complexity (with fewer than 2000 learnable parameters), and demonstrates superior generalization capabilities. This will help improve the quality of long-term real-time monitoring and management of AF, reduce the burden on clinicians, and ultimately improve patient outcomes. [ABSTRACT FROM AUTHOR]

Whilst previous research has linked attenuation of the mu rhythm to the observation of specific visual categories, and even to a potential role in action observation via a putative mirror neuron system, much of this work has not considered what specific type of information might be coded in this oscillatory response when triggered via vision. Here, we sought to determine whether the mu rhythm contains content-specific information about the identity of familiar (and also unfamiliar) graspable objects. In the present study, right-handed participants (N = 27) viewed images of both familiar (apple, wine glass) and unfamiliar (cubie, smoothie) graspable objects, whilst performing an orthogonal task at fixation. Multivariate pattern analysis (MVPA) revealed significant decoding of familiar, but not unfamiliar, visual object categories in the mu rhythm response. Thus, simply viewing familiar graspable objects may automatically trigger activation of associated tactile and/or motor properties in sensorimotor areas, reflected in the mu rhythm. In addition, we report significant attenuation in the central beta band for both familiar and unfamiliar visual objects, but not in the mu rhythm. Our findings highlight how analysing two different aspects of the oscillatory response – either attenuation or the representation of information content – provide complementary views on the role of the mu rhythm in response to viewing graspable object categories. • The Mu Rhythm oscillation contains fine-grained information about the identity of familiar, graspable objects. • We present evidence of a possible oscillatory marker for cross-sensory effects involving sensorimotor and visual cortices. • Different analysis techniquesimply different conclusions about specific oscillations in the perception of graspable objects. • The pattern of results observed in the alpha rhythm is broadly consistent with sharpening accounts of Predictive Processing. [ABSTRACT FROM AUTHOR]

Out-of-hospital cardiac arrest (OHCA) patients from minoritized communities have lower rates of initial shockable rhythm, which is linked to favorable outcomes. We sought to evaluate the importance of initial shockable rhythm on OHCA outcomes and factors that mediate differences in initial shockable rhythm. We performed a retrospective study of the 2013–2022 Texas Cardiac Arrest Registry to Enhance Survival (TX-CARES). Using census tract data, we stratified OHCAs into majority race/ethnicity communities: >50% White, >50% Black, and >50% Hispanic/Latino. We compared logistic regression models between community race/ethnicity and OHCA outcome: (1) unadjusted, (2) adjusting for bystander CPR (bCPR), and (3) adjusting for initial rhythm. Using structural equation modeling, we performed mediation analyses between community race/ethnicity, OHCA characteristics, and initial shockable rhythm. We included 22,730 OHCAs from majority White (21.1% initial shockable rhythm), 4,749 from majority Black (15.3% shockable), and 16,054 majority Hispanic/Latino (16.1% shockable) communities. Odds of favorable neurologic outcome were lower for majority Black (0.4 [0.3–0.5]) and Hispanic/Latino (0.6 [0.6–0.7]). While adjusting for bCPR minimally changed outcome odds, adjusting for shockable rhythm increased odds for Black (0.5 [0.4–0.5]) and Hispanic/Latino (0.7 [0.6–0.8]) communities. On mediation analysis for majority Black, the top mediators of initial shockable rhythm were public location (14.6%), bystander witnessed OHCA (11.6%), and female gender (5.7%). The top mediators for majority Hispanic/Latino were bystander-witnessed OHCA (10.2%), public location (3.52%), and bystander CPR (3.49%), Bystander-witnessed OHCA and public location were the largest mediators of shockable rhythm for OHCAs from minoritized communities. [ABSTRACT FROM AUTHOR]

• Global mean I c is characterized by evident weekly rhythms during most seasons. • Global annual mean I c is reduced by 0.10 K during weekends relative to weekdays. • Global mean I s only displays a pronounced weekly rhythm during winter daytime. • Both global I c and I s reductions during weekends tend to increase with urban ISP. Investigating the weekly rhythms of urban heat islands (UHIs) is critical for gaining deep insights into the urban climate changes caused by periodic cycles of human activities. However, the weekly rhythms of both canopy and surface UHIs (termed I c and I s) remain poorly understood at a large spatial scale. Leveraging daily screen-level air temperature (T a) and satellite land surface temperature (T s) observations (2015∼2020), we show that the weekly rhythms of I c averaged for all selected cities exhibit an evident peak-and-valley pattern across most seasons, with the annual mean I c reduction during weekends of 0.09 ± 0.01 K (mean ± S.E., p < 0.05) for daytime and 0.10 ± 0.01 K (p < 0.05) for nighttime when compared to weekdays. In contrast, the I s only displays a pronounced weekly rhythm during winter daytime, with the corresponding I s reduction during weekends of 0.07 ± 0.01 K (p < 0.05) relative to weekdays. These findings remain robust against potential observation errors in T a and T s. From an intra-city perspective, both I c and I s reductions during weekends escalate with increasing urban impervious surface percentage. This study illustrates the significance of short-term cycles of human activities in shaping global urban climates. [ABSTRACT FROM AUTHOR]

The global burden caused by cardiovascular disease is substantial, with heart disease representing the most common cause of death around the world. There remains a need to develop better mechanistic models of cardiac function in order to combat this health concern. Heart rhythm disorders, or arrhythmias, are one particular type of disease which has been amenable to quantitative investigation. Here we review the application of quantitative methodologies to explore dynamical questions pertaining to arrhythmias. We begin by describing single-cell models of cardiac myocytes, from which two and three dimensional models can be constructed. Special focus is placed on results relating to pattern formation across these spatially-distributed systems, especially the formation of spiral waves of activation. Next, we discuss mechanisms which can lead to the initiation of arrhythmias, focusing on the dynamical state of spatially discordant alternans, and outline proposed mechanisms perpetuating arrhythmias such as fibrillation. We then review experimental and clinical results related to the spatio-temporal mapping of heart rhythm disorders. Finally, we describe treatment options for heart rhythm disorders and demonstrate how statistical physics tools can provide insights into the dynamics of heart rhythm disorders. [ABSTRACT FROM AUTHOR]

Background: Data on extracorporeal cardiopulmonary resuscitation (ECPR) in patients with out-of-hospital cardiac arrest (OHCA) and initially nonshockable rhythms are limited.Objective: This study aimed to evaluate the long-term neurological outcomes of ECPR for patients with OHCA and initially nonshockable rhythms.Methods: In this single-center, consecutive, retrospective, observational study, patients with OHCA and initially nonshockable rhythms who underwent ECPR between January 2012 and December 2017 were included. All patients with refractory cardiopulmonary arrest were transported while undergoing conventional CPR and received ECPR on arrival in the emergency department. We retrospectively collected characteristics at admission and neurological outcomes at the last visit or telephone interview. Cerebral performance category (CPC) scales 1 and 2 were defined as good neurological outcomes and CPC scales 3, 4, and 5 were defined as poor neurological outcomes.Results: Of the 39 patients included in this study, 32 died in the hospital and only 7 survived. There were 4, 0, 0, 3, and 32 patients with CPC 1, 2, 3, 4, and 5, respectively. The proportion of good neurological outcomes for all patients was 10.3% (95% CI 2.9-24.2%) and 14.3% (95% CI 4.0-32.7%) for patients with pulseless electrical activity. No patients with asystole had a good neurological outcome. Median follow-up period was 1052 days (interquartile range 116-1589 days) for those who survived to discharge.Conclusions: Approximately 10% of initially nonshockable patients with OHCA, generally considered to be a poor prognosis, could acquire good neurological outcomes when they underwent ECPR with our indications. [ABSTRACT FROM AUTHOR]

Dairy cows have a daily pattern of feed intake which influences ruminal fermentation and nutrient absorption. Milk synthesis also exhibits a daily rhythm and is altered by the timing of feed availability. Nutrients can regulate physiological rhythms, but it is unclear which specific nutrients affect the rhythms of milk synthesis in the cow. The objective of this study was to determine the effect of the timing of acetate infusion on the daily rhythms of feed intake, milk synthesis, milk fatty acids, plasma insulin and metabolites, and core body temperature. Ten lactating ruminally cannulated Holstein cows (127 ± 24.6 d in milk; mean ± standard deviation) were arranged in a 3 × 3 Latin square design. Treatments were ruminal infusions of 600 g/d of acetate either continuously throughout the day (CON) or over 8 h/d during the day (day treatment, DT; 0900 to 1700 h) or the night (night treatment, NT; 2100 to 0500 h). Experimental periods were 14 d with a 7-d washout between periods. Cows were milked every 6 h during the final 7 d of each experimental period to determine the daily pattern of milk synthesis. Blood samples were taken to represent every 4 h across the day and plasma glucose, insulin, β-hydroxybutyrate, urea nitrogen, and acetate concentration were measured. An intravaginal temperature logger was used to measure core body temperature. Data were analyzed with cosinor-based rhythmometry to test the fit of a cosine function with a period of 24 h and to determine the acrophase (time at peak) and amplitude (peak to mean) of each rhythm. Milk yield fit a daily rhythm for all treatments and DT and NT phase-delayed the rhythm and DT increased the robustness of the rhythm. Milk protein concentration fit a daily rhythm for all treatments and DT increased robustness, whereas NT phase-delayed the rhythm. Plasma acetate concentration also fit a daily rhythm in all treatments. Plasma acetate peaked at ∼1600 h in CON and DT and at 0053 h in NT, reflecting the timing of treatment infusions. There was a daily rhythm in plasma β-hydroxybutyrate that reflected the plasma acetate rhythm. Core body temperature fit a rhythm for all treatments, but the amplitude of the rhythm was smaller than previously observed. In conclusion, the timing of acetate infusion influences peripheral rhythms of milk synthesis and plasma metabolites. [ABSTRACT FROM AUTHOR]

Background: Recent guidelines suggest that coronary angiography (CAG) should be considered for out-of-hospital cardiac arrest (OHCA) survivors, including those without ST elevation (STE) and without shockable rhythms. However, there is no prospective data to support CAG for survivors with nonshockable rhythms and no STE post resuscitation.Methods: This was a re-analysis of the PEARL study (randomized OHCA survivors without STE to early CAG versus not). Patients were subdivided by initial rhythm as nonshockable (Nsh) vs shockable (Sh). The primary outcome was coronary angiographic evidence of acute culprit lesion, with secondary outcomes being survival to hospital discharge and neurological recovery.Results: The PEARL study included 99 patients with OHCA from a presumed cardiac etiology, 24 with nonshockable and 75 with shockable rhythms. There was no difference in the frequency of CAG between the two groups [71% (Nsh) and 75% (Sh); p = 0.79], presence of CAD [81% (Nsh) and 68% (sh); p = 0.37, or culprit lesions identified in each group [50% (Nsh) and 45% (Sh); p = 0.78. Nonshockable patients had worse discharge survival [33% (Nsh) vs 57% (Sh); p = 0.04] and those survived, had worse neurological recovery [30% (Nsh) vs 54% (Sh); p = 0.02] compared to shockable patients.Conclusions: OHCA survivors presenting with nonshockable rhythms and no STE post resuscitation had similar prevalence of culprit coronary lesions to those with shockable rhythms. CAG may be considered in patients with OHCA without STE regardless of initial presenting rhythm. There was no benefit of emergent CAG both in shockable and non-shockable rhythms. [ABSTRACT FROM AUTHOR]

Continuous interactions between physiological body–brain rhythms influence how individuals act, perceive, and evaluate their environment. Despite increasing interest, the intricate interface between breathing, cardiac, neural rhythms, and cognitive function remains poorly understood. By evaluating current theoretical and empirical implications, we derive an integrative framework of a 'body–brain dynamic system' that combines a hidden hierarchical structure with dynamical state transitions. We propose that body–brain signals can interchangeably drive state- and task-specific coupling mechanisms which influence cognitive functions. The dynamical nature of this framework parallels the intrinsic variability of human behavior, and ultimately aims at better understanding how individuals act in and adapt to a dynamically changing environment. Although physiological activity from the body and the brain are often studied in isolation, accumulating evidence shows that body signals (e.g., respiratory and heart rhythms) modulate neural activity and influence cognitive functions. We propose to look at continuous and bidirectional body–brain interactions through the lens of a dynamic system, with a hierarchical but flexible functional organization, and the scope to optimize adaptation in a dynamic environment. After defining possible body–brain states in action, re-action, and perception, we provide empirical examples to address the causal role of body–brain dynamics in behavior and put forward implications for its clinical translation. [ABSTRACT FROM AUTHOR]

Background: Whether atrial fibrillation (AF) pattern or timing of AF therapy modifies the effectiveness of early rhythm control (ERC) is not known.Objectives: This study sought to compare clinical characteristics and outcomes in patients presenting with different AF patterns on ERC vs usual care.Methods: The effects of ERC were compared in first-diagnosed AF (FDAF), paroxysmal AF (paroxAF), and persistent AF (persAF) in this prespecified analysis of the EAST-AFNET 4 (Early treatment of atrial fibrillation for stroke prevention) trial. Associations between AF pattern and primary outcomes (first primary outcome: cardiovascular death, stroke, and hospitalization for heart failure and acute coronary syndrome; second primary outcome: nights spent in hospital per year) were compared over a mean follow-up of 5.1 years. Changes in health-related quality of life were assessed by the EQ-5D.Results: FDAF patients (n = 1,048, enrolled 7 days after diagnosing AF) were slightly older (71 years of age, 48.0% female) than patients with paroxAF (n = 994, 70 years of age, 50.0% female) and persAF (n = 743, 70 years of age, 38.0% female). ERC reduced the primary outcome in all 3 AF patterns. Hospitalizations for acute coronary syndrome were highest in FDAF (incidence rate ratio [IRR]: 1.50; 95% CI: 0.83-2.69; P for interaction = 0.032) compared with paroxAF (IRR: 0.64; 95% CI: 0.32-1.25) and persAF (IRR: 0.50; 95% CI: 0.25-1.00). FDAF patients spent more nights in hospital (IRR: 1.38; 95% CI: 1.12-1.70; P for interaction = 0.004) than paroxAF (IRR: 0.84; 95% CI: 0.67-1.03), and persAF (IRR: 1.02; 95% CI: 0.80-1.30) patients. ERC improved health-related quality of life (EQ-5D score) in patients with paroxAF and persAF but not in patients with FDAF (P = 0.019).Conclusions: ERC reduces the first primary composite outcome in all AF patterns. Patients with FDAF are at high risk for hospitalization and acute coronary syndrome, particularly on ERC. (Early treatment of atrial fibrillation for stroke prevention trial; ISRCTN04708680; Early Treatment of Atrial Fibrillation for Stroke Prevention Trial [EAST]; NCT01288352; Early treatment of Atrial fibrillation for Stroke prevention Trial [EAST]; EudraCT2010-021258-20). [ABSTRACT FROM AUTHOR]

[Display omitted] • Parasites likely time themselves to daily host or environmental rhythms. • We studied the fish louse Argulus foliaceus transcriptome over day-night cycles. • Approximately 50% of annotated lice genes showed significant daily rhythms. • Rhythmic gene functions included feeding, development, and potential drug targets. • This provides important resources for application of chronotherapy in fish lice. Parasites, similar to all other organisms, time themselves to environmental cues using a molecular clock to generate and maintain rhythms. Chronotherapeutic (timed treatment) techniques based on such rhythms offer great potential for improving control of chronic, problematic parasites. Fish lice are a key disease threat in aquaculture, with current control insufficient. Assessing the rhythmicity of fish lice transcriptomes offers not only insight into the viability of chronotherapy, but the opportunity to identify new drug targets. Here, for the first known time in any crustacean parasite, diel changes in gene transcription are examined, revealing that approximately half of the Argulus foliaceus annotated transcriptome displays significant daily rhythmicity. We identified rhythmically transcribed putative clock genes including core clock/cycle and period/timeless pairs, alongside rhythms in feeding-associated genes and processes involving immune response, as well as fish louse drug targets. A substantial number of gene pathways showed peak transcription in hours immediately preceding onset of light, potentially in anticipation of peak host anti-parasite responses or in preparation for increased feeding activity. Genes related to immune haemocyte activity and chitin development were more highly transcribed 4 h post light onset, although inflammatory gene transcription was highest during dark periods. Our study provides an important resource for application of chronotherapy in fish lice; timed application could increase efficacy and/or reduce dose requirement, improving the current landscape of drug resistance and fish health while reducing the economic cost of infection. [ABSTRACT FROM AUTHOR]

The considerable mortality and morbidity associated with atrial fibrillation (AF) pose a substantial burden on patients and health care services. Although the management of AF historically focused on decreasing AF recurrence, it evolved over time in favor of rate control. Recently, more emphasis has been placed on reducing adverse cardiovascular outcomes using rhythm control, generally by using safe and effective rhythm-control therapies (typically antiarrhythmic drugs and/or AF ablation). Evidence increasingly supports early rhythm control in patients with AF that has not become long-standing, but current clinical practice and guidelines do not yet fully reflect this change. Early rhythm control may effectively reduce irreversible atrial remodeling and prevent AF-related deaths, heart failure, and strokes in high-risk patients. It has the potential to halt progression and potentially save patients from years of symptomatic AF; therefore, it should be offered more widely. [ABSTRACT FROM AUTHOR]

Aims: Actigraphy studies of individuals with bipolar disorders (BD) suggest that illness progression may be associated with a range of progressive disruptions in 24-hour rest-activity rhythms (RAR). However, those longitudinal studies were undertaken in older adults with extended histories or illness and treatment rather than young people with emerging BD. To our knowledge, this is the first study to use network modelling to examine the statistical associations between clinical phenotypes of BD and different subsets of RAR markers.Methods: This study of adolescents and young adults (mean age 22 years; 69% female) uses network modelling to examine which self-rated or actigraphic markers of RAR are more strongly associated with full threshold BD (referred to as Stage 2; N = 15) compared with BD-at risk syndromes (subthreshold presentations referred to as Stage 1; N = 25).Results: Network analysis demonstrated that some RAR are associated with both stage of BD and a family history of BD (such as longer sleep duration and higher levels of daytime impairment). Markers of circadian rhythmicity indicated that regulation of this system is weaker in Stage 2 compared with Stage 1 of BD.Limitations: The small subgroup samples may have undermined the ability to detect some associations between phenotypes and RAR.Conclusions: Network modelling may offer a useful strategy for visualizing and analysing patterns of association between RAR and clinical phenotypes defined by stage of illness, familial loading or symptom profile. This could prove useful in understanding the underlying pathophysiology of sleep-wake cycle and circadian rhythm disturbances in BD. [ABSTRACT FROM AUTHOR]

This article argues for conceptualising the land-water nexus not primarily in spatial terms, but above all as a set of spatio temporal rhythms of increasing and decreasing wetness and fluidity. By investigating human engagement with water and land as rhythms, the corresponding and conflicting dynamics of particular places becoming – for longer or shorter periods – land, water or a mixture of both can be traced as an evolving web of relationships between human imaginations and practices, and the materialities of water, mud, sediment, dams, floodgates, etc. The article illustrates this approach with two brief ethnographic examples from northern Europe: In the depopulated Estonian Soomaa wetlands, some of the few remaining inhabitants are in the process of redefining unruly fluctuating water as a tourism destination. In doing so, however, these tourism operators are finding themselves and their "products" caught up in volatile and complicated spatiotemporal dynamics, including the difficulty to predict flooding and to coordinate high water with their potential customers' spare time, which is bound to working/school weeks and public holidays. On the Kemi River in Finnish Lapland, water flows are not only conditioned by precipitation and seasons, but also – through an intricate hydropower infrastructure – by the electricity market, triggering continued disputes about appropriate spatiotemporal rhythms in the land-water nexus. Seasonality and hydroelectricity generation point to the inherent rhythmicity of the land-water nexus, which is significant not only because it reflects the experience of people inhabiting and engaging with their in-between environments. A rhythms approach can also de-centre the (often illusive) quest for what the water-land nexus is, and instead focus on how this nexus continually comes into being and is negotiated by both its inhabitants and other people. This argument builds on anthropological thinking about temporality and materiality, and indicates how the two must be combined for better understanding how human life relates to the land-water nexus. [ABSTRACT FROM AUTHOR]