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Purpose: The purpose of the study was to determine the effect of moderately strenuous aerobic exercise training on heart rate variability (HRV) and heart rate turbulence (HRT) in patients with an implantable cardioverter defibrillator (ICD). Methods: Patients were randomized to a 24-week home-based aerobic exercise (EX) training program (n = 84) or to usual care (UC) (n = 76). All subjects underwent 24-h Holter monitoring at baseline, 8 and 24 weeks. Generalized estimating equations were used to test the effects of exercise on HRV and HRT outcomes. Results: The study group was comprised of n = 160 patients (124 M, 36 F, age 54.9 ± 12.2 years) with an ICD for primary (43%) or secondary prevention (57%). Compared to UC, EX was associated with a significant improvement in parasympathetic HRV for root mean square of successive differences (rMSSD; p =.05) at 8 weeks and global HRV for standard deviation of all normal (N-N) intervals (SDNN; p =.05) and standard deviation of 5-min averages N-N intervals (SDANN; p =.03) at 24 weeks. When stratified by adherence, those who were ≥80% adherent (minutes/week) had significant improvements in parasympathetic HRV (rMSSD, pNN50) and global HRV (SDNN, SDANN) at 8 weeks, and a further significant improvement in global HRV (SDNN, SDANN, SDNN index) at 24 weeks. Neither HRT nor ventricular ectopy changed with exercise training. Conclusion: Moderately strenuous aerobic exercise improved parasympathetic and global HRV indices following an ICD, with greater adherence associated with greater improvements. Clinical trial registration: Clinicaltrials.gov: NCT 00522340. [ABSTRACT FROM AUTHOR]

Human interpersonal capacities emerge from coordinated neural, biological, and behavioral activity unfolding within and between people. However, developmental research to date has allocated comparatively little focus to the dynamic processes of how social interactions emerge across these levels of analysis. Second-person neuroscience and dynamic systems approach together to offer an integrative framework for addressing these questions. This study quantified respiratory sinus arrhythmia and social behavior (∼360 observations per system) from 44 mothers and typically developing 9-month-old infants during a novel modified "still-face" (text message perturbation) task. Stochastic autoregression models indicate that the infant parasympathetic nervous system is coupled within and between people second by second and is sensitive to social context. Intraindividual, we found positive coupling between infants' parasympathetic nervous system activity and their social behavior in the subsequent second, but only during the moments and periods of active caregiver engagement. Between people, we found a bidirectional coregulatory feedback loop: Mothers' parasympathetic activity positively predicted that of their infant in the subsequent second, a form of synchrony that decreased during the text message perturbation and did not fully recover. Conversely, infant parasympathetic activity negatively predicted that of their mother at the subsequent second, a form of synchrony that was invariant over social context. Findings reveal unidirectional parasympathetic coupling within infants and a complementary allostatic feedback loop between mother and infant parasympathetic systems. They offer novel evidence of a dynamic, socially embedded parasympathetic system at previously undocumented timescales, contributing to both basic science and potential clinical targets to better support adaptive, multisystem social development. Public Significance Statement: This study investigated how the subconscious, "rest and digest" parasympathetic nervous system supports babies' abilities to interact with others. Results suggest that the parasympathetic system changes in real-time to help babies regulate their bodies to engage socially and that parasympathetic activity is synchronized between mothers and babies in a coregulatory fashion. Findings improve scientific knowledge and may, in the future, aid clinical efforts to support children's development. [ABSTRACT FROM AUTHOR]

This study aimed to utilize the nonnegative matrix factorization (NNMF) algorithm for muscle synergy analysis, extracting synergy structures and muscle weightings and mining biomarkers reflecting changes in muscle fatigue from these synergy structures. A leg press exercise to induce fatigue was performed by 11 participants. Surface electromyography (sEMG) data from seven muscles, electrocardiography (ECG) data, Borg CR-10 scale scores, and the z-axis acceleration of the weight block were simultaneously collected. Three indices were derived from the synergy structures: activation phase difference, coactivation area, and coactivation time. The indicators were further validated for single-leg landing. Differences in heart rate (HR) and heart rate variability (HRV) were observed across different fatigue levels, with varying degrees of disparity. The median frequency (MDF) exhibited a consistent decline in the primary working muscle groups. Significant differences were noted in activation phase difference, coactivation area, and coactivation time before and after fatigue onset. Moreover, a significant correlation was found between the activation phase difference and the coactivation area with fatigue intensity. The further application of single-leg landing demonstrated the effectiveness of the coactivation area. These indices can serve as biomarkers reflecting simultaneous alterations in the central nervous system and muscle activity post-exertion. [ABSTRACT FROM AUTHOR]

Introduction: Early Exercise Intolerance (EEI) is associated with delayed recovery and longer time to Return To Play (RTP), but this has not been established. Participants; (n = 52, male n = 30) UK university-aged rugby-union student-athletes. Methods: Student-athletes completed baseline screening (July–October 2021 and 2022). The test battery was repeated within 48 h, 4, 8 and 14 days after a Sports-Related Concussion (SRC) with the Buffalo Concussion Bike or Treadmill Test to set sub-symptom heart rate threshold. Student-athletes then completed a controlled early exercise protocol in-between reassessment (days 3, 5–7 and 9–13). Those with EEI were compared to those with early-exercise tolerance. Outcome measures: Post-Concussion Symptom Scale, Immediate Post-Concussion and Cognitive Test, Vestibular-Ocular Motor Screening Tool and the Revised Perceived Academic Impact Tool. Results: EEI was seen throughout the initial 14-days post-SRC (23.8%, 22.4%, 25.5%. 25.0%). EEI was associated with a slower reaction time within 48 h (−0.01 (−0.030–0.043) Vs 0.06 (0.033–0.24), p = 0.004) and greater VOMS scores within 48 h; (0.00 (0.00–4.00) Vs 5.50 (2.75–9.00), p = 0.016) and 4 days (0.00 (0.00–2.00) Vs 5.00 (0.00–6.00), p = 0.044). RTP was 12.5 days longer in those with EEI at 14-days post-SRC. Conclusion: EEI is prevalent following an SRC in university-aged student-athletes and was associated with delayed recovery and RTP. [ABSTRACT FROM AUTHOR]

Background and purpose: This study investigated the effects of deep abdominal breathing on cardiovascular parameters and symptoms in patients with postural orthostatic tachycardia syndrome (POTS) during head‐up tilt‐table (HUT) challenge. Methods: Thirty POTS patients completed two consecutive rounds of 10‐min HUT in a crossover design. One round was HUT without intervention, and one round combined the HUT with deep breathing at a rate of 6 breaths/min. Cardiovascular parameters, including mean blood pressure and maximum and mean heart rate (HR), were measured supine and standing. Symptoms were assessed using the Vanderbilt Orthostatic Symptom Score (VOSS). Results: During the breathing technique, the mean HR increase was −7.35 bpm (95% confidence interval [CI] = −11.71 to −2.98), and the maximum HR increase was −6.27 bpm (95% CI = −11.85 to −0.68, p = 0.041), significantly lower compared to normal breathing. Additionally, improvements were observed in all absolute cardiovascular parameters during standing, with VOSS symptoms simultaneously and significantly decreasing by −5.38 (95% CI = −10.43 to −0.36). Conclusions: Slow deep abdominal breathing can act as a simple technique to reduce the standing HR increase upon HUT in patients with POTS. This suggests that modulation of the cardiopulmonary neurocircuits and the respiratory pump may reduce HR increase and symptoms in patients with POTS. The findings of this study highlight the use of a safe, zero‐cost, and simple behavioral tool to suggest to POTS patients for symptom relief apart from standard treatment. The observed improvements in cardiovascular parameters and symptoms offer a promising therapeutic approach for patients in times of inadequate treatment options. [ABSTRACT FROM AUTHOR]

Background: Dismounted military operations require soldiers to complete cognitive tasks whilst undertaking demanding and repeated physical taskings. Objective: To assess the effects of repeated fast load carriage bouts on cognitive performance, perceptual responses, and psychophysiological markers. Methods: Twelve civilian males (age, 28 ± 8 y; stature, 186 ± 6 cm; body mass 84.3 ± 11.1 kg; V̇O2max, 51.5 ± 6.4 mL·kg−1·min−1) completed three ∼65-min bouts of a Fast Load Carriage Protocol (FLCP), each interspersed with a 65-min recovery period, carrying a representative combat load of 25 kg. During each FLCP, cognitive function was assessed using a Shoot/Don't-Shoot Task (SDST) and a Military-Specific Auditory N-Back Task (MSANT), along with subjective ratings. Additional psychophysiological markers (heart rate variability, salivary cortisol, and dehydroepiandrosterone-sulfate concentrations) were also measured. Results: A main effect of bout on MSANT combined score metric (p <.001, Kendall's W = 69.084) and for time on the accuracy-speed trade-off parameter of the SDST (p =.025, Ѡ2 =.024) was evident. These likely changes in cognitive performance were coupled with subjective data indicating that participants perceived that they increased their mental effort to maintain cognitive performance (bout: p <.001, Ѡ2 =.045; time: p <.001, Ѡ2 =.232). Changes in HRV and salivary markers were also evident, likely tracking increased stress. Conclusion: Despite the increase in physiological and psychological stress, cognitive performance was largely maintained; purportedly a result of increased mental effort. Application: Given the likely increase in dual-task interference in the field environment compared with the laboratory, military commanders should seek approaches to manage cognitive load where possible, to maintain soldier performance. [ABSTRACT FROM AUTHOR]

Despite the association of neighborhood quality with poorer adult health, limited research has explored the association between neighborhood disadvantage, e.g. Area Deprivation Index (ADI), and older Black adults' health, prospectively. This observational study examined the association between ADI and changes in longitudinal physical health within older Black adults. The analytic sample (n = 317) included data from waves 1 & 2 of the Baltimore Study of Black Aging: Patterns of Cognitive Aging (BSBA-PCA). Study variables included the Area Deprivation Index (ADI), objective (e.g. average heart rate) and subjective (e.g. activities of daily living) measures of physical health. Multiple linear regression models were conducted controlling for sociodemographic and social support characteristics. Participants living in more disadvantaged neighborhoods, based on national and state ADIs, were more likely to have a decreasing heart rate even after adjusting for covariates. Likewise, participants reporting increasing levels of ADL difficulty were living in a neighborhood with greater disadvantage based on national and state ADI rankings. Significant social support received and ADI (national and state) interactions were observed for average heart rate. The findings suggest that research on the effect of neighborhood quality and social support can enhance our understanding of its impact on older Black adults' health prospectively. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study is to evaluate the efficacy of heated humidified high flow nasal cannula (HFNC) therapy as a conservative treatment option for newborns suffering from nasal stenosis, a condition that often leads to respiratory distress and feeding difficulties. Given the increasing utilization of HFNC in various upper and lower respiratory tract indications, characterized by its flow-based mechanism and minimal mucosal damage, we seek to investigate its potential benefits in this specific patient population. Methods: A retrospective chart review of newborns with congenital nasal stenosis treated with HFNC for respiratory distress or feeding difficulties in a pediatric tertiary center between 2014 and 2022. Data were collected for demographic characteristics, clinical presentation and ventilatory requirements, pre and post HFNC application. Results: Six infants with nasal stenosis were included in the study cohort. Five were diagnosed with congenital pyriform aperture stenosis, three of whom had additional midnasal stenosis. One patient had nasal synechiae. Two patients had failed surgical treatment and all patients failed conservative treatment prior to HFNC treatment. Following HFNC use, improvement was noted in oxygen saturations, heart and respiratory rates, meal volumes and weight. None of the patients required any additional sinonasal surgical treatment. No complications were observed. Conclusions: In this case series, we present the first documented use of HFNC treatment for nasal stenosis, showing favorable results. Further studies with a larger cohort, wider range of conditions and extended follow-up periods are needed to establish the risks and benefits of HFNC for neonatal nasal stenosis. [ABSTRACT FROM AUTHOR]

Loss of regulation of the autonomic nervous system is found in many diseases from the age of 50 to 60 yr and even more so in older patients. The imbalance is usually manifested by an increase in sympathetic tone, long considered to be the most deleterious element in terms of cardiac rhythmic risk, but also by a reduction in the effectiveness of short-term regulation of the baroreflex arc (partial loss of parasympathetic control). Techniques for analysing this autonomic disorder by analysing heart rate regulation are widely available in outpatient clinics and provide interesting indicators of cardiovascular and cerebrovascular risk. Deceleration capacity of cardiac autonomic control has been identified for its prognostic role in high-risk patients and in the general population. Further research is indicated to assess the value of this marker in anaesthetic risk management by targeting procedures with greater risk of intraoperative and postoperative autonomic dysfunction. [ABSTRACT FROM AUTHOR]

Perioperative myocardial injury after noncardiac surgery is associated with postoperative mortality. Heart rate (HR) is an independent risk factor for perioperative myocardial injury. In this pilot trial we tested the feasibility of a randomised, placebo-controlled trial of personalised HR-targeted perioperative ivabradine. This was a single-centre, randomised, placebo-controlled, double-blind, parallel group, feasibility pilot trial conducted at Geneva University Hospitals. We included patients ≥75 yr old or ≥45 yr old with cardiovascular risk factors planned for intermediate- or high-risk surgery. Patients were randomised to receive ivabradine (2.5, 5.0, or 7.5 mg) or placebo according to their HR, twice daily, from the morning of surgery until postoperative day 2. Primary outcomes were appropriate dosage and blinding success rates. Between October 2020 and January 2022, we randomised 78 patients (recruitment rate of 1.3 patients week−1). Some 439 of 444 study drug administrations were adequate (99% appropriate dosage rate). The blinding success rate was 100%. There were 137 (31%) administrations of Pill A (placebo in both groups for HR ≤70 beats min−1). Nine (11.5%) patients had a high-sensitive cardiac troponin T elevation ≥14 ng L−1 between any two measurements. The number of bradycardia episodes was eight in the placebo group and nine in the ivabradine group. This pilot study demonstrates the feasibility of, and provides guidance for, a future trial testing the efficacy of personalised perioperative ivabradine. Future studies should include patients at higher risk of cardiac complications. NCT04436016. [ABSTRACT FROM AUTHOR]

Although it is clear that people experience physiological arousal in anticipation of news-focused medical consultations, our knowledge of people's experiences during and throughout these consultations is scarce. We examine interbeat interval responses (IBI) of patients and doctors during real-life medical consultations to understand how the experiences of both parties change throughout these encounters and whether they differ from each other. We also examine how the type of news delivered affects responses. We measured the IBI responses of patients and their oncologists throughout 102 consultations in which providers delivered news (classified as good, bad, or status quo) to patients about a recent computerized tomography scan. We observed two distinct phases of consultations: an initial "news" delivery phase and a subsequent "information" phase. During the news phase, on average, patients' IBI responses rapidly increased–indicating less autonomic arousal over time – whereas doctors' responses did not change over time. In contrast, throughout the information phase, on average, both patients' and doctors' responses remained steady. During the information phase, responses differed based on news type: on average, status quo consultations involved an increase in autonomic arousal, whereas good and bad news consultations involved no changes. Lastly, we observed significant variability in patients' responses during both phases. In sum, on average, patients (but not doctors) experience decreases in autonomic arousal while news is being delivered, suggesting that anticipatory distress regarding these consultations wanes quickly. However, our results also indicate that patients' experiences vary from one another, and future research should focus on factors explaining this variability. [ABSTRACT FROM AUTHOR]

Purpose: surgery under local anaesthesia can be a stressful experience for patients. The aim of this study was to determine the influence of a non-pharmacological psychotropic measures (NPTM) on the anxiety and stress levels of individuals undergoing ophthalmic surgery. This is the first study to use a bilateral haptic NPTM for this purpose. Methods: In this clinical interventional case-control study, we assessed objective and subjective stress parameters immediately pre- and postoperatively. We randomly assigned patients to one of two groups: an intervention group with NPTM (n = 70) and a control group (n = 68). Results: When comparing objective parameters (heart rate, blood pressure, and sweat secretion), there were no significant differences between the two groups pre- and postoperatively (p ≥ 0.05). Subjectively, 79% of patients in the intervention group perceived a positive effect from the NPTM (p < 0.01). Patients undergoing eye surgery for the first time described a positive effect significantly more often (p = 0.027). Conclusions: Our study results show that subjectively perceived anxiety and stress during eye surgery is significantly improved by using a bimanual NPTM. The majority of the patients experienced a positive effect on their wellbeing, particularly those undergoing eye surgery for the first time, although there was also a positive effect for patients who had previously undergone eye surgery. While the haptic NPTM used in this study has a positive impact on patients' perception of ophthalmic surgery, all patients undergoing surgery under local anaesthesia may benefit from this approach. [ABSTRACT FROM AUTHOR]

S‐Limonene (s‐Lim) is a monocyclic monoterpene found in a variety of plants and has been shown to present antioxidant and cardioprotective activity in experimental models of myocardial infarction. The aim of this study was to evaluate the potential mechanism by which s‐Lim exerts its antiarrhythmic effect, focusing on the blockade of β‐adrenoceptor (β‐AR) and its effects on various in vivo and in vitro parameters, including electrocardiogram (ECG) measurements, left ventricular developed pressure (LVDP), the β‐adrenergic pathway, sarcomeric shortening and L‐type calcium current (ICa,L). In isolated hearts, 10 μM of s‐Lim did not alter the ECG profile or LVPD. s‐Lim increased the heart rate corrected QT interval (QTc) (10.8%) at 50 μM and reduced heart rate at the concentrations of 30 (12.4%) and 50 μM (16.6%). s‐Lim (10 μM) also inhibited the adrenergic response evoked by isoproterenol (ISO) (1 μM) reducing the increased of heart rate, LVDP and ECG changes. In ventricular cardiomyocyte, s‐Lim antagonized the effect of dobutamine by preventing the increase of sarcomeric shortening, demonstrating a similar effect to atenolol (blocker β1‐AR). In vivo, s‐Lim antagonized the effect of ISO (agonists β1‐AR), presenting a similar effect to propranolol (a non‐selective blocker β‐AR). In ventricular cardiomyocyte, s‐Lim did not alter the voltage dependence for ICa,L activation or the ICa,L density. In addition, s‐Lim did not affect changes in the ECG effect mediated by 5 μM forskolin (an activator of adenylate cyclase). In an in vivo caffeine/ISO‐induced arrhythmia model, s‐Lim (1 mg/kg) presented antiarrhythmic action verified by a reduced arrhythmia score, heart rate, and occurrence of ventricular premature beats and inappropriate sinus tachycardia. These findings indicate that the antiarrhythmic activity of s‐Lim is related to blockade of β‐AR in the heart. [ABSTRACT FROM AUTHOR]

Advanced signal processing of photoplethysmographic data enables novel analyses which may improve the understanding of the pathogenesis of dysglycemia associated with sleep disorders. We aimed to identify sleep-related pulse wave characteristics in diabetic patients compared to normoglycemic individuals, independent of cardiovascular-related comorbidities. This cross-sectional evaluation of the population-based Swedish CArdioPulmonary bioImage Study (SCAPIS) included overnight oximetry-derived pulse wave data from 3997 subjects (45 % males, age 50–64 years). Metabolic status was classified as normoglycemic (n = 3220), pre-diabetic (n = 544), or diabetic (n = 233). Nine validated pulse wave features proposed to influence cardiovascular risk were derived and compared between metabolic status groups. Logistic prediction models and genetic matching were applied to capture diabetes-related pulse wave characteristics during sleep. The model was controlled for anthropometrics, lifestyle, sleep apnea, and in the final adjustment even for cardiometabolic factors like dyslipidaemia, hypertension, and coronary artery calcification. Pulse wave-derived parameters differed between normoglycemic and diabetic individuals in eight dimensions in unadjusted as well as in the partially adjusted model (anthropometric factors and sleep apnea, p ≤ 0.001). All covariates confirmed significant differences between normoglycemic and diabetic subjects (all p ≤ 0.001). Reduced cardio-respiratory coupling (respiratory-related pulse oscillations) (β = −0.010, p = 0.012), as well as increased vascular stiffness (shortened pulse propagation time (β = −0.015, p = 0.001), were independently associated with diabetes even when controlled for cardiometabolic factors. These results were confirmed through a matched cohort comparative analysis. Photoplethysmographic pulse wave analysis during sleep can be utilized to capture multiple features of modified autonomic regulation and cardiovascular consequences in diabetic subjects. Dampened heart rate variability and increased vascular stiffness during sleep showed the strongest associations with diabetes. • Several characteristics of the nocturnal pulse wave signal (PPG) are associated with diabetes. • Elevated vascular stiffness and reduced heart rate modulation identified in diabetic subjects. • Overnight PPG may detect diabetes-related consequences of metabolic dysfunction during sleep. [ABSTRACT FROM AUTHOR]

Pre-sleep stress or hyperarousal is a known key etiological component in insomnia disorder. Despite this, physiological alterations during the sleep onset are not well-understood. In particular, insomnia and obstructive sleep apnea (OSA) are highly prevalent co-morbid conditions, where autonomic regulation may be altered. We aimed to characterize heart rate variability (HRV) during sleep onset as a potential measure of pre-sleep hyperarousal. We described the profile of pre-sleep HRV measures and explore autonomic differences in participants with self-reported insomnia disorder (with no OSA, n = 69; with mild OSA, n = 70; with moderate or severe OSA, n = 66), compared to normal sleep controls (n = 123). Heart rate data during the sleep onset process were extracted for HRV analyses. During the sleep onset process, compared to normal sleep controls, participants with insomnia had altered HRV, indicated by higher heart rate (p = 0.004), lower SDNN (p = 0.003), reduced pNN20 (p < 0.001) and pNN50 (p = 0.010) and lower powers (p < 0.001). Participants with insomnia and moderate/severe OSA may have further deteriorated HRV outcomes compared to no/mild OSA patients with insomnia but differences were not significant. Insomnia itself was associated with significantly higher heart rate, lower pNN20, and lower high frequency power even after adjustment for age, gender, BMI and OSA severity. Participants with insomnia had lower vagal activity during the sleep onset period, which may be compounded by OSA, reflected in higher heart rates and lower HRV. These altered heart rate dynamics may serve as a physiological biomarker for insomnia during bedtime wakefulness, or as a potential tool to evaluate the efficacy of behavioral interventions which target bedtime stress. • Altered heart rate dynamics may present in subjects with insomnia even before sleep. • HRV may be a biomarker of hyper-arousal during wakefulness before sleep onset. • Tracking HRV during sleep onset may have value in evaluation/treatments for insomnia. • Bedtime HRV is a target marker for sleep onset difficulty due to hyperarousal/stress. [ABSTRACT FROM AUTHOR]

Thermal performance curves (TPCs) provide a framework for understanding the effects of temperature on ectotherm performance and fitness. TPCs are often used to test hypotheses regarding local adaptation to temperature or to develop predictions for how organisms will respond to climate warming. However, for aquatic organisms such as fishes, most TPCs have been estimated for adult life stages, and little is known about the shape of TPCs or the potential for thermal adaptation at sensitive embryonic life stages. To examine how latitudinal gradients shape TPCs at early life stages in fishes, we used two populations of Fundulus heteroclitus that have been shown to exhibit latitudinal variation along the thermal cline as adults. We exposed embryos from both northern and southern populations and their reciprocal crosses to eight different temperatures (15°C, 18°C, 21°C, 24°C, 27°C, 30°C, 33°C, and 36°C) until hatch and examined the effects of developmental temperature on embryonic and larval traits (shape of TPCs, heart rate, and body size). We found that the pure southern embryos had a right‐shifted TPC (higher thermal optimum (Topt) for developmental rate, survival, and embryonic growth rate) whereas pure northern embryos had a vertically shifted TPC (higher maximum performance (Pmax) for developmental rate). Differences across larval traits and cross‐type were also found, such that northern crosses hatched faster and hatched at a smaller size compared to the pure southern population. Overall, these observed differences in embryonic and larval traits are consistent with patterns of both local adaptation and countergradient variation. Highlights: Local adaptation and countergradient variation influence the shape of embryo thermal performance curves in two locally adapted populations of killifish. Embryos also had a narrower thermal breadth than adults due to reduced cold tolerance. [ABSTRACT FROM AUTHOR]

Purpose We aimed to document the acceptability (enrollment rate) and feasibility (phone call delivery rate) of implementing a behavioral PA intervention over 12 weeks, in addition to documenting its effects on patient-reported outcomes and physical functioning. This study also describes the costs of carrying out a behavioral PA intervention. A total of 40 participants were randomized in a 1:1 ratio. The tailored behavioral PA intervention was developed based on the most recent PA guidelines in pediatric oncology and on the COM-B framework to enact PA behavior changes. The prescription (frequency, intensity, time and type (FITT)) was adjusted each week during the weekly support calls. The control group did not receive the intervention. 26 males and 14 females (13.6 years old on average and 2.9 years post-cancer treatment on average) participated in our study. The acceptability rate was 90.9% and the feasibility rate was > 85%. We found that 85% improved PA frequency, 80% improved PA intensity, 100% improved PA time, and 50.0% achieved the recommended PA guidelines. No adverse events were reported over the duration of the intervention. Physical function improved with longer 6-minute walk distances in the intervention group (465.8 ± 74.5 m) than in the control group (398.7 ± 92.9 m) (p = 0.016). PROs scores for all participants were within the limits of the normal range. The estimated cost per participant of carrying out this intervention was USD $126.57. Our 12-week behavioral PA intervention, based on the COM-B framework, was found to be acceptable, feasible and safe in childhood cancer survivors. This study is an important step in the right direction to make exercise standard practice in pediatric oncology. Clinical trial registration: NCT04947709. [ABSTRACT FROM AUTHOR]

Prominent theories of nonsuicidal self-injury (NSSI) propose that the behaviour is characterised by amplified emotional responses. However, little is known about how people who self-injure respond during emotional challenge. We measured subjective and physiological responding (heart rate, heart rate variability, and electrodermal responding) among young adults with past-year NSSI (n = 51) and those with no lifetime NSSI (n = 50) during a resting baseline, a stress induction, and a post-stress resting phase. Participants reported the extent to which they spontaneously used cognitive reappraisal and expressive suppression during the post-stress phase. Two weeks later, a subset of the sample (n = 42) reported how they remembered feeling during the laboratory session. Although the NSSI group reported considerably greater emotion dysregulation than Controls, both groups showed similar subjective and psychological reactivity to, and recovery from, emotional challenge. Both groups used reappraisal and suppression regulation strategies following acute stress to a similar extent, and later came to remember the emotional challenge in a similar manner. Within the NSSI group, past-year self-injury tended to be infrequent and sporadic. Only 43.6% of the sample participated in the follow-up survey assessing memory of emotional challenge. Findings demonstrate that the role of emotion in NSSI is more complex than prominent theories can account for, raising substantial questions regarding the nature of emotion in NSSI. A more comprehensive understanding of the role of emotion in NSSI is needed to inform intervention strategies to better support people who self-injure. • An amplified emotional response to challenge is thought to underlie self-injury. • People who self-injure report elevated emotion dysregulation compared to controls. • Both groups showed similar subjective and physiological responses to acute stress. • Both groups later remembered their emotional experience in a similar manner. • A greater understanding of emotion in self-injury is needed to inform treatment. [ABSTRACT FROM AUTHOR]

Heart rate variability (HRV) is often reduced in patients with major depressive disorder (MDD) and is linked to symptoms. However, prior studies have mainly focused on short-term HRV, with limited exploration of the 24-h HRV circadian rhythm, despite its ability to comprehensively capture overall HRV distribution and dynamic fluctuations. In this study, we investigated the circadian rhythms of 24-h HRV indices in patients with MDD and their associations with symptom severity. We recorded 24-h electrocardiograms in 73 patients with MDD (53 in major depressive episode and 20 in remission period) and 31 healthy controls. An extended cosine model was used to model the circadian rhythm of six HRV indices by five parameters: the mesor, amplitude, duty cycle, curve smoothness, and acrophase. Symptom severity was evaluated using the Hamilton Depression Scale and Hamilton Anxiety Scale. Compared with the control group, patients with MDD had a significantly smaller SampEn mesor, higher HF duty cycle, and lower heart rate (HR) duty cycle. They also had a significantly higher curve smoothness for HR, RMSSD, and HF. The mesor for SampEn, along with the curve smoothness for HR and ln RMSSD, were associated with certain symptoms in patients with MDD. Limitations. The cross-sectional design and psychiatric treatment of most patients with MDD limited our findings. Patients with MDD exhibit abnormal HRV circadian rhythms that are associated with symptoms. Moreover, 24-h ECG monitoring may potentially serve as an adjunct value to objectively evaluate clinical symptoms in these patients. • 24-h ECG data was utilized to capture characteristics of circadian rhythm. • We proposed an extended cosine model for measuring six HRV indices' circadian rhythm. • Several significant differences in HRV circadian rhythm were found between patients with MDD and control. • Significant associations were found between abnormal HRV circadian rhythm and symptoms in patients with MDD. [ABSTRACT FROM AUTHOR]

Heart rate variability (HRV) is widely recognized as an effective and valuable tool for evaluating cardiac autonomic modulation. However, various factors can influence HRV before and during assessment, complicating the interpretation and comparability of results. This review outlines the different factors affecting HRV and underscores the importance of considering them to ensure consistent and reliable HRV outcomes. Key influencing factors are categorized into physiological (e.g., age, gender, genetics), lifestyle (e.g., physical activity, alcohol use, smoking, drugs, diet), environmental (e.g., time of day, temperature, noise), and methodological (e.g., body position, recording duration, and respiration) domains. Knowing these factors can help researchers and physicians gain a better understanding of HRV and improve the interpretation of their findings. Consequently, this can lead to the development of standardized methods for consistently assessing and interpreting HRV measures in clinical practice. [ABSTRACT FROM AUTHOR]

The purpose of this study was to clarify the relationships between glycemia and function of the autonomic nervous system (ANS), assessed via resting-state functional connectivity (FC) and heart-rate variability (HRV). Data for this study were extracted from the Leipzig Study for Mind-Body-Emotion Interactions, including 146 healthy adults (114 young, 32 older). Variables of interest were glycated hemoglobin (HbA1c), resting-state FC in the salience aspect of the central-autonomic (S-CAN) and salience network (SN) and HRV (RMSSD and high-frequency HRV (HF-HRV)). HbA1c was inversely correlated with FC in the S-CAN but not SN. HbA1c was inversely correlated with HRV. Both RMSSD and log(HF-HRV) were correlated with FC in the S-CAN and SN. Age- (not sex-related) differences were observed in the Hb1Ac-FC associations (stronger in older adults) while sex- (not age-related) differences were observed in the HRV-FC (stronger in females). These findings extend the diabetes literature to healthy adults in relating glycemia and brain function. The age- and sex-related differences in these relationships highlight the need to account for the potential effects of age and sex in future investigations. • Glycated hemoglobin inversely related with functional connectivity (FC) in controls. • High heart rate variability (RMSSD) was associated with high FC. • Age- but not sex-related differences found in the association between Hb1Ac and FC. • Sex- but not age-related differences found in the association between HRV and FC. [ABSTRACT FROM AUTHOR]

Remote photoplethysmography (rPPG) is a low-cost technique to measure physiological parameters such as heart rate by analyzing videos of a person. There has been growing attention to this technique due to the increased possibilities and demand for running psychological experiments on online platforms. Technological advancements in commercially available cameras and video processing algorithms have led to significant progress in this field. However, despite these advancements, past research indicates that suboptimal video recording conditions can severely compromise the accuracy of rPPG. In this study, we aimed to develop an open-source rPPG methodology and test its performance on videos collected via an online platform, without control of the hardware of the participants and the contextual variables, such as illumination, distance, and motion. Across two experiments, we compared the results of the rPPG extraction methodology to a validated dataset used for rPPG testing. Furthermore, we then collected 231 online video recordings and compared the results of the rPPG extraction to finger pulse oximeter data acquired with a validated mobile heart rate application. Results indicated that the rPPG algorithm was highly accurate, showing a significant degree of convergence with both datasets thus providing an improved tool for recording and analyzing heart rate in online experiments. [ABSTRACT FROM AUTHOR]

Despite the increasing popularity of ambulatory assessment, the reliability and validity of psychophysiological signals from wearable devices is unproven in daily life settings. We evaluated the reliability and validity of physiological signals (electrocardiogram, ECG; photoplethysmography, PPG; electrodermal activity, EDA) collected from two wearable devices (Movisens EcgMove4 and Empatica E4) in the lab (N = 67) and daily life (N = 20) among adults aged 18–64 with Mindware as the laboratory gold standard. Results revealed that both wearable devices' valid data rates in daily life were lower than in the laboratory (Movisens ECG 82.94 vs. 93.10%, Empatica PPG 8.79 vs. 26.14%, and Empatica EDA 41.16 vs. 42.67%, respectively). The poor valid data rates of Empatica PPG signals in the laboratory could be partially attributed to participants' hand movements (r = –.27, p =.03). In laboratory settings, heart rate (HR) derived from both wearable devices exhibited higher concurrent validity than heart rate variability (HRV) metrics (ICCs 0.98–1.00 vs. 0.75–0.97). The number of skin conductance responses (SCRs) derived from Empatica showed higher concurrent validity than skin conductance level (SCL, ICCs 0.38 vs. 0.09). Movisens EcgMove4 provided more reliable and valid HRV measurements than Empatica E4 in both laboratory (split-half reliability: 0.95–0.99 vs. 0.85–0.98; concurrent validity: 0.95–1.00 vs. 0.75–0.98; valid data rate: 93.10 vs. 26.14%) and ambulatory settings (split-half reliability: 0.99–1.00 vs. 0.89–0.98; valid data rate: 82.94 vs. 8.79%). Although the reliability and validity of wearable devices are improving, findings suggest researchers should select devices that yield consistently robust and valid data for their measures of interest. [ABSTRACT FROM AUTHOR]

The Use of Heated Garments as a Warm-Up for Sprint and Submaximal Effort Cycling. JEPonline 2024;27(5):57-69. The purpose of the study was to compare physiological and biomechanical responses using passive and active warm-up techniques. Two separate cycling experiments were conducted differing in intensity: 1) maximal effort, sprint cycling; 2) Submaximal steady state cycling. The 2 experiments were completed with different groups of subjects in separate labs. The sprint subjects (Sprint: n = 7, 22.2 ± 2.6 yrs, 78.6 ± 15.0 kg, 174.4 ± 10.8 cm) completed a 6-sec sprint test and a 30-sec sprint test with peak power output, maximum torque, and maximal cadence measured. The submaximal subjects (47.5 ± 14.4 yrs, 76.4 ± 12.9 kg, 169.3 ± 9.6 cm) completed a 10-min submaximal effort at a fixed intensity with physiological variables (rate of oxygen consumption, rate of carbon dioxide expired, and heart rate) measured. Each experiment consisted of subjects completing a passive warm-up using heated trousers as well as an active warm-up. Sprint results: peak power output and maximum torque were greater pre- vs. post-passive, but not following the active warm-up during the 2nd 6-sec (P < 0.05). For the 30-sec test, neither the peak power output nor the average power was different between the passive and the active warm-up (P > 0.05). Submaximal results: none of the physiological variables were different between the warm-up conditions (P > 0.05). Overall, it was determined that the passive warm-up could be a substitute for the active warm-up for sprint and/or submaximal cycling efforts. [ABSTRACT FROM AUTHOR]

Background: Respiration is a crucial determinant of autonomic balance and heart rate variability (HRV). The comparative effect of spontaneous versus paced breathing on HRV has been almost exclusively explored in healthy adults and never been investigated in an injured military cohort. Objective: To examine the effect of spontaneous versus paced breathing on HRV in veterans with combat‐related traumatic injury (CRTI). Design: Observational cohort study. Setting: ArmeD serVices trAuma rehabilitatioN outComE (ADVANCE) study, Stanford Hall, UK. Participants: The sample consisted of 100 randomly selected participants who sustained CRTI (eg, amputation) during their deployment (Afghanistan 2003–2014) and were recruited into the ongoing ADVANCE prospective cohort study. Intervention: Not applicable. Main Outcome Measure: HRV was recorded using a single‐lead ECG. HRV data were acquired during a sequential protocol of 5‐minute spontaneous breathing followed immediately by 5 minutes of paced breathing (six cycles/minute) among fully rested and supine participants. HRV was reported using time domain (root mean square of successive differences), frequency domain (low frequency and high frequency) and nonlinear (sample entropy) measures. The agreement between HRV during spontaneous versus paced breathing was examined using the Bland–Altman analysis. Results: The mean age of participants was 36.5 ± 4.6 years. Resting respiratory rate was significantly higher with spontaneous versus paced breathing (13.4 ± 3.4 vs. 7.6 ± 2.0 breaths/minute; p <.001), respectively. Resting mean heart rate and root mean square of successive differences were significantly higher with paced breathing than spontaneous breathing (p <.001). Paced breathing significantly increased median low frequency power than spontaneous breathing (p <.001). No significant difference was found in the absolute power of high frequency between the two breathing protocols. The Bland–Altman analysis revealed poor agreement between HRV values during spontaneous and paced breathing conditions with wide limits of agreement. Conclusion: Slow‐paced breathing leads to higher HRV than spontaneous breathing and could overestimate resting "natural‐state" HRV. [ABSTRACT FROM AUTHOR]

BACKGROUND: Cardiopulmonary exercise testing (CPET) is a unique diagnostic tool that assesses the functional capacity of the heart, lungs, and peripheral oxidative system in an integrated manner. However, the clinical utility of CPET for evaluating interstitial lung disease (ILD) remains uncertain. The objective of this study was to determine the predictive value of CPET for mortality in subjects with ILD. METHODS: We prospectively enrolled subjects with ILD who underwent CPET at a tertiary medical center in Taiwan and followed up their survival status for 12 months. Mortality prediction was based on comparing CPET parameters between subjects who survived and those who died. We further analyzed CPET parameters that showed significant differences using receiver operating characteristic curves to identify their optimal cutoff values. RESULTS: A total of 106 newly diagnosed subjects with ILD underwent CPET, and the 1-y mortality rate was 7.5%. Six CPET variables were found to be significant predictors of mortality: peak oxygen consumption, oxygen pulse, end-tidal partial pressure of carbon dioxide, heart rate recovery 1 min after CPET, minute ventilation to carbon dioxide output slope, and functional aerobic impairment. We calculated a summed score by adding the number of CPET variables that exceeded their cutoff values. Subjects with a summed score of 6 had a 1-y survival rate of only 25%, whereas subjects with scores of 0-5 had a survival rate of 98%. CONCLUSIONS: In conclusion, the summed score represents a useful tool for screening patients with ILD who can undergo a CPET to determine their prognosis. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to investigate the effects of motor imagery (MI), action observation (AO), and action execution (AE) interventions on the autonomic nervous system (ANS) in individuals with chronic stroke. Methods: This was a single-center, randomized, case-control study. Thirty-six patients were randomly assigned to MI (n = 10), AO (n = 15), and the AE group (n = 11). Heart rate (HR)-based measurements (HR, heart rate variability (HRV)) and blood pressure were evaluated before the practice of each group. In the MI group, participants were instructed to imagine themselves walking at their own comfortable pace for 5 minutes. Meanwhile, in the AO group, participants were shown a video of a person walking for 5 minutes. Finally, in the AE group, participants were instructed to actually walk for 5 minutes. Then, all measurements were taken again. Results: A statistically significant difference was found in HR and mean RR interval within the AE group (p < 0.05). There was a statistically significant difference in the Root Mean Square of Successive Differences Between Normal Heartbeats (RMSSD) (ms) within the AO group (p < 0.05). There was a significant difference in HR and mean RR intervals (ms) between groups (p < 0.05). According to post-hoc analyses, HR was statistically significantly higher in the AE group compared to the other groups, and the mean RR interval was statistically significantly lower (p < 0.05). Conclusions: In conclusion, in patients with chronic stroke, AE and AO may affect ANS by increasing sympathetic activation. It is recommended for future studies to evaluate whether patients actually engage in imagery during the MI task. [ABSTRACT FROM AUTHOR]

Background: Previous research highlighted variability in electrocardiogram (ECG) readings across patient positions, particularly in the context of COVID‐19 patients with pulmonary complications requiring prone positioning as part of the treatment. Objective: This study aimed to elucidate the effects of prone positioning on ECG parameters and explore its association with the severity of COVID‐19. Methods: A prospective cohort study involved 60 patients diagnosed with COVID‐19 and presenting pulmonary complications. ECGs were recorded in both supine and prone positions, and analyzed for various parameters including heart rate, QRS axis, and QTc interval. Clinical severity was assessed using APACHE II scores and SpO2/FiO2 ratios. Results: Prone positioning led to an increase in heart rate (mean difference: 2.100, 95% CI: 0.471–3.729, p = 0.012), with minor shifts in the QRS axis. Heart rate and QRS axis demonstrated strong positive correlations between positions, with Pearson's correlation coefficients of 0.927 and 0.894, respectively. The study also found a significant association between prolonged QTc intervals in the prone position and elevated APACHE II scores, with a relative risk of 10.75 (95% CI: 1.82–63.64, p = 0.008). Conclusions: The prone positioning caused minor yet significant changes in heart rate and QRS axis. The correlation of prolonged QTc intervals in the prone position with higher APACHE II scores suggests the prognostic relevance of prone ECG in COVID‐19 patients. However, further research is needed to fully understand the clinical implications and mechanisms of these findings. [ABSTRACT FROM AUTHOR]

Multimodal communication is a human feature that enables diverse interactions. In human–robot interaction (HRI), robots have to communicate using human skills so that they can seem natural and assist effectively. Most research uses predefined gestures to equip robots with social abilities. However, researchers scarcely consider generating bioinspired involuntary behavior to improve a robot's expressiveness and communication. Human studies revealed that involuntary behavior affects how others perceive communicative intentions. Therefore, mimicking human involuntary behavior may positively affect HRI. This article extends our previous work on equipping robots with involuntary behavior with a user study that evaluates the use of bioinspiration for complementing gestures. A preliminary test is conducted with 15 participants to determine if they can perceive the intensities of the involuntary processes heart rate, pupil size, blink rate, breathing rate, and motor activity. 63 new participants interacted with a robot with bioinspired behaviors or a robot only showing predefined gestures to evaluate the robots' warmth, competence, and discomfort. The results show that the preliminary test participants differentiated the intensities of the involuntary processes. Participants in the second study find the robot with bioinspired behaviors significantly warmer and more competent than the robot with predefined gestures, with no discomfort difference. [ABSTRACT FROM AUTHOR]

Heart rate (HR) is a key indicator of fitness and cardiovascular health, and accurate HR monitoring and prediction are essential for enhancing personalized fitness experiences. The rise of wearable technology has significantly improved the ability to track personal health, including HR metrics. Accurate modeling of HR response during workouts is crucial for providing effective fitness recommendations, which help users achieve their goals while maintaining safe workout intensities. Although several HR monitoring and prediction models have been developed for personalized fitness recommendations, many remain impractical for real-world applications, and the domain of personalization in fitness applications still lacks sufficient research and innovation. This paper presents a hybrid approach to modeling HR response to workout intensity for personalized fitness recommendations. The proposed approach integrates a physiological model using Dynamic Bayesian Networks (DBNs) to capture heart rate dynamics during workout sessions. DBNs, combined with Long Short-Term Memory (LSTM) networks, model the evolution of HR over time based on workout intensity and individual fitness characteristics. The DBN parameters are dynamically derived from flexible neural networks that account for each user's personalized health state, enabling the prediction of a full HR profile for each workout, while incorporating factors such as workout history and environmental factors. An adaptive feature selection module further enhances the model's performance by focusing on relevant data and ensuring responsiveness to new data. We validated the proposed approach on the FitRec dataset, and experimental results show that our model can accurately predict HR responses to workout intensity in future sessions, achieving an average mean absolute error of 5.2 BPM per workout—significantly improving upon existing models. In addition to HR prediction, the model provides real-time fitness personalized recommendations based on individual's observed workout intensity to an exercise. These findings demonstrate the model's effectiveness in delivering precise, user personalized heart response to exercise with potential applications in fitness apps for personalized training and health monitoring. [ABSTRACT FROM AUTHOR]

This study investigated the antistress effects of yuzu synthetic fragrances by employing three experiments on humans and mice using two yuzu synthetic fragrances and five single compounds. We prepared two synthetic fragrances based on the component analysis of two natural yuzu essential oils extracted by cold-pressed and steam-distilled extraction methods. Chromogranin A (CgA) and heart rate (HR) were used as stress indices in human experiments. Immobility time during the forced swim test was used as a stress index in mice experiments. We analyzed brain mechanisms by measuring the expression of neurotrophic factors, brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), and neurotrophin-3 (NT-3) in the mice experiments. Synthetic yuzu fragrance mimicked steam-distilled oil (SD) significantly reduced participants' heart rate in experiment 1. In the forced swim test conducted in experiment 2, SD significantly reduced immobility time, and increased the expression of neurotrophic factors BDNF, NGF, and NT-3 in the hippocampus of mice. In experiment 3, focusing on single compounds, terpinen-4-ol significantly reduced immobility time in the forced swim test. These findings indicate that inhalation of SD and terpinen-4-ol has antistress effects. Terpinen-4-ol is a strong candidate for further investigation as a potential stress-reducing agent. [ABSTRACT FROM AUTHOR]

The activation of the musculature of the larynx of six professional trumpeters during performance was analysed using audio, electroglottography (EGG), oxygen saturation, and heart rate signals. Two university trumpet teachers listened to the audio recordings, to evaluate the participants' laryngeal effort during performance. Statistical analysis was performed to explore if there were any correlations between parameters extracted from the EGG data and the responses to the audio stimuli by the listeners. Two hundred and fifty (250) laryngeal articulations were identified where laryngeal raising and effort was observed during trumpet performance. It was not possible to find any correlation between the EGG data and the auditory evaluation results, but both listeners could clearly hear the laryngeal effort. [ABSTRACT FROM AUTHOR]

This paper introduces a novel method for emotion classification within virtual reality (VR) environments, which integrates biosignal processing with advanced machine learning techniques. It focuses on the processing and analysis of electrocardiography (ECG) and galvanic skin response (GSR) signals, which are established indicators of emotional states. To develop a predictive model for emotion classification, we extracted key features, i.e., heart rate variability (HRV), morphological characteristics, and Hjorth parameters. We refined the dataset using a feature selection process based on statistical techniques to optimize it for machine learning applications. The model achieved an accuracy of 97.78% in classifying emotional states, demonstrating that by accurately identifying and responding to user emotions in real time, VR systems can become more immersive, personalized, and emotionally resonant. Ultimately, the potential applications of this method are extensive, spanning various fields. Emotion recognition in education would allow further implementation of adapted learning environments through responding to the current emotional states of students, thereby fostering improved engagement and learning outcomes. The capability for emotion recognition could be used by virtual systems in psychotherapy to provide more personalized and effective therapy through dynamic adjustments of the therapeutic content. Similarly, in the entertainment domain, this approach could be extended to provide the user with a choice regarding emotional preferences for experiences. These applications highlight the revolutionary potential of emotion recognition technology in improving the human-centric nature of digital experiences. [ABSTRACT FROM AUTHOR]

Background: The body of literature regarding the use of an upper limb exoskeleton during authentic working conditions is sparse. Objective: The aim of this study was to evaluate the effectiveness of an upper limb exoskeleton in reducing muscle strain during authentic industrial construction work. Methods: Fifteen male participants, comprising of roofers, scaffolders, builders, bricklayers, and graders performing overhead work participated in the study. During work without (REF) and with exoskeleton (EXO), muscle activity from 8 muscles, heart rate (HR), metabolic equivalent (MET), and upper arm elevation angles were recorded. Results: When using the exoskeleton, a significant reduction of 20.2% in average muscle activity of 8 muscles was found. The largest effect focused on m. deltoideus, where 46.2 and 32.2% reduction occurred in medial and anterior parts of the muscle, respectively. HR and MET were unaffected. Upper arm elevation angles were similar between REF and EXO, indicating equal biomechanical loading. Conclusions: This study indicates that exoskeletons show great promise in reducing the potential for musculoskeletal strain during authentic overhead construction work. [ABSTRACT FROM AUTHOR]

The Electro Cardio Gram is a very valuable clinical tool to access the electric function of the heart. It provides insight into the different phases of the heart beat and various kinds of disorders which may affect them. In the past decades various algorithms to detect and delineate ECG beats have been developed. The complex-lead based algorithms compute a virtual-lead by averaging the samples of an arbitrary number of channels. In this study exponential weighted moving powers based estimates for the skewness, kurtosis and signal to noise ratio are used to select the channels which are included in the resulting complex lead signal. According to these parameters the channels are labelled bad, poor, scaled and good. A weighted average is used to to compute the next sample of the complex lead from the channels labelled good and scaled. The 75 30minutes records of the "St.-Petersburg Institute of Cardiological Technics 12-lead Arrhythmia Database" are used to evaluate the proposed approach. The average sensitivity increases to 99.61% and to 99.63% in total compared to 99.57% and 99.59% for the standard approach. The average and overall specificity increases to 99.65% and the F1 and F-M scores to 0.9964. This shows that the estimates provide sufficient information about the quality, to successfully reduce the distortion of the complex-lead signal by artefacts and strong muscle signals while avoiding the additional time delay imposed by standard window based methods. [ABSTRACT FROM AUTHOR]

Background and Objectives: The aim of this study was to investigate the effects of 12-week somatosensory games on heart rate variability and sleep-related biomarkers in middle-aged women with poor sleep quality. Research Design and Methods: Twenty-nine women with poor sleep quality were recruited as participants randomly assigned into ring fit adventure exergame group (RFA, n = 15) and control group (CON, n = 14). The RFA group received ring fit adventure exergame for 60 min each time, 2 times a week, for 12 weeks. The CON group was not allowed to participate in intervention activities during the study period. Heart rate variability, sleep quality, cortisol, serotonin, and high-sensitive C-reactive protein were measured before and after the 12-week intervention. Results: The Pittsburgh Sleep Quality Index total score in the RFA group was significantly lower compared with the CON group. The value of the standard deviation of normal NN intervals and the root mean square of the successive RR Differences were significantly increased in the RFA group, when compared with the CON group. The change in the logarithm of high frequency (log HF) was significantly higher and change in the logarithm of low frequency to high frequency ratio (log LF/HF) was significantly lower in the RFA group, when compared to the CON group. The change level of serotonin in the RFA group was significantly higher compared with the CON group. Discussion and Implications: The results suggest that somatosensory games might improve sleep quality, increase serotonin level, and decrease sympathetic nerve activities in middle-aged women with poor sleep quality. [ABSTRACT FROM AUTHOR]

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Objective: Non‐invasive biomarkers have recently shown promise for seizure forecasting in people with epilepsy. In this work, we developed a seizure‐day forecasting algorithm based on nocturnal sleep features acquired using a smart shirt. Methods: Seventy‐eight individuals with epilepsy admitted to the Centre hospitalier de l'Université de Montréal epilepsy monitoring unit wore the Hexoskin biometric smart shirt during their stay. The shirt continuously measures electrocardiography, respiratory, and accelerometry activity. Ten sleep features, including sleep efficiency, sleep latency, sleep duration, time spent in non‐rapid eye movement sleep (NREM) and rapid eye movement sleep (REM), wakefulness after sleep onset, average heart and breathing rates, high‐frequency heart rate variability, and the number of position changes, were automatically computed using the Hexoskin sleep algorithm. Each night's features were then normalized using a reference night for each patient. A support vector machine classifier was trained for pseudo‐prospective seizure‐day forecasting, with forecasting horizons of 16‐ and 24‐h to include both diurnal and nocturnal seizures (24‐h) or diurnal seizures only (16‐h). The algorithm's performance was assessed using a nested leave‐one‐patient‐out cross‐validation approach. Results: Improvement over chance (IoC) performances were achieved for 48.7% and 40% of patients with the 16‐ and 24‐h forecasting horizons, respectively. For patients with IoC performances, the proposed algorithm reached mean IoC, sensitivity and time in warning of 34.3%, 86.0%, and 51.7%, respectively for the 16‐h horizon, and 34.2%, 64.4% and 30.2%, respectively, for the 24‐h horizon. Significance: Smart shirt‐based nocturnal sleep analysis holds promise as a non‐invasive approach for seizure‐day forecasting in a subset of people with epilepsy. Further investigations, particularly in a residential setting with long‐term recordings, could pave the way for the development of innovative and practical seizure forecasting devices. Plain Language Summary: Seizure forecasting with wearable devices may improve the quality of life of people living with epilepsy who experience unpredictable, recurrent seizures. In this study, we have developed a seizure forecasting algorithm using sleep characteristics obtained from a smart shirt worn at night by a large number of hospitalized patients with epilepsy (78). A daily seizure forecast was generated following each night using machine learning methods. Our results show that around half of people with epilepsy may benefit from such an approach. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to assess the effect of needle insertion angle on pain during labial infiltration anesthesia in the anterior maxillary region. Material and Methods: In this parallel‐design randomized clinical trial, participants were randomly assigned to four groups for labial infiltration anesthesia of the anterior maxilla. Local anesthesia was performed with needle orientation parallel to the longitudinal axis of the tooth using a conventional syringe (Syringe‐0), needle at α angle with a conventional syringe (Syringe‐α), computer‐controlled local anesthetic delivery (CCLAD) device parallel to the longitudinal axis of the tooth (CCLAD‐0), and CCLAD at α angle (CCLAD‐α). The heart rate (HR), blood pressure (BP), and respiratory rate (RR) of participants were measured before needle insertion, immediately after needle insertion, and immediately after the injection by a vital signs monitor. The level of pain experienced by participants was quantified using a numerical rating scale (NRS). Data were analyzed by repeated‐measures ANOVA and regression models (α = 0.05). Results: Thirty‐six participants aged from 21 to 60 years, with a mean age of 35.36 years were recruited. The mean pain scores were 7.44, 4.67, 2.89, and 0.67 in groups Syringe‐0, Syringe‐α, CCLAD‐0, and CCLAD‐α, respectively (p < 0.001). Age and sex had no significant effect on pain scores (p = 0.914 and p = 0.702, respectively). The four groups had no significant difference in vital signs (p > 0.05). Conclusions: Injection at an α angle and the application of CCLAD can be used in clinical practice to decrease the pain experienced by participants during labial infiltration anesthesia of the anterior maxilla. Trial Registration: Iranian Registry of Clinical Trials: IRCT20230719058849N1. [ABSTRACT FROM AUTHOR]

Background: Siponimod, a second-generation, selective sphingosine 1- phosphate receptor (S1PR) 1 and 5 modulator, represents an important therapeutic choice for active secondary progressive multiple sclerosis (SPMS). Besides the beneficial immunomodulatory effects, siponimod impacts cardiovascular function through S1PR1 modulation. Short-term vagomimetic effects on cardiac activity have proved to be mitigated by dose titration. However, long-term consequences are less known. Objectives: This study aimed to investigate the long-term impact of siponimod on cardiac autonomic modulation in people with SPMS (pwSPMS). Methods: Heart rate variability (HRV) and vascular hemodynamic parameters were evaluated using Multiple Trigonometric Regressive Spectral analysis in 47 pwSPMS before siponimod therapy and after one, three, six and 12 months of treatment. Autonomic activation tests (tilt test for the sympathetic and deep breathing test for the parasympathetic cardiac modulation) were performed at each examination. Results: pwSPMS preserved regular cardiovascular modulation responses during the autonomic tests reflected in the variation of several HRV parameters, such as RMSSD, pNN50, total power of HRV, high-frequency and low-frequency bands of the spectral domain or hemodynamic vascular parameters (Cwk, Zao, TPR, MAP) and baroreflex sensitivity (BRS). In the long-term follow-up, RMSSD, pNN50, total power, BRS and CwK presented a significant decrease, underlining a reduction of the parasympathetic and a shift towards sympathetic predominance in cardiac autonomic modulation that tends to stabilise after 1 year of treatment. Conclusion: Due to dose titration, the short-term effects of siponimod on cardiac autonomic modulation are mitigated. The long-term impact on cardiac autonomic modulation is similar to fingolimod. The autonomic activation tests showed normal cardiovascular responses during 1-year followup in pwSPMS, confirming the safety profile of siponimod. Further research on autonomic function could reveal whether the observed sympathetic activation is a compensatory response to S1P signaling intervention or a feature of the disease, while also shedding light on the role of S1PR modulation in MS. [ABSTRACT FROM AUTHOR]

Beta‐blockers are widely used medications for a variety of indications, including heart failure, myocardial infarction, cardiac arrhythmias, and hypertension. Genetic variability in pharmacokinetic (e.g., CYP2D6) and pharmacodynamic (e.g., ADRB1, ADRB2, ADRA2C, GRK4, GRK5) genes have been studied in relation to beta‐blocker exposure and response. We searched and summarized the strength of the evidence linking beta‐blocker exposure and response with the six genes listed above. The level of evidence was high for associations between CYP2D6 genetic variation and both metoprolol exposure and heart rate response. Evidence indicates that CYP2D6 poor metabolizers experience clinically significant greater exposure and lower heart rate in response to metoprolol compared with those who are not poor metabolizers. Therefore, we provide therapeutic recommendations regarding genetically predicted CYP2D6 metabolizer status and metoprolol therapy. However, there was insufficient evidence to make therapeutic recommendations for CYP2D6 and other beta‐blockers or for any beta‐blocker and the other five genes evaluated (updates at www.cpicpgx.org). [ABSTRACT FROM AUTHOR]

Background: Maturation of the mouse is accompanied by the increase in heart rate. However, the mechanisms underlying this process remain unclear. We performed an action potentials (APs) recordings in mouse sinoatrial node (SAN) true pacemaker cells and in silico analysis to clarify the mechanisms underlying pre–postnatal period heart rate changes. Results: The APs of true pacemaker cells at different stages had similar configurations and dV/dtmax values. The cycle length, action potential duration (APD90), maximal diastolic potential (MDP), and AP amplitude decreased, meanwhile the velocity of diastolic depolarization (DDR) increased from E12.5 stage to adult. Using a pharmacological approach we found that in SAN true pacemaker cells ivabradine reduces the DDR and the cycle length significantly stronger in E12.5 than in newborn and adult mice, whereas the effects of Ni2+ and nifedipine were significantly stronger in adult mice. Computer simulations further suggested that the density of the hyperpolarization–activated pacemaker сurrent (If) decreased during development, whereas transmembrane and intracellular Ca2+ flows increased. Conclusions: The ontogenetic decrease in IK1 density from E12.5 to adult leads to depolarization of MDP to the voltage range in which calcium currents are activated, thereby shifting the balance from the "membrane‐clock" to the "calcium‐clock." Key Findings: ontogenesis, ionic mechanisms, electrophysiological properties, action potential, sinoatrial node cell. [ABSTRACT FROM AUTHOR]

This study evaluated the safety, tolerability, pharmacokinetics, and pharmacodynamics of BI 685509 after oral single rising doses (SRDs) or multiple rising doses (MRDs) in healthy volunteers. In the SRD trial (NCT02694354; February 29, 2016), within each of the three dose groups (DGs), six subjects received BI 685509 (1.0, 2.5, or 5.0 mg) and two received placebo (N = 24). In the MRD trial (NCT03116906; April 17, 2017), within each of the five DGs, nine subjects received BI 685509 (uptitrated to 1 mg once daily [qd; DG1], 2.5 mg twice daily [DG2], 5.0 mg qd [DG3]; 3.0 mg three times daily [tid; DG4] or 4.0 mg tid [DG5]) and three received placebo, for 14–17 days (N = 60). In the SRD trial, 7/24 subjects (29.2%) had ≥ 1 adverse event (AE), most frequently orthostatic dysregulation (n = 4). In the MRD trial, 26/45 subjects (57.8%) receiving BI 685509 had ≥ 1 AE, most frequently orthostatic dysregulation and fatigue (each n = 12). Tolerance development led to a marked decrease in orthostatic dysregulation events (DG3). BI 685509 was rapidly absorbed after oral administration, and exposure increased in a dose-proportional manner after single doses. Multiple dosing resulted in near–dose-proportional increase in exposure and limited accumulation. BI 685509 pharmacokinetics appeared linear with time; steady state occurred 3–5 days after each multiple-dosing period. Increased plasma cyclic guanosine monophosphate and decreased blood pressure followed by a compensatory increase in heart rate indicated target engagement. BI 685509 was generally well tolerated; orthostatic dysregulation may be appropriately countered by careful uptitration. [ABSTRACT FROM AUTHOR]

Baroreflex is critical to maintain blood pressure homeostasis, and the quantification of baroreflex regulation function (BRF) can provide guidance for disease diagnosis, treatment, and healthcare. Current quantification of BRF such as baroreflex sensitivity cannot represent BRF systematically. From the perspective of complex systems, we regard that BRF is the emergence result of fluctuate states and interactions in physiological mechanisms. Therefore, the three‐layer emergence is studied in this work, which is from physiological mechanisms to physiological indexes and then to BRF. On this basis, since the entropy in statistical physics macroscopically measures the fluctuations of system's states, in this work, the principle of maximum entropy is adopted, and a new index called PhysioEnt is proposed to quantify the fluctuations of four physiological indexes, i.e., baroreflex sensitivity, heart rate, heart rate variability, and systolic blood pressure, which aims to represent BRF in the resting condition. Further, two datasets with different subjects are analyzed, and some new findings can be obtained, such as the contributions of the physiological interactions among organs/tissues. With measurable indexes, the proposed method is expected to support individualized medicine. [ABSTRACT FROM AUTHOR]

Aging is a major risk factor for sinoatrial node (SAN) dysfunction, which can impair heart rate (HR) control and heart rate variability (HRV). HR and HRV are determined by intrinsic SAN function and its regulation by the autonomic nervous system (ANS). The purpose of this study was to use multi-scale multi-fractal detrended fluctuation analysis (MSMFDFA; a complexity-based approach to analyze multi-fractal dynamics) to longitudinally assess changes in multi-fractal HRV properties and SAN function in ECG time series recorded repeatedly across the full adult lifespan in mice. ECGs were recorded in anesthetized mice in baseline conditions and after autonomic nervous system blockade every three months beginning at 6 months of age until the end of life. MSMFDFA was used to assess HRV and SAN function every three months between 6 and 27 months of age. Intrinsic HR (i.e. HR during ANS blockade) remained relatively stable until 15 months of age, and then progressively declined until study endpoint at 27 months of age. MSMFDFA revealed sudden and rapid changes in multi-fractal properties of the ECG RR interval time series in aging mice. In particular, multi-fractal spectrum width (MFSW, a measure of multi-fractality) was relatively stable between 6 months and 15 months of age and then progressively increased at 27 months of age. These changes in MFSW were evident in baseline conditions and during ANS blockade. Thus, intrinsic SAN function declines progressively during aging and is manifested by age-associated changes in multi-fractal HRV across the lifespan in mice, which can be accurately quantified by MSMFDFA. [ABSTRACT FROM AUTHOR]

Background Despite extensive research, the effects of L-carnitine supplementation in treating obesity are still unclear and equivocal. L-carnitine transports fatty acids into mitochondria for oxidation and is marketed as a weight loss supplement. The purpose of the present research is to investigate the efficacy of L-carnitine during concurrent training on the functional capacities and body composition in obese men. Methods Thirty nonactive, obese males (age = 37.2 ± 1.5 years; body mass index = 33.8 ± 2.5 kg/m 2) participated in this research. The participants were randomly divided into three groups: experimental group 1 (EXP1)—concurrent training with L-carnitine supplementation; experimental group 2 (EXP2)—L-carnitine supplementation without training; and control group—without training or L-carnitine supplementation. Concurrent training was performed for 8 weeks, three sessions per week, with a training intensity ranging from 60 to 75% of the maximum heart rate reserve and one-repetition maximum. Both experimental groups were supplemented with 35 mg L-carnitine supplement per kilogram body weight. Various functional and body composition variables were collected at three time points (pre-test, mid-test, and post-test). Results A number of variables were significantly improved in EXP1 after 4 and 8 weeks (systolic blood pressure, maximal oxygen consumption, weight, body mass index, and one-repetition maximum) and only after 8-weeks (diastolic blood pressure, resting heart rate, percentage of body fat, and fat-free mass). No significant changes were observed for EXP2 and the control group. Conclusion L-carnitine supplementation, in conjunction with concurrent training, emerges as a highly effective approach for enhancing body composition and boosting functional capacities in obese adult men. Therefore, it is recommended that overweight male individuals integrate concurrent training into their regimen while taking L-carnitine. [ABSTRACT FROM AUTHOR]

LEDs simplify the personalization of lighting. However, research on the effects of personalizable lighting is in its infancy. The present study investigates the impact of personalizable workplace lighting on subjective parameters, cognition, and physiological stress while performing cognitive tests. In a cross-over design, 22 participants were randomly assigned to standard workplace lighting and lighting with adjustable illuminance and color temperature for two hours on two separate days. Subjective outcome measures were sleepiness, affect, and asthenopic complaints. We further assessed vigilance and three cognitive domains (task switching, working memory, and information processing) and derived heart rate variability parameters from an electrocardiogram. Some beneficial effects of personalizable lighting on cognitive performance were observed, although the overall results remain inconclusive. Standard and personalizable lighting did not differ in subjective ratings and physiological stress responses. Exploratory analysis of personalizable lighting revealed significant variation in self-selected workplace illuminances and limited variation in self-selected correlated color temperatures. Despite the preference for increased workplace illuminance under personalizable lighting, no visual impairment was observed compared to standard lighting. Personalizable workplace lighting is a promising new design feature to support individual visual and nonvisual lighting needs in daylight-deprived environments. [ABSTRACT FROM AUTHOR]

Light has been demonstrated to influence transient mood states in healthy populations and can be used as a treatment for clinical mood disorders. However, it is still interesting to know whether stimulus with relatively low light levels can moderate the transient mood state of people with depressive tendencies, and what are the effects respectively from light levels and light color. In this study, 10 subjects with depressive tendencies were recruited and screened to receive a typical lighting intervention, including five crossover conditions with the 300 l×-isoluminance groups (red, 6500 K-white, blue) and 6500 K-isospectral groups (50 lx, 300 lx, and 1500 lx). Negative cognitive bias, high-frequency heart rate variability, and subjective emotion were measured at different stages during the lighting intervention. Statistical results demonstrated that the lighting condition of 1500 lx-6500 K was associated with a transient positive mood state (p < 0.001) and had a significant positive moderating effect on the negative cognitive biases compared with the other groups (p =.017). Colored lights are more likely to trigger negative emotions and negative cognitive biases. [ABSTRACT FROM AUTHOR]

Introduction and Objective Sauna bathing, a practice with deep cultural roots, particularly in Finnish society, has garnered global interest for its potential health benefits. This review aims to consolidate current knowledge on the physiological and health-related effects of regular sauna use, exploring the breadth of benefits and identifying potential risks and safety considerations. Review Methods This study synthesizes findings from a broad range of scientific papers, focusing on the impact of traditional sauna use. Publications were selected based on their relevance to health outcomes associated with sauna bathing, including cardiovascular health, mental well-being, and overall mortality. Studies not directly assessing the impact of traditional sauna practices or lacking in methodological rigor were excluded. The literature search encompassed databases such as PubMed and Scopus, with an emphasis on systematic reviews and longitudinal studies to ensure the inclusion of high-quality evidence. Results In this section of the study, we focus on the impact of sauna bathing on cardiovascular health, synthesizing evidence from multiple studies to understand the relationship between regular sauna use and various cardiovascular outcomes. The physiological responses induced by sauna exposure, including elevated heart rate, increased blood flow, and sweating, mimic moderate physical exercise, which has known benefits for cardiovascular health. [ABSTRACT FROM AUTHOR]

Slow breathing (SB) reduces sympathetic nervous system activity, the heart rate (HR), and blood pressure (BP) and increases parasympathetic nervous system activity, HR variability, and oxygen saturation which may lead to quicker recovery between bouts of exercise. Therefore, the purpose of this study was to examine whether a SB technique using the 4-7-8 method between sets of barbell back squats (SQs) would attenuate drops in power and bar velocity. In a randomized, crossover design, 18 healthy resistance-trained college-aged males (age: 20.7 ± 1.4 years, body height: 178.6 ± 6.4 cm, body mass: 82.2 ± 15.0 kg, 4.5 ± 2.4 years of experience) performed 5 sets of 3 repetitions of SQs with normal breathing (CON) or SB during the 3-min recovery between sets. Peak and average power and bar velocity were assessed using a linear positioning transducer. HR recovery (RHR), systolic BP recovery (RBP), the rating of perceived exertion (RPE) and the rating of perceived recovery score (RS) were assessed after each set. There were no significant differences between conditions for peak and average power and bar velocity, RBP, RPE, and RS (p > 0.211). SB led to a greater RHR after set 2 (SB: 51.0 ± 14.9 bpm vs. CON: 44.5 ± 11.5 bpm, p = 0.025) and 3 (SB: 48.3 ± 13.5 bpm vs. CON: 37.7 ± 11.7 bpm, p = 0.006) compared to the CON condition. SB was well tolerated, did not hinder nor improve training performance and improved RHR after the middle sets of SQs. Further investigations are warranted to examine the effects of other SB techniques and to determine SB's effects on different training stimuli as well as its effects over an entire workout and post-workout recovery metrics. [ABSTRACT FROM AUTHOR]