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response, which might lead to sudden rise in blood pressure (BP), causing intracranial hemorrhage, cerebral edema, and prolonged hospital stay. Dexmedetomidine has been shown to blunt the sympathoadrenal response to surgery. Aims and Objectives: The present study was undertaken to assess the efficacy and safety of dexmedetomidine in attenuating stress responses to skull pin holder application as compared to normal saline. Materials and Methods: After obtaining approval from the institutional ethics committee and written informed consent, patients of either sex undergoing elective craniotomy at the attached hospitals of Bangalore Medical College and Research Institute, Bengaluru, India, were randomized in a 1:1 ratio to receive normal saline or dexmedetomidine as premedication. Hemodynamic parameters, i.e., heart rate (HR), systolic BP (SBP), diastolic BP (DBP), and mean arterial pressure (MAP), were monitored at various time points until 30 min after skull pin application. Data were analyzed using the chi-squared test, repeated measure ANOVA, unpaired t-test, and Mann--Whitney U test, wherever applicable. Results: A total of 52 patients were included in the study, with 26 patients in each group. All the baseline parameters were matched. As a stress response, a significant increase in HR was seen after intubation (90.69 bpm) and skull pin insertion (87.92 bpm) in the normal saline group. However, there was no significant variation in HR in the dexmedetomidine group over 30 min (69.19 bpm-74.15 bpm). Dexmedetomidine reduced HR significantly as compared to normal saline after intubation (P = 0.03). Dexmedetomidine lowered SBP and DBP as compared to baseline throughout 30 min without any excursions during intubation and skull pin insertion. The SBP was significantly lower in the dexmedetomidine group after intubation as compared to saline (P = 0.02). Although a reduction in SBP was noted after skull pin insertion in the dexmedetomidine group, it was not statistically significant than saline. No significant difference was noted in DBP, MAP, or blood glucose between the two groups. No incidents of hypotension and bradycardia were noted. Conclusion: Dexmedetomidine maintained basal HR throughout 30 min without any variations in response to intubation and skull pin insertion. It also reduced SBP and DBP over 30 min. HR and SBP were significantly lower in the dexmedetomidine group as compared to saline after intubation. The same effect was noted in the dexmedetomidine group as compared to saline after skull pin insertion, but it was not statistically significant. [ABSTRACT FROM AUTHOR]

Beat-by-beat monitoring of hemodynamic parameters in the left ventricle contributes to the early diagnosis and treatment of heart failure, valvular heart disease, and other cardiovascular diseases. Current accurate measurement methods for ventricular hemodynamic parameters are inconvenient for monitoring hemodynamic indexes in daily life. The objective of this study is to propose a method for estimating intraventricular hemodynamic parameters in a beat-to-beat style based on non-invasive PCG (phonocardiogram) and PPG (photoplethysmography) signals. Three beagle dogs were used as subjects. PCG, PPG, electrocardiogram (ECG), and invasive blood pressure signals in the left ventricle were synchronously collected while epinephrine medicine was injected into the veins to produce hemodynamic variations. Various doses of epinephrine were used to produce hemodynamic variations. A total of 40 records (over 12,000 cardiac cycles) were obtained. A deep neural network was built to simultaneously estimate four hemodynamic parameters of one cardiac cycle by inputting the PCGs and PPGs of the cardiac cycle. The outputs of the network were four hemodynamic parameters: left ventricular systolic blood pressure (SBP), left ventricular diastolic blood pressure (DBP), maximum rate of left ventricular pressure rise (MRR), and maximum rate of left ventricular pressure decline (MRD). The model built in this study consisted of a residual convolutional module and a bidirectional recurrent neural network module which learnt the local features and context relations, respectively. The training mode of the network followed a regression model, and the loss function was set as mean square error. When the network was trained and tested on one subject using a five-fold validation scheme, the performances were very good. The average correlation coefficients (CCs) between the estimated values and measured values were generally greater than 0.90 for SBP, DBP, MRR, and MRD. However, when the network was trained with one subject's data and tested with another subject's data, the performance degraded somewhat. The average CCs reduced from over 0.9 to 0.7 for SBP, DBP, and MRD; however, MRR had higher consistency, with the average CC reducing from over 0.9 to about 0.85 only. The generalizability across subjects could be improved if individual differences were considered. The performance indicates the possibility that hemodynamic parameters could be estimated by PCG and PPG signals collected on the body surface. With the rapid development of wearable devices, it has up-and-coming applications for self-monitoring in home healthcare environments. [ABSTRACT FROM AUTHOR]

Background: The bed bath is an important part of nursing care. There are few studies evaluating the effects of traditional and dry bed baths on patients. Aim: This study was performed with the aim of investigating the effect of traditional and dry bed baths given to intensive care unit patients on the patients' hemodynamic parameters, the duration of the bathing procedure and the cost of consumable items. Methods: This was a randomized crossover clinical trial and a prospective study. The study was conducted in a General Surgery Intensive Care Unit with 22 intensive care patients aged 18 and over, who had a nursing diagnosis of bathing personal care deficiency. Each patient was given two types of bed baths at an interval of 24 h: a traditional bed bath and a dry bed bath performed with single‐use tissues. Immediately before each bath, in the 5th, 10th and 15th minute of bathing, immediately after bathing and 30 min after bathing, body temperature, heart rate, blood pressure, breathing rate and peripheral oxygen saturation measurement changes over time were compared within the group using the Friedman test. The Wilcoxon signed ranks test was used to compare the variables of bathing duration and bathing consumable item costs between the bathing procedures. Results: It was found that at the completion of traditional and dry bed bathing, the participants' body temperature, blood pressure, heart rate and breathing rate parameters were statistically significantly lower than before bathing, whereas peripheral oxygen saturation values showed a significant increase (p < 0.05). It was found that the dry bed bath took a statistically significantly shorter time than the traditional bed bath and that the cost of consumable bathing materials was less (p < 0.05). Conclusions: It was concluded that traditional and dry bed baths given to intensive care patients affected their hemodynamic parameters and that the dry bed bath was superior to the traditional bed bath in that it took less time and that it cost less. Summary statement: What is already known about this topic? Traditional and dry bed baths are personal care procedures that are frequently carried out by nurses with patients in intensive care units.Bed baths may affect the hemodynamic parameters of patients in intensive care units, but few studies have evaluated their effects.Determination of the hemodynamic parameters of patients during bed baths, the duration of bathing and the cost of consumable bathing materials may help nurses to achieve patients' body hygiene in a more reliable way and to decide on and adopt measures to minimize risks. What this paper adds? This paper contributes to the performance of personal hygiene. It is necessary to closely monitor the hemodynamic parameters of intensive care patients when they are being given bed baths.This study has direct effects in awakening nurses to the potential risk of bed baths causing a change in hemodynamic parameters in intensive care patients and in taking measures to reduce these risks to a minimum. Also, giving dry bed baths, which are superior in taking less time and having lower costs, provides advantages to nurses in terms of work load, physical difficulties and finance. The implications of this paper: This study emphasizes the positive impacts of dry bed baths carried out by nurses for patients in intensive care units.The dry bed bath can be accepted as enhancing patient safety by being easy to perform and by shortening the time when the patient is exposed to environmental risks. [ABSTRACT FROM AUTHOR]

With the development of implants and microdevices used in the human body, supplying the energy of these devices is a challenge. One of the safest ways to overcome the challenge is to harvest the energy from the human body. In this study, the blood flow, wall deformation, and hemodynamic parameters of the aortic artery are evaluated based on computational fluid dynamics (CFD). Also, the artery displacement is linked to the output voltage by using Gauss' law. The results show that for the artery under study, the proximal descending thoracic aorta (PDTA) is the best place to harvest energy, although there is the highest blood pressure on the ascending aorta (AAo) and the highest wall displacement is in the aortic arch. Part of this result depends on the morphology of the existing aortic artery. Also, the piezoelectric model of PZT‐5H harvests the most energy and polyvinylidene fluoride (PVDF) has the least, which can harvest power density of 1.34 and 1.27 × 10−3(μW/mm3) respectively. [ABSTRACT FROM AUTHOR]

Numerous studies have evaluated the effects of hemodynamic parameters on aneurysm formation. However, the reasons why aneurysms do not initiate in intracranial arteries are still unclear. This study aimed to investigate the influence of hemodynamic parameters, wall shear stress (WSS) and strain, on aneurysm formation by comparing between aneurysmal and non-aneurysmal arteries. Fifty-eight patients with paraclinoid aneurysms on one side were enrolled. Based on magnetic resonance angiography, each patient's left and right internal carotid arteries (ICAs) were reconstructed. For a patient having an aneurysm on one side, the ICA with the paraclinoid aneurysm was defined as the aneurysmal artery after eliminating the aneurysm, whereas the opposite ICA without aneurysm was defined as the non-aneurysmal artery. Computational fluid dynamics and fluid-structure interaction analyses were then performed for both aneurysmal and non-aneurysmal arteries. Finally, the relationship between high hemodynamic parameters and aneurysm location was investigated. For aneurysmal arteries, high WSS and strain locations were well-matched with the aneurysm formation site. Also, considerable correlations between high WSS and strain locations were observed. However, there was no significant relationship between high hemodynamic parameters and aneurysm formation for non-aneurysmal arteries. The findings are helpful for understanding aneurysm formation mechanism and encouraging further relevant research. [ABSTRACT FROM AUTHOR]

Acute kidney injury (AKI) is a major postoperative complication that lacks established intraoperative predictors. Our objective was to develop a prediction model using preoperative and high-frequency intraoperative data for postoperative AKI. In this retrospective cohort study, we evaluated 77,428 operative cases at a single academic center between 2016 and 2022. A total of 11,212 cases with serum creatinine (sCr) data were included in the analysis. Then, 8519 cases were randomly assigned to the training set and the remainder to the validation set. Fourteen preoperative and twenty intraoperative variables were evaluated using elastic net followed by hierarchical group least absolute shrinkage and selection operator (LASSO) regression. The training set was 56% male and had a median [IQR] age of 62 (51-72) and a 6% AKI rate. Retained model variables were preoperative sCr values, the number of minutes meeting cutoffs for urine output, heart rate, perfusion index intraoperatively, and the total estimated blood loss. The area under the receiver operator characteristic curve was 0.81 (95% CI, 0.77-0.85). At a score threshold of 0.767, specificity was 77% and sensitivity was 74%. A web application that calculates the model score is available online. Our findings demonstrate the utility of intraoperative time series data for prediction problems, including a new potential use of the perfusion index. Further research is needed to evaluate the model in clinical settings.

Abstract Background Laparoscopic Total Extra-peritoneal Inguinal Hernia Repair(TEP) presents escalated risks of surgical complications, notably bleeding, particularly in European Hernia Society (EHS) types 3 and recurrent inguinal hernia. In this study, we introduced an innovative technique using indocyanine green-labeled fluorescence laparoscopy to mitigate intraoperative complications, including bleeding and rupture of the hernial sac. Methods This retrospective study reviewed records of 17 patients who underwent TEP repair at Anqing Municipal Hospital between July and August 2023. Intraoperatively, fluorescence imaging was utilized to trace the pathway of the spermatic vessels and outline the boundaries of the hernia sac to facilitate a thorough dissection. Results The procedure was successfully completed in all 17 patients, with a median operation time of 42 min (range: 30–51 min). Median intraoperative blood loss was 5 ml (range: 3–8 ml). Complete dissection of the hernia sac was achieved in each case without any incidents of sac rupture. Hemodynamic parameters of blood flow within the spermatic artery on postoperative day 1 showed no statistically significant deviations from the preoperative values. Furthermore, during the 7-month follow-up period, there were no cases of seroma formation or hernia recurrence. Conclusion Our findings suggest that employing indocyanine green-labeled fluorescence technology in TEP repair significantly reduces intraoperative complications, notably bleeding and rupture of the hernial sac. This technique demonstrated a negligible impact on the hemodynamic parameters of the spermatic artery and reduced the overall surgical time.

Abstract Evaluating fluid responsiveness with dynamic parameters is recommended for fluid management. However, in hemodynamically stable patients who are breathing spontaneously, accurately measuring stroke volume variation via echocardiography and passive leg raising is challenging due to subtle SV changes. This study aimed to identify normal SV changes in healthy volunteers and evaluate the precision of hemodynamic parameters in screening mild hypovolemia in patients. This prospective, repeated-measures, cross-sectional study screened 269 subjects via echocardiography. Initially, 45 healthy volunteers underwent a fluid challenge test, the outcomes of which served as criteria to screen 215 ICU patients. Among these patients, 53 underwent additional fluid challenge testing. Hemodynamic parameters, including medians of maximum velocity time integrals (VTImaxs), peak velocity of VTImax (PV), internal jugular vein diameters (IJVD), and area (IJVA) were repeatedly measured first at a 60° upper body elevation (UBE), second in a supine position, third at UBE, fourth in a supine position, and lastly in a supine position after fluid loading. The hemodynamic responses to the position changes were compared between 83 fluid non-responders and 15 fluid responders. Fluid responsiveness was defined as fluid-induced medians’ change of VTImaxs (fluid-induced median VTImax change) ≥ 10%. None of the healthy volunteers showed the mean value of repeatedly measured medians of VTImaxs ≥ 7%, following either UBE position (UBE-induced median VTImax change) or fluid loading (fluid-induced median VTImax change). UBE-induced median VTImax and PV changes were significantly correlated with fluid responsiveness (p

Background: Laparoscopic Total Extra-peritoneal Inguinal Hernia Repair(TEP) presents escalated risks of surgical complications, notably bleeding, particularly in European Hernia Society (EHS) types 3 and recurrent inguinal hernia. In this study, we introduced an innovative technique using indocyanine green-labeled fluorescence laparoscopy to mitigate intraoperative complications, including bleeding and rupture of the hernial sac. Methods: This retrospective study reviewed records of 17 patients who underwent TEP repair at Anqing Municipal Hospital between July and August 2023. Intraoperatively, fluorescence imaging was utilized to trace the pathway of the spermatic vessels and outline the boundaries of the hernia sac to facilitate a thorough dissection. Results: The procedure was successfully completed in all 17 patients, with a median operation time of 42 min (range: 30–51 min). Median intraoperative blood loss was 5 ml (range: 3–8 ml). Complete dissection of the hernia sac was achieved in each case without any incidents of sac rupture. Hemodynamic parameters of blood flow within the spermatic artery on postoperative day 1 showed no statistically significant deviations from the preoperative values. Furthermore, during the 7-month follow-up period, there were no cases of seroma formation or hernia recurrence. Conclusion: Our findings suggest that employing indocyanine green-labeled fluorescence technology in TEP repair significantly reduces intraoperative complications, notably bleeding and rupture of the hernial sac. This technique demonstrated a negligible impact on the hemodynamic parameters of the spermatic artery and reduced the overall surgical time. [ABSTRACT FROM AUTHOR]

Background: The rupture of intracranial aneurysms (IAs) would result in subarachnoid hemorrhage with high mortality and disability. Predicting the risk of IAs rupture remains a challenge. Methods: This paper proposed an effective method for classifying IAs rupture status by integrating a PointNet-based model and machine learning algorithms. First, medical image segmentation and reconstruction algorithms were applied to 3D Digital Subtraction Angiography (DSA) imaging data to construct three-dimensional IAs geometric models. Geometrical parameters of IAs were then acquired using Geomagic, followed by the computation of hemodynamic clouds and hemodynamic parameters using Computational Fluid Dynamics (CFD). A PointNet-based model was developed to extract different dimensional hemodynamic cloud features. Finally, five types of machine learning algorithms were applied on geometrical parameters, hemodynamic parameters, and hemodynamic cloud features to classify and recognize IAs rupture status. The classification performance of different dimensional hemodynamic cloud features was also compared. Results: The 16-, 32-, 64-, and 1024-dimensional hemodynamic cloud features were extracted with the PointNet-based model, respectively, and the four types of cloud features in combination with the geometrical parameters and hemodynamic parameters were respectively applied to classify the rupture status of IAs. The best classification outcomes were achieved in the case of 16-dimensional hemodynamic cloud features, the accuracy of XGBoost, CatBoost, SVM, LightGBM, and LR algorithms was 0.887, 0.857, 0.854, 0.857, and 0.908, respectively, and the AUCs were 0.917, 0.934, 0.946, 0.920, and 0.944. In contrast, when only utilizing geometrical parameters and hemodynamic parameters, the accuracies were 0.836, 0.816, 0.826, 0.832, and 0.885, respectively, with AUC values of 0.908, 0.922, 0.930, 0.884, and 0.921. Conclusion: In this paper, classification models for IAs rupture status were constructed by integrating a PointNet-based model and machine learning algorithms. Experiments demonstrated that hemodynamic cloud features had a certain contribution weight to the classification of IAs rupture status. When 16-dimensional hemodynamic cloud features were added to the morphological and hemodynamic features, the models achieved the highest classification accuracies and AUCs. Our models and algorithms would provide valuable insights for the clinical diagnosis and treatment of IAs. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to research the effect of different bed head angles on the hemodynamic parameters of intensive care patients lying in the supine position. Methods: This study was a non‐randomized and non‐controlled, quasi‐experimental repeated measures study. The study was conducted with 50 intensive care patients aged 18 and over in a general surgery intensive care unit in Turkey. With each patient in the supine position, the bed head was raised to an angle of 0°, 20°, 30°, and 45° without a pillow, and the hemodynamic parameters of central venous pressure, systolic and diastolic blood pressure, heart rate, breathing rate, and peripheral oxygen saturation were recorded after 0 and 10 min. Results: It was found that the mean central venous pressure value measured at min 0 and 10 was higher when the intensive care patients' bed head angle was raised to 45° than when the bed head was at an angle of 0° or 20° (p <.05). It was found that the patients' other hemodynamic parameters were not affected by different bed head angles. Conclusions: It was concluded as a result of this research that in intensive care patients in the supine position, only central venous pressure was affected by bed head angle, and that central venous pressure measurement can be reliably made at a bed head angle of 30°. [ABSTRACT FROM AUTHOR]

• Thyme oil aromatherapy is effective in the management of COVID-19 symptoms. • Thyme oil aromatherapy was effective on the regulation of vital signs and haemodynamic parameters in COVID-19 patients. • The use of thyme oil via an inhaler stick is effective and safe. To determine the effect of aromatherapy with thyme oil on disease symptoms, vital signs, and hemodynamic parameters in COVID-19 patients. We conducted the randomized controlled trial with 140 (experimental group=70, control group=70) COVID-19 patients. Patients admitted to the COVID-19 service of the Batman Training and Research Hospital were included in the sample between 31.01 - 31.08 2022. Patients in the experimental group inhaled thyme oil 3 times a day during 5 days. At the end of day 5, symptoms and hemodynamic parameters were measured as posttest. Vital signs were measured 3 times a day during 5 days. The control group only received routine treatment. Thyme oil was found to be effective in relieving symptoms of shortness of breath, dizziness, secretion, diarrhea, weakness, loss of appetite, cough, headache and muscle joint pain. Although there was improvement in the symptoms of nausea-vomiting, runny nose and loss of taste-smell, the effect was not statistically significant. Thyme oil significantly decreased body temperature, pulse rate and respiratory rate (p <0.05), increased SPO 2 (p <0.05), and did not affect systolic and diastolic blood pressure (p >0.05). It had a significant effect on the regulation of pH, decreased CO 2 and increased O 2 significantly (p <0.05). Thyme oil aromatherapy was effective in reducing symptoms, regulating vital signs and hemodynamic parameters. Accordingly, thyme oil is recommended as non-pharmacological treatment method in COVID-19 patients. [ABSTRACT FROM AUTHOR]

Evaluating fluid responsiveness with dynamic parameters is recommended for fluid management. However, in hemodynamically stable patients who are breathing spontaneously, accurately measuring stroke volume variation via echocardiography and passive leg raising is challenging due to subtle SV changes. This study aimed to identify normal SV changes in healthy volunteers and evaluate the precision of hemodynamic parameters in screening mild hypovolemia in patients. This prospective, repeated-measures, cross-sectional study screened 269 subjects via echocardiography. Initially, 45 healthy volunteers underwent a fluid challenge test, the outcomes of which served as criteria to screen 215 ICU patients. Among these patients, 53 underwent additional fluid challenge testing. Hemodynamic parameters, including medians of maximum velocity time integrals (VTImaxs), peak velocity of VTImax (PV), internal jugular vein diameters (IJVD), and area (IJVA) were repeatedly measured first at a 60° upper body elevation (UBE), second in a supine position, third at UBE, fourth in a supine position, and lastly in a supine position after fluid loading. The hemodynamic responses to the position changes were compared between 83 fluid non-responders and 15 fluid responders. Fluid responsiveness was defined as fluid-induced medians' change of VTImaxs (fluid-induced median VTImax change) ≥ 10%. None of the healthy volunteers showed the mean value of repeatedly measured medians of VTImaxs ≥ 7%, following either UBE position (UBE-induced median VTImax change) or fluid loading (fluid-induced median VTImax change). UBE-induced median VTImax and PV changes were significantly correlated with fluid responsiveness (p < 0.001, AUC 0.959; p < 0.001, AUC 0.804). The significant correlations were demonstrated via multivariable analysis using binary logistic regression (p = 0.001, OR 90.1) and the correlation coefficient (R2 = 0.793) using linear regression analysis. UBE-induced median VTImax changes (≥ 11.8% and 7.98%) predicted fluid-induced median VTImax changes ≥ 10% and 7% (AUC 0.959 and 0.939). The collapsibility and variation of IJVD and IJVA showed no significant correlation. An increase in the mean value of medians of repeatedly measured VTImaxs transitioning from an UBE to a supine position, effectively screened mild hypovolemia and demonstrated a significant correlation with fluid responsiveness in spontaneously breathing patients maintaining hemodynamic stability. [ABSTRACT FROM AUTHOR]

PURPOSE: To compare the hemodynamic performance of three (Bottom Up non-ballet, Top-Down non-ballet, Top Down ballet) idealized stent graft configurations used during endovascular repair of abdominal aortic aneurysms, under the influence of various rheological models. METHODS: Ten rheological models are assumed and a commercial finite volume solver is employed for the simulation of blood flow under realistic boundary conditions. An appropriate mesh convergence study is performed and five hemodynamic variables are computed: the time average wall shear stress (TAWSS), oscillatory shear index (OSI), relative residence time (RRT), endothelial cell activation potential (ECAP) and displacement force (DF) for all three configurations. RESULTS: The choice of blood flow model may affect results, but does not constitute a significant determinant on the overall performance of the assumed stent grafts. On the contrary, stent graft geometry has a major effect. Specifically, the Bottom Up non-ballet type is characterized by the least favorable performance presenting the lowest TAWSS and the highest OSI, RRT and ECAP values. On the other hand, the Top Down ballet type presents hemodynamic advantages yielding the highest TAWSS and lowest OSI, RRT and ECAP average values. Furthermore, the ballet type is characterized by the lowest DF, although differences observed are small and their clinical relevance uncertain. CONCLUSIONS: The effect of the assumed rheological model on the overall performance of the grafts is not significant. It is thus relatively safe to claim that it is the type of stent graft that determines its overall performance rather than the adopted blood flow model. [ABSTRACT FROM AUTHOR]

Aim: To evaluate how preoperative anxiety affects hemodynamic parameters in patients who were undergoing surgery and to evaluate for the rise in blood pressure and heart rate in patients with higher preoperative anxiety. Methodology: 60 patients were observed for the hemodynamic changes due to anxiety in preoperative period, before induction and after induction. The anxiety scores were analysed and tabulated. Result: Preoperative anxiety has a significant impact on heart rate, systolic blood pressure, diastolic blood pressure and SpO2 of the study participants. Conclusion: During pre-operative period there is no impact of anxiety on hemodynamic parameters. But before induction there was significant impact of anxiety on heart rate, systolic blood pressure, diastolic blood pressure and SpO2. [ABSTRACT FROM AUTHOR]

Abstract Computational fluid dynamics (CFD) has been utilized to calculate hemodynamic parameters in anterior communicating artery aneurysm (AComA), which is located at a junction between left and right A1 and A2 segments. However, complete or half circle of Willis (CoW) models are used indiscriminately. This study aims to suggest recommendations for determining suitable CoW model. Five patient-specific CoW models with AComA were used, and each model was divided into complete, left-half, and right-half models. After validating the CFD using a flow experiment, the hemodynamic parameters and flow patterns in five AComAs were compared. In four out of five cases, inflow from one A1 side had a dominant influence on the AComA, while both left and right A1 sides affected the AComA in the remaining case. Also, the average difference in time-averaged wall shear stress between the complete and half models for four cases was 4.6%, but it was 62% in the other case. The differences in the vascular resistances of left and right A1 and A2 segments greatly influenced the flow patterns in the AComA. These results may help to enhance clinicians’ understanding of blood flow in the brain, leading to improvements in diagnosis and treatment of cerebral aneurysms.

Abstract Progressive cerebral infarction (PCI) is a common complication in patients with ischemic stroke that leads to poor prognosis. Blood pressure (BP) can indicate post‐stroke hemodynamic changes which play a key role in the development of PCI. The authors aim to investigate the association between BP‐derived hemodynamic parameters and PCI. Clinical data and BP recordings were collected from 80 patients with cerebral infarction, including 40 patients with PCI and 40 patients with non‐progressive cerebral infarction (NPCI). Hemodynamic parameters were calculated from the BP recordings of the first 7 days after admission, including systolic and diastolic BP, mean arterial pressure, and pulse pressure (PP), with the mean values of each group calculated and compared between daytime and nighttime, and between different days. Hemodynamic parameters and circadian BP rhythm patterns were compared between PCI and NPCI groups using t‐test or non‐parametric equivalent for continuous variables, Chi‐squared test or Fisher's exact test for categorical variables, Cox proportional hazards regression analysis and binary logistic regression analysis for potential risk factors. In PCI and NPCI groups, significant decrease of daytime systolic BP appeared on the second and sixth days, respectively. Systolic BP and fibrinogen at admission, daytime systolic BP of the first day, nighttime systolic BP of the third day, PP, and the ratio of abnormal BP circadian rhythms were all higher in the PCI group. PCI and NPCI groups were significantly different in BP circadian rhythm pattern. PCI is associated with higher systolic BP, PP and more abnormal circadian rhythms of BP.

Computational fluid dynamics (CFD) has been utilized to calculate hemodynamic parameters in anterior communicating artery aneurysm (AComA), which is located at a junction between left and right A1 and A2 segments. However, complete or half circle of Willis (CoW) models are used indiscriminately. This study aims to suggest recommendations for determining suitable CoW model. Five patient-specific CoW models with AComA were used, and each model was divided into complete, left-half, and right-half models. After validating the CFD using a flow experiment, the hemodynamic parameters and flow patterns in five AComAs were compared. In four out of five cases, inflow from one A1 side had a dominant influence on the AComA, while both left and right A1 sides affected the AComA in the remaining case. Also, the average difference in time-averaged wall shear stress between the complete and half models for four cases was 4.6%, but it was 62% in the other case. The differences in the vascular resistances of left and right A1 and A2 segments greatly influenced the flow patterns in the AComA. These results may help to enhance clinicians' understanding of blood flow in the brain, leading to improvements in diagnosis and treatment of cerebral aneurysms. [ABSTRACT FROM AUTHOR]

Background: Modified Electroconvulsive Therapy (ECT) under anesthesia is an important modality in the treatment of severe persistent depression, bipolar disorder and schizophrenia; specially in case resistant to pharmacological therapy; but this procedure has got many side effects, specifically the hemodynamic alteration is markedly observed. Aim: The aim of present study to compare between Dexmedetomidine and esmolol as effective pretreatment regimens on attenuation of hemodynamic parameters during electroconvulsive therapy. Materials and Methods: After getting approval of the study protocol by the institutional ethics committee (H) of Assam Medical College and Hospital, Dibrugarh and getting written informed consent from the patients and their relatives, fifty cases aged between 20-40 years belonging to ASA grade I and II scheduled for ECT are included in the study and grouped in 2 groups of 25 patients each. Group E received IV esmolol 1mg/kg body weight diluted up to 10ml of normal saline and infused within 2 minutes as premedication. Group D received IV Dexmedetomidine 0.5 mcg/kg diluted to 10ml of normal saline and infused within 10 minutes as premedication. Hemodynamic parameters heart rate (HR), systolic blood pressure, diastolic blood pressure and mean blood pressure at baseline (before induction), after study drug infusion and after ECT application were recorded at different time intervals and presented along with demographic data. Statistical analysis was done with SPSS software using student t-test and Chi square test. Results: In this study, the baseline systolic blood pressure, diastolic blood pressure and mean blood pressure was statistically insignificant. The heart rate(HR), systolic blood pressure(SBP) and diastolic blood pressure(DBP) was significantly decreased in both esmolol and Dexmedetomidine group after drug administration and at 1,3,5 and 10 min post ECT shock. However, the decrease in MAP was statistically insignificant in both the groups after premedication, at 1,3,5,10 minutes of delivery of ECT shock. The mean time of return of spontaneous respiration was statistically insignificant. Conclusion: Based on the present hospital based observational study, we came to the conclusion that an intravenous premedication agent in ECT, both esmolol at a dose of 0.1 mg/kg and Dexmedetomidine at a dose of 0.5 mcg/kg results in attenuation of cardiovascular (HR, BP, MAP) effects but more reduction of hemodynamic parameters were seen in the Dexmedetomidine compared to esmolol. The mean blood pressure however was unaffected. [ABSTRACT FROM AUTHOR]

Cardiac damage caused by radiation in the long term varies according to the radiation dose received by the heart. In this study, it was aimed to evaluate the damage caused by different radiation doses in the heart, together with hemodynamic parameters, immunhistochemistry, and histopathological analyzes for long term. The animals were divided into four groups: The rats in control group (Group 1) were not irradiated; the rats in group 2 were irradiated with 5 Gy; the rats in group 3 were irradiated with 10 Gy and the rats in group 4 were irradiated with 20 Gy. Hemodynamic parameters and indices were determined from the impedance cardiography (ICG) recording in the whole groups before they were irradiated with RT and 180 days after RT. And then, interleukin-1β, interleukin-10, TNF-α, apopthosis were determined in all groups. In addition, histological changes of heart and aorta were evaluated. Histopathologic, cytokine and hemodynamic findings supported that cardiac damage increased with increasing radiation dose. it is important in terms of being an alternative and supportive method to other methods to be able to detect heart diseases caused by RT with the ICG method. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Caudal block is a type of regional anesthesia suitable for inguinal hernia surgery in children. Our goal was to determine the effectiveness of caudal block combined with general anesthesia in providing intraand postoperative analgesia and its effect on hemodynamic stability and drug consumption. PATIENTS AND METHODS: Prospective, randomized controlled study included 78 boys, 3-5 years, with an indication for inguinal herniorrhaphy, divided into groups G (general anesthesia, n=39) and G+C (general anesthesia + caudal block, n=39). We monitored hemodynamic parameters intraoperatively, postoperative pain, and total consumption of all medicaments in the perioperative period. The monitoring of complications and side effects of drugs was also carried out. RESULTS: Boys in group G had statistically significantly higher values of heart rate in the 5th minute (p<0.01), in the 25th minute (p<0.01), and after awakening from anesthesia (p<0.01). We obtained similar results with systolic and diastolic pressure values in the 5th minute (p<0.01), 15th minute (p<0.01), 25th minute (p<0.01), before awakening from anesthesia (p<0.01) and after awakening (p<0.01). They also had significantly statistically higher total consumption of propofol, fentanyl, and acetaminophen (p<0.01). Boys in group G+C had significantly lower postoperative pain scores: initially (p<0.01), after 2 hours (p<0.01), and after 5 hours (p<0.01). No complications occurred in this group. CONCLUSIONS: In children, the combination of general anesthesia with caudal block, compared to general anesthesia only, is more effi- cient in suppressing visceral pain, leading to better hemodynamic stability, and reducing the consumption of medicines in the perioperative period. [ABSTRACT FROM AUTHOR]

Progressive cerebral infarction (PCI) is a common complication in patients with ischemic stroke that leads to poor prognosis. Blood pressure (BP) can indicate post‐stroke hemodynamic changes which play a key role in the development of PCI. The authors aim to investigate the association between BP‐derived hemodynamic parameters and PCI. Clinical data and BP recordings were collected from 80 patients with cerebral infarction, including 40 patients with PCI and 40 patients with non‐progressive cerebral infarction (NPCI). Hemodynamic parameters were calculated from the BP recordings of the first 7 days after admission, including systolic and diastolic BP, mean arterial pressure, and pulse pressure (PP), with the mean values of each group calculated and compared between daytime and nighttime, and between different days. Hemodynamic parameters and circadian BP rhythm patterns were compared between PCI and NPCI groups using t‐test or non‐parametric equivalent for continuous variables, Chi‐squared test or Fisher's exact test for categorical variables, Cox proportional hazards regression analysis and binary logistic regression analysis for potential risk factors. In PCI and NPCI groups, significant decrease of daytime systolic BP appeared on the second and sixth days, respectively. Systolic BP and fibrinogen at admission, daytime systolic BP of the first day, nighttime systolic BP of the third day, PP, and the ratio of abnormal BP circadian rhythms were all higher in the PCI group. PCI and NPCI groups were significantly different in BP circadian rhythm pattern. PCI is associated with higher systolic BP, PP and more abnormal circadian rhythms of BP. [ABSTRACT FROM AUTHOR]

Olga Safonicheva,1 Kira Kryuchkova,1 Irina Lazareva,1 Pavel Chekulaev,1 Marina Ovchinnikova,1 Vladislav Kurshev,1 Elena Budanova,2 Victoria Gameeva,3 Victor Gavrilov,4 Vitaly Epishev,5 Victoria Zaborova1 1Institute of Clinical Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; 2Institute of Public Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; 3Luzhniki Sports Clinic, Moscow, Russia; 4Moscow Institute of Physics and Technology (National Research University), Moscow Region, Russia; 5Research Center for Sports Science, South Ural State University, Chelyabinsk, RussiaCorrespondence: Olga Safonicheva, Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya Street, 8/2, Moscow, 119991, Russia, Tel +7 926 534-62-65, Fax +7 495 609-14-00, Email safonicheva.o@mail.ruBackground: Many authors have noted the lack of knowledge on the causal relationship between the degree of physical activity, the dynamics, and outcomes of diseases, as well as the influence of sports history on the rehabilitation potential of former athletes.Purpose: Assessment of the functional state of the cardiovascular system according to the indicators of electrocardiography, polycardiography, echocardiography and the level of physical performance in masters athletes.Patients and Methods: The study included a main group consisting of 100 athletes, who had undergone electrocardiography, poly-electrocardiography, ultrasound echocardiography, heart rate and blood pressure measurement to determine their level of physical performance. The subjects were then divided into 2 groups. The first group included 75 people who continue to be active in regular sports activities. The second group consisted of 25 people who completely stopped training or had only occasional, unsystematic physical activities. A control group of 31 people, consisting of people of the same age who had not been involved in sports earlier, was examined according to the same program.Results: The data obtained by us show that sports activities do contribute to the increasing stability of the body and maximize the deployment of the capabilities of the circulatory system, including their long-term preservation in masters athletic. Athletes who have stopped training have signs of age-related changes in the heart and blood vessels, which seem to be more frequent and earlier than those who continue training. A higher degree of myocardial contractility (in 90.67% of cases) can also be seen in the main group.Conclusion: Masters athletes and those who stopped training after completing their sports career, should have notably thorough medical supervision and undergo regular annual in-depth examination.Keywords: blood pressure, heart rate, PWC170, physical work capacity, cardiodynamics, hemodynamic parameters

Beat-by-beat monitoring of hemodynamic parameters in the left ventricle contributes to the early diagnosis and treatment of heart failure, valvular heart disease, and other cardiovascular diseases. Current accurate measurement methods for ventricular hemodynamic parameters are inconvenient for monitoring hemodynamic indexes in daily life. The objective of this study is to propose a method for estimating intraventricular hemodynamic parameters in a beat-to-beat style based on non-invasive PCG (phonocardiogram) and PPG (photoplethysmography) signals. Three beagle dogs were used as subjects. PCG, PPG, electrocardiogram (ECG), and invasive blood pressure signals in the left ventricle were synchronously collected while epinephrine medicine was injected into the veins to produce hemodynamic variations. Various doses of epinephrine were used to produce hemodynamic variations. A total of 40 records (over 12,000 cardiac cycles) were obtained. A deep neural network was built to simultaneously estimate four hemodynamic parameters of one cardiac cycle by inputting the PCGs and PPGs of the cardiac cycle. The outputs of the network were four hemodynamic parameters: left ventricular systolic blood pressure (SBP), left ventricular diastolic blood pressure (DBP), maximum rate of left ventricular pressure rise (MRR), and maximum rate of left ventricular pressure decline (MRD). The model built in this study consisted of a residual convolutional module and a bidirectional recurrent neural network module which learnt the local features and context relations, respectively. The training mode of the network followed a regression model, and the loss function was set as mean square error. When the network was trained and tested on one subject using a five-fold validation scheme, the performances were very good. The average correlation coefficients (CCs) between the estimated values and measured values were generally greater than 0.90 for SBP, DBP, MRR, and MRD. However, when the network was trained with one subject’s data and tested with another subject’s data, the performance degraded somewhat. The average CCs reduced from over 0.9 to 0.7 for SBP, DBP, and MRD; however, MRR had higher consistency, with the average CC reducing from over 0.9 to about 0.85 only. The generalizability across subjects could be improved if individual differences were considered. The performance indicates the possibility that hemodynamic parameters could be estimated by PCG and PPG signals collected on the body surface. With the rapid development of wearable devices, it has up-and-coming applications for self-monitoring in home healthcare environments.

Background: To compare efficacy between oral lignocaine viscous 2% and oral lignocaine spray 10% in attenuating the hemodynamic response for laryngoscopy & endotracheal intubation prior to general anaesthesia. Materials and Methods: This study was carried out in 60 patients belonging to ASA I& II, aged between 20 to50 years undergoing elective surgeries. The study will be conducted for a period of 1year in Department of Anaesthesia in Kurnool Medical College, Kurnool. Patients who had hypersensitivity to study drug, patients with severe renal, hepatic, respiratory, cardiac disease, neurological, psychiatric disorders, Difficult Airway-Cormack & Lehane grade 3 and 4 were excluded from the study. Divided in to two groups. Group V receives 10ml of 2% or a lignocaine viscous gargle for 5 minutes prior to induction. Group S receives five puffs of oral lignocaine spray 10% prior to induction. The values for HR, SBP, DBP, and MAP, SPO2 were obtained baseline, after induction, immediately after intubation and 1,3,5 and10 minutes after intubation and compared among the groups. Results: In the current study, after induction the mean HEART RATE starts increasing in group S and in group V mean heart rates tart decreasing after induction and slightly raised after immediately after intubation and gradually decreasing till 10 min after intubation. In group S immediately after intubation highest mean heart rate was observed, and start decreasing at 1 minute, 3 minute, 5minute and 10 minute after intubation but not reached baseline level, the mean heart rate between two groups from after induction to 10 minutes after intubation was significant. (p<0.05). In group S mean SBP start increasing immediately after intubation and gradually start decreasing from 1 minute after intubation to 10 minutes after intubation. The mean SBP between two groups from 1 minute after induction to 10 minutes after intubation was significant. (p<0.05). In group V mean DBP start decreasing immediately after intubation and slightly increased immediately after intubation and gradually decreasing till 10 min after intubation. The mean DBP between two groups from after induction to 10 minutes after intubation was significant. (p<0.05). The mean MAP starts increasing in group S till immediately after intubation and gradually start decreasing from 1 minute after intubation to 10 minutes after intubation but reached baseline level at 3minutes.However, in group V mean MAP start decreasing immediately after intubation and slightly increased immediately after intubation and gradually decreasing till 10 min after intubation. The mean MAP between two groups from after induction to 10 minutes after intubation was significant. (p<0.05). After induction the mean SPO2 starts increasing in both groups and reached to 100% in both groups. Conclusion: The study concluded that oral lignocaine viscous 2% was more effective in blunting the haemodynamic response to laryngoscopy and endotracheal intubation than lignocaine spray 10% No significant adverse events occurred during the study. [ABSTRACT FROM AUTHOR]

Diabetic retinopathy (DR) is a rapidly emerging retinal abnormality worldwide, which can cause significant vision loss by disrupting the vascular structure in the retina. Recently, optical coherence tomography angiography (OCTA) has emerged as an effective imaging tool for diagnosing and monitoring DR. OCTA produces high-quality 3-dimensional images and provides deeper visualization of retinal vessel capillaries and plexuses. The clinical relevance of OCTA in detecting, classifying, and planning therapeutic procedures for DR patients has been highlighted in various studies. Quantitative indicators obtained from OCTA, such as blood vessel segmentation of the retina, foveal avascular zone (FAZ) extraction, retinal blood vessel density, blood velocity, flow rate, capillary vessel pressure, and retinal oxygen extraction, have been identified as crucial hemodynamic features for screening DR using computer-aided systems in artificial intelligence (AI). AI has the potential to assist physicians and ophthalmologists in developing new treatment options. In this review, we explore how OCTA has impacted the future of DR screening and early diagnosis. It also focuses on how analysis methods have evolved over time in clinical trials. The future of OCTA imaging and its continued use in AI-assisted analysis is promising and will undoubtedly enhance the clinical management of DR. Graphical abstract [ABSTRACT FROM AUTHOR]

Simple Summary: Young calves suffering from neonatal diseases received as emergencies often require resuscitation as they are in cardiovascular shock resulting in dehydration or generalized sepsis. The objectives of our study were to evaluate the various tools available to assess shock, and to determine their relationship to survival in calves referred as emergencies. Clinical parameters, a blood analysis, and blood pressure were measured upon arrival at the Veterinary Clinic for Ruminants of Liège on 45 calves from 1 day to 4 months old suffering from various diseases. The results indicate that higher blood lactates upon arrival were associated with an elevated heart rate, increased shock index (defined as the heart rate to systolic blood pressure ratio), and higher clinical shock score. Furthermore, higher initial blood lactate and the shock index were correlated with increased mortality in calves suffering from digestive diseases. In conclusion, the evaluation of specific shock parameters, such as blood lactates and blood pressure in calves could help clinicians to identify critical patients and improve outcomes through better shock management. Diseases in young calves received as emergencies are often associated with hypovolemic and/or septic shocks. The objectives of our study were to (1) assess the correlation between clinical hemodynamic parameters and blood L-lactates (LAC), systolic blood pressure (SBP), and the shock index (SI) recorded upon arrival; and (2) to evaluate how these parameters were related to short-term outcomes in calves under 4 months of age presented as emergencies. We conducted a single-observer prospective observational study on calves aged from 1 day to 4 months, presented to the Veterinary Clinic for Ruminants of Liège from December 2020 to May 2022. Forty-five calves were included in the study. The statistical analysis revealed a significant correlation between LAC and heart rate (r = 0.570; p < 0.05) and LAC and SI (r = 0.373; p < 0.05). A high LAC value at admission was significantly associated with a negative outcome (death) (p < 0.05). In calves suffering from obstructive digestive diseases, the SI was related to the outcome and the analysis indicated a cut-off value of 1.13 (Se = 0.77, Spe = 1). In conclusion, in our study, the initial blood L-lactate value was correlated with heart rate, the shock index, and the clinical shock score, and admission hyperlactatemia was associated with a poor prognosis in calves under 4 months of age. In this cohort, the shock index in calves suffering from digestive diseases was linked with mortality. [ABSTRACT FROM AUTHOR]

Aim: To assess the association with outcomes of cardiac index (CI) and mixed venous oxygen saturation (SvO2) in comatose patients resuscitated from out-of-hospital cardiac arrest (OHCA). Methods: In the cohort study of 789 patients included in the "BOX"-trial, 565 (77%) patients were included in this hemodynamic substudy (age 62 ± 13 years, male sex 81%). Pulmonary artery catheters were inserted shortly after ICU admission. CI and SvO2 were measured as soon as possible in the ICU and until awakening or death. The endpoints were all-cause mortality at 1 year and renal failure defined as need for renal replacement therapy. Results: First measured CI was median 1.7 (1.4–2.1) l/min/m2, and first measured SvO2 was median 67 (61–73) %. CI < median with SvO2 > median was present in 222 (39%), and low SvO2 with CI < median was present in 59 (11%). Spline analysis indicated that SvO2 value < 55% was associated with poor outcome. Low CI at admission was not significantly associated with mortality in multivariable analysis (p = 0.14). SvO2 was significantly inversely associated with mortality (hazard ratioadjusted: 0.91 (0.84–0.98) per 5% increase in SvO2, p = 0.01). SvO2 was significantly inversely associated with renal failure after adjusting for confounders (ORadjusted: 0.73 [0.62–0.86] per 5% increase in SvO2, p = 0.001). The combination of lower CI and lower SvO2 was associated with higher risk of mortality (hazard ratioadjusted: 1.54 (1.06–2.23) and renal failure (ORadjusted: 5.87 [2.34–14.73]. Conclusion: First measured SvO2 after resuscitation from OHCA was inversely associated with mortality and renal failure. If SvO2 and CI were below median, the risk of poor outcomes increased significantly. Registration: The BOX-trial is registered at clinicaltrials.gov (NCT03141099, date 2017–30–04, retrospectively registered). [ABSTRACT FROM AUTHOR]

Wearable technologies face challenges due to signal instability, hindering their usage. Thus, it is crucial to comprehend the connection between dynamic patterns in photoplethysmography (PPG) signals and cardiovascular health. In our study, we collected 401 multimodal recordings from two public databases, evaluating hemodynamic conditions like blood pressure (BP), cardiac output (CO), vascular compliance (C), and peripheral resistance (R). Using irregular-resampling auto-spectral analysis (IRASA), we quantified chaotic components in PPG signals and employed different methods to measure the fractal dimension (FD) and entropy. Our findings revealed that in surgery patients, the power of chaotic components increased with vascular stiffness. As the intensity of CO fluctuations increased, there was a notable strengthening in the correlation between most complexity measures of PPG and these parameters. Interestingly, some conventional morphological features displayed a significant decrease in correlation, indicating a shift from a static to dynamic scenario. Healthy subjects exhibited a higher percentage of chaotic components, and the correlation between complexity measures and hemodynamics in this group tended to be more pronounced. Causal analysis showed that hemodynamic fluctuations are main influencers for FD changes, with observed feedback in most cases. In conclusion, understanding chaotic patterns in PPG signals is vital for assessing cardiovascular health, especially in individuals with unstable hemodynamics or during ambulatory testing. These insights can help overcome the challenges faced by wearable technologies and enhance their usage in real-world scenarios. [ABSTRACT FROM AUTHOR]

Purpose: Neurosurgeons can manage unruptured intracranial aneurysms (UIAs). However, the stability of UIAs under follow-up remains uncertain. This study aimed to examine the risk factors associated with the instability (rupture or growth) of UIAs during follow-up. Methods: We obtained information on patients with UIA who underwent ≥ 6 months of the time of flight-magnetic resonance angiography (TOF-MRA) imaging follow-up in two centers. Computer-assisted semi-automated measurement (CASAM) techniques were used for recording morphological parameters and determining the growth of these aneurysms. We also recorded hemodynamic parameters at the beginning of the follow-up. The univariate and multivariate Cox regression analyses were performed to calculate hazard ratios with corresponding 95% confidence intervals for the clinical, morphological, and hemodynamic risk factors for aneurysm instability. Results: A total of 304 aneurysms from 263 patients (80.4%) were included for analysis. The annual aneurysm growth rate was 4.7%. Significant predictive factors for aneurysm instability in the multivariate analysis were as follows: poorly controlled hypertension (hazard ratio (HR), 2.97 (95% CI, 1.27–6.98), P = 0.012); aneurysms located on posterior circulation (HR, 7.81 (95% CI, 2.28–26.73), P = 0.001), posterior communication artery (HR, 3.01 (95% CI, 1.07–8.46), P = 0.036), and cavernous carotid artery (HR, 3.78 (95% CI, 1.18–12.17), P = 0.026); and size ratio ≥ 0.87 (HR, 2.54 (95% CI, 1.14–5.68), P = 0.023). Conclusions: The management of UIAs should focus on the control of hypertension during the follow-up. Aneurysms on the posterior communicating artery, posterior circulation, and cavernous carotid arteries require intensive surveillance or timely treatment. [ABSTRACT FROM AUTHOR]

The main hazards in the process of manual handling work are triggered by human factors and ergonomics. This study is intended to implement a valid approach to quantitatively evaluate the risk level during manual handling work. A risk assessment model for manual handling workers was proposed based on subjective and objective correlation. A simulation experiment of manual handling process was developed and an ergonomics evaluation method was carried out. The 33‐point human joint model of BlazePose neural network and the Rapid Upper Limb Analysis (RULA) method were utilized to determine the risk posture and risk index of the manual handling workers. This study brought together hemodynamic parameters and the score of Borg Rating of Perceived Exertion (RPE) scale and Physical Resources Scale (PRS) to obtain the final comprehensive index of work risk. The results showed that the risk indexes from the three stages of the experiment obtained by RULA method were 3, 4, and 7. And the scores of comprehensive indexes obtained by the risk assessment model were 1.841, 1.900, and 1.987, suggesting that the evaluation model based on subjective and objective correlation had the same ability to determine the risk levels of different handling tasks. Therefore, the risk assessment model proposed in this study verified the effectiveness of the comprehensive evaluation index integrating hemodynamic parameters and subjective evaluation scores. [ABSTRACT FROM AUTHOR]

BackgroundAtrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with a high risk of stroke. This study was designed to investigate the relationship between hemodynamic parameters and left atrial thrombus/spontaneous echo contrast (LAT/SEC) in non-valvular atrial fibrillation (NVAF) patients and establish a predictive nomogram that integrates hemodynamic parameters with clinical predictors to predict the risk of LAT/SEC.MethodsFrom January 2019 to September 2022, a total of 354 consecutive patients with NVAF were enrolled in this cross-sectional study at the First Affiliated Hospital of Guangxi Medical University. To identify the optimal predictive features, we employed least absolute shrinkage and selection operator (LASSO) regression. A multivariate logistic regression model was subsequently constructed, and the results were visualized with a nomogram. We evaluated the model's performance using discrimination, calibration, and the concordance index (C-index).ResultsWe observed a 38.7% incidence of SEC/TH in NVAF patients. Independent influencing factors of LAT/SEC were identified through LASSO and multivariate logistic regression. Finally, four indicators were included, namely, previous stroke/transient ischaemic attack (OR = 4.25, 95% CI = 1.57–12.23, P = 0.006), left atrial volume index (LAVI) (OR = 1.04, 95% CI = 1.01–1.06, P = 0.001), S/D ratio (OR = 0.27, 95% CI = 0.11–0.59, P = 0.002), and left atrial acceleration factor (OR = 4.95, 95% CI = 2.05–12.79, P = 0.001). The nomogram, which incorporated these four influencing factors, demonstrated excellent predictive ability. The training set had a C-index of 0.878, while the validation set had a C-index of 0.872. Additionally, the calibration curve demonstrated great consistency between the predicted probabilities and the observed outcomes, and the decision curve analysis confirmed the important clinical advantage of the model for patients with NVAF.ConclusionOur findings indicate that an enlarged left atrium and abnormal hemodynamic parameters in the left atrial and pulmonary veins are linked to a greater risk of LAT/SEC. Previous stroke/transient ischaemic attack, LAVI, the S/D ratio, and left atrial acceleration factor were independently associated with LAT/SEC in NVAF patients. With the incorporation of these four variables, the developed nomogram effectively predicts the risk of LAT/SEC and outperforms the CHA2DS2-VASc score.

Abstract Background Information obtained from arterial pulse waveforms (APW) can be useful for characterizing the cardiovascular system. To achieve this, it is necessary to know the detailed characteristics of APWs in different states of an organism, which would allow APW parameters (APW‐Ps) to be assigned to particular (patho)physiological conditions. Therefore, our work aimed to characterize 35 APW‐Ps in rats under the influence of isoflurane (ISO) and Zoletil/xylazine (ZO/XY) anesthesia and to study the effect of root extract from Acanthopanax senticosus (ASRE) in these anesthetic conditions. Methods The right jugular vein of anesthetized rats was cannulated for the administration of ASRE and the left carotid artery for the detection of APWs from which 35 APW‐Ps were evaluated. Results We obtained data on 35 APW‐Ps, which significantly depended on the anesthesia, and thus, they characterized the cardiovascular system under these two conditions. ASRE transiently modulated all 35 APW‐Ps, including a transient decrease in systolic and diastolic blood pressure (BP) and heart rate or increases in pulse BP, dP/dtmax, and systolic and diastolic areas. Whereas the transient effects of ASRE were similar, the extract had prolonged disturbing effects on the cardiovascular system in rats under ZO/XY but not under ISO anesthesia. This negative effect can result from the disturbance caused by ZO/XY anesthesia on the cardiovascular system. Conclusions We characterized 35 APW‐Ps of rats under ISO and ZO/XY anesthesia and found that ASRE contains compounds that can modulate the properties of the cardiovascular system, which significantly depended on the status of the cardiovascular system. This should be considered when using ASRE as a nutritional supplement by individuals with cardiovascular problems.

Background. Hemodynamic parameters are interrelated with both the threshold of salt sensitivity and the type of initial autonomic tone. Available data on such relationships are insufficient. Objective — to identify the hemodynamic parameters and features in students with different thresholds of salt sensitivity and types of autonomic tone.Methods. The study enrolled 174 second-year students of Kirov State Medical University, aged 18–23, who gave consent to the survey. The study was conducted over a period of four months and included two stages. At the first stage, all participants were evaluated for the threshold of salt sensitivity. According to the results, two groups were formed: group A — students with a normal threshold of salt sensitivity (n = 127); group B — students with a high threshold of salt sensitivity (n = 39). In the formed groups, a comparative analysis of hemodynamic parameters was carried out. At the second stage of the study, after assessing the initial autonomic tone, three groups were identified: group 1 (n = 40) — students with equilibrium of the sympathetic and parasympathetic systems (normotension); group 2 (n = 104) — students with dominating parasympathetic regulation of the heart rhythm (vagotonia); group 3 (n = 22) — students with dominating sympathetic regulation of the heart rhythm (sympathicotonia). Hemodynamic parameters were also studied in these groups. Statistical data processing was carried out using Statistica Advanced 10 for Windows RU. The differences between the comparison groups were assessed using parametric Student’s t-test and non-parametric Mann-Whitney U-test.Results. A high threshold of salt sensitivity was revealed in 23% of students. When comparing hemodynamic parameters in the groups, it was found that students with high thresholds of salt sensitivity had significantly higher values of systolic blood pressure, diastolic blood pressure, pulse pressure and average hemodynamic pressure than students with a low threshold. Differences in hemodynamics in students may be caused by differences in the original autonomic tone. Thus, students with vagotonia, if compared to those with normotension, have significantly lower values of heart rate, cardiac minute output, double product, and circulatory efficiency ratio, but a higher value of the peripheral vascular resistance. Students with sympathicotonia have statistically higher heart rate, cardiac minute output, and double product values.Conclusion. The assessment of hemodynamic parameters in healthy young people in relation to the threshold of salt sensitivity and the initial autonomic tone enables the risk factors for the development of hypertension to be assessed, prehypertension (high normal blood pressure) to be identified, and preventive programs aimed at reducing the number of diseases of the cardiovascular system to be developed.

IntroductionThe current recommendations for the management of neonatal polycythemia are that partial exchange transfusion (PET) should be performed if the hematocrit is >70% in an asymptomatic neonate, or if the haematocrit is >65% in a symptomatic neonate. The hemodynamic effects of PET for neonatal polycythemia have not been well researched.ObjectivesTo evaluate the hemodynamic effects of PET in neonates with polycythemia.MethodologyProspective observational study conducted in a neonatal intensive care unit of a tertiary care teaching hospital enrolling 21 neonates with polycythemia who underwent PET. Hemodynamic and echocardiographic parameters were obtained prior to PET and 6 h after procedure.ResultsThe mean gestational age of neonates with polycythemia was 35.08 ± 2.35 weeks with a mean birth weight of 1,929 ± 819.2 g. There was a significant improvement noted in heart rate and oxygen saturation post PET procedure (p

ABSTRACTObjective Reducing maternal morbidity and mortality has been a challenge for low and middle-income countries, especially in the setting of hypertensive disorders of pregnancy. Improved strategies for treating obstetric patients with resistant hypertension are needed. We sought to explore whether hemodynamic parameters may be used to identify patients that develop resistant hypertension in pregnancy.Methods Retrospective cohort study among pregnant patients with gestational hypertension or preeclampsia that experienced severe blood pressure elevations. Hemodynamic variables were evaluated, including cardiac output (CO), and total peripheral resistance (TPR). The primary endpoint was resistant hypertension. An exploratory logistic regression was performed to evaluate the association between the hemodynamic profile and the development of resistant hypertension. Adverse maternal and fetal outcomes were additionally described according to the presence of resistant hypertension.Results Fifty-seven patients with severe pregnancy hypertension were included, of whom 34 developed resistant hypertension (59.7%). The resistant hypertension group, in comparison to those without resistant hypertension, presented with a hypodynamic profile characterized by reduced CO 1400 dyn-s/cm5 (64.7% vs. 39.1%, p: 0.057). Logistic regression analysis revealed an association between a hypodynamic profile and resistant hypertension (OR 3.252, 95% CI 1.079–9.804; p = 0.035). Newborns of the resistant hypertension group had more frequent low birth weight (

Background: Endotracheal intubation is a common procedure during general anesthesia, often associated with post-operative complications such as sore throat and emergence cough. This study aimed to investigate the efficacy of three intra-cuff solutions—air, normal saline, and 2% lignocaine—in mitigating these complications and their impact on intubation attempts and hemodynamic parameters. Methods: A randomized clinical trial was conducted involving 114 patients undergoing elective surgeries. Participants were divided into three groups based on the intra-cuff solution used. Intubation attempts, post-operative sore throat, emergence cough, and physiological parameters were assessed and statistically analysed. Results: The use of 2% lignocaine significantly reduced the number of intubation attempts (p < 0.001*) compared to air and normal saline. Additionally, lignocaine was associated with a significantly lower incidence of post-operative sore throat (p = 0.011*) and emergence cough (p = 0.010*) compared to the other solutions. However, there were no significant differences in hemodynamic parameters between the groups. Conclusion: This study suggests that 2% lignocaine may be a preferable intra-cuff solution for endotracheal intubation, as it reduces intubation attempts and the incidence of postoperative complications. Further research and clinical trials are needed to validate these findings and refine the selection criteria for intra-cuff solutions. [ABSTRACT FROM AUTHOR]

Background: This comparative study aimed to evaluate the impact of adding dexmedetomidine as an adjuvant to 0.75% isobaric ropivacaine in subarachnoid block for patients undergoing total abdominal hysterectomy. Methods: Fifty female patients within the age range of 35-65 years, classified as ASA grades I and II, were included in this study. They were divided into two groups: Group A (Dexmedetomidine) and Group B (Control). Various parameters were assessed, including the duration of sensory and motor blockade, duration of analgesia, and hemodynamic parameters. Results: The addition of dexmedetomidine significantly prolonged the duration of sensory blockade (142.20 ± 5.61 vs. 74.40 ± 3.91 minutes, p < 0.001), motor blockade (233.80 ± 4.15 vs. 140.80 ± 5.53 minutes, p < 0.001), and analgesia (358.80 ± 7.26 vs. 179.60 ± 7.76 minutes, p < 0.001) compared to the control group. Hemodynamic parameters remained stable, and the incidence of side effects was low. Conclusion: The addition of dexmedetomidine to ropivacaine in subarachnoid block provides prolonged sensory and motor blockade, leading to extended postoperative analgesia, without compromising hemodynamic stability. This approach presents a promising option for pain management in patients undergoing total abdominal hysterectomy. [ABSTRACT FROM AUTHOR]

Purpose: Image-based blood flow simulations are increasingly used to investigate the hemodynamics in intracranial aneurysms (IAs). However, a strong variability in segmentation approaches as well as the absence of individualized boundary conditions (BCs) influence the quality of these simulation results leading to imprecision and decreased reliability. This study aims to analyze these influences on relevant hemodynamic parameters within IAs. Methods: As a follow-up study of an international multiple aneurysms challenge, the segmentation results of five IAs differing in size and location were investigated. Specifically, five possible outlet BCs were considered in each of the IAs. These are comprised of the zero-pressure condition (BC1), a flow distribution based on Murray's law with the exponents n = 2 (BC2) and n = 3 (BC3) as well as two advanced flow-splitting models considering the real vessels by including circular cross sections (BC4) or anatomical cross sections (BC5), respectively. In total, 120 time-dependent blood flow simulations were analyzed qualitatively and quantitatively, focusing on five representative intra-aneurysmal flow and five shear parameters such as vorticity and wall shear stress. Results: The outlet BC variation revealed substantial differences. Higher shear stresses (up to Δ9.69 Pa), intrasaccular velocities (up to Δ0.15 m/s) and vorticities (up to Δ629.22 1/s) were detected when advanced flow-splitting was applied compared to the widely used zero-pressure BC. The tendency of outlets BCs to over- or underestimate hemodynamic parameters is consistent across different segmentations of a single aneurysm model. Segmentation-induced variability reaches Δ19.58 Pa, Δ0.42 m/s and Δ957.27 1/s, respectively. Excluding low fidelity segmentations, however, (a) reduces the deviation drastically (>43%) and (b) leads to a lower impact of the outlet BC on hemodynamic predictions. Conclusion: With a more realistic lumen segmentation, the influence of the BC on the resulting hemodynamics is decreased. A realistic lumen segmentation can be ensured, e.g., by using high-resolved 2D images. Furthermore, the selection of an advanced outflow-splitting model is advised and the use of a zero-pressure BC and BC based on Murray's law with exponent n = 3 should be avoided. [ABSTRACT FROM AUTHOR]

Background: Arterial hypertension is one of the most common co-morbid conditions affecting general population, which contributes to pathogenesis of various diseases worsening the treatment outcome. Aim: The aim of this study was to observe peri-operative hemodynamic parameters in hypertensive geriatric patients posted for lower limb orthopaedic surgery under spinal anaesthesia. Methods: A prospective observational study conducted at Bone and Joint Hospital, an associated hospital of GMC Srinagar after approval by Institutional Ethical Committee. 60 patients in total which were divided into two groups, controlled Hypertension (28 patient with systolic blood pressure between 120 to 139 mmHg and diastolic blood pressure between 80 to 89 mmHg, and, uncontrolled hypertension (32 patients with systolic blood pressure between ≥140 mmHg and diastolic blood pressure between ≥90 mmHg). The pre-operative assessment of patients including thorough history, particularly regarding known cases of hypertension and its duration or newly detected cases, use of anti-hypertensive medications, history of other co-morbid diseases, previous anaesthetic exposure, any other drug history, allergy to any drug and personal habits were elicited. Peri-operative complications (bradycardia, tachycardia, hypertension, hypotension, arrhythmias, myocardial ischaemia, cerebrovascular accidents heart failure etc.) were also noted. Results: There were 46.66% (n=28) patients who had controlled hypertension while as uncontrolled hypertension was seen in 53.55% (n=32) patients. Significant statistical difference was obtained when intraoperative MAP was correlated with two study groups at 10 to 40 minutes and at 70 minutes. At all other time intervals the difference was insignificant. Hypotension was seen more in uncontrolled hypertension (84.37%) compared to patients who had controlled hypertension (28.57%). The difference observed was statistically significant (p 0.00001). Conclusion: Based on the findings from this study, we concluded that necessary precautions to be taken while administering spinal anaesthesia in hypertensive geriatric patients as the incidence of hypotension can lead to deleterious cardiovascular effects, other end organ damage and even sudden death in these patients. [ABSTRACT FROM AUTHOR]

Purpose: to substantiate, develop and evaluate the effectiveness of a physical therapy program for young women with hypertensive neurocirculatory dystonia at the outpatient stage. Material & Methods: under our supervision there were 28 women with a diagnosis of neurocirculatory dystonia of hypertonic type; they were randomly divided into two groups: main (14 patients) and control (14 patients); the average age of patients in the main group was 20,1±0,35 years, in the control group – 20,6±0,23 years. The course of physical therapy for patients of the main and control groups lasted for 5 months. The patients of the main group underwent rehabilitation measures according to the program of physical therapy, which included kinesiotherapy using therapeutic exercises based on dance aerobics in combination with regulated breathing exercises, taking into account the tone of the ANS and autogenic training, patients of the control group were engaged in the E.V. Doliger physical therapy program for patients with NCD. Results: the functional indicators of the cardiovascular and autonomic nervous system obtained during the primary study indicated the absence of economization of the work of the cardiovascular system, the presence of dysfunction of the autonomic nervous system in the direction of the predominance of the activity of the sympathetic department. After 5 months of using physical therapy programs, when re-examined, patients in both groups showed a decrease in heart rate and a decrease in blood pressure; stroke volume in the main group was within normal limits, in the control group, a decrease in stroke volume indicated a reduced myocardial contractility; the decrease in the minute volume of blood in the main group was due to a decrease in heart rate, in the control group – due to a decrease in heart rate and stroke volume. The value of the Kerdo index in the main group corresponded to the state of eutonia, in the control group – sympathicotonia. Conclusions: in the course of the study, we came to the conclusion that a physical therapy program was developed, which included kinesitherapy using therapeutic exercises based on dance aerobics in combination with regulated breathing exercises, taking into account the tone of the parasympathetic and sympathetic divisions of the autonomic nervous system and autogenic training, is effective and contributes to the normalization of hemodynamic parameters and the tone of the autonomic nervous system, which improves the quality of life of NCD patients. The conducted studies have confirmed the need for the use of physical therapy, including kinesitherapy using therapeutic exercises based on dance aerobics in combination with regulated breathing exercises, taking into account the tone of the ANS and autogenous training.

OBJECTIVE: In this work, based on intelligent computing, the biological signals of patients were analyzed to investigate the hemodynamic changes and pulmonary complications of Nalmefene Hcl combined with general anesthesia (GA) in laparoscopic gynecological tumor surgery (GTS). PATIENTS AND METHODS: Eighty computer-aided GTS patients were randomly divided into a control group (n = 40) and an observation group (n = 40). Biomedical electrocardiogram (ECG) signals were detected by wavelet neural network in all patients undergoing laparoscopic gynecological tumor surgery and were computerized according to the android interface definition language model (AIDL). GA was used during surgery. The observation group was injected intravenously with 0.2 μg/kg naproxenacin hydrochloride after operation. The control group was given 1 mL 0.9% sodium chloride solution after operation. Mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR), pulse oxygen saturation (SPO), coma score, and adverse reactions (AR) were compared between the two groups at 10, 20, and 30 minutes after wakefulness. The hemodynamic parameters between the two groups were compared. Serum urocholine (URO) and creatinine (Cre) levels were analyzed in patients without complications. RESULTS: ECG waveform based on wavelet neural network has a high recognition rate and strong generalization ability. 37 patients in the observation group recovered within 10 minutes after surgery, and the recovery rate at 30 minutes was 95%. 30 patients in the control group awoke 10 minutes after the operation, and the recovery rate at 30 minutes m-AR was 75%. The average abstract windows toolkit (AWT) of the observation group and control group was 11.87 ± 5.78 min and 16.46 ± 5.32 min, respectively, and the difference was significant (p < 0.05). There were significant differences in HR, systolic blood pressure (SBP), and diastolic blood pressure (DBP) between the observation group and the control group during the extubation (p < 0.05). Blood gas indexes PaO2, PvO2, PaCO2, and PvCO2 in the observation group were significantly different from those in the control group half an hour after the operation and half an hour after pneumoperitoneum (p > 0.05). CONCLUSIONS: Intelligent computational biological signal detection was beneficial to the development of surgery. Nalmefene Hcl combined with GA on the basis of the AIDL model has a significant effect on the awakening of GTS patients and can shorten sleep time. Patients with underlying cardiac disease were more likely to develop postoperative lung complications. [ABSTRACT FROM AUTHOR]

Background: Laryngoscopy and endotracheal intubation are stressful for patients, as these procedures can produce tachycardia, hypertension, and arrhythmias. Aim of work: The aim of the current study was to compare the effect of magnesium sulphate and two doses of dexmedetomidine on hemodynamic response to laryngoscopy and tracheal intubation. Patients and methods: This comparative prospective randomized controlled (single-blind) clinical study was carried out in Zagazig University hospitals on 80 patients during the period from May 2019 to February 2020. Patients were divided randomly into four groups each is 20 patients: Group Da: 20 Patients received dexmedetomidine 0.5mcg/kg in 20 ml normal saline intravenous infusion over 10 min. Group Db: 20 Patients received dexmedetomidine 1mcg/kg in 20 ml normal saline intravenous infusion. Group M: 20 Patients received magnesium sulphate 30mg/kg in 20 ml normal saline intravenous in fusion over 10 min. Group C: 20 Patients received 20 ml 0.9% in 20 ml normal saline intravenous infusion over 10 min. Results: The heart rate in Db group was statistically lower than other groups, Heart rate in the Da group were statistically significantly lower compared to group M and group C. Systolic blood pressure was statistically significantly lower in group Db compared to another group. Conclusions: Through this study, we can conclude that Dexmedetomidine 1mcg/kg is more effective than dexmedetomidine 0.5mcg/kg and magnesium sulphate 30mg/kg in decreasing the hemodynamic response to laryngoscopy and tracheal intubation. [ABSTRACT FROM AUTHOR]

Background: This study aimed to evaluate the effect of cloth mask vs. N95 mask on cardiovascular and pulmonary parameters at rest and during physical activity in health-care providers. Materials and Methods: Hundred health-care providers (45 men and 55 women) were included in the study. The procedure comprised of pre-test and post-test outcome measures like hemodynamic parameters comprising of heart rate,[15] respiratory rate,[16] peak expiratory flow rate[7] and oxygen saturation[7] taken on first day with cloth mask and second day with an N95 mask consecutively. Outcome measures were measured during quite sitting and brisk walking on treadmill, which was a self-paced test. Subjects manually selected their comfortable speed while walking on the treadmill, when exhausted the test was terminated. Comparing values of the outcome measures we found the effect of N95 masks and cloth masks on hemodynamic parameters, oxygenation and peak expiratory flow rate during rest and physical activity. Results: This study resulted in favor of N95 masks (P < 0.05). The difference was significant, concluding a slight increase in the respiratory rate (P = 0.0009) and heart rate (P = 0.0001) while wearing a cloth mask in comparison with an N95 mask. Oxygen saturation and peak expiratory flow rate were significantly maintained during physical activity while wearing an N95 mask, compared to a cloth mask (P = 0.0001). Conclusion: N95 masks should be utilized by health-care providers as, they did not impair respiratory rate, heart rate, oxygenation, and peak expiratory flow rate at rest and during physical activity. In comparison with cloth masks, N95 masks were better in maintaining oxygen saturation and peak expiratory flow rate during physical activity. [ABSTRACT FROM AUTHOR]

Phthalic selenoanhydride (R-Se) solved in physiological buffer releases various reactive selenium species including H2Se. It is a potential compound for Se supplementation which exerts several biological effects, but its effect on the cardiovascular system is still unknown. Therefore, herein we aimed to study how R-Se affects rat hemodynamic parameters and vasoactive properties in isolated arteries. The right jugular vein of anesthetized Wistar male rats was cannulated for IV administration of R-Se. The arterial pulse waveform (APW) was detected by cannulation of the left carotid artery, enabling the evaluation of 35 parameters. R-Se (1–2 µmol kg−1), but not phthalic anhydride or phthalic thioanhydride, transiently modulated most of the APW parameters including a decrease in systolic and diastolic blood pressure, heart rate, dP/dtmax relative level, or anacrotic/dicrotic notches, whereas systolic area, dP/dtmin delay, dP/dtd delay, anacrotic notch relative level or its delay increased. R-Se (~10–100 µmol L−1) significantly decreased the tension of precontracted mesenteric, femoral, and renal arteries, whereas it showed a moderate vasorelaxation effect on thoracic aorta isolated from normotensive Wistar rats. The results imply that R-Se acts on vascular smooth muscle cells, which might underlie the effects of R-Se on the rat hemodynamic parameters. [ABSTRACT FROM AUTHOR]

Direct laryngoscopy and endotracheal intubation is a noxious stimuli and induce sympathomimetic responses. Although well tolerated in healthy subjects, it may impose life-threatening arrhythmias, left ventricular failure or rupture of cerebral aneurysm in susceptible patients. The aim is to study the effects of intravenous labetalol and lignocaine on haemodynamic responses to laryngoscopy and endotracheal intubation. Materials and methods: It is a cross-sectional and randomized controlled study with two study groups was planned. 70 patients were randomly assigned to one of two groups: those receiving Labetalol 0.25 mg/kg (n=35) or those receiving lignocaine 1mg/kg (n=35). The parameters assessed are heart rate, systolic BP, diastolic BP and Mean arterial pressure. Baseline parameters were recorded at the time of induction, post-intubation immediately and 1, 3, 5, 10 minutes later. Results: In the current study, at the time of induction, the mean heart rate was 65.97±5.22 per min in group LB whereas the mean heart rate was 76.66±8.49 per min in group LG which was statistically significant (P value <0.001). There was significantly reduced systolic blood pressure at 1min after intubation, 3min after intubation, 5min after intubation, and 10min after intubation in patients of group LB when compared with patients of group LG (P value <0.05). Significantly reduced diastolic blood pressure at 1 min after intubation, 3 min after intubation, 5 min after intubation, and 10 min after intubation in patients of group LB when compared with patients of group LG (P value <0.05). Conclusions: It was concluded in the present study that intravenous labetalol of dosage 0.25 mg/kg before laryngoscopy and endotracheal intubation was efficient in attenuating the hemodynamic parameters. [ABSTRACT FROM AUTHOR]

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