Search Results (7,259)

Periodic limb movements in sleep (PLMS) are a prevalent disorder characterized by rhythmic, involuntary movements of the lower limbs, such as dorsiflexion of the ankle and extension of the big toe, occurring in periodic intervals during sleep. These movements are often linked to disrupted autonomic nervous system (ANS) activity and altered interoception. Interoception involves perceiving internal bodily states, like heartbeat, breathing, hunger, and temperature, and plays a crucial role in maintaining homeostasis and the mind–body connection. This review explores the complex relationships between PLMS, heart rate variability (HRV), ANS dysregulation, and their impact on psychiatric disorders. By synthesizing the existing literature, it provides insights into how ANS dysregulation and altered interoceptive processes, alongside PLMS, contribute to psychiatric conditions. The review highlights the potential for integrated diagnostic and therapeutic approaches and presents a cause-and-effect model illustrating the mutual influence of psychiatric disorders, ANS dysregulation, PLMS, and interoception. Full article

Background/Objectives: Photoplethysmography (PPG) signals, which measure blood volume changes through light absorption, are increasingly used for non-invasive cardiovascular disease (CVD) detection. Analyzing PPG signals can help identify irregular heart patterns and other indicators of CVD. Methods: This research involves a total of 41 subjects sourced from the CapnoBase database, consisting of 21 normal subjects and 20 CVD cases. In the initial stage, heuristic optimization algorithms, such as ABC-PSO, the Cuckoo Search algorithm (CSA), and the Dragonfly algorithm (DFA), were applied to reduce the dimension of the PPG data. Next, these Dimensionally Reduced (DR) PPG data are then fed into various classifiers such as Linear Regression (LR), Linear Regression with Bayesian Linear Discriminant Classifier (LR-BLDC), K-Nearest Neighbors (KNN), PCA-Firefly, Linear Discriminant Analysis (LDA), Kernel LDA (KLDA), Probabilistic LDA (ProbLDA), SVM-Linear, SVM-Polynomial, and SVM-RBF, to identify CVD. Classifier performance is evaluated using Accuracy, Kappa, MCC, F1 Score, Good Detection Rate (GDR), Error rate, and Jaccard Index (JI). Results: The SVM-RBF classifier for ABC PSO dimensionality reduced values outperforms other classifiers, achieving the highest accuracy of 95.12% along with the minimum error rate of 4.88%. In addition to that, it provides an MCC and kappa value of 0.90, a GDR and F1 score of 95%, and a Jaccard Index of 90.48%. Conclusions: This study demonstrated that heuristic-based optimization and machine learning classification of PPG signals are highly effective for the non-invasive detection of cardiovascular disease. Full article

Background: There is still limited evidence on the results of prehabilitation in very old frail patients. The aim of this study is to analyze the outcomes and course of octogenarian and nonagenarian patients undergoing prehabilitation before surgery for colorectal cancer (CRC). Methods: a prospective study was conducted in a tertiary hospital from 2018 to 2022. All patients diagnosed with CRC over 80 years old and proposed for surgery were included. A comprehensive geriatric assessment (CGA) for frailty detection was performed, and the therapeutic decision was taken by the multidisciplinary tumor committee. Prehabilitation led by the geriatric team was performed. The rate of medical and surgical complications, hospital stay, in-hospital mortality, and first-year mortality were recorded. Results: CRC surgery was proposed in 184 patients >80 years. After a multidisciplinary decision, surgery was performed on 126 (68.5%) patients, of whom 12 (0.5%) were nonagenarians. Fifty percent of octogenarians and 86% of nonagenarians were frail. Prehabilitation consisted of the following: adapted physical exercise (100%); oral nutritional supplementation (73.8%); anemia treatment (59.5%); delirium prevention (5.6%); antidepressant treatment (15.9%); vitamin D supplementation (21.4%); and pharmacological deprescription (38.1%). The post-surgical complication rate was low (4.3% surgical and 29.4% medical complications), and in-hospital mortality was very low (3.2%). Nonagenarian patients had a higher rate of complications compared to octogenarians (OR 4.0 (95% CI 1.13–14.12))—mainly heart failure (OR 4.68 (95% CI 1.21–18.09))—but there were no differences in hospital stay or first-year mortality. Conclusions: prehabilitation in very old patients with CRC surgery is possible and provides good results. Full article

Background: Severe aortic stenosis (AS) may present with different flow, gradient and left ventricular ejection fraction (LVEF) patterns. Paradoxical low-flow low-gradient (PLF-LG) severe AS has a specific clinical profile, but its prognosis and management remain controversial. Our aim is to evaluate the impact of different AS patterns in the incidence of major clinical events. Methods: A retrospective observational study was carried out on all the consecutive patients diagnosed with severe AS at our tertiary hospital centre in 2021. Echocardiographic measurements were carefully reviewed, and patients were classified following current guidelines into four categories: high gradient (HG), concordant low-flow low-gradient (CLF-LG), paradoxical low-flow low-gradient (PLF-LG) and normal-flow low-gradient (NF-LG). The baseline characteristics and clinical events (heart failure admission, intervention and death) at 1-year follow-up were collected from medical records. The association between categories and events was established using Student’s t test or ANOVA as required. Results: 205 patients with severe AS were included in the study (81 ± 10 years old, 52.7% female). Category distribution was as follows: HG (138, 67.3%), PLF-LG (34, 19.8%), CLF-LG (21, 10.2%) and NF-LG (12, 5.9%). During the follow-up, 24.8% were admitted due to heart failure, 68.3% received valve replacement (51.7% TAVR) and 22% died. Severe tricuspid regurgitation was more frequent in patients with PLF-LG than in HG AS (14.7% vs. 2.2%; p < 0.01). Despite no differences in intervention rate, more patients with PLF-LG (32.4% vs. 15.9%; p = 0.049) died during the evolution. Conclusions: The PLF-LG pattern was the second most common pattern of severe AS in our cohort, and it was related to a higher mortality with no differences in intervention rate. Thus, this controversial category, rather than being underestimated, should be followed closely and considered for early intervention. Full article

(1) Background: Our previous studies indicated that low-intensity extremely low-frequency electric field (ELF-EF) treatment alters autonomic activities, as revealed through heart rate variability (HRV) analysis. However, the high-frequency (HF) component of HRV that reflects parasympathetic activity showed no changes either during or after the end of the treatment, suggesting the involvement of sympathetic nerves. (2) Methods: To examine this issue in the present study, the effect of ELF-EF on skin conductance (SC), which is controlled solely by sympathetic nerves, was analyzed. Twelve healthy subjects underwent a 20 min ELF-EF treatment (applied voltage: 9 kV, induced current density: below 6 mA/m²) and a sham treatment in a random order with an interval of more than 2 weeks. SC and HRV were recorded under the eyes-open condition during a 2 min period both before and after the treatment. (3) Results: The number of spontaneous fluctuations in skin conductance (SC-SFs) significantly decreased after the ELF-EF treatment, suggesting psychological changes, including relaxation. The skin conductance level, heart rate, and HRV indices did not change after the ELF-EF treatment. (4) Conclusion: The results support the idea that low-intensity ELF-EF affects autonomic nerves by reducing sympathetic activity, as reflected by SC-SFs. Full article

Manual ventilation, most commonly with a bag-valve mask, is a form of short-term ventilation used during resuscitative efforts in emergent and out-of-hospital scenarios. However, compared to mechanical ventilation, manual ventilation is an operator-dependent skill that is less well controlled and is highly subject to providing inappropriate ventilation to the patient. This article first reviews recent manual ventilation guidelines set forth by the American Heart Association and European Resuscitation Council for providing appropriate manual ventilation parameters (e.g., tidal volume and respiratory rate) in different patient populations in the setting of cardiopulmonary resuscitation. There is then a brief review of clinical and manikin-based studies that demonstrate healthcare providers routinely hyperventilate patients during manual ventilation, particularly in emergent scenarios. A discussion of the possible mechanisms of injury that can occur during inappropriate manual hyperventilation follows, including adverse hemodynamic alterations and lung injury such as acute barotrauma, gastric regurgitation and aspiration, and the possibility of a subacute, inflammatory-driven lung injury. Together, these injurious processes are described as manual-ventilation-induced lung injury (MVILI). This review concludes with a discussion that highlights recent progress in techniques and technologies for minimizing manual hyperventilation and MVILI, with a particular emphasis on tidal-volume feedback devices. Full article

As important recreational spaces for urban residents, urban microgreen parks enhance the urban living environment and alleviate psychological pressure on residents. The visual, auditory, and olfactory senses are crucial forms of perception in human interaction with nature, and the sustainable perceptual design of miniature green parks under their interaction has become a recent research hotspot. This study aimed to investigate the effects of the visual, acoustic, and olfactory environments (e.g., aromatic green vegetation) on human perception in miniature green parks. Participants were evenly divided into eight groups, including single-sensory groups, multi-sensory interaction groups, and a control group. Eye-tracking technology, blood pressure monitoring, and the Semantic Differential (SD) scales and Profile of Mood State (POMS) were used to assess the effectiveness of physical and mental perception recovery in each group. The results revealed that in an urban microgreen space environment with relatively low ambient noise, visual–auditory, visual–olfactory, and visual–auditory–olfactory interactive stimuli were more effective in promoting the recovery of visual attention than single visual stimuli. Additionally, visual–auditory–olfactory interactive stimuli were able to optimize the quality of spatial perception by using positive sensory inputs to effectively mask negative experiences. Simultaneously, environments with a high proportion of natural sounds had the strongest stimuli, and in the visual–auditory group, systolic blood pressure at S7 and heart rate at S9 significantly decreased (p < 0.05), with reductions of 18.60 mmHg and 20.15 BPM, respectively. Aromatic olfactory sources were more effective in promoting physical and mental relaxation compared to other olfactory sources, with systolic blood pressure reductions of 24.40 mmHg (p < 0.01) for marigolds, 23.35 mmHg (p < 0.01) for small-leaved boxwood, and 27.25 mmHg (p < 0.05) for camphor trees. Specific auditory and olfactory conditions could guide visual focus, such as birdsong directing attention to trees, insect sounds drawing attention to herbaceous plants, floral scents attracting focus to flowers, and leaf scents prompting observation of a wider range of natural vegetation. In summary, significant differences exist between single-sensory experiences and multi-sensory modes of spatial perception and interaction in urban microgreen parks. Compared to a silent and odorless environment, the integration of acoustic and olfactory elements broadened the scope of visual attention, and In the visual–auditory–olfactory interactive perception, the combination of natural sounds and aromatic camphor tree scents had the best effect on attention recovery, thereby improving the quality of spatial perception in urban microgreen parks. Full article

No consensus exists on whether acute aerobic exercise alters the glomerular filtration rate in older adults. Objective: To assess the immediate effects of three aerobic exercise intensities on the estimated glomerular filtration rate (eGFR) in healthy, sedentary older adults. Methods: Eighteen healthy, sedentary older adults (ten men and eight women) voluntarily participated in this study. The participants underwent three standardized aerobic exercise tests (100%, 80%, and 60% of the maximal heart rate) on a bicycle ergometer. Blood samples were collected to determine cholesterol, triacylglycerols, glucose, serum creatinine (Cr), Cystatin C (CysC) concentrations, and eGFR. Results: eGFR and serum concentrations of Cr and CysC were not modified at any exercise intensity. There was a negative correlation between blood total cholesterol vs. eGFR (R = −0.512, R = −0.582, R = −0.531; p < 0.05) at rest, 60%, and 100% of the maximal heart rate, respectively. In addition, a negative correlation existed for age vs. eGFR at 60% of the maximal heart rate (R = −0.516; p < 0.05). Conclusions: Short-duration aerobic exercise of low, moderate, and vigorous intensity did not significantly affect eGFR and is considered safe for kidney function in healthy, sedentary older adults. However, regular monitoring of kidney function in older people engaged in moderate- and high-intensity exercise is advised. Full article

A new method based on the Recurrence Quantification Analysis (RQA) of the heart rate (HR) offers an objective, efficient alternative to traditional methods for Aerobic Threshold (AerT) identification that have practical limitations due to the complexity of equipment and interpretation. This study aims to validate the RQA-based method’s applicability across varied demographics, exercise protocols, and health status. Data from 123 cardiopulmonary exercise tests were analyzed, and participants were categorized into four groups: athletes, young athletes, obese individuals, and cardiac patients. Each participant’s AerT was assessed using both traditional ventilatory equivalent methods and the automatic RQA-based method. Ordinary Least Products (OLP) regression analysis revealed strong correlations (r > 0.77) between the RQA-based and traditional methods in both oxygen consumption (VO₂) and HR at the AerT. Mean percentage differences in HR were below 2.5%, and the Technical Error for HR at AerT was under 8%. The study validates the RQA-based method, directly applied to HR time series, as a reliable tool for the automatic detection of the AerT, demonstrating its accuracy across diverse age groups and fitness levels. These findings suggest a versatile, cost-effective, non-invasive, and objective tool for personalized exercise prescription and health risk stratification, thereby fulfilling the study’s goal of broadening the method’s applicability. Full article

The prolonged overstimulation of β-adrenergic receptors (β-ARs), a member of the G protein-coupled receptor (GPCR) family, causes abnormalities in the density and functionality of the receptor and contributes to cardiac dysfunctions, leading to the development and progression of heart diseases, especially heart failure (HF). Despite recent advancements in HF therapy, mortality and morbidity rates continue to be high. Treatment with β-AR antagonists (β-blockers) has improved clinical outcomes and reduced overall hospitalization and mortality rates. However, several barriers in the management of HF remain, providing opportunities to develop new strategies that focus on the functions and signal transduction of β-ARs involved in the pathogenesis of HF. As β-AR can signal through multiple pathways influenced by different receptor subtypes, expression levels, and signaling components such as G proteins, G protein-coupled receptor kinases (GRKs), β-arrestins, and downstream effectors, it presents a complex mechanism that could be targeted in HF management. In this narrative review, we focus on the regulation of β-ARs at the receptor, G protein, and effector loci, as well as their signal transductions in the physiology and pathophysiology of the heart. The discovery of potential ligands for β-AR that activate cardioprotective pathways while limiting off-target signaling is promising for the treatment of HF. However, applying findings from preclinical animal models to human patients faces several challenges, including species differences, the genetic variability of β-ARs, and the complexity and heterogeneity of humans. In this review, we also summarize recent updates and future research on the regulation of β-ARs in the molecular basis of HF and highlight potential therapeutic strategies for HF. Full article

Maintaining a high level of physical activity provides significant health benefits for children, particularly in enhancing cardiorespiratory fitness and maintaining a healthy weight. This study aimed to investigate the impact of weight status on children’s hemodynamic parameters and aerobic fitness levels. This cross-sectional study included 350 rural primary school children (146 boys and 204 girls) aged 11–13 years, randomly selected from two schools in the King Cetshwayo District, KwaDlangezwa area of KwaZulu-Natal. The anthropometric measurements recorded included height, weight, waist circumference, and hip circumference, with percentiles calculated using Cole’s Lambda, Mu, and Sigma method. Additionally, skinfold measurements were obtained at four sites (biceps, triceps, subscapular, and suprailiac). Hemodynamic measurements included systolic blood pressure, diastolic blood pressure, and heart rate. Aerobic fitness was assessed using the 20 m shuttle run test, which evaluated speed, level, and age. The healthy group demonstrated significantly lower ratios in several measurements compared to those of the overweight group, i.e., the VO₂max was 6% higher (<0.001), the waist-to-hip ratio was 6% lower (<0.001), the body fat percentage was 16% lower (<0.001), the waist circumference was 12% lower (<0.001), and the resting heart rate was 3% lower (p ≤ 0.055). Differences in systolic and diastolic blood pressure were also observed, with the systolic pressure 2% lower (p ≤ 0.116) and the diastolic pressure 3% lower (p ≤ 0.086) in the healthy group. The study revealed a significant association between body weight status, aerobic fitness, and blood pressure parameters. Conducted in rural primary schools in KwaDlangezwa, KwaZulu-Natal, the research highlights notable correlations among weight status, aerobic competence, and blood pressure (BP) in children aged 11 to 13 years. The findings indicate that children with a healthy body weight showed higher VO₂max levels and a reduced risk of developing childhood obesity and hypertension, unlike their overweight or obese peers, who displayed lower aerobic fitness and higher blood pressure. Full article

Benzodiazepines, a significant group of newly recognised water contaminants, are psychotropic medications prescribed for common anxiety symptoms and sleep disorders. They resist efficient degradation during sewage treatment and endure in aquatic environments. Their presence in aquatic matrices is increasing, particularly after the recent pandemic period, which has led many people to systematically use benzodiazepines to manage anxiety. In previous studies, an important interference of this class of drugs on both the larval and adult stages of some aquatic species has been demonstrated, with effects on behaviour and embryonic development. This study examined the influence of delorazepam, a diazepam metabolite, on Artemia salina development to gain insight into responses in naupliar larvae. Results demonstrated that treatments (1, 5, and 10 µg/L) increase the hatching percentage and induce a desynchronisation in growth. Mortality was only slightly increased (close to 10% at six days post-hatching), but lipid reserve consumption was modified, with the persistence of lipid globules at the advanced naupliar stages. Locomotory activity significantly decreased only at 10 µg/L treatment. No teratogenic effects were observed, though modest damages were noticed in the posterior trunk and eyes, two targets of environmental toxicity. The negative impact of delorazepam on Artemia salina adds to those already reported in other species of invertebrates and vertebrates, which are not yet considered targets of these drugs. This study underscores the need for further research and immediate attention to this class of contaminants and the importance of monitoring their presence during environmental risk assessments. Full article

Background: Multimorbidity, polypharmacy, and inappropriate prescribing are significant challenges in the geriatric population. Tools such as the Beers List, FORTA, and STOPP/START criteria have been developed to identify potentially inappropriate prescribing (PIP). STOPP/START criteria detect both potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs). The latest, third version of STOPP/START criteria expands the tool, based on the growing literature. The study aimed to evaluate the prevalence of PIP and the number of PIP per person identified by STOPP/START version 3 and to compare it to the previous version. Methods: This retrospective, cross-sectional study enrolled one hundred geriatric patients with polypharmacy from two day-care centers for partially dependent people in Poland. Collected data included demographic and medical data. STOPP/START version 3 was used to identify potentially inappropriate prescribing, whereas the previous version served as a reference. Results: STOPP version 3 detected at least one PIM in 73% of the study group, a significantly higher result than that for version 2 (56%). STOPP version 3 identified more PIMs per person than the previous version. Similarly, START version 3 had a significantly higher prevalence of PPOs (74% vs. 57%) and a higher number of PPOs per person than the previous version. The newly formed STOPP criteria with high prevalence were those regarding NSAIDs, including aspirin in cardiovascular indications. Frequent PPOs regarding newly formed START criteria were the lack of osmotic laxatives for chronic constipation, the lack of mineralocorticoid receptor antagonists, and SGLT-2 inhibitors in heart failure. Conclusions: This study showed the high effectiveness of the STOPP/START version 3 criteria in identifying potentially inappropriate prescribing, with a higher detection rate than version 2. Full article

Heat stress resulting from global climate change has been demonstrated to adversely affect growth, development, and reproduction of marine organisms. The Zhikong scallop (Chlamys farreri), an important economical mollusk in China, faces increasing risks of summer mortality due to the prolonged heat waves. The heart, responsible for transporting gas and nutrients, is vital in maintaining homeostasis and physiological status in response to environmental changes. In this study, the effect of heat stress on the cardiac function of C. farreri was investigated during the continuous 30-day heat stress at 27 °C. The results showed the heart rate of scallops increased due to stress in the initial phase of high temperature exposure, peaking at 12 h, and then gradually recovered, indicating an acclimatization at the end of the experiment. In addition, the levels of catalase (CAT), superoxide dismutase (SOD), and total antioxidant capacity (T-AOC) exhibited an initial increase followed by recovery in response to heat stress. Furthermore, transcriptome analysis of the heart identified 3541 differentially expressed genes (DEGs) in response to heat stress. Subsequent GO and KEGG enrichment analysis showed that these genes were primarily related to signal transduction and oxidative stress, such as the phosphatidylinositol signaling system, regulation of actin cytoskeleton, MAPK signaling pathway, FoxO signaling pathway, etc. In addition, two modules were identified as significant responsive modules according to the weighted gene co-expression network analysis (WGCNA). The upregulation of key enzymes within the base excision repair and gap junction pathways indicated that the heart of C. farreri under heat stress enhanced DNA repair and maintained cellular integrity. In addition, the variable expression of essential signaling molecules and cytoskeletal regulators suggested that the heart of C. farreri modulated cardiomyocyte contraction, intracellular signaling, and heart rate through complex regulation of phosphorylation and calcium dynamics in response to heat stress. Collectively, this study enhances our understanding of cardiac function and provides novel evidence for unraveling the mechanism underlying the thermal response in mollusks. Full article

Objective: Research about the impact of acute stress on inhibitory control remains a contentious topic, with no consensus reached thus far. This study aims to investigate the effects of acute stress on an individual’s inhibitory control abilities and to elucidate the underlying neural mechanisms by analyzing resting state electroencephalogram (EEG) data. Methods: We recruited 32 male college students through participant recruitment information to undergo within-subject experiments under stress and non-stress conditions. Physiological indicators (cortisol and heart rate), self-report questionnaires, and behavioral data from the Stroop task were collected before, during, and after the experiment. Additionally, a five-minute eyes closed resting state EEG data collection was conducted during the Stroop task before. Results: (1) Acute stress led to a reduction in the conflict effect during the participants’ Stroop task in individuals. (2) Stress resulted in an increase in the power of the beta in the resting state EEG. (3) Acute stress caused an increase in the duration of class D and an increase in the transition probabilities from classes C and B to class D in the microstates of the resting state EEG. (4) Acute stress leads to an increase in beta power values in individuals’ resting state EEGs, which is significantly negatively correlated with the reduction of the conflict effect in the Stroop task under stress. Conclusions: Acute stress can enhance individuals’ attentional level, thereby promoting inhibitory control performance. Full article