A study of poststenotic shear layer instabilities

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Aerobic Exercise during Pregnancy and Presence of Fetal-Maternal Heart Rate Synchronization

It has been shown that short-term direct interaction between maternal and fetal heart rates may take place and that this interaction is affected by the rate of maternal respiration. The aim of this study was to determine the effect of maternal aerobic exercise during pregnancy on the occurrence of fetal-maternal heart rate synchronization.In 40 pregnant women at the 36th week of gestation, 21 of whom exercised regularly, we acquired 18 min. RR interval time series obtained simultaneously in the mothers and their fetuses from magnetocardiographic recordings. The time series of the two groups were examined with respect to their heart rate variability, the maternal respiratory rate and the presence of synchronization epochs as determined on the basis of synchrograms. Surrogate data were used to assess whether the occurrence of synchronization was due to chance.In the original data, we found synchronization occurred less often in pregnancies in which the mothers had exercised regularly. These subjects also displayed higher combined fetal-maternal heart rate variability and lower maternal respiratory rates. Analysis of the surrogate data showed shorter epochs of synchronization and a lack of the phase coordination found between maternal and fetal beat timing in the original data.The results suggest that fetal-maternal heart rate coupling is present but generally weak. Maternal exercise has a damping effect on its occurrence, most likely due to an increase in beat-to-beat differences, higher vagal tone and slower breathing rates

The calming effect of a new wearable device during the anticipation of public speech

We assessed the calming effect of doppel, a wearable device that delivers heartbeat-like tactile stimulation on the wrist. We tested whether the use of doppel would have a calming effect on physiological arousal and subjective reports of state anxiety during the anticipation of public speech, a validated experimental task that is known to induce anxiety. Two groups of participants were tested in a single-blind design. Both groups wore the device on their wrist during the anticipation of public speech, and were given the cover story that the device was measuring blood pressure. For only one group, the device was turned on and delivered a slow heartbeat-like vibration. Participants in the doppel active condition displayed lower increases in skin conductance responses relative to baseline and reported lower anxiety levels compared to the control group. Therefore, the presence, as opposed to its absence, of a slow rhythm, which in the present study was instantiated as an auxiliary slow heartbeat delivered through doppel, had a significant calming effect on physiological arousal and subjective experience during a socially stressful situation. This finding is discussed in relation to past research on responses and entrainment to rhythms, and their effects on arousal and mood

Evidence and clinical relevance of maternal-fetal cardiac coupling:A scoping review

BACKGROUND: Researchers have long suspected a mutual interaction between maternal and fetal heart rhythms, referred to as maternal-fetal cardiac coupling (MFCC). While several studies have been published on this phenomenon, they vary in terms of methodologies, populations assessed, and definitions of coupling. Moreover, a clear discussion of the potential clinical implications is often lacking. Subsequently, we perform a scoping review to map the current state of the research in this field and, by doing so, form a foundation for future clinically oriented research on this topic.METHODS: A literature search was performed in PubMed, Embase, and Cochrane. Filters were only set for language (English, Dutch, and German literature were included) and not for year of publication. After screening for the title and the abstract, a full-text evaluation of eligibility followed. All studies on MFCC were included which described coupling between heart rate measurements in both the mother and fetus, regardless of the coupling method used, gestational age, or the maternal or fetal health condition.RESULTS: 23 studies remained after a systematic evaluation of 6,672 studies. Of these, 21 studies found at least occasional instances of MFCC. Methods used to capture MFCC are synchrograms and corresponding phase coherence indices, cross-correlation, joint symbolic dynamics, transfer entropy, bivariate phase rectified signal averaging, and deep coherence. Physiological pathways regulating MFCC are suggested to exist either via the autonomic nervous system or due to the vibroacoustic effect, though neither of these suggested pathways has been verified. The strength and direction of MFCC are found to change with gestational age and with the rate of maternal breathing, while also being further altered in fetuses with cardiac abnormalities and during labor.CONCLUSION: From the synthesis of the available literature on MFCC presented in this scoping review, it seems evident that MFCC does indeed exist and may have clinical relevance in tracking fetal well-being and development during pregnancy.</p

Injection locking of quantum-dot microlasers operating in the few-photon regime

The research leading to these results has received funding from the European Research Council under the European Union's Seventh Framework ERC Grant Agreement No. 615613 and from the German Research Foundation via CRC 787.We experimentally and theoretically investigate injection locking of quantum dot (QD) microlasers in the regime of cavity quantum electrodynamics (CQED). We observe frequency locking and phase-locking where cavity-enhanced spontaneous emission enables simultaneous stable oscillation at the master frequency and at the solitary frequency of the slave microlaser. Measurements of the second-order autocorrelation function prove this simultaneous presence of both master and slave-like emission, where the former has coherent character with g(2)(0) = 1 while the latter one has thermal character with g(2)(0) = 2. Semiclassical rate equations explain this peculiar behavior by cavity enhanced spontaneous emission and a low number of photons in the laser mode.PostprintPeer reviewe

New perspectives in catheter ablation for atrial fibrillation Towards a better treatment to reach better outcomes

The overall aim of the studies presented in this thesis is to elucidate whether there is still room for improvement in the field of catheter ablation for AF either paroxysmal and persistent, and the following chapters will guide the reader in a virtual path that addresses this issue

Power velocity integral technique for quantification of flow in valvular heart disease

Thesis (S.B. and M.Eng.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science, 2000.Includes bibliographical references (leaves 147-150) and indexes.This electronic version was submitted by the student author. The certified thesis is available in the Institute Archives and Special Collections.The noninvasive quantification of pathologic backflow, often referred to as regurgitant flow, associated with valvular heart disease has been an elusive medical goal. To date, techniques based on ultrasound have been unsatisfactory due to weak assumptions and indirect estimations. Here, instead, the proposal is to estimate regurgitant flow directly from the Doppler spectrum of the backscattered ultrasound . As backscattered spectral power is hypothesized to be proportional to the sonified blood volume, and spectral frequency is directly related to velocity of flow, the product of power and velocity should be proportional to flow. However, researchers have long assumed the above principles held only for laminar flow, and not for regurgitant jets in which turbulence augments backscatter. Yet as will be demonstrated, the challenge can be surmounted by analyzing the Doppler spectrum at the origin of the regurgitant jet, where flow is laminar since turbulence has not yet developed. Development of a software system that incorporates the theories expounded above, problems encountered using implementation, and their eventual resolution will presently ensue. In the system, power measurements were also calibrated by applying a dual-beam technique, providing absolute values of flow volume. Also presented are in vitro and in vivo data that demonstrate a high degree of accuracy between true flow volume and flow volume measured by the calibratedinte gral of Doppler power times velocity over time (PVTI). Such measurement of turbulent flow volumes directly and noninvasively is unprecedented and overcomes the limitations of current techniques.by Shawn M. Hwang.S.B.and M.Eng

Towards respiratory muscle-protective mechanical ventilation in the critically ill: technology to monitor and assist physiology

Inadequate delivery of ventilatory assist and unphysiological respiratory drive may severely worsen respiratory muscle function in mechanically ventilated critically ill patients. Diaphragm weakness in these patients is exceedingly common (>60% of patients) and associated with poor clinical outcomes, including difficult ventilator liberation, increased risks of intensive care unit (ICU) and hospital readmission, and mortality. The underlying mechanisms of diaphragm dysfunction were extensively discussed in this thesis. Pathways primarily include the development of diaphragm disuse atrophy due to muscle inactivity or low respiratory drive (strong clinical evidence), and diaphragm injury as a result of excessive breathing effort due to insufficient ventilator assist or excessive respiratory drive (moderate evidence, mostly from experimental work). Excessive breathing effort may also worsen lung injury through pathways that include high lung stress and strain, pendelluft, increased lung perfusion, and patient-ventilator dyssynchrony. Relatively little attention has been paid to the effects of critical illness and mechanical ventilation on the expiratory muscles; however, dysfunction of these muscles has been linked to inadequate central airway clearance and extubation failure. The motivation for performing the work presented in this thesis was the hypothesis that maintaining physiological levels of respiratory muscle activity under mechanical ventilation could prevent or attenuate the development respiratory muscle weakness, and hence, improve patient outcomes. This strategy, integrated with lung-protective ventilation, was recently proposed by international experts from different professional societies (this thesis), and is referred to as a combined lung and diaphragm-protective ventilation approach. Today, an important barrier for implementing and evaluating such an approach is the lack of feasible, reliable and well-understood modalities to assess breathing effort at the bedside, as well as strategies for assisting and restoring respiratory muscle function during mechanical ventilation. Furthermore, monitoring breathing effort is crucial to identify potential relationships between patient management and detrimental respiratory (muscle) function that can be targeted to improve clinical outcomes. In this thesis we identified and improved monitoring modalities for the diaphragm (Part I), we investigated the impact of mechanical ventilation on the respiratory pump, especially the diaphragm (Part II), and we evaluated a novel strategy for maintaining expiratory muscle activity under mechanical ventilation (Part III)