Assessment Of Blood Pressure Regulatory Controls To Detect Hypovolemia And Orthostatic Intolerance

Regulation of blood pressure is vital for maintaining organ perfusion and homeostasis. A significant decline in arterial blood pressure could lead to fainting and hypovolemic shock. In contrast to young and healthy, people with impaired autonomic control due to aging or disease find regulating blood pressure rather demanding during orthostatic challenge. This thesis performed an assessment of blood pressure regulatory controls during orthostatic challenge via traditional as well as novel approaches with two distinct applications 1) to design a robust automated system for early identification of hypovolemia and 2) to assess orthostatic tolerance in humans. In chapter 3, moderate intensity hemorrhage was simulated via lower-body negative pressure (LBNP) with an aim to identify moderate intensity hemorrhage (-30 and -40 mmHg LBNP) from resting baseline. Utilizing features extracted from common vital sign monitors, a classification accuracy of 82% and 91% was achieved for differentiating -30 and -40 mmHg LBNP, respectively from baseline. In chapter 4, cause-and-effect relationship between the representative signals of the cardiovascular and postural systems to ascertain blood pressure homeostasis during standing was performed. The degree of causal interaction between the two systems, studied via convergent cross mapping (CCM), showcased the existence of a significant bi-directional interaction between the representative signals of two systems to regulate blood pressure. Therefore, the two systems should be accounted for jointly when addressing physiology behind fall. Further, in chapter 5, the potential of artificial gravity (2-g) induced via short-arm human centrifuge at feet towards evoking blood pressure regulatory controls analogous to standing was investigated. The observation of no difference in the blood pressure regulatory controls, during 2-g centrifugation compared to standing, strongly supported the hypothesis of artificial hypergravity for mitigating cardiovascular deconditioning, hence minimizing post-flight orthostatic intolerance

Inferring a causal relationship between environmental factors and respiratory infections using convergent cross-mapping

The incidence of respiratory infections in the population is related to many factors, among which environmental factors such as air quality, temperature, and humidity have attracted much attention. In particular, air pollution has caused widespread discomfort and concern in developing countries. Although the correlation between respiratory infections and air pollution is well known, establishing causality between them remains elusive. In this study, by conducting theoretical analysis, we updated the procedure of performing the extended convergent cross-mapping (CCM, a method of causal inference) to infer the causality between periodic variables. Consistently, we validated this new procedure on the synthetic data generated by a mathematical model. For real data in Shaanxi province of China in the period of 1 January 2010 to 15 November 2016, we first confirmed that the refined method is applicable by investigating the periodicity of influenza-like illness cases, an air quality index, temperature, and humidity through wavelet analysis. We next illustrated that air quality (quantified by AQI), temperature, and humidity affect the daily influenza-like illness cases, and, in particular, the respiratory infection cases increased progressively with increased AQI with a time delay of 11 days

Significant Role of the Cardiopostural Interaction in Blood Pressure Regulation During Standing

Cardiovascular and postural control systems have been studied independently despite the increasing evidence showing the importance of cardio-postural interaction in blood pressure regulation. In this study, we aimed to assess the role of cardio-postural interaction in relation to cardiac baroreflex in blood pressure regulation under orthostatic stress before and after mild exercise. Physiological variables representing cardiovascular control (heart rate and systolic blood pressure), lower limb muscle activation (electromyography), and postural sway (center of pressure derived from force and moment data during sway) were measured from 17 healthy participants (25±2 years; 8 females) during a sit-to stand test before and after sub-maximal exercise. The cardio-postural control (characterized by baroreflex-mediated muscle-pump effect in response to blood pressure changes, i.e., muscle-pump baroreflex) was assessed using wavelet transform coherence and causality analyses in relation to the baroreflex control of heart rate. Significant cardio-postural blood pressure control was evident counting for almost half of the interaction time with blood pressure changes that observed in the cardiac baroreflex (36.6-72.5% pre-exercise and 34.7-53.9% post-exercise). Thus, cardio-postural input to blood pressure regulation should be considered when investigating orthostatic intolerance. A reduction of both cardiac and muscle-pump baroreflexes in blood pressure regulation was observed post-exercise and was likely due to the absence of excessive venous pooling and a less stressed system after mild exercise. With further studies using more effective protocols evoking venous pooling and muscle-pump activity, the cardio-postural interaction could improve our understanding of the autonomic control system and ultimately lead to a more accurate diagnosis of cardio-postural dysfunctions

Bibliometric Perspectives on Medical Innovation using the Medical Subject Headings (MeSH) of PubMed

Multiple perspectives on the nonlinear processes of medical innovations can be distinguished and combined using the Medical Subject Headings (MeSH) of the Medline database. Focusing on three main branches-"diseases," "drugs and chemicals," and "techniques and equipment"-we use base maps and overlay techniques to investigate the translations and interactions and thus to gain a bibliometric perspective on the dynamics of medical innovations. To this end, we first analyze the Medline database, the MeSH index tree, and the various options for a static mapping from different perspectives and at different levels of aggregation. Following a specific innovation (RNA interference) over time, the notion of a trajectory which leaves a signature in the database is elaborated. Can the detailed index terms describing the dynamics of research be used to predict the diffusion dynamics of research results? Possibilities are specified for further integration between the Medline database, on the one hand, and the Science Citation Index and Scopus (containing citation information), on the other.Comment: forthcoming in the Journal of the American Society for Information Science and Technolog

Aerospace Medicine and Biology: A continuing bibliography with indexes, supplement 144

This bibliography lists 257 reports, articles, and other documents introduced into the NASA scientific and technical information system in July 1975

Directional coupling detection through cross-distance vectors

Inferring the coupling direction from measured time series of complex systems is challenging. We propose a new state space based causality measure obtained from cross-distance vectors for quantifying interaction strength. It is a model-free noise-robust approach that requires only a few parameters. The approach is applicable to bivariate time series and is resilient to artefacts and missing values. The result is two coupling indices that quantify coupling strength in each direction more accurately than the already established state space measures. We test the proposed method on different dynamical systems and analyse numerical stability. As a result, a procedure for optimal parameter selection is proposed, circumventing the challenge of determining the optimal embedding parameters. We show it is robust to noise and reliable in shorter time series. Moreover, we show that it can detect cardiorespiratory interaction in measured data. A numerically efficient implementation is available at https://repo.ijs.si/mbresar/cd-vec

A mathematical model for breath gas analysis of volatile organic compounds with special emphasis on acetone

Recommended standardized procedures for determining exhaled lower respiratory nitric oxide and nasal nitric oxide have been developed by task forces of the European Respiratory Society and the American Thoracic Society. These recommendations have paved the way for the measurement of nitric oxide to become a diagnostic tool for specific clinical applications. It would be desirable to develop similar guidelines for the sampling of other trace gases in exhaled breath, especially volatile organic compounds (VOCs) which reflect ongoing metabolism. The concentrations of water-soluble, blood-borne substances in exhaled breath are influenced by: (i) breathing patterns affecting gas exchange in the conducting airways; (ii) the concentrations in the tracheo-bronchial lining fluid; (iii) the alveolar and systemic concentrations of the compound. The classical Farhi equation takes only the alveolar concentrations into account. Real-time measurements of acetone in end-tidal breath under an ergometer challenge show characteristics which cannot be explained within the Farhi setting. Here we develop a compartment model that reliably captures these profiles and is capable of relating breath to the systemic concentrations of acetone. By comparison with experimental data it is inferred that the major part of variability in breath acetone concentrations (e.g., in response to moderate exercise or altered breathing patterns) can be attributed to airway gas exchange, with minimal changes of the underlying blood and tissue concentrations. Moreover, it is deduced that measured end-tidal breath concentrations of acetone determined during resting conditions and free breathing will be rather poor indicators for endogenous levels. Particularly, the current formulation includes the classical Farhi and the Scheid series inhomogeneity model as special limiting cases.Comment: 38 page

COGNITIVE REAPPRAISAL MODERATES THE QUADRATIC ASSOCIATION BETWEEN HEART RATE VARIABILITY AND NEGATIVE AFFECTIVITY

There is uncertainty as to how heart rate variability (HRV), an index of flexible physiological reactivity, relates to an individual’s tendency to experience negative emotions. Research suggests that high and low HRV may reflect maladaptive physiological processes associated with negative affectivity and that association may depend on an individual’s use of emotion regulation strategies, such as cognitive reappraisal. The current study examined the moderating role of cognitive reappraisal in the quadratic association between HRV and negative affectivity. Electrocardiograms were recorded at rest for 269 young adults who then completed self-report rating scales assessing trait negative affectivity and trait cognitive reappraisal. As predicted, high and low HRV were associated with high negative affectivity at low levels of cognitive reappraisal. These results suggest that, contrary to traditional views, high HRV may not be an adaptive characteristic in the context of low trait reappraisal