Changes in heart rate variability and QT variability during the first trimester of pregnancy

The risk of new-onset arrhythmia during pregnancy is high, presumably relating to changes in both haemodynamic and cardiac autonomic function. The ability to non-invasively assess an individual's risk of developing arrhythmia during pregnancy would therefore be clinically significant. We aimed to quantify electrocardiographic temporal characteristics during the first trimester of pregnancy and to compare these with non-pregnant controls.Ninety-nine pregnant women and sixty-three non-pregnant women underwent non-invasive cardiovascular and haemodynamic assessment during a protocol consisting of various physiological states (postural manoeurvres, light exercise and metronomic breathing). Variables measured included stroke volume, cardiac output, heart rate, heart rate variability, QT and QT variability and QTVI (a measure of the variability of QT relative to that of RR).Heart rate (p < 0.0005, p < 0.0005, p < 0.0005) and cardiac output (p = 0.043, p < 0.0005, p < 0.0005) were greater in pregnant women in all physiological states (respectively for the supine position, light exercise and metronomic breathing state), whilst stroke volume was lower in pregnancy only during the supine position (p < 0.0005). QTe (Q wave onset to T wave end) and QTa (T wave apex) were significantly shortened (p < 0.05) and QTeVI and QTaVI were increased in pregnancy in all physiological states (p < 0.0005). QT variability (p < 0.002) was greater in pregnant women during the supine position, whilst heart rate variability was reduced in pregnancy in all states (p < 0.0005).Early pregnancy is associated with substantial changes in heart rate variability, reflecting a reduction in parasympathetic tone and an increase in sympathetic activity. QTVI shifted to a less favourable value, reflecting a greater than normal amount of QT variability. QTVI appears to be a useful method for quantifying changes in QT variability relative to RR (or heart rate) variability, being sensitive not only to physiological state but also to gestational age. We support the use of non-invasive markers of cardiac electrical variability to evaluate the risk of arrhythmic events in pregnancy, and we recommend the use of multiple physiological states during the assessment protocol

Proving Safety with Trace Automata and Bounded Model Checking

Loop under-approximation is a technique that enriches C programs with additional branches that represent the effect of a (limited) range of loop iterations. While this technique can speed up the detection of bugs significantly, it introduces redundant execution traces which may complicate the verification of the program. This holds particularly true for verification tools based on Bounded Model Checking, which incorporate simplistic heuristics to determine whether all feasible iterations of a loop have been considered. We present a technique that uses \emph{trace automata} to eliminate redundant executions after performing loop acceleration. The method reduces the diameter of the program under analysis, which is in certain cases sufficient to allow a safety proof using Bounded Model Checking. Our transformation is precise---it does not introduce false positives, nor does it mask any errors. We have implemented the analysis as a source-to-source transformation, and present experimental results showing the applicability of the technique

Lifting CDCL to template-based abstract domains for program verification

The success of Conflict Driven Clause Learning (CDCL) for Boolean satisfiability has inspired adoption in other domains. We present a novel lifting of CDCL to program analysis called Abstract Conflict Driven Learning for Programs (ACDLP). ACDLP alternates between model search, which performs over-approximate deduction with constraint propagation, and conflict analysis, which performs under-approximate abduction with heuristic choice. We instantiate the model search and conflict analysis algorithms with an abstract domain of template polyhedra, strictly generalizing CDCL from the Boolean lattice to a richer lattice structure. Our template polyhedra can express intervals, octagons and restricted polyhedral constraints over program variables. We have implemented ACDLP for automatic bounded safety verification of C programs. We evaluate the performance of our analyser by comparing with CBMC, which uses Boolean CDCL, and Astrée, a commercial abstract interpretation tool. We observe two orders of magnitude reduction in the number of decisions, propagations, and conflicts as well as a 1.5x speedup in runtime compared to CBMC. Compared to Astrée, ACDLP solves twice as many benchmarks and has much higher precision. This is the first instantiation of CDCL with a template polyhedra abstract domain

P wave indices, heart rate variability and anthropometry in a healthy South Asian population

Background: South Asians have a low prevalence of atrial fibrillation (AF) in comparison with White Europeans despite a higher burden of hypertension, diabetes mellitus and coronary artery disease. The reason for this disparity is unclear but may relate to electrophysiological or structural differences within the atria or variations in autonomic function. We aimed to assess these areas using a range of non-invasive cardiac investigations. Methods: A prospective cohort study was performed on 200 South Asian and 200 Caucasian healthy volunteers aged 18–40 years. All subjects underwent electrocardiography (ECG), echocardiography and anthropometric measurements. Eighty subjects in each cohort underwent 24 hour ambulatory ECG and fifty subjects in each cohort underwent exercise testing. Results: Compared with White Europeans, South Asians were of a smaller height with lower lean body mass and smaller left atrial size. They had reduced P wave dispersion and P wave terminal force in lead V1. South Asians had a lower burden of supraventricular ectopy. They had a higher mean heart rate and South Asian males had lower heart rate variability, suggestive of sympathetic predominance. Exercise capacity was lower in South Asians. Conclusions: South Asians have differences in left atrial size, P wave indices, burden of supraventricular ectopy, heart rate, heart rate variability and anthropometric measurements. These differences may relate to variations in atrial morphology, atrial electrophysiology and autonomic function and might help to explain why South Asians are less susceptible to developing AF

Abnormal ECG Findings in Athletes: Clinical Evaluation and Considerations.

PURPOSE OF REVIEW: Pre-participation cardiovascular evaluation with electrocardiography is normal practice for most sporting bodies. Awareness about sudden cardiac death in athletes and recognizing how screening can help identify vulnerable athletes have empowered different sporting disciplines to invest in the wellbeing of their athletes. RECENT FINDINGS: Discerning physiological electrical alterations due to athletic training from those representing cardiac pathology may be challenging. The mode of investigation of affected athletes is dependent on the electrical anomaly and the disease(s) in question. This review will highlight specific pathological ECG patterns that warrant assessment and surveillance, together with an in-depth review of the recommended algorithm for evaluation

Active region formation through the negative effective magnetic pressure instability

The negative effective magnetic pressure instability operates on scales encompassing many turbulent eddies and is here discussed in connection with the formation of active regions near the surface layers of the Sun. This instability is related to the negative contribution of turbulence to the mean magnetic pressure that causes the formation of large-scale magnetic structures. For an isothermal layer, direct numerical simulations and mean-field simulations of this phenomenon are shown to agree in many details in that their onset occurs at the same depth. This depth increases with increasing field strength, such that the maximum growth rate of this instability is independent of the field strength, provided the magnetic structures are fully contained within the domain. A linear stability analysis is shown to support this finding. The instability also leads to a redistribution of turbulent intensity and gas pressure that could provide direct observational signatures.Comment: 19 pages, 10 figures, submitted to Solar Physic

Building Better Bit-Blasting for Floating-Point Problems

An effective approach to handling the theory of floating-point is to reduce it to the theory of bit-vectors. Implementing the required encodings is complex, error prone and requires a deep understanding of floating-point hardware. This paper presents SymFPU, a library of encodings that can be included in solvers. It also includes a verification argument for its correctness, and experimental results showing that its use in CVC4 out-performs all previous tools. As well as a significantly improved performance and correctness, it is hoped this will give a simple route to add support for the theory of floating-point

Influence of antenatal physical exercise on haemodynamics in pregnant women: a flexible randomisation approach

Background: Normal pregnancy is associated with marked changes in haemodynamic function, however theinfluence and potential benefits of antenatal physical exercise at different stages of pregnancy and postpartumremain unclear. The aim of this study was therefore to characterise the influence of regular physical exercise onhaemodynamic variables at different stages of pregnancy and also in the postpartum period.Methods: Fifty healthy pregnant women were recruited and randomly assigned (2 × 2 × 2 design) to a land orwater-based exercise group or a control group. Exercising groups attended weekly classes from the 20th week ofpregnancy onwards. Haemodynamic assessments (heart rate, cardiac output, stroke volume, total peripheralresistance, systolic and diastolic blood pressure and end diastolic index) were performed using the Task Forcehaemodynamic monitor at 12–16, 26–28, 34–36 and 12 weeks following birth, during a protocol including posturalmanoeurvres (supine and standing) and light exercise.Results: In response to an acute bout of exercise in the postpartum period, stroke volume and end diastolic indexwere greater in the exercise group than the non-exercising control group (p = 0.041 and p = 0.028 respectively).Total peripheral resistance and diastolic blood pressure were also lower (p = 0.015 and p = 0.007, respectively) in theexercise group. Diastolic blood pressure was lower in the exercise group during the second trimester (p = 0.030).Conclusions: Antenatal exercise does not appear to substantially alter maternal physiology with advancinggestation, speculating that the already vast changes in maternal physiology mask the influences of antenatalexercise, however it does appear to result in an improvement in a woman’s haemodynamic function (enhancedventricular ejection performance and reduced blood pressure) following the end of pregnancy

The Magnetic Sun: Reversals and Long-Term Variations

A didactic introduction to current thinking on some aspects of the solar dynamo is given for geophysicists and planetary scientists.Comment: 17 pages, 9 figures; Space Science Rev., in pres

A Comparison of Solar Cycle Variations in the Equatorial Rotation Rates of the Sun's Subsurface, Surface, Corona, and Sunspot Groups

Using the Solar Optical Observing Network (SOON) sunspot-group data for the period 1985-2010, the variations in the annual mean equatorial-rotation rates of the sunspot groups are determined and compared with the known variations in the solar equatorial-rotation rates determined from the following data: i) the plasma rotation rates at 0.94Rsun, 0.95Rsun,...,1.0Rsun measured by Global Oscillation Network Group (GONG) during the period 1995-2010, ii) the data on the soft X-ray corona determined from Yohkoh/SXT full disk images for the years 1992-2001, iii) the data on small bright coronal structures (SBCS) which were traced in Solar and Heliospheric Observatory (SOHO)/EIT images during the period 1998-2006, and iv) the Mount Wilson Doppler-velocity measurements during the period 1986-2007. A large portion (up to approximate 30 deg latitude) of the mean differential-rotation profile of the sunspot groups lies between those of the internal differential-rotation rates at 0.94Rsun and 0.98Rsun.The variation in the yearly mean equatorial-rotation rate of the sunspot groups seems to be lagging that of the equatorial-rotation rate determined from the GONG measurements by one to two years.The amplitude of the latter is very small.The solar-cycle variation in the equatorial-rotation rate of the solar corona closely matches that determined from the sunspot-group data.The variation in the equatorial-rotation rate determined from the Mount Wilson Doppler-velocity data closely resembles the corresponding variation in the equatorial-rotation rate determined from the sunspot-group data that included the values of the abnormal angular motions (> 3 deg per day) of the sunspot groups. Implications of these results are pointed out.Comment: 22 pages, 10 figures, accepted by Solar Physic