Developing the Effective Method of Spectral Harmonic Energy Ratio to Analyze the Arterial Pulse Spectrum

In this article, we analyze the arterial pulse in the spectral domain. A parameter, the spectral harmonic energy ratio (SHER), is developed to assess the features of the overly decreased spectral energy in the fourth to sixth harmonic for palpitation patients. Compared with normal subjects, the statistical results reveal that the mean value of SHER in the patient group (57.7 ± 27.9) is significantly higher than that of the normal group (39.7 ± 20.9) (P-value = .0066 < .01). This means that the total energy in the fourth to sixth harmonic of palpitation patients is significantly less than it is in normal subjects. In other words, the spectral distribution of the arterial pulse gradually decreases for normal subjects while it decreases abruptly in higher-order harmonics (the fourth, fifth and sixth harmonics) for palpitation patients. Hence, SHER is an effective method to distinguish the two groups in the spectral domain. Also, we can thus know that a “gradual decrease” might mean a “balanced” state, whereas an “abrupt decrease” might mean an “unbalanced” state in blood circulation and pulse diagnosis. By SHER, we can determine the ratio of energy distribution in different harmonic bands, and this method gives us a novel viewpoint from which to comprehend and quantify the spectral harmonic distribution of circulation information conveyed by the arterial pulse. These concepts can be further applied to improve the clinical diagnosis not only in Western medicine but also in traditional Chinese medicine (TCM)

Radial Pressure Pulse and Heart Rate Variability in Heat- and Cold-Stressed Humans

This study aims to explore the effects of heat and cold stress on the radial pressure pulse (RPP) and heart rate variability (HRV). The subjects immersed their left hand into 45°C and 7°C water for 2 minutes. Sixty healthy subjects (age 25 ± 4 yr; 29 men and 31 women) were enrolled in this study. All subjects underwent the supine temperature measurements of the bilateral forearms, brachial arterial blood pressure, HRV and RPP with a pulse analyzer in normothermic conditions, and thermal stresses. The power spectral low-frequency (LF) and high-frequency (HF) components of HRV decreased in the heat test and increased in the cold test. The heat stress significantly reduced radial augmentation index (AIr) (P < .05), but the cold stress significantly increased AIr (P < .01). The spectral energy of RPP did not show any statistical difference in 0 ~ 10 Hz region under both conditions, but in the region of 10 ~ 50 Hz, there was a significant increase (P < .01) in the heat test and a significant decrease in the cold test (P < .01). The changes in AIr induced by heat and cold stress were significantly negatively correlated with the spectral energy in the region of 10 ~ 50 Hz (SE10−50 Hz) but not in the region of 0 ~ 10 Hz (SE0−10 Hz). The results demonstrated that the SE10−50 Hz, which only possessed a small percentage in total pulse energy, presented more physiological characteristics than the SE0−10 Hz under the thermal stresses

Using the computer-based feedback (CBF) system to investigate the juniorphysicians’s and clinical-instructors perceptions for the benefits of general medicine clinical-instructors training program

Background: The purpose of this study is to examine the clinical-instructors and junior-physicians (residents and interns) perceptions for the general-medicine training program by using bi-directional interactive and self-assessments computer-based feedback (CBF) and paper-based multisource feedback assessment (PBMFA) systems for the efficiency and benefit evaluation.Methods: Between 2011 January to 2013 December, junior-physicians and their clinical-instructors in the same medical team were enrolled consecutively for monitoring the CBF scores gave by each other after each clinical course. A total of 321 residents, 298 interns and 110 clinical-instructors who participated in the core competency general-medicine training program in 6-months period were included in the study. The CBF and PBMFA evaluations are undergone paralleled to gather the suggested information in different levels of Kirkpatrick evolutional theory.Results: The results showed that lecturers, being 5-10 years as attending physicians, internal medicine sub-specialty clinical-instructors are most benefit from the general medicine training program. Accordingly, the CBF scores of junior-physicians was positively correlated with the times (&gt; 3-times) of exposure to the medical teams that leaded by qualified clinical-instructors. Both clinical-instructors and junior-physicians have positive attitude to the value of the general-medicine training program. Interestingly, a good consistency was existed between residents CBF scores and PBMFA grades for their core-competency performance. Comparatively, the overall perception of clinical-instructors and junior-physicians for the general-medicine training was very positive.Conclusions: Clinical-instructors and junior-physicians had positive perception of CBF and PBMFA systems which could give us different information to improve and strength the further core-competency general-medicine training program by appropriate utilization