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South Africans living in low socioeconomic areas have self-reported unusually long sleep durations (approximately 9-10 h). One hypothesis is that these long durations may be a compensatory response to poor sleep quality as a result of stressful environments. This study aimed to investigate whether fear of not being safe during sleep is associated with markers of sleep quality or duration in men and women. South Africans (n = 411, 25-50 y, 57% women) of African-origin living in an urban township, characterised by high crime and poverty rates, participated in this study. Participants are part of a larger longitudinal cohort study: Modelling the Epidemiologic Transition Study (METS)-Microbiome. Customised questions were used to assess the presence or absence of fears related to feeling safe during sleep, and the Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index were used to assess daytime sleepiness, sleep quality and insomnia symptom severity respectively. Adjusted logistic regression models indicated that participants who reported fears related to safety during sleep were more likely to report poor sleep quality (PSQI > 5) compared to participants not reporting such fears and that this relationship was stronger among men than women. This is one of the first studies outside American or European populations to suggest that poor quality sleep is associated with fear of personal safety in low-SES South African adults.
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Distúrbios do Início e da Manutenção do Sono , Masculino , Adulto , Humanos , Feminino , Autorrelato , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Estudos Longitudinais , Sono/fisiologia , Medo , Classe Social , Inquéritos e QuestionáriosRESUMO
There is a bidirectional relationship between poor sleep and both mood- and anxiety-related disorders, which are among leading global health concerns. Additionally, both disordered sleep and these psychiatric disorders appear to be independently associated with altered autonomic nervous system (ANS) function. We hypothesise that ANS dysregulation during sleep may explain part of the relationship between poor sleep and mood- and anxiety-related disorders. Heart rate variability (HRV) is a frequently used marker of ANS function and gives an indication of ANS input to the heart - in particular, of the relative contributions of sympathetic and parasympathetic activity. A systematic review of PubMed, Scopus and Web of Science yielded 41 studies dealing with sleep, mood- and anxiety-related disorders and sleep-related HRV. Hyperarousal during sleep, reflecting a predominance of sympathetic activation and indicative of ANS dysregulation, may be an important factor in the association between poor sleep and mood-related disorders. Longitudinal studies and mediation analyses are necessary to further understand the potential mediating role of ANS dysregulation on the relationship between poor sleep and mood- and anxiety-related disorders.
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Sistema Nervoso Autônomo , Distúrbios do Início e da Manutenção do Sono , Humanos , Frequência Cardíaca/fisiologia , Depressão , Sono/fisiologia , AnsiedadeRESUMO
INTRODUCTION: Abstaining from unwanted behaviors requires a sufficient balance between the executive and impulsive cognitive systems. Working memory (WM) is a vital component of both systems, identified in a wide range of research as the central and dominant component of executive function. WM potentially modulates the desires, tendencies, and behaviors specific to and seen in individuals with substance use disorder (SUD) and obesogenic eating (OE). Compared to healthy populations, research has shown individuals with SUD, as well as those who display OE, to have some degree of executive dysfunction, and both conditions have far-reaching health care implications. Additionally, these deficits are associated with impulsive behavior. Research has proposed that impulsive and so-called reward-driven responses could be altered through cognitive therapy and that both SUD and OE could benefit from working memory training (WMT). METHOD: In this narrative review, we systematically align extant empirical reasoning and evidence with these assumptions. Our main aim is to ascertain and summarize the value of WMT for the treatment of both SUD and food reward consummatory behaviors. As a means to include detailed narrative accounts of all papers of potential value, our thresholds for meaningful improvements in both WM and unwanted behaviors are broad. RESULTS: The results from the eleven qualifying studies are as follows: Nine of ten studies show a significant positive training effect of WMT on one or more components of WM capacity; three of six eligible papers (two on alcohol and one on opioid addiction) deliver notable improvements in SUD in response to WMT. One of two suitable studies showed WMT to be a moderately efficacious form of therapy for OE. Conversely, WMT appears to have negligible therapeutic benefit for cognitive function deficits or psychopathology unrelated to WM, suggesting that WMT has unique treatment efficacy for impulsive human behaviors. CONCLUSION: In conclusion, more rigorous and uniform studies on WMT and impulsive harmful behaviors are required to give proof of the benefits of this potential useful treatment.
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Memória de Curto Prazo , Transtornos Relacionados ao Uso de Substâncias , Cognição/fisiologia , Função Executiva , Humanos , Aprendizagem/fisiologia , Transtornos Relacionados ao Uso de Substâncias/terapiaRESUMO
OBJECTIVE: To describe the effect of robotic locomotor training (RLT) and activity-based training (ABT) on cardiovascular indices during various physiological positions in individuals with spinal cord injury. DESIGN: Randomized controlled pilot study. SETTING: Private practice: Therapy & Beyond Centre - Walking with Brandon Foundation, Sports Science Institute of South Africa, Cape Town, South Africa. PARTICIPANTS: Participants with chronic traumatic motor incomplete tetraplegia (N=16) who resided in the Western Cape, South Africa. INTERVENTION: Robotic locomotor training (Ekso GT) and activity-based training over a 24-week intervention. MAIN OUTCOME MEASURES: Brachial and ankle blood pressure, heart rate, heart rate variability, and cardiovascular efficiency during 4 physiological positions. RESULTS: No differences between groups or over time were evident in resting systolic and diastolic blood pressure, ankle systolic pressure, ankle brachial pressure index, and heart rate variability. Standing heart rate at 24 weeks was significantly higher in the ABT group (95.58±12.61 beats/min) compared with the RLT group (75.14±14.96 beats/min) (P=.05). In the RLT group, no significant changes in heart rate variability (standard deviation R-R interval and root mean square of successive differences) was found between the standing and 6-minute walk test physiological positions throughout the intervention. Cardiovascular efficiency in the RLT group during the 6-minute walk test improved from 11.1±2.6 at baseline to 7.5±2.8 beats per meter walked at 6 weeks and was maintained from 6 to 24 weeks. CONCLUSIONS: Large effect sizes and significant differences between groups found in this pilot study support the clinical effectiveness of RLT and ABT for changing cardiovascular indices as early as 6 weeks and up to 24 weeks of rehabilitation. RLT may be more effective than ABT in improving cardiac responses to orthostatic stress. Based on heart rate variability metrics, the stimulus of standing has comparable effects to RLT on the parasympathetic nervous system. Cardiovascular efficiency of exoskeleton walking improved, particularly over the first 6 weeks. Both the RLT and ABT interventions were limited in their effect on brachial and ankle blood pressure. A randomized controlled trial with a larger sample size is warranted to further examine these findings.
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Pressão Sanguínea/fisiologia , Terapia por Exercício/instrumentação , Exoesqueleto Energizado , Frequência Cardíaca/fisiologia , Robótica/instrumentação , Traumatismos da Medula Espinal/reabilitação , Adulto , Terapia por Exercício/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Posicionamento do Paciente , Projetos Piloto , Teste de CaminhadaRESUMO
The aim of this paper is to investigate the cardiorespiratory synchronization in athletes subjected to extreme physical stress combined with a cognitive stress tasks. ECG and respiration were measured in 14 athletes before and after the Ironman competition. Stroop test was applied between the measurements before and after the Ironman competition to induce cognitive stress. Synchrogram and empirical mode decomposition analysis were used for the first time to investigate the effects of physical stress, induced by the Ironman competition, on the phase synchronization of the cardiac and respiratory systems of Ironman athletes before and after the competition. A cognitive stress task (Stroop test) was performed both pre- and post-Ironman event in order to prevent the athletes from cognitively controlling their breathing rates. Our analysis showed that cardiorespiratory synchronization increased post-Ironman race compared to pre-Ironman. The results suggest that the amount of stress the athletes are recovering from post-competition is greater than the effects of the Stroop test. This indicates that the recovery phase after the competition is more important for restoring and maintaining homeostasis, which could be another reason for stronger synchronization.
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Soil and water bioengineering is a technology that encourages scientists and practitioners to combine their knowledge and skills in the management of ecosystems with a common goal to maximize benefits to both man and the natural environment. It involves techniques that use plants as living building materials, for: (i) natural hazard control (e.g., soil erosion, torrential floods and landslides) and (ii) ecological restoration or nature-based re-introduction of species on degraded lands, river embankments, and disturbed environments. For a bioengineering project to be successful, engineers are required to highlight all the potential benefits and ecosystem services by documenting the technical, ecological, economic and social values. The novel approaches used by bioengineers raise questions for researchers and necessitate innovation from practitioners to design bioengineering concepts and techniques. Our objective in this paper, therefore, is to highlight the practice and research needs in soil and water bioengineering for reconciling natural hazard control and ecological restoration. Firstly, we review the definition and development of bioengineering technology, while stressing issues concerning the design, implementation, and monitoring of bioengineering actions. Secondly, we highlight the need to reconcile natural hazard control and ecological restoration by posing novel practice and research questions.
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Conservação dos Recursos Naturais/métodos , Recuperação e Remediação Ambiental/métodos , Água Doce , Águas Salinas , Solo , Biodegradação Ambiental , Recuperação e Remediação Ambiental/instrumentaçãoRESUMO
PURPOSE: Methylphenidate (MPH) and other stimulants have been shown to enhance physical performance. However, stimulant research has almost exclusively been conducted in young, active persons with a normal BMI, and may not generalize to other groups. The purpose of this study was to determine whether the ergogenic response to MPH could be predicted by individual level characteristics. METHODS: We investigated whether weekly minutes of moderate-to-vigorous physical activity (MVPA), age, and BMI could predict the ergogenic response to MPH. In a double-blind, cross-over design 29 subjects (14M, 15F, 29.7 ± 9.68 years, BMI: 26.1 ± 6.82, MVPA: 568.8 ± 705.6 min) ingested MPH or placebo before performing a handgrip task. Percent change in mean force between placebo and MPH conditions was used to evaluate the extent of the ergogenic response. RESULTS: Mean force was significantly higher in MPH conditions [6.39% increase, T(25) = 3.09, p = 0.005 118.8 ± 37.96 (± SD) vs. 111.8 ± 34.99 Ns] but variable (coefficient of variation:163%). Using linear regression, we observed that min MVPA (T(25) = -2.15, ß = -0.400, p = 0.044) and age [T(25) = -3.29, ß = -0.598, p = 0.003] but not BMI [T(25) = 1.67, ß = 0.320 p = 0.109] significantly predicted percent change in mean force in MPH conditions. CONCLUSIONS: We report that lower levels of physical activity and younger age predict an improved ergogenic response to MPH and that this may be explained by differences in dopaminergic function. This study illustrates that the ergogenic response to MPH is partly dependent on individual differences such as habitual levels of physical activity and age.
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Estimulantes do Sistema Nervoso Central/farmacologia , Força da Mão/fisiologia , Metilfenidato/farmacologia , Valor Preditivo dos Testes , Adulto , Estudos Cross-Over , Ergonomia , Feminino , Humanos , Individualidade , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
OBJECTIVE: Poor weight management may relate to a reduction in neurobehavioural control over food intake and heightened reactivity of the brain's neural reward pathways. Here we explore the neurophysiology of food-related visual cue processing in weight reduced and weight relapsed women by assessing differences in cortical arousal and attentional processing using a food-Stroop paradigm. METHODS: 51 women were recruited into 4 groups: reduced-weight participants (RED, n=14) compared to BMI matched low-weight controls (LW-CTL, n=18); and weight relapsed participants (REL, n=10) compared to BMI matched high-weight controls (HW-CTL, n=9). Eating behaviour and body image questionnaires were completed. Two Stroop tasks (one containing food images, the other containing neutral images) were completed with record of electroencephalography (EEG). RESULTS: Differences in cortical arousal were found in RED versus LW-CTL women, and were seen during food task execution only. Compared to their controls, RED women exhibited lower relative delta band power (p=0.01) and higher relative beta band power (p=0.01) over the right frontal cortex (F4). Within the RED group, delta band oscillations correlated positively with self-reported habitual fat intake and with body shape dissatisfaction. CONCLUSIONS: As compared to women matched for phenotype but with no history of weight reduction, reduced-overweight/obese women show increased neurobehavioural control over external food cues and the inhibition of reward-orientated feeding responses. Insight into these self-regulatory mechanisms which attenuate food cue saliency may aid in the development of cognitive remediation therapies which facilitate long-term weight loss.
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Cognição/fisiologia , Sinais (Psicologia) , Alimentos , Sobrepeso/psicologia , Percepção Visual/fisiologia , Adolescente , Adulto , Imagem Corporal/psicologia , Estudos de Casos e Controles , Eletroencefalografia , Comportamento Alimentar/psicologia , Feminino , Humanos , Pessoa de Meia-Idade , Obesidade/psicologia , Recidiva , Adulto JovemRESUMO
Heightened food cue-reactivity in overweight and obese individuals has been related to aberrant functioning of neural circuitry implicated in motivational behaviours and reward-seeking. Here we explore the neurophysiology of visual food cue-reactivity in overweight and obese women, as compared with normal weight women, by assessing differences in cortical arousal and attentional processing elicited by food and neutral image inserts in a Stroop task with record of EEG spectral band power and ERP responses. Results show excess right frontal (F8) and left central (C3) relative beta band activity in overweight women during food task performance (indicative of pronounced early visual cue-reactivity) and blunted prefrontal (Fp1 and Fp2) theta band activity in obese women during office task performance (suggestive of executive dysfunction). Moreover, as compared to normal weight women, food images elicited greater right parietal (P4) ERP P200 amplitude in overweight women (denoting pronounced early attentional processing) and shorter right parietal (P4) ERP P300 latency in obese women (signifying enhanced and efficient maintained attentional processing). Differential measures of cortical arousal and attentional processing showed significant correlations with self-reported eating behaviour and body shape dissatisfaction, as well as with objectively assessed percent fat mass. The findings of the present study suggest that heightened food cue-reactivity can be neurophysiologically measured, that different neural circuits are implicated in the pathogenesis of overweight and obesity, and that EEG techniques may serve useful in the identification of endophenotypic markers associated with an increased risk of externally mediated food consumption.
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Sinais (Psicologia) , Potenciais Evocados/fisiologia , Comportamento Alimentar/fisiologia , Obesidade/fisiopatologia , Sobrepeso/fisiopatologia , Adiposidade , Adulto , Nível de Alerta/fisiologia , Atenção/fisiologia , Imagem Corporal , Índice de Massa Corporal , Eletroencefalografia , Feminino , Lobo Frontal/fisiologia , Voluntários Saudáveis , Humanos , Motivação/fisiologia , Projetos Piloto , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Handgrip is a ubiquitous human movement that was critical in our evolution. However, the differences in brain activity between grip type (i.e. power or precision) and pattern (i.e. dynamic or static) are not fully understood. In order to address this, we performed Activation Likelihood Estimation (ALE) analysis between grip type and grip pattern using functional magnetic resonance imaging (fMRI) data. ALE provides a probabilistic summary of the BOLD response in hundreds of subjects, which is often beyond the scope of a single fMRI experiment. METHODS: We collected data from 28 functional magnetic resonance data sets, which included a total of 398 male and female subjects. Using ALE, we analyzed the BOLD response during power, precision, static and dynamic grip in a range of forces and age in right handed healthy individuals without physical impairment, cardiovascular or neurological dysfunction using a variety of grip tools, feedback and experimental training. RESULTS: Power grip generates unique activation in the postcentral gyrus (areas 1 and 3b) and precision grip generates unique activation in the supplementary motor area (SMA, area 6) and precentral gyrus (area 4a). Dynamic handgrip generates unique activation in the precentral gyrus (area 4p) and SMA (area 6) and of particular interest, both dynamic and static grip share activation in the area 2 of the postcentral gyrus, an area implicated in the evolution of handgrip. According to effect size analysis, precision and dynamic grip generates stronger activity than power and static, respectively. CONCLUSION: Our study demonstrates specific differences between grip type and pattern. However, there was a large degree of overlap in the pre and postcentral gyrus, SMA and areas of the frontal-parietal-cerebellar network, which indicates that other mechanisms are potentially involved in regulating handgrip. Further, our study provides empirically based regions of interest, which can be downloaded here within, that can be used to more effectively study power grip in a range of populations and conditions.
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Encéfalo/fisiologia , Força da Mão/fisiologia , Imageamento por Ressonância Magnética , Neuroimagem , Feminino , Lobo Frontal , Humanos , Masculino , Lobo ParietalRESUMO
CONTEXT: An important component of the effective management of chronic noncommunicable disease is the assessment and management of psychosocial stress. The measurement and modulation of heart rate variability (HRV) may be valuable in this regard. OBJECTIVE: To describe the measurement and physiological control of HRV; to describe the impact of psychosocial stress on cardiovascular disease, metabolic syndrome, and chronic respiratory disease, and the relationship between these diseases and changes in HRV; and to describe the influence of biofeedback and exercise on HRV and the use of HRV biofeedback in the management of chronic disease. DATA SOURCES AND STUDY SELECTION: The PubMed, Medline, and Embase databases were searched (up to August 2013). Additional articles were obtained from the reference lists of relevant articles and reviews. Articles were individually selected for further review based on the quality and focus of the study, and the population studied. RESULTS: Heart rate variability is reduced in stress and in many chronic diseases, and may even predict the development and prognosis of some diseases. Heart rate variability can be increased with both exercise and biofeedback. Although the research on the effect of exercise is conflicting, there is evidence that aerobic training may increase HRV and cardiac vagal tone both in healthy individuals and in patients with disease. Heart rate variability biofeedback is also an effective method of increasing HRV and cardiac vagal tone, and has been shown to decrease stress and reduce the morbidity and mortality of disease. CONCLUSION: The assessment and management of psychosocial stress is a challenging but important component of effective comprehensive lifestyle interventions for the management of noncommunicable disease. It is, therefore, important for the sports and exercise physician to have an understanding of the therapeutic use of HRV modulation, both in the reduction of stress and in the management of chronic disease.
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Biorretroalimentação Psicológica , Exercício Físico/fisiologia , Frequência Cardíaca/fisiologia , Reabilitação , Medicina Esportiva , Doença Crônica/reabilitação , Humanos , Estresse Psicológico/fisiopatologia , Estresse Psicológico/reabilitaçãoRESUMO
Emotional processing in bipolar disorder (BD) is impaired. We aimed to measure the effects of mindfulness based cognitive-behavioral therapy (MBCT) in BD on emotional processing, as measured by event related potentials (ERP) and by heart rate variability (HRV). ERP and HRV were recorded during the completion of a visual matching task, which included object matching, affect matching, and affect labeling. Individuals with BD (n = 12) were compared with controls (n = 9) to obtain baseline data prior to the individuals with BD undergoing an 8-week MBCT intervention. ERP and HRV recording was repeated after the MBCT intervention in BD. Participants with BD had exaggerated ERP N170 amplitude and increased HRV HF peak compared to controls, particularly during the affect matching condition. After an 8-week MBCT intervention, participants with BD showed attenuation of ERP N170 amplitude and reduced HRV HF peak. Our findings support findings from the literature emphasizing that emotional processing in BD is altered, and suggesting that MBCT may improve emotional processing in BD.
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Transtorno Bipolar/fisiopatologia , Transtorno Bipolar/terapia , Emoções/fisiologia , Potenciais Evocados/fisiologia , Frequência Cardíaca/fisiologia , Atenção Plena/métodos , Adulto , Transtorno Bipolar/diagnóstico , Terapia Cognitivo-Comportamental/métodos , Eletrocardiografia/métodos , Eletroencefalografia/métodos , Feminino , Humanos , Masculino , Estimulação Luminosa/métodos , Projetos PilotoRESUMO
This article reviews the brain structures and neural circuitry underlying the motor system as it pertains to endurance exercise. Some obvious phenomena that occur during endurance racing events that need to be explained neurophysiologically are variable pacing strategies, the end spurt, motivation and the rating of perceived exertion. Understanding the above phenomena physiologically is problematic due to the sheer complexity of obtaining real-time brain measurements during exercise. In those rare instances where brain measurements have been made during exercise, the measurements have usually been limited to the sensory and motor cortices; or the exercise itself was limited to small muscle groups. Without discounting the crucial importance of the primary motor cortex in the execution of voluntary movement, it is surprising that very few exercise studies pay any attention to the complex and dynamic organization of motor action in relation to the subcortical nuclei, given that they are essential for the execution of normal movement patterns. In addition, the findings from laboratory-based exercise performance trials are hampered by the absence of objective measures of the motivational state of subjects. In this review we propose that some of the above phenomena may be explained by distinguishing between voluntary, vigorous and urgent motor behaviours during exercise, given that different CNS structures and neurotransmitters are involved in the execution of these different motor behaviours.
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Encéfalo/fisiologia , Sistema Nervoso Central/fisiologia , Exercício Físico/fisiologia , Córtex Motor/fisiologia , Resistência Física/fisiologia , Humanos , PercepçãoRESUMO
This study examines the acute effect of heart rate variability (HRV) biofeedback on HRV measures during and immediately after biofeedback and during the following laboratory-induced stress. Eighteen healthy males exposed to work-related stress were randomised into an HRV biofeedback group (BIO) or a comparative group (COM). Subjects completed a modified Stroop task before (Stroop 1) and after (Stroop 2) the intervention. Both groups had similar physiological responses to stress in Stroop 1. In Stroop 2, the COM group responded similarly to the way they did to Stroop 1: respiratory frequency (RF) and heart rate (HR) increased, RMSSD and high frequency (HF) power decreased or had a tendency to decrease, while low frequency (LF) power showed no change. The BIO group responded differently in Stroop 2: while RF increased and LF power decreased, HR, RMSSD and HF power showed no change. In the BIO group, RMSSD was higher in Stroop 2 compared to Stroop 1. In conclusion, HRV biofeedback induced a short term carry-over effect during both the following rest period and laboratory-induced stress suggesting maintained HF vagal modulation in the BIO group after the intervention, and maintained LF vagal modulation in the COM group.
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Biorretroalimentação Psicológica , Cognição/fisiologia , Frequência Cardíaca/fisiologia , Estresse Fisiológico/fisiologia , Estresse Psicológico/fisiopatologia , Adulto , Sistema Nervoso Autônomo/fisiopatologia , Humanos , Masculino , Testes Neuropsicológicos , Projetos Piloto , Taxa Respiratória/fisiologiaRESUMO
This pilot study examines the effect of heart rate variability (HRV) biofeedback on measures of electroencephalogram (EEG) during and immediately after biofeedback. Eighteen healthy males exposed to work-related stress, were randomised into an HRV biofeedback (BIO) or a comparative group (COM). EEG was recorded during the intervention and during rest periods before and after the intervention. Power spectral density in theta, alpha and beta frequency bands and theta/beta ratios were calculated. During the intervention, the BIO group had higher relative theta power [Fz and Pz (p < 0.01), Cz (p < 0.05)], lower fronto-central relative beta power (p < 0.05), and higher theta/beta [Fz and Cz (p < 0.01), Pz (p < 0.05)] than the COM group. The groups showed different responses after the intervention with increased posterior theta/beta (p < 0.05) in the BIO group and altered posterior relative theta (p < 0.05), central relative beta (p = 0.06) and central-posterior theta/beta (p < 0.01) in the post-intervention rest period. The findings of this study suggest that a single session of HRV biofeedback after a single training session was associated with changes in EEG suggestive of increased internal attention and relaxation both during and after the intervention. However, the comparative intervention was associated with changes suggestive of increased mental effort and possible anxiety during and after the intervention.
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Biorretroalimentação Psicológica/métodos , Encéfalo/fisiologia , Eletroencefalografia/métodos , Frequência Cardíaca/fisiologia , Adulto , Atenção/fisiologia , Humanos , Masculino , Projetos Piloto , Teste de StroopRESUMO
Acute type A dissection is among the most dangerous of vascular diseases and is associated with a high lethality. Surgery for type A dissection is a complex procedure which is accompanied by relevant blood losses and severe deterioration of the coagulation system. Either due to the dissection or the surgical procedure, perfusion of affected organs can be diminished or completely disrupted with the risk of irreversible organ damage especially in the brain. Perioperative anesthesiological management for type A dissection is demanding and involves maintaining hemodynamic stability, surveillance of cerebral oxygenation and transesophageal echocardiographical diagnostic support for the decision-making of the most appropriate surgical approach. Furthermore, reestablishment of sufficient hemostasis can be challenging and requires thorough understanding of the relevant aspects affecting normal hemostasis during surgical repair of aortic dissection. In this article relevant pathophysiological aspects and basic principles of anesthesiological management of type A dissection are described.
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Anestesia , Aneurisma Aórtico/cirurgia , Dissecção Aórtica/cirurgia , Procedimentos Cirúrgicos Vasculares/métodos , Dissecção Aórtica/diagnóstico , Dissecção Aórtica/fisiopatologia , Aneurisma Aórtico/diagnóstico , Aneurisma Aórtico/fisiopatologia , Circulação Cerebrovascular/fisiologia , Parada Circulatória Induzida por Hipotermia Profunda , Ecocardiografia Transesofagiana , Humanos , Concentração de Íons de Hidrogênio , Monitorização Intraoperatória , Medição de Risco , Terminologia como AssuntoRESUMO
We report a breakthrough in the search for versatile diffractive elements for cold neutrons. Nanoparticles are spatially arranged by holographical means in a photopolymer. These grating structures show remarkably efficient diffraction of cold neutrons up to about 50% for effective thicknesses of only 200 ââµm. They open up a profound perspective for next generation neutron-optical devices with the capability to tune or modulate the neutron diffraction efficiency.
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Aortic aneurysms are frequent in the elderly who often suffer from relevant co-morbidities. In Germany it is estimated that approximately 250,000 patients suffer from an aortic aneurysm. Due to the high risk of cardiac or pulmonary complications operative management poses a challenge to the anesthesiologist. Especially hemodynamic management during aortic cross-clamping requires anesthesiologic know-how and an anticipatory use of vasodilators and catecholamines. Furthermore, the anesthesiologist has to protect renal function. In order to avoid paraplegia due to spinal ischemia cerebrospinal fluid drainage may be necessary in patients with aneurysms of the thoracic aorta. In recent years endovascular repair of aortic aneurysms has been established in addition to conventional open surgery. As a consequence in some patients aortic surgery can be performed under regional or local anesthesia. In special cases thoracic endovascular repair requires a medicinal induction of heart arrest or the reduction of aortic blood flow by overpacing.
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Anestesia , Aneurisma da Aorta Abdominal/cirurgia , Aneurisma da Aorta Torácica/cirurgia , Procedimentos Cirúrgicos Cardíacos , Procedimentos Cirúrgicos Eletivos , Anestesia Epidural , Aneurisma da Aorta Abdominal/epidemiologia , Aneurisma da Aorta Abdominal/patologia , Aneurisma da Aorta Torácica/epidemiologia , Aneurisma da Aorta Torácica/patologia , Constrição , Alemanha , Hemodinâmica/fisiologia , Humanos , Isquemia/prevenção & controle , Monitorização Intraoperatória , Fármacos Neuroprotetores/uso terapêutico , Medicação Pré-Anestésica , Substâncias Protetoras/uso terapêutico , Traumatismo por Reperfusão/prevenção & controleRESUMO
We performed an experimental test of the Kochen-Specker theorem based on an inequality derived from the Peres-Mermin proof, using spin-path (momentum) entanglement in a single neutron system. Following the strategy proposed by Cabello et al. [Phys. Rev. Lett. 100, 130404 (2008)10.1103/PhysRevLett.100.130404], a Bell-like state was generated, and three expectation values were determined. The observed violation 2.291 +/- 0.008 not less, dbl equals1 clearly shows that quantum mechanical predictions cannot be reproduced by noncontextual hidden-variable theories.