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Annals of the New York Academy of... Oct 2019Regular rhythm facilitates audiomotor entrainment and synchronization in motor behavior and vocalizations between individuals. As rhythm entrainment between interacting...
Regular rhythm facilitates audiomotor entrainment and synchronization in motor behavior and vocalizations between individuals. As rhythm entrainment between interacting agents is correlated with higher levels of cooperation and prosocial affiliative behavior, humans can potentially map regular speech rhythm onto higher cooperation and friendliness between interacting individuals. We tested this hypothesis at two rhythmic levels: pulse (recurrent acoustic events) and meter (hierarchical structuring of pulses based on their relative salience). We asked the listeners to make judgments of the hostile or collaborative attitude of two interacting agents who exhibit either regular or irregular pulse (Experiment 1) or meter (Experiment 2). The results confirmed a link between the perception of social affiliation and rhythmicity: evenly distributed pulses (vowel onsets) and consistent grouping of pulses into recurrent hierarchical patterns are more likely to be perceived as cooperation signals. People are more sensitive to regularity at the level of pulse than at the level of meter, and they are more confident when they associate cooperation with isochrony in pulse. The evolutionary origin of this faculty is possibly the need to transmit and perceive coalition information in social groups of human ancestors. We discuss the implications of these findings for the emergence of speech in humans.
Topics: Adolescent; Adult; Female; Humans; Judgment; Language; Male; Multilingualism; Periodicity; Social Behavior; Speech; Speech Perception; Young Adult
PubMed: 31373001
DOI: 10.1111/nyas.14193 -
Cureus Jan 2022Colon carcinoma (CA) is one of the most common cancers worldwide. Cardiac metastasis in CA is quite rare with only a few incidences. These tumors are usually clinically...
Colon carcinoma (CA) is one of the most common cancers worldwide. Cardiac metastasis in CA is quite rare with only a few incidences. These tumors are usually clinically silent and are discovered on autopsy. We present a case of a 62-year-old woman, known diabetic, hypertensive, and hypothyroid patient, who presented with complaints of abdominal distention and obstipation with multiple episodes of vomiting undigested food particles for three days. She had been passing dark tarry stools infrequently for over a month. She complained of a progressive loss of appetite and 5 kg weight loss over a month. Her examination revealed pallor and irregular pulse with a rate of 94/min. She had a distended non-tender abdomen and absent bowel sounds. Contrast-enhanced computed tomography (CECT) abdomen showed circumferential thickening of the descending colon, causing acute stenosis with multiple liver metastases and enlarged pericolic lymph nodes. Serum carcinoembryonic antigen (CEA) was elevated, 55.45 ng/mL. She underwent an emergency exploratory laparotomy with transverse loop colostomy. Histopathology report showed moderately differentiated adenocarcinoma. ECG showed atrial fibrillation and two-dimensional echocardiogram showed right ventricular metastasis. High-resolution computed tomography (HRCT) thorax was done to confirm the diagnosis. The common sites of metastases from colorectal cancer are the lymph nodes, liver, and lungs. When cardiac metastasis occurs, it often presents with features of heart failure. Our patient presented with atrial fibrillation. As the incidence of cardiac metastasis is quite rare, there is no standard established treatment. Certain chemotherapeutic drugs, such as 5-fluorouracil, oxaliplatin, irinotecan (FOLFIRINOX regimen), have been shown to improve cardiac metastases. Due to the extensive spread of primary cancer in our patient, she was planned for palliative chemotherapy; however, the patient expired before initiation of therapy.
PubMed: 35145823
DOI: 10.7759/cureus.21703 -
Heart (British Cardiac Society) Jun 2021
Topics: Atrial Fibrillation; Echocardiography, Doppler, Pulsed; Heart Failure; Humans; Reproducibility of Results
PubMed: 33727256
DOI: 10.1136/heartjnl-2020-318923 -
Frontiers in Cardiovascular Medicine 2023Heart rate (HR) is closely related to heart rhythm patterns, and its irregularity can imply serious health problems. Therefore, HR is used in the diagnosis of many... (Review)
Review
Heart rate (HR) is closely related to heart rhythm patterns, and its irregularity can imply serious health problems. Therefore, HR is used in the diagnosis of many health conditions. Traditionally, HR has been measured through an electrocardiograph (ECG), which is subject to several practical limitations when applied in everyday settings. In recent years, the emergence of smartphones and microelectromechanical systems has allowed innovative solutions for conveniently measuring HR, such as smartphone ECG, smartphone photoplethysmography (PPG), and seismocardiography (SCG). However, these measurements generally rely on external sensor hardware or are highly susceptible to inaccuracies due to the presence of significant levels of motion artifact. Data from gyrocardiography (GCG), however, while largely overlooked for this application, has the potential to overcome the limitations of other forms of measurements. For this scoping review, we performed a literature search on HR measurement using smartphone gyroscope data. In this review, from among the 114 articles that we identified, we include seven relevant articles from the last decade (December 2012 to January 2023) for further analysis of their respective methods for data collection, signal pre-processing, and HR estimation. The seven selected articles' sample sizes varied from 11 to 435 participants. Two articles used a sample size of less than 40, and three articles used a sample size of 300 or more. We provide elaborations about the algorithms used in the studies and discuss the advantages and disadvantages of these methods. Across the articles, we noticed an inconsistency in the algorithms used and a lack of established standardization for performance evaluation for HR estimation using smartphone GCG data. Among the seven articles included, five did not perform any performance evaluation, while the other two used different reference signals (HR and PPG respectively) and metrics for accuracy evaluation. We conclude the review with a discussion of challenges and future directions for the application of GCG technology.
PubMed: 38164464
DOI: 10.3389/fcvm.2023.1329290 -
European Heart Journal. Digital Health Mar 2022Atrial fibrillation (AF) is a major cause of morbidity and mortality. Current guidelines support performing electrocardiogram (ECG) screenings to spot AF in high-risk...
AIMS
Atrial fibrillation (AF) is a major cause of morbidity and mortality. Current guidelines support performing electrocardiogram (ECG) screenings to spot AF in high-risk patients. The purpose of this study was to validate a new algorithm aimed to identify AF in patients measured with a recent FDA-cleared contact-free optical device.
METHODS AND RESULTS
Study participants were measured simultaneously using two devices: a contact-free optical system that measures chest motion vibrations (investigational device, 'Gili') and a standard reference bed-side ECG monitor (Mindray). Each reference ECG was evaluated by two board certified cardiologists that defined each trace as: regular rhythm, AF, other irregular rhythm or indecipherable/missing. A total of 3582, 30-s intervals, pertaining to 444 patients (41.9% with a history of AF) were made available for analysis. Distribution of patients with active AF, other irregular rhythm, and regular rhythm was 16.9%, 29.5%, and 53.6% respectively. Following application of cross-validated machine learning approach, the observed sensitivity and specificity were 0.92 [95% confidence interval (CI): 0.91-0.93] and 0.96 (95% CI: 0.95-0.96), respectively.
CONCLUSION
This study demonstrates for the first time the efficacy of a contact-free optical device for detecting AF.
PubMed: 36713997
DOI: 10.1093/ehjdh/ztab108 -
Sensors (Basel, Switzerland) Feb 2023Intervals of low-quality photoplethysmogram (PPG) signals might lead to significant inaccuracies in estimation of pulse arrival time (PAT) during polysomnography (PSG)...
Intervals of low-quality photoplethysmogram (PPG) signals might lead to significant inaccuracies in estimation of pulse arrival time (PAT) during polysomnography (PSG) studies. While PSG is considered to be a "gold standard" test for diagnosing obstructive sleep apnea (OSA), it also enables tracking apnea-related nocturnal blood pressure fluctuations correlated with PAT. Since the electrocardiogram (ECG) is recorded synchronously with the PPG during PSG, it makes sense to use the ECG signal for PPG signal-quality assessment. (1) Objective: to develop a PPG signal-quality assessment algorithm for robust PAT estimation, and investigate the influence of signal quality on PAT during various sleep stages and events such as OSA. (2) Approach: the proposed algorithm uses R and T waves from the ECG to determine approximate locations of PPG pulse onsets. The MESA database of 2055 PSG recordings was used for this study. (3) Results: the proportions of high-quality PPG were significantly lower in apnea-related oxygen desaturation (matched-pairs rc = 0.88 and rc = 0.97, compared to OSA and hypopnea, respectively, when < 0.001) and arousal (rc = 0.93 and rc = 0.98, when < 0.001) than in apnea events. The significantly large effect size of interquartile ranges of PAT distributions was between low- and high-quality PPG ( < 0.001, rc = 0.98), and regular and irregular pulse waves ( < 0.001, rc = 0.74), whereas a lower quality of the PPG signal was found to be associated with a higher interquartile range of PAT across all subjects. Suggested PPG signal quality-based PAT evaluation reduced deviations (e.g., rc = 0.97, rc = 0.97, rc = 0.99 in hypopnea, oxygen desaturation, and arousal stages, respectively, when < 0.001) and allowed obtaining statistically larger differences between different sleep stages and events. (4) Significance: the implemented algorithm has the potential to increase the robustness of PAT estimation in PSG studies related to nocturnal blood pressure monitoring.
Topics: Humans; Polysomnography; Photoplethysmography; Heart Rate; Sleep Apnea, Obstructive; Oxygen
PubMed: 36850820
DOI: 10.3390/s23042220 -
Computational and Mathematical Methods... 2021Pulse rate variability monitoring and atrial fibrillation detection algorithms have been widely used in wearable devices, but the accuracies of these algorithms are...
BACKGROUND
Pulse rate variability monitoring and atrial fibrillation detection algorithms have been widely used in wearable devices, but the accuracies of these algorithms are restricted by the signal quality of pulse wave. Time synchronous averaging is a powerful noise reduction method for periodic and approximately periodic signals. It is usually used to extract single-period pulse waveforms, but has nothing to do with pulse rate variability monitoring and atrial fibrillation detection traditionally. If this method is improved properly, it may provide a new way to measure pulse rate variability and to detect atrial fibrillation, which may have some potential advantages under the condition of poor signal quality.
OBJECTIVE
The objective of this paper was to develop a new measure of pulse rate variability by improving existing time synchronous averaging and to detect atrial fibrillation by the new measure of pulse rate variability.
METHODS
During time synchronous averaging, two adjacent periods were regarded as the basic unit to calculate the average signal, and the difference between waveforms of the two adjacent periods was the new measure of pulse rate variability. 3 types of distance measures (Euclidean distance, Manhattan distance, and cosine distance) were tested to measure this difference on a simulated training set with a capacity of 1000. The distance measure, which can accurately distinguish regular pulse rate and irregular pulse rate, was used to detect atrial fibrillation on the testing set with a capacity of 62 (11 with atrial fibrillation, 8 with premature contraction, and 43 with sinus rhythm). The receiver operating characteristic curve was used to evaluate the performance of the indexes.
RESULTS
The Euclidean distance between waveforms of the two adjacent periods performs best on the training set. On the testing set, the Euclidean distance in atrial fibrillation group is significantly higher than that of the other two groups. The area under receiver operating characteristic curve to identify atrial fibrillation was 0.998. With the threshold of 2.1, the accuracy, sensitivity, and specificity were 98.39%, 100%, and 98.04%, respectively. This new index can detect atrial fibrillation from pulse wave signal.
CONCLUSION
This algorithm not only provides a new perspective to detect AF but also accomplishes the monitoring of PRV and the extraction of single-period pulse wave through the same technical route, which may promote the popularization and application of pulse wave.
Topics: Algorithms; Analysis of Variance; Atrial Fibrillation; Computational Biology; Diagnosis, Computer-Assisted; Heart Rate; Humans; Machine Learning; Pulse Wave Analysis; ROC Curve; Radial Artery; Wearable Electronic Devices
PubMed: 33868451
DOI: 10.1155/2021/5597559 -
The American Journal of Case Reports May 2021BACKGROUND Tachycardia from atrial fibrillation or flutter can lead to left ventricular systolic dysfunction. Some patients deteriorate quickly, and there is an acute...
BACKGROUND Tachycardia from atrial fibrillation or flutter can lead to left ventricular systolic dysfunction. Some patients deteriorate quickly, and there is an acute drop in their left ventricular systolic function; however, they tend to normalize rapidly after treatment of the underlying arrhythmia. The aim of publishing the present case is to maintain awareness that tachycardia is one of the etiologies of acute systolic heart failure, which is potentially reversible by treatment when recognized. CASE REPORT An 88-year-old woman with a history of hypertension and diabetes presented to the emergency department with shortness of breath and new-onset atrial fibrillation. The physical examination revealed jugular vein distention, an irregular heart rate of approximately 140 beats/min, bilateral basal lung crackles, and no murmurs. One week before this presentation, she underwent electrocardiography, which showed she was in sinus rhythm, and transthoracic echocardiography, which indicated an ejection fraction of 65%. After hospital admission, she was started on beta-blockers for heart rate control and diuretics for heart failure management. As her symptoms persisted, she underwent a transesophageal echocardiography-guided cardioversion, where her ejection fraction was 30%. A repeat transthoracic echocardiography 3 days after the cardioversion indicated the ejection fraction had normalized to 60%. She was followed up every month in the Outpatient Cardiology Clinic and has remained asymptomatic for 1 year to date. CONCLUSIONS Although most literature describes tachycardia-induced cardiomyopathy as a chronic process, it can be acute. Patients benefit from rhythm control, and with early diagnosis and appropriate management, the prognosis is good.
Topics: Aged, 80 and over; Atrial Fibrillation; Cardiomyopathies; Female; Heart Failure; Humans; Tachycardia; Ventricular Function, Left
PubMed: 33970894
DOI: 10.12659/AJCR.930732 -
Health Technology Assessment... Jan 2020Atrial fibrillation (AF) is the most common type of cardiac arrhythmia and is associated with an increased risk of stroke and congestive heart failure. Lead-I...
BACKGROUND
Atrial fibrillation (AF) is the most common type of cardiac arrhythmia and is associated with an increased risk of stroke and congestive heart failure. Lead-I electrocardiogram (ECG) devices are handheld instruments that can be used to detect AF at a single time point in people who present with relevant signs or symptoms.
OBJECTIVE
To assess the diagnostic test accuracy, clinical impact and cost-effectiveness of using single time point lead-I ECG devices for the detection of AF in people presenting to primary care with relevant signs or symptoms, and who have an irregular pulse compared with using manual pulse palpation (MPP) followed by a 12-lead ECG in primary or secondary care.
DATA SOURCES
MEDLINE, MEDLINE Epub Ahead of Print and MEDLINE In-Process & Other Non-Indexed Citations, EMBASE, PubMed, Cochrane Databases of Systematic Reviews, Cochrane Central Database of Controlled Trials, Database of Abstracts of Reviews of Effects and the Health Technology Assessment Database.
METHODS
The systematic review methods followed published guidance. Two reviewers screened the search results (database inception to April 2018), extracted data and assessed the quality of the included studies. Summary estimates of diagnostic accuracy were calculated using bivariate models. An economic model consisting of a decision tree and two cohort Markov models was developed to evaluate the cost-effectiveness of lead-I ECG devices.
RESULTS
No studies were identified that evaluated the use of lead-I ECG devices for patients with signs or symptoms of AF. Therefore, the diagnostic accuracy and clinical impact results presented are derived from an asymptomatic population (used as a proxy for people with signs or symptoms of AF). The summary sensitivity of lead-I ECG devices was 93.9% [95% confidence interval (CI) 86.2% to 97.4%] and summary specificity was 96.5% (95% CI 90.4% to 98.8%). One study reported limited clinical outcome data. Acceptability of lead-I ECG devices was reported in four studies, with generally positive views. The de novo economic model yielded incremental cost-effectiveness ratios (ICERs) per quality-adjusted life-year (QALY) gained. The results of the pairwise analysis show that all lead-I ECG devices generated ICERs per QALY gained below the £20,000-30,000 threshold. Kardia Mobile (AliveCor Ltd, Mountain View, CA, USA) is the most cost-effective option in a full incremental analysis.
LIMITATIONS
No published data evaluating the diagnostic accuracy, clinical impact or cost-effectiveness of lead-I ECG devices for the population of interest are available.
CONCLUSIONS
Single time point lead-I ECG devices for the detection of AF in people with signs or symptoms of AF and an irregular pulse appear to be a cost-effective use of NHS resources compared with MPP followed by a 12-lead ECG in primary or secondary care, given the assumptions used in the base-case model.
FUTURE WORK
Studies assessing how the use of lead-I ECG devices in this population affects the number of people diagnosed with AF when compared with current practice would be useful.
STUDY REGISTRATION
This study is registered as PROSPERO CRD42018090375.
FUNDING
The National Institute for Health Research Health Technology Assessment programme.
Topics: Atrial Fibrillation; Cost-Benefit Analysis; Electrocardiography; Heart Failure; Humans; Mass Screening; Models, Economic; Predictive Value of Tests; Primary Health Care; Pulse; Quality-Adjusted Life Years; Stroke; Technology Assessment, Biomedical
PubMed: 31933471
DOI: 10.3310/hta24030 -
Neuroscience Apr 2021Perceiving the temporal regularity in a sequence of repetitive sensory events facilitates the preparation and execution of relevant behaviors with tight temporal...
Perceiving the temporal regularity in a sequence of repetitive sensory events facilitates the preparation and execution of relevant behaviors with tight temporal constraints. How we estimate temporal regularity from repeating patterns of sensory stimuli is not completely understood. We developed a decision-making task in which participants had to decide whether a train of visual, auditory, or tactile pulses, had a regular or an irregular temporal pattern. We tested the hypothesis that subjects categorize stimuli as irregular by accumulating the time differences between the predicted and observed times of sensory pulses defining a temporal rhythm. Results suggest that instead of waiting for a single large temporal deviation, participants accumulate timing-error signals and judge a pattern as irregular when the amount of evidence reaches a decision threshold. Model fits of bounded integration showed that this accumulation occurs with negligible leak of evidence. Consistent with previous findings, we show that participants perform better when evaluating the regularity of auditory pulses, as compared with visual or tactile stimuli. Our results suggest that temporal regularity is estimated by comparing expected and measured pulse onset times, and that each prediction error is accumulated towards a threshold to generate a behavioral choice.
Topics: Auditory Perception; Humans; Touch
PubMed: 33549694
DOI: 10.1016/j.neuroscience.2021.01.035