Impact of diabetes on cardiopulmonary function: the added value of a combined cardiopulmonary and echocardiography stress test

2021 ◽  
Author(s):  
Nicola Riccardo Pugliese ◽  
Alessandra Pieroni ◽  
Nicolò De Biase ◽  
Valerio Di Fiore ◽  
Lorenzo Nesti ◽  
...  
Keyword(s):  
Stress Test ◽  
Added Value ◽  
Cardiopulmonary Function

scholarly journals QT variability unrelated to RR variability during stress testing for identification of coronary artery disease

2021 ◽  
Vol 379 (2212) ◽  
Author(s):  
Marta González del Castillo ◽  
David Hernando ◽  
Michele Orini ◽  
Pablo Laguna ◽  
Jari Viik ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Stress Testing ◽  
Stress Test ◽  
Ventricular Repolarization ◽  
Added Value ◽  
Acute Ischemia ◽  
Time Frequency ◽  
Artery Disease ◽  
Repolarization Dynamics

Stress test electrocardiogram (ECG) analysis is widely used for coronary artery disease (CAD) diagnosis despite its limited accuracy. Alterations in autonomic modulation of cardiac electrical activity have been reported in CAD patients during acute ischemia. We hypothesized that those alterations could be reflected in changes in ventricular repolarization dynamics during stress testing that could be measured through QT interval variability (QTV). However, QTV is largely dependent on RR interval variability (RRV), which might hinder intrinsic ventricular repolarization dynamics. In this study, we investigated whether different markers accounting for low-frequency (LF) oscillations of QTV unrelated to RRV during stress testing could be used to separate patients with and without CAD. Power spectral density of QTV unrelated to RRV was obtained based on time-frequency coherence estimation. Instantaneous LF power of QTV and QTV unrelated to RRV were obtained. LF power of QTV unrelated to RRV normalized by LF power of QTV was also studied. Stress test ECG of 100 patients were analysed. Patients referred to coronary angiography were classified into non-CAD or CAD group. LF oscillations in QTV did not show significant differences between CAD and non-CAD groups. However, LF oscillations in QTV unrelated to RRV were significantly higher in the CAD group as compared with the non-CAD group when measured during the first phases of exercise and last phases of recovery. ROC analysis of these indices revealed area under the curve values ranging from 61 to 73%. Binomial logistic regression analysis revealed LF power of QTV unrelated to RRV, both during the first phase of exercise and last phase of recovery, as independent predictors of CAD. In conclusion, this study highlights the importance of removing the influence of RRV when measuring QTV during stress testing for CAD identification and supports the added value of LF oscillations of QTV unrelated to RRV to diagnose CAD from the first minutes of exercise. This article is part of the theme issue ‘Advanced computation in cardiovascular physiology: new challenges and opportunities’.

The Added Value of Graphical Input and Display for Electron Lens Design

1990 ◽  
Vol 48 (1) ◽  
pp. 190-191
Author(s):  
B. Lencova ◽  
G. Wisselink
Keyword(s):  
Flux Density ◽  
Numerical Data ◽  
Added Value ◽  
Lens Design ◽  
Step Size ◽  
Magnetic Lens ◽  
Flux Lines ◽  
Fine Mesh ◽  
Electron Lens ◽  
User Friendly

Recent progress in computer technology enables the calculation of lens fields and focal properties on commonly available computers such as IBM ATs. If we add to this the use of graphics, we greatly increase the applicability of design programs for electron lenses. Most programs for field computation are based on the finite element method (FEM). They are written in Fortran 77, so that they are easily transferred from PCs to larger machines.The design process has recently been made significantly more user friendly by adding input programs written in Turbo Pascal, which allows a flexible implementation of computer graphics. The input programs have not only menu driven input and modification of numerical data, but also graphics editing of the data. The input programs create files which are subsequently read by the Fortran programs. From the main menu of our magnetic lens design program, further options are chosen by using function keys or numbers. Some options (lens initialization and setting, fine mesh, current densities, etc.) open other menus where computation parameters can be set or numerical data can be entered with the help of a simple line editor. The "draw lens" option enables graphical editing of the mesh - see fig. I. The geometry of the electron lens is specified in terms of coordinates and indices of a coarse quadrilateral mesh. In this mesh, the fine mesh with smoothly changing step size is calculated by an automeshing procedure. The options shown in fig. 1 allow modification of the number of coarse mesh lines, change of coordinates of mesh points or lines, and specification of lens parts. Interactive and graphical modification of the fine mesh can be called from the fine mesh menu. Finally, the lens computation can be called. Our FEM program allows up to 8000 mesh points on an AT computer. Another menu allows the display of computed results stored in output files and graphical display of axial flux density, flux density in magnetic parts, and the flux lines in magnetic lenses - see fig. 2. A series of several lens excitations with user specified or default magnetization curves can be calculated and displayed in one session.

Preliminary Findings on the Use of Session Questionnaires to Improve Clinician-Client Alliance With Special Consideration to Clinical Education

2015 ◽  
Vol 25 (1) ◽  
pp. 50-60
Author(s):  
Anu Subramanian
Keyword(s):  
Graduate Students ◽  
Clinical Education ◽  
Clinical Decision Making ◽  
Rating Scale ◽  
Treatment Effectiveness ◽  
Clinical Decision ◽  
Added Value ◽  
Therapeutic Outcomes ◽  
Specific Feedback ◽  
Stakeholder Perspective

ASHA's focus on evidence-based practice (EBP) includes the family/stakeholder perspective as an important tenet in clinical decision making. The common factors model for treatment effectiveness postulates that clinician-client alliance positively impacts therapeutic outcomes and may be the most important factor for success. One strategy to improve alliance between a client and clinician is the use of outcome questionnaires. In the current study, eight parents of toddlers who attended therapy sessions at a university clinic responded to a session outcome questionnaire that included both rating scale and descriptive questions. Six graduate students completed a survey that included a question about the utility of the questionnaire. Results indicated that the descriptive questions added value and information compared to using only the rating scale. The students were varied in their responses regarding the effectiveness of the questionnaire to increase their comfort with parents. Information gathered from the questionnaire allowed for specific feedback to graduate students to change behaviors and created opportunities for general discussions regarding effective therapy techniques. In addition, the responses generated conversations between the client and clinician focused on clients' concerns. Involving the stakeholder in identifying both effective and ineffective aspects of therapy has advantages for clinical practice and education.

Messung der Stimmfrequenz im Paargespräch – Chancen für Diagnostik und Intervention in der Paartherapie

2020 ◽  
Vol 68 (4) ◽  
pp. 217-227 ◽  
Author(s):  
Lisanne J. Bulling ◽  
Isabella C. Bertschi ◽  
Céline C. Stadelmann ◽  
Tina Niederer ◽  
Guy Bodenmann
Keyword(s):  
Social Stress ◽  
Stress Test ◽  
Trier Social Stress Test

Zusammenfassung. Die vorliegende Arbeit stellt die bisherigen empirischen Befunde zur Sprachgrundfrequenz (f0) in Paargesprächen vor und untersucht, wie sich die f0 nach einer experimentellen Stressinduktion im anschließenden spontanen Gespräch zwischen den Partner_innen verändert, wie die f0 mit der verbalen Stressäußerung zusammenhängt und wie sie zwischen den beiden Partner_innen kovariiert. Von 128 heterosexuellen Paaren nahm jeweils eine Person pro Paar am Trier Social Stress Test (TSST) teil. Die dem TSST vorangehende und anschließende naturalistische Interaktion zwischen den Partner_innen wurde gefilmt und nach Gesprächsthema und Art der Stressäußerung kodiert. Wie vorherige Studien zur f0 im Paargespräch zeigte auch die vorliegende Studie, dass die f0 wichtige Informationen über die Partnerschaft enthält. Während eine Erhöhung der f0 in Gesprächen über einen paarinternen Stressor (d.h. bei Konfliktgesprächen) mit negativen Kommunikationsmustern einherging, zeigte die vorliegende Studie, dass die f0 bei Gesprächen über einen paarexternen Stressor (d.h. beim TSST) mit emotionsorientierten Stressäußerungen einherging, also einer für den Stressbewältigungsprozess förderlichen Art der Kommunikation. Die Oszillatorenmodelle zeigen darüber hinaus, dass eine Kopplung der f0 zwischen den Partner_innen besteht, was darauf hindeutet, dass die nicht gestressten Partner_innen auf die paraverbalen Stressäußerungen der gestressten Partner_innen mit ihren eigenen paraverbalen Stressäußerungen reagieren.

Stressinduzierte Herabsetzung der Aufmerksamkeit bei jungen Erwachsenen mit ADHS-ähnlicher Symptomatik

2010 ◽  
Vol 39 (4) ◽  
pp. 213-216 ◽  
Author(s):  
Reinhold G. Laessle ◽  
Edith Hansen-Spinger
Keyword(s):  
Stress Test ◽  
Median Split

Zusammenfassung. Theoretischer Hintergrund: Modelle zur Aufrechterhaltung des ADHS-Syndroms postulieren, dass die allgemeine Aufmerksamkeitsleistung und damit auch die Selbstaufmerksamkeit durch Stress vermindert werden kann. Fragestellung: In der Studie wurde geprüft, ob sich dieser Effekt bereits bei Personen aus der gesunden Bevölkerung zeigt, die einen hohen Ausprägungsgrad an ADHS-ähnlicher Symptomatik aufweisen. Methode: 84 Männer mit einem mittleren Alter von 23 Jahren wurden getestet. Die Stressinduktion erfolgte durch mentale Arithmetik aus dem Trier Sozial Stress-Test. Die Aufmerksamkeitsleistung wurde mit dem Frankfurter Aufmerksamkeitsinventar gemessen. Die Gruppierung der Probanden erfolgte durch Median-Split aufgrund der Selbstbeurteilungsskala aus den Homburger ADHS-Skalen für Erwachsene in solche mit hoher bzw. niedriger ADHS-Tendenz. Ergebnisse: Bezüglich der Aufmerksamkeitsleistung zeigte sich der erwartete Interaktionseffekt (Gruppierung × Bedingung) mit schlechterer Leistung nach Stress nur für Personen mit hoher ADHS-Tendenz (p < .002). Schlussfolgerung: Die Ergebnisse deuten auf den Nutzen der Einbeziehung spezifischer stressbezogener Bausteine in Behandlungsprogramme für ADHS-Patienten hin.

Sign in / Sign up

Export Citation Format

Share Document