scholarly journals Pulse Rate Variability in Emergency Physicians During Shifts: Pilot Cross-Sectional Study

10.2196/13909 ◽  
2019 ◽  
Vol 7 (10) ◽  
pp. e13909
Author(s):  
Gregory Andrew Peters ◽  
Matthew L Wong ◽  
Joshua W Joseph ◽  
Leon D Sanchez
Keyword(s):  
Pulse Rate ◽  
High Frequency ◽  
Low Frequency ◽  
Fourth Quarter ◽  
Emergency Physicians ◽  
Pulse Rate Variability ◽  
Significant Difference ◽  
Standard Pulse ◽  
Academic Year ◽  
Frequency Power

Background The high prevalence of physician burnout, particularly in emergency medicine, has garnered national attention in recent years. Objective means of measuring stress while at work can facilitate research into stress reduction interventions, and wearable photoplethysmography (PPG) technology has been proposed as a potential solution. However, the use of low-burden wearable biosensors to study training and clinical practice among emergency physicians (EP) remains untested. Objective This pilot study aimed to (1) determine the feasibility of recording on-shift photoplethysmographic data from EP, (2) assess the quality of these data, and (3) calculate standard pulse rate variability (PRV) metrics from the acquired dataset and examine patterns in these variables over the course of an academic year. Methods A total of 21 EP wore PPG biosensors on their wrists during clinical work in the emergency department during a 9-hour shift. Recordings were collected during the first quarter of the academic year, then again during the fourth quarter of the same year for comparison. The overall rate of usable data collection per time was computed. Standard pulse rate (PR) and PRV metrics from these two time points were calculated and entered into Student t tests. Results More than 400 hours of data were entered into these analyses. Interpretable data were captured during 8.54% of the total recording time overall. In the fourth quarter of the academic year compared with the first quarter, there was no significant difference in median PR (75.8 vs 76.8; P=.57), mean R-R interval (0.81 vs 0.80; P=.32), SD of R-R interval (0.11 vs 0.11; P=.93), root mean square of successive difference of R-R interval (0.81 vs 0.80; P=.96), low-frequency power (3.5×103 vs 3.4×103; P=.79), high-frequency power (8.5×103 vs 8.3×103; P=.91), or low-frequency to high-frequency ratio (0.42 vs 0.41; P=.43), respectively. Power estimates for each of these tests exceeded .90. A secondary analysis of the resident-only subgroup similarly showed no significant differences over time, despite power estimates greater than .80. Conclusions Although the use of PPG biosensors to record real-time physiological data from EP while providing clinical care seems operationally feasible, this study fails to support the notion that such an approach can efficiently provide reliable estimates of metrics of interest. No significant differences in PR or PRV metrics were found at the end of the year compared with the beginning. Although these methods may offer useful applications to other domains, it may currently have limited utility in the contexts of physician training and wellness.

scholarly journals Pulse Rate Variability in Emergency Physicians During Shifts: Pilot Cross-Sectional Study (Preprint)

2019 ◽  
Author(s):  
Gregory Andrew Peters ◽  
Matthew L Wong ◽  
Joshua W Joseph ◽  
Leon D Sanchez
Keyword(s):  
Pulse Rate ◽  
High Frequency ◽  
Low Frequency ◽  
Fourth Quarter ◽  
Emergency Physicians ◽  
Pulse Rate Variability ◽  
Significant Difference ◽  
Standard Pulse ◽  
Academic Year ◽  
Frequency Power

BACKGROUND The high prevalence of physician burnout, particularly in emergency medicine, has garnered national attention in recent years. Objective means of measuring stress while at work can facilitate research into stress reduction interventions, and wearable photoplethysmography (PPG) technology has been proposed as a potential solution. However, the use of low-burden wearable biosensors to study training and clinical practice among emergency physicians (EP) remains untested. OBJECTIVE This pilot study aimed to (1) determine the feasibility of recording on-shift photoplethysmographic data from EP, (2) assess the quality of these data, and (3) calculate standard pulse rate variability (PRV) metrics from the acquired dataset and examine patterns in these variables over the course of an academic year. METHODS A total of 21 EP wore PPG biosensors on their wrists during clinical work in the emergency department during a 9-hour shift. Recordings were collected during the first quarter of the academic year, then again during the fourth quarter of the same year for comparison. The overall rate of usable data collection per time was computed. Standard pulse rate (PR) and PRV metrics from these two time points were calculated and entered into Student <italic>t</italic> tests. RESULTS More than 400 hours of data were entered into these analyses. Interpretable data were captured during 8.54% of the total recording time overall. In the fourth quarter of the academic year compared with the first quarter, there was no significant difference in median PR (75.8 vs 76.8; <italic>P</italic>=.57), mean R-R interval (0.81 vs 0.80; <italic>P</italic>=.32), SD of R-R interval (0.11 vs 0.11; <italic>P</italic>=.93), root mean square of successive difference of R-R interval (0.81 vs 0.80; <italic>P</italic>=.96), low-frequency power (3.5×103 vs 3.4×103; <italic>P</italic>=.79), high-frequency power (8.5×103 vs 8.3×103; <italic>P</italic>=.91), or low-frequency to high-frequency ratio (0.42 vs 0.41; <italic>P</italic>=.43), respectively. Power estimates for each of these tests exceeded .90. A secondary analysis of the resident-only subgroup similarly showed no significant differences over time, despite power estimates greater than .80. CONCLUSIONS Although the use of PPG biosensors to record real-time physiological data from EP while providing clinical care seems operationally feasible, this study fails to support the notion that such an approach can efficiently provide reliable estimates of metrics of interest. No significant differences in PR or PRV metrics were found at the end of the year compared with the beginning. Although these methods may offer useful applications to other domains, it may currently have limited utility in the contexts of physician training and wellness.

Real Ear Sound Pressure Levels Developed by Three Portable Stereo System Earphones

1992 ◽  
Vol 1 (4) ◽  
pp. 52-55 ◽  
Author(s):  
Gail L. MacLean ◽  
Andrew Stuart ◽  
Robert Stenstrom
Keyword(s):  
High Frequency ◽  
Sound Pressure ◽  
Low Frequency ◽  
Test System ◽  
Output Frequency ◽  
Frequency Effects ◽  
Adult Men ◽  
Frequency Responses ◽  
Significant Difference ◽  
Sound Pressure Levels

Differences in real ear sound pressure levels (SPLs) with three portable stereo system (PSS) earphones (supraaural [Sony Model MDR-44], semiaural [Sony Model MDR-A15L], and insert [Sony Model MDR-E225]) were investigated. Twelve adult men served as subjects. Frequency response, high frequency average (HFA) output, peak output, peak output frequency, and overall RMS output for each PSS earphone were obtained with a probe tube microphone system (Fonix 6500 Hearing Aid Test System). Results indicated a significant difference in mean RMS outputs with nonsignificant differences in mean HFA outputs, peak outputs, and peak output frequencies among PSS earphones. Differences in mean overall RMS outputs were attributed to differences in low-frequency effects that were observed among the frequency responses of the three PSS earphones. It is suggested that one cannot assume equivalent real ear SPLs, with equivalent inputs, among different styles of PSS earphones.

scholarly journals Can a simple, short-term memory task help to screen dyslexia?

2019 ◽  
Author(s):  
Nick Perham ◽  
Toni Howell ◽  
Andy Watt
Keyword(s):  
High Frequency ◽  
Short Term Memory ◽  
Memory Task ◽  
Compulsory Education ◽  
Low Frequency ◽  
Short Term ◽  
Term Order ◽  
Significant Difference ◽  
Support Students

AbstractFunding to support students with dyslexia in post-compulsory education is under pressure and more efficient assessments may offset some of this shortfall. We tested potential tasks for screening dyslexia: recall of adjective-noun, compared to noun-adjective, pairings (syntax) and recall of high versus low frequency letter pairings (bigrams). Students who reported themselves as dyslexic failed to show a normal syntax effect (greater recall of adjective-noun compared to noun-adjective pairings) and no significant difference in recall between the two types of bigrams whereas students who were not dyslexic showed the syntax effect and a bias towards recalling high frequency bigrams. Findings are consistent with recent explanations of dyslexia suggesting that those affected find it difficult to learn and utilise sequential long-term order information (Szmalec et al. Journal of Experimental Psychology: Learning, Memory & Cognition, 37(5) ,1270-1279, 2011). Further, ROC curve analyses revealed both tasks showed acceptable diagnostic properties as they were able to discriminate between the two groups of participants.

Elevated heart rate variability in physically active postmenopausal women: a cardioprotective effect?

1996 ◽  
Vol 271 (2) ◽  
pp. H455-H460 ◽  
Author(s):  
K. P. Davy ◽  
N. L. Miniclier ◽  
J. A. Taylor ◽  
E. T. Stevenson ◽  
D. R. Seals
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Postmenopausal Women ◽  
High Frequency ◽  
Low Frequency ◽  
Total Power ◽  
High Frequency Power ◽  
Fat Percentage ◽  
Physically Active ◽  
Frequency Power

Coronary heart disease (CHD) and cardiac sudden death (CSD) incidence accelerates after menopause, but the incidence is lower in physically active versus less active women. Low heart rate variability (HRV) is a risk factor for CHD and CSD. The purpose of the present investigation was to test the hypothesis that HRV at rest is greater in physically active compared with less active postmenopausal women. If true, we further hypothesized that the greater HRV in the physically active women would be closely associated with an elevated spontaneous cardiac baroreflex sensitivity (SBRS). HRV (both time and frequency domain measures) and SBRS (sequence method) were measured during 5-min periods of controlled frequency breathing (15 breaths/min) in the supine, sitting, and standing postures in 9 physically active postmenopausal women (age = 53 +/- 1 yr) and 11 age-matched controls (age = 56 +/- 2 yr). Body weight, body mass index, and body fat percentage were lower (P < 0.01) and maximal oxygen uptake was higher (P < 0.01) in the physically active group. The standard deviation of the R-R intervals (time domain measure) was higher in all postures in the active women (P < 0.05) as were the high-frequency, low-frequency, and total power of HRV. SBRS also was higher (P < 0.05) in the physically active women in all postures and accounted for approximately 70% of the variance in the high-frequency power of HRV (P < 0.05). The results of the present investigation indicate that physically active postmenopausal women demonstrate higher levels of HRV compared with age-matched, less active women. Furthermore, SBRS accounted for the majority of the variance in the high-frequency power of HRV, suggesting the possibility of a mechanistic link with cardiac vagal modulation of heart rate. Our findings may provide insight into a possible cardioprotective mechanism in physically active postmenopausal women.

Effects of oral arsenic trioxide therapy on QT intervals in patients with acute promyelocytic leukemia: implications for long-term cardiac safety

Blood ◽  
2006 ◽  
Vol 108 (1) ◽  
pp. 103-106 ◽  
Author(s):  
Chung-Wah Siu ◽  
Wing-Yan Au ◽  
Cindy Yung ◽  
Cyrus R. Kumana ◽  
Chu-Pak Lau ◽  
...  
Keyword(s):  
Arsenic Trioxide ◽  
High Frequency ◽  
Peak Plasma ◽  
Low Frequency ◽  
Holter Monitoring ◽  
Cardiac Safety ◽  
High Frequency Power ◽  
Qt Intervals ◽  
Frequency Power

Ventricular tachyarrhythmias may occur during intravenous arsenic trioxide (As2O3). This has not happened during oral As2O3. Sixteen patients were studied by electrocardiography and 24-hour Holter monitoring at baseline, during and after oral As2O3 (As2O3-ON, As2O3-OFF). QT and corrected QT (QTc) were significantly longer during As2O3-ON than in As2O3-OFF, but QT and QTc dispersions were comparable. The patients' 24-hour heart rates were higher during As2O3-ON than in As2O3-OFF. QTc intervals at each hour were longer during As2O3-ON than in As2O3-OFF. However, QTc prolongation of more than 30 milliseconds only occurred at one time point (2 hours) after oral As2O3, resulting in QTc of more than 500 milliseconds in 3 of 16 patients, all within 4 hours of oral As2O3. Although the standard deviation of normal RR interval was lower during As2O3-ON, ratios of low frequency to high frequency power for As2O3-ON and As2O3-OFF were comparable. No ventricular proarrhythmias were observed. These observations, due to the lower peak plasma arsenic reached during oral As2O3, may explain the relative cardiac safety of oral As2O3. (Blood. 2006;108:103-106)

scholarly journals The interpretation of very high frequency band of instantaneous pulse rate variability during paced respiration

2014 ◽  
Vol 13 (1) ◽  
pp. 46 ◽  
Author(s):  
Chia-Chi Chang ◽  
Hung-Yi Hsu ◽  
Tzu-Chien Hsiao
Keyword(s):  
Frequency Band ◽  
Pulse Rate ◽  
High Frequency ◽  
High Frequency Band ◽  
Very High Frequency ◽  
Pulse Rate Variability ◽  
Paced Respiration ◽  
Very High

Topographic Electroencephalographic Study with Power Ratio Index Mapping in Patients with Malignant Brain Tumors

Neurosurgery ◽  
1985 ◽  
Vol 17 (4) ◽  
pp. 613-619 ◽  
Author(s):  
Ken Nagata ◽  
Cordell E. Gross ◽  
Glenn W. Kindt ◽  
J. Michael Geier ◽  
Geoffrey R. Adey
Keyword(s):  
Brain Tumors ◽  
High Frequency ◽  
Low Frequency ◽  
Power Ratio ◽  
Malignant Brain Tumors ◽  
Power Spectral ◽  
Beta Power ◽  
Index Mapping ◽  
Low Frequency Power ◽  
Frequency Power

Abstract A variant of electroencephalogram (EEG) power spectral mapping called power ratio index (PRI) mapping was used to monitor 15 patients with malignant brain tumors. This index is generated by dividing the low frequency (delta, theta) power by the high frequency (alpha, beta) power. Because the nonparoxysmal effect of a brain tumor on the EEG is reflected as a relative loss of high frequency power and a gain in low frequency power, utilization of the PRI has the effect of placing the epicenter of the “power dysfunction” coincident with the epicenter of the tumor.

Heart rate variability and dissociation in panic disorder

2011 ◽  
Vol 26 (S2) ◽  
pp. 147-147
Author(s):  
T. Diveky ◽  
D. Kamaradova ◽  
A. Grambal ◽  
K. Latalova ◽  
J. Prasko ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Panic Disorder ◽  
Frequency Band ◽  
High Frequency ◽  
Power Spectra ◽  
Low Frequency ◽  
Very Low Frequency ◽  
Significant Difference ◽  
Before And After

The aim of our study is to measure very low frequency band (VLF), low frequency band (LF) and high frequency band (HF) components of R-R interval during orthostatic experiment in panic disorder patients before and after treatment.MethodsWe assessed heart rate variability in 19 patients with panic disorder before and after 6-weeks treatment with antidepressants combined with CBT and 18 healthy controls. They were regularly assessed on the CGI, BAI and BDI. Heart rate variability was assessed during 5 min standing, 5 min supine and 5 min standing positions before and after the treatment. Power spectra were computed using a fast Fourier transformation for very low frequency - VLF (0.0033 - 0.04 Hz), low-frequency - LF (0.04-0.15 Hz) and high frequency - HF (0.15-0.40 Hz) powers.Results19 panic disorder patients entered a 6-week open-label treatment study with combination of SSRI and cognitive behavioral therapy. A combination of CBT and pharmacotherapy proved to be the effective treatment of patients. They significantly improved in all rating scales. There were highly statistical significant differences between panic patients and control group in all components of power spectral analysis in 2nd and in two component of 3rd (LF and HF in standing) positions. There was also statistically significant difference between these two groups in LF/HF ratio in supine position (2nd). During therapy there was tendency to increasing values in all three positions in components of HRV power spectra, but there was only statistically significant increasing in HF1 component.Supported by project IGA MZ ČR NS 10301-3/2009

scholarly journals Autonomic Conditions in Tinnitus and Implications for Korean Medicine

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Eun Ji Choi ◽  
Younghee Yun ◽  
Seungyeon Yoo ◽  
Kyu Seok Kim ◽  
Jeong-Su Park ◽  
...  
Keyword(s):  
High Frequency ◽  
Low Frequency ◽  
Retrospective Chart Review ◽  
Frequency Component ◽  
Total Power ◽  
High Frequency Component ◽  
Chronic Patients ◽  
Research Attention ◽  
Korean Medicine ◽  
Significant Difference

Tinnitus patients suffer from not only auditory sensations but also physical, mental, and social difficulties. Even though tinnitus is believed to be associated with the autonomic nervous system, changes in autonomic conditions in tinnitus patients are not receiving much research attention. The aims of this study were to investigate the autonomic condition of tinnitus patients and to consider Korean medicine in the treatment of tinnitus with an evidence-based approach. We performed a retrospective chart review and compared the heart rate variability (HRV) parameters of 40 tinnitus patients (19 acute and 21 chronic) and 40 healthy controls. In tinnitus patients, the power of the high frequency component and total power of the HRV significantly decreased(P<0.05), and the low frequency to high frequency ratio significantly increased(P<0.05). There was no significant difference between the acute and chronic patients. When comparing each group with the controls, there was a tendency that the longer the duration of tinnitus was, the larger the observed HRV change was. In conclusion, tinnitus patients have vagal withdrawal and sympathetic overactivity, and chronic tinnitus more strongly affects autonomic conditions than acute tinnitus. This study provides evidence for Korean medical treatments of tinnitus, such as acupuncture and Qi-training, that cause modulation of cardiac autonomic function.

Frequency-dependent velocity analysis and offset-dependent low-frequency amplitude anomalies from hydrocarbon-bearing reservoirs in the southern North Sea, Norwegian sector

Geophysics ◽  
2017 ◽  
Vol 82 (6) ◽  
pp. N51-N60 ◽  
Author(s):  
Sayyid Suhail Ahmad ◽  
R. James Brown ◽  
Alejandro Escalona ◽  
Børge O. Rosland
Keyword(s):  
North Sea ◽  
High Frequency ◽  
Spectral Decomposition ◽  
Low Frequency ◽  
Velocity Analysis ◽  
Frequency Dependent ◽  
Lower Velocity ◽  
The North ◽  
Significant Difference ◽  
The North Sea

Our aim was to identify some of the characteristics of low-frequency anomalies. Specifically, we have looked, in 3D broadband data from the North Sea, for any offset dependence in these anomalies and any frequency-related change in normal moveout (NMO) velocity that could influence stacking power over different frequencies. After high-resolution spectral decomposition, two types of low-frequency anomaly have been identified associated with hydrocarbon-bearing reservoirs: (1) at the reservoir top and (2) below the reservoir, with a time delay of approximately 100–200 ms. Both types of anomalies indicate offset dependence. On the near-offset stacks, they are relatively strong, but they tend to be absent on the far-offset stacks. In addition, horizon velocity analysis, which was performed along the horizons picked at the tops of reservoir and nonreservoir intervals, has revealed frequency-dependent NMO velocity. For nonreservoir events, we found no significant difference between the NMO velocities for the low-frequency and high-frequency filtered common-midpoint gathers. However, along the anomalously low-frequency events observed at the tops of, and below, oil-bearing reservoirs, lower velocity is observed for low-frequency and higher velocity for high-frequency filtered gathers. If these properties turn out to be universally typical, increased understanding and inclusion of them could lead to improved workflows and help increase the reliability of low-frequency analysis as a hydrocarbon indicator.

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