Role of interleukin-6 levels in cardiovascular autonomic dysfunction in type 2 diabetic patients

International Nuclear Information System (INIS)

Shinohara, Tetsuji; Takahashi, Naohiko; Kakuma, Tetsuya; Hara, Masahide; Yoshimatsu, Hironobu; Yufu, Kunio; Anan, Futoshi; Nakagawa, Mikiko; Saikawa, Tetsunori

2008-01-01

Increased serum interleukin-6 (IL-6) levels are associated with an increased risk of cardiovascular disease, and cardiovascular autonomic dysfunction is associated with high mortality in type 2 diabetic patients. However, the relationship between IL-6 levels and cardiovascular autonomic dysfunction has not been fully elucidated. The aim of this study was to determine whether serum IL-6 levels are associated with cardiovascular autonomic dysfunction in type 2 diabetic patients. Eighty type 2 diabetic patients who did not have organic heart disease were categorized into a high IL-6 group (>2.5 pg/ml, n= 0, age 59±12 years) or a non-high IL-6 group ( 123 I-metaiodobenzylguanidine (MIBG) scintigraphy. The body mass index values (BMI), fasting insulin levels and homeostasis model assessment index values were higher in the high IL-6 group than in the non-high IL-6 group (p 123 I-MIBG myocardial uptake values were lower (p 123 I-MIBG was higher (p 123 I-MIBG during the delayed phase. The results indicate that elevated IL-6 levels are associated with depressed cardiovascular autonomic function and obesity in type 2 diabetic patients. (orig.)

Plasma DNA Mediate Autonomic Dysfunctions and White Matter Injuries in Patients with Parkinson’s Disease

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Meng-Hsiang Chen

2017-01-01

Full Text Available Background. Cardiovascular autonomic dysfunction is well known in Parkinson’s disease (PD presentation and it produces hypoperfusion of vital organs. The association between cardiovascular autonomic dysfunction and oxidative stress was examined in previous animal models. Oxidative stress and neuroinflammation were thought to have roles in PD pathogenesis. Owing to the relative low intrinsic antioxidative properties, brain white matter (WM is vulnerable to the oxidative stress. This study is conducted to examine possible relationships by using a hypothesis-driven mediation model. Methods. Twenty-nine patients with PD and 26 healthy controls participated in this study, with complete examinations of cardiac autonomic parameters, plasma DNA level, and WM integrity. A single-level three-variable mediation model was used to investigate the possible relationships. Results. The elevated serum oxidative stress biomarkers include plasma nuclear DNA and mitochondrial DNA, and poorer cardiac autonomic parameters and multiple regional microstructural WM changes are demonstrated. Further mediation analysis shows that plasma nuclear DNA served as the mediators between poorer baroreflex sensitivity and mean diffusivity changes in cingulum. Conclusions. These results provide a possible pathophysiology for how the poor baroreflex sensitivity and higher oxidative stress adversely impacted the WM integrity. This model could provide us with a piece of the puzzle of the entire PD pathogenesis.

Sudden death and paroxysmal autonomic dysfunction in stiff-man syndrome.

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Mitsumoto, H; Schwartzman, M J; Estes, M L; Chou, S M; La Franchise, E F; De Camilli, P; Solimena, M

1991-04-01

Two women with typical stiff-man syndrome (SMS) developed increasingly frequent attacks of muscle spasms with severe paroxysmal autonomic dysfunctions such as transient hyperpyrexia, diaphoresis, tachypnea, tachycardia, pupillary dilation, and arterial hypertension. Autoantibodies to GABA-ergic neurons were identified in the serum of both patients and in the cerebrospinal fluid of one. Both died suddenly and unexpectedly. General autopsy did not reveal the cause of death. Neuropathological studies revealed perivascular gliosis in the spinal cord and brain stem of one patient and lymphocytic perivascular infiltration in the spinal cord, brain stem, and basal ganglia of the other. The occurrence of a chronic inflammatory reaction in one of the two patients supports the idea that an autoimmune disease against GABA-ergic neurons may be involved in SMS. A review of the literature indicates that functional impairment in SMS is severe and prognosis is unpredictable because of the potential for sudden and unexpected death. Both muscular abnormalities and autonomic dysfunctions may result from autoimmunity directed against GABA-ergic neurons.

Diabetic cardiac autonomic dysfunction. Parasympathetic versus sympathetic

International Nuclear Information System (INIS)

Uehara, Akihiko; Kurata, Chinori; Sugi, Toshihiko; Mikami, Tadashi; Shouda, Sakae

1999-01-01

Diabetic cardiac autonomic dysfunction often causes lethal arrhythmia and sudden cardiac death. 123 I-Metaiodobenzylguanidine (MIBG) can evaluate cardiac sympathetic dysfunction, and analysis of heart rate variability (HRV) can reflect cardiac parasympathetic activity. We examined whether cardiac parasympathetic dysfunction assessed by HRV may correlate with sympathetic dysfunction assessed by MIBG in diabetic patients. In 24-hour electrocardiography, we analyzed 4 HRV parameters: high-frequency power (HF), HF in the early morning (EMHF), rMSSD and pNN50. MIBG planar images and SPECT were obtained 15 minutes (early) and 150 minutes (late) after injection and the heart washout rate was calculated. The defect score in 9 left ventricular regions was scored on a 4 point scale (0=normal - 3=severe defect). In 20 selected diabetic patients without congestive heart failure, coronary artery disease and renal failure, parasympathetic HRV parameters had a negative correlation with the sum of defect scores (DS) in the late images (R=-0.47 to -0.59, p<0.05) and some parameters had a negative correlation with the washout rate (R=-0.50 to -0.55, p<0.05). In a total of 64 diabetic patients also, these parameters had a negative correlation with late DS (R=-0.28 to -0.35, p<0.05) and early DS (R=-0.27 to -0.32, p<0.05). The progress of diabetic cardiac parasympathetic dysfunction may parallel the sympathetic one. (author)

Anxiety sensitivity in adolescents with somatoform autonomic dysfunction and adolescents with insulin dependent diabetes mellitus.

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Pisarić, Maja; Nisević, Sanja

2011-01-01

Anxiety sensitivity is defined as a belief that anxiety or fear may cause illness, embarrassment, or additional anxiety. The main purpose of this study was to find out if there were differences among adolescents with insulin dependent diabetes mellitus, adolescents with somatoform autonomic dysfunction and their healthy peers in different aspects of psychological functioning and anxiety sensitivity. The sample consisted of 93 subjects, aged 12 to 16. Hamburg Neuroticism and Extraversion Scale, Child Behaviour Checklist and Childhood Anxiety Sensitivity Index were administrated. The adolescents with somatoform autonomic dysfunction had significantly higher scores on neuroticism scale, different Child Behaviour Checklist subscales, and on anxiety sensitivity. Both groups with diagnosed illness had lower scores on extraversion scale compared to healthy peers. This study has shown that the adolescents with somatoform autonomic dysfunction are more prone to fears regarding bodily functioning, and that they are at a higher risk of developing an anxiety disorder.

Cardiovascular autonomic dysfunction in Ehlers-Danlos syndrome-Hypermobile type.

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Hakim, Alan; O'Callaghan, Chris; De Wandele, Inge; Stiles, Lauren; Pocinki, Alan; Rowe, Peter

2017-03-01

Autonomic dysfunction contributes to health-related impairment of quality of life in the hypermobile type of Ehlers-Danlos syndrome (hEDS). Typical signs and symptoms include tachycardia, hypotension, gastrointestinal dysmotility, and disturbed bladder function and sweating regulation. Cardiovascular autonomic dysfunction may present as Orthostatic Intolerance, Orthostatic Hypotension, Postural Orthostatic Tachycardia Syndrome, or Neurally Mediated Hypotension. The incidence, prevalence, and natural history of these conditions remain unquantified, but observations from specialist clinics suggest they are frequently seen in hEDS. There is growing understanding of how hEDS-related physical and physiological pathology contributes to the development of these conditions. Evaluation of cardiovascular symptoms in hEDS should include a careful history and clinical examination. Tests of cardiovascular function range from clinic room observation to tilt-table assessment to other laboratory investigations such as supine and standing catecholamine levels. Non-pharmacologic treatments include education, managing the environment to reduce exposure to triggers, improving cardiovascular fitness, and maintaining hydration. Although there are limited clinical trials, the response to drug treatments in hEDS is supported by evidence from case and cohort observational data, and short-term physiological studies. Pharmacologic therapy is indicated for patients with moderate-severe impairment of daily function and who have inadequate response or tolerance to conservative treatment. Treatment in hEDS often requires a focus on functional maintenance. Also, the negative impact of cardiovascular symptoms on physical and psycho-social well-being may generate a need for a more general evaluation and on-going management and support. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Role of interleukin-6 levels in cardiovascular autonomic dysfunction in type 2 diabetic patients

Energy Technology Data Exchange (ETDEWEB)

Shinohara, Tetsuji; Takahashi, Naohiko; Kakuma, Tetsuya; Hara, Masahide; Yoshimatsu, Hironobu [Oita University, Department of Internal Medicine 1, Faculty of Medicine, Yuhu, Oita (Japan); Yufu, Kunio; Anan, Futoshi; Nakagawa, Mikiko; Saikawa, Tetsunori [Oita University, Department of Cardiovascular Science, Oita (Japan)

2008-09-15

Increased serum interleukin-6 (IL-6) levels are associated with an increased risk of cardiovascular disease, and cardiovascular autonomic dysfunction is associated with high mortality in type 2 diabetic patients. However, the relationship between IL-6 levels and cardiovascular autonomic dysfunction has not been fully elucidated. The aim of this study was to determine whether serum IL-6 levels are associated with cardiovascular autonomic dysfunction in type 2 diabetic patients. Eighty type 2 diabetic patients who did not have organic heart disease were categorized into a high IL-6 group (>2.5 pg/ml, n= 0, age 59{+-}12 years) or a non-high IL-6 group (<2.5 pg/ml, n=40, 61{+-}12 years). Cardiac autonomic function was assessed by baroreflex sensitivity, heart rate variability, plasma norepinephrine concentrations and {sup 123}I-metaiodobenzylguanidine (MIBG) scintigraphy. The body mass index values (BMI), fasting insulin levels and homeostasis model assessment index values were higher in the high IL-6 group than in the non-high IL-6 group (p<0.01). Early and delayed {sup 123}I-MIBG myocardial uptake values were lower (p<0.01), and the percent washout rate of {sup 123}I-MIBG was higher (p<0.05) in the high IL-6 group than in the non-high IL-6 group. Furthermore, multiple regression analysis revealed that the IL-6 level was independently predicted by the BMI and the myocardial uptake of {sup 123}I-MIBG during the delayed phase. The results indicate that elevated IL-6 levels are associated with depressed cardiovascular autonomic function and obesity in type 2 diabetic patients. (orig.)

Vitamin D in the Spectrum of Prediabetes and Cardiovascular Autonomic Dysfunction.

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Dimova, Rumyana; Tankova, Tsvetalina; Chakarova, Nevena

2017-09-01

Vitamin D is a fat-soluble secosteroid hormone with pleiotropic effects. 1,25-Dihydroxyvitamin D coordinates the biosynthesis of neurotransmitters in the central nervous system, which regulate cardiovascular autonomic function and may explain its putative role in the development of cardiovascular autonomic neuropathy (CAN). CAN is an independent risk factor for mortality in patients with diabetes and prediabetes and is associated with an increased risk of developing type 2 diabetes and cardiovascular disease. Accumulating data indicate the presence of peripheral nerve injury at these early stages of dysglycemia and its multifactorial pathogenesis. Prediabetes is associated with vitamin D insufficiency. Vitamin D is proposed to prevent the progression of glucose intolerance. The putative underlying mechanisms include maintenance of the intracellular calcium concentration, direct stimulation of insulin receptor expression, and enhancement of the insulin response to glucose transporters. Vitamin D exerts a protective effect on peripheral nerve fibers by decreasing the demyelination process and inducing axonal regeneration. The effects of vitamin D supplementation on glucose tolerance and related autonomic nerve dysfunction have been a recent focus of scientific interest. Although well-designed observational studies are available, the causative relation between vitamin D deficiency, glucose intolerance, and CAN is still debatable. One reason might be that interventional studies are unpersuasive with regard to the beneficial clinical effects of vitamin D supplementation. Because of its favorable side effect profile, vitamin D supplementation might represent an attractive therapeutic option for treating the pandemic prevalence of prediabetes and vitamin D deficiency. Vitamin D supplementation can improve glucose tolerance and cardiovascular autonomic function and can thus reduce cardiovascular mortality among subjects with different stages of glucose intolerance and

Cardiac Autonomic Dysfunction in Offspring of Hypertensive Parents During Exercise.

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Almeida, Leonardo Barbosa de; Peçanha, Tiago; Mira, Pedro Augusto de Carvalho; Souza, Livia Victorino de; da Silva, Lílian Pinto; Martinez, Daniel Godoy; Freitas, Isabelle Magalhães Guedes; Laterza, Mateus Camaroti

2017-12-01

Offspring of hypertensive parents present autonomic dysfunction at rest and during physiological maneuvers. However, the cardiac autonomic modulation during exercise remains unknown. This study tested whether the cardiac autonomic modulation would be reduced in offspring of hypertensive parents during exercise. Fourteen offspring of hypertensive and 14 offspring of normotensive individuals were evaluated. The groups were matched by age (24.5±1.0 vs. 26.6±1.5 years; p=0.25) and BMI (22.8±0.6 vs. 24.2±1.0 kg/m 2 ; p=0.30). Blood pressure and heart rate were assessed simultaneously during 3 min at baseline followed by 3-min isometric handgrip at 30% of maximal voluntary contraction. Cardiac autonomic modulation was evaluated using heart rate variability. Primary variables were subjected to two-way ANOVA (group vs. time). P valueexercise protocol. In contrast, offspring of hypertensive subjects showed a reduction of SDNN (Basal=34.8±3.5 vs. 45.2±3.7 ms; Exercise=30.8±3.3 vs. 41.5±3.9 ms; p group=0.01), RMSSD (Basal=37.1±3.7 vs. 52.0±6.0 ms; Exercise=28.6±3.4 vs. 41.9±5.3 ms; p group=0.02) and pNN50 (Basal=15.7±4.0 vs. 29.5±5.5%; Exercise=7.7±2.4 vs. 18.0±4.3%; p group=0.03) during the exercise protocol in comparison with offspring of normotensive parents. We concluded that normotensive offspring of hypertensive parents exhibit impaired cardiac autonomic modulation during exercise. © Georg Thieme Verlag KG Stuttgart · New York.

Rapid-Onset Obesity with Hypothalamic Dysfunction, Hypoventilation, and Autonomic Dysregulation (ROHHAD) Syndrome: A Case Report

OpenAIRE

Bagheri; Pourbakhtyaran; Talebi Kiasari; Taherkhanchi; Salarian; Sadeghi

2016-01-01

Introduction Rapid-onset obesity with hypoventilation, hypothalamic dysfunction, and autonomic dysregulation (ROHHAD) is a rare disease. To date, there have been only few reported cases of ROHHAD syndrome. Case Presentation We report a 5-year-old- Iranian girl who had normal growth and development until her 4th year of life. At that time, the patient developed weight gain, constipation, coldness in the extremities, and hyperhidros...

[THE CORRECTION WITH NOOPHEN OF AUTONOMIC DYSFUNCTION IN YOUNG MEN WITH HYPERTENSION].

Science.gov (United States)

Knyazkova, I I; Kuzminova, N V; Osovskaya, N Yu

2015-01-01

The aim of this study was to investigate the influence of antihypertensive therapy with adding of gamma-amino-beta-phenylbutyric acid hydrochloride on the autonornic regulation of tcardiovascular system and the psychoemotional status in young men with hypertension. The study included 58 male with hypertension, aged 18-39 years (mean age 31.7 yearst 2.3 years), of them 28 patients (group I) administered beta-blocker and the other received a complex therapy which included beta-blocker and gamma-amino-beta-phenylbutyric acid hydrochiotide--Noofen ("OlainFarm", Latvia) 250 mg 3 times a day for 4 weeks. The control group consisted of 20 healthy indi&iduals aged 18-39 years (mean age 31.5 years +/- 2.5 years). The examination included of standard clinical; biochemical and instrumental investigatIons. We conducted a clinical measurement of blorid pressure, ambulatory blood pressure monitoring (ABPM), Doppler echocardiography, heart rate variability, autononlic symptoms questionnaire and Spielberger--Hanina Anxiety Scale. Analysis of circadian blbod pressure profile arid autonomic nervous system state in young men with hypertension, in spite of the short disenle history demonstratnl violations of the blood pressure circadian rhythm associated with the violation of the autonomic regulation of cardiovascular system as indreased sympathetic activity and decreased parasympathetic activity heart tate. In hypertensive patients with autonomic dysfunction we noted a reduction of level of mental health, which was reflected in an increase in'the number of people with high and moderate levels of reactive and personal anxiety It has been demonstratedthat the use of combination therapy with adding Noofen in young hypertensive men and autonomic dysfunction helped significantly improve the HRV parameters and restore autonomic balance on time parameters of heart rate variability reduced the level of reactive anxiety and imprdved the psychoemotional state.

Microglia PACAP and glutamate: Friends or foes in seizure-induced autonomic dysfunction and SUDEP?

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Bhandare, Amol M; Kapoor, Komal; Farnham, Melissa M J; Pilowsky, Paul M

2016-06-01

Seizure-induced cardiorespiratory autonomic dysfunction is a major cause of sudden unexpected death in epilepsy (SUDEP), and the underlying mechanism is unclear. Seizures lead to increased synthesis, and release of glutamate, pituitary adenylate cyclase activating polypeptide (PACAP), and other neurotransmitters, and cause extensive activation of microglia at multiple regions in the brain including central autonomic cardiorespiratory brainstem nuclei. Glutamate contributes to neurodegeneration, and inflammation in epilepsy. PACAP has neuroprotective, and anti-inflammatory properties, whereas microglia are key players in inflammatory responses in CNS. Seizure-induced increase in PACAP is neuroprotective. PACAP produces neuroprotective effects acting on microglial PAC1 and VPAC1 receptors. Microglia also express glutamate transporters, and their expression can be increased by PACAP in response to harmful or stressful situations such as seizures. Here we discuss the mechanism of autonomic cardiorespiratory dysfunction in seizure, and the role of PACAP, glutamate and microglia in regulating cardiorespiratory brainstem neurons in their physiological state that could provide future therapeutic options for SUDEP. Copyright © 2016 Elsevier B.V. All rights reserved.

Cardiac Autonomic Dysfunction in Type 2 Diabetes – Effect of Hyperglycemia and Disease Duration

OpenAIRE

Mika P. Tarvainen; Mika P. Tarvainen; Tomi Petteri Laitinen; Jukka Antero Lipponen; David eCornforth; Herbert eJelinek

2014-01-01

Heart rate variability (HRV) is reduced in diabetes mellitus (DM) patients, suggesting dysfunction of cardiac autonomic regulation and an increased risk for cardiac events. The aim of this paper was to examine the associations of blood glucose level (BGL), glycated hemoglobin (HbA1c) and duration of diabetes with cardiac autonomic regulation assessed by HRV analysis. Resting electrocardiogram (ECG), recorded over 20 minutes in supine position, and clinical measurements of 189 healthy controls...

Cardiac Autonomic Dysfunction in Type 2 Diabetes – Effect of Hyperglycemia and Disease Duration

OpenAIRE

Tarvainen, Mika P.; Laitinen, Tomi P.; Lipponen, Jukka A.; Cornforth, David J.; Jelinek, Herbert F.

2014-01-01

Heart rate variability (HRV) is reduced in diabetes mellitus (DM) patients, suggesting dysfunction of cardiac autonomic regulation and an increased risk for cardiac events. The aim of this paper was to examine the associations of blood glucose level (BGL), glycated hemoglobin (HbA1c), and duration of diabetes with cardiac autonomic regulation assessed by HRV analysis. Resting electrocardiogram (ECG), recorded over 20 min in supine position, and clinical measurements of 189 healthy controls an...

Cardiovascular Autonomic Dysfunction in Patients with Morbid Obesity

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Sant Anna Junior, Maurício de [Programa de Tratamento Multidisciplinar da Obesidade do Hospital Universitário Clementino Fraga Filho da Universidade Federal do Rio de Janeiro - UFRJ - Rio de Janeiro, RJ (Brazil); Departamento de Fisioterapia do Centro Universitário Anhanguera Niterói - UNIAN, Niterói, RJ (Brazil); Programa de pós-graduação em Ciências Médicas, Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Instituto Federal de Educação, Ciência e Tecnologia do Rio de Janeiro, Rio de Janeiro, RJ (Brazil); Carneiro, João Regis Ivar; Carvalhal, Renata Ferreira [Programa de Tratamento Multidisciplinar da Obesidade do Hospital Universitário Clementino Fraga Filho da Universidade Federal do Rio de Janeiro - UFRJ - Rio de Janeiro, RJ (Brazil); Torres, Diego de Faria Magalhães [Programa de Tratamento Multidisciplinar da Obesidade do Hospital Universitário Clementino Fraga Filho da Universidade Federal do Rio de Janeiro - UFRJ - Rio de Janeiro, RJ (Brazil); Departamento de Fisioterapia da Universidade Federal do Rio de Janeiro - UFRJ, Rio de Janeiro, RJ (Brazil); Cruz, Gustavo Gavina da; Quaresma, José Carlos do Vale [Programa de Tratamento Multidisciplinar da Obesidade do Hospital Universitário Clementino Fraga Filho da Universidade Federal do Rio de Janeiro - UFRJ - Rio de Janeiro, RJ (Brazil); Lugon, Jocemir Ronaldo [Divisão de Nefrologia - Faculdade de Medicina da Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Guimarães, Fernando Silva, E-mail: fguimaraes_pg@yahoo.com.br [Departamento de Fisioterapia da Universidade Federal do Rio de Janeiro - UFRJ, Rio de Janeiro, RJ (Brazil); Programa de pós-graduação em Ciências da Reabilitação - Centro Universitário Augusto Motta, Rio de Janeiro, RJ (Brazil)

2015-12-15

Morbid obesity is directly related to deterioration in cardiorespiratory capacity, including changes in cardiovascular autonomic modulation. This study aimed to assess the cardiovascular autonomic function in morbidly obese individuals. Cross-sectional study, including two groups of participants: Group I, composed by 50 morbidly obese subjects, and Group II, composed by 30 nonobese subjects. The autonomic function was assessed by heart rate variability in the time domain (standard deviation of all normal RR intervals [SDNN]; standard deviation of the normal R-R intervals [SDNN]; square root of the mean squared differences of successive R-R intervals [RMSSD]; and the percentage of interval differences of successive R-R intervals greater than 50 milliseconds [pNN50] than the adjacent interval), and in the frequency domain (high frequency [HF]; low frequency [LF]: integration of power spectral density function in high frequency and low frequency ranges respectively). Between-group comparisons were performed by the Student’s t-test, with a level of significance of 5%. Obese subjects had lower values of SDNN (40.0 ± 18.0 ms vs. 70.0 ± 27.8 ms; p = 0.0004), RMSSD (23.7 ± 13.0 ms vs. 40.3 ± 22.4 ms; p = 0.0030), pNN50 (14.8 ± 10.4 % vs. 25.9 ± 7.2%; p = 0.0061) and HF (30.0 ± 17.5 Hz vs. 51.7 ± 25.5 Hz; p = 0.0023) than controls. Mean LF/HF ratio was higher in Group I (5.0 ± 2.8 vs. 1.0 ± 0.9; p = 0.0189), indicating changes in the sympathovagal balance. No statistical difference in LF was observed between Group I and Group II (50.1 ± 30.2 Hz vs. 40.9 ± 23.9 Hz; p = 0.9013). morbidly obese individuals have increased sympathetic activity and reduced parasympathetic activity, featuring cardiovascular autonomic dysfunction.

Cardiovascular Autonomic Dysfunction in Patients with Morbid Obesity

International Nuclear Information System (INIS)

Sant Anna Junior, Maurício de; Carneiro, João Regis Ivar; Carvalhal, Renata Ferreira; Torres, Diego de Faria Magalhães; Cruz, Gustavo Gavina da; Quaresma, José Carlos do Vale; Lugon, Jocemir Ronaldo; Guimarães, Fernando Silva

2015-01-01

Morbid obesity is directly related to deterioration in cardiorespiratory capacity, including changes in cardiovascular autonomic modulation. This study aimed to assess the cardiovascular autonomic function in morbidly obese individuals. Cross-sectional study, including two groups of participants: Group I, composed by 50 morbidly obese subjects, and Group II, composed by 30 nonobese subjects. The autonomic function was assessed by heart rate variability in the time domain (standard deviation of all normal RR intervals [SDNN]; standard deviation of the normal R-R intervals [SDNN]; square root of the mean squared differences of successive R-R intervals [RMSSD]; and the percentage of interval differences of successive R-R intervals greater than 50 milliseconds [pNN50] than the adjacent interval), and in the frequency domain (high frequency [HF]; low frequency [LF]: integration of power spectral density function in high frequency and low frequency ranges respectively). Between-group comparisons were performed by the Student’s t-test, with a level of significance of 5%. Obese subjects had lower values of SDNN (40.0 ± 18.0 ms vs. 70.0 ± 27.8 ms; p = 0.0004), RMSSD (23.7 ± 13.0 ms vs. 40.3 ± 22.4 ms; p = 0.0030), pNN50 (14.8 ± 10.4 % vs. 25.9 ± 7.2%; p = 0.0061) and HF (30.0 ± 17.5 Hz vs. 51.7 ± 25.5 Hz; p = 0.0023) than controls. Mean LF/HF ratio was higher in Group I (5.0 ± 2.8 vs. 1.0 ± 0.9; p = 0.0189), indicating changes in the sympathovagal balance. No statistical difference in LF was observed between Group I and Group II (50.1 ± 30.2 Hz vs. 40.9 ± 23.9 Hz; p = 0.9013). morbidly obese individuals have increased sympathetic activity and reduced parasympathetic activity, featuring cardiovascular autonomic dysfunction

Artificial neural network models for prediction of cardiovascular autonomic dysfunction in general Chinese population

Science.gov (United States)

2013-01-01

Background The present study aimed to develop an artificial neural network (ANN) based prediction model for cardiovascular autonomic (CA) dysfunction in the general population. Methods We analyzed a previous dataset based on a population sample consisted of 2,092 individuals aged 30–80 years. The prediction models were derived from an exploratory set using ANN analysis. Performances of these prediction models were evaluated in the validation set. Results Univariate analysis indicated that 14 risk factors showed statistically significant association with CA dysfunction (P < 0.05). The mean area under the receiver-operating curve was 0.762 (95% CI 0.732–0.793) for prediction model developed using ANN analysis. The mean sensitivity, specificity, positive and negative predictive values were similar in the prediction models was 0.751, 0.665, 0.330 and 0.924, respectively. All HL statistics were less than 15.0. Conclusion ANN is an effective tool for developing prediction models with high value for predicting CA dysfunction among the general population. PMID:23902963

Regulation of cerebral blood flow in patients with autonomic dysfunction and severe postural hypotension

DEFF Research Database (Denmark)

Hesse, Birger; Mehlsen, Jesper; Boesen, Finn

2002-01-01

Whether cerebral blood flow (CBF) autoregulation is maintained in autonomic dysfunction has been debated for a long time, and the rather sparse data available are equivocal. The relationship between CBF and mean arterial blood pressure (MABP) was therefore tested in eight patients with symptoms...

Modulation of Cardiac Autonomic Dysfunction in Ischemic Stroke following Ayurveda (Indian System of Medicine Treatment

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Sriranjini Sitaram Jaideep

2014-01-01

Full Text Available Objectives. Cardiac autonomic dysfunction in stroke has implications on morbidity and mortality. Ayurveda (Indian system of medicine describes stroke as pakshaghata. We intended to study the effect of Ayurveda therapies on the cardiac autonomic dysfunction. Methods. Fifty patients of ischemic stroke (middle cerebral artery territory (mean age 39.26 ± 9.88 years; male 43, female 7 were recruited within one month of ictus. All patients received standard allopathic medications as advised by neurologist. In addition, patients were randomized to receive physiotherapy (Group I or Ayurveda treatment (Group II for 14 days. Continuous electrocardiogram and finger arterial pressure were recorded for 15 min before and after treatments and analyzed offline to obtain heart rate and blood pressure variability and baroreflex sensitivity (BRS. Results were analysed by RMANOVA. Results. Patients in Group II showed statistically significant improvement in cardiac autonomic parameters. The standard deviation of normal to normal intervals,and total and low frequency powers were significantly enhanced (F=8.16, P=0.007, F=9.73, P=0.004, F=13.51, and P=0.001, resp.. The BRS too increased following the treatment period (F=10.129, P=0.004. Conclusions. The current study is the first to report a positive modulation of cardiac autonomic activity after adjuvant Ayurveda treatment in ischemic stroke. Further long term studies are warranted.

Cardiovascular Autonomic Dysfunction in Patients with Morbid Obesity

Science.gov (United States)

de Sant Anna Junior, Maurício; Carneiro, João Regis Ivar; Carvalhal, Renata Ferreira; Torres, Diego de Faria Magalhães; da Cruz, Gustavo Gavina; Quaresma, José Carlos do Vale; Lugon, Jocemir Ronaldo; Guimarães, Fernando Silva

2015-01-01

Background Morbid obesity is directly related to deterioration in cardiorespiratory capacity, including changes in cardiovascular autonomic modulation. Objective This study aimed to assess the cardiovascular autonomic function in morbidly obese individuals. Methods Cross-sectional study, including two groups of participants: Group I, composed by 50 morbidly obese subjects, and Group II, composed by 30 nonobese subjects. The autonomic function was assessed by heart rate variability in the time domain (standard deviation of all normal RR intervals [SDNN]; standard deviation of the normal R-R intervals [SDNN]; square root of the mean squared differences of successive R-R intervals [RMSSD]; and the percentage of interval differences of successive R-R intervals greater than 50 milliseconds [pNN50] than the adjacent interval), and in the frequency domain (high frequency [HF]; low frequency [LF]: integration of power spectral density function in high frequency and low frequency ranges respectively). Between-group comparisons were performed by the Student’s t-test, with a level of significance of 5%. Results Obese subjects had lower values of SDNN (40.0 ± 18.0 ms vs. 70.0 ± 27.8 ms; p = 0.0004), RMSSD (23.7 ± 13.0 ms vs. 40.3 ± 22.4 ms; p = 0.0030), pNN50 (14.8 ± 10.4 % vs. 25.9 ± 7.2%; p = 0.0061) and HF (30.0 ± 17.5 Hz vs. 51.7 ± 25.5 Hz; p = 0.0023) than controls. Mean LF/HF ratio was higher in Group I (5.0 ± 2.8 vs. 1.0 ± 0.9; p = 0.0189), indicating changes in the sympathovagal balance. No statistical difference in LF was observed between Group I and Group II (50.1 ± 30.2 Hz vs. 40.9 ± 23.9 Hz; p = 0.9013). Conclusion morbidly obese individuals have increased sympathetic activity and reduced parasympathetic activity, featuring cardiovascular autonomic dysfunction. PMID:26536979

Prevalence and pattern of cardiac autonomic dysfunction in newly detected type 2 diabetes mellitus.

Science.gov (United States)

Jyotsna, Viveka P; Sahoo, Abhay; Sreenivas, V; Deepak, K K

2009-01-01

Cardiac autonomic functions were assessed in 145 consecutive recently detected type 2 diabetics. Ninety-nine healthy persons served as controls. Criteria for normalcy were, heart rate variation during deep breathing >or=15 beats/min, deep breathing expiratory to inspiratory R-R ratio >or=1.21, Valsalva ratio >or=1.21, sustained handgrip test >or=16 mm of mercury, cold pressor test >or=10, BP response to standing or=1.04. An abnormal test was defined as the above parameters being or=30 mm of mercury and dysfunction was found in 44.2% and sympathetic dysfunction in 51.9% diabetics. Among healthy controls, these figures were 11.9% and 22.1%, respectively. Cardiac autonomic function was normal in 7.8% patients and 32.5% healthy controls.

Diabetic retinopathy is associated with insulin resistance and cardiovascular autonomic dysfunction in type 2 diabetic patients

International Nuclear Information System (INIS)

Anan, Futoshi; Takayuki, Masaki; Takahashi, Naohiko; Nakagawa, Mikiko; Eshima, Nobuoki; Saikawa, Tetsunori; Yoshimatsu, Hironobu

2009-01-01

Diabetic retinopathy (DR) and cardiovascular autonomic dysfunction are associated with high mortality in type 2 diabetic patients. This preliminary study was therefore designed to test the hypothesis that DR is associated with insulin resistance and cardiovascular autonomic dysfunction in type 2 diabetic patients without insulin treatment. Seventy persons were diagnosed to have type 2 diabetes in the examination from June 2004 to May 2006. The study group consisted of 29 type 2 diabetic patients with DR (age: 58±6 years, mean±standard deviation (s.d.)) and 41 type 2 diabetic patients with no DR (NDR) (n=41, 58±5 years). Cardiovascular autonomic function was assessed by baroreflex sensitivity (BRS), heart rate variability, plasma norepinephrine concentration and cardiac 123 I-metaiodobenzylguanidine (MIBG) scintigraphic findings. DR patients had lower BRS, early and delayed 123 I-MIBG myocardial uptake values and higher percent washout rate (WR) of 123 I-MIBG than the NDR patients. With respect to metabolic findings, DR patients had higher fasting plasma insulin concentration (P 123 I-MIBG (P 123 I-MIBG are independently associated with DR in Japanese patients with type 2 diabetes mellitus. (author)

Anxiety, depression and autonomic nervous system dysfunction in hypertension.

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Bajkó, Zoltán; Szekeres, Csilla-Cecília; Kovács, Katalin Réka; Csapó, Krisztina; Molnár, Sándor; Soltész, Pál; Nyitrai, Erika; Magyar, Mária Tünde; Oláh, László; Bereczki, Dániel; Csiba, László

2012-06-15

This study examined the relationship between autonomic nervous system dysfunction, anxiety and depression in untreated hypertension. 86 newly diagnosed hypertensive patients and 98 healthy volunteers were included in the study. The psychological parameters were assessed with Spielberger State-Trait Anxiety Inventory and Beck Depression Inventory by a skilled psychologist. Autonomic parameters were examined during tilt table examination (10min lying position, 10min passive tilt). Heart rate variability (HRV) was calculated by autoregressive methods. Baroreflex sensitivity (BRS) was calculated by non-invasive sequence method from the recorded beat to beat blood pressure values and RR intervals. Significantly higher state (42.6±9.3 vs. 39.6±10.7 p=0.05) and trait (40.1±8.9 vs. 35.1±8.6, p<0.0001) anxiety scores were found in the hypertension group. There was no statistically significant difference in the depression level. LF-RRI (Low Frequency-RR interval) of HRV in passive tilt (377.3±430.6 vs. 494.1±547, p=0.049) and mean BRS slope (11.4±5.5 vs. 13.2±6.4, p=0.07) in lying position were lower in hypertensives. Trait anxiety score correlates significantly with sympatho/vagal balance (LF/HF-RRI) in passive tilt position (Spearman R=-0.286, p=0.01). Anxiety could play a more important role than depression in the development of hypertension. Altered autonomic control of the heart could be one of the pathophysiological links between hypertension and psychological factors. Copyright © 2012 Elsevier B.V. All rights reserved.

Genetic autonomic disorders.

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Axelrod, Felicia B

2013-03-01

Genetic disorders affecting the autonomic nervous system can result in abnormal development of the nervous system or they can be caused by neurotransmitter imbalance, an ion-channel disturbance or by storage of deleterious material. The symptoms indicating autonomic dysfunction, however, will depend upon whether the genetic lesion has disrupted peripheral or central autonomic centers or both. Because the autonomic nervous system is pervasive and affects every organ system in the body, autonomic dysfunction will result in impaired homeostasis and symptoms will vary. The possibility of genetic confirmation by molecular testing for specific diagnosis is increasing but treatments tend to remain only supportive and directed toward particular symptoms. Copyright © 2013 Elsevier Inc. All rights reserved.

Dysfunction of autonomic nervous system in childhood obesity: a cross-sectional study.

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Petra Baum

Full Text Available OBJECTIVE: To assess the distribution of autonomic nervous system (ANS dysfunction in overweight and obese children. METHODS: Parasympathetic and sympathetic ANS function was assessed in children and adolescents with no evidence of impaired glucose metabolism by analysis of heart rate variability (low frequency power ln(LF, high frequency power, ln(HF; ln(LF/HF ratio, ratio of longest RR interval during expiration to shortest interval during inspiration (E/I ratio, root mean square of successive differences (RMSSD; sympathetic skin response (SSR; and quantitative pupillography (pupil diameter in darkness, light reflex amplitude, latency, constriction velocity, re-dilation velocity. The relationship of each ANS variable to the standard deviation score of body mass index (BMI-SDS was assessed in a linear model considering age, gender and pubertal stage as co-variates and employing an F-statistic to compare the fit of nested models. Group comparisons between normal weight and obese children as well as an analysis of dependence on insulin resistance (as indexed by the Homeostasis Model Assessment of Insulin Resistance, HOMA-IR were performed for parameters shown to correlate with BMI-SDS. Statistical significance was set at 5%. RESULTS: Measurements were performed in 149 individuals (mean age 12.0 y; 90 obese 45 boys; 59 normal weight, 34 boys. E/I ratio (p = 0.003, ln(HF (p = 0.03, pupil diameter in darkness (p = 0.01 were negatively correlated with BMI-SDS, whereas ln(LF/HF was positively correlated (p = 0.05. Early re-dilation velocity was in trend negatively correlated to BMI-SDS (p = 0.08. None of the parameters that depended significantly on BMI-SDS was found to be significantly correlated with HOMA-IR. CONCLUSION: These findings demonstrate extended ANS dysfunction in obese children and adolescents, affecting several organ systems. Both parasympathetic activity and sympathetic activity are reduced. The conspicuous pattern of ANS dysfunction

Dysfunction of autonomic nervous system in childhood obesity: a cross-sectional study.

Science.gov (United States)

Baum, Petra; Petroff, David; Classen, Joseph; Kiess, Wieland; Blüher, Susann

2013-01-01

To assess the distribution of autonomic nervous system (ANS) dysfunction in overweight and obese children. Parasympathetic and sympathetic ANS function was assessed in children and adolescents with no evidence of impaired glucose metabolism by analysis of heart rate variability (low frequency power ln(LF), high frequency power, ln(HF); ln(LF/HF) ratio, ratio of longest RR interval during expiration to shortest interval during inspiration (E/I ratio), root mean square of successive differences (RMSSD); sympathetic skin response (SSR); and quantitative pupillography (pupil diameter in darkness, light reflex amplitude, latency, constriction velocity, re-dilation velocity). The relationship of each ANS variable to the standard deviation score of body mass index (BMI-SDS) was assessed in a linear model considering age, gender and pubertal stage as co-variates and employing an F-statistic to compare the fit of nested models. Group comparisons between normal weight and obese children as well as an analysis of dependence on insulin resistance (as indexed by the Homeostasis Model Assessment of Insulin Resistance, HOMA-IR) were performed for parameters shown to correlate with BMI-SDS. Statistical significance was set at 5%. Measurements were performed in 149 individuals (mean age 12.0 y; 90 obese 45 boys; 59 normal weight, 34 boys). E/I ratio (p = 0.003), ln(HF) (p = 0.03), pupil diameter in darkness (p = 0.01) were negatively correlated with BMI-SDS, whereas ln(LF/HF) was positively correlated (p = 0.05). Early re-dilation velocity was in trend negatively correlated to BMI-SDS (p = 0.08). None of the parameters that depended significantly on BMI-SDS was found to be significantly correlated with HOMA-IR. These findings demonstrate extended ANS dysfunction in obese children and adolescents, affecting several organ systems. Both parasympathetic activity and sympathetic activity are reduced. The conspicuous pattern of ANS dysfunction raises the possibility that obesity may give

Linear Analysis of Autonomic Activity and Its Correlation with Creatine Kinase-MB in Overt Thyroid Dysfunctions.

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Mavai, Manisha; Singh, Yogendra Raj; Gupta, R C; Mathur, Sandeep K; Bhandari, Bharti

2018-04-01

Autonomic activity may be deranged in thyroid dysfunctions and may lead to cardiovascular morbidity and mortality. Myopathy is a common manifestation in thyroid disorders and may be associated with raised serum creatine kinase (CK). We hypothesized that cardiovascular abnormality in thyroid dysfunction may manifest as raised CK-MB. This study was designed to investigate the correlation of CK and its isoform CK-MB with thyroid profile and linear parameters of heart rate variability (HRV). The study was conducted on 35 hypothyroid and hyperthyroid patients each, and 25 age-matched healthy controls. Autonomic activity was assessed by simple short term 5-min HRV. Biochemical evaluation of serum thyroid profile, CK-NAC and CK-MB were estimated in all the subjects. Our results demonstrated low HRV in hypo- as well as hyperthyroid patients. We observed significantly higher serum CK levels in hypothyroid patients when compared to hyperthyroids and controls. However, no significant differences were observed in CK-MB levels in the three groups. Significant positive correlation of CK with TSH and negative correlation with some HRV parameters (LF power, HF power, total power, SDNN, RMSSD) was observed in hypothyroid patients. Whereas correlation of CK-MB with thyroid profile as well as HRV parameters was non-significant in all the groups. Based on the CK and CK-MB findings and their correlation, we conclude that the cardiovascular changes seen in thyroid dysfunctions may primarily be due to autonomic imbalance without apparent cardiac muscle involvement. Whereas, raised CK levels indicate predominantly skeletal muscle involvement in hypothyroid patients.

The impact of autonomic dysfunction on survival in patients with dementia with Lewy bodies and Parkinson's disease with dementia.

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Kajsa Stubendorff

Full Text Available INTRODUCTION: Autonomic dysfunction is a well-known feature in neurodegenerative dementias, especially common in α-synucleinopathies like dementia with Lewy bodies and Parkinson's disease with dementia. The most common symptoms are orthostatic hypotension, incontinence and constipation, but its relevance in clinical practice is poorly understood. There are no earlier studies addressing the influence of autonomic dysfunction on clinical course and survival. The aim of this study was to investigate the frequency of the three most common features of autonomic dysfunction and analyze how it affects survival. METHODS: Thirty patients with dementia with Lewy bodies and Parkinson's disease with dementia were included in this prospective, longitudinal follow-up study. Presence of incontinence and constipation was recorded at baseline. Blood pressure was measured at baseline, after 3 months and after 6 months according to standardized procedures, with 5 measurements during 10 minutes after rising. Orthostatic hypotension was defined using consensus definitions and persistent orthostatic hypotension was defined as 5 or more measurements with orthostatic hypotension. Difference in survival was analyzed 36 months after baseline. RESULTS: There was a high frequency of persistent orthostatic blood pressure (50%, constipation (30% and incontinence (30%. Patients with persistent orthostatic hypotension had a significantly shorter survival compared to those with no or non-persistent orthostatic hypotension (Log rank x(2 = 4.47, p = 0.034. Patients with constipation and/or urinary incontinence, in addition to persistent orthostatic hypotension, had a poorer prognosis compared to those with isolated persistent orthostatic hypotension or no orthostatic hypotension (Log rank x(2 = 6.370, p = 0.041. DISCUSSION: According to our findings, the identification of autonomic dysfunction seems to be of great importance in clinical practice, not only to

Insights into the background of autonomic medicine.

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Laranjo, Sérgio; Geraldes, Vera; Oliveira, Mário; Rocha, Isabel

2017-10-01

Knowledge of the physiology underlying the autonomic nervous system is pivotal for understanding autonomic dysfunction in clinical practice. Autonomic dysfunction may result from primary modifications of the autonomic nervous system or be secondary to a wide range of diseases that cause severe morbidity and mortality. Together with a detailed history and physical examination, laboratory assessment of autonomic function is essential for the analysis of various clinical conditions and the establishment of effective, personalized and precise therapeutic schemes. This review summarizes the main aspects of autonomic medicine that constitute the background of cardiovascular autonomic dysfunction. Copyright © 2017 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

Testing for autonomic neuropathy

DEFF Research Database (Denmark)

Hilsted, J

1984-01-01

Autonomic neuropathy is a common complication in long-term diabetes, about 30% of the patients showing measurable signs of autonomic dysfunction after 10 years duration of disease. The diagnosis is often difficult to establish because clinical symptoms generally occur late in the course of the di......Autonomic neuropathy is a common complication in long-term diabetes, about 30% of the patients showing measurable signs of autonomic dysfunction after 10 years duration of disease. The diagnosis is often difficult to establish because clinical symptoms generally occur late in the course...

Autonomic Blockade Reverses Endothelial Dysfunction in Obesity-Associated Hypertension.

Science.gov (United States)

Gamboa, Alfredo; Figueroa, Rocío; Paranjape, Sachin Y; Farley, Ginnie; Diedrich, Andre; Biaggioni, Italo

2016-10-01

Impaired nitric oxide (NO) vasodilation (endothelial dysfunction) is associated with obesity and thought to be a factor in the development of hypertension. We previously found that NO synthesis inhibition had similar pressor effects in obese hypertensives compared with healthy control during autonomic blockade, suggesting that impaired NO vasodilation is secondary to sympathetic activation. We tested this hypothesis by determining the effect of autonomic blockade (trimethaphan 4 mg/min IV) on NO-mediated vasodilation (increase in forearm blood flow to intrabrachial acetylcholine) compared with endothelial-independent vasodilation (intrabrachial sodium nitroprusside) in obese hypertensive subjects (30blood flow (from 3.9±0.7 to 5.2±1.2 mL/100 mL per minute, P=0.078). As expected, NO-mediated vasodilation was blunted on the intact day compared with NO-independent vasodilation; forearm blood flow increased from 3.6±0.6 to 10.1±1.1 with the highest dose of nitroprusside, but only from 3.7±0.4 to 7.2±0.8 mL/100 mL per minute with the highest dose of acetylcholine, Pblood flow responses to acetylcholine were restored by autonomic blockade and were no longer different to nitroprusside (from 6.2±1.1 to 11.4±1.6 mL/100 mL per minute and from 5.2±0.9 to 12.5±0.9, respectively, P=0.58). Our results support the concept that sympathetic activation contributes to the impairment in NO-mediated vasodilation seen in obesity-associated hypertension and provides further rationale to explore it as a therapeutic target. © 2016 American Heart Association, Inc.

Autonomic Impairment in Borderline Personality Disorder: A Laboratory Investigation

Science.gov (United States)

Weinberg, Anna; Klonsky, E. David; Hajcak, Greg

2009-01-01

Recent research suggests that emotional dysfunction in psychiatric disorders can be reflected in autonomic abnormalities. The present study examines sympathetic and parasympathetic autonomic nervous system activity in individuals with Borderline Personality Disorder (BPD) before, during, and following a social stressor task. Data were obtained…

Rapid-onset obesity with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation (ROHHAD) syndrome may have a hypothalamus-periaqueductal gray localization.

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Chow, Cristelle; Fortier, Marielle Valerie; Das, Lena; Menon, Anuradha P; Vasanwala, Rashida; Lam, Joyce C M; Ng, Zhi Min; Ling, Simon Robert; Chan, Derrick W S; Choong, Chew Thye; Liew, Wendy K M; Thomas, Terrence

2015-05-01

Anatomical localization of the rapid-onset obesity with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation (ROHHAD) syndrome has proved elusive. Most patients had neuroimaging after cardiorespiratory collapse, revealing a range of ischemic lesions. A 15-year-old obese boy with an acute febrile encephalopathy had hypoventilation, autonomic dysfunction, visual hallucinations, hyperekplexia, and disordered body temperature, and saltwater regulation. These features describe the ROHHAD syndrome. Cerebrospinal fluid analysis showed pleocytosis, elevated neopterins, and oligoclonal bands, and serology for systemic and antineuronal antibodies was negative. He improved after receiving intravenous steroids, immunoglobulins, and long-term mycophenolate. Screening for neural crest tumors was negative. Magnetic resonance imaging of the brain early in his illness showed focal inflammation in the periaqueductal gray matter and hypothalamus. This unique localization explains almost all symptoms of this rare autoimmune encephalitis. Copyright © 2015 Elsevier Inc. All rights reserved.

Anxiety sensitivity in adolescents with somatoform autonomic dysfunction and adolescents with insulin dependent diabetes mellitus

OpenAIRE

Pisarić Maja; Nišević Sanja

2011-01-01

Anxiety sensitivity is defined as a belief that anxiety or fear may cause illness, embarrassment, or additional anxiety. The main purpose of this study was to find out if there were differences among adolescents with insulin dependent diabetes mellitus, adolescents with somatoform autonomic dysfunction and their healthy peers in different aspects of psychological functioning and anxiety sensitivity. The sample consisted of 93 subjects, aged 12 to 16. Hamburg Neuroticism and Extraversion...

Autonomic Predictors of Hospitalization Due to Heart Failure Decompensation in Patients with Left Ventricular Systolic Dysfunction.

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Ludmiła Daniłowicz-Szymanowicz

Full Text Available Autonomic nervous system balance can be significantly deteriorated during heart failure exacerbation. However, it is still unknown whether these changes are only the consequence of heart failure decompensation or can also predict development thereof. Objectives were to verify if simple, non-invasive autonomic parameters, such as baroreflex sensitivity and short-term heart rate variability can provide independent of other well-known clinical parameters information on the risk of heart failure decompensation in patients with left ventricular systolic dysfunction.In 142 stable patients with left ventricular ejection fraction ≤ 40%, baroreflex sensitivity and short-term heart rate variability, as well as other well-known clinical parameters, were analyzed. During 23 ± 9 months of follow-up 19 patients were hospitalized due to the heart failure decompensation (EVENT.Pre-specified cut-off values of baroreflex sensitivity (≤2.4 ms/mmHg and low frequency power index of heart rate variability (≤19 ms2 were significantly associated with the EVENTs (hazard ratio 4.43, 95% confidence interval [CI] 1.35-14.54 and 5.41, 95% CI 1.87-15.65 respectively. EVENTs were also associated with other parameters, such as left ventricular ejection fraction, NYHA class, diuretic use, renal function, brain natriuretic peptide and hemoglobin level, left atrial size, left and right ventricular heart failure signs. After adjusting baroreflex sensitivity and low frequency power index for each of the abovementioned parameters, autonomic parameters were still significant predictors of hospitalization due to the heart failure decompensation.Simple, noninvasive autonomic indices can be helpful in identifying individuals with increased risk of hospitalization due to the heart failure decompensation among clinically stable patients with left ventricular systolic dysfunction, even when adjusted for other well-known clinical parameters.

Association between Diastolic Dysfunction with Inflammation and Oxidative Stress in Females ob/ob Mice

Science.gov (United States)

Sartori, Michelle; Conti, Filipe F.; Dias, Danielle da Silva; dos Santos, Fernando; Machi, Jacqueline F.; Palomino, Zaira; Casarini, Dulce E.; Rodrigues, Bruno; De Angelis, Kátia; Irigoyen, Maria-Claudia

2017-01-01

Objective: To evaluate autonomic and cardiovascular function, as well as inflammatory and oxidative stress markers in ob/ob female mice. Methods: Metabolic parameters, cardiac function, arterial pressure (AP), autonomic, hormonal, inflammatory, and oxidative stress markers were evaluated in 12-weeks female wild-type (WT group) and ob/ob mice (OB group). Results: OB animals showed increased body weight, blood glucose, and triglyceride levels, along with glucose intolerance, when compared to WT animals. Ejection fraction (EF) and AP were similar between groups; however, the OB group presented diastolic dysfunction, as well as an impairment on myocardial performance index. Moreover, the OB group exhibited important autonomic dysfunction and baroreflex sensitivity impairment, when compared to WT group. OB group showed increased Angiotensin II levels in heart and renal tissues; decreased adiponectin and increased inflammatory markers in adipose tissue and spleen. Additionally, OB mice presented a higher damage to proteins and lipoperoxidation and lower activity of antioxidant enzymes in kidney and heart. Correlations were found between autonomic dysfunction with angiotensin II and inflammatory mediators, as well as between inflammation and oxidative stress. Conclusions: Our results showed that female adult ob/ob mice presented discrete diastolic dysfunction accompanied by autonomic disorder, which is associated with inflammation and oxidative stress in these animals. PMID:28878683

Association between Diastolic Dysfunction with Inflammation and Oxidative Stress in Females ob/ob Mice

Directory of Open Access Journals (Sweden)

Michelle Sartori

2017-08-01

Full Text Available Objective: To evaluate autonomic and cardiovascular function, as well as inflammatory and oxidative stress markers in ob/ob female mice.Methods: Metabolic parameters, cardiac function, arterial pressure (AP, autonomic, hormonal, inflammatory, and oxidative stress markers were evaluated in 12-weeks female wild-type (WT group and ob/ob mice (OB group.Results: OB animals showed increased body weight, blood glucose, and triglyceride levels, along with glucose intolerance, when compared to WT animals. Ejection fraction (EF and AP were similar between groups; however, the OB group presented diastolic dysfunction, as well as an impairment on myocardial performance index. Moreover, the OB group exhibited important autonomic dysfunction and baroreflex sensitivity impairment, when compared to WT group. OB group showed increased Angiotensin II levels in heart and renal tissues; decreased adiponectin and increased inflammatory markers in adipose tissue and spleen. Additionally, OB mice presented a higher damage to proteins and lipoperoxidation and lower activity of antioxidant enzymes in kidney and heart. Correlations were found between autonomic dysfunction with angiotensin II and inflammatory mediators, as well as between inflammation and oxidative stress.Conclusions: Our results showed that female adult ob/ob mice presented discrete diastolic dysfunction accompanied by autonomic disorder, which is associated with inflammation and oxidative stress in these animals.

Relationship among esophageal dysfunction, diabetic gastro-enteropathy, and autonomic neuropathy

International Nuclear Information System (INIS)

Yeh, S.H.; Liu, R.S.; Wu, L.C.; Lin, H.D.; Wang, S.J.; Lin, W.H.

1985-01-01

This study assessed the relationship of esophageal radionuclide transit (RT) to diabetic gastroenteropethy (CEP) and autonomic neuropathy (AN). Data were acquired in list mode after an oral dose of 0.5 mCi Tc-99m sulfur colloid in 10 ml of water in the supine position. A modified computer routine was used to calculate: (A) total mean transit time (TMTT) in sec, (B) residual fraction after the first swallow (RF), and )C) retrograde index (RI). Twenty-one patients (pts) with diabetes and 25 normal subjects (N) were studied. Eleven pts belonged to Group 1 with symptomatic GEP and AN; 5, Group 2 with no GEP but with AN; and 5, Group 3 with neither. Abnormal RT mainly occurred in Group 1. RI was the best parameter with respective sensitivity and specificity of 0.91 (10/110 and 0.96 (24/25. RI was abnormal in 10/11 pts with GEP (Group 1), but normal in all 10 pts without GEP (Groups 2 and 3). All 5 pts only with AN (group 2) had normal RI. The authors conclude that esophageal dysfunction is present in nearly all pts with diabetic GEP. However, the presence of AN alone will not explain esophageal transit abnormality

Autonomic Nervous System Disorders

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Your autonomic nervous system is the part of your nervous system that controls involuntary actions, such as the beating of your heart ... breathing and swallowing Erectile dysfunction in men Autonomic nervous system disorders can occur alone or as the result ...

Eyeball Pressure Stimulation Unveils Subtle Autonomic Cardiovascular Dysfunction in Persons with a History of Mild Traumatic Brain Injury.

Science.gov (United States)

Hilz, Max J; Aurnhammer, Felix; Flanagan, Steven R; Intravooth, Tassanai; Wang, Ruihao; Hösl, Katharina M; Pauli, Elisabeth; Koehn, Julia

2015-11-15

After mild traumatic brain injury (mTBI), patients have increased long-term mortality rates, persisting even beyond 13 years. Pathophysiology is unclear. Yet, central autonomic network dysfunction may contribute to cardiovascular dysregulation and increased mortality. Purely parasympathetic cardiovascular challenge by eyeball pressure stimulation (EP), might unveil subtle autonomic dysfunction in post-mTBI patients. We investigated whether mild EP shows autonomic cardiovascular dysregulation in post-mTBI patients. In 24 patients (34 ± 12 years; 5-86 months post-injury) and 27 controls (30 ± 11 years), we monitored respiration, electrocardiographic RR intervals (RRI), systolic and diastolic blood pressure (BPsys, BPdia) before and during 2 min of 30 mm Hg EP, applied by an ophthalmologic ocular pressure device (Okulopressor(®)). We calculated spectral powers of RRI in the mainly sympathetic low frequency (LF; 0.04-0.15 Hz) and parasympathetic high frequency (HF; 0.15-0.5 Hz) ranges, and of BP in the sympathetic LF range, the RRI-LF/HF ratio as index of the sympathetic-parasympathetic balance, normalized (nu) RRI-LF- and HF-powers, and LF- and HF-powers after natural logarithmic transformation (ln). Parameters before and during EP in post-mTBI patients and controls were compared by repeated measurement analysis of variance with post hoc analysis (p < 0.05). During EP, BPsys and BPdia increased in post-mTBI patients. Only in controls but not in post-mTBI patients, EP increased RRI-HFnu-powers and decreased RRI-LF-powers, RRI-LFnu-powers, BPsys-LF-powers, BPsys-lnLF-powers and BPdia-lnLF-powers. RRI-LF/HF ratios slightly increased in post-mTBI patients but slightly decreased in controls upon EP. Even with only mild EP, our controls showed normal EP responses and shifted sympathetic-parasympathetic balance towards parasympathetic predominance. In contrast, our post-mTBI patients could not increase parasympathetic heart rate modulation but

Is There an Association Between Markers of Cardiovascular Autonomic Dysfunction at Discharge From Rehabilitation and Participation 1 and 5 Years Later in Individuals With Spinal Cord Injury?

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Rianne Ravensbergen, H J; de Groot, Sonja; Post, Marcel W; Bongers-Janssen, Helma M; van der Woude, Lucas H; Claydon, Victoria E

2016-09-01

To determine whether physical activity and participation 1 and 5 years after discharge are associated with measures of cardiovascular autonomic function: prevalence of hypotension and reduced peak heart rate at discharge from initial inpatient spinal cord injury (SCI) rehabilitation. Prospective cohort study. Rehabilitation centers. Individuals with SCI (N=146). Not applicable. We recorded markers of cardiovascular autonomic dysfunction (resting blood pressure and peak heart rate) and personal and lesion characteristics at the time of discharge from rehabilitation. Parameters for participation (social health status dimension of the Sickness Impact Profile) and physical activity (Physical Activity Scale for Individuals with Physical Disabilities [PASIPD]) were measured 1 and 5 years after discharge. Effects of prevalence of cardiovascular autonomic dysfunction were analyzed using linear regression analysis while correcting for possible confounders. We found no significant association between hypotension and social health status dimension of the Sickness Impact Profile or PASIPD, either at 1 or at 5 years after discharge. A significant association between peak heart rate and social health status dimension of the Sickness Impact Profile was found at 1 year after discharge, showing poorer participation in individuals with low peak heart rate (ie, cardiovascular autonomic dysfunction). The unadjusted relation between peak heart rate and the social health status dimension of the Sickness Impact Profile was significant at 5 years, but not when adjusted for confounders. We found associations between peak heart rate and PASIPD for both 1 and 5 years after discharge; however, these were not significant after correction for potential confounding factors. Autonomic dysfunction after SCI is a crucial factor influencing quality of life. We found that cardiovascular autonomic impairment, assessed from low peak heart rate, was associated with reduced participation after 1 year

Autonomic symptoms in idiopathic REM behavior disorder

DEFF Research Database (Denmark)

Ferini-Strambi, Luigi; Oertel, Wolfgang; Dauvilliers, Yves

2014-01-01

Patients with idiopathic REM sleep behavior disorder (iRBD) are at very high risk of developing neurodegenerative synucleinopathies, which are disorders with prominent autonomic dysfunction. Several studies have documented autonomic dysfunction in iRBD, but large-scale assessment of autonomic...... symptoms has never been systematically performed. Patients with polysomnography-confirmed iRBD (318 cases) and controls (137 healthy volunteers and 181 sleep center controls with sleep diagnoses other than RBD) were recruited from 13 neurological centers in 10 countries from 2008 to 2011. A validated scale...

Lateral medullary infarction with cardiovascular autonomic dysfunction: an unusual presentation with review of the literature.

Science.gov (United States)

Huynh, Tridu R; Decker, Barbara; Fries, Timothy J; Tunguturi, Ajay

2018-01-24

We report an unusual case of lateral medullary infarction presenting with orthostatic hypotension with pre-syncope without vertigo or Horner's syndrome. Case report with review of the literature. A 67-year-old man presented with pre-syncope and ataxia without vertigo. Initial brain CT and MRI were normal. Neurological evaluation revealed right-beating nystagmus with left gaze, vertical binocular diplopia, right upper-extremity dysmetria, truncal ataxia with right axial lateropulsion, and right-facial and lower extremity hypoesthesia. Bedside blood pressure measurements disclosed orthostatic hypotension. He had normal sinus rhythm on telemetry and normal ejection fraction on echocardiogram. A repeat brain MRI disclosed an acute right dorsolateral medullary infarct. Autonomic testing showed reduced heart rate variability during paced deep breathing, attenuated late phase II and phase IV overshoot on Valsalva maneuver, and a fall of 25 mmHg of blood pressure at the end of a 10-min head-up tilt with no significant change in heart rate. These results were consistent with impaired sympathetic and parasympathetic cardiovascular reflexes. He was discharged to acute rehabilitation a week later with residual right dysmetria and ataxia. Lateral medullary infarctions are usually reported as partial presentations of classical lateral medullary syndrome with accompanying unusual symptoms ranging from trigeminal neuralgias to hiccups. Pre-syncope from orthostatic hypotension is a rare presentation. In the first 3-4 days, absence of early DWI MRI findings is possible in small, dorsolateral medullary infarcts with sensory disturbances. Physicians should be aware of this presentation, as early diagnosis and optimal therapy are associated with good prognosis.

Rapid-onset obesity with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation (ROHHAD): Response to ventilatory challenges.

Science.gov (United States)

Carroll, Michael S; Patwari, Pallavi P; Kenny, Anna S; Brogadir, Cindy D; Stewart, Tracey M; Weese-Mayer, Debra E

2015-12-01

Hypoventilation is a defining feature of Rapid-onset Obesity with Hypothalamic dysfunction, Hypoventilation and Autonomic Dysregulation (ROHHAD), a rare respiratory and autonomic disorder. This chronic hypoventilation has been explained as the result of dysfunctional chemosensory control circuits, possibly affecting peripheral afferent input, central integration, or efferent motor control. However, chemosensory function has never been quantified in a cohort of ROHHAD patients. Therefore, the purpose of this study was to assess the response to awake ventilatory challenge testing in children and adolescents with ROHHAD. The ventilatory, cardiovascular and cerebrovascular responses in 25 distinct comprehensive physiological recordings from seven unique ROHHAD patients to three different gas mixtures were analyzed at breath-to-breath and beat-to-beat resolution as absolute measures, as change from baseline, or with derived metrics. Physiologic measures were recorded during a 3-min baseline period of room air, a 3-min gas exposure (of 100% O2; 95% O2, 5% CO2; or 14% O2, 7% CO2 balanced with N2), and a 3-min recovery period. An additional hypoxic challenge was conducted which consisted of either five or seven tidal breaths of 100% N2. While ROHHAD cases showed a diminished VT and inspiratory drive response to hypoxic hypercapnia and absent behavioral awareness of the physiologic compromise, most ventilatory, cardiovascular, and cerebrovascular measures were similar to those of previously published controls using an identical protocol, suggesting a mild chemosensory deficit. Nonetheless, the high mortality rate, comorbidity and physiological fragility of patients with ROHHAD demand continued clinical vigilance. © 2015 Wiley Periodicals, Inc.

Autonomic Dysfunction in Patients with Mild to Moderate Alzheimer's Disease

DEFF Research Database (Denmark)

Jensen-Dahm, Christina; Waldemar, Gunhild; Staehelin Jensen, Troels

2015-01-01

BACKGROUND: Autonomic function has received little attention in Alzheimer's disease (AD). AD pathology has an impact on brain regions which are important for central autonomic control, but it is unclear if AD is associated with disturbance of autonomic function. OBJECTIVE: To investigate autonomic...

Cardiovascular autonomic dysfunction due to diabetes mellitus: An ...

African Journals Online (AJOL)

Cardiovascular autonomic neuropathy (CAN) is a common form of diabetes autonomic neuropathy, causes abnormalities in heart rate control as well as central and peripheral vascular dynamics, and may carry an increased risk of mortality. The aim of this article was to review the importance of identifying CAN and ...

[Construction and clinical evaluation of novel methods for detecting autoinomic dysfunction].

Science.gov (United States)

Obayashi, Konen

2012-05-01

The autonomic nervous system innervates every organ in the body. Since autonomic disturbances affect patient survival, an understanding of and recognition of these disturbances are important. We adopted several new methods to evaluate autonomic function accurately for detecting the onset of small-fiber neuropathy, such as laser-Doppler flowmetry, ultrasonography, 123I-MIBG scintigraphy, electrogastrography, cystometry, glucose-tolerance test, near-infrared spectrophotoscopy, blood pressure tests, and evaluation of sweating. After these examinations, we applied potential effective treatments to improve the survival and daily activity of these patients. We also evaluated the effect of liver transplantation on autonomic dysfunction of familial amyloidotic polyneuropathy (FAP) patients using our tools. Liver transplantation not only prevents the progression of autonomic dysfunction in these patients but also improves some autonomic symptoms in the early stage after the operation. As all domino-liver transplantation-induced amyloid neuropathies, including our cases, were of the sensory type rather than with autonomic involvement, assessment of the pain threshold by preferential stimulation of A delta fibers is a particularly useful tool for diagnosing the onset of small-fiber neuropathies in these patients in addition to autonomic testing. Analyses and comparison of patients with FAP and domino-liver-transplanted patients with autonomic, sensory and motor dysfunction may give a clue to elucidate the pathogenesis and treatment of neuropathy in FAP. As autonomic disturbances play an important role in the symptomatology of small-fiber neuropathy, liver-transplanted FAP, and domino-liver-transplanted patients, further studies of autonomic dysfunction in these patients may lead to the pathogenesis of the disease.

Rapid-Onset Obesity with Hypothalamic Dysfunction, Hypoventilation, and Autonomic Dysregulation (ROHHAD): exome sequencing of trios, monozygotic twins and tumours

OpenAIRE

Barclay, Sarah F.; Rand, Casey M.; Borch, Lauren A.; Nguyen, Lisa; Gray, Paul A.; Gibson, William T.; Wilson, Richard J. A.; Gordon, Paul M. K.; Aung, Zaw; Berry-Kravis, Elizabeth M.; Ize-Ludlow, Diego; Weese-Mayer, Debra E.; Bech-Hansen, N. Torben

2015-01-01

Background Rapid-onset Obesity with Hypothalamic Dysfunction, Hypoventilation, and Autonomic Dysregulation (ROHHAD) is thought to be a genetic disease caused by de novo mutations, though causative mutations have yet to be identified. We searched for de novo coding mutations among a carefully-diagnosed and clinically homogeneous cohort of 35 ROHHAD patients. Methods We sequenced the exomes of seven ROHHAD trios, plus tumours from four of these patients and the unaffected monozygotic (MZ) twin ...

Role of the functional status of the autonomic nervous system in the clinical course of purulent meningitis

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D. A. Zadiraka

2014-04-01

Full Text Available Purulent meningitis is defined by high indices of sickness and lethality rates, a great risk of cerebral and extracerebral complications development, steady residual consequences formation. During neuroinfections, the state of adaptation mechanisms, which is characterized by exhaustion of regulatory systems with the development of decompensation, plays a crucial part. Heart rate variability clearly reflects the degree of regulatory system tension caused by the influence of both physiological and pathological factors. Research aim: to increase the autonomic dysfunction diagnostics efficiency for patients suffering from purulent meningitis in the disease dynamics based on the complex of clinical evidence and functional status of autonomic nervous system. Materials and methods. There were 60 patients with purulent meningitis under medical observation. Wein’s questionnaire was used for the detection of clinical presentations of autonomic dysfunction. Functional status of autonomic nervous system was diagnosed using the method of computer-based cardiointervalometry. The screening group was formed of 20 healthy individuals. Research findings and theirs discussion. Cerebral meningeal symptom was dominant among the patients suffering from purulent meningitis at the peak of the disease. At hospitalization every fifth person (23,3% had the objective evidence of autonomic dysfunction in the form of a postural tremor of upper limbs and eyelids. The analysis of autonomic nervous system parameters functional status among the patients suffering from purulent meningitis at the peak of disease showed heart rate variability decrease in the main branches of autonomic regulation and the presence of autonomic imbalance towards vagotonia. Since the second week, clinical signs of autonomic dysfunction prevailed in the dynamics of patients suffering from purulent meningitis in the course of standard treatment, which was proved by Wein’s survey of the patients. The

Cardiovascular Autonomic Neuropathy in Systemic Lupus Erythematosus.

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Alam, Md Mahboob; Das, Pinaki; Ghosh, Parasar; Zaman, Md Salim Uz; Boro, Madhusmita; Sadhu, Manika; Mazumdar, Ardhendu

2015-01-01

Objective is to evaluate cardiovascular autonomic function in SLE by simple non-invasive tests. A case control study was carried out involving 18-50 yrs old previously diagnosed SLE patients and same number of age and sex-matched controls. Parasympathetic function was assessed by heart rate (HR) response to Valsalva maneuver, deep breathing and standing. Sympathetic function was evaluated by blood pressure response to standing and sustained hand-grip test (HGT). There were 50 female SLE patients. They had significantly higher minimum resting HR and diastolic blood pressure (DBP). HR variation with deep breathing, expiratory inspiratory ratio, 30:15 ratio and DBP change in response to HGT were significantly lower inpatients compared to controls. Thirty patients (60%) had at least one abnormal or two borderline test results indicating autonomic impairment of which 27 had parasympathetic dysfunction and 7 had sympathetic dysfunction. Autonomic dysfunction is common in SLE with higher prevalence of parasympathetic impairment.

Comparison of Prediction Model for Cardiovascular Autonomic Dysfunction Using Artificial Neural Network and Logistic Regression Analysis

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Zeng, Fangfang; Li, Zhongtao; Yu, Xiaoling; Zhou, Linuo

2013-01-01

Background This study aimed to develop the artificial neural network (ANN) and multivariable logistic regression (LR) analyses for prediction modeling of cardiovascular autonomic (CA) dysfunction in the general population, and compare the prediction models using the two approaches. Methods and Materials We analyzed a previous dataset based on a Chinese population sample consisting of 2,092 individuals aged 30–80 years. The prediction models were derived from an exploratory set using ANN and LR analysis, and were tested in the validation set. Performances of these prediction models were then compared. Results Univariate analysis indicated that 14 risk factors showed statistically significant association with the prevalence of CA dysfunction (P<0.05). The mean area under the receiver-operating curve was 0.758 (95% CI 0.724–0.793) for LR and 0.762 (95% CI 0.732–0.793) for ANN analysis, but noninferiority result was found (P<0.001). The similar results were found in comparisons of sensitivity, specificity, and predictive values in the prediction models between the LR and ANN analyses. Conclusion The prediction models for CA dysfunction were developed using ANN and LR. ANN and LR are two effective tools for developing prediction models based on our dataset. PMID:23940593

Autonomic dysfunction in mild cognitive impairment: evidence from power spectral analysis of heart rate variability in a cross-sectional case-control study.

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Paola Nicolini

Full Text Available Mild cognitive impairment (MCI is set to become a major health problem with the exponential ageing of the world's population. The association between MCI and autonomic dysfunction, supported by indirect evidence and rich with clinical implications in terms of progression to dementia and increased risk of mortality and falls, has never been specifically demonstrated.To conduct a comprehensive assessment of autonomic function in subjects with MCI by means of power spectral analysis (PSA of heart rate variability (HRV at rest and during provocative manoeuvres.This cross-sectional study involved 80 older outpatients (aged ≥ 65 consecutively referred to a geriatric unit and diagnosed with MCI or normal cognition (controls based on neuropsychological testing. PSA was performed on 5-minute electrocardiographic recordings under three conditions--supine rest with free breathing (baseline, supine rest with paced breathing at 12 breaths/minute (parasympathetic stimulation, and active standing (orthosympathetic stimulation--with particular focus on the changes from baseline to stimulation of indices of sympathovagal balance: normalized low frequency (LFn and high frequency (HFn powers and the LF/HF ratio. Blood pressure (BP was measured at baseline and during standing. Given its exploratory nature in a clinical population the study included subjects on medications with a potential to affect HRV.There were no significant differences in HRV indices between the two groups at baseline. MCI subjects exhibited smaller physiological changes in all three HRV indices during active standing, consistently with a dysfunction of the orthosympathetic system. Systolic BP after 10 minutes of standing was lower in MCI subjects, suggesting dysautonomia-related orthostatic BP dysregulation.Our study is novel in providing evidence of autonomic dysfunction in MCI. This is associated with orthostatic BP dysregulation and the ongoing follow-up of the study population will

Autonomic neuropathy-in its many guises-as the initial manifestation of the antiphospholipid syndrome.

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Schofield, Jill R

2017-04-01

Autonomic disorders have previously been described in association with the antiphospholipid syndrome. The present study aimed to determine the clinical phenotype of patients in whom autonomic dysfunction was the initial manifestation of the antiphospholipid syndrome and to evaluate for autonomic neuropathy in these patients. This was a retrospective study of 22 patients evaluated at the University of Colorado who were found to have a disorder of the autonomic nervous system as the initial manifestation of antiphospholipid syndrome. All patients had persistent antiphospholipid antibody positivity and all patients who underwent skin biopsy were found to have reduced sweat gland nerve fiber density suggestive of an autonomic neuropathy. All patients underwent an extensive evaluation to rule out other causes for their autonomic dysfunction. Patients presented with multiple different autonomic disorders, including postural tachycardia syndrome, gastrointestinal dysmotility, and complex regional pain syndrome. Despite most having low-titer IgM antiphospholipid antibodies, 13 of the 22 patients (59%) suffered one or more thrombotic event, but pregnancy morbidity was minimal. Prothrombin-associated antibodies were helpful in confirming the diagnosis of antiphospholipid syndrome. We conclude that autonomic neuropathy may occur in association with antiphospholipid antibodies and may be the initial manifestation of the syndrome. Increased awareness of this association is important, because it is associated with a significant thrombotic risk and a high degree of disability. In addition, anecdotal experience has suggested that antithrombotic therapy and intravenous immunoglobulin therapy may result in significant clinical improvement in these patients.

The clinical presentation and diagnosis of epileptic autonomic auras

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Marina Revditovna Kremenchugskaya

2012-01-01

Full Text Available Objective: to refine the pattern of clinical manifestations of epileptic autonomic auras (EAA and to reveal clinical, electroencephalographic, and neuroimaging ratios. Patients and methods. Eighteen patients (8, 41% men and 10, 59% women aged 9 to 27years (mean 18±5years were examined. The examination encompassed analysis of history data, clinical and neurological studies, long-term video-assisted electroencephalographic monitoring, and magnetic resonance imaging (MRI of the brain. Results. In most patients (n = 12, 67%, the symptoms of EAA corresponded to the criteria for abdominal one. In the other patients, the clinical manifestations resembled autonomic paroxysms as attacks of panic. Interictal pathological changes on an electroencephalogram (EEG were present in the frontal, temporal, and frontotemporal regions in 4 (22%, 6 (33%, and 7 (39% patients, respectively, as well as in both the left and right hemispheres without significant differences. Pathological EEG changes were not found in one case. MRI detected that 13 (72% patients had structural changes that were potentially eliptogenic. Conclusion. The clinical symptoms of EAA give information on the site of a primary pathological focus. It is necessary to differentiate EAA from non-epileptic paroxysmal states. The autonomic phenomena of epileptic genesis help study the functional organizations of the autonomic nervous system.

Pattern of Presentation of Multiple Organ Dysfunction Syndrome in ...

African Journals Online (AJOL)

Background: Multiple organ dysfunction syndrome is the sequential failure of several organ systems after a trigger event, like sepsis, massive transfusions, burns, trauma and cardiogenic shock. Aim and Objectives- The pattern of presentation of multiple organ dysfunction and the risk factors associated with multiple organ ...

Autonomic dysfunction in diabetes : a consequence of cardiovascular damage

NARCIS (Netherlands)

Lefrandt, J D; Smit, A J; Zeebregts, C J; Gans, R O B; Hoogenberg, K H

2010-01-01

In 1976, D.J. Ewing showed a clear survival disadvantage for diabetic patients that had 'diabetic autonomic neuropathy', as assessed by heart rate and blood pressure variations during a battery of bedside tests. However, these variations do not solely depend on autonomic nervous system function, but

Autonomic skin responses in females with Fabry disease

DEFF Research Database (Denmark)

Møller, Anette Torvin; Bach, Flemming W.; Feldt-Rasmussen, Ulla

2009-01-01

Fabry disease is a genetic lysosomal disorder with dysfunction of the lysosomal enzyme alpha-galactosidase A causing accumulation of glycolipids in multiple organs including the nervous system and with neuropathy as a prominent manifestation. Neurological symptoms include pain and autonomic...... dysfunction. This study examined peripheral autonomic nerve function in 19 female patients with Fabry disease and 19 sex and age-matched controls by measuring (1) sweat production following acetylcholine challenge; (2) the sympathetically mediated vasoconstrictor responses to inspiratory gasp, stress...

Autonomic, locomotor and cardiac abnormalities in a mouse model of muscular dystrophy: targeting the renin-angiotensin system.

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Sabharwal, Rasna; Chapleau, Mark W

2014-04-01

New Findings What is the topic of this review? This symposium report summarizes autonomic, cardiac and skeletal muscle abnormalities in sarcoglycan-δ-deficient mice (Sgcd-/-), a mouse model of limb girdle muscular dystrophy, with emphasis on the roles of autonomic dysregulation and activation of the renin-angiotensin system at a young age. What advances does it highlight? The contributions of the autonomic nervous system and the renin-angiotensin system to the pathogenesis of muscular dystrophy are highlighted. Results demonstrate that autonomic dysregulation precedes and predicts later development of cardiac dysfunction in Sgcd-/- mice and that treatment of young Sgcd-/- mice with the angiotensin type 1 receptor antagonist losartan or with angiotensin-(1-7) abrogates the autonomic dysregulation, attenuates skeletal muscle pathology and increases spontaneous locomotor activity. Muscular dystrophies are a heterogeneous group of genetic muscle diseases characterized by muscle weakness and atrophy. Mutations in sarcoglycans and other subunits of the dystrophin-glycoprotein complex cause muscular dystrophy and dilated cardiomyopathy in animals and humans. Aberrant autonomic signalling is recognized in a variety of neuromuscular disorders. We hypothesized that activation of the renin-angiotensin system contributes to skeletal muscle and autonomic dysfunction in mice deficient in the sarcoglycan-δ (Sgcd) gene at a young age and that this early autonomic dysfunction contributes to the later development of left ventricular (LV) dysfunction and increased mortality. We demonstrated that young Sgcd-/- mice exhibit histopathological features of skeletal muscle dystrophy, decreased locomotor activity and severe autonomic dysregulation, but normal LV function. Autonomic regulation continued to deteriorate in Sgcd-/- mice with age and was accompanied by LV dysfunction and dilated cardiomyopathy at older ages. Autonomic dysregulation at a young age predicted later development of

Frontier studies on fatigue, autonomic nerve dysfunction, and sleep-rhythm disorder.

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Tanaka, Masaaki; Tajima, Seiki; Mizuno, Kei; Ishii, Akira; Konishi, Yukuo; Miike, Teruhisa; Watanabe, Yasuyoshi

2015-11-01

Fatigue is defined as a condition or phenomenon of decreased ability and efficiency of mental and/or physical activities, caused by excessive mental or physical activities, diseases, or syndromes. It is often accompanied by a peculiar sense of discomfort, a desire to rest, and reduced motivation, referred to as fatigue sensation. Acute fatigue is a normal condition or phenomenon that disappears after a period of rest; in contrast, chronic fatigue, lasting at least 6 months, does not disappear after ordinary rest. Chronic fatigue impairs activities and contributes to various medical conditions, such as cardiovascular disease, epileptic seizures, and death. In addition, many people complain of chronic fatigue. For example, in Japan, more than one third of the general adult population complains of chronic fatigue. It would thus be of great value to clarify the mechanisms underlying chronic fatigue and to develop efficient treatment methods to overcome it. Here, we review data primarily from behavioral, electrophysiological, and neuroimaging experiments related to neural dysfunction as well as autonomic nervous system, sleep, and circadian rhythm disorders in fatigue. These data provide new perspectives on the mechanisms underlying chronic fatigue and on overcoming it.

ANALYSIS OF A DIFFERENTIATED APPROACH TO THE APPOINTMENT OF DICK METHODS IN BIOFEEDBACK CORRECTION AUTONOMIC DYSFUNCTION

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A. G. Polyakova

2013-01-01

Full Text Available Goal of research: analysis of the effectiveness of Biofeedback therapy is differentiated depending on the clinical forms of autonomic dysfunction. Exchange rate control efficacy of biofeedback hardware was conducted on the dynamics of clinical andl aboratory data, surveys and assessment of the functional State of the SNC using heart rate variability, vegetative resonance test, Kerdo index definition, as well as èlektrokardiografiče applications and questionnaires, characterizing the State of psychoemotional sphere (Spilbergera–Hanina, test, Luscher. Laboratory tests include a complete blood count with evaluation of Adaptive reactions of the organism. The results of the rehabilitation complex of the patients with the use of biofeedback have confirmed its effectiveness.

Cardiac autonomic testing and treating heart disease. 'A clinical perspective'

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Nicholas L. DePace

2014-12-01

Full Text Available Background Coronary heart disease (CHD is a major health concern, affecting nearly half the middle-age population and responsible for nearly one-third of all deaths. Clinicians have several major responsibilities beyond diagnosing CHD, such as risk stratification of patients for major adverse cardiac events (MACE and treating risks, as well as the patient. This second of a two-part review series discusses treating risk factors, including autonomic dysfunction, and expected outcomes. Methods Therapies for treating cardiac mortality risks including cardiovascular autonomic neuropathy (CAN, are discussed. Results While risk factors effectively target high-risk patients, a large number of individuals who will develop complications from heart disease are not identified by current scoring systems. Many patients with heart conditions, who appear to be well-managed by traditional therapies, experience MACE. Parasympathetic and Sympathetic (P&S function testing provides more information and has the potential to further aid doctors in individualizing and titrating therapy to minimize risk. Advanced autonomic dysfunction (AAD and its more severe form cardiovascular autonomic neuropathy have been strongly associated with an elevated risk of cardiac mortality and are diagnosable through autonomic testing. This additional information includes patient-specific physiologic measures, such as sympathovagal balance (SB. Studies have shown that establishing and maintaining proper SB minimizes morbidity and mortality risk. Conclusions P&S testing promotes primary prevention, treating subclinical disease states, as well as secondary prevention, thereby improving patient outcomes through (1 maintaining wellness, (2 preventing symptoms and disorder and (3 treating subclinical manifestations (autonomic dysfunction, as well as (4 disease and symptoms (autonomic neuropathy.

The preserved autonomic functions may provide the asymptomatic clinical status in heart failure despite advanced left ventricular systolic dysfunction.

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Kocaman, Sinan Altan; Taçoy, Gülten; Ozdemir, Murat; Açıkgöz, Sadık Kadri; Cengel, Atiye

2010-12-01

Autonomic dysfunction is an important marker of prognosis in congestive heart failure (CHF) and may determine the symptoms and progression of CHF. The aim of our study was to investigate whether preserved autonomic function assessed by heart rate variability (HRV) analyses is related to absence of CHF symptoms despite prominently reduced systolic function. The study had a cross-sectional observational design. Fifty patients with left ventricular ejection fraction (EF) below 40% were enrolled. The patients were divided into two groups according to their CHF symptomatic status as Group 1 (NYHA functional class I, asymptomatic group) and Group 2 (NYHA functional class ≥ II, symptomatic group). Plasma C-reactive protein (CRP), N-terminal proB-type natriuretic peptide (NT-proBNP) levels, echocardiographic parameters and HRV indices were measured while the patients were clinically stable in each group. Possible factors associated with the development of CHF symptoms were assessed by using multiple regression analysis. Baseline clinical characteristics and left ventricular EF were similar in the two groups. Serum CRP (15 ± 21 vs 7 ± 18 mg/L, p=0.011) and NT-proBNP levels (1935 ± 1088 vs 1249 ± 1083 pg/mL, p=0.020) were significantly higher in symptomatic group. The HRV parameters (SDNN: 78 ± 57 vs 122 ± 42 ms, p=0.001; SDANN: 65 ± 55 vs 84 ± 38 ms, p=0.024; SDNNi: 36 ± 41 vs 70 ± 46 ms, pfunction were significantly associated with the asymptomatic status (SDNN, OR: 1.016, 95%CI: 1.002-1.031, p=0.028; SDNNi, OR: 1.030, 95%CI: 1.008-1.052, p=0.006; TI, OR: 1.088, 95%CI: 1.019-1.161, p=0.011). Preserved autonomic functions were shown to be associated with absence of CHF symptoms independently of angiotensin converting enzyme inhibitor/angiotensin receptor blocker's treatment and BNP levels and may be protective against the development of CHF symptoms despite advanced left ventricular systolic dysfunction.

Balancing the autonomic nervous system to reduce inflammation in rheumatoid arthritis

NARCIS (Netherlands)

Koopman, F. A.; van Maanen, M. A.; Vervoordeldonk, M. J.; Tak, P. P.

2017-01-01

Imbalance in the autonomic nervous system (ANS) has been observed in many established chronic autoimmune diseases, including rheumatoid arthritis (RA), which is a prototypic immune-mediated inflammatory disease (IMID). We recently discovered that autonomic dysfunction precedes and predicts arthritis

Autonomic hyper-reflexia modulated by percutaneous epidural neurostimulation: a preliminary report.

Science.gov (United States)

Richardson, R R; Cerullo, L J; Meyer, P R

1979-06-01

Our clinical experience in the management of five paraplegic or quadriplegic patients with subjective complaints and objective findings of autonomic hyper-reflexia is presented. These five patients had epidural neurostimulation systems implanted percutaneously to regulate intractable spasticity. During a follow-up period varying from 2 months to almost 2 years, four of the five patients experienced no episodes of autonomic dysfunction with the use of a low frequency, low voltage, square wave pulse output. From their responses and from recent neurophysiological evidence, the potential benefit of percutaneous epidural neurostimulation in the modulation of autonomic hyper-reflexia without antihypertensive medication is suggested. Further follow-up of these patients and additional clinical research should be performed to confirm our initial clinical impressions.

Altered balance in the autonomic nervous system in schizophrenic patients

DEFF Research Database (Denmark)

Nielsen, B M; Mehlsen, J; Behnke, K

1988-01-01

.05). Heart-rate response to inspiration was greater in non-medicated schizophrenics compared to normal subjects (P less than 0.05), whereas no difference was found between medicated and non-medicated schizophrenics. The results show that the balance in the autonomic nervous system is altered in schizophrenic...... patients with a hyperexcitability in both the sympathetic and the parasympathetic division. Our study has thus indicated a dysfunction in the autonomic nervous system per se and the previous interpretations of attentional orienting responses in schizophrenia is questioned. Medication with neuroleptics......The aim of the present study was to evaluate the autonomic nervous function in schizophrenic patients. Twenty-eight patients (29 +/- 6 years) diagnosed as schizophrenics and in stable medication were included, together with ten schizophrenic patients (25 +/- 5 years) who were unmedicated. Eleven...

Altered Behavioral and Autonomic Pain Responses in Alzheimer’s Disease Are Associated with Dysfunctional Affective, Self-Reflective and Salience Network Resting-State Connectivity

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Paul A. Beach

2017-09-01

Full Text Available While pain behaviors are increased in Alzheimer’s disease (AD patients compared to healthy seniors (HS across multiple disease stages, autonomic responses are reduced with advancing AD. To better understand the neural mechanisms underlying these phenomena, we undertook a controlled cross-sectional study examining behavioral (Pain Assessment in Advanced Dementia, PAINAD scores and autonomic (heart rate, HR pain responses in 24 HS and 20 AD subjects using acute pressure stimuli. Resting-state fMRI was utilized to investigate how group connectivity differences were related to altered pain responses. Pain behaviors (slope of PAINAD score change and mean PAINAD score were increased in patients vs. controls. Autonomic measures (HR change intercept and mean HR change were reduced in severe vs. mildly affected AD patients. Group functional connectivity differences associated with greater pain behavior reactivity in patients included: connectivity within a temporal limbic network (TLN and between the TLN and ventromedial prefrontal cortex (vmPFC; between default mode network (DMN subcomponents; between the DMN and ventral salience network (vSN. Reduced HR responses within the AD group were associated with connectivity changes within the DMN and vSN—specifically the precuneus and vmPFC. Discriminant classification indicated HR-related connectivity within the vSN to the vmPFC best distinguished AD severity. Thus, altered behavioral and autonomic pain responses in AD reflects dysfunction of networks and structures subserving affective, self-reflective, salience and autonomic regulation.

[A case of hereditary sensory and autonomic neuropathy type 1E with frontal lobe dysfunction as an initial symptom].

Science.gov (United States)

Watanabe, Masashi; Matsumoto, Yushi; Okamoto, Kensho; Okuda, Bungo; Mizuta, Ikuko; Mizuno, Toshiki

2017-12-27

A 49-year-old man had developed gradually personality change, gait disturbance, and hearing loss for five years. On admission, he presented with frontal release signs, stuttering, vertical gaze palsy, sensorineural deafness, muscle rigidity, ataxia, and sensory disturbance with areflexia in the lower extremities. Brain MRI demonstrated atrophy in the cerebellum and midbrain tegmentum as well as cerebral atrophy, predominantly in the frontal lobe. He was tentatively diagnosed as progressive supranuclear palsy on the basis of clinical features and imagings. On nerve conduction study, no sensory nerve action potentials were elicited in the upper and lower extremities. Details of family history revealed a hereditary sensory neuropathy with autosomal dominant inheritance in his relatives. Because genetic analysis showed a rare missense mutation (c.1483T>C, p.Y495H) in DNA methyltransferase 1 gene, we diagnosed him as having hereditary sensory and autonomic neuropathy type 1E (HSAN1E). In addition, p.M232R mutation in prion protein gene was detected. It should be kept in mind that there are some patients with HSAN1E presenting with frontal lobe dysfunction as an initial symptom and with clinical features mimicking progressive supranuclear palsy.

Evaluating the autonomic nervous system in patients with laryngopharyngeal reflux.

Science.gov (United States)

Huang, Wan-Ju; Shu, Chih-Hung; Chou, Kun-Ta; Wang, Yi-Fen; Hsu, Yen-Bin; Ho, Ching-Yin; Lan, Ming-Ying

2013-06-01

The pathogenesis of laryngopharyngeal reflux (LPR) remains unclear. It is linked to but distinct from gastroesophageal reflux disease (GERD), which has been shown to be related to disturbed autonomic regulation. The aim of this study is to investigate whether autonomic dysfunction also plays a role in the pathogenesis of LPR. Case-control study. Tertiary care center. Seventeen patients with LPR and 19 healthy controls, aged between 19 and 50 years, were enrolled in the study. The patients were diagnosed with LPR if they had a reflux symptom index (RSI) ≥ 13 and a reflux finding score (RFS) ≥ 7. Spectral analysis of heart rate variability (HRV) analysis was used to assess autonomic function. Anxiety and depression levels measured by the Beck Anxiety Inventory (BAI) and Beck Depression Inventory II (BDI-II) were also conducted. In HRV analysis, high frequency (HF) represents the parasympathetic activity of the autonomic nervous system, whereas low frequency (LF) represents the total autonomic activity. There were no significant differences in the LF power and HF power between the 2 groups. However, significantly lower HF% (P = .003) and a higher LF/HF ratio (P = .012) were found in patients with LPR, who demonstrated poor autonomic modulation and higher sympathetic activity. Anxiety was also frequently observed in the patient group. The study suggests that autonomic dysfunction seems to be involved in the pathogenesis of LPR. The potential beneficial effect of autonomic nervous system modulation as a therapeutic modality for LPR merits further investigation.

Autonomic dysfunction elicited by a medulla oblongata injury after fourth ventricle tumor surgery in a pediatric patient.

Science.gov (United States)

Martín-Gallego, A; Andrade-Andrade, I; Dawid-Milner, M S; Domínguez-Páez, M; Romero-Moreno, L; González-García, L; Carrasco-Brenes, A; Segura-Fernández-Nogueras, M; Ros-López, B; Arráez-Sánchez, M A

2016-01-01

We report the case of a 9-year-old male patient with a recurrent fourth ventricle anaplastic ependymoma who developed severe arterial hypertension and blood pressure lability during and after surgery. A punctual bilateral lesion located within mid dorsal medulla oblongata caused by both infiltration and surgical resection was observed in postoperative MRI. Three years later, the patient remained neurologically stable but the family referred the presence of a chronic tachycardia as well as palpitations and sweating with flushing episodes related to environmental stress. On autonomic evaluation, an increase in sympathetic outflow with tachycardia together with orthostatic hypotension caused by baroreceptor reflex dysfunction was observed. We postulate that a bilateral injury to both nuclei of the solitary tract may have caused central dysautonomia. Copyright © 2015 Elsevier B.V. All rights reserved.

Recent advances in orthostatic hypotension presenting orthostatic dizziness or vertigo.

Science.gov (United States)

Kim, Hyun-Ah; Yi, Hyon-Ah; Lee, Hyung

2015-11-01

Orthostatic hypotension (OH), a proxy for sympathetic adrenergic failure, is the most incapacitating sign of autonomic failure. Orthostatic dizziness (OD) is known to be the most common symptom of OH. However, recent studies have demonstrated that 30-39 % of patients with OH experienced rotatory vertigo during upright posture (i.e., orthostatic vertigo, OV), which challenges the dogma that OH induces dizziness and not vertigo. A recent population-based study on spontaneously occurring OD across a wide age range showed that the one-year and lifetime prevalence of OD was 10.9 and 12.5 %, respectively. Approximately 83 % of patients with OD had at least one abnormal autonomic function test result. So far, 11 subtypes of OD have been proposed according to the pattern of autonomic dysfunction, and generalized autonomic failure of sympathetic adrenergic and parasympathetic cardiovagal functions was the most common type. Four different patterns of OH, such as classic, delayed, early, and transient type have been found in patients with OD. The head-up tilt test and Valsalva maneuver should be performed for a comprehensive evaluation of sympathetic adrenergic failure in patients with OD/OV. This review summarizes current advances in OH presenting OD/OV, with a particular focus on the autonomic dysfunction associated with OD.

Cognitive, behavioral, and autonomic correlates of mind wandering and perseverative cognition in major depression

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Cristina eOttaviani

2015-01-01

Full Text Available Autonomic dysregulation has been hypothesized to play a role in the relationships between psychopathology and cardiovascular risk. An important transdiagnostic factor that has been associated with autonomic dysfunction is perseverative cognition (PC, mainly present in Major Depressive Disorder (MDD in the form of rumination. As the ability to adaptively let our mind wander (MW without ruminating is critical to mental health, this study aimed to examine the autonomic concomitants of functional versus dysfunctional intrusive thoughts in MDD.Ambulatory heart rate (HR and variability (HRV of 18 MDD subjects and 18 healthy controls were recorded for 24 hours. Approximately every 30 minutes during waking hours subjects reported their ongoing thoughts and moods using electronic diaries. Random regression models were performed. Compared to controls, MDD subjects were more often caught during episodes of PC. In both groups, PC required more effort to be inhibited and interfered more with ongoing activities compared to MW (ps < .0001. This cognitive rigidity was mirrored by autonomic inflexibility, as PC was characterized by lower HRV (p < .0001 compared to MW. A worse mood was reported by MDD patients compared to controls, independently of their ongoing cognitive process. Controls, however, showed the highest mood worsening during PC compared to being on task and MW. HRV during rumination correlated with self reported somatic symptoms on the same day and several dispositional traits. MDD subjects showed lower HRV during sleep, which correlated with hopelessness rumination. Results show that PC is associated with autonomic dysfunctions in both healthy and MDD subjects. Understanding when spontaneous thought is adaptive and when it is not may clarify its role in the etiology of mood disorders, shedding light on the still unexplained association between psychopathology, chronic stress, and risk for health.

Autonomic nervous system and lipid metabolism: findings in anxious-depressive spectrum and eating disorders.

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Pistorio, Elisabetta; Luca, Maria; Luca, Antonina; Messina, Vincenzo; Calandra, Carmela

2011-10-28

To correlate lipid metabolism and autonomic dysfunction with anxious-depressive spectrum and eating disorders. To propose the lipid index (LI) as a new possible biomarker. 95 patients and 60 controls were enrolled from the University Psychiatry Unit of Catania and from general practitioners (GPs). The patients were divided into four pathological groups: Anxiety, Depression, Anxious-Depressive Disorder and Eating Disorders [Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision (DSM-IV-TR) official/appendix criteria]. The levels of the cholesterol, triglycerides and apolipoproteins A and B were determined. The LI, for each subject, was obtained through a mathematical operation on the values of the cholesterol and triglycerides levels compared with the maximum cut-off of the general population. The autonomic functioning was tested with Ewing battery tests. Particularly, the correlation between heart rate variability (HRV) and lipid metabolism has been investigated. Pathological and control groups, compared among each other, presented some peculiarities in the lipid metabolism and the autonomic dysfunction scores. In addition, a statistically significant correlation has been found between HRV and lipid metabolism. Lipid metabolism and autonomic functioning seem to be related to the discussed psychiatric disorders. LI, in addition, could represent a new possible biomarker to be considered.

Autonomic nervous system and lipid metabolism: findings in anxious-depressive spectrum and eating disorders

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Messina Vincenzo

2011-10-01

Full Text Available Abstract Objective To correlate lipid metabolism and autonomic dysfunction with anxious-depressive spectrum and eating disorders. To propose the lipid index (LI as a new possible biomarker. Methods 95 patients and 60 controls were enrolled from the University Psychiatry Unit of Catania and from general practitioners (GPs. The patients were divided into four pathological groups: Anxiety, Depression, Anxious-Depressive Disorder and Eating Disorders [Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision (DSM-IV-TR official/appendix criteria]. The levels of the cholesterol, triglycerides and apolipoproteins A and B were determined. The LI, for each subject, was obtained through a mathematical operation on the values of the cholesterol and triglycerides levels compared with the maximum cut-off of the general population. The autonomic functioning was tested with Ewing battery tests. Particularly, the correlation between heart rate variability (HRV and lipid metabolism has been investigated. Results Pathological and control groups, compared among each other, presented some peculiarities in the lipid metabolism and the autonomic dysfunction scores. In addition, a statistically significant correlation has been found between HRV and lipid metabolism. Conclusions Lipid metabolism and autonomic functioning seem to be related to the discussed psychiatric disorders. LI, in addition, could represent a new possible biomarker to be considered.

Autonomic symptoms in idiopathic REM behavior disorder: a multicentre case-control study.

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Ferini-Strambi, Luigi; Oertel, Wolfgang; Dauvilliers, Yves; Postuma, Ronald B; Marelli, Sara; Iranzo, Alex; Arnulf, Isabelle; Högl, Birgit; Birgit, Högl; Manni, Raffaele; Miyamoto, Tomoyuki; Fantini, Maria-Livia; Puligheddu, Monica; Jennum, Poul; Sonka, Karel; Santamaria, Joan; Zucconi, Marco; Rancoita, Paola M V; Leu-Semenescu, Smeranda; Frauscher, Birgit; Terzaghi, Michele; Miyamoto, Masayuki; Unger, Marcus; Stiasny-Kolster, Karin; Desautels, Alex; Wolfson, Christina; Pelletier, Amélie; Montplaisir, Jacques

2014-06-01

Patients with idiopathic REM sleep behavior disorder (iRBD) are at very high risk of developing neurodegenerative synucleinopathies, which are disorders with prominent autonomic dysfunction. Several studies have documented autonomic dysfunction in iRBD, but large-scale assessment of autonomic symptoms has never been systematically performed. Patients with polysomnography-confirmed iRBD (318 cases) and controls (137 healthy volunteers and 181 sleep center controls with sleep diagnoses other than RBD) were recruited from 13 neurological centers in 10 countries from 2008 to 2011. A validated scale to study the disorders of the autonomic nervous system in Parkinson's disease (PD) patients, the SCOPA-AUT, was administered to all the patients and controls. The SCOPA-AUT consists of 25 items assessing the following domains: gastrointestinal, urinary, cardiovascular, thermoregulatory, pupillomotor, and sexual dysfunction. Our results show that compared to control subjects with a similar overall age and sex distribution, patients with iRBD experience significantly more problems with gastrointestinal, urinary, and cardiovascular functioning. The most prominent differences in severity of autonomic symptoms between our iRBD patients and controls emerged in the gastrointestinal domain. Interestingly, it has been reported that an altered gastrointestinal motility can predate the motor phase of PD. The cardiovascular domain SCOPA-AUT score in our study in iRBD patients was intermediate with respect to the scores reported in PD patients by other authors. Our findings underline the importance of collecting data on autonomic symptoms in iRBD. These data may be used in prospective studies for evaluating the risk of developing neurodegenerative disorders.

The first report of CADASIL in Peru: Olfactory dysfunction on initial presentation

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Anastasia Vishnevetsky

2016-12-01

Full Text Available Cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy (CADASIL is a rare, heritable, small vessel vascular disease caused by mutations in the Notch3 gene that is characterized by migraines, subcortical vascular events, cognitive decline, and mood disturbances. However, many CADASIL cases present with unusual symptoms such as status epilepticus, a movement disorder, or sensory dysfunction. This study describes the clinical, genetic, and radiologic characteristics of a Peruvian family with CADASIL in which multiple family members presented with severe olfactory deficits. Seven members of the family have symptoms suggestive of CADASIL, with genetic testing revealing R133C mutations in the two patients who underwent genetic testing. Cognitive testing and olfactory identification testing (Smell Identification Test were performed in three CADASIL patients revealing total anosmia in two tested patients and severe hyposmia in the other. Olfactory dysfunction has been associated with various neurologic and psychiatric conditions, though few studies have linked it with neurovascular disorders such as CADASIL. This first reported case of CADASIL in Peru emphasizes that symptomatic olfactory dysfunction may be an unusual presentation of CADASIL and that olfactory dysfunction is important to evaluate in CADASIL patients.

Pain and autonomic dysfunction in patients with sarcoidosis and small fibre neuropathy

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M. Bakkers (Mayienne); C.G. Faber (Carin); M. Drent (Marjolein); M.C.E. Hermans; S.I. van Nes (Sonja); G. Lauria (Giuseppe); M.H. de Baets (Marc); I.S.J. Merkies (Ingemar)

2010-01-01

textabstractSmall fibre neuropathy (SFN) has been demonstrated in sarcoidosis. However, a systematic analysis of neuropathic pain and autonomic symptoms, key features of SFN, has not been performed. Clinimetric evaluation of pain and autonomic symptoms using the neuropathic pain scale (NPS) and the

Effect of Sleep/Wake Cycle on Autonomic Regulation

International Nuclear Information System (INIS)

Jabeen, S.

2015-01-01

Objective: To evaluate the association between irregular sleep/wake cycle in shift workers and autonomic regulation. Study Design: Cross-sectional, analytical study. Place and Duration of Study: Dow University Hospital, Karachi, from August to November 2013. Methodology: All health care providers working in rotating shifts making a total (n=104) were included. Instrument was an integrated questionnaire applied to assess autonomic regulation, taken from Kroz et al. on scoring criteria, ranging from 18 - 54, where higher rating signifies strong autonomic regulation, indicating a stable Autonomic Nervous System (ANS) and vice versa. Participants were interviewed and their response was recorded by the investigator. Influence of sleep misalignment was measured quantitatively to extract index of autonomic activity. Results: There was a reduced trend in autonomic strength amongst shift workers. The mean score obtained on the Autonomic Scale was 37.8 ± 5.9. Conclusion: Circadian misalignment has an injurious influence on ANS which might be valuable in controlling autonomic dysfunction that leads to fatal triggers in rotating shift workers. (author)

When do the symptoms of autonomic nervous system malfunction appear in patients with Parkinson's disease?

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De Luka, Silvio R; Svetel, Marina; Pekmezović, Tatjana; Milovanović, Branislav; Kostić, Vladimir S

2014-04-01

Dysautonomia appears in almost all patients with Parkinson's disease (PD) in a certain stage of their condition. The aim of our study was to detect the development and type of autonomic disorders, find out the factors affecting their manifestation by analyzing the potential association with demographic variables related to clinical presentation, as well as the symptoms of the disease in a PD patient cohort. The patients with PD treated at the Clinic of Neurology in Belgrade during a 2-year period, divided into 3 groups were studied: 25 de novo patients, 25 patients already treated and had no long-term levodopa therapy-related complications and 22 patients treated with levodopa who manifested levodopa-induced motor complications. Simultaneously, 35 healthy control subjects, matched by age and sex, were also analyzed. Autonomic nervous system malfunction was defined by Ewing diagnostic criteria. The tests, indicators of sympathetic and parasympathetic nervous systems, were significantly different in the PD patients as compared with the controls, suggesting the failure of both systems. However, it was shown, in the selected groups of patients, that the malfunction of both systems was present in two treated groups of PD patients, while de novo group manifested only sympathetic dysfunction. For this reason, the complete autonomic neuropathy was diagnosed only in the treated PD patients, while de novo patients were defined as those with the isolated sympathetic dysfunction. The patients with the complete autonomic neuropathy differed from the subjects without such neuropathy in higher cumulative and motor unified Parkinson's disease rating score (UPDRS) (p nervous system disturbances among PD patients from the near onset of disease, with a predominant sympathetic nervous system involvement. The patients who developed complete autonomic neuropathy (both sympathetic and parasympathetic) were individuals with considerable level of functional failure, more severe clinical

Cardiac autonomic imbalance by social stress in rodents: understanding putative biomarkers

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Susan K Wood, Phd

2014-08-01

Full Text Available Exposure to stress or traumatic events can lead to the development of depression and anxiety disorders. In addition to the debilitating consequences on mental health, patients with psychiatric disorders also suffer from autonomic imbalance, making them susceptible to a variety of medical disorders. Emerging evidence utilizing spectral analysis of heart rate variability (HRV, a reliable noninvasive measure of cardiovascular autonomic regulation, indicates that patients with depression and various anxiety disorders (i.e., panic, social, generalized anxiety disorders, and post traumatic stress disorder are characterized by decreased HRV. Social stressors in rodents are ethologically relevant experimental stressors that recapitulate many of the dysfunctional behavioral and physiological changes that occur in psychological disorders. In this review, evidence from clinical studies and preclinical stress models identify putative biomarkers capable of precipitating the comorbidity between disorders of the mind and autonomic dysfunction. Specifically, the role of corticotropin releasing factor, neuropeptide Y and inflammation are investigated. The impetus for this review is to highlight stress-related biomarkers that may prove critical in the development of autonomic imbalance in stress -related psychiatric disorders.

Limits of clinical tests to screen autonomic function in diabetes type 1.

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Ducher, M; Bertram, D; Sagnol, I; Cerutti, C; Thivolet, C; Fauvel, J P

2001-11-01

A precocious detection of cardiac autonomic dysfunction is of major clinical interest that could lead to a more intensive supervision of diabetic patients. However, classical clinical exploration of cardiac autonomic function is not easy to undertake in a reproducible way. Thus, respective interests of autonomic nervous parameters provided by both clinical tests and computerized analysis of resting blood pressure were checked in type 1 diabetic patients without orthostatic hypotension and microalbuminuria. Thirteen diabetic subjects matched for age and gender to thirteen healthy subjects volunteered to participate to the study. From clinical tests (standing up, deep breathing, Valsalva maneuver, handgrip test), autonomic function was scored according to Ewing's methodology. Analysis of resting beat to beat blood pressure provided autonomic indices of the cardiac function (spectral analysis or Z analysis). 5 of the 13 diabetic patients exhibited a pathological score (more than one pathological response) suggesting the presence of cardiovascular autonomic dysfunction. The most discriminative test was the deep breathing test. However, spectral indices of BP recordings and baro-reflex sensitivity (BRS) of these 5 subjects were similar to those of healthy subjects and of remaining diabetic subjects. Alteration in Ewing's score given by clinical tests may not reflect an alteration of cardiac autonomic function in asymptomatic type 1 diabetic patients, because spectral indices of sympathetic and parasympathetic (including BRS) function were within normal range. Our results strongly suggest to confront results provided by both methodologies before concluding to an autonomic cardiac impairment in asymptomatic diabetic patients.

Gastrointestinal Autonomic Dysfunction in Patients with Parkinson’s Disease

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Joong-Seok Kim

2015-05-01

Full Text Available Currently, gastrointestinal dysfunctions in Parkinson’s disease (PD are well-recognized problems and are known to be an initial symptom in the pathological process that eventually results in PD. Gastrointestinal symptoms may result from the involvement of either the central or enteric nervous systems, or these symptoms may be side effects of antiparkinsonian medications. Weight loss, excessive salivation, dysphagia, nausea/gastroparesis, constipation, and defecation dysfunction all may occur. Increased identification and early detection of these symptoms can result in a significant improvement in the quality of life for PD patients.

A STUDY ON CARDIOVASCULAR AUTONOMIC FUNCTIONS IN CAREGIVERS OF STROKE PATIENTS

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Ghouse Mubarak

2017-08-01

Full Text Available BACKGROUND Stroke (cerebrovascular accident is an important cause of disability in countries like India and longterm care of these bedridden patients is usually undertaken by the family members. A caregiver is a person who takes responsibility for those who cannot completely care for themselves. Taking care of a chronically ill member in the family usually causes stress to the caregiver causing disturbances in the autonomic function. Thus, the present study is undertaken to find out the effect of longterm caregiving on cardiovascular autonomic functions in a caregiver. MATERIALS AND METHODS 57 caregivers of post-stroke bedridden patients, both male and female, were included in this longitudinal study. Parasympathetic activity was assessed by observing the heart rate changes to immediate standing from lying down position, heart rate changes during deep breathing and heart rate changes during Valsalva manoeuvre. Sympathetic activity was assessed by observing blood pressure changes on immediate standing from lying down position and blood pressure changes during sustained hand grip. RESULTS The results of the present study showed statistically significant decrease in Valsalva ratio, decrease in the heart rate following deep breathing and statistically significant increase in systolic blood pressure in response to immediate standing suggestive of autonomic imbalance. CONCLUSION Our findings suggest that longterm caregiving is accompanied by dysfunction of the cardiac autonomic nervous system, and these individuals are more prone to autonomic neuropathy.

The pattern of autonomic tone disorder and its correction in children with overactive bladder

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S. L. Morozov

2014-01-01

Full Text Available Autonomic nervous system dysregulation is one of the leading components in the pathogenesis of neurogenic bladder dysfunction. These disorders lead to diverse changes in the functions of the sympathetic and parasympathetic systems with disordered release of mediators (norepinephrine, acetylcholine, hormones of the adrenal cortex and other endocrine glands, a number of biologically active substances (polypeptides, prostaglandins, as well as to the impaired sensitivity of vascular a- and p-adrenoceptors. Children with dysuria concurrently develop visceral, CNS, and circulatory system dysfunctions and metabolic disturbances. The paper describes the clinical trial of children with overactive bladder, which demonstrates the autonomic tone in these patients (и=44. The findings point to the important involvement of the autonomic nervous system in the pathogenesis of the disease and provide a rationale for the incorporation of vegetotropic drugs normalizing the autonomic nervous system into the combination therapy of overactive bladder.

The Degree of Autonomic Modulation Is Associated With the Severity of Microvascular Complications in Patients With Type 1 Diabetes

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Fleischer, Jesper; Cichosz, Simon Lebech; Jakobsen, Poul Erik

2015-01-01

OBJECTIVE: The objective of this study was to elucidate whether the degree of autonomic modulation is associated with the degree of microvascular complications in patients with type 1 diabetes. METHODS: A total of 290 type 1 individuals with diabetes were randomly recruited during normal visits t......, nephropathy, and peripheral neuropathy in individuals with type 1 diabetes patients. CONCLUSIONS: Autonomic dysfunction is present in early stages of retinopathy, nephropathy, and peripheral neuropathy in patients with type 1 diabetes....

Sexual and urinary dysfunction following laparoscopic total mesorectal excision in male patients: A prospective study

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Deepak George

2018-01-01

Full Text Available Aims: Even with the use of nerve-sparing techniques, there is a risk of bladder and sexual dysfunction after total mesorectal excision (TME. Laparoscopic TME is believed to improve this autonomic nerve dysfunction, but this is not demonstrated conclusively in the literature. In Indian patients generally, the stage at which the patients present is late and presumably the risk of autonomic nerve injury is more; however, there is no published data in this respect. Materials and Methods: This prospective study in male patients who underwent laparoscopic TME evaluated the bladder and sexual dysfunction using objective standardised scores, measuring residual urine and post-voided volume. The International Prostatic Symptom Score (IPSS and International Index of Erectile Function score were used respectively to assess the bladder and sexual dysfunction preoperatively at 1, 3, 6 months and at 1 year. Results: Mean age of the study group was 58 years. After laparoscopic TME in male patients, the moderate to severe bladder dysfunction (IPSS <8 is observed in 20.4% of patients at 3 months, and at mean follow-up of 9.2 months, it was seen only in 2.9%. There is more bladder and sexual dysfunction in low rectal tumours compared to mid-rectal tumours. At 3 months, 75% had sexual dysfunction, 55% at median follow-up of the group at 9.2 months. Conclusion: After laparoscopic TME, bladder dysfunction is seen in one-fifth of the patients, which recovers in the next 6 months to 1 year. Sexual dysfunction is observed in 75% of patients immediately after TME which improves to 55% over 9.2 months.

Rapid-onset obesity with hypothalamic dysfunction, hypoventilation and autonomic dysregulation (ROHHAD): a case with additional features and review of the literature.

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Chew, H B; Ngu, L H; Keng, W T

2011-03-01

A rare syndrome of rapid-onset obesity with hypothalamic dysfunction, hypoventilation and autonomic dysregulation (ROHHAD) has been recently described. We report the first patient with this syndrome in Southeast Asia and review reported cases to date. Our patient was good health with normal development until the age of 2. He then developed hyperphagic obesity, hypersomnolence, seizures, alveolar hypoventilation, central hypothyroidism, sodium and water dysregulation, gastrointestinal dysmotility, strabismus, disordered temperature and irregular heart rate, altered sweating, delayed puberty, mental retardation and recurrent respiratory tract infections. The cardiomyopathy with heart failure and abnormal cerebral spinal fluid (CSF) neurotransmitter analysis present in our patient have not been reported previously. Tumours of the sympathetic nervous system are known to be associated with this syndrome but had not been found in our patient at the time of reporting. We highlight the difficulty of achieving the diagnosis of ROHHAD syndrome and its overlap with other well-established disease entities. The mortality and morbidity resulting from the high incidence of cardiorespiratory arrest may be prevented by early ventilatory support.

Autonomic Function Impairment and Brain Perfusion Deficit in Parkinson’s Disease

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Wei-Che Lin

2017-06-01

Full Text Available IntroductionAutonomic disorders have been recognized as important Parkinson’s disease (PD components. Some vulnerable structures are related to the central autonomic network and have also been linked to autonomic function alterations. The aims of the study are to evaluate the severity of the autonomic dysfunction and the cortical hypoperfusion using arterial spin labeling (ASL MRI. And then, possible relationships of significant between-group differences in perfusion pattern to clinical variables and autonomic functions were examined to determine the pharmaceutical effects of dopaminergic treatment on cerebral blood flow (CBF in patients with PD.MethodsBrain ASL MRI was carried out in 20 patients with PD (6 men and 14 women, mean age: 63.3 ± 6.4 years and 22 sex- and age-matched healthy volunteers to assess whole-brain CBF and the effects of dopaminergic therapy on perfusion. All subjects underwent a standardized evaluation of cardiovagal and adrenergic function including a deep breathing, Valsalva maneuver, and 5-min head-up tilt test. Perfusion MRI data were acquired on a 3.0 T scanner with a pulsed continuous ASL technique. The CBF, autonomic parameters, and clinical data were analyzed after adjusting for age and sex.ResultsPatients exhibited a decline in autonomic function (rapid heart rate in response to deep breathing, low baroreflex sensitivity, high systolic and diastolic pressure, and altered tilting test response, widespread low CBF, and robust response to dopaminergic therapy. Lower perfusion in the middle frontal gyrus was associated with increased clinical disease severity (Unified Parkinson’s Disease Rating Scale I score, P < 0.001. Lower perfusion in autonomic control areas, such as the frontal lobe and insula, were significantly associated with autonomic impairment (P < 0.001.ConclusionsOur study indicates that PD is a progressive neurodegenerative disorder that changes the perfusion of central nervous system

The Role of the Autonomic Nervous System in the Pathophysiology of Obesity

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Daniela Guarino

2017-09-01

Full Text Available Obesity is reaching epidemic proportions globally and represents a major cause of comorbidities, mostly related to cardiovascular disease. The autonomic nervous system (ANS dysfunction has a two-way relationship with obesity. Indeed, alterations of the ANS might be involved in the pathogenesis of obesity, acting on different pathways. On the other hand, the excess weight induces ANS dysfunction, which may be involved in the haemodynamic and metabolic alterations that increase the cardiovascular risk of obese individuals, i.e., hypertension, insulin resistance and dyslipidemia. This article will review current evidence about the role of the ANS in short-term and long-term regulation of energy homeostasis. Furthermore, an increased sympathetic activity has been demonstrated in obese patients, particularly in the muscle vasculature and in the kidneys, possibily contributing to increased cardiovascular risk. Selective leptin resistance, obstructive sleep apnea syndrome, hyperinsulinemia and low ghrelin levels are possible mechanisms underlying sympathetic activation in obesity. Weight loss is able to reverse metabolic and autonomic alterations associated with obesity. Given the crucial role of autonomic dysfunction in the pathophysiology of obesity and its cardiovascular complications, vagal nerve modulation and sympathetic inhibition may serve as therapeutic targets in this condition.

Hereditary sensory and autonomic neuropathy type IID caused by an SCN9A mutation.

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Yuan, Junhui; Matsuura, Eiji; Higuchi, Yujiro; Hashiguchi, Akihiro; Nakamura, Tomonori; Nozuma, Satoshi; Sakiyama, Yusuke; Yoshimura, Akiko; Izumo, Shuji; Takashima, Hiroshi

2013-04-30

To identify the clinical features of Japanese patients with suspected hereditary sensory and autonomic neuropathy (HSAN) on the basis of genetic diagnoses. On the basis of clinical, in vivo electrophysiologic, and pathologic findings, 9 Japanese patients with sensory and autonomic nervous dysfunctions were selected. Eleven known HSAN disease-causing genes and 5 related genes were screened using a next-generation sequencer. A homozygous mutation, c.3993delGinsTT, was identified in exon 22 of SCN9A from 2 patients/families. The clinical phenotype was characterized by adolescent or congenital onset with loss of pain and temperature sensation, autonomic nervous dysfunctions, hearing loss, and hyposmia. Subsequently, this mutation was discovered in one of patient 1's sisters, who also exhibited sensory and autonomic nervous system dysfunctions, with recurrent fractures being the most predominant feature. Nerve conduction studies revealed definite asymmetric sensory nerve involvement in patient 1. In addition, sural nerve pathologic findings showed loss of large myelinated fibers in patient 1, whereas the younger patient showed normal sural nerve pathology. We identified a novel homozygous mutation in SCN9A from 2 Japanese families with autosomal recessive HSAN. This loss-of-function SCN9A mutation results in disturbances in the sensory, olfactory, and autonomic nervous systems. We propose that SCN9A mutation results in the new entity of HSAN type IID, with additional symptoms including hyposmia, hearing loss, bone dysplasia, and hypogeusia.

Nocturnal Anxiety in a Youth with Rapid-onset Obesity, Hypothalamic Dysfunction, Hypoventilation, and Autonomic Dysregulation (ROHHAD).

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Grudnikoff, Eugene; Foley, Carmel; Poole, Claudette; Theodosiadis, Eva

2013-08-01

Behavioral and psychiatric disorders are common in youth with rapid-onset obesity with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation (ROHHAD). We outline a rational approach to psychiatric treatment of a patient with a complex medical condition. We report the course of symptoms in a teen with ROHHAD, the inpatient treatment, and review current evidence for use of psychopharmacologic agents in youth with sleep and anxiety disturbances. A 14-year-old female began rapidly gaining weight as a preschooler, developed hormonal imbalance, and mixed sleep apnea. Consultation was requested after a month of ROHHAD exacerbation, with severe anxiety, insomnia, and auditory hallucinations. Olanzapine and citalopram were helpful in controlling the symptoms. Following discharge, the patient gained weight and olanzapine was discontinued. Lorazepam was started in coordination with pulmonary service. Relevant pharmacologic considerations included risk of respiratory suppression, history of paradoxical reaction to hypnotics, hepatic isoenzyme interactions and side effects of antipsychotics. Core symptoms of ROHHAD may precipitate psychiatric disorders. A systematic evidence-based approach to psychopharmacology is necessary in the setting of psychiatric consultation.

Laryngeal Dysfunction: Assessment and Management for the Clinician.

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Hull, James H; Backer, Vibeke; Gibson, Peter G; Fowler, Stephen J

2016-11-01

The larynx is one of the most highly innervated organs in humans and serves a number of vitally important, complex, and highly evolved biological functions. On a day-to-day basis, the larynx functions autonomously, addressing several roles including airway protection, swallowing, and phonation. In some situations the larynx appears to adopt a functional state that could be considered maladaptive or "dysfunctional." This laryngeal dysfunction can underpin and account for a number of respiratory symptoms that otherwise appear incongruous with a clinical disease state and/or contribute to the development of symptoms that appear "refractory" to treatment. These include conditions associated with a heightened tendency for inappropriate laryngeal closure (e.g., inducible laryngeal obstruction), voice disturbance, and chronic cough. Recognition of laryngeal dysfunction is important to deliver targeted treatment and failure to recognize the condition can lead to repeated use of inappropriate treatment. Diagnosis is not straightforward, however, and many patients appear to present with symptoms attributable to laryngeal dysfunction, but in whom the diagnosis has been overlooked in clinical work-up for some time. This review provides an overview of the current state of knowledge in the field of laryngeal dysfunction, with a focus on pragmatic clinical assessment and management.

An anatomical and physiological basis for the cardiovascular autonomic nervous system consequences of sport-related brain injury.

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La Fountaine, Michael F

2017-11-29

Concussion is defined as a complex pathophysiological process affecting the brain that is induced by the application or transmission of traumatic biomechanical forces to the head. The result of the impact is the onset of transient symptoms that may be experienced for approximately 2weeks in most individuals. However, in some individuals, symptoms may not resolve and persist for a protracted period and a chronic injury ensues. Concussion symptoms are generally characterized by their emergence through changes in affect, cognition, or multi-sensory processes including the visual and vestibular systems. An emerging consequence of concussion is the presence of cardiovascular autonomic nervous system dysfunction that is most apparent through hemodynamic perturbations and provocations. Further interrogation of data that are derived from continuous digital electrocardiograms and/or beat-to-beat blood pressure monitoring often reveal an imbalance of parasympathetic or sympathetic nervous system activity during a provocation after an injury. The disturbance is often greatest early after injury and a resolution of the dysfunction occurs in parallel with other symptoms. The possibility exists that the disturbance may remain if the concussion does not resolve. Unfortunately, there is little evidence in humans to support the etiology for the emergence of this post-injury dysfunction. As such, evidence from experimental models of traumatic brain injury and casual observations from human studies of concussion implicate a transient abnormality of the anatomical structures and functions of the cardiovascular autonomic nervous system. The purpose of this review article is to provide a mechanistic narrative of multi-disciplinary evidence to support the anatomical and physiological basis of cardiovascular autonomic nervous system dysfunction after concussion. The review article will identify the anatomical structures of the autonomic nervous system and propose a theoretical framework

Autonomic Nervous System in Paralympic Athletes with Spinal Cord Injury.

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Walter, Matthias; Krassioukov, Andrei V

2018-05-01

Individuals sustaining a spinal cord injury (SCI) frequently suffer from sensorimotor and autonomic impairment. Damage to the autonomic nervous system results in cardiovascular, respiratory, bladder, bowel, and sexual dysfunctions, as well as temperature dysregulation. These complications not only impede quality of life, but also affect athletic performance of individuals with SCI. This article summarizes existing evidence on how damage to the spinal cord affects the autonomic nervous system and impacts the performance in athletes with SCI. Also discussed are frequently used performance-enhancing strategies, with a special focus on their legal aspect and implication on the athletes' health. Copyright © 2018 Elsevier Inc. All rights reserved.

Autonomic headache with autonomic seizures: a case report.

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Ozge, Aynur; Kaleagasi, Hakan; Yalçin Tasmertek, Fazilet

2006-10-01

The aim of the report is to present a case of an autonomic headache associated with autonomic seizures. A 19-year-old male who had had complex partial seizures for 15 years was admitted with autonomic complaints and left hemicranial headache, independent from seizures, that he had had for 2 years and were provoked by watching television. Brain magnetic resonance imaging showed right hippocampal sclerosis and electroencephalography revealed epileptic activity in right hemispheric areas. Treatment with valproic acid decreased the complaints. The headache did not fulfil the criteria for the diagnosis of trigeminal autonomic cephalalgias, and was different from epileptic headache, which was defined as a pressing type pain felt over the forehead for several minutes to a few hours. Although epileptic headache responds to anti-epileptics and the complaints of the present case decreased with antiepileptics, it has been suggested that the headache could be a non-trigeminal autonomic headache instead of an epileptic headache.

Methods of investigation for cardiac autonomic dysfunction in human research studies

DEFF Research Database (Denmark)

Bernardi, Luciano; Spallone, Vincenza; Stevens, Martin

2011-01-01

This consensus document provides evidence-based guidelines regarding the evaluation of diabetic cardiovascular autonomic neuropathy (CAN) for human research studies as a result of the work of the CAN Subcommittee of the Toronto Diabetic Neuropathy Expert Group. The CAN subcommittee critically...... reviewed the limitations and strengths of the available diagnostic approaches for CAN and the need for developing new tests for autonomic function. It was concluded that the most sensitive and specific approaches currently available to evaluate CAN in clinical research are: 1) heart rate variability, 2......) baroreflex sensitivity, 3) muscle sympathetic nerve activity, 4) plasma catecholamines, and 5) heart sympathetic imaging. It was also recommended that efforts should be undertaken to develop new non-invasive and safe CAN tests to be used in clinical research, with a higher sensitivity and specificity...

Physicians' response to sexual dysfunction presented by a younger vs. An older adult.

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Gewirtz-Meydan, Ateret; Ayalon, Liat

2017-12-01

The aim of this study is to determine whether physicians have an age bias regarding sexual dysfunction presented by older vs. younger patients in terms of attributed diagnosis, etiology, proposed treatment and perceived prognosis. An on-line survey consisting of one of two, randomly administered, case vignettes, which differed only by the age of the patient (28 or 78). In both cases, the patient was described as suffering from occasional erectile dysfunction with a clear psychosocial indication. A total of 236 physicians responded to the survey. Overall, 110 physicians received an "old" vignette and 126 physicians received a "young" vignette. Even though both cases presented with a clear psychosocial etiology, the "older" vignette was more likely to be diagnosed with erectile dysfunction whereas the "younger" vignette was more likely to be diagnosed with performance anxiety. The "older" vignette's dysfunction was more likely to be attributed to hormonal changes, health problems and decreased sexual desire. Physicians were more likely to recommend testosterone replacement therapy (TRT) and PDE5 inhibitors (PDE5i; such as Sildenafil; Vardenafil; Tadalafil) as well as a referral to urology to the "older" vignette. In contrast, the "younger" vignette was more often referred to a sexologist and received a more positive prognosis than the older patient. This study demonstrates an age bias among physicians regarding sexuality in later life. Of particular note is the tendency to prescribe PDE5i to the older patient, despite the clear psychosocial indication presented in the case vignette. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Subtle Cardiovascular Dysfunction in the Unilateral 6-Hydroxydopamine-Lesioned Rat

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K. Slack

2010-01-01

Full Text Available The present study evaluated whether the unilateral 6-hydroxydopamine (6-OHDA model of Parkinson's disease produces autonomic deficits. Autonomic parameters were assessed by implanting a small radiofrequency telemetry device which measured heart rate variability (HRV, diurnal rhythms of heart rate (HR, core body temperature (cBT and locomotor activity (LA. Rats then received 6-OHDA lesion or sham surgery. 6-OHDA lesioned rats exhibited head and body axis biases, defective sensorimotor function (“disengage” test, and prominent apomorphine rotation (all P<.05 versus controls. Diurnal rhythm of HR was lower for 6-OHDA lesioned rats (n=8 versus controls (n=6; P<.05. Whilst HR decreased similarly in both groups during the day, there was a greater decrease in HR for the 6-OHDA lesioned rats at night (by 38 b.p.m. relative to 17 b.p.m. for controls. LA and cBT did not differ between surgery groups. This study indicates the unilateral 6-OHDA model of PD shows subtle signs of cardiovascular autonomic dysfunction.

Hereditary sensory and autonomic neuropathies: types II, III, and IV

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Axelrod Felicia B

2007-10-01

Full Text Available Abstract The hereditary sensory and autonomic neuropathies (HSAN encompass a number of inherited disorders that are associated with sensory dysfunction (depressed reflexes, altered pain and temperature perception and varying degrees of autonomic dysfunction (gastroesophageal reflux, postural hypotention, excessive sweating. Subsequent to the numerical classification of four distinct forms of HSAN that was proposed by Dyck and Ohta, additional entities continue to be described, so that identification and classification are ongoing. As a group, the HSAN are rare diseases that affect both sexes. HSAN III is almost exclusive to individuals of Eastern European Jewish extraction, with incidence of 1 per 3600 live births. Several hundred cases with HSAN IV have been reported. The worldwide prevalence of HSAN type II is very low. This review focuses on the description of three of the disorders, HSAN II through IV, that are characterized by autosomal recessive inheritance and onset at birth. These three forms of HSAN have been the most intensively studied, especially familial dysautonomia (Riley-Day syndrome or HSAN III, which is often used as a prototype for comparison to the other HSAN. Each HSAN disorder is likely caused by different genetic errors that affect specific aspects of small fiber neurodevelopment, which result in variable phenotypic expression. As genetic tests are routinely used for diagnostic confirmation of HSAN III only, other means of differentiating between the disorders is necessary. Diagnosis is based on the clinical features, the degree of both sensory and autonomic dysfunction, and biochemical evaluations, with pathologic examinations serving to further confirm differences. Treatments for all these disorders are supportive.

Bladder, Bowel, and Sexual Dysfunction in Parkinson's Disease

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Ryuji Sakakibara

2011-01-01

Full Text Available Bladder dysfunction (urinary urgency/frequency, bowel dysfunction (constipation, and sexual dysfunction (erectile dysfunction (also called “pelvic organ” dysfunctions are common nonmotor disorders in Parkinson's disease (PD. In contrast to motor disorders, pelvic organ autonomic dysfunctions are often nonresponsive to levodopa treatment. The brain pathology causing the bladder dysfunction (appearance of overactivity involves an altered dopamine-basal ganglia circuit, which normally suppresses the micturition reflex. By contrast, peripheral myenteric pathology causing slowed colonic transit (loss of rectal contractions and central pathology causing weak strain and paradoxical anal sphincter contraction on defecation (PSD, also called as anismus are responsible for the bowel dysfunction. In addition, hypothalamic dysfunction is mostly responsible for the sexual dysfunction (decrease in libido and erection in PD, via altered dopamine-oxytocin pathways, which normally promote libido and erection. The pathophysiology of the pelvic organ dysfunction in PD differs from that in multiple system atrophy; therefore, it might aid in differential diagnosis. Anticholinergic agents are used to treat bladder dysfunction in PD, although these drugs should be used with caution particularly in elderly patients who have cognitive decline. Dietary fibers, laxatives, and “prokinetic” drugs such as serotonergic agonists are used to treat bowel dysfunction in PD. Phosphodiesterase inhibitors are used to treat sexual dysfunction in PD. These treatments might be beneficial in maximizing the patients' quality of life.

Bladder, bowel, and sexual dysfunction in Parkinson's disease.

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Sakakibara, Ryuji; Kishi, Masahiko; Ogawa, Emina; Tateno, Fuyuki; Uchiyama, Tomoyuki; Yamamoto, Tatsuya; Yamanishi, Tomonori

2011-01-01

Bladder dysfunction (urinary urgency/frequency), bowel dysfunction (constipation), and sexual dysfunction (erectile dysfunction) (also called "pelvic organ" dysfunctions) are common nonmotor disorders in Parkinson's disease (PD). In contrast to motor disorders, pelvic organ autonomic dysfunctions are often nonresponsive to levodopa treatment. The brain pathology causing the bladder dysfunction (appearance of overactivity) involves an altered dopamine-basal ganglia circuit, which normally suppresses the micturition reflex. By contrast, peripheral myenteric pathology causing slowed colonic transit (loss of rectal contractions) and central pathology causing weak strain and paradoxical anal sphincter contraction on defecation (PSD, also called as anismus) are responsible for the bowel dysfunction. In addition, hypothalamic dysfunction is mostly responsible for the sexual dysfunction (decrease in libido and erection) in PD, via altered dopamine-oxytocin pathways, which normally promote libido and erection. The pathophysiology of the pelvic organ dysfunction in PD differs from that in multiple system atrophy; therefore, it might aid in differential diagnosis. Anticholinergic agents are used to treat bladder dysfunction in PD, although these drugs should be used with caution particularly in elderly patients who have cognitive decline. Dietary fibers, laxatives, and "prokinetic" drugs such as serotonergic agonists are used to treat bowel dysfunction in PD. Phosphodiesterase inhibitors are used to treat sexual dysfunction in PD. These treatments might be beneficial in maximizing the patients' quality of life.

Neuronal autoantibodies in epilepsy patients with peri-ictal autonomic findings.

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Baysal-Kirac, Leyla; Tuzun, Erdem; Erdag, Ece; Ulusoy, Canan; Vanli-Yavuz, Ebru Nur; Ekizoglu, Esme; Peach, Sian; Sezgin, Mine; Bebek, Nerses; Gurses, Candan; Gokyigit, Aysen; Vincent, Angela; Baykan, Betul

2016-03-01

Autonomic dysfunction has frequently been reported in autoimmune encephalitis associated with seizures and there is growing evidence that epilepsy patients may display neuronal autoantibodies (NAAb). The aim of this study was to investigate the frequency of NAAb in epilepsy patients with peri-ictal autonomic findings. Fifty-eight patients (37 women/21 men; average age of 34.2 ± 9.9 years and epilepsy duration of 19.1 ± 9.6 years) who had at least one video-EEG recorded focal or secondary generalized seizure with clear-cut documented peri-ictal autonomic findings, or consistently reported seizures with autonomic semiology, were included. NAAb were tested by RIA or cell based assays. NAAb were present in 17 of 58 (29.3%) patients. Among seropositive patients, antibodies were directed against N-methyl-D-aspartate receptor (NMDAR) in 5 (29%), contactin-associated protein-like 2 (CASPR2) in 5 (29%), uncharacterized voltage gated potassium channel (VGKC)-complex antigens in 3 (18%), glutamic acid decarboxylase (GAD) in 2 (12%), glycine receptor (GLYR) in one (6%) and type A gamma aminobutyric acid receptor (GABAAR) in one patient (6%). Peri-ictal gastrointestinal manifestations, piloerection, ictal fever, urinary urge, and cough occurred more commonly in the seropositive group. The prevalences of psychotic attacks and status epilepticus were significantly increased in the seropositive group. Seropositivity prevalence in our patient group with peri-ictal autonomic findings is higher than other previously reported epilepsy cohorts. In our study, ictal fever-VGKC-complex antibody and pilomotor seizure-GABAAR antibody associations were documented for the first time. Chronic epilepsy patients with peri-ictal autonomic semiology, history of status epilepticus and psychotic disorder may benefit from autoantibody screening.

A 41-year-old man with polyarthritis and severe autonomic neuropathy

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Matthew E Bourcier

2008-09-01

Full Text Available Matthew E Bourcier, Aaron I VinikEastern Virginia Medical School, Norfolk, VA, USAAbstract: Orthostasis due to autonomic neuropathy can cause severe debilitation and prove refractory to treatment. This report describes a case of severe sympathetic and parasympathetic autonomic dysfunction as a consequence of acetylcholine receptor antibodies and Sjogren’s syndrome. Symptomatic management, plasma fluid expanders, and IVIG therapy failed to offer a salutary response to the condition. Etanercept therapy provided improvement of the orthostasis and autonomic function measured as high and low frequency respiratory effects on heart rate variability as well as enhancement of skin blood flow using Laser Doppler. It would be of considerable interest to determine the effectiveness of etanercept in other autoimmune neuropathies.Keywords: autonomic neuropathy, etanercept, IntraEpidermal Nerve Fibers (IENF, acetylcholine receptor antibodies, laser doppler skin blood flow, orthostasis

Balance of automatic nervous system in children having signs of endothelial dysfunction, that were born and are domiciled in contaminated territories

International Nuclear Information System (INIS)

Kondrashova, V.G.; Kolpakov, Yi.Je.; Vdovenko, V.Yu.; And Others

2014-01-01

Due to peculiarities of physiological pathways providing adaptive responses the children having signs of endothelial dysfunction are characterized by a more pronounced dysregulation of autonomous nervous system both in a resting state and under a functional load simulation, and also by a high strain of adaptation pathways. The lack of autonomous support of cardiovascular system is caused by inadequate adaptive responses of both central regulatory bodies (hypothalamus, vasomotor center) and peripheral receptors. Mainly the failure of segmental autonomous (parasympathetic) structures was revealed. The mode of their response to stress in this case corresponds to that in healthy individuals but at a lower functional level. There is a reduced aerobic capacity of the organism by the Robinson index, contributing to low adaptive range to non-specific stress in children being domiciled on contaminated territories including children having the endothelial dysfunction. Endothelial dysfunction was associated with more pronounced manifestations of autonomic dysregulation and reduced aerobic capacity of the organism being the risk factors of development of a range of somatic diseases requiring the development of prevention measures in children permanently residing in contaminated areas

Maladaptive autonomic regulation in PTSD accelerates physiological aging

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John B Williamson

2015-01-01

Full Text Available A core manifestation of posttraumatic stress disorder is a disconnection between physiological state and psychological and behavior processes necessary to adequately respond to environmental demands. Patients with PTSD experience oscillations in autonomic states that support either fight and flight behaviors or withdrawal, immobilization, and dissociation without an intervening calm state that would provide opportunities for positive social interactions. This defensive autonomic disposition is adaptive in dangerous and life threatening situations, but in the context of every-day life may lead to significant psychosocial distress and deteriorating social relationships. The perpetuation of these maladaptive autonomic responses, may contribute to the development of comorbid mental health issues such as depression, loneliness, and hostility that further modify the nature of cardiovascular behavior in the context of internal and external stressors. Over time, changes in autonomic, endocrine, and immune function contribute to deteriorating health, which is potently expressed in brain dysfunction and cardiovascular health. In this theoretical review paper, we review the literature on the chronic health effects of post-traumatic stress disorder. We discuss the brain networks underlying post-traumatic stress disorder in the context of autonomic efferent and afferent contributions and how disruption of these networks leads to poor health outcomes. Finally, we discuss treatments based on our theoretical model of posttraumatic stress disorder.

Autonomic and metabolic effects of OSA in childhood obesity.

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Oliveira, F M; Tran, W H; Lesser, D; Bhatia, R; Ortega, R; Mittelman, S D; Keens, T G; Davidson Ward, S L; Khoo, M C

2010-01-01

This study investigates the effects of exposure to intermittent hypoxia on cardiovascular autonomic control and metabolic function in obese children with obstructive sleep apnea (OSA). Each subject underwent: (1) a polysomnography; (2) morning fasting blood samples and a subsequent FSIVGTT; (3) noninvasive measurement of respiration, arterial blood pressure, and heart rate during supine and standing postures. Assessment of adiposity was performed using a DEXA scan. From these measurements, we deduced the pertinent sleep parameters, Bergman minimal model parameters and the parameters characterizing a minimal model of cardiovascular variability. Results suggest that intermittent hypoxia in OSA contributes independently to insulin resistance and autonomic dysfunction in overweight children.

[Sacroiliac joint dysfunction presented with acute low back pain: three case reports].

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Hamauchi, Shuji; Morimoto, Daijiro; Isu, Toyohiko; Sugawara, Atsushi; Kim, Kyongsong; Shimoda, Yusuke; Motegi, Hiroaki; Matsumoto, Ryoji; Isobe, Masanori

2010-07-01

Sacroiliac joint (SIJ) can cause low back pain when its joint capsule and ligamentous tissue are damaged. We report our experience in treating three SIJ dysfunction patients presenting with acute low back pain (a 38 year-old male, a 24 year-old male, and a 32 year-old female). SIJ dysfunction was diagnosed using the one-finger test, the modified Newton test, and SIJ injection. In all three patients, lumbar MRI demonstrated slightly degenerated lumbar lesions (lumbar canal stenosis, lumbar disc hernia). Two patients had paresthesia or pain in the leg and all three patients showed iliac muscle tenderness in the groin, which was thought to be a referred symptom because of improvement after SIJ injection. The two male patients returned to work and the problems have not recurred. Although our female patient resumed daily life as a housewife, her condition recurred at intervals of 2-3 months and she required regular SIJ injections. The prevalence of SIJ dysfunction of low back pain is about 10%, so it should be considered as a differential diagnosis when treating low back pain and designing treatment for lumbar spinal disorders.

Psychosocial profile of male patients presenting with sexual dysfunction in a psychiatric outpatient department in Mumbai, India

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Kalra, Gurvinder; Kamath, Ravindra; Subramanyam, Alka; Shah, Henal

2015-01-01

Introduction: Sexual dysfunction can occur due to biological problems, relationship problems, lack of proper sexual knowledge or a combination of these. India is often known as the land of Kamasutra. But as far as sexuality research is concerned, there is a paucity of relevant data from India. In view of this, we conducted a study to assess the psychosocial profile of males presenting with sexual dysfunction to psychiatry out-patient department of a tertiary medical hospital. Materials and Methods: Hundred consecutive male patients presenting with sexual dysfunction were screened using Arizona Sexual Experiences Scale for clinical sexual dysfunction and after obtaining their informed consent were included in this study. They were assessed using a semi-structured proforma, Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision criteria, Mini-International Neuropsychiatric Interview, and Dyadic Adjustment Scale. Results: Majority of our respondents were in the 18–30 years age group and were married. The main source of sex knowledge for 69% of them was peer group. Age of onset of masturbation was 11–13 years for 43% of them. Premature ejaculation was the most common sexual dysfunction seen in the respondents. Marital discord was seen in significantly lesser number of respondents (32.35%) as also major depressive disorder that was seen in only 16%. Discussion: Premature ejaculation was the most common sexual dysfunction in our sample. Despite the sexual dysfunction, marital discord and depression were seen less commonly in our respondents. PMID:25657457

Psychosocial profile of male patients presenting with sexual dysfunction in a psychiatric outpatient department in Mumbai, India.

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Kalra, Gurvinder; Kamath, Ravindra; Subramanyam, Alka; Shah, Henal

2015-01-01

Sexual dysfunction can occur due to biological problems, relationship problems, lack of proper sexual knowledge or a combination of these. India is often known as the land of Kamasutra. But as far as sexuality research is concerned, there is a paucity of relevant data from India. In view of this, we conducted a study to assess the psychosocial profile of males presenting with sexual dysfunction to psychiatry out-patient department of a tertiary medical hospital. Hundred consecutive male patients presenting with sexual dysfunction were screened using Arizona Sexual Experiences Scale for clinical sexual dysfunction and after obtaining their informed consent were included in this study. They were assessed using a semi-structured proforma, Diagnostic and Statistical Manual of Mental Disorders, 4(th) Edition, Text Revision criteria, Mini-International Neuropsychiatric Interview, and Dyadic Adjustment Scale. Majority of our respondents were in the 18-30 years age group and were married. The main source of sex knowledge for 69% of them was peer group. Age of onset of masturbation was 11-13 years for 43% of them. Premature ejaculation was the most common sexual dysfunction seen in the respondents. Marital discord was seen in significantly lesser number of respondents (32.35%) as also major depressive disorder that was seen in only 16%. Premature ejaculation was the most common sexual dysfunction in our sample. Despite the sexual dysfunction, marital discord and depression were seen less commonly in our respondents.

Role of Exercise Training on Autonomic Changes and Inflammatory Profile Induced by Myocardial Infarction

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Rodrigues, Bruno; Lira, Fabio S.; Consolim-Colombo, Fernanda M.; Rocha, Juraci A.; Caperuto, Erico C.; De Angelis, Kátia; Irigoyen, Maria-Cláudia

2014-01-01

The cardiovascular autonomic imbalance in patients after myocardial infarction (MI) provides a significant increase in mortality rate, and seems to precede metabolic, hormonal, and immunological changes. Moreover, the reduction in the parasympathetic function has been associated with inflammatory response in different pathological conditions. Over the years, most of the studies have indicated the exercise training (ET) as an important nonpharmacological tool in the management of autonomic dysfunction and reduction in inflammatory profile after a myocardial infarction. In this work, we reviewed the effects of ET on autonomic imbalance after MI, and its consequences, particularly, in the post-MI inflammatory profile. Clinical and experimental evidence regarding relationship between alterations in autonomic regulation and local or systemic inflammation response after MI were also discussed. PMID:25045212

Role of Exercise Training on Autonomic Changes and Inflammatory Profile Induced by Myocardial Infarction

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Bruno Rodrigues

2014-01-01

Full Text Available The cardiovascular autonomic imbalance in patients after myocardial infarction (MI provides a significant increase in mortality rate, and seems to precede metabolic, hormonal, and immunological changes. Moreover, the reduction in the parasympathetic function has been associated with inflammatory response in different pathological conditions. Over the years, most of the studies have indicated the exercise training (ET as an important nonpharmacological tool in the management of autonomic dysfunction and reduction in inflammatory profile after a myocardial infarction. In this work, we reviewed the effects of ET on autonomic imbalance after MI, and its consequences, particularly, in the post-MI inflammatory profile. Clinical and experimental evidence regarding relationship between alterations in autonomic regulation and local or systemic inflammation response after MI were also discussed.

Dysautonomia (Autonomic Dysfunction)

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... are impotence (in men) and a fall in blood pressure during standing (orthostatic hypotension). Excessive sympathetic activity can present as hypertension or a rapid pulse rate. Treatment There is usually no cure for dysautonomia. Secondary forms may improve with treatment of the underlying ...

[A role of the autonomic nervous system in cerebro-cardiac disorders].

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Basantsova, N Yu; Tibekina, L M; Shishkin, A N

The authors consider anatomical/physiological characteristics and a role of different autonomic CNS regions, including insula cortex, amygdala complex, anterior cingulate cortex, ventral medial prefrontal cortex, hypothalamus and epiphysis, involved in the regulation of cardiovascular activity. The damage of these structures, e.g., due to the acute disturbance of cerebral blood circulation, led to arrhythmia, including fatal arrhythmia, in previously intact myocardium; systolic and diastolic dysfunction, ischemic changes considered in the frames of cerebro-cardial syndrome. On the cellular level, the disturbance of autonomic regulation resulted in catechol amine excitotoxicity, oxidative stress and free radical myocardium injury.

Rapid-Onset Obesity with Hypothalamic Dysfunction, Hypoventilation, and Autonomic Dysregulation (ROHHAD): exome sequencing of trios, monozygotic twins and tumours.

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Barclay, Sarah F; Rand, Casey M; Borch, Lauren A; Nguyen, Lisa; Gray, Paul A; Gibson, William T; Wilson, Richard J A; Gordon, Paul M K; Aung, Zaw; Berry-Kravis, Elizabeth M; Ize-Ludlow, Diego; Weese-Mayer, Debra E; Bech-Hansen, N Torben

2015-08-25

Rapid-onset Obesity with Hypothalamic Dysfunction, Hypoventilation, and Autonomic Dysregulation (ROHHAD) is thought to be a genetic disease caused by de novo mutations, though causative mutations have yet to be identified. We searched for de novo coding mutations among a carefully-diagnosed and clinically homogeneous cohort of 35 ROHHAD patients. We sequenced the exomes of seven ROHHAD trios, plus tumours from four of these patients and the unaffected monozygotic (MZ) twin of one (discovery cohort), to identify constitutional and somatic de novo sequence variants. We further analyzed this exome data to search for candidate genes under autosomal dominant and recessive models, and to identify structural variations. Candidate genes were tested by exome or Sanger sequencing in a replication cohort of 28 ROHHAD singletons. The analysis of the trio-based exomes found 13 de novo variants. However, no two patients had de novo variants in the same gene, and additional patient exomes and mutation analysis in the replication cohort did not provide strong genetic evidence to implicate any of these sequence variants in ROHHAD. Somatic comparisons revealed no coding differences between any blood and tumour samples, or between the two discordant MZ twins. Neither autosomal dominant nor recessive analysis yielded candidate genes for ROHHAD, and we did not identify any potentially causative structural variations. Clinical exome sequencing is highly unlikely to be a useful diagnostic test in patients with true ROHHAD. As ROHHAD has a high risk for fatality if not properly managed, it remains imperative to expand the search for non-exomic genetic risk factors, as well as to investigate other possible mechanisms of disease. In so doing, we will be able to confirm objectively the ROHHAD diagnosis and to contribute to our understanding of obesity, respiratory control, hypothalamic function, and autonomic regulation.

A comparative study of lipid profile and autonomic functions in vegetarian and non-vegetarian postmenopausal women

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Arunima Chaudhuri

2013-01-01

Full Text Available Background: The prevalence of dyslipedaemia, autonomic dysfunction leading to cardiovascular diseases, increases with menopause and an ageing population. Autonomic dysfunction as measured by lower heart rate variability is an established risk factor for cardiac death. Diet and nutrition have been extensively investigated as risk factors for major cardiovascular diseases and are also linked to other cardiovascular risk factors. Objectives: To compare lipid profile and autonomic functions of postmenopausal women on vegetarian and non- vegetarian diet. Materials and Methods: 120 Postmenopausal women (menopausal duration and age-matched without any gross systemic disease from an Industrial population were selected. Sixty women were on vegetarian diet and 60 on non-vegetarian diet. BMI and waist/hip ratios were calculated, lipid profile was analyzed, and autonomic function tests were carried out. A comparison was done between the two groups using Students t test. Pearson′s correlation coefficient was calculated between the independent variable (lipid profile parameters and the dependent variables (deep breath test, valsalva ratio, 30:15 ratio, OTT, IHG, CPT to understand the effect of lipid profile on autonomic control of heart. Results : Significant increases in total cholesterol, triglyceride, LDL, cholesterol/HDL ratio were noticed in women on non-vegetarian diet. Results of autonomic function tests, i.e. valsalva ratio, deep breath test, 30: 15R-R intervals ratio, isometric hand grip test, cold pressor test, and orthostatic tolerance test were significantly worsened in postmenopausal women on non-vegetarian diet. Conclusion: Dietary factors may be an important cause of alteration of lipid metabolism. Increased cholesterol decreases heart rate variability and increased LDL cholesterol decreases baroreceptor sensitivity thereby worsening autonomic functions in postmenopausal women.

Total autonomic blockage and primary sinus node dysfunction in a ...

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history confirmed the episodic headaches but there was no record of a similar incident. A Caesarean section done in 1996 had been uneventful. She apparently had ... dysfunction, the machine did not have a memory store for subsequent study, and moreover we were unable to confirm this diagnosis, as the hospital had no ...

Autonomic stress reactivity and craving in individuals with problematic Internet use.

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Moretta, Tania; Buodo, Giulia

2018-01-01

The link between autonomic stress reactivity and subjective urge/craving has been less systematically examined in behavioral addictions (i.e. problematic Internet use) than in substance use disorders. The present study investigated whether problematic Internet users (PU) show enhanced autonomic stress reactivity than non-PU, indexed by lower Heart Rate Variability (HRV) and higher Skin Conductance Level (SCL) reactivity during the Trier Social Stress Test (TSST), whether greater reactivity is related to stronger Internet craving, and whether problematic Internet usage is associated with some dysfunctional psychological features. Based on their Internet Addiction Test scores, participants were divided into PU (N = 24) and non-PU (N = 21). Their heart rate and skin conductance were continuously recorded during baseline, social stressors, and recovery. Craving for Internet usage were collected using a Likert scale before and after the TSST. The SDNN, an overall measure of HRV, was significantly lower in PU than non-PU during baseline, but not during and after stressful task. Furthermore, only among PU a significant negative correlation emerged between SDNN during recovery and craving ratings after the test. No group differences emerged for SCL. Lastly, PU endorsed more mood, obsessive-compulsive, and alcohol-related problems. Our findings suggest that problems in controlling one's use of the Internet may be related to reduced autonomic balance at rest. Moreover, our results provide new insights into the characterization of craving in PIU, indicating the existence of a relationship between craving for Internet usage and reduced autonomic flexibility.

Asymptomatic ST-depression during exercise testing in children and adolescents with type 1 diabetes mellitus and autonomic dysfunction

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Dmitry Nikitich Laptev

2015-04-01

Full Text Available Aim. The aim of this study was to investigate cardiac autonomic function as assessed by ST dynamics during and post-exercise in children and adolescents with type 1 diabetes mellitus (T1DM. Materials and methods. The study included 71 young patients with T1DM. The patients were aged 9?18 years and had no history of macrovascular disease or renal disease, including microalbuminuria. Cardiac autonomic function was assessed using cardiovascular tests and 24-h ECG monitoring with automatic calculation of QT interval and heart rate variability parameters. Each patient underwent the physical working capacity 170 test. Results. The prevalence of cardiovascular autonomic neuropathy (CAN was 30.9%. The frequency of asymptomatic ST-segment depression increased during exercise in 10 (45.5% patients with CAN (CAN+ compared with 9 (18.4% patients without CAN (CAN-; p=0.042. During the recovery period, asymptomatic ST-segment depression was present in the first minute in 8 (36.4% CAN+ patients compared with 1 (2% CAN- patient (p=0.0003 and in the second minute in 5 (22.7% CAN+ patients compared with 1 (2% CAN- patient (p=0.0095. Conclusion. Children and adolescents with T1DM and impaired autonomic function have increased prevalence of asymptomatic ST-segment depression during and post-exercise. The presence of cardiovascular risk factors in children and adolescents with T1DM and CAN may contribute to the increased cardiovascular morbidity and mortality during adulthood in patients with T1DM.

Asymptomatic ST-depression during exercise testing in children and adolescents with type 1 diabetes mellitus and autonomic dysfunction

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Dmitry Nikitich Laptev

2015-04-01

Full Text Available Aim. The aim of this study was to investigate cardiac autonomic function as assessed by ST dynamics during and post-exercise in children and adolescents with type 1 diabetes mellitus (T1DM.Materials and methods. The study included 71 young patients with T1DM. The patients were aged 9–18 years and had no history of macrovascular disease or renal disease, including microalbuminuria. Cardiac autonomic function was assessed using cardiovascular tests and 24-h ECG monitoring with automatic calculation of QT interval and heart rate variability parameters. Each patient underwent the physical working capacity 170 test.Results. The prevalence of cardiovascular autonomic neuropathy (CAN was 30.9%. The frequency of asymptomatic ST-segment depression increased during exercise in 10 (45.5% patients with CAN (CAN+ compared with 9 (18.4% patients without CAN (CAN-; p=0.042. During the recovery period, asymptomatic ST-segment depression was present in the first minute in 8 (36.4% CAN+ patients compared with 1 (2% CAN- patient (p=0.0003 and in the second minute in 5 (22.7% CAN+ patients compared with 1 (2% CAN- patient (p=0.0095.Conclusion. Children and adolescents with T1DM and impaired autonomic function have increased prevalence of asymptomatic ST-segment depression during and post-exercise. The presence of cardiovascular risk factors in children and adolescents with T1DM and CAN may contribute to the increased cardiovascular morbidity and mortality during adulthood in patients with T1DM.

Cardiac autonomic dysfunction is associated with high-risk albumin-to-creatinine ratio in young adolescents with type 1 diabetes in AdDIT (adolescent type 1 diabetes cardio-renal interventional trial).

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Cho, Yoon Hi; Craig, Maria E; Davis, Elizabeth A; Cotterill, Andrew M; Couper, Jennifer J; Cameron, Fergus J; Benitez-Aguirre, Paul Z; Dalton, R Neil; Dunger, David B; Jones, Timothy W; Donaghue, Kim C

2015-04-01

This study examined the association between cardiac autonomic dysfunction and high albumin-to-creatinine ratio (ACR) in adolescents with type 1 diabetes. Adolescents recruited as part of a multicenter screening study (n = 445, 49% female, aged 10-17 years, mean duration 6.9 years; mean HbA1c 8.4%, 68 mmol/mol) underwent a 10-min continuous electrocardiogram recording for heart rate variability analysis. Time-domain heart rate variability measures included baseline heart rate, SD of the R-R interval (SDNN), and root mean squared difference of successive R-R intervals (RMSSD). Spectral analysis included sympathetic (low-frequency) and parasympathetic (high-frequency) components. Standardized ACR were calculated from six early morning urine collections using an established algorithm, reflecting age, sex, and duration, and stratified into ACR tertiles, where the upper tertile reflects higher nephropathy risk. The upper-tertile ACR group had a faster heart rate (76 vs. 73 bpm; P < 0.01) and less heart rate variability (SDNN 68 vs. 76 ms, P = 0.02; RMSSD 63 vs. 71 ms, P = 0.04). HbA1c was 8.5% (69 mmol/mmol) in the upper tertile vs. 8.3% (67 mmol/mol) in the lower tertiles (P = 0.07). In multivariable analysis, upper-tertile ACR was associated with faster heart rate (β = 2.5, 95% CI 0.2-4.8, P = 0.03) and lower RMSSD (β = -9.5, 95% CI -18.2 to -0.8, P = 0.03), independent of age and HbA1c. Adolescents at potentially higher risk for nephropathy show an adverse cardiac autonomic profile, indicating sympathetic overdrive, compared with the lower-risk group. Longitudinal follow-up of this cohort will further characterize the relationship between autonomic and renal dysfunction and the effect of interventions in this population. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Autonomic and inflammatory consequences of posttraumatic stress disorder and the link to cardiovascular disease.

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Brudey, Chevelle; Park, Jeanie; Wiaderkiewicz, Jan; Kobayashi, Ihori; Mellman, Thomas A; Marvar, Paul J

2015-08-15

Stress- and anxiety-related disorders are on the rise in both military and general populations. Over the next decade, it is predicted that treatment of these conditions, in particular, posttraumatic stress disorder (PTSD), along with its associated long-term comorbidities, will challenge the health care system. Multiple organ systems are adversely affected by PTSD, and PTSD is linked to cancer, arthritis, digestive disease, and cardiovascular disease. Evidence for a strong link between PTSD and cardiovascular disease is compelling, and this review describes current clinical data linking PTSD to cardiovascular disease, via inflammation, autonomic dysfunction, and the renin-angiotensin system. Recent clinical and preclinical evidence regarding the role of the renin-angiotensin system in the extinction of fear memory and relevance in PTSD-related immune and autonomic dysfunction is also addressed. Copyright © 2015 the American Physiological Society.

Effects of glucose ingestion on autonomic and cardiovascular measures during rest and mental challenge

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Synowski, S.J.; Kop, W.J.; Warwick, Z.S.; Waldstein, S.R.

2013-01-01

Background High levels of dietary sugar consumption may result in dysregulated glucose metabolism and lead to elevated cardiovascular disease risk via autonomic nervous system and cardiovascular dysfunction. Altered cardiovascular function can be examined using perturbation tasks such as mental

Autonomic dysfunction with early respiratory syncytial virus-related infection.

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Stock, Claire; Teyssier, Georges; Pichot, Vincent; Goffaux, Philippe; Barthelemy, Jean-Claude; Patural, Hugues

2010-08-25

Apparent life-threatening events (ALTE) and/or prolonged apnoea have been well-documented during respiratory syncytial virus (RSV) infection in infants less than 2 months of age but fundamental mechanisms remain unclear. The possibility of a central origin for the development of severe cardiac and respiratory events encouraged us, to explore the autonomic nervous system (ANS) profile of infected infants, since ANS activity may contribute to the constellation of symptoms observed during severe forms of RSV bronchiolitis. Eight infants (2 preterm and 6 full-term) less than 2 months of age and presenting with severe and apnoeic forms of RSV infection were evaluated using non-invasive electrophysiological monitoring obtained simultaneously for approximately 2 consecutive hours, including a quiet sleep period. Eight control subjects, paired for gestational and postnatal age, were also evaluated. ANS status was monitored using electrocardiogram recordings and quantified through a frequency-domain analysis of heart rate variability (HRV). This included sympathetic (VLF and LF) and parasympathetic (HF) indices as well as a measure of baroreflex sensitivity (BRS) obtained using non-invasive continuous arterial pressure. Regardless of gestational and postnatal age, heart rate variability components (Ptot, VLF, LF, and HF) and baroreflex components (alpha LF, alpha HF and sBR) were found to be significantly lower in the RSV-infected group than in the control group (pimportance of maintaining prolonged cardiopulmonary monitoring. Copyright 2010 Elsevier B.V. All rights reserved.

Exercise improves cardiac autonomic function in obesity and diabetes.

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Voulgari, Christina; Pagoni, Stamatina; Vinik, Aaron; Poirier, Paul

2013-05-01

Physical activity is a key element in the prevention and management of obesity and diabetes. Regular physical activity efficiently supports diet-induced weight loss, improves glycemic control, and can prevent or delay type 2 diabetes diagnosis. Furthermore, physical activity positively affects lipid profile, blood pressure, reduces the rate of cardiovascular events and associated mortality, and restores the quality of life in type 2 diabetes. However, recent studies have documented that a high percentage of the cardiovascular benefits of exercise cannot be attributed solely to enhanced cardiovascular risk factor modulation. Obesity in concert with diabetes is characterized by sympathetic overactivity and the progressive loss of cardiac parasympathetic influx. These are manifested via different pathogenetic mechanisms, including hyperinsulinemia, visceral obesity, subclinical inflammation and increased thrombosis. Cardiac autonomic neuropathy is an underestimated risk factor for the increased cardiovascular morbidity and mortality associated with obesity and diabetes. The same is true for the role of physical exercise in the restoration of the heart cardioprotective autonomic modulation in these individuals. This review addresses the interplay of cardiac autonomic function in obesity and diabetes, and focuses on the importance of exercise in improving cardiac autonomic dysfunction. Copyright © 2013 Elsevier Inc. All rights reserved.

Pulse wave velocity and cardiac autonomic function in type 2 diabetes mellitus.

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Chorepsima, Stamatina; Eleftheriadou, Ioanna; Tentolouris, Anastasios; Moyssakis, Ioannis; Protogerou, Athanasios; Kokkinos, Alexandros; Sfikakis, Petros P; Tentolouris, Nikolaos

2017-05-19

Increased carotid-femoral pulse wave velocity (PWV) has been associated with incident cardiovascular disease, independently of traditional risk factors. Cardiac autonomic dysfunction is a common complication of diabetes and has been associated with reduced aortic distensibility. However, the association of cardiac autonomic dysfunction with PWV is not known. In this study we examined the association between cardiac autonomic function and PWV in subjects with type 2 diabetes mellitus. A total of 290 patients with type 2 diabetes were examined. PWV was measured at the carotid-femoral segment with applanation tonometry. Central mean arterial blood pressure (MBP) was determined by the same apparatus. Participants were classified as having normal (n = 193) or abnormal (n = 97) PWV values using age-corrected values. Cardiac autonomic nervous system activity was determined by measurement of parameters of heart rate variability (HRV). Subjects with abnormal PWV were older, had higher arterial blood pressure and higher heart rate than those with normal PWV. Most of the values of HRV were significantly lower in subjects with abnormal than in those with normal PWV. Multivariate analysis, after controlling for various confounding factors, demonstrated that abnormal PWV was associated independently only with peripheral MBP [odds ratio (OR) 1.049, 95% confidence intervals (CI) 1.015-1.085, P = 0.005], central MBP (OR 1.052, 95% CI 1.016-1.088, P = 0.004), log total power (OR 0.490, 95% CI 0.258-0.932, P = 0.030) and log high frequency power (OR 0.546, 95% CI 0.301-0.991, P = 0.047). In subjects with type 2 diabetes, arterial blood pressure and impaired cardiac autonomic function is associated independently with abnormal PWV.

Central- and autonomic nervous system coupling in schizophrenia

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Schulz, Steffen; Bolz, Mathias; Bär, Karl-Jürgen

2016-01-01

The autonomic nervous system (ANS) dysfunction has been well described in schizophrenia (SZ), a severe mental disorder. Nevertheless, the coupling between the ANS and central brain activity has been not addressed until now in SZ. The interactions between the central nervous system (CNS) and ANS need to be considered as a feedback–feed-forward system that supports flexible and adaptive responses to specific demands. For the first time, to the best of our knowledge, this study investigates central–autonomic couplings (CAC) studying heart rate, blood pressure and electroencephalogram in paranoid schizophrenic patients, comparing them with age–gender-matched healthy subjects (CO). The emphasis is to determine how these couplings are composed by the different regulatory aspects of the CNS–ANS. We found that CAC were bidirectional, and that the causal influence of central activity towards systolic blood pressure was more strongly pronounced than such causal influence towards heart rate in paranoid schizophrenic patients when compared with CO. In paranoid schizophrenic patients, the central activity was a much stronger variable, being more random and having fewer rhythmic oscillatory components. This study provides a more in-depth understanding of the interplay of neuronal and autonomic regulatory processes in SZ and most likely greater insights into the complex relationship between psychotic stages and autonomic activity. PMID:27044986

The characteristics of autonomic nervous system disorders in burning mouth syndrome and Parkinson disease.

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Koszewicz, Magdalena; Mendak, Magdalena; Konopka, Tomasz; Koziorowska-Gawron, Ewa; Budrewicz, Sławomir

2012-01-01

To conduct a clinical electrophysiologic evaluation of autonomic nervous system functions in patients with burning mouth syndrome and Parkinson disease and estimate the type and intensity of the autonomic dysfunction. The study involved 83 subjects-33 with burning mouth syndrome, 20 with Parkinson disease, and 30 controls. The BMS group included 27 women and 6 men (median age, 60.0 years), and the Parkinson disease group included 15 women and 5 men (median age, 66.5 years). In the control group, there were 20 women and 10 men (median age, 59.0 years). All patients were subjected to autonomic nervous system testing. In addition to the Low autonomic disorder questionnaire, heart rate variability (HRV), deep breathing (exhalation/inspiration [E/I] ratio), and sympathetic skin response (SSR) tests were performed in all cases. Parametric and nonparametric tests (ANOVA, Kruskal-Wallis, and Scheffe tests) were used in the statistical analysis. The mean values for HRV and E/I ratios were significantly lower in the burning mouth syndrome and Parkinson disease groups. Significant prolongation of SSR latency in the foot was revealed in both burning mouth syndrome and Parkinson disease patients, and lowering of the SSR amplitude occurred in only the Parkinson disease group. The autonomic questionnaire score was significantly higher in burning mouth syndrome and Parkinson disease patients than in the control subjects, with the Parkinson disease group having the highest scores. In patients with burning mouth syndrome, a significant impairment of both the sympathetic and parasympathetic nervous systems was found but sympathetic/parasympathetic balance was preserved. The incidence and intensity of autonomic nervous system dysfunction was similar in patients with burning mouth syndrome and Parkinson disease, which may suggest some similarity in their pathogeneses.

Physiotherapy of chronic prostatitis complicated with erectile dysfunction

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I. A. Kolmatsui; L. V. Barabash; S. V. Alaitseva; O. V. Dostovalova; O. Ye. Golosova

2012-01-01

Multimodality physiotherapy of chronic prostatitis complicated with erectile dysfunction, consisting of: EHF-puncture, sine-wave -pelotherapy of the penis zone, remedial gymnastics, iodic-bromine baths, and digital prostate massage was developed. Administration of the medical technology leaded up to reduction of inflammation in pelvic minor organs, improvement in penis microcirculation, and improvement in autonomic nervous systems state, enhancement of erectile function and improvement of qua...

Cardiac Autonomic Function Is Associated With the Coronary Microcirculatory Function in Patients With Type 2 Diabetes

DEFF Research Database (Denmark)

von Scholten, Bernt Johan; Hansen, Christian Stevns; Hasbak, Philip

2016-01-01

Cardiac autonomic dysfunction and cardiac microvascular dysfunction are diabetic complications associated with increased mortality, but the association between these has been difficult to assess. We applied new and sensitive methods to assess this in patients with type 2 diabetes mellitus (T2DM......). In a cross-sectional design, coronary flow reserve (CFR) assessed by cardiac (82)Rb-positron emission tomography/computed tomography, cardiac autonomic reflex tests, and heart rate variability indices were performed in 55 patients with T2DM, without cardiovascular disease, and in 28 control subjects. Cardiac....... A heart rate variability index, reflecting sympathetic and parasympathetic function (low-frequency power), and the late heart-to-mediastinum ratio, reflecting the function of adrenergic receptors and sympathetic activity, were positively correlated with CFR after adjustment for age and heart rate...

Functional Imaging of Autonomic Regulation: Methods and Key Findings

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Paul M Macey

2016-01-01

Full Text Available Central nervous system processing of autonomic function involves a network of regions throughout the brain which can be visualized and measured with neuroimaging techniques, notably functional magnetic resonance imaging (fMRI. The development of fMRI procedures has both confirmed and extended earlier findings from animal models, and human stroke and lesion studies. Assessments with fMRI can elucidate interactions between different central sites in regulating normal autonomic patterning, and demonstrate how disturbed systems can interact to produce aberrant regulation during autonomic challenges. Understanding autonomic dysfunction in various illnesses reveals mechanisms that potentially lead to interventions in the impairments. The objectives here are to: 1 describe the fMRI neuroimaging methodology for assessment of autonomic neural control, 2 outline the widespread, lateralized distribution of function in autonomic sites in the normal brain which includes structures from the neocortex through the medulla and cerebellum, 3 illustrate the importance of the time course of neural changes when coordinating responses, and how those patterns are impacted in conditions of sleep-disordered breathing, and 4 highlight opportunities for future research studies with emerging methodologies. Methodological considerations specific to autonomic testing include timing of challenges relative to the underlying fMRI signal, spatial resolution sufficient to identify autonomic brainstem nuclei, blood pressure and blood oxygenation influences on the fMRI signal, and the sustained timing, often measured in minutes of challenge periods and recovery. Key findings include the lateralized nature of autonomic organization, which is reminiscent of asymmetric motor, sensory and language pathways. Testing brain function during autonomic challenges demonstrate closely-integrated timing of responses in connected brain areas during autonomic challenges, and the involvement with

An Endotoxin Tolerance Signature Predicts Sepsis and Organ Dysfunction at Initial Clinical Presentation

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Olga M. Pena

2014-11-01

Interpretation: Our data support an updated model of sepsis pathogenesis in which endotoxin tolerance-mediated immune dysfunction (cellular reprogramming is present throughout the clinical course of disease and related to disease severity. Thus endotoxin tolerance might offer new insights guiding the development of new therapies and diagnostics for early sepsis.

Hormonal and cardiovascular reflex assessment in a female patient with pure autonomic failure

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Heno Ferreira Lopes

2000-09-01

Full Text Available We report the case of a 72-year-old female with pure autonomic failure, a rare entity, whose diagnosis of autonomic dysfunction was determined with a series of complementary tests. For approximately 2 years, the patient has been experiencing dizziness and a tendency to fall, a significant weight loss, generalized weakness, dysphagia, intestinal constipation, blurred vision, dry mouth, and changes in her voice. She underwent clinical assessment and laboratory tests (biochemical tests, chest X-ray, digestive endoscopy, colonoscopy, chest computed tomography, abdomen and pelvis computed tomography, abdominal ultrasound, and ambulatory blood pressure monitoring. Measurements of catecholamine and plasmatic renin activity were performed at rest and after physical exercise. Finally the patient underwent physiological and pharmacological autonomic tests that better diagnosed dysautonomia.

Autonomic Modulation in Duchenne Muscular Dystrophy during a Computer Task: A Prospective Control Trial.

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Mayra Priscila Boscolo Alvarez

Full Text Available Duchenne Muscular Dystrophy (DMD is characterized by progressive muscle weakness that can lead to disability. Owing to functional difficulties faced by individuals with DMD, the use of assistive technology is essential to provide or facilitate functional abilities. In DMD, cardiac autonomic dysfunction has been reported in addition to musculoskeletal impairment. Consequently, the objective was to investigate acute cardiac autonomic responses, by Heart Rate Variability (HRV, during computer tasks in subjects with DMD.HRV was assessed by linear and nonlinear methods, using the heart rate monitor Polar RS800CX chest strap Electrocardiographic measuring device. Then, 45 subjects were included in the group with DMD and 45 in the healthy Typical Development (TD control group. They were assessed for twenty minutes at rest sitting, and five minutes after undergoing a task on the computer.Individuals with DMD had a statistically significant lower parasympathetic cardiac modulation at rest when compared to the control group, which further declined when undergoing the tasks on the computer.DMD patients presented decreased HRV and exhibited greater intensity of cardiac autonomic responses during computer tasks characterized by vagal withdrawal when compared to the healthy TD control subjects.

Autonomic nervous system profile in fibromyalgia patients and its modulation by exercise: a mini review.

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Kulshreshtha, Poorvi; Deepak, Kishore K

2013-03-01

This review imparts an impressionistic tone to our current understanding of autonomic nervous system abnormalities in fibromyalgia. In the wake of symptoms present in patients with fibromyalgia (FM), autonomic dysfunction seems plausible in fibromyalgia. A popular notion is that of a relentless sympathetic hyperactivity and hyporeactivity based on heart rate variability (HRV) analyses and responses to various physiological stimuli. However, some exactly opposite findings suggesting normal/hypersympathetic reactivity in patients with fibromyalgia do exist. This heterogeneous picture along with multiple comorbidities accounts for the quantitative and qualitative differences in the degree of dysautonomia present in patients with FM. We contend that HRV changes in fibromyalgia may not actually represent increased cardiac sympathetic tone. Normal muscle sympathetic nerve activity (MSNA) and normal autonomic reactivity tests in patients with fibromyalgia suggest defective vascular end organ in fibromyalgia. Previously, we proposed a model linking deconditioning with physical inactivity resulting from widespread pain in patients with fibromyalgia. Deconditioning also modulates the autonomic nervous system (high sympathetic tone and a low parasympathetic tone). A high peripheral sympathetic tone causes regional ischaemia, which in turn results in widespread pain. Thus, vascular dysregulation and hypoperfusion in patients with FM give rise to ischaemic pain leading to physical inactivity. Microvascular abnormalities are also found in patients with FM. Therapeutic interventions (e.g. exercise) that result in vasodilatation and favourable autonomic alterations have proven to be effective. In this review, we focus on the vascular end organ in patients with fibromyalgia in particular and its modulation by exercise in general. © 2012 The Authors Clinical Physiology and Functional Imaging © 2012 Scandinavian Society of Clinical Physiology and Nuclear Medicine.

Type 2 diabetes and cardiac autonomic neuropathy screening using dynamic pupillometry

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Lerner, Alana G.; Bernabé-Ortiz, Antonio; Ticse, Ray; Hernandez, Arturo; Huaylinos, Yvonne; Pinto, Miguel E.; Málaga, Germán; Checkley, William; Gilman, Robert H.; Miranda, J. Jaime

2015-01-01

Aim To determine if changes in pupillary response are useful as a screening tool for diabetes and to assess whether pupillometry is associated with cardiac autonomic neuropathy. Methods We conducted a cross-sectional study with participants drawn from two settings: a hospital and a community site. At the community site, individuals with newly diagnosed diabetes as well as a random sample of control individuals without diabetes, confirmed by oral glucose tolerance test, were selected. Participants underwent an LED light stimulus test and eight pupillometry variables were measured. Outcomes were diabetes, defined by oral glucose tolerance test, and cardiac autonomic dysfunction, determined by a positive readout on two of four diagnostic tests: heart rate response to the Valsalva manoeuvre; orthostatic hypotension; 30:15 ratio; and expiration-to-inspiration ratio. The area under the curve, best threshold, sensitivity and specificity of each pupillometry variable was calculated. Results Data from 384 people, 213 with diabetes, were analysed. The mean (±SD) age of the people with diabetes was 58.6 (±8.2) years and in the control subjects it was 56.1 (±8.6) years. When comparing individuals with and without diabetes, the amplitude of the pupil reaction had the highest area under the curve [0.69 (sensitivity: 78%; specificity: 55%)]. Cardiac autonomic neuropathy was present in 51 of the 138 people evaluated (37.0%; 95% CI 28.8–45.1). To diagnose cardiac autonomic neuropathy, two pupillometry variables had the highest area under the curve: baseline pupil radius [area under the curve: 0.71 (sensitivity: 51%; specificity: 84%)], and amplitude of the pupil reaction [area under the curve: 070 (sensitivity: 82%; specificity: 55%)]. Conclusions Pupillometry is an inexpensive technique to screen for diabetes and cardiac autonomic neuropathy, but it does not have sufficient accuracy for clinical use as a screening tool. PMID:25761508

The Role of Vegetative Dysfunction and Its Correction in Gastroesophageal Reflux Disease

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G.V. Osyodlo

2014-04-01

Full Text Available The article analyzes the findings regarding the effect of vegetative dysfunction on the course of gastroesophageal reflux disease, the expediency of autonomic imbalance correction by phenibut on the background of antisecretory therapy with pantoprazole is shown, it helps to improve the immediate and long-term results.

Physiotherapy of chronic prostatitis complicated with erectile dysfunction

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I. A. Kolmatsui

2012-01-01

Full Text Available Multimodality physiotherapy of chronic prostatitis complicated with erectile dysfunction, consisting of: EHF-puncture, sine-wave -pelotherapy of the penis zone, remedial gymnastics, iodic-bromine baths, and digital prostate massage was developed. Administration of the medical technology leaded up to reduction of inflammation in pelvic minor organs, improvement in penis microcirculation, and improvement in autonomic nervous systems state, enhancement of erectile function and improvement of quality of life of men.

Medulla oblongata damage and cardiac autonomic dysfunction in Parkinson disease.

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Pyatigorskaya, Nadya; Mongin, Marie; Valabregue, Romain; Yahia-Cherif, Lydia; Ewenczyk, Claire; Poupon, Cyril; Debellemaniere, Eden; Vidailhet, Marie; Arnulf, Isabelle; Lehéricy, Stephane

2016-12-13

To characterize medulla oblongata damage using diffusion tensor imaging (DTI) in Parkinson disease (PD) and correlate it with dysfunction of the cardiac sympathetic/vagal balance. Fifty-two patients with PD and 24 healthy controls were included in the study. All participants underwent clinical examination and 3T MRI using 3D T1-weighted imaging and DTI. DTI metrics were calculated within manually drawn regions of interest. Heart rate variability was evaluated using spectral analysis of the R-R cardiac interval during REM and slow-wave sleep based on continuous overnight electrocardiographic monitoring. Respiratory frequency was measured in 30-second contiguous epochs of REM and slow-wave sleep. The relationships between imaging and cardiac variables were calculated using partial correlations followed by the multiple comparisons permutation approach. The changes in heart rate and respiratory frequency variability from slow-wave sleep to REM sleep in healthy controls were no longer detectable in patients with PD. There were significant increases in the mean (p = 0.006), axial (p = 0.006), and radial diffusivities (p = 0.005) in the medulla oblongata of patients with PD. In PD, diffusion changes were specifically correlated with a lower heart rate and respiratory frequency variability during REM sleep. This study provides evidence that medulla oblongata damage underlies cardiac sympathetic/vagal balance and respiratory dysfunction in patients with PD. © 2016 American Academy of Neurology.

Heart Rate Variability in Patients with Acute Ischemic Stroke at Different Stages of Renal Dysfunction: A Cross-sectional Observational Study

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Lin Wei

2017-01-01

Conclusions: Autonomic dysfunction is aggravated with the progression of eGFR stage in patients with acute ischemic stroke; the eGFR is an independent factor of LF/HF in the adjusted models. Stroke severity and a history of diabetes are more significantly associated with HRV in patients with acute ischemic stroke at different stages of renal dysfunction.

Psychosocial profile of male patients presenting with sexual dysfunction in a psychiatric outpatient department in Mumbai, India

OpenAIRE

Kalra, Gurvinder; Kamath, Ravindra; Subramanyam, Alka; Shah, Henal

2015-01-01

Introduction: Sexual dysfunction can occur due to biological problems, relationship problems, lack of proper sexual knowledge or a combination of these. India is often known as the land of Kamasutra. But as far as sexuality research is concerned, there is a paucity of relevant data from India. In view of this, we conducted a study to assess the psychosocial profile of males presenting with sexual dysfunction to psychiatry out-patient department of a tertiary medical hospital. Materials and Me...

Cardiovascular autonomic dysfunction and carotid stiffness in adults with repaired tetralogy of Fallot.

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Novaković, Marko; Prokšelj, Katja; Starc, Vito; Jug, Borut

2017-06-01

Adults after surgical repair of tetralogy of Fallot (ToF) may have impaired vascular and cardiac autonomic function. Thus, we wanted to assess interrelations between heart rate variability (HRV) and heart rate recovery (HRR), as parameters of cardiac autonomic function, and arterial stiffness, as a parameter of vascular function, in adults with repaired ToF as compared to healthy controls. In a case-control study of adults with repaired ToF and healthy age-matched controls we measured: 5-min HRV variability (with time and frequency domain data collected), carotid artery stiffness (through pulse-wave analysis using echo-tracking ultrasound) and post-exercise HRR (cycle ergometer exercise testing). Twenty-five patients with repaired ToF (mean age 38 ± 10 years) and 10 healthy controls (mean age 39 ± 8 years) were included. Selected HRR and HRV (time-domain) parameters, but not arterial stiffness were significantly reduced in adults after ToF repair. Moreover, a strong association between late/slow HRR (after 2, 3 and 4 min) and carotid artery stiffness was detected in ToF patients (r = -0.404, p = 0.045; r = -0.545, p = 0.005 and r = -0.545, p = 0.005, respectively), with statistical significance retained even after adjusting for age, gender, resting heart rate and β-blockers use (r = -0.393, p = 0.024 for HRR after 3 min). Autonomic cardiac function is impaired in patients with repaired ToF, and independently associated with vascular function in adults after ToF repair, but not in age-matched healthy controls. These results might help in introducing new predictors of cardiovascular morbidity in a growing population of adults after surgical repair of ToF.

Association between Depression, Pressure Pain Sensitivity, Stress and Autonomous Nervous System Function in Stable Ischemic Heart Disease

DEFF Research Database (Denmark)

Ballegaard, Søren; Bergmann, Natasha; Karpatschof, Benny

2016-01-01

Background: Depression and ischemic heart disease (IHD) are associated with persistent stress and autonomic nervous system (ANS) dysfunction. The former can be measured by pressure pain sensitivity (PPS) of the sternum, and the latter by the PPS and systolic blood pressure (SBP) response to a til...... in depression, reduction in persistent stress, and restoration of ANS dysfunction was only seen in non-users, suggesting a central role of beta-adrenergic receptors in the association between these factors....

Cardiac autonomic modulation impairments in advanced breast cancer patients.

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Arab, Claudia; Vanderlei, Luiz Carlos Marques; da Silva Paiva, Laércio; Fulghum, Kyle Levi; Fristachi, Carlos Elias; Nazario, Afonso Celso Pinto; Elias, Simone; Gebrim, Luiz Henrique; Ferreira Filho, Celso; Gidron, Yori; Ferreira, Celso

2018-05-02

To compare cardiac autonomic modulation in early- versus advanced-stage breast cancer patients before any type of cancer treatment and investigate associated factors. This cross-sectional study included women (30-69 years old) with primary diagnosis of breast cancer and women with benign breast tumors. We evaluated cardiac modulation by heart rate variability and assessed factors of anxiety, depression, physical activity, and other relevant medical variables. Patients were divided into three groups based on TNM staging of cancer severity: early-stage cancer (n = 42), advanced-stage cancer (n = 37), or benign breast tumors to serve as a control (n = 37). We analyzed heart rate variability in time and frequency domains. The advanced-stage cancer group had lower vagal modulation than early-stage and benign groups; also, the advance-stage group had lower overall heart rate variability when compared to benign conditions. Heart rate variability was influenced by age, menopausal status, and BMI. Heart rate variability seems to be a promising, non-invasive tool for early diagnosis of autonomic dysfunction in breast cancer and detection of cardiovascular impairments at cancer diagnosis. Cardiac autonomic modulation is inversely associated with breast cancer staging.

The sensory channel of presentation alters subjective ratings and autonomic responses towards disgusting stimuli -Blood pressure, heart rate and skin conductance in response to visual, auditory, haptic and olfactory presented disgusting stimuli-

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Ilona eCroy

2013-09-01

Full Text Available Disgust causes specific reaction patterns, observable in mimic responses and body reactions. Most research on disgust deals with visual stimuli. However, pictures may cause another disgust experience than sounds, odors or tactile stimuli. Therefore disgust experience evoked by four different sensory channels was compared.A total of 119 participants received 3 different disgusting and one control stimulus, each presented through the visual, auditory, tactile and olfactory channel. Ratings of evoked disgust as well as responses of the autonomic nervous system (heart rate, skin conductance level, systolic blood pressure were recorded and the effect of stimulus labeling and of repeated presentation was analyzed. Ratings suggested that disgust could be evoked through all senses; they were highest for visual stimuli. However, autonomic reaction towards disgusting stimuli differed according to the channel of presentation. In contrast to the other, olfactory disgust stimuli provoked a strong decrease of systolic blood pressure. Additionally, labeling enhanced disgust ratings and autonomic reaction for olfactory and tactile, but not for visual and auditory stimuli. Repeated presentation indicated that participant’s disgust rating diminishes to all but olfactory disgust stimuli. Taken together we argue that the sensory channel through which a disgust reaction is evoked matters.

The artificial somato-autonomic reflex arch does not improve bowel function in subjects with spinal cord injury

DEFF Research Database (Denmark)

Rasmussen, Mikkel Mylius; Krogh, Klaus; Clemmensen, Dorte

2015-01-01

Study design: Prospective cohort study. Objective: Although introduced for neurogenic bladder dysfunction, it has been suggested that the artificial somato-autonomic reflex arch alleviates neurogenic bowel dysfunction (NBD). We aimed at evaluating the effects of the reflex arch on NBD. Setting......: Denmark. Methods: Ten subjects with supraconal spinal cord injury (SCI) (nine males, median age 46 years) had an anastomosis created between the ventral part of the fifth lumbar or first sacral nerve root and the ventral part of the second sacral nerve root. Standardized assessment of segmental colorectal...... sphincter pressures and rectal capacity did not change, and no change was seen in NBD score (median 13.5 (baseline) vs 12.5 (follow-up), P=0.51), St Marks fecal incontinence score (4.5 vs 5.0, P=0.36) and Cleveland constipation score (6.0 vs 8.0, P=0.75). Conclusions: The artificial somato-autonomic reflex...

Iatrogenic causes of salivary gland dysfunction

International Nuclear Information System (INIS)

Schubert, M.M.; Izutsu, K.T.

1987-01-01

Saliva is important for maintaining oral health and function. There are instances when medical therapy is intended to decrease salivary flow, such as during general anesthesia, but most instances of iatrogenic salivary gland dysfunction represent untoward or unavoidable side-effects. The clinical expression of the salivary dysfunction can range from very minor transient alteration in saliva flow to a total loss of salivary function. The most common forms of therapy that interfere with salivation are drug therapies, cancer therapies (radiation or chemotherapy), and surgical therapy. These therapies can affect salivation by a number of different mechanisms that include: disruption of autonomic nerve function related to salivation, interference with acinar or ductal cell functions related to salivation, cytotoxicity, indirect effects (vasoconstriction/dilation, fluid and electrolyte balance, etc.), and physical trauma to salivary glands and nerves. A wide variety of drugs is capable of increasing or decreasing salivary flow by mimicking autonomic nervous system actions or by directly acting on cellular processes necessary for salivation: drugs can also indirectly affect salivation by altering fluid and electrolyte balance or by affecting blood flow to the glands. Ionizing radiation can cause permanent damage to salivary glands, damage that is manifest as acinar cell destruction with subsequent atrophy and fibrosis of the glands. Cancer chemotherapy can cause changes in salivation, but the changes are usually much less severe and only transient. Finally, surgical and traumatic injuries interfere with salivation because of either disruption of gland innervation or gross physical damage (or removal) of glandular tissue (including ducts)

Parasympathetic nervous system dysfunction, as identified by pupil light reflex, and its possible connection to hearing impairment

OpenAIRE

Wang, Yang; Zekveld, Adriana A.; Naylor, Graham; Ohlenforst, Barbara; Jansma, Elise P.; Lorens, Artur; Lunner, Thomas; Kramer, Sophia E.

2016-01-01

Context\\ud Although the pupil light reflex has been widely used as a clinical diagnostic tool for autonomic nervous system dysfunction, there is no systematic review available to summarize the evidence that the pupil light reflex is a sensitive method to detect parasympathetic dysfunction. Meanwhile, the relationship between parasympathetic functioning and hearing impairment is relatively unknown.\\ud \\ud Objectives\\ud To 1) review the evidence for the pupil light reflex being a sensitive meth...

Activating thyrotropin receptor mutations are present in nonadenomatous hyperfunctioning nodules of toxic or autonomous multinodular goiter.

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Tonacchera, M; Agretti, P; Chiovato, L; Rosellini, V; Ceccarini, G; Perri, A; Viacava, P; Naccarato, A G; Miccoli, P; Pinchera, A; Vitti, P

2000-06-01

Toxic multinodular goiter, a heterogeneous disease producing hyperthyroidism, is frequently found in iodine-deficient areas. The pathogenesis of this common clinical entity is still unclear. The aim of the present study was to search for activating TSH receptor (TSHr) or Gs alpha mutations in areas of toxic or functionally autonomous multinodular goiters that appeared hyperfunctioning at thyroid scintiscan but did not clearly correspond to definite nodules at physical or ultrasonographic examination. Surgical tissue specimens from nine patients were carefully dissected, matching thyroid scintiscan and thyroid ultrasonography, to isolate hyperfunctioning and nonfunctioning areas even if they did not correspond to well-defined nodules. TSHr and Gs alpha mutations were searched for by direct sequencing after PCR amplification of genomic DNA. Only 2 adenomas were identified at microscopic examination, whereas the remaining 18 hyperfunctioning areas corresponded to hyperplastic nodules containing multiple aggregates of micromacrofollicules not surrounded by a capsule. Activating TSHr mutations were detected in 14 of these 20 hyperfunctioning areas, whereas no mutation was identified in nonfunctioning nodules or areas contained in the same gland. No Gs alpha mutation was found. In conclusion, activating TSHr mutations are present in the majority of nonadenomatous hyperfunctioning nodules scattered throughout the gland in patients with toxic or functionally autonomous multinodular goiter.

Abnormal autonomic cardiac response to transient hypoxia in sickle cell anemia

International Nuclear Information System (INIS)

Sangkatumvong, S; Khoo, M C K; Coates, T D

2008-01-01

The objective of this study was to non-invasively assess cardiac autonomic control in subjects with sickle cell anemia (SCA) by tracking the changes in heart rate variability (HRV) that occur following brief exposure to a hypoxic stimulus. Five African–American SCA patients and seven healthy control subjects were recruited to participate in this study. Each subject was exposed to a controlled hypoxic stimulus consisting of five breaths of nitrogen. Time-varying spectral analysis of HRV was applied to estimate the cardiac autonomic response to the transient episode of hypoxia. The confounding effects of changes in respiration on the HRV spectral indices were reduced by using a computational model. A significant decrease in the parameters related to parasympathetic control was detected in the post-hypoxic responses of the SCA subjects relative to normal controls. The spectral index related to sympathetic activity, on the other hand, showed a tendency to increase the following hypoxic stimulation, but the change was not significant. This study suggests that there is some degree of cardiovascular autonomic dysfunction in SCA that is revealed by the response to transient hypoxia

Upper gastrointestinal sensory-motor dysfunction in diabetes mellitus

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Zhao, Jing-Bo; Frøkjær, Jens Brøndum; Drewes, Asbjørn Mohr; Ejskjaer, Niels

2006-01-01

Gastrointestinal (GI) sensory-motor abnormalities are common in patients with diabetes mellitus and may involve any part of the GI tract. Abnormalities are frequently sub-clinical, and fortunately only rarely do severe and life-threatening problems occur. The pathogenesis of abnormal upper GI sensory-motor function in diabetes is incompletely understood and is most likely multi-factorial of origin. Diabetic autonomic neuropathy as well as acute suboptimal control of diabetes has been shown to impair GI motor and sensory function. Morphological and biomechanical remodeling of the GI wall develops during the duration of diabetes, and may contribute to motor and sensory dysfunction. In this review sensory and motility disorders of the upper GI tract in diabetes is discussed; and the morphological changes and biomechanical remodeling related to the sensory-motor dysfunction is also addressed. PMID:16718808

Exercise-induced ventricular arrhythmias and vagal dysfunction in Chagas disease patients with no apparent cardiac involvement

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Henrique Silveira Costa

2015-04-01

Full Text Available INTRODUCTION : Exercise-induced ventricular arrhythmia (EIVA and autonomic imbalance are considered as early markers of heart disease in Chagas disease (ChD patients. The objective of the present study was to verify the differences in the occurrence of EIVA and autonomic maneuver indexes between healthy individuals and ChD patients with no apparent cardiac involvement. METHODS : A total of 75 ChD patients with no apparent cardiac involvement, aged 44.7 (8.5 years, and 38 healthy individuals, aged 44.0 (9.2 years, were evaluated using echocardiography, symptom-limited treadmill exercise testing and autonomic function tests. RESULTS : The occurrence of EIVA was higher in the chagasic group (48% than in the control group (23.7% during both the effort and the recovery phases. Frequent ventricular contractions occurred only in the patient group. Additionally, the respiratory sinus arrhythmia index was significantly lower in the chagasic individuals compared with the control group. CONCLUSIONS : ChD patients with no apparent cardiac involvement had a higher frequency of EIVA as well as more vagal dysfunction by respiratory sinus arrhythmia. These results suggest that even when asymptomatic, ChD patients possess important arrhythmogenic substrates and subclinical disease.

Design of an Autonomous Transport System for Coastal Areas

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Andrzej Lebkowski

2018-03-01

Full Text Available The article presents a project of an autonomous transport system that can be deployed in coastal waters, bays or between islands. Presented solutions and development trends in the transport of autonomous and unmanned units (ghost ships are presented. The structure of the control system of autonomous units is discussed together with the presentation of applied solutions in the field of artificial intelligence. The paper presents the concept of a transport system consisting of autonomous electric powered vessels designed to carry passengers, bikes, mopeds, motorcycles or passenger cars. The transport task is to be implemented in an optimal way, that is, most economically and at the same time as safe as possible. For this reason, the structure of the electric propulsion system that can be found on such units is shown. The results of simulation studies of autonomous system operation using simulator of marine navigational environment are presented.

The role of autonomic function in exercise-induced endogenous analgesia : a case-control study in myalgic encephalomyelitis/chronic fatigue syndrome and healthy people

OpenAIRE

Van Oosterwijck, Jessica; Marusic, Uros; De Wandele, Inge; Paul, Lorna; Meeus, Mira; Moorkens, Greta; Lambrecht, Luc; Danneels, Lieven; Nijs, Jo

2017-01-01

BACKGROUND: Patients with myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS) are unable to activate brain-orchestrated endogenous analgesia (or descending inhibition) in response to exercise. This physiological impairment is currently regarded as one factor explaining post-exertional malaise in these patients. Autonomic dysfunction is also a feature of ME/CFS. OBJECTIVES: This study aims to examine the role of the autonomic nervous system in exercise-induced analgesia in healthy...

Heart rate responses to autonomic challenges in obstructive sleep apnea.

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Paul M Macey

Full Text Available Obstructive sleep apnea (OSA is accompanied by structural alterations and dysfunction in central autonomic regulatory regions, which may impair dynamic and static cardiovascular regulation, and contribute to other syndrome pathologies. Characterizing cardiovascular responses to autonomic challenges may provide insights into central nervous system impairments, including contributions by sex, since structural alterations are enhanced in OSA females over males. The objective was to assess heart rate responses in OSA versus healthy control subjects to autonomic challenges, and, separately, characterize female and male patterns. We studied 94 subjects, including 37 newly-diagnosed, untreated OSA patients (6 female, age mean ± std: 52.1 ± 8.1 years; 31 male aged 54.3 ± 8.4 years, and 57 healthy control subjects (20 female, 50.5 ± 8.1 years; 37 male, 45.6 ± 9.2 years. We measured instantaneous heart rate with pulse oximetry during cold pressor, hand grip, and Valsalva maneuver challenges. All challenges elicited significant heart rate differences between OSA and control groups during and after challenges (repeated measures ANOVA, p<0.05. In post-hoc analyses, OSA females showed greater impairments than OSA males, which included: for cold pressor, lower initial increase (OSA vs. control: 9.5 vs. 7.3 bpm in females, 7.6 vs. 3.7 bpm in males, OSA delay to initial peak (2.5 s females/0.9 s males, slower mid-challenge rate-of-increase (OSA vs. control: -0.11 vs. 0.09 bpm/s in females, 0.03 vs. 0.06 bpm/s in males; for hand grip, lower initial peak (OSA vs. control: 2.6 vs. 4.6 bpm in females, 5.3 vs. 6.0 bpm in males; for Valsalva maneuver, lower Valsalva ratio (OSA vs. control: 1.14 vs. 1.30 in females, 1.29 vs. 1.34 in males, and OSA delay during phase II (0.68 s females/1.31 s males. Heart rate responses showed lower amplitude, delayed onset, and slower rate changes in OSA patients over healthy controls, and impairments may be more pronounced in

Effects of Weekly Low-Frequency rTMS on Autonomic Measures in Children with Autism Spectrum Disorder

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Manuel Fernando Casanova

2014-10-01

Full Text Available The term autism spectrum disorder (ASD describes a range of conditions characterized by impairments in social interactions, communication, and by restricted and repetitive behaviors. ASD may also present with symptoms suggestive of autonomic nervous system (ANS dysfunction. The objective of this study was to determine the effect of 18 sessions of low frequency repetitive transcranial magnetic stimulation (rTMS on autonomic function in children with ASD by recording electrocardiogram (EKG and electrodermal activity pre-, post- and during each rTMS session. The autonomic measures of interest in this study were R-R cardiointervals in EKG (R-R, time and frequency domain measures of heart rate variability (HRV and skin conductance level (SCL. HRV measures such as R-R intervals, standard deviation of cardiac intervals, pNN50 (percentage of cardiointervals>50 ms different from preceding interval, power of high frequency (HF and low frequency (LF components of HRV spectrum, LF/HF ratio, were then derived from the recorded EKG. We expected that the course of 18 weekly inhibitory low-frequency rTMS applied to the dorsolateral prefrontal cortex (DLPFC would enhance autonomic balance by facilitating frontal inhibition of limbic activity thus resulting in decreased overall heart rate, increased HRV (in a form of increased HF power, decreased LF power (resulting in decreased LF/HF ratio, and decreased SCL. Behavioral evaluations post-18 TMS showed decreased irritability, hyperactivity, stereotype behavior and compulsive behavior ratings while autonomic measures indicated a significant increase in cardiac interval variability and a decrease of tonic SCL. The results suggest that 18 sessions of low frequency rTMS in ASD results in increased cardiac vagal control and reduced sympathetic arousal.

Energy homeostasis, autonomic activity and obesity

NARCIS (Netherlands)

Scheurink, AJW; Balkan, B; Nyakas, C; vanDijk, G; Steffens, AB; Bohus, B

1995-01-01

Obesity is often accompanied by alterations in both sympathetic and parasympathetic autonomic functions. The present paper summarizes the results of a number of studies designed to investigate autonomic functioning in normal, genetically, and experimentally obese rats, Particular emphasis is given

Orthostatic Intolerance and Postural Orthostatic Tachycardia Syndrome in Joint Hypermobility Syndrome/Ehlers-Danlos Syndrome, Hypermobility Type: Neurovegetative Dysregulation or Autonomic Failure?

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Claudia Celletti

2017-01-01

Full Text Available Background. Joint hypermobility syndrome/Ehlers-Danlos syndrome, hypermobility type (JHS/EDS-HT, is a hereditary connective tissue disorder mainly characterized by generalized joint hypermobility, skin texture abnormalities, and visceral and vascular dysfunctions, also comprising symptoms of autonomic dysfunction. This study aims to further evaluate cardiovascular autonomic involvement in JHS/EDS-HT by a battery of functional tests. Methods. The response to cardiovascular reflex tests comprising deep breathing, Valsalva maneuver, 30/15 ratio, handgrip test, and head-up tilt test was studied in 35 JHS/EDS-HT adults. Heart rate and blood pressure variability was also investigated by spectral analysis in comparison to age and sex healthy matched group. Results. Valsalva ratio was normal in all patients, but 37.2% of them were not able to finish the test. At tilt, 48.6% patients showed postural orthostatic tachycardia, 31.4% orthostatic intolerance, 20% normal results. Only one patient had orthostatic hypotension. Spectral analysis showed significant higher baroreflex sensitivity values at rest compared to controls. Conclusions. This study confirms the abnormal cardiovascular autonomic profile in adults with JHS/EDS-HT and found the higher baroreflex sensitivity as a potential disease marker and clue for future research.

Orthostatic Intolerance and Postural Orthostatic Tachycardia Syndrome in Joint Hypermobility Syndrome/Ehlers-Danlos Syndrome, Hypermobility Type: Neurovegetative Dysregulation or Autonomic Failure?

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Celletti, Claudia; Camerota, Filippo; Castori, Marco; Censi, Federica; Gioffrè, Laura; Calcagnini, Giovanni; Strano, Stefano

2017-01-01

Background . Joint hypermobility syndrome/Ehlers-Danlos syndrome, hypermobility type (JHS/EDS-HT), is a hereditary connective tissue disorder mainly characterized by generalized joint hypermobility, skin texture abnormalities, and visceral and vascular dysfunctions, also comprising symptoms of autonomic dysfunction. This study aims to further evaluate cardiovascular autonomic involvement in JHS/EDS-HT by a battery of functional tests. Methods . The response to cardiovascular reflex tests comprising deep breathing, Valsalva maneuver, 30/15 ratio, handgrip test, and head-up tilt test was studied in 35 JHS/EDS-HT adults. Heart rate and blood pressure variability was also investigated by spectral analysis in comparison to age and sex healthy matched group. Results . Valsalva ratio was normal in all patients, but 37.2% of them were not able to finish the test. At tilt, 48.6% patients showed postural orthostatic tachycardia, 31.4% orthostatic intolerance, 20% normal results. Only one patient had orthostatic hypotension. Spectral analysis showed significant higher baroreflex sensitivity values at rest compared to controls. Conclusions. This study confirms the abnormal cardiovascular autonomic profile in adults with JHS/EDS-HT and found the higher baroreflex sensitivity as a potential disease marker and clue for future research.

Self-reported post-exertional fatigue in Gulf War veterans: roles of autonomic testing

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Li, Mian; Xu, Changqing; Yao, Wenguo; Mahan, Clare M.; Kang, Han K.; Sandbrink, Friedhelm; Zhai, Ping; Karasik, Pamela A.

2014-01-01

To determine if objective evidence of autonomic dysfunction exists from a group of Gulf War veterans with self-reported post-exertional fatigue, we evaluated 16 Gulf War ill veterans and 12 Gulf War controls. Participants of the ill group had self- reported, unexplained chronic post-exertional fatigue and the illness symptoms had persisted for years until the current clinical study. The controls had no self-reported post-exertional fatigue either at the time of initial survey nor at the time of the current study. We intended to identify clinical autonomic disorders using autonomic and neurophysiologic testing in the clinical context. We compared the autonomic measures between the 2 groups on cardiovascular function at both baseline and head-up tilt, and sudomotor function. We identified 1 participant with orthostatic hypotension, 1 posture orthostatic tachycardia syndrome, 2 distal small fiber neuropathy, and 1 length dependent distal neuropathy affecting both large and small fiber in the ill group; whereas none of above definable diagnoses was noted in the controls. The ill group had a significantly higher baseline heart rate compared to controls. Compound autonomic scoring scale showed a significant higher score (95% CI of mean: 1.72–2.67) among ill group compared to controls (0.58–1.59). We conclude that objective autonomic testing is necessary for the evaluation of self-reported, unexplained post-exertional fatigue among some Gulf War veterans with multi-symptom illnesses. Our observation that ill veterans with self-reported post-exertional fatigue had objective autonomic measures that were worse than controls warrants validation in a larger clinical series. PMID:24431987

Sacroiliac joint dysfunction.

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Ilaslan, Hakan; Arslan, Ahmet; Koç, Omer Nadir; Dalkiliç, Turker; Naderi, Sait

2010-07-01

Sacroiliac joint dysfunction is a disorder presenting with low back and groin pain. It should be taken into consideration during the preoperative differential diagnosis of lumbar disc herniation, lumbar spinal stenosis and facet syndrome. Four cases with sacroiliac dysfunction are presented. The clinical and radiological signs supported the evidence of sacroiliac dysfunction, and exact diagnosis was made after positive response to sacroiliac joint block. A percutaneous sacroiliac fixation provided pain relief in all cases. The mean VAS scores reduced from 8.2 to 2.2. It is concluded that sacroiliac joint dysfunction diagnosis requires a careful physical examination of the sacroiliac joints in all cases with low back and groin pain. The diagnosis is made based on positive response to the sacroiliac block. Sacroiliac fixation was found to be effective in carefully selected cases.

The Human Element and Autonomous Ships

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Sauli Ahvenjärvi

2016-09-01

Full Text Available The autonomous ship technology has become a “hot” topic in the discussion about more efficient, environmentally friendly and safer sea transportation solutions. The time is becoming mature for the introduction of commercially sensible solutions for unmanned and fully autonomous cargo and passenger ships. Safety will be the most interesting and important aspect in this development. The utilization of the autonomous ship technology will have many effects on the safety, both positive and negative. It has been announced that the goal is to make the safety of an unmanned ship better that the safety of a manned ship. However, it must be understood that the human element will still be present when fully unmanned ships are being used. The shore-based control of a ship contains new safety aspects and an interesting question will be the interaction of manned and unmanned ships in the same traffic area. The autonomous ship technology should therefore be taken into account on the training of seafarers. Also it should not be forgotten that every single control algorithm and rule of the internal decision making logic of the autonomously navigating ship has been designed and coded by a human software engineer. Thus the human element is present also in this point of the lifetime navigation system of the autonomous ship.

The relation of autonomic function to physical fitness in patients suffering from alcohol dependence.

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Herbsleb, Marco; Schulz, Steffen; Ostermann, Stephanie; Donath, Lars; Eisenträger, Daniela; Puta, Christian; Voss, Andreas; Gabriel, Holger W; Bär, Karl-Jürgen

2013-10-01

Reduced cardio-vascular health has been found in patients suffering from alcohol dependence. Low cardio-respiratory fitness is an independent predictor of cardio-vascular disease. We investigated physical fitness in 22 alcohol-dependent patients 10 days after acute alcohol withdrawal and compared results with matched controls. The standardized 6-min walk test (6 MWT) was used to analyze the relationship of autonomic dysfunction and physical fitness. Ventilatory indices and gas exchanges were assessed using a portable spiroergometric system while heart rate recordings were obtained separately. We calculated walking distance, indices of heart rate variability and efficiency parameters of heart rate and breathing. In addition, levels of exhaled carbon monoxide were measured in all participants to account for differences in smoking behaviour. Multivariate analyses of variance (MANOVA) were performed to investigate differences between patients and controls with regard to autonomic and efficiency parameters. Patients walked a significantly shorter distance in comparison to healthy subjects during the 6 MWT. Significantly decreased heart rate variability was observed before and after the test in patients when compared to controls, while no such difference was observed during exercise. The efficiency parameters indicated significantly reduced efficiency in physiological regulation when the obtained parameters were normalized to the distance. The 6 MWT is an easily applied instrument to measure physical fitness in alcohol dependent patients. It can also be used during exercise interventions. Reduced physical fitness, as observed in our study, might partly be caused by autonomic dysfunction, leading to less efficient regulation of physiological processes during exercise. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

A Secure, Scalable and Elastic Autonomic Computing Systems Paradigm: Supporting Dynamic Adaptation of Self-* Services from an Autonomic Cloud

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Abdul Jaleel

2018-05-01

Full Text Available Autonomic computing embeds self-management features in software systems using external feedback control loops, i.e., autonomic managers. In existing models of autonomic computing, adaptive behaviors are defined at the design time, autonomic managers are statically configured, and the running system has a fixed set of self-* capabilities. An autonomic computing design should accommodate autonomic capability growth by allowing the dynamic configuration of self-* services, but this causes security and integrity issues. A secure, scalable and elastic autonomic computing system (SSE-ACS paradigm is proposed to address the runtime inclusion of autonomic managers, ensuring secure communication between autonomic managers and managed resources. Applying the SSE-ACS concept, a layered approach for the dynamic adaptation of self-* services is presented with an online ‘Autonomic_Cloud’ working as the middleware between Autonomic Managers (offering the self-* services and Autonomic Computing System (requiring the self-* services. A stock trading and forecasting system is used for simulation purposes. The security impact of the SSE-ACS paradigm is verified by testing possible attack cases over the autonomic computing system with single and multiple autonomic managers running on the same and different machines. The common vulnerability scoring system (CVSS metric shows a decrease in the vulnerability severity score from high (8.8 for existing ACS to low (3.9 for SSE-ACS. Autonomic managers are introduced into the system at runtime from the Autonomic_Cloud to test the scalability and elasticity. With elastic AMs, the system optimizes the Central Processing Unit (CPU share resulting in an improved execution time for business logic. For computing systems requiring the continuous support of self-management services, the proposed system achieves a significant improvement in security, scalability, elasticity, autonomic efficiency, and issue resolving time

Predicting athletes' functional and dysfunctional emotions: The role of the motivational climate and motivation regulations.

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Ruiz, Montse C; Haapanen, Saara; Tolvanen, Asko; Robazza, Claudio; Duda, Joan L

2017-08-01

This study examined the relationships between perceptions of the motivational climate, motivation regulations, and the intensity and functionality levels of athletes' pleasant and unpleasant emotional states. Specifically, we examined the hypothesised mediational role of motivation regulations in the climate-emotion relationship. We also tested a sequence in which emotions were assumed to be predicted by the motivational climate dimensions and then served as antecedents to variability in motivation regulations. Participants (N = 494) completed a multi-section questionnaire assessing targeted variables. Structural equation modelling (SEM) revealed that a perceived task-involving climate was a positive predictor of autonomous motivation and of the impact of functional anger, and a negative predictor of the intensity of anxiety and dysfunctional anger. Autonomous motivation was a partial mediator of perceptions of a task-involving climate and the impact of functional anger. An ego-involving climate was a positive predictor of controlled motivation, and of the intensity and impact of functional anger and the intensity of dysfunctional anger. Controlled motivation partially mediated the relationship between an ego-involving climate and the intensity of dysfunctional anger. Good fit to the data also emerged for the motivational climate, emotional states, and motivation regulations sequence. Findings provide support for the consideration of hedonic tone and functionality distinctions in the assessment of athletes' emotional states.

Neurogenic bowel dysfunction in patients with spinal cord injury, myelomeningocele, multiple sclerosis and Parkinson's disease

Institute of Scientific and Technical Information of China (English)

Richard A Awad

2011-01-01

Exciting new features have been described concerning neurogenic bowel dysfunction, including interactions between the central nervous system, the enteric nervous system, axonal injury, neuronal loss, neurotransmission of noxious and non-noxious stimuli, and the fields of gastroenterology and neurology. Patients with spinal cord injury, myelomeningocele, multiple sclerosis and Parkinson's disease present with serious upper and lower bowel dysfunctions characterized by constipation, incontinence, gastrointestinal motor dysfunction and altered visceral sensitivity. Spinal cord injury is associated with severe autonomic dysfunction, and bowel dysfunction is a major physical and psychological burden for these patients. An adult myelomeningocele patient commonly has multiple problems reflecting the multisystemic nature of the disease. Multiple sclerosis is a neurodegenerative disorder in which axonal injury, neuronal loss, and atrophy of the central nervous system can lead to permanent neurological damage and clinical disability. Parkinson's disease is a multisystem disorder involving dopaminergic, noradrenergic, serotoninergic and cholinergic systems, characterized by motor and non-motor symptoms. Parkinson's disease affects several neuronal structures outside the substantia nigra, among which is the enteric nervous system. Recent reports have shown that the lesions in the enteric nervous system occur in very early stages of the disease, even before the involvement of the central nervous system. This has led to the postulation that the enteric nervous system could be critical in the pathophysiology of Parkinson's disease, as it could represent the point of entry for a putative environmental factor to initiate the pathological process. This review covers the data related to the etiology, epidemiology, clinical expression, pathophysiology, genetic aspects, gastrointestinal motor dysfunction, visceral sensitivity, management, prevention and prognosis of neurogenic bowel

Immune thrombocytopenia with multi-organ dysfunction syndrome as a rare presentation of scrub typhus: a case report.

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Ittyachen, Abraham M; Abraham, Saramma P; Krishnamoorthy, Smitha; Vijayan, Anuroopa; Kokkat, Jayamohan

2017-10-06

Scrub typhus is an acute infectious illness caused by Orientia tsutsugamushi. It is endemic to a part of the world known as the "tsutsugamushi triangle". Humans are accidental hosts in this zoonotic disease. About a third of patients admitted with scrub typhus have evidence of multi-organ dysfunction. Multi-organ dysfunction secondary to scrub typhus carries a high mortality rate. We report a 65-year old lady who was admitted in a Tertiary Care Center in the state of Kerala in India, with 7 day history of fever, myalgia and reduced urine output. Head to foot examination revealed the presence of an eschar on her chest. One week prior to the onset of her illness she had gone trekking through a hilly forest area. She was clinically suspected to have scrub typhus, which was later confirmed with laboratory tests. She developed multi-organ dysfunction syndrome secondary to this illness. Though there was an improvement in the multi-organ dysfunction, thrombocytopenia alone failed to improve. Bone marrow study was done which was suggestive of immune thrombocytopenia. Patient was given a course of steroids with which the thrombocytopenia improved. Failure of platelet count to normalize even after there has been a general improvement of other markers of multi-organ dysfunction in scrub typhus should prompt the clinician to consider other potential causes of thrombocytopenia. An unusual finding as this calls for further research to understand the molecular mechanisms behind such an event. Further, considering the close similarity in clinical presentation of several tropical illnesses, meticulous history taking and a detailed physical examination needs to be emphasized.

Autonomic dysfunction and new-onset atrial fibrillation in patients with left ventricular systolic dysfunction after acute myocardial infarction: a CARISMA substudy

DEFF Research Database (Denmark)

Jøns, Christian; Raatikainen, Pekka; Gang, Uffe J

2010-01-01

Atrial fibrillation (AF) increases morbidity and mortality in patients with previous myocardial infarction and left ventricular systolic dysfunction. The purpose of this study was to identify patients with a high risk for new-onset AF in this population using invasive and noninvasive...

PET imaging of the autonomic nervous system

International Nuclear Information System (INIS)

THACKERAY, James T.; BENGEL, Frank M.

2016-01-01

The autonomic nervous system is the primary extrinsic control of heart rate and contractility, and is subject to adaptive and maladaptive changes in cardiovascular disease. Consequently, noninvasive assessment of neuronal activity and function is an attractive target for molecular imaging. A myriad of targeted radiotracers have been developed over the last 25 years for imaging various components of the sympathetic and parasympathetic signal cascades. While routine clinical use remains somewhat limited, a number of larger scale studies in recent years have supplied momentum to molecular imaging of autonomic signaling. Specifically, the findings of the ADMIRE HF trial directly led to United States Food and Drug Administration approval of 123I-metaiodobenzylguanidine (MIBG) for Single Photon Emission Computed Tomography (SPECT) assessment of sympathetic neuronal innervation, and comparable results have been reported using the analogous PET agent 11C-meta-hydroxyephedrine (HED). Due to the inherent capacity for dynamic quantification and higher spatial resolution, regional analysis may be better served by PET. In addition, preliminary clinical and extensive preclinical experience has provided a broad foundation of cardiovascular applications for PET imaging of the autonomic nervous system. Recent years have witnessed the growth of novel quantification techniques, expansion of multiple tracer studies, and improved understanding of the uptake of different radiotracers, such that the transitional biology of dysfunctional subcellular catecholamine handling can be distinguished from complete denervation. As a result, sympathetic neuronal molecular imaging is poised to play a role in individualized patient care, by stratifying cardiovascular risk, visualizing underlying biology, and guiding and monitoring therapy.

Simvastatin-induced cardiac autonomic control improvement in fructose-fed female rats

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Renata Juliana da Silva

2011-01-01

Full Text Available OBJECTIVE: Because autonomic dysfunction has been found to lead to cardiometabolic disorders and because studies have reported that simvastatin treatment has neuroprotective effects, the objective of the present study was to investigate the effects of simvastatin treatment on cardiovascular and autonomic changes in fructose-fed female rats. METHODS: Female Wistar rats were divided into three groups: controls (n=8, fructose (n=8, and fructose+ simvastatin (n=8. Fructose overload was induced by supplementing the drinking water with fructose (100 mg/L, 18 wks. Simvastatin treatment (5 mg/kg/day for 2 wks was performed by gavage. The arterial pressure was recorded using a data acquisition system. Autonomic control was evaluated by pharmacological blockade. RESULTS: Fructose overload induced an increase in the fasting blood glucose and triglyceride levels and insulin resistance. The constant rate of glucose disappearance during the insulin intolerance test was reduced in the fructose group (3.4+ 0.32%/min relative to that in the control group (4.4+ 0.29%/min. Fructose+simvastatin rats exhibited increased insulin sensitivity (5.4+0.66%/min. The fructose and fructose+simvastatin groups demonstrated an increase in the mean arterial pressure compared with controls rats (fructose: 124+2 mmHg and fructose+simvastatin: 126 + 3 mmHg vs. controls: 112 + 2 mmHg. The sympathetic effect was enhanced in the fructose group (73 + 7 bpm compared with that in the control (48 + 7 bpm and fructose+simvastatin groups (31+8 bpm. The vagal effect was increased in fructose+simvastatin animals (84 + 7 bpm compared with that in control (49 + 9 bpm and fructose animals (46+5 bpm. CONCLUSION: Simvastatin treatment improved insulin sensitivity and cardiac autonomic control in an experimental model of metabolic syndrome in female rats. These effects were independent of the improvements in the classical plasma lipid profile and of reductions in arterial pressure. These results

EFFECTIVENESS OF BIOFEEDBACK IN THE CLOSED LOOP OF HEART RATE VARIABILITY AND PACED BREATHING IN THE PATIENTS WITH SOMATOFORM AUTONOMIC DYSFUNCTION

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K. E. Morozova

2014-06-01

Full Text Available To study the effectiveness of biofeedback (BFB in the closed loop of heart rate variability (HRV and paced breathing in patients with somatoform autonomic dysfunction (SAD 20 patients with SAD (14 women and 6 men, mean age 19,53 ± 1,55 were examined. All probationers were divided into two groups comparable for sex and age: 1 – BFB group (15 patients, in which 7 sessions was held and 2 – the comparison group (5 patients, where only two sessions were completed -at the first and seventh day of the study. Additionally, all patients in both groups received diet food (Table № 10 by Pevzner, mebicar, glycine, tiotriazolin. Effectiveness of biofeedback was evaluated by comparing of parameters optimality (O, sensitivity (S, the efficiency (E and the integral index BQI in both groups. It was determined that biofeedback in the closed loop of HRV and paced breathing allows to optimize the state of the regulatory systems of the body in patients with SAD, moreover the combination of biofeedback sessions in the test loop and medical treatment are significantly better than isolated pharmacological therapy. High effectiveness of biofeedback in closed loop of HRV and paced breathing in patients with SAD allows us to recommend it as independent method of treatment, and as a component of combined therapy of this disease.

Diastolic dysfunction characterizes cirrhotic cardiomyopathy

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Piyush O. Somani

2014-11-01

Conclusions: Present study shows that although diastolic dysfunction is a frequent event in cirrhosis, it is usually of mild degree and does not correlate with severity of liver dysfunction. There are no significant differences in echocardiographic parameters between alcoholic and non-alcoholic cirrhosis. HRS is not correlated to diastolic dysfunction in cirrhotic patients. There is no difference in survival at one year between patients with or without diastolic dysfunction. Diastolic dysfunction in cirrhosis is unrelated to circulatory dysfunction, ascites and HRS.

On heart rate variability and autonomic activity in homeostasis and in systemic inflammation.

Science.gov (United States)

Scheff, Jeremy D; Griffel, Benjamin; Corbett, Siobhan A; Calvano, Steve E; Androulakis, Ioannis P

2014-06-01

Analysis of heart rate variability (HRV) is a promising diagnostic technique due to the noninvasive nature of the measurements involved and established correlations with disease severity, particularly in inflammation-linked disorders. However, the complexities underlying the interpretation of HRV complicate understanding the mechanisms that cause variability. Despite this, such interpretations are often found in literature. In this paper we explored mathematical modeling of the relationship between the autonomic nervous system and the heart, incorporating basic mechanisms such as perturbing mean values of oscillating autonomic activities and saturating signal transduction pathways to explore their impacts on HRV. We focused our analysis on human endotoxemia, a well-established, controlled experimental model of systemic inflammation that provokes changes in HRV representative of acute stress. By contrasting modeling results with published experimental data and analyses, we found that even a simple model linking the autonomic nervous system and the heart confound the interpretation of HRV changes in human endotoxemia. Multiple plausible alternative hypotheses, encoded in a model-based framework, equally reconciled experimental results. In total, our work illustrates how conventional assumptions about the relationships between autonomic activity and frequency-domain HRV metrics break down, even in a simple model. This underscores the need for further experimental work towards unraveling the underlying mechanisms of autonomic dysfunction and HRV changes in systemic inflammation. Understanding the extent of information encoded in HRV signals is critical in appropriately analyzing prior and future studies. Copyright © 2014 Elsevier Inc. All rights reserved.

Autonomous power networks based power system

International Nuclear Information System (INIS)

Jokic, A.; Van den Bosch, P.P.J.

2006-01-01

This paper presented the concept of autonomous networks to cope with this increased complexity in power systems while enhancing market-based operation. The operation of future power systems will be more challenging and demanding than present systems because of increased uncertainties, less inertia in the system, replacement of centralized coordinating activities by decentralized parties and the reliance on dynamic markets for both power balancing and system reliability. An autonomous network includes the aggregation of networked producers and consumers in a relatively small area with respect to the overall system. The operation of an autonomous network is coordinated and controlled with one central unit acting as an interface between internal producers/consumers and the rest of the power system. In this study, the power balance problem and system reliability through provision of ancillary services was formulated as an optimization problem for the overall autonomous networks based power system. This paper described the simulation of an optimal autonomous network dispatching in day ahead markets, based on predicted spot prices for real power, and two ancillary services. It was concluded that large changes occur in a power systems structure and operation, most of them adding to the uncertainty and complexity of the system. The introduced concept of an autonomous power network-based power system was shown to be a realistic and consistent approach to formulate and operate a market-based dispatch of both power and ancillary services. 9 refs., 4 figs

Control of autonomous ground vehicles: a brief technical review

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Babak, Shahian-Jahromi; Hussain, Syed A.; Karakas, Burak; Cetin, Sabri

2017-07-01

This paper presents a brief review of the developments achieved in autonomous vehicle systems technology. A concise history of autonomous driver assistance systems is presented, followed by a review of current state of the art sensor technology used in autonomous vehicles. Standard sensor fusion method that has been recently explored is discussed. Finally, advances in embedded software methodologies that define the logic between sensory information and actuation decisions are reviewed.

Autonomous Cryogenic Load Operations: KSC Autonomous Test Engineer

Science.gov (United States)

Shrading, Nicholas J.

2012-01-01

The KSC Autonomous Test Engineer (KATE) program has a long history at KSC. Now a part of the Autonomous Cryogenic Load Operations (ACLO) mission, this software system has been sporadically developed over the past 20+ years. Originally designed to provide health and status monitoring for a simple water-based fluid system, it was proven to be a capable autonomous test engineer for determining sources of failure in. the system, As part.of a new goal to provide this same anomaly-detection capability for a complicated cryogenic fluid system, software engineers, physicists, interns and KATE experts are working to upgrade the software capabilities and graphical user interface. Much progress was made during this effort to improve KATE. A display ofthe entire cryogenic system's graph, with nodes for components and edges for their connections, was added to the KATE software. A searching functionality was added to the new graph display, so that users could easily center their screen on specific components. The GUI was also modified so that it displayed information relevant to the new project goals. In addition, work began on adding new pneumatic and electronic subsystems into the KATE knowledgebase, so that it could provide health and status monitoring for those systems. Finally, many fixes for bugs, memory leaks, and memory errors were implemented and the system was moved into a state in which it could be presented to stakeholders. Overall, the KATE system was improved and necessary additional features were added so that a presentation of the program and its functionality in the next few months would be a success.

Olfactory bulb dysgenesis, mirror neuron system dysfunction, and autonomic dysregulation as the neural basis for autism.

Science.gov (United States)

Brang, David; Ramachandran, V S

2010-05-01

Autism is a disorder characterized by social withdrawal, impoverished language and empathy, and a profound inability to adopt another's viewpoint - a failure to construct a "theory of mind" for interpreting another person's thoughts and intentions. We previously showed that these symptoms might be explained, in part, by a paucity of mirror neurons. Prompted by an MRI report of an individual with autism, we now suggest that there may be, in addition, a congenital aplasia/dysplasia of the olfactory bulbs with consequent reduction of vasopressin and oxytocin receptor binding. There may also be sub-clinical temporal lobe epilepsy affecting the recently discovered third visual system that is rich in "empathy" related mirror neurons (MNS) and projects (via the TOP junction - just below the inferior parietal lobule) to limbic structures that regulate autonomic outflow. This causes deranged autonomic feedback, resulting in additional deficiencies in MNS with loss of emotional empathy and introspection.

Autonomic neuropathy in diabetes mellitus

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Alberto eVerrotti

2014-12-01

Full Text Available Diabetic autonomic neuropathy (DAN is a serious and common complication of diabetes, often overlooked and misdiagnosed. It is a systemic-wide disorder that may be asymptomatic in the early stages. The most studied and clinically important form of DAN is cardiovascular autonomic neuropathy (CAN defined as the impairment of autonomic control of the cardiovascular system in patients with diabetes after exclusion of other causes. The reported prevalence of DAN varies widely depending on inconsistent definition, different diagnostic method, different patient cohorts studied. The pathogenesis is still unclear and probably multifactorial. Once DAN becomes clinically evident, no form of therapy has been identified which can effectively stop or reverse it. Prevention strategies are based on strict glycemic control with intensive insulin treatment, multifactorial intervention and lifestyle modification including control of hypertension, dyslipidemia, stop smoking, weight loss and adequate physical exercise. The present review summarizes the latest knowledge regarding clinical presentation, epidemiology, pathogenesis and management of DAN, with some mention to childhood and adolescent population.

Impact of cancer and chemotherapy on autonomic nervous system function and cardiovascular reactivity in young adults with cancer: a case-controlled feasibility study.

Science.gov (United States)

Adams, Scott C; Schondorf, Ronald; Benoit, Julie; Kilgour, Robert D

2015-05-18

Preliminary evidence suggests cancer- and chemotherapy-related autonomic nervous system (ANS) dysfunction may contribute to the increased cardiovascular (CV) morbidity- and mortality-risks in cancer survivors. However, the reliability of these findings may have been jeopardized by inconsistent participant screening and assessment methods. Therefore, good laboratory practices must be established before the presence and nature of cancer-related autonomic dysfunction can be characterized. The purpose of this study was to assess the feasibility of conducting concurrent ANS and cardiovascular evaluations in young adult cancer patients, according to the following criteria: i) identifying methodological pitfalls and proposing good laboratory practice criteria for ANS testing in cancer, and ii) providing initial physiologic evidence of autonomic perturbations in cancer patients using the composite autonomic scoring scale (CASS). Thirteen patients (mixed diagnoses) were assessed immediately before and after 4 cycles of chemotherapy. Their results were compared to 12 sex- and age-matched controls. ANS function was assessed using standardized tests of resting CV (tilt-table, respiratory sinus arrhythmia and Valsalva maneuver) and sudomotor (quantitative sudomotor axon reflex test) reactivity. Cardiovascular reactivity during exercise was assessed using a modified Astrand-Ryhming cycle ergometer protocol. Our feasibility criteria addressed: i) recruitment potential, ii) retention rates, iii) pre-chemotherapy assessment potential, iv) test performance/tolerability, and v) identification and minimizing the influence of potentially confounding medication. T-tests and repeated measures ANOVAs were used to assess between- and within-group differences at baseline and follow-up. The overall success rate in achieving our feasibility criteria was 98.4 %. According to the CASS, there was evidence of ANS impairment at baseline in 30.8 % of patients, which persisted in 18.2 % of patients

Impact of cancer and chemotherapy on autonomic nervous system function and cardiovascular reactivity in young adults with cancer: a case-controlled feasibility study

International Nuclear Information System (INIS)

Adams, Scott C.; Schondorf, Ronald; Benoit, Julie; Kilgour, Robert D.

2015-01-01

Preliminary evidence suggests cancer- and chemotherapy-related autonomic nervous system (ANS) dysfunction may contribute to the increased cardiovascular (CV) morbidity- and mortality-risks in cancer survivors. However, the reliability of these findings may have been jeopardized by inconsistent participant screening and assessment methods. Therefore, good laboratory practices must be established before the presence and nature of cancer-related autonomic dysfunction can be characterized. The purpose of this study was to assess the feasibility of conducting concurrent ANS and cardiovascular evaluations in young adult cancer patients, according to the following criteria: i) identifying methodological pitfalls and proposing good laboratory practice criteria for ANS testing in cancer, and ii) providing initial physiologic evidence of autonomic perturbations in cancer patients using the composite autonomic scoring scale (CASS). Thirteen patients (mixed diagnoses) were assessed immediately before and after 4 cycles of chemotherapy. Their results were compared to 12 sex- and age-matched controls. ANS function was assessed using standardized tests of resting CV (tilt-table, respiratory sinus arrhythmia and Valsalva maneuver) and sudomotor (quantitative sudomotor axon reflex test) reactivity. Cardiovascular reactivity during exercise was assessed using a modified Astrand-Ryhming cycle ergometer protocol. Our feasibility criteria addressed: i) recruitment potential, ii) retention rates, iii) pre-chemotherapy assessment potential, iv) test performance/tolerability, and v) identification and minimizing the influence of potentially confounding medication. T-tests and repeated measures ANOVAs were used to assess between- and within-group differences at baseline and follow-up. The overall success rate in achieving our feasibility criteria was 98.4 %. According to the CASS, there was evidence of ANS impairment at baseline in 30.8 % of patients, which persisted in 18.2 % of patients

Outcomes of bowel program in spinal cord injury patients with neurogenic bowel dysfunction

Directory of Open Access Journals (Sweden)

Zuhal Ozisler

2015-01-01

Full Text Available In this study, we aimed to determine gastrointestinal problems associated with neurogenic bowel dysfunction in spinal cord injury patients and to assess the efficacy of bowel program on gastrointestinal problems and the severity of neurogenic bowel dysfunction. Fifty-five spinal cord injury patients were included in this study. A bowel program according to the characteristics of neurogenic bowel dysfunction was performed for each patient. Before and after bowel program, gastrointestinal problems (constipation, difficult intestinal evacuation, incontinence, abdominal pain, abdominal distension, loss of appetite, hemorrhoids, rectal bleeding and gastrointestinal induced autonomic dysreflexia and bowel evacuation methods (digital stimulation, oral medication, suppositories, abdominal massage, Valsalva maneuver and manual evacuation were determined. Neurogenic bowel dysfunction score was used to assess the severity of neurogenic bowel dysfunction. At least one gastrointestinal problem was identified in 44 (80% of the 55 patients before bowel program. Constipation (56%, 31/55 and incontinence (42%, 23/55 were the most common gastrointestinal problems. Digital rectal stimulation was the most common method for bowel evacuation, both before (76%, 42/55 and after (73%, 40/55 bowel program. Oral medication, enema and manual evacuation application rates were significantly decreased and constipation, difficult intestinal evacuation, abdominal distention, and abdominal pain rates were significantly reduced after bowel program. In addition, mean neurogenic bowel dysfunction score was decreased after bowel program. An effective bowel program decreases the severity of neurogenic bowel dysfunction and reduces associated gastrointestinal problems in patients with spinal cord injury.

Current challenges in autonomous vehicle development

Science.gov (United States)

Connelly, J.; Hong, W. S.; Mahoney, R. B., Jr.; Sparrow, D. A.

2006-05-01

The field of autonomous vehicles is a rapidly growing one, with significant interest from both government and industry sectors. Autonomous vehicles represent the intersection of artificial intelligence (AI) and robotics, combining decision-making with real-time control. Autonomous vehicles are desired for use in search and rescue, urban reconnaissance, mine detonation, supply convoys, and more. The general adage is to use robots for anything dull, dirty, dangerous or dumb. While a great deal of research has been done on autonomous systems, there are only a handful of fielded examples incorporating machine autonomy beyond the level of teleoperation, especially in outdoor/complex environments. In an attempt to assess and understand the current state of the art in autonomous vehicle development, a few areas where unsolved problems remain became clear. This paper outlines those areas and provides suggestions for the focus of science and technology research. The first step in evaluating the current state of autonomous vehicle development was to develop a definition of autonomy. A number of autonomy level classification systems were reviewed. The resulting working definitions and classification schemes used by the authors are summarized in the opening sections of the paper. The remainder of the report discusses current approaches and challenges in decision-making and real-time control for autonomous vehicles. Suggested research focus areas for near-, mid-, and long-term development are also presented.

Evaluation of cardiac autonomic function in overweight males: A cross-sectional study

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Debasish Das

2017-01-01

Full Text Available Background and Aim: Cardiovascular autonomic function tests (CAFTs are non-invasive tests that can assess both sympathetic and parasympathetic autonomic functions. Autonomic dysfunction may be considered as a risk factor for obesity and vice versa. For measurement of obesity, body mass index (BMI is a simple, valid and inexpensive method. Hence, this study was designed to evaluate the effect of obesity based on BMI criteria on autonomic nervous system based on CAFT in young adult males. Methods: A cross-sectional study was carried out on 43 young adult males in the age group of 18–25 years with an age-matched control (n = 43 group. After initial screening, anthropometric measurements were recorded. CAFTs were performed and recorded by the Cardiac Autonomic Neuropathy Analysis System (CANWin. Unpaired t- test was done to compare the parameters of study and control groups in Microsoft Excel® 2010. Results: Parasympathetic test parameters of study and control groups when expressed in mean ± standard deviation were not found statistically significant (P > 0.05. The fall in systolic blood pressure (BP in orthostatic test of study group (12.19 ± 4.8 mmHg was significantly (P = 0.0001 higher than that of control group (7.33 ± 5.16 mmHg. Increase in diastolic BP in isometric handgrip exercise test of study group (11.84 ± 5.39 mmHg was significantly less (P = 0.004 than that of control group (16.39 ± 8.71 mmHg. Conclusion: Overweight young males have altered sympathetic activity but parasympathetic activity did not show any significant difference when compared to normal weight males.

Autonomic Neuropathy

Science.gov (United States)

... risk of autonomic neuropathy. Other diseases. Amyloidosis, porphyria, hypothyroidism and cancer (usually due to side effects from treatment) may also increase the risk of autonomic neuropathy. ...

Hereditary motor and autonomic neuronopathy 1 maps to chromosome 20q13.2-13.3

Directory of Open Access Journals (Sweden)

W. Marques Jr.

2004-11-01

Full Text Available The spinal muscular atrophies (SMA or hereditary motor neuronopathies result from the continuous degeneration and death of spinal cord lower motor neurons, leading to progressive muscular weakness and atrophy. We describe a large Brazilian family exhibiting an extremely rare, late-onset, dominant, proximal, and progressive SMA accompanied by very unusual manifestations, such as an abnormal sweating pattern, and gastrointestinal and sexual dysfunctions, suggesting concomitant involvement of the autonomic nervous system. We propose a new disease category for this disorder, `hereditary motor and autonomic neuronopathy', and attribute the term, `survival of motor and autonomic neurons 1' (SMAN1 to the respective locus that was mapped to a 14.5 cM region on chromosome 20q13.2-13.3 by genetic linkage analysis and haplotype studies using microsatellite polymorphic markers. This locus lies between markers D20S120 and D20S173 showing a maximum LOD score of 4.6 at D20S171, defining a region with 33 known genes, including several potential candidates. Identifying the SMAN1 gene should not only improve our understanding of the molecular mechanisms underlying lower motor neuron diseases but also help to clarify the relationship between motor and autonomic neurons.

Intelligent autonomous systems 12. Vol. 2. Proceedings

Energy Technology Data Exchange (ETDEWEB)

Lee, Sukhan [Sungkyunkwan Univ., Gyeonggi-Do (Korea, Republic of). College of Information and Communication Engineering; Yoon, Kwang-Joon [Konkuk Univ., Seoul (Korea, Republic of); Cho, Hyungsuck [Daegu Gyeongbuk Institute of Science and Technology, Daegu (Korea, Republic of); Lee, Jangmyung (eds.) [Pusan National Univ. (Korea, Republic of). Dept. of Electronics Engineering

2013-02-01

Recent research in Intelligent and Autonomous Systems. Volume 2 of the proceedings of the 12th International Conference IAS-12, held June 26-29, 2012, jeju Island, Korea. Written by leading experts in the field. Intelligent autonomous systems are emerged as a key enabler for the creation of a new paradigm of services to humankind, as seen by the recent advancement of autonomous cars licensed for driving in our streets, of unmanned aerial and underwater vehicles carrying out hazardous tasks on-site, and of space robots engaged in scientific as well as operational missions, to list only a few. This book aims at serving the researchers and practitioners in related fields with a timely dissemination of the recent progress on intelligent autonomous systems, based on a collection of papers presented at the 12th International Conference on Intelligent Autonomous Systems, held in Jeju, Korea, June 26-29, 2012. With the theme of ''Intelligence and Autonomy for the Service to Humankind, the conference has covered such diverse areas as autonomous ground, aerial, and underwater vehicles, intelligent transportation systems, personal/domestic service robots, professional service robots for surgery/rehabilitation, rescue/security and space applications, and intelligent autonomous systems for manufacturing and healthcare. This volume 2 includes contributions devoted to Service Robotics and Human-Robot Interaction and Autonomous Multi-Agent Systems and Life Engineering.

Distinctive cardiac autonomic dysfunction following stress exposure in both sexes in an animal model of PTSD.

Science.gov (United States)

Koresh, Ori; Kaplan, Zeev; Zohar, Joseph; Matar, Michael A; Geva, Amir B; Cohen, Hagit

2016-07-15

It is unclear whether the poor autonomic flexibility or dysregulation observed in patients with posttraumatic stress disorder (PTSD) represents a pre-trauma vulnerability factor or results from exposure to trauma. We used an animal model of PTSD to assess the association between the behavioral response to predator scent stress (PSS) and the cardiac autonomic modulation in male and female rats. The rats were surgically implanted with radiotelemetry devices to measure their electrocardiograms and locomotor activity (LMA). Following baseline telemetric monitoring, the animals were exposed to PSS or sham-PSS. Continuous telemetric monitoring (24h/day sampling) was performed over the course of 7days. The electrocardiographic recordings were analyzed using the time- and frequency-domain indexes of heart rate variability (HRV). The behavioral response patterns were assessed using the elevated plus maze and acoustic startle response paradigms for the retrospective classification of individuals according to the PTSD-related cut-off behavioral criteria. During resting conditions, the male rats had significantly higher heart rates (HR) and lower HRV parameters than the female rats during both the active and inactive phases of the daily cycle. Immediately after PSS exposure, both the female and male rats demonstrated a robust increase in HR and a marked drop in HRV parameters, with a shift of sympathovagal balance towards sympathetic predominance. In both sexes, autonomic system habituation and recovery were selectively inhibited in the rats whose behavior was extremely disrupted after exposure to PSS. However, in the female rats, exposure to the PSS produced fewer EBR rats, with a more rapid recovery curve than that of the male rats. PSS did not induce changes to the circadian rhythm of the LMA. According to our results, PTSD can be conceptualized as a disorder that is related to failure-of-recovery mechanisms that impede the restitution of physiological homeostasis

The Bering Autonomous Target Detection

DEFF Research Database (Denmark)

Jørgensen, John Leif; Denver, Troelz; Betto, Maurizio

2003-01-01

An autonomous asteroid target detection and tracking method has been developed. The method features near omnidirectionality and focus on high speed operations and completeness of search of the near space rather than the traditional faint object search methods, employed presently at the larger...... telescopes. The method has proven robust in operation and is well suited for use onboard spacecraft. As development target for the method and the associated instrumentation the asteroid research mission Bering has been used. Onboard a spacecraft, the autonomous detection is centered around the fully...... autonomous star tracker the Advanced Stellar Compass (ASC). One feature of this instrument is that potential targets are registered directly in terms of date, right ascension, declination, and intensity, which greatly facilitates both tracking search and registering. Results from ground and inflight tests...

Assessment of autonomic nervous system by using empirical mode decomposition-based reflection wave analysis during non-stationary conditions

International Nuclear Information System (INIS)

Chang, C C; Hsiao, T C; Kao, S C; Hsu, H Y

2014-01-01

Arterial blood pressure (ABP) is an important indicator of cardiovascular circulation and presents various intrinsic regulations. It has been found that the intrinsic characteristics of blood vessels can be assessed quantitatively by ABP analysis (called reflection wave analysis (RWA)), but conventional RWA is insufficient for assessment during non-stationary conditions, such as the Valsalva maneuver. Recently, a novel adaptive method called empirical mode decomposition (EMD) was proposed for non-stationary data analysis. This study proposed a RWA algorithm based on EMD (EMD-RWA). A total of 51 subjects participated in this study, including 39 healthy subjects and 12 patients with autonomic nervous system (ANS) dysfunction. The results showed that EMD-RWA provided a reliable estimation of reflection time in baseline and head-up tilt (HUT). Moreover, the estimated reflection time is able to assess the ANS function non-invasively, both in normal, healthy subjects and in the patients with ANS dysfunction. EMD-RWA provides a new approach for reflection time estimation in non-stationary conditions, and also helps with non-invasive ANS assessment. (paper)

Autonomous Cryogenic Load Operations: Knowledge-Based Autonomous Test Engineer

Science.gov (United States)

Schrading, J. Nicolas

2013-01-01

The Knowledge-Based Autonomous Test Engineer (KATE) program has a long history at KSC. Now a part of the Autonomous Cryogenic Load Operations (ACLO) mission, this software system has been sporadically developed over the past 20 years. Originally designed to provide health and status monitoring for a simple water-based fluid system, it was proven to be a capable autonomous test engineer for determining sources of failure in the system. As part of a new goal to provide this same anomaly-detection capability for a complicated cryogenic fluid system, software engineers, physicists, interns and KATE experts are working to upgrade the software capabilities and graphical user interface. Much progress was made during this effort to improve KATE. A display of the entire cryogenic system's graph, with nodes for components and edges for their connections, was added to the KATE software. A searching functionality was added to the new graph display, so that users could easily center their screen on specific components. The GUI was also modified so that it displayed information relevant to the new project goals. In addition, work began on adding new pneumatic and electronic subsystems into the KATE knowledge base, so that it could provide health and status monitoring for those systems. Finally, many fixes for bugs, memory leaks, and memory errors were implemented and the system was moved into a state in which it could be presented to stakeholders. Overall, the KATE system was improved and necessary additional features were added so that a presentation of the program and its functionality in the next few months would be a success.

Autonomous Flight in Unknown Indoor Environments

OpenAIRE

Bachrach, Abraham Galton; He, Ruijie; Roy, Nicholas

2009-01-01

This paper presents our solution for enabling a quadrotor helicopter, equipped with a laser rangefinder sensor, to autonomously explore and map unstructured and unknown indoor environments. While these capabilities are already commodities on ground vehicles, air vehicles seeking the same performance face unique challenges. In this paper, we describe the difficulties in achieving fully autonomous helicopter flight, highlighting the differences between ground and helicopter robots that make it ...

Discerning non-autonomous dynamics

Energy Technology Data Exchange (ETDEWEB)

Clemson, Philip T.; Stefanovska, Aneta, E-mail: aneta@lancaster.ac.uk

2014-09-30

the Poincaré oscillator with quasi-periodic forcing. In this way we not only discuss and review each method, but also present properties which help to clearly distinguish the three classes of systems when analysed in an inverse approach—from measured, or numerically generated data. In particular, this review provides a framework to tackle inverse problems in these areas and clearly distinguish non-autonomous dynamics from chaos or stochasticity.

Discerning non-autonomous dynamics

International Nuclear Information System (INIS)

Clemson, Philip T.; Stefanovska, Aneta

2014-01-01

the Poincaré oscillator with quasi-periodic forcing. In this way we not only discuss and review each method, but also present properties which help to clearly distinguish the three classes of systems when analysed in an inverse approach—from measured, or numerically generated data. In particular, this review provides a framework to tackle inverse problems in these areas and clearly distinguish non-autonomous dynamics from chaos or stochasticity

Advancing Autonomous Operations for Deep Space Vehicles

Science.gov (United States)

Haddock, Angie T.; Stetson, Howard K.

2014-01-01

Starting in Jan 2012, the Advanced Exploration Systems (AES) Autonomous Mission Operations (AMO) Project began to investigate the ability to create and execute "single button" crew initiated autonomous activities [1]. NASA Marshall Space Flight Center (MSFC) designed and built a fluid transfer hardware test-bed to use as a sub-system target for the investigations of intelligent procedures that would command and control a fluid transfer test-bed, would perform self-monitoring during fluid transfers, detect anomalies and faults, isolate the fault and recover the procedures function that was being executed, all without operator intervention. In addition to the development of intelligent procedures, the team is also exploring various methods for autonomous activity execution where a planned timeline of activities are executed autonomously and also the initial analysis of crew procedure development. This paper will detail the development of intelligent procedures for the NASA MSFC Autonomous Fluid Transfer System (AFTS) as well as the autonomous plan execution capabilities being investigated. Manned deep space missions, with extreme communication delays with Earth based assets, presents significant challenges for what the on-board procedure content will encompass as well as the planned execution of the procedures.

Experimental and numerical study of an autonomous flap

NARCIS (Netherlands)

Bernhammer, L.O.; Navalkar, S.T.; Sodja, J.; De Breuker, R.; Karpel, M.

2015-01-01

This paper presents the experimental and numerical study of an autonomous load alleviation concept using trailing edge flaps. The flaps are autonomous units, which for instance can be used for gust load alleviation. The unit is self-powered and self-actuated through trailing edge tabs which are

Caenorhabditis elegans as a model system for studying non-cell-autonomous mechanisms in protein-misfolding diseases

Directory of Open Access Journals (Sweden)

Carmen I. Nussbaum-Krammer

2014-01-01

Full Text Available Caenorhabditis elegans has a number of distinct advantages that are useful for understanding the basis for cellular and organismal dysfunction underlying age-associated diseases of protein misfolding. Although protein aggregation, a key feature of human neurodegenerative diseases, has been typically explored in vivo at the single-cell level using cells in culture, there is now increasing evidence that proteotoxicity has a non-cell-autonomous component and is communicated between cells and tissues in a multicellular organism. These discoveries have opened up new avenues for the use of C. elegans as an ideal animal model system to study non-cell-autonomous proteotoxicity, prion-like propagation of aggregation-prone proteins, and the organismal regulation of stress responses and proteostasis. This Review focuses on recent evidence that C. elegans has mechanisms to transmit certain classes of toxic proteins between tissues and a complex stress response that integrates and coordinates signals from single cells and tissues across the organism. These findings emphasize the potential of C. elegans to provide insights into non-cell-autonomous proteotoxic mechanisms underlying age-related protein-misfolding diseases.

Experimental Autonomous Road Vehicle with Logical Artificial Intelligence

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Sergey Sergeevich Shadrin

2017-01-01

Full Text Available This article describes some technical issues regarding the adaptation of a production car to a platform for the development and testing of autonomous driving technologies. A universal approach to performing the reverse engineering of electric power steering (EPS for the purpose of external control is also presented. The primary objective of the related study was to solve the problem associated with the precise prediction of the dynamic trajectory of an autonomous vehicle. This was accomplished by deriving a new equation for determining the lateral tire forces and adjusting some of the vehicle parameters under road test conductions. A Mivar expert system was also integrated into the control system of the experimental autonomous vehicle. The expert system was made more flexible and effective for the present application by the introduction of hybrid artificial intelligence with logical reasoning. The innovation offers a solution to the major problem of liability in the event of an autonomous transport vehicle being involved in a collision.

Semi-Autonomous Systems Laboratory

Data.gov (United States)

Federal Laboratory Consortium — VisionThe Semi-Autonomous Systems Lab focuses on developing a comprehensive framework for semi-autonomous coordination of networked robotic systems. Semi-autonomous...

Effects of the Fourth Ventricle Compression in the Regulation of the Autonomic Nervous System: A Randomized Control Trial

Directory of Open Access Journals (Sweden)

Ana Paula Cardoso-de-Mello-e-Mello-Ribeiro

2015-01-01

Full Text Available Introduction. Dysfunction of the autonomic nervous system is an important factor in the development of chronic pain. Fourth ventricle compression (CV-4 has been shown to influence autonomic activity. Nevertheless, the physiological mechanisms behind these effects remain unclear. Objectives. This study is aimed at evaluating the effects of fourth ventricle compression on the autonomic nervous system. Methods. Forty healthy adults were randomly assigned to an intervention group, on whom CV-4 was performed, or to a control group, who received a placebo intervention (nontherapeutic touch on the occipital bone. In both groups, plasmatic catecholamine levels, blood pressure, and heart rate were measured before and immediately after the intervention. Results. No effects related to the intervention were found. Although a reduction of norepinephrine, systolic blood pressure, and heart rate was found after the intervention, it was not exclusive to the intervention group. In fact, only the control group showed an increment of dopamine levels after intervention. Conclusion. Fourth ventricle compression seems not to have any effect in plasmatic catecholamine levels, blood pressure, or heart rate. Further studies are needed to clarify the CV-4 physiologic mechanisms and clinical efficacy in autonomic regulation and pain treatment.

Learner Behaviors and Perceptions of Autonomous Language Learning

Science.gov (United States)

Bekleyen, Nilüfer; Selimoglu, Figen

2016-01-01

The purpose of the present study was to investigate the learners' behaviors and perceptions about autonomous language learning at the university level in Turkey. It attempts to reveal what type of perceptions learners held regarding teachers' and their own responsibilities in the language learning process. Their autonomous language learning…

Cardiac autonomic regulation is disturbed in children with euthyroid Hashimoto thyroiditis.

Science.gov (United States)

Kilic, Ayhan; Gulgun, Mustafa; Tascilar, Mehmet Emre; Sari, Erkan; Yokusoglu, Mehmet

2012-03-01

Hashimoto thyroiditis (chronic autoimmune thyroiditis) is the most common form of thyroiditis in childhood. Previous studies have found autonomic dysfunction of varying magnitude in patients with autoimmune diseases, which is considered a cardiovascular risk factor. We aimed to evaluate the heart rate variability (HRV), a measure of cardiac autonomic modulation, in children with euthyroid Hashimoto thyroiditis (eHT). The study included 32 patients with eHT (27 girls and 5 boys; mean age 11 ± 4.1 years, range 8-16; body mass index 0.47 ± 0.69 kg/m(2)), as judged by normal or minimally elevated serum TSH levels (normal range: 0.34-5.6 mIU/l) and normal levels of free thyroid hormones (FT4 and FT3) and 38 euthyroid age-matched controls. Patients with eHT and control subjects underwent physical examination and 24-hour ambulatory ECG monitoring. Time-domain parameters of HRV were evaluated for cardiac autonomic functions. Children with eHT displayed significantly lower values of time-domain parameters of SDANN (standard deviation of the averages of NN intervals), RMSSD (square root of the mean of the sum of the squares of differences between adjacent NN intervals), NN50 counts (number of pairs of adjacent NN intervals differing by more than 50 ms) and PNN50 (NN50 count divided by the total number of all NN intervals) for each 5-min interval, compared to healthy controls (p < 0.05 for each), indicating the decreased beat-to-beat variation of heart rate. In conclusion, eHT is associated with disturbed autonomic regulation of heart rate. Hence, the children with eHT are at higher risk for developing cardiovascular diseases.

R1 autonomic nervous system in acute kidney injury.

Science.gov (United States)

Hering, Dagmara; Winklewski, Pawel J

2017-02-01

Acute kidney injury (AKI) is a rapid loss of kidney function resulting in accumulation of end metabolic products and associated abnormalities in fluid, electrolyte and acid-base homeostasis. The pathophysiology of AKI is complex and multifactorial involving numerous vascular, tubular and inflammatory pathways. Neurohumoral activation with heightened activity of the sympathetic nervous system and renin-angiotensin-aldosterone system play a critical role in this scenario. Inflammation and/or local renal ischaemia are underlying mechanisms triggering renal tissue hypoxia and resultant renal microcirculation dysfunction; a common feature of AKI occurring in numerous clinical conditions leading to a high morbidity and mortality rate. The contribution of renal nerves to the pathogenesis of AKI has been extensively demonstrated in a series of experimental models over the past decades. While this has led to better knowledge of the pathogenesis of human AKI, therapeutic approaches to improve patient outcomes are scarce. Restoration of autonomic regulatory function with vagal nerve stimulation resulting in anti-inflammatory effects and modulation of centrally-mediated mechanisms could be of clinical relevance. Evidence from experimental studies suggests that a therapeutic splenic ultrasound approach may prevent AKI via activation of the cholinergic anti-inflammatory pathway. This review briefly summarizes renal nerve anatomy, basic insights into neural control of renal function in the physiological state and the involvement of the autonomic nervous system in the pathophysiology of AKI chiefly due to sepsis, cardiopulmonary bypass and ischaemia/reperfusion experimental model. Finally, potentially preventive experimental pre-clinical approaches for the treatment of AKI aimed at sympathetic inhibition and/or parasympathetic stimulation are presented. © 2016 John Wiley & Sons Australia, Ltd.

Passive and Self-Powered Autonomous Sensors for Remote Measurements

Directory of Open Access Journals (Sweden)

Mauro Serpelloni

2009-02-01

Full Text Available Autonomous sensors play a very important role in the environmental, structural, and medical fields. The use of this kind of systems can be expanded for several applications, for example in implantable devices inside the human body where it is impossible to use wires. Furthermore, they enable measurements in harsh or hermetic environments, such as under extreme heat, cold, humidity or corrosive conditions. The use of batteries as a power supply for these devices represents one solution, but the size, and sometimes the cost and unwanted maintenance burdens of replacement are important drawbacks. In this paper passive and self-powered autonomous sensors for harsh or hermetical environments without batteries are discussed. Their general architectures are presented. Sensing strategies, communication techniques and power management are analyzed. Then, general building blocks of an autonomous sensor are presented and the design guidelines that such a system must follow are given. Furthermore, this paper reports different proposed applications of autonomous sensors applied in harsh or hermetic environments: two examples of passive autonomous sensors that use telemetric communication are proposed, the first one for humidity measurements and the second for high temperatures. Other examples of self-powered autonomous sensors that use a power harvesting system from electromagnetic fields are proposed for temperature measurements and for airflow speeds.

Passive and self-powered autonomous sensors for remote measurements.

Science.gov (United States)

Sardini, Emilio; Serpelloni, Mauro

2009-01-01

Autonomous sensors play a very important role in the environmental, structural, and medical fields. The use of this kind of systems can be expanded for several applications, for example in implantable devices inside the human body where it is impossible to use wires. Furthermore, they enable measurements in harsh or hermetic environments, such as under extreme heat, cold, humidity or corrosive conditions. The use of batteries as a power supply for these devices represents one solution, but the size, and sometimes the cost and unwanted maintenance burdens of replacement are important drawbacks. In this paper passive and self-powered autonomous sensors for harsh or hermetical environments without batteries are discussed. Their general architectures are presented. Sensing strategies, communication techniques and power management are analyzed. Then, general building blocks of an autonomous sensor are presented and the design guidelines that such a system must follow are given. Furthermore, this paper reports different proposed applications of autonomous sensors applied in harsh or hermetic environments: two examples of passive autonomous sensors that use telemetric communication are proposed, the first one for humidity measurements and the second for high temperatures. Other examples of self-powered autonomous sensors that use a power harvesting system from electromagnetic fields are proposed for temperature measurements and for airflow speeds.

Examining accident reports involving autonomous vehicles in California.

Directory of Open Access Journals (Sweden)

Francesca M Favarò

Full Text Available Autonomous Vehicle technology is quickly expanding its market and has found in Silicon Valley, California, a strong foothold for preliminary testing on public roads. In an effort to promote safety and transparency to consumers, the California Department of Motor Vehicles has mandated that reports of accidents involving autonomous vehicles be drafted and made available to the public. The present work shows an in-depth analysis of the accident reports filed by different manufacturers that are testing autonomous vehicles in California (testing data from September 2014 to March 2017. The data provides important information on autonomous vehicles accidents' dynamics, related to the most frequent types of collisions and impacts, accident frequencies, and other contributing factors. The study also explores important implications related to future testing and validation of semi-autonomous vehicles, tracing the investigation back to current literature as well as to the current regulatory panorama.

Examining accident reports involving autonomous vehicles in California.

Science.gov (United States)

Favarò, Francesca M; Nader, Nazanin; Eurich, Sky O; Tripp, Michelle; Varadaraju, Naresh

2017-01-01

Autonomous Vehicle technology is quickly expanding its market and has found in Silicon Valley, California, a strong foothold for preliminary testing on public roads. In an effort to promote safety and transparency to consumers, the California Department of Motor Vehicles has mandated that reports of accidents involving autonomous vehicles be drafted and made available to the public. The present work shows an in-depth analysis of the accident reports filed by different manufacturers that are testing autonomous vehicles in California (testing data from September 2014 to March 2017). The data provides important information on autonomous vehicles accidents' dynamics, related to the most frequent types of collisions and impacts, accident frequencies, and other contributing factors. The study also explores important implications related to future testing and validation of semi-autonomous vehicles, tracing the investigation back to current literature as well as to the current regulatory panorama.

Examining accident reports involving autonomous vehicles in California

Science.gov (United States)

Nader, Nazanin; Eurich, Sky O.; Tripp, Michelle; Varadaraju, Naresh

2017-01-01

Autonomous Vehicle technology is quickly expanding its market and has found in Silicon Valley, California, a strong foothold for preliminary testing on public roads. In an effort to promote safety and transparency to consumers, the California Department of Motor Vehicles has mandated that reports of accidents involving autonomous vehicles be drafted and made available to the public. The present work shows an in-depth analysis of the accident reports filed by different manufacturers that are testing autonomous vehicles in California (testing data from September 2014 to March 2017). The data provides important information on autonomous vehicles accidents’ dynamics, related to the most frequent types of collisions and impacts, accident frequencies, and other contributing factors. The study also explores important implications related to future testing and validation of semi-autonomous vehicles, tracing the investigation back to current literature as well as to the current regulatory panorama. PMID:28931022

Cardiovascular autonomic function in Cushing's syndrome.

Science.gov (United States)

Fallo, F; Maffei, P; Dalla Pozza, A; Carli, M; Della Mea, P; Lupia, M; Rabbia, F; Sonino, N

2009-01-01

Cardiac autonomic dysfunction is associated with increased cardiovascular mortality. No data on sympathovagal balance are available in patients with Cushing's syndrome, in whom cardiovascular risk is high. We studied 10 patients with newly diagnosed Cushing's syndrome (1 male/9 females; age mean+/-SD, 47+/-10 yr) and 10 control subjects matched for age, sex, body mass index, and cardiovascular risk factors. In both groups there were 7 patients with arterial hypertension, 3 with diabetes mellitus, and 2 with obesity. Cardiac autonomic function was evaluated by analysis of short time heart rate variability (HRV) measures in frequency domain over 24-h, daytime, and nighttime. The 24-h ambulatory blood pressure monitoring and echocardiography were also performed. In comparison with controls, patients with Cushing's syndrome had lower 24-h (1.3+/-0.6 vs 3.7+/-1.5, mean+/-SD, p<0.01), daytime (2.0+/-1.4 vs 4.5+/-1.6, p<0.01), and night-time (1.0+/-0.4 vs 3.5+/-2.3, p<0.01) low-frequency/ high frequency (LF/HF) power ratio. In the presence of similar LF power, the difference was due to elevation in HF power in Cushing's syndrome compared to controls: 24-h, 12.7+/-6.7 vs 5.8+/-2.8, p<0.01; daytime, 10.2+/-7.3 vs 4.5+/-2.1, p<0.05; nighttime, 14.2+/-7.0 vs 7.8+/-4.7, p<0.05. Eight Cushing patients vs 4 controls had a non-dipping blood pressure profile. At echocardiography, Cushing patients had a greater left ventricular mass index and/or relative wall thickness, and impaired diastolic function, compared with controls. Compared to controls, patients with Cushing's syndrome showed a sympathovagal imbalance, characterized by a relatively increased parasympathetic activity. Whether this autonomic alteration is meant to counterbalance cortisol-induced effects on blood pressure and cardiac structure/function or has a different pathophysiological significance is still unknown.

Longitudinal Control for Mengshi Autonomous Vehicle via Gauss Cloud Model

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Hongbo Gao

2017-12-01

Full Text Available Dynamic robustness and stability control is a requirement for self-driving of autonomous vehicle. Longitudinal control technique of autonomous vehicle is basic theory and one key complex technique which must have the reliability and precision of vehicle controller. The longitudinal control technique is one of the foundations of the safety and stability of autonomous vehicle control. In our paper, we present a longitudinal control algorithm based on cloud model for Mengshi autonomous vehicle to ensure the dynamic stability and tracking performance of Mengshi autonomous vehicle. The longitudinal control algorithm mainly uses cloud model generator to control the acceleration of the autonomous vehicle to achieve the goal that controls the speed of Mengshi autonomous vehicle. The proposed longitudinal control algorithm based on cloud model is verified by real experiments on Highway driving scene. The experiments results of the acceleration and speed show that the algorithm is validity and stability.

Autonomic components of Complex Regional Pain Syndrome (CRPS) are favourably affected by Electrical Twitch-Obtaining Intramuscular Stimulation (ETOIMS): effects on blood pressure and heart rate.

Science.gov (United States)

Chu, Jennifer; Bruyninckx, Frans; Neuhauser, Duncan V

2017-07-01

Favourable pain relief results on evoking autonomous twitches at myofascial trigger points with Electrical Twitch Obtaining Intramuscular Stimulation (ETOIMS). To document autonomic nervous system (ANS) dysfunction in Complex Regional Pain Syndrome (CRPS) from blood pressure (BP) and pulse/heart rate changes with ETOIMS. A patient with persistent pain regularly received serial ETOIMS sessions of 60, 90, 120 or ≥150 min over 24 months. Outcome measures include BP: systolic, diastolic, pulse pressure and pulse/heart rate, pre-session/immediate-post-session summed differences (SDPPP index), and pain reduction. His results were compared with that of two other patients and one normal control. Each individual represented the following maximal elicitable twitch forces (TWF) graded 1-5: maximum TWF2: control subject; maximum TWF3: CRPS patient with suspected ANS dysfunction; and maximum TWF4 and TWF5: two patients with respective slow-fatigue and fast-fatigue twitches who during ETOIMS had autonomous twitching at local and remote myotomes simultaneously from denervation supersensitivity. ETOIMS results between TWFs were compared using one-way analysis of variance test. The patients showed immediate significant pain reduction, BP and pulse/heart rate changes/reduction(s) except for diastolic BP in the TWF5 patient. TWF2 control subject had diastolic BP reduction with ETOIMS but not with rest. Linear regression showed TWF grade to be the most significant variable in pain reduction, more so than the number of treatments, session duration and treatment interval. TWF grade was the most important variable in significantly reducing outcome measures, especially pulse/heart rate. Unlike others, the TWF3 patient had distinctive reductions in SDPPP index. Measuring BP and pulse/heart rate is clinically practical for alerting ANS dysfunction maintained CRPS. SDPPP index (≥26) and pulse/heart rate (≥8) reductions with almost every ETOIMS treatment, plus inability to evoke

Autonomic control of the heart is altered in Sprague-Dawley rats with spontaneous hydronephrosis

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Arnold, Amy C.; Shaltout, Hossam A.; Gilliam-Davis, Shea; Kock, Nancy D.

2011-01-01

The renal medulla plays an important role in cardiovascular regulation, through interactions with the autonomic nervous system. Hydronephrosis is characterized by substantial loss of renal medullary tissue. However, whether alterations in autonomic control of the heart are observed in this condition is unknown. Thus we assessed resting hemodynamics and baroreflex sensitivity (BRS) for control of heart rate in urethane/chloralose-anesthetized Sprague-Dawley rats with normal or hydronephrotic kidneys. While resting arterial pressure was similar, heart rate was higher in rats with hydronephrosis (290 ± 12 normal vs. 344 ± 11 mild/moderate vs. 355 ± 13 beats/min severe; P hydronephrosis, with no differences in measures of indirect sympathetic activity among conditions. As a secondary aim, we investigated whether autonomic dysfunction in hydronephrosis is associated with activation of the renin-angiotensin system (RAS). There were no differences in circulating angiotensin peptides among conditions, suggesting that the impaired autonomic function in hydronephrosis is independent of peripheral RAS activation. A possible site for angiotensin II-mediated BRS impairment is the solitary tract nucleus (NTS). In normal and mild/moderate hydronephrotic rats, NTS administration of the angiotensin II type 1 receptor antagonist candesartan significantly improved the BRS, suggesting that angiotensin II provides tonic suppression to the baroreflex. In contrast, angiotensin II blockade produced no significant effect in severe hydronephrosis, indicating that at least within the NTS baroreflex suppression in these animals is independent of angiotensin II. PMID:21460193

Longitudinal Control for Mengshi Autonomous Vehicle via Cloud Model

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Gao, H. B.; Zhang, X. Y.; Li, D. Y.; Liu, Y. C.

2018-03-01

Dynamic robustness and stability control is a requirement for self-driving of autonomous vehicle. Longitudinal control method of autonomous is a key technique which has drawn the attention of industry and academe. In this paper, we present a longitudinal control algorithm based on cloud model for Mengshi autonomous vehicle to ensure the dynamic stability and tracking performance of Mengshi autonomous vehicle. An experiments is applied to test the implementation of the longitudinal control algorithm. Empirical results show that if the longitudinal control algorithm based Gauss cloud model are applied to calculate the acceleration, and the vehicles drive at different speeds, a stable longitudinal control effect is achieved.

Simulating autonomous driving styles: Accelerations for three road profiles

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Karjanto Juffrizal

2017-01-01

Full Text Available This paper presents a new experimental approach to simulate projected autonomous driving styles based on the accelerations at three road profiles. This study was focused on the determination of ranges of accelerations in triaxial direction to simulate the autonomous driving experience. A special device, known as the Automatic Acceleration and Data controller (AUTOAccD, has been developed to guide the designated driver to accomplish the selected accelerations based on the road profiles and the intended driving styles namely assertive, defensive and light rail transit (LRT. Experimental investigations have been carried out at three different road profiles (junction, speed hump, and corner with two designated drivers with five trials on each condition. A driving style with the accelerations of LRT has also been included in this study as it is significant to the present methodology because the autonomous car is predicted to accelerate like an LRT, in such a way that it enables the users to conduct activities such as working on a laptop, using personal devices or eating and drinking while travelling. The results demonstrated that 92 out of 110 trials of the intended accelerations for autonomous driving styles could be achieved and simulated on the real road by the designated drivers. The differences between the two designated drivers were negligible, and the rates of succeeding in realizing the intended accelerations were high. The present approach in simulating autonomous driving styles focusing on accelerations can be used as a tool for experimental setup involving autonomous driving experience and acceptance.

12th International Conference on Intelligent Autonomous Systems

CERN Document Server

Cho, Hyungsuck; Yoon, Kwang-Joon; Lee, Jangmyung

2013-01-01

Intelligent autonomous systems are emerged as a key enabler for the creation of a new paradigm of services to humankind, as seen by the recent advancement of autonomous cars licensed for driving in our streets, of unmanned aerial and underwater vehicles carrying out hazardous tasks on-site, and of space robots engaged in scientific as well as operational missions, to list only a few. This book aims at serving the researchers and practitioners in related fields with a timely dissemination of the recent progress on intelligent autonomous systems, based on a collection of papers presented at the 12th International Conference on Intelligent Autonomous Systems, held in Jeju, Korea, June 26-29, 2012. With the theme of “Intelligence and Autonomy for the Service to Humankind, the conference has covered such diverse areas as autonomous ground, aerial, and underwater vehicles, intelligent transportation systems, personal/domestic service robots, professional service robots for surgery/rehabilitation, rescue/security ...

Advanced Autonomous Systems for Space Operations

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Gross, A. R.; Smith, B. D.; Muscettola, N.; Barrett, A.; Mjolssness, E.; Clancy, D. J.

2002-01-01

otherwise possible, as well as many more efficient and low cost applications. In addition, utilizing component and system modeling and reasoning capabilities, autonomous systems will play an increasing role in ground operations for space missions, where they will both reduce the human workload as well as provide greater levels of monitoring and system safety. This paper will focus specifically on new and innovative software for remote, autonomous, space systems flight operations. Topics to be presented will include a brief description of key autonomous control concepts, the Remote Agent program that commanded the Deep Space 1 spacecraft to new levels of system autonomy, recent advances in distributed autonomous system capabilities, and concepts for autonomous vehicle health management systems. A brief description of teaming spacecraft and rovers for complex exploration missions will also be provided. New on-board software for autonomous science data acquisition for planetary exploration will be described, as well as advanced systems for safe planetary landings. A new multi-agent architecture that addresses some of the challenges of autonomous systems will be presented. Autonomous operation of ground systems will also be considered, including software for autonomous in-situ propellant production and management, and closed- loop ecological life support systems (CELSS). Finally, plans and directions for the future will be discussed.

Effect of Mild Hyperglycemia on Autonomic Function in Obstructive Sleep Apnea

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Peltier, Amanda C.; Bagai, Kanika; Artibee, Kay; Diedrich, André; Garland, Emily; Elasy, Thomas; Shi, Yaping; Wang, Lily; Feldman, Eva L.; Robertson, David; Malow, Beth A.

2014-01-01

Obstructive sleep apnea (OSA) has been hypothesized to cause a hypersympathetic state, which may be the mechanism for the increased incidence of cardiovascular disease in OSA. However, there is a high prevalence of hyperglycemia in OSA patients which may also contribute to autonomic dysfunction. Thirty-five patients with OSA and eleven controls with average body-mass index (BMI) of 32.0 ± 4.6 underwent polysomnography, glucose tolerance testing, autonomic function tests, lying and standing catecholamines, overnight urine collection, and baseline ECG and continuous blood pressure measurements for spectral analysis. A linear regression model adjusting for age and BMI was used to analyze spectral data, other outcome measures were analyzed with Kruskal-Wallis test. Twenty-three OSA patients and two control patients had hyperglycemia (based on 2001 American Diabetes Association criteria). AHI correlated with total power and low frequency (LF) power (r=0.138, 0.177, p=0.031; and r= 0.013) but not with the LF/high frequency (HF) ratio (p=0.589). Glucose negatively correlated with LF systolic power (r=-0.171, p=0.038) but not AHI (p=0.586) and was marginally associated with pnn50, total power, LF, and HF power (p ranged from 0.07 to 0.08). These data suggest that patients with OSA and mild hyperglycemia have a trend towards lower heart rate variability and sympathetic tone. Hyperglycemia is an important confounder and should be evaluated in studies of OSA and autonomic function. PMID:21796355

Erectile dysfunction as a manifestation of urogenital autonomic neuropathy in patients with type 1 diabetes: epidemiology, classification, pathophysiology, diagnosis and treatment options

OpenAIRE

Gagik Radikovich Galstyan; yana Grigor'evna Shwarts; Sergey Anatol'evich Dubsky; Aleksandr Evgen'evich Lepetukhin; Roman Viktorovich Rozhivanov; Dmitry Gennadievich Kurbatov

2014-01-01

Sexual dysfunction characterized by a significant decline in the quality of life of patients and leading to infertility and problems in social life is diagnosed in more than 40% of patients with diabetes mellitus (DM).Erectile dysfunction is the most common sexual disorder in DM patients. The article describes epidemiology, classification, pathophysiology, diagnostic and treatment of erectile dysfunction in T1DM patients.

Affective and Autonomic Responses to Erotic Images: Evidence of Disgust-Based Mechanisms in Female Sexual Interest/Arousal Disorder.

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DePesa, Natasha S; Cassisi, Jeffrey E

2017-09-01

Disgust has recently been implicated in the development and maintenance of female sexual dysfunction, yet most empirical studies have been conducted with a sexually healthy sample. The current study contributes to the literature by expanding the application of a disgust model of sexual functioning to a clinically relevant sample of women with low sexual desire/arousal and accompanying sexual distress. Young women (mean age = 19.12 years) with psychometrically defined sexual dysfunction (i.e., female sexual interest/arousal disorder [FSIAD] group) and a healthy control group were compared in their affective (i.e., facial electromyography [EMG] and self-report) and autonomic (i.e., heart rate and electrodermal activity) responses to disgusting, erotic, positive, and neutral images. Significant differences were predicted in responses to erotic images only. Specifically, it was hypothesized that the FSIAD group would display affective and autonomic responses consistent with a disgust response, while responses from the control group would align with a general appetitive response. Results largely supported study hypotheses. The FSIAD group displayed significantly greater negative facial affect, reported more subjective disgust, and recorded greater heart rate deceleration than the control group in response to erotic stimuli. Greater subjective disgust response corresponded with more sexual avoidance behavior. Planned follow-up analyses explored correlates of subjective disgust responses.

Diabetes and Retinal Vascular Dysfunction

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Eui Seok Shin

2014-01-01

Full Text Available Diabetes predominantly affects the microvascular circulation of the retina resulting in a range of structural changes unique to this tissue. These changes ultimately lead to altered permeability, hyperproliferation of endothelial cells and edema, and abnormal vascularization of the retina with resulting loss of vision. Enhanced production of inflammatory mediators and oxidative stress are primary insults with significant contribution to the pathogenesis of diabetic retinopathy (DR. We have determined the identity of the retinal vascular cells affected by hyperglycemia, and have delineated the cell autonomous impact of high glucose on function of these cells. We discuss some of the high glucose specific changes in retinal vascular cells and their contribution to retinal vascular dysfunction. This knowledge provides novel insight into the molecular and cellular defects contributing to the development and progression of diabetic retinopathy, and will aid in the development of innovative, as well as target specific therapeutic approaches for prevention and treatment of DR.

Sleep disordered breathing and autonomic function in overweight and obese children and adolescents

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Annelies Van Eyck

2016-12-01

Full Text Available Obstructive sleep apnoea (OSA, common in children with obesity, is associated with cardiovascular morbidity. Autonomic dysfunction has been suggested to be a key player in the development of these complications. We investigated the relationship between obesity, OSA and sympathetic activity in children. 191 children with obesity were included and distributed into two groups: 131 controls and 60 with OSA. Beat-to-beat RR interval data were extracted from polysomnography for heart rate variability analysis. Urinary free cortisol levels were determined. Urinary free cortisol did not differ between groups and was not associated with OSA, independent of the level of obesity. Differences in heart rate variability measures were found: mean RR interval decreased with OSA, while low/high-frequency band ratio and mean heart rate increased with OSA. Heart rate variability measures correlated with OSA, independent of obesity parameters and age: oxygen desaturation index correlated with mean heart rate (r=0.19, p=0.009 and mean RR interval (r= −0.18, p=0.02, while high-frequency bands and low/high-frequency band ratio correlated with arterial oxygen saturation measured by pulse oximetry (SpO2 (r= −0.20, p=0.008 and r= −0.16, p=0.04 and SpO2 nadir (r=0.23, p=0.003 and r= −0.19, p=0.02. These results suggest that sympathetic heart activity is increased in children with obesity and OSA. Measures of hypoxia were related to increased sympathetic tone, suggesting that intermittent hypoxia is involved in autonomic dysfunction.

Sympathetic overactivity precedes metabolic dysfunction in a fructose model of glucose intolerance in mice

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Angelis, Katia De; Senador, Danielle D.; Mostarda, Cristiano; Irigoyen, Maria C.

2012-01-01

Consumption of high levels of fructose in humans and animals leads to metabolic and cardiovascular dysfunction. There are questions as to the role of the autonomic changes in the time course of fructose-induced dysfunction. C57/BL male mice were given tap water or fructose water (100 g/l) to drink for up to 2 mo. Groups were control (C), 15-day fructose (F15), and 60-day fructose (F60). Light-dark patterns of arterial pressure (AP) and heart rate (HR), and their respective variabilities were measured. Plasma glucose, lipids, insulin, leptin, resistin, adiponectin, and glucose tolerance were quantified. Fructose increased systolic AP (SAP) at 15 and 60 days during both light (F15: 123 ± 2 and F60: 118 ± 2 mmHg) and dark periods (F15: 136 ± 4 and F60: 136 ± 5 mmHg) compared with controls (light: 111 ± 2 and dark: 117 ± 2 mmHg). SAP variance (VAR) and the low-frequency component (LF) were increased in F15 (>60% and >80%) and F60 (>170% and >140%) compared with C. Cardiac sympatho-vagal balance was enhanced, while baroreflex function was attenuated in fructose groups. Metabolic parameters were unchanged in F15. However, F60 showed significant increases in plasma glucose (26%), cholesterol (44%), triglycerides (22%), insulin (95%), and leptin (63%), as well as glucose intolerance. LF of SAP was positively correlated with SAP. Plasma leptin was correlated with triglycerides, insulin, and glucose tolerance. Results show that increased sympathetic modulation of vessels and heart preceded metabolic dysfunction in fructose-consuming mice. Data suggest that changes in autonomic modulation may be an initiating mechanism underlying the cluster of symptoms associated with cardiometabolic disease. PMID:22319048

Erectile dysfunction as a manifestation of urogenital autonomic neuropathy in patients with type 1 diabetes: epidemiology, classification, pathophysiology, diagnosis and treatment options

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Gagik Radikovich Galstyan

2014-05-01

Full Text Available Sexual dysfunction characterized by a significant decline in the quality of life of patients and leading to infertility and problems in social life is diagnosed in more than 40% of patients with diabetes mellitus (DM.Erectile dysfunction is the most common sexual disorder in DM patients. The article describes epidemiology, classification, pathophysiology, diagnostic and treatment of erectile dysfunction in T1DM patients.

Tracked robot controllers for climbing obstacles autonomously

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Vincent, Isabelle

2009-05-01

Research in mobile robot navigation has demonstrated some success in navigating flat indoor environments while avoiding obstacles. However, the challenge of analyzing complex environments to climb obstacles autonomously has had very little success due to the complexity of the task. Unmanned ground vehicles currently exhibit simple autonomous behaviours compared to the human ability to move in the world. This paper presents the control algorithms designed for a tracked mobile robot to autonomously climb obstacles by varying its tracks configuration. Two control algorithms are proposed to solve the autonomous locomotion problem for climbing obstacles. First, a reactive controller evaluates the appropriate geometric configuration based on terrain and vehicle geometric considerations. Then, a reinforcement learning algorithm finds alternative solutions when the reactive controller gets stuck while climbing an obstacle. The methodology combines reactivity to learning. The controllers have been demonstrated in box and stair climbing simulations. The experiments illustrate the effectiveness of the proposed approach for crossing obstacles.

TREATMENT OF NEUROGENIC ERECTILE DYSFUNCTION IN PATIENTS WITH TYPE I DIABETES

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D. G. Kurbatov

2017-01-01

Full Text Available Introduction. The urogenital form of autonomic diabetic polyneuropathy is a specific lesion of the autonomic nervous system in diabetic patients. It is main pathogenetic cause of sexual disorders in this category of patients. The most common violation of sexual function in patients with diabetes is erectile dysfunction (ED.Objective. Diagnosis of peripheral neuropathy with ED caused by type I diabetes and assessment of the effectiveness phosphodiesterase type 5 inhibitor (PDE5-I in its treatment.Materials and methods. The study included 40 patients with ED due to type 1 diabetes at the age of 25.7 ± 6.1. The duration of type 1 diabetes was 18 ± 9.7 years. All 40 patients, initially and after the course of therapy with the PDE5-Is, underwent a neuromyographic study with the determination of the excitation propagation rate for nervus peroneus and nervus pudendus, endothelial function evaluation on the EndoPat ™ device, and the questionnaire on the international index of erectile function (IIEF-5 scale.Results. In 30 (75.0% men, endothelial dysfunction was determined according to EndoPat ™. In the range of the gray zone of reactive hyperemia index (RHI was detected in 7 men (16.6%. Normal function of the endothelium was revealed in 3 cases (8.4%. In the control study, the following data were found: endothelial dysfunction was detected in 6 patients (16.6% according to Endo Pat ™, in 14 patients (33.4% in the range of gray zone of RHI, endothelial function was normalized in 20 patients (50.0%. According to the neuromyographic study, initially all patients had diabetic neuropathy in both the distal and urogenital forms. After therapy, significant positive dynamics were shown. Based on the results of the questionnaire on the scale of IIEF-5, initially all patients showed ED of varying severity. With the control questionnaire after therapy, there was an improvement in erectile function.Conclusions. Given the high incidence of endothelial

[Response of pancreatic polypeptide to a protein rich meal in insulin non dependent diabetes melitus and autonomic neuropathy].

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Kostić, N; Zamaklar, M; Novaković, R; Stajić, S

1994-01-01

Parasympathetic function and plasma hPP response to a protein rich meal were evaluated in 105 insulin non-dependent diabetic patients: 20 with autonomic neuropathy (group A), diagnosed by Clonidin test; 35 patients with neurophysiological evidence of polyneuropath (group B); 30 patients with autonomic neuropathy and polineuropathy (group C), and 20 patients without any sign of neuropathy (group D). Plasma hPP levels were determined by RIA using an anti-hPP antiserum, kindly provided by Prof. S. R. Bloom (Hammersmith Hospital, London). Blood was taken at 0. 45 and 60 minutes after the beginning of the meal. In groups A and C, the meal induced hPP increase was significantly lower than in group D (p 0.001). All group B patients had a marked increase in the peptide, similar to that in diabetics without neuropathy. These result ssuggest that diabetic autonomic neuropathy is associated with dysfunction of hPP secretion, and that the evaluation of hPP response to test meal may be a sensitive and simple method for the assessment of paraympathetic impairment in diabetes.

Identifying and Working with Dysfunctional Families.

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Bilynsky, Natalie Sufler; Vernaglia, Elizabeth Rudow

1999-01-01

A school counselor is often called upon to intervene when a child's progress and the classroom environment begin to suffer because of the child's dysfunctional family. The article presents a six-stage, problem-solving model for school counselors in their work with children from dysfunctional families. Presents a case example to illustrate the…

Strengthening exercises improve symptoms and quality of life but do not change autonomic modulation in fibromyalgia: a randomized clinical trial.

Science.gov (United States)

Gavi, Maria Bernadete Renoldi Oliveira; Vassalo, Dalton Valentin; Amaral, Fabian Tadeu; Macedo, Danielle Constância Felício; Gava, Pablo Lúcio; Dantas, Eduardo Miranda; Valim, Valéria

2014-01-01

Autonomic dysfunction is an important mechanism that could explain many symptoms observed in fibromyalgia (FM). Exercise is an effective treatment, with benefits potentially mediated through changes in autonomic modulation. Strengthening is one of the less studied exercises in FM, and the acute and chronic effects of strengthening on the autonomic system remain unknown. The objective of this study was to assess the chronic effects of strengthening exercises (STRE) on autonomic modulation, pain perception and the quality of life (QOL) of FM patients. Eighty sedentary women with FM (ACR 1990) were randomly selected to participate in STRE or flexibility (FLEX) exercises in a blinded controlled trial. The intensity of STRE was set at 45% of the estimated load of 1 Repetition Maximum (RM) in 12 different exercises. Outcomes were Visual Analog Scale (VAS) for pain, Heart Rate Variability (HRV) analysis, treadmill test, the sit and reach test (Wells and Dillon's Bench), maximal repetitions test and handgrip dynamometry; and quality of life by the Fibromyalgia Impact Questionnaire (FIQ), the Beck and Idate Trait-State Inventory (IDATE), a short-form health survey (SF-36). The STRE group was more effective to strength gain for all muscles and pain control after 4 and 16 weeks (pquality of life, no effect was observed on the autonomic modulation in both groups. This observation suggests that changes in autonomic modulation are not a target tobe clinically achieved in fibromyalgia. ClinicalTrials.gov NCT02004405.

Autonomous nutrient detection for water quality monitoring

OpenAIRE

Maher, Damien; Cleary, John; Cogan, Deirdre; Diamond, Dermot

2012-01-01

The ever increasing demand for real time environmental monitoring is currently being driven by strong legislative and societal drivers. Low cost autonomous environmental monitoring systems are required to meet this demand as current monitoring solutions are insufficient. This poster presents an autonomous nutrient analyser platform for water quality monitoring. Results from a field trial of the nutrient analyser are reported along with current work to expand the range of water quality targ...

Dysfunctional stress responses in chronic pain.

Science.gov (United States)

Woda, Alain; Picard, Pascale; Dutheil, Frédéric

2016-09-01

Many dysfunctional and chronic pain conditions overlap. This review describes the different modes of chronic deregulation of the adaptive response to stress which may be a common factor for these conditions. Several types of dysfunction can be identified within the hypothalamo-pituitary-adrenal axis: basal hypercortisolism, hyper-reactivity, basal hypocortisolism and hypo-reactivity. Neuroactive steroid synthesis is another component of the adaptive response to stress. Dehydroepiandrosterone (DHEA) and its sulfated form DHEA-S, and progesterone and its derivatives are synthetized in cutaneous, nervous, and adipose cells. They are neuroactive factors that act locally. They may have a role in the localization of the symptoms and their levels can vary both in the central nervous system and in the periphery. Persistent changes in neuroactive steroid levels or precursors can induce localized neurodegeneration. The autonomic nervous system is another component of the stress response. Its dysfunction in chronic stress responses can be expressed by decreased basal parasympathethic activity, increased basal sympathetic activity or sympathetic hyporeactivity to a stressful stimulus. The immune and genetic systems also participate. The helper-T cells Th1 secrete pro-inflammatory cytokines such as IL-1-β, IL-2, IL-6, IL-8, IL-12, IFN-γ, and TNF-α, whereas Th2 secrete anti-inflammatory cytokines: IL-4, IL-10, IGF-10, IL-13. Chronic deregulation of the Th1/Th2 balance can occur in favor of anti- or pro-inflammatory direction, locally or systemically. Individual vulnerability to stress can be due to environmental factors but can also be genetically influenced. Genetic polymorphisms and epigenetics are the main keys to understanding the influence of genetics on the response of individuals to constraints. Copyright © 2016 Elsevier Ltd. All rights reserved.

Nature's Autonomous Oscillators

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Mayr, H. G.; Yee, J.-H.; Mayr, M.; Schnetzler, R.

2012-01-01

Nonlinearity is required to produce autonomous oscillations without external time dependent source, and an example is the pendulum clock. The escapement mechanism of the clock imparts an impulse for each swing direction, which keeps the pendulum oscillating at the resonance frequency. Among nature's observed autonomous oscillators, examples are the quasi-biennial oscillation and bimonthly oscillation of the Earth atmosphere, and the 22-year solar oscillation. The oscillations have been simulated in numerical models without external time dependent source, and in Section 2 we summarize the results. Specifically, we shall discuss the nonlinearities that are involved in generating the oscillations, and the processes that produce the periodicities. In biology, insects have flight muscles, which function autonomously with wing frequencies that far exceed the animals' neural capacity; Stretch-activation of muscle contraction is the mechanism that produces the high frequency oscillation of insect flight, discussed in Section 3. The same mechanism is also invoked to explain the functioning of the cardiac muscle. In Section 4, we present a tutorial review of the cardio-vascular system, heart anatomy, and muscle cell physiology, leading up to Starling's Law of the Heart, which supports our notion that the human heart is also a nonlinear oscillator. In Section 5, we offer a broad perspective of the tenuous links between the fluid dynamical oscillators and the human heart physiology.

Enhanced pain and autonomic responses to ambiguous visual stimuli in chronic Complex Regional Pain Syndrome (CRPS) type I.

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Cohen, H E; Hall, J; Harris, N; McCabe, C S; Blake, D R; Jänig, W

2012-02-01

Cortical reorganisation of sensory, motor and autonomic systems can lead to dysfunctional central integrative control. This may contribute to signs and symptoms of Complex Regional Pain Syndrome (CRPS), including pain. It has been hypothesised that central neuroplastic changes may cause afferent sensory feedback conflicts and produce pain. We investigated autonomic responses produced by ambiguous visual stimuli (AVS) in CRPS, and their relationship to pain. Thirty CRPS patients with upper limb involvement and 30 age and sex matched healthy controls had sympathetic autonomic function assessed using laser Doppler flowmetry of the finger pulp at baseline and while viewing a control figure or AVS. Compared to controls, there were diminished vasoconstrictor responses and a significant difference in the ratio of response between affected and unaffected limbs (symmetry ratio) to a deep breath and viewing AVS. While viewing visual stimuli, 33.5% of patients had asymmetric vasomotor responses and all healthy controls had a homologous symmetric pattern of response. Nineteen (61%) CRPS patients had enhanced pain within seconds of viewing the AVS. All the asymmetric vasomotor responses were in this group, and were not predictable from baseline autonomic function. Ten patients had accompanying dystonic reactions in their affected limb: 50% were in the asymmetric sub-group. In conclusion, there is a group of CRPS patients that demonstrate abnormal pain networks interacting with central somatomotor and autonomic integrational pathways. © 2011 European Federation of International Association for the Study of Pain Chapters.

Differences in autonomic nerve function in patients with silent and symptomatic myocardial ischaemia.

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Shakespeare, C. F.; Katritsis, D.; Crowther, A.; Cooper, I. C.; Coltart, J. D.; Webb-Peploe, M. W.

1994-01-01

BACKGROUND--Autonomic neuropathy provides a mechanism for the absence of symptoms in silent myocardial ischaemia, but characterisation of the type of neuropathy is lacking. AIM--To characterise and compare autonomic nerve function in patients with silent and symptomatic myocardial ischaemia. METHODS AND RESULTS--The Valsalva manoeuvre, heart rate variation (HRV) in response to deep breathing and standing, lower body negative pressure, isometric handgrip, and the cold pressor test were performed by patients with silent (n = 25) and symptomatic (n = 25) ambulatory ischaemia and by controls (n = 21). No difference in parasympathetic efferent function between patients with silent and symptomatic ischaemia was recorded, but both had significantly less HRV in response to standing than the controls (p < 0.005 for silent and p < 0.01 for symptomatic). Patients with silent ischaemia showed an increased propensity for peripheral vasodilatation compared with symptomatic patients (p < 0.02) and controls (p < 0.04). Impaired sympathetic function was found in patients with pure silent ischaemia (n = 4) compared with the remaining patients with silent ischaemia whose pain pathways were presumed to be intact. CONCLUSIONS--Patients with silent ischaemia and pain pathways presumed to be intact have an enhanced peripheral vasodilator response, and if this applied to the coronary vasculature it could provide a mechanism for limiting ischaemia to below the pain threshold. Patients with pure silent ischaemia have evidence of sympathetic autonomic dysfunction. Images PMID:8297687

Working with Chronically Dysfunctional Families.

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Younger, Robert; And Others

This paper reviews family therapy with chronically dysfunctional families including the development of family therapy and current trends which appear to give little guidance toward working with severely dysfunctional families. A theoretical stance based upon the systems approach to family functioning and pathology is presented which suggests: (1)…

Central insulin and leptin-mediated autonomic control of glucose homeostasis.

Science.gov (United States)

Marino, Joseph S; Xu, Yong; Hill, Jennifer W

2011-07-01

Largely as a result of rising obesity rates, the incidence of type 2 diabetes is escalating rapidly. Type 2 diabetes results from multi-organ dysfunctional glucose metabolism. Recent publications have highlighted hypothalamic insulin- and adipokine-sensing as a major determinant of peripheral glucose and insulin responsiveness. The preponderance of evidence indicates that the brain is the master regulator of glucose homeostasis, and that hypothalamic insulin and leptin signaling in particular play a crucial role in the development of insulin resistance. This review discusses the neuronal crosstalk between the hypothalamus, autonomic nervous system, and tissues associated with the pathogenesis of type 2 diabetes, and how hypothalamic insulin and leptin signaling are integral to maintaining normal glucose homeostasis. Copyright © 2011 Elsevier Ltd. All rights reserved.

Intelligent (Autonomous) Power Controller Development for Human Deep Space Exploration

Science.gov (United States)

Soeder, James; Raitano, Paul; McNelis, Anne

2016-01-01

As NASAs Evolvable Mars Campaign and other exploration initiatives continue to mature they have identified the need for more autonomous operations of the power system. For current human space operations such as the International Space Station, the paradigm is to perform the planning, operation and fault diagnosis from the ground. However, the dual problems of communication lag as well as limited communication bandwidth beyond GEO synchronous orbit, underscore the need to change the operation methodology for human operation in deep space. To address this need, for the past several years the Glenn Research Center has had an effort to develop an autonomous power controller for human deep space vehicles. This presentation discusses the present roadmap for deep space exploration along with a description of conceptual power system architecture for exploration modules. It then contrasts the present ground centric control and management architecture with limited autonomy on-board the spacecraft with an advanced autonomous power control system that features ground based monitoring with a spacecraft mission manager with autonomous control of all core systems, including power. It then presents a functional breakdown of the autonomous power control system and examines its operation in both normal and fault modes. Finally, it discusses progress made in the development of a real-time power system model and how it is being used to evaluate the performance of the controller and well as using it for verification of the overall operation.

Autonomic Neuropathy—a Prospective Cohort Study of Symptoms and E/I Ratio in Normal Glucose Tolerance, Impaired Glucose Tolerance, and Type 2 Diabetes

Directory of Open Access Journals (Sweden)

Malin Zimmerman

2018-03-01

Full Text Available BackgroundAutonomic neuropathy in diabetes, in addition to causing a range of symptoms originating from the autonomic nervous system, may increase cardiovascular morbidity. Our aim was to study the progression of autonomic neuropathy, based on symptom score and evaluation of an autonomic test, in persons with normal and impaired glucose tolerance and in patients with type 2 diabetes (T2D.MethodsParticipants were recruited in 2003/2004 with a follow-up in 2014. The participants’ glucose tolerance was categorized using oral glucose tolerance tests. Symptoms were evaluated using an autonomic symptom score (ASS, ECG was used to test cardiac autonomic function based on the expiration/inspiration ratio (E/I ratio, and blood samples were taken on both occasions.ResultsASSs were higher at follow-up in the T2D patients than in the normal glucose tolerance group (mean 1.21 ± 1.30 vs. 0.79 ± 0.7; p < 0.05. E/I ratio did not deteriorate more than could be expected as an aging effect in well-controlled T2D. No relationship was found between E/I ratio and HbA1c or ASS.ConclusionThe presence of autonomic symptoms increased over time in T2D patients, but the symptoms did not correlate with the E/I ratio in this metabolically well-controlled cohort. ASSs can be a useful clinical tool when assessing the progression of autonomic dysfunction in patients with abnormal glucose metabolism.

Spinal Trauma is Never without Sin: A Tetraplegia Patient Presented Without any Symptoms

OpenAIRE

EFEOGLU, Melis; AKOGLU, Haldun; AKOGLU, Tayfun; EROGLU, Serkan Emre; ONUR, Ozge Ecmel; DENIZBASI, Arzu

2016-01-01

SUMMARY: Spinal cord injuries are amongst the most dangerous injuries, leading to high mortality and morbidity. Injured patients are occasionally faced with life-threatening complications and quality-of-life changing neurological deficits. Thoracic and cervical spinal segments are the most effected sites of injury and a wide range of complications including paraplegia, respiratory and cardiovascular compromise secondary to autonomic dysfunction or tetraplegia may ensue. We aim to draw attenti...

Comparison of three filters in asteroid-based autonomous navigation

International Nuclear Information System (INIS)

Cui Wen; Zhu Kai-Jian

2014-01-01

At present, optical autonomous navigation has become a key technology in deep space exploration programs. Recent studies focus on the problem of orbit determination using autonomous navigation, and the choice of filter is one of the main issues. To prepare for a possible exploration mission to Mars, the primary emphasis of this paper is to evaluate the capability of three filters, the extended Kalman filter (EKF), unscented Kalman filter (UKF) and weighted least-squares (WLS) algorithm, which have different initial states during the cruise phase. One initial state is assumed to have high accuracy with the support of ground tracking when autonomous navigation is operating; for the other state, errors are set to be large without this support. In addition, the method of selecting asteroids that can be used for navigation from known lists of asteroids to form a sequence is also presented in this study. The simulation results show that WLS and UKF should be the first choice for optical autonomous navigation during the cruise phase to Mars

Overview of the Autonomic Nervous System

Science.gov (United States)

... be reversible or progressive. Anatomy of the autonomic nervous system The autonomic nervous system is the part of ... organs they connect with. Function of the autonomic nervous system The autonomic nervous system controls internal body processes ...

Chronic pelvic floor dysfunction.

Science.gov (United States)

Hartmann, Dee; Sarton, Julie

2014-10-01

The successful treatment of women with vestibulodynia and its associated chronic pelvic floor dysfunctions requires interventions that address a broad field of possible pain contributors. Pelvic floor muscle hypertonicity was implicated in the mid-1990s as a trigger of major chronic vulvar pain. Painful bladder syndrome, irritable bowel syndrome, fibromyalgia, and temporomandibular jaw disorder are known common comorbidities that can cause a host of associated muscular, visceral, bony, and fascial dysfunctions. It appears that normalizing all of those disorders plays a pivotal role in reducing complaints of chronic vulvar pain and sexual dysfunction. Though the studies have yet to prove a specific protocol, physical therapists trained in pelvic dysfunction are reporting success with restoring tissue normalcy and reducing vulvar and sexual pain. A review of pelvic anatomy and common findings are presented along with suggested physical therapy management. Copyright © 2014 Elsevier Ltd. All rights reserved.

Autonomous operation of distributed storages in microgrids

DEFF Research Database (Denmark)

Loh, Poh Chiang; Chai, Yi Kai; Li, Ding

2014-01-01

Operation of distributed generators in microgrids has been widely discussed, but would not be fully autonomous if distributed energy storages are not considered. Storages are important since they provide energy buffering to load changes, energy levelling to source variations and ride-through enha......Operation of distributed generators in microgrids has been widely discussed, but would not be fully autonomous if distributed energy storages are not considered. Storages are important since they provide energy buffering to load changes, energy levelling to source variations and ride......-through enhancement to the microgrids. Recognising their importance, this study presents a scheme for sharing power among multiple distributed storages in coordination with the distributed sources and loads. The scheme prompts the storages to autonomously sense for local operating conditions, requesting for maximum...... to help with meeting the extra load demand. The described process takes place autonomously with energy eventually shared among the storages in proportion to their ratings. To test the concepts discussed, experiments have been performed with favourable results obtained for performance verification....

Modeling of an autonomous microgrid for renewable energy sources integration

DEFF Research Database (Denmark)

Serban, I.; Teodorescu, Remus; Guerrero, Josep M.

2009-01-01

The frequency stability analysis in an autonomous microgrid (MG) with renewable energy sources (RES) is a continuously studied issue. This paper presents an original method for modeling an autonomous MG with a battery energy storage system (BESS) and a wind power plant (WPP), with the purpose...

Predictors and diagnosis of cardiac autonomic nervous dysfunction in patients with type 1 and type 2 diabetes mellitus

Directory of Open Access Journals (Sweden)

Kirill A. Popov

2017-08-01

Full Text Available Diabetic cardiovascular autonomic neuropathy (DCAN is a diabetic complication characterised by early dissemination of sympathetic and parasympathetic, small-fibre neuronal degeneration. DCAN is the most dangerous and insidious complication that influences the clinical course and mortality rate of diabetes; however, it is often underestimated and not recognised by practitioners. Medical history and a physical examination are not sufficient for diagnosing DCAN. Laboratory diagnosis and the instrumental methods used to evaluate DCAN are time-consuming and not always available. Early detection of DCAN in diabetic patients is important for the early implementation of therapy. Today, there is no uniform diagnostic algorithm for DCAN in patients with various disorders of carbohydrate metabolism. This is due to the insufficient number of clinical trials and limitations of current protocols. This review presents an overview of the clinical and experimental studies of DCAN. The epidemiology, clinical manifestations, risk factors and underlying pathogenesis of DCAN are considered. The advantages and disadvantages of conventional and new diagnostic methods are discussed.

Paraganglioma of the Cauda Equina Presenting with Erectile and Sphincter Dysfunction

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Wiesław Marcol

2009-06-01

Full Text Available Paragangliomas of the cauda equina are rare neuroepithelial tumors, usually manifesting clinically as sciatica. Here, we report a case of cauda equina paraganglioma with an unusual course in a 43-year-old man. His main complaints were erectile and sphincter dysfunction. The low back pain was initially ascribed to accidental injury. Magnetic resonance imaging revealed intradural tumor at the L2/L3 level. The patient underwent gross tumor resection, and the diagnosis of paraganglioma was based on neuropathologic examination. The symptoms completely resolved after tumor resection.

Advanced control architecture for autonomous vehicles

Science.gov (United States)

Maurer, Markus; Dickmanns, Ernst D.

1997-06-01

An advanced control architecture for autonomous vehicles is presented. The hierarchical architecture consists of four levels: a vehicle level, a control level, a rule-based level and a knowledge-based level. A special focus is on forms of internal representation, which have to be chosen adequately for each level. The control scheme is applied to VaMP, a Mercedes passenger car which autonomously performs missions on German freeways. VaMP perceives the environment with its sense of vision and conventional sensors. It controls its actuators for locomotion and attention focusing. Modules for perception, cognition and action are discussed.

Science, technology and the future of small autonomous drones.

Science.gov (United States)

Floreano, Dario; Wood, Robert J

2015-05-28

We are witnessing the advent of a new era of robots - drones - that can autonomously fly in natural and man-made environments. These robots, often associated with defence applications, could have a major impact on civilian tasks, including transportation, communication, agriculture, disaster mitigation and environment preservation. Autonomous flight in confined spaces presents great scientific and technical challenges owing to the energetic cost of staying airborne and to the perceptual intelligence required to negotiate complex environments. We identify scientific and technological advances that are expected to translate, within appropriate regulatory frameworks, into pervasive use of autonomous drones for civilian applications.

Acute renal dysfunction in liver diseases

OpenAIRE

Betrosian, Alex P; Agarwal, Banwari; Douzinas, Emmanuel E

2007-01-01

Renal dysfunction is common in liver diseases, either as part of multiorgan involvement in acute illness or secondary to advanced liver disease. The presence of renal impairment in both groups is a poor prognostic indicator. Renal failure is often multifactorial and can present as pre-renal or intrinsic renal dysfunction. Obstructive or post renal dysfunction only rarely complicates liver disease. Hepatorenal syndrome (HRS) is a unique form of renal failure associated with advanced liver dise...

Catecholamines and diabetic autonomic neuropathy

DEFF Research Database (Denmark)

Hilsted, J

1995-01-01

In diabetic patients with autonomic neuropathy plasma noradrenaline concentration, used as an index of sympathetic nervous activity, is low. This decrease is, however, only found in patients with a long duration of diabetes with clinically severe autonomic neuropathy. This apparent insensitivity...... of plasma catecholamine measurements is not due to changes in the clearance of catecholamines in diabetic autonomic neuropathy. The physiological responses to infused adrenaline and to noradrenaline are enhanced, for noradrenaline mainly cardiovascular responses. Adrenoceptors (alpha and beta adrenoceptors......) are not altered in circulating blood cells in diabetic autonomic neuropathy. Thus, a generalized up-regulation of adrenoceptors does not occur in diabetic autonomic neuropathy....

QFD-based conceptual design of an autonomous underwater robot

Directory of Open Access Journals (Sweden)

Thip Pasawang

2015-12-01

Full Text Available Autonomous underwater robots in the past few years have been designed according to the individual concepts and experiences of the researchers. To design a robot, which meets all the requirements of potential users, is an advanced work. Hence, a systematic design method that could include users’ preferences and requirements is needed. This paper presents the quality function deployment (QFD technique to design an autonomous underwater robot focusing on the Thai Navy military mission. Important user requirements extracted from the QFD method are the ability to record videos, operating at depth up to 10 meters, the ability to operate remotely with cable and safety concerns related to water leakages. Less important user requirements include beauty, using renewable energy, operating remotely with radio and ability to work during night time. The important design parameters derived from the user requirements are a low cost-controller, an autonomous control algorithm, a compass sensor and vertical gyroscope, and a depth sensor. Of low-importance ranked design parameters include the module design, use clean energy, a low noise electric motor, remote surveillance design, a pressure hull, and a beautiful hull form design. The study results show the feasibility of using QFD techniques to systematically design the autonomous underwater robot to meet user requirements. Mapping between the design and expected parameters and a conceptual drafting design of an autonomous underwater robot are also presented.

A Community Perspective on Bowel Management and Quality of Life after Spinal Cord Injury: The Influence of Autonomic Dysreflexia.

Science.gov (United States)

Inskip, Jessica A; Lucci, Vera-Ellen M; McGrath, Maureen S; Willms, Rhonda; Claydon, Victoria E

2018-05-01

Autonomic dysfunction is common in individuals with spinal cord injury (SCI) and leads to numerous abnormalities, including profound cardiovascular and bowel dysfunction. In those with high-level lesions, bowel management is a common trigger for autonomic dysreflexia (AD; hypertension provoked by sensory stimuli below the injury level). Improving bowel care is integral for enhancing quality of life (QoL). We aimed to describe the relationships between bowel care, AD, and QoL in individuals with SCI. We performed an online community survey of individuals with SCI. Those with injury at or above T7 were considered at risk for AD. Responses were received from 287 individuals with SCI (injury levels C1-sacral and average duration of injury 17.1 ± 12.9 [standard deviation] years). Survey completion rate was 73% (n = 210). Bowel management was a problem for 78%: it interfered with personal relationships (60%) and prevented staying (62%) and working (41%) away from home. The normal bowel care duration was >60 min in 24% and most used digital rectal stimulation (59%); 33% reported bowel incontinence at least monthly. Of those at risk for AD (n = 163), 74% had AD symptoms during bowel care; 32% described palpitations. AD interfered with activities of daily living in 51%. Longer durations of bowel care (p < 0.001) and more severe AD (p = 0.04) were associated with lower QoL. Bowel management is a key concern for individuals with SCI and is commonly associated with symptoms of AD. Further studies should explore ways to manage bowel dysfunction, increase self-efficacy, and ameliorate the impact of AD to improve QoL.

Etat de l'art des véhicules sous-marins autonomes, verrous technologiques

OpenAIRE

Michel, J; Duranton, R

1990-01-01

Autonomous Underwater Vehicles, also called "free-swimming vehicles" are self propelled bodies, equipped with their own energy package and with no solid communication link with the surface. At the beginning of the 90s, a renewed interest from the Underwater Intervention Community for autonomous vehicles and quite a number of new projects were announced or started. The present paper aims at presenting an updated State of the Art on the development of autonomous vehicles. It addresses the follo...

Association between depression, pressure pain sensitivity, stress and autonomous nervous system function in stable ischemic heart disease

DEFF Research Database (Denmark)

Ballegaard, Søren; Bergmann, Natasha; Karpatschof, Benny

2016-01-01

Background: Depression and ischemic heart disease (IHD) are associated with persistent stress and autonomic nervous system (ANS) dysfunction. The former can be measured by pressure pain sensitivity (PPS) of the sternum, and the latter by the PPS and systolic blood pressure (SBP) response to a tilt...... table test (TTT). Beta-blocker treatment reduces the efferent beta-adrenergic ANS function, and thus, the physiological stress response. Objective: To test the effect of beta-blockers on changes in depression score in patients with IHD, as well as the influence on persistent stress and ANS dysfunction...... PPS score correlated in non-users, only (r = 0.69, p = 0.007). Reduction in resting PPS correlated with an increase in PPS and SBP response to TTT. Conclusions: Stress intervention in patients with IHD was anti-depres- sive in non-users, only. Similarly, the association between the reduction...

Validation of the Korean Version of the Scale for Outcomes in Parkinson’s Disease-Autonomic

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Ji-Young Kim

2017-01-01

Full Text Available Objective Autonomic symptoms are commonly observed in patients with Parkinson’s disease (PD and often limit the activities of daily living. The Scale for Outcomes in Parkinson’s disease-Autonomic (SCOPA-AUT was developed to evaluate and quantify autonomic symptoms in PD. The goal of this study was to translate the original SCOPA-AUT, which was written in English, into Korean and to evaluate its reliability and validity for Korean PD patients. Methods For the translation, the following processes were performed: forward translation, backward translation, expert review, pretest of the pre-final version and development of the final Korean version of SCOPA-AUT (K-SCOPA-AUT. In total, 127 patients with PD from 31 movement disorder clinics of university-affiliated hospitals in Korea were enrolled in this study. All patients were assessed using the K-SCOPA-AUT and other motor, non-motor, and quality of life scores. Test-retest reliability for the K-SCOPA-AUT was assessed over a time interval of 10−14 days. Results The internal consistency and reliability of the K-SCOPA-AUT was 0.727 as measured by the mean Cronbach’s α-coefficient. The test-retest correlation reliability was 0.859 by the Guttman split-half coefficient. The total K-SCOPA-AUT score showed a positive correlation with other non-motor symptoms [the Korean version of non-motor symptom scale (K-NMSS], activities of daily living (Unified Parkinson’s Disease Rating Scale part II and quality of life [the Korean version of Parkinson’s Disease Quality of Life 39 (K-PDQ39]. Conclusion The K-SCOPA-AUT had good reliability and validity for the assessment of autonomic dysfunction in Korean PD patients. Autonomic symptom severities were associated with many other motor and non-motor impairments and influenced quality of life.

Autonomous control of distributed storages in microgrids

DEFF Research Database (Denmark)

Loh, Poh Chiang; Blaabjerg, Frede

2011-01-01

Operation of distributed generators in microgrids has widely been discussed, but would not be fully autonomous, if distributed storages are not considered. Storages in general are important, since they provide energy buffering to load changes, energy leveling to source variations and ride......-through enhancement to the overall microgrids. Recognizing their importance, this paper presents a scheme for sharing power among multiple distributed storages, in coordination with the distributed sources and loads. The scheme prompts the storages to autonomously sense for system conditions, requesting for maximum...

PTSD and Sexual Dysfunction in Men and Women.

Science.gov (United States)

Yehuda, Rachel; Lehrner, Amy; Rosenbaum, Talli Y

2015-05-01

Difficulties in sexual desire and function often occur in persons with posttraumatic stress disorder (PTSD), but many questions remain regarding the mechanisms underlying the occurrence of sexual problems in PTSD. The aim of this review was to present a model of sexual dysfunction in PTSD underpinned by an inability to regulate and redirect the physiological arousal needed for healthy sexual function away from aversive hyperarousal and intrusive memories. A literature review pertaining to PTSD and sexual function was conducted. Evidence for the comorbidity of sexual dysfunction and PTSD is presented, and biological and psychological mechanisms that may underlie this co-occurrence are proposed. This manuscript presents evidence of sexual dysfunction in conjunction with PTSD, and of the neurobiology and neuroendocrinology of PTSD and sexual function. Sexual dysfunction following trauma exposure may be mediated by PTSD-related biological, cognitive, and affective processes. The treatment of PTSD must include attention to sexual dysfunction and vice versa. © 2015 International Society for Sexual Medicine.

Autonomic cardiac innervation

Science.gov (United States)

Hasan, Wohaib

2013-01-01

Autonomic cardiac neurons have a common origin in the neural crest but undergo distinct developmental differentiation as they mature toward their adult phenotype. Progenitor cells respond to repulsive cues during migration, followed by differentiation cues from paracrine sources that promote neurochemistry and differentiation. When autonomic axons start to innervate cardiac tissue, neurotrophic factors from vascular tissue are essential for maintenance of neurons before they reach their targets, upon which target-derived trophic factors take over final maturation, synaptic strength and postnatal survival. Although target-derived neurotrophins have a central role to play in development, alternative sources of neurotrophins may also modulate innervation. Both developing and adult sympathetic neurons express proNGF, and adult parasympathetic cardiac ganglion neurons also synthesize and release NGF. The physiological function of these “non-classical” cardiac sources of neurotrophins remains to be determined, especially in relation to autocrine/paracrine sustenance during development.   Cardiac autonomic nerves are closely spatially associated in cardiac plexuses, ganglia and pacemaker regions and so are sensitive to release of neurotransmitter, neuropeptides and trophic factors from adjacent nerves. As such, in many cardiac pathologies, it is an imbalance within the two arms of the autonomic system that is critical for disease progression. Although this crosstalk between sympathetic and parasympathetic nerves has been well established for adult nerves, it is unclear whether a degree of paracrine regulation occurs across the autonomic limbs during development. Aberrant nerve remodeling is a common occurrence in many adult cardiovascular pathologies, and the mechanisms regulating outgrowth or denervation are disparate. However, autonomic neurons display considerable plasticity in this regard with neurotrophins and inflammatory cytokines having a central regulatory

Experimental Autonomous Road Vehicle with Logical Artificial Intelligence

OpenAIRE

Sergey Sergeevich Shadrin; Oleg Olegovich Varlamov; Andrey Mikhailovich Ivanov

2017-01-01

This article describes some technical issues regarding the adaptation of a production car to a platform for the development and testing of autonomous driving technologies. A universal approach to performing the reverse engineering of electric power steering (EPS) for the purpose of external control is also presented. The primary objective of the related study was to solve the problem associated with the precise prediction of the dynamic trajectory of an autonomous vehicle. This was accomplish...

Sexual Dysfunction and Intimacy for Ostomates.

Science.gov (United States)

Albaugh, Jeffrey A; Tenfelde, Sandi; Hayden, Dana M

2017-07-01

Sex and intimacy presents special challenges for the ostomate. Since some colorectal surgery patients will require either temporary or permanent stomas, intimacy and sexuality is a common issue for ostomates. In addition to the stoma, nerve damage, radiotherapy, and chemotherapy are often used in conjunction with stoma creation for cancer patients, thereby adding physiological dysfunction to the personal psychological impact of the stoma, leading to sexual dysfunction. The purpose of this paper is to describe the prevalence, etiology, and the most common types of sexual dysfunction in men and women after colorectal surgery and particularly those patients with stomas. In addition, treatment strategies for sexual dysfunction will also be described.

Autonomous Vehicles Navigation with Visual Target Tracking: Technical Approaches

Directory of Open Access Journals (Sweden)

Zhen Jia

2008-12-01

Full Text Available This paper surveys the developments of last 10 years in the area of vision based target tracking for autonomous vehicles navigation. First, the motivations and applications of using vision based target tracking for autonomous vehicles navigation are presented in the introduction section. It can be concluded that it is very necessary to develop robust visual target tracking based navigation algorithms for the broad applications of autonomous vehicles. Then this paper reviews the recent techniques in three different categories: vision based target tracking for the applications of land, underwater and aerial vehicles navigation. Next, the increasing trends of using data fusion for visual target tracking based autonomous vehicles navigation are discussed. Through data fusion the tracking performance is improved and becomes more robust. Based on the review, the remaining research challenges are summarized and future research directions are investigated.

Xanthogranuloma of the intrasellar region presenting in pituitary dysfunction: a case report

Directory of Open Access Journals (Sweden)

Nishiuchi Takamasa

2012-04-01

Full Text Available Abstract Introduction Differentiation of cystic mass lesions of the sellar and parasellar regions may pose a diagnostic dilemma for physicians, neurosurgeons, radiologists and pathologists involved in treating patients with these entities. A considerable number of tumors previously identified as craniopharyngiomas may, in fact, have been xanthogranulomas. We report a case of pituitary dysfunction caused by xanthogranuloma of the intrasellar region. Case presentation A 47-year-old man of Japanese descent presented to our institution with a tumor located exclusively in the intrasellar region which manifested as severe hypopituitarism. MRI revealed a clearly defined intrasellar mass that was heterogeneously hyperintense on T1-weighted images and markedly hypointense on T2-weighted images. We preoperatively diagnosed the patient with Rathke's cleft cyst or non-functioning pituitary adenoma. Although the tumor was completely removed using a transsphenoidal approach, the improvement of the patient's endocrine function was marginal, and continued endocrine replacement therapy was needed. Postoperatively, a histological examination revealed the tumor to be a xanthogranuloma of the intrasellar region. His visual field defects and headache improved. Conclusion Because diagnosis depends on surgical intervention and xanthogranulomas of the intrasellar region are very rare, the natural history of xanthogranuloma is still unknown. Therefore, this entity is difficult to diagnose preoperatively. We suggest that xanthogranuloma should be included in the differential diagnosis, even in the case of sellar lesions, to formulate appropriate postoperative management and improve endocrine outcomes.

Progressive supranuclear palsy: neuronal and glial cytoskeletal pathology in the higher order processing autonomic nuclei of the lower brainstem.

Science.gov (United States)

Rüb, U; Del Tredici, K; Schultz, C; de Vos, R A I; Jansen Steur, E N H; Arai, K; Braak, H

2002-02-01

The medial and lateral parabrachial nuclei (MPB, LPB), the gigantocellular reticular nucleus (GI), the raphes magnus (RMG) and raphes obscurus nuclei (ROB), as well as the intermediate reticular zone (IRZ) represent pivotal subordinate brainstem centres, all of which control autonomic functions. In this study, we investigated the occurrence and severity of the neuronal and glial cytoskeletal pathology in these six brainstem nuclei from 17 individuals with clinically diagnosed and neuropathologically confirmed progressive supranuclear palsy (PSP). The association between the severity of the pathology and the duration of the disease was investigated by means of correlation analysis. The brainstem nuclei in all of the PSP cases were affected by the neuronal cytoskeletal pathology, with the IRZ and GI regularly showing severe involvement, the MPB, RMG, and ROB marked involvement, and the LPB mild involvement. In the six nuclear greys studied, glial cells undergo alterations of their cytoskeleton on an irregular basis, whereby diseased oligodendrocytes predominantly presented as coiled bodies and affected astrocytes as thorn-shaped astrocytes. In all six nuclei, the severity of the neuronal or glial cytoskeletal pathology showed no correlation with the duration of PSP. In view of their functional role, the neuronal pathology in the nuclei studied offers a possible explanation for the autonomic dysfunctions that eventually develop in the course of PSP.

Health, autonomic financing and transferences

Directory of Open Access Journals (Sweden)

David Cantarero Prieto

2002-01-01

Full Text Available The present paper has as objective to study the whole relative problem to the autonomous communities and regional heath care expenditure financing in Spain. This article has a dual purpose. First, the financing of the current health care attendance is approached in the Spanish regions passing magazine to its possible variants and we observe that the balance of our system is clearly inclined towards the side of the integration in the general pattern of financing («Fiscal Room» with specific conditions («Mixed System». Secondly, we examine the new situation in the mark of health care and its corresponding financing in the new model approved in 2001, in terms of the effects of tax assignment on autonomous communities.

The sympathetic skin response in diabetic neuropathy and its relationship to autonomic symptoms

International Nuclear Information System (INIS)

Al-Moallem, Mansour A.; Zaidan, Radwan M.; Alkali, Nura H.

2008-01-01

Objective was to examine the utility of the sympathetic skin response (SSR) as a measure of impaired autonomic function among diabetic patients in Saudi Arabia. In this case-control study, baseline SSR was obtained from 18 healthy subjects, followed by nerve conduction studies and SSR testing on a consecutive cohort of 50 diabetic patients with peripheral neuropathy. The SSR in diabetic patients was compared between those with autonomic neuropathy and those without autonomic neuropathy. This study was conducted at the King Khalid University Hospital, Riyadh, Saudi Arabia, from June 2006 to June 2007. The SSR was present in all healthy subjects and in 32 diabetic patients. Among 16 patients with autonomic neuropathy, the SSR was absent in 14 and present in 2, while 4 of 34 patients lacking evidence of autonomic neuropathy had absent SSR. Using Fisher's exact test, we found a strong association between absent SSR and autonomic neuropathy (p<0.001), however, not with age or duration of diabetes mellitus. As a diagnostic test of autonomic neuropathy, the SSR had a sensitivity of 87.5%, a specificity of 88.2%, a positive predictive value of 77.8%, and a negative predictive value of 93.7%. Absence of the SSR is a reliable indicator of autonomic neuropathy among patients with diabetes mellitus in Saudi Arabia. (author)

Neural network regulation driven by autonomous neural firings

Science.gov (United States)

Cho, Myoung Won

2016-07-01

Biological neurons naturally fire spontaneously due to the existence of a noisy current. Such autonomous firings may provide a driving force for network formation because synaptic connections can be modified due to neural firings. Here, we study the effect of autonomous firings on network formation. For the temporally asymmetric Hebbian learning, bidirectional connections lose their balance easily and become unidirectional ones. Defining the difference between reciprocal connections as new variables, we could express the learning dynamics as if Ising model spins interact with each other in magnetism. We present a theoretical method to estimate the interaction between the new variables in a neural system. We apply the method to some network systems and find some tendencies of autonomous neural network regulation.

Toward autonomous spacecraft

Science.gov (United States)

Fogel, L. J.; Calabrese, P. G.; Walsh, M. J.; Owens, A. J.

1982-01-01

Ways in which autonomous behavior of spacecraft can be extended to treat situations wherein a closed loop control by a human may not be appropriate or even possible are explored. Predictive models that minimize mean least squared error and arbitrary cost functions are discussed. A methodology for extracting cyclic components for an arbitrary environment with respect to usual and arbitrary criteria is developed. An approach to prediction and control based on evolutionary programming is outlined. A computer program capable of predicting time series is presented. A design of a control system for a robotic dense with partially unknown physical properties is presented.

12th International Conference on Intelligent Autonomous Systems (IAS-12)

CERN Document Server

Yoon, Kwang-Joon; Lee, Jangmyung; Frontiers of Intelligent Autonomous Systems

2013-01-01

This carefully edited volume aims at providing readers with the most recent progress on intelligent autonomous systems, with its particular emphasis on intelligent autonomous ground, aerial and underwater vehicles as well as service robots for home and healthcare under the context of the aforementioned convergence. “Frontiers of Intelligent Autonomous Systems” includes thoroughly revised and extended papers selected from the 12th International Conference on Intelligent Autonomous Systems (IAS-12), held in Jeju, Korea, June 26-29, 2012. The editors chose 35 papers out of the 202 papers presented at IAS-12 which are organized into three chapters: Chapter 1 is dedicated to autonomous navigation and mobile manipulation, Chapter 2 to unmanned aerial and underwater vehicles and Chapter 3 to service robots for home and healthcare. To help the readers to easily access this volume, each chapter starts with a chapter summary introduced by one of the editors: Chapter 1 by Sukhan Lee, Chapter 2 by Kwang Joon Yoon and...

Autonomic computing enabled cooperative networked design

CERN Document Server

Wodczak, Michal

2014-01-01

This book introduces the concept of autonomic computing driven cooperative networked system design from an architectural perspective. As such it leverages and capitalises on the relevant advancements in both the realms of autonomic computing and networking by welding them closely together. In particular, a multi-faceted Autonomic Cooperative System Architectural Model is defined which incorporates the notion of Autonomic Cooperative Behaviour being orchestrated by the Autonomic Cooperative Networking Protocol of a cross-layer nature. The overall proposed solution not only advocates for the inc

Negotiating the Traffic: Can Cognitive Science Help Make Autonomous Vehicles a Reality?

Science.gov (United States)

Chater, Nick; Misyak, Jennifer; Watson, Derrick; Griffiths, Nathan; Mouzakitis, Alex

2018-02-01

To drive safely among human drivers, cyclists and pedestrians, autonomous vehicles will need to mimic, or ideally improve upon, humanlike driving. Yet, driving presents us with difficult problems of joint action: 'negotiating' with other users over shared road space. We argue that autonomous driving provides a test case for computational theories of social interaction, with fundamental implications for the development of autonomous vehicles. Copyright © 2017 Elsevier Ltd. All rights reserved.

Reliable and Efficient Autonomous Driving: the Need for Heterogeneous Vehicular Networks

OpenAIRE

Zheng, Kan; Zheng, Qiang; Yang, Haojun; Zhao, Long; Hou, Lu; Chatzimisios, Periklis

2015-01-01

Autonomous driving technology has been regarded as a promising solution to reduce road accidents and traffic congestion, as well as to optimize the usage of fuel and lane. Reliable and high efficient Vehicle-to-Vehicle (V2V) and Vehicle-to-Infrastructure (V2I) communications are essential to let commercial autonomous driving vehicles be on the road before 2020. The current paper firstly presents the concept of Heterogeneous Vehicular NETworks (HetVNETs) for autonomous driving, in which an imp...

Knowledge-based and integrated monitoring and diagnosis in autonomous power systems

Science.gov (United States)

Momoh, J. A.; Zhang, Z. Z.

1990-01-01

A new technique of knowledge-based and integrated monitoring and diagnosis (KBIMD) to deal with abnormalities and incipient or potential failures in autonomous power systems is presented. The KBIMD conception is discussed as a new function of autonomous power system automation. Available diagnostic modelling, system structure, principles and strategies are suggested. In order to verify the feasibility of the KBIMD, a preliminary prototype expert system is designed to simulate the KBIMD function in a main electric network of the autonomous power system.

Herpes zoster producing temporary erectile dysfunction.

Science.gov (United States)

Rix, G H; Carroll, D N; MacFarlane, J R

2001-12-01

Varicella Zoster affecting the sacral dermatomes is a rare but well recognised cause of urinary retention. Only one case of erectile dysfunction associated with Varicella Zoster has previously been described, which was longstanding, but no cases of transient erectile dysfunction following Zoster infection are recorded. We present one such case.

High-frequency autonomic modulation: a new model for analysis of autonomic cardiac control.

Science.gov (United States)

Champéroux, Pascal; Fesler, Pierre; Judé, Sebastien; Richard, Serge; Le Guennec, Jean-Yves; Thireau, Jérôme

2018-05-03

Increase in high-frequency beat-to-beat heart rate oscillations by torsadogenic hERG blockers appears to be associated with signs of parasympathetic and sympathetic co-activation which cannot be assessed directly using classic methods of heart rate variability analysis. The present work aimed to find a translational model that would allow this particular state of the autonomic control of heart rate to be assessed. High-frequency heart rate and heart period oscillations were analysed within discrete 10 s intervals in a cohort of 200 healthy human subjects. Results were compared to data collected in non-human primates and beagle dogs during pharmacological challenges and torsadogenic hERG blockers exposure, in 127 genotyped LQT1 patients on/off β-blocker treatment and in subgroups of smoking and non-smoking subjects. Three states of autonomic modulation, S1 (parasympathetic predominance) to S3 (reciprocal parasympathetic withdrawal/sympathetic activation), were differentiated to build a new model of heart rate variability referred to as high-frequency autonomic modulation. The S2 state corresponded to a specific state during which both parasympathetic and sympathetic systems were coexisting or co-activated. S2 oscillations were proportionally increased by torsadogenic hERG-blocking drugs, whereas smoking caused an increase in S3 oscillations. The combined analysis of the magnitude of high-frequency heart rate and high-frequency heart period oscillations allows a refined assessment of heart rate autonomic modulation applicable to long-term ECG recordings and offers new approaches to assessment of the risk of sudden death both in terms of underlying mechanisms and sensitivity. © 2018 The Authors. British Journal of Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society.

Gastroparesis is associated with oxytocin deficiency, oesophageal dysmotility with hyperCCKemia, and autonomic neuropathy with hypergastrinemia

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Uvnäs-Moberg Kerstin

2009-02-01

Full Text Available Abstract Background Gastrointestinal (GI dysmotility and autonomic neuropathy are common problems among diabetics with largely unknown aetiology. Many peptides are involved in the autonomic nervous system regulating the GI tract. The aim of this study was to examine if concentrations of oxytocin, cholecystokinin (CCK, gastrin and vasopressin in plasma differ between diabetics with normal function and dysfunction in GI motility. Methods Nineteen patients with symptoms from the GI tract who had been examined with gastric emptying scintigraphy, oesophageal manometry, and deep-breathing test were included. They further received a fat-rich meal, after which blood samples were collected and plasma frozen until analysed for hormonal concentrations. Results There was an increase in postprandial oxytocin plasma concentration in the group with normal gastric emptying (p = 0.015 whereas subjects with delayed gastric emptying had no increased oxytocin secretion (p = 0.114. Both CCK and gastrin levels increased after the meal, with no differences between subjects with normal respective delayed gastric emptying. The concentration of vasopressin did not increase after the meal. In patients with oesophageal dysmotility the basal level of CCK tended to be higher (p = 0.051 and those with autonomic neuropathy had a higher area under the curve (AUC of gastrin compared to normal subjects (p = 0.007. Conclusion Reduced postprandial secretion of oxytocin was found in patients with delayed gastric emptying, CCK secretion was increased in patients with oesophageal dysmotility, and gastrin secretion was increased in patients with autonomic neuropathy. The findings suggest that disturbed peptide secretion may be part of the pathophysiology of digestive complications in diabetics.

Recent Advances in Bathymetric Surveying of Continental Shelf Regions Using Autonomous Vehicles

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Holland, K. T.; Calantoni, J.; Slocum, D.

2016-02-01

Obtaining bathymetric observations within the continental shelf in areas closer to the shore is often time consuming and dangerous, especially when uncharted shoals and rocks present safety concerns to survey ships and launches. However, surveys in these regions are critically important to numerical simulation of oceanographic processes, as bathymetry serves as the bottom boundary condition in operational forecasting models. We will present recent progress in bathymetric surveying using both traditional vessels retrofitted for autonomous operations and relatively inexpensive, small team deployable, Autonomous Underwater Vehicles (AUV). Both systems include either high-resolution multibeam echo sounders or interferometric sidescan sonar sensors with integrated inertial navigation system capabilities consistent with present commercial-grade survey operations. The advantages and limitations of these two configurations employing both unmanned and autonomous strategies are compared using results from several recent survey operations. We will demonstrate how sensor data collected from unmanned platforms can augment or even replace traditional data collection technologies. Oceanographic observations (e.g., sound speed, temperature and currents) collected simultaneously with bathymetry using autonomous technologies provide additional opportunities for advanced data assimilation in numerical forecasts. Discussion focuses on our vision for unmanned and autonomous systems working in conjunction with manned or in-situ systems to optimally and simultaneously collect data in environmentally hostile or difficult to reach areas.

Autonomic and Vascular Control in Prehypertensive Subjects with a Family History of Arterial Hypertension

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Josária Ferraz Amaral

2018-02-01

Full Text Available Abstract Background: Individuals with a family history of systemic arterial hypertension (FHSAH and / or prehypertension have a higher risk of developing this pathology. Objective: To evaluate the autonomic and vascular functions of prehypertensive patients with FHSAH. Methods: Twenty-five young volunteers with FHSAH, 14 normotensive and 11 prehypertensive subjects were submitted to vascular function evaluation by forearm vascular conductance(VC during resting and reactive hyperemia (Hokanson® and cardiac and peripheral autonomic modulation, quantified, respectively, by spectral analysis of heart rate (ECG and systolic blood pressure (SBP (FinometerPRO®. The transfer function analysis was used to measure the gain and response time of baroreflex. The statistical significance adopted was p ≤ 0.05. Results: Pre-hypertensive individuals, in relation to normotensive individuals, have higher VC both at rest (3.48 ± 1.26 vs. 2.67 ± 0.72 units, p = 0.05 and peak reactive hyperemia (25, 02 ± 8.18 vs. 18.66 ± 6.07 units, p = 0.04. The indices of cardiac autonomic modulation were similar between the groups. However, in the peripheral autonomic modulation, greater variability was observed in prehypertensive patients compared to normotensive individuals (9.4 [4.9-12.7] vs. 18.3 [14.8-26.7] mmHg2; p < 0.01 and higher spectral components of very low (6.9 [2.0-11.1] vs. 13.5 [10.7-22.4] mmHg2, p = 0.01 and low frequencies (1.7 [1.0-3.0] vs. 3.0 [2.0-4.0] mmHg2, p = 0.04 of SBP. Additionally, we observed a lower gain of baroreflex control in prehypertensive patients compared to normotensive patients (12.16 ± 4.18 vs. 18.23 ± 7.11 ms/mmHg, p = 0.03, but similar delay time (-1.55 ± 0.66 vs. -1.58 ± 0.72 s, p = 0.90. Conclusion: Prehypertensive patients with FHSAH have autonomic dysfunction and increased vascular conductance when compared to normotensive patients with the same risk factor.

The Impact of Early Life Stress on Growth and Cardiovascular Risk: A Possible Example for Autonomic Imprinting?

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Buchhorn, Reiner; Meint, Sebastian; Willaschek, Christian

2016-01-01

Early life stress is imprinting regulatory properties with life-long consequences. We investigated heart rate variability in a group of small children with height below the third percentile, who experienced an episode of early life stress due to heart failure or intra uterine growth retardation. These children appear to develop autonomic dysfunction in later life. Compared to the healthy control group heart rate variability (HRV) is reduced on average in a group of 101 children with short stature. Low HRV correlates to groups of children born small for gestational age (SGA), children with cardiac growth failure and children with congenital syndromes, but not to those with constitutional growth delay (CGD), who had normal HRV. Reduced HRV indicated by lower RMSSD and High Frequency (HF)-Power is indicating reduced vagal activity as a sign of autonomic imbalance. It is not short stature itself, but rather the underlying diseases that are the cause for reduced HRV in children with height below the third percentile. These high risk children-allocated in the groups with an adverse autonomic imprinting in utero or infancy (SGA, congenital heart disease and congenital syndromes)-have the highest risk for 'stress diseases' such as cardiovascular disease in later life. The incidence of attention deficit disorder is remarkably high in our group of short children.

Flocking algorithm for autonomous flying robots.

Science.gov (United States)

Virágh, Csaba; Vásárhelyi, Gábor; Tarcai, Norbert; Szörényi, Tamás; Somorjai, Gergő; Nepusz, Tamás; Vicsek, Tamás

2014-06-01

Animal swarms displaying a variety of typical flocking patterns would not exist without the underlying safe, optimal and stable dynamics of the individuals. The emergence of these universal patterns can be efficiently reconstructed with agent-based models. If we want to reproduce these patterns with artificial systems, such as autonomous aerial robots, agent-based models can also be used in their control algorithms. However, finding the proper algorithms and thus understanding the essential characteristics of the emergent collective behaviour requires thorough and realistic modeling of the robot and also the environment. In this paper, we first present an abstract mathematical model of an autonomous flying robot. The model takes into account several realistic features, such as time delay and locality of communication, inaccuracy of the on-board sensors and inertial effects. We present two decentralized control algorithms. One is based on a simple self-propelled flocking model of animal collective motion, the other is a collective target tracking algorithm. Both algorithms contain a viscous friction-like term, which aligns the velocities of neighbouring agents parallel to each other. We show that this term can be essential for reducing the inherent instabilities of such a noisy and delayed realistic system. We discuss simulation results on the stability of the control algorithms, and perform real experiments to show the applicability of the algorithms on a group of autonomous quadcopters. In our case, bio-inspiration works in two ways. On the one hand, the whole idea of trying to build and control a swarm of robots comes from the observation that birds tend to flock to optimize their behaviour as a group. On the other hand, by using a realistic simulation framework and studying the group behaviour of autonomous robots we can learn about the major factors influencing the flight of bird flocks.

Autonomous teamwork and psychological well-being

NARCIS (Netherlands)

Mierlo, van H.; Rutte, C.G.; Seinen, B.; Kompier, M.A.J.

2001-01-01

Few studies investigated the assumed positive effects of autonomous groups on individual psychological well-being. In the present study we investigated the hypotheses that (1) group autonomy is positively related to psychological well-being, (2) this relationship is mediated by individual autonomy,

Autonomic Nervous System Responses to Concussion: Arterial Pulse Contour Analysis

Directory of Open Access Journals (Sweden)

Michael F La Fountaine

2016-02-01

Full Text Available The arterial pulse wave (APW has a distinct morphology whose contours reflect dynamics in cardiac function and peripheral vascular tone as a result of sympathetic nervous system (SNS control. With a transition from rest to increased metabolic demand, the expected augmentation of SNS outflow will not only affect arterial blood pressure and heart rate, it will also induce changes to the contours of the APW. Following a sports concussion, a transient state cardiovascular autonomic dysfunction is present. How this state affects the APW, has yet to be described. A prospective, parallel-group study on cardiovascular autonomic control (i.e., digital electrocardiogram and continuous beat-to-beat blood pressure was performed in the seated upright position in ten athletes with concussion and 7 non-injured control athletes. Changes in APW were compared at rest and during the first 60 seconds (F60 of an isometric handgrip test (IHGT in concussed athletes and non-injured controls within 48 hours (48hr and 1 week (1wk of injury. The concussion group was further separated by the length of time until they were permitted to return to play (RTP>1wk; RTP≤1wk. SysSlope, an indirect measurement of stroke volume, was significantly lower in the concussion group at rest and during F60 at 48hr and 1wk; a paradoxical decline in SysSlope occurred at each visit during the transition from rest to IHGT F60. The RTP>1wk group had lower SysSlope (405±200; 420±88; 454±236 mmHg/s, respectively at rest 48hr compared to the RTP≤1wk and controls. Similarly at 48hr rest, several measurements of arterial stiffness were abnormal in RTP>1wk compared to RTP≤1wk and controls: Peak-to-Notch Latency (0.12±0.04; 0.16±0.02; 0.17±0.05, respectively, Notch Relative Amplitude (0.70±0.03; 0.71±0.04; 0.66±0.14, respectively and Stiffness Index (6.4±0.2; 5.7±0.4; 5.8±0.5, respectively. Use of APW revealed that concussed athletes have a transient increase in peripheral artery

Are Turkish University Students Autonomous or Not?

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Büşra Kırtık

2017-01-01

Full Text Available The present study tried to determine Turkish learners’ attitudes, and the Turkish education system’s approach towards learner autonomy with regard to three main points: 1 whether Turkish university students are aware of learner autonomy or not 2 whether Turkish university students have the characteristics of autonomous learners (whether they are autonomous learners or not, and 3 if the Turkish education system is suitable for fostering learner autonomy or not from the viewpoint of the participants. Participants were 50 second grade learners in the English Language Teaching Departments of Hacettepe University (N=10, Mehmet Akif Ersoy University (N=10, and Uludag University (N=30 who had already taken courses about learner autonomy.  The data were collected by means of a questionnaire which had two Likert-scale sections and an open-ended questions section. The first Likert-scale section contained 15 characteristics of autonomous learners each of which was rated by the participants in a scale from strongly disagree to agree, from 1 to 5. In the second Likert-scale section, the participants were asked to rate the Turkish education system’s five basic elements such as school curriculums, course materials, approaches used by the teachers in classrooms, learning activities, and classroom settings. Additionally, learners’ opinions about their awareness and understanding of learner autonomy were gathered by five open ended questions. The results proposed that the participants were aware of learner autonomy, and had the characteristics of autonomous learners. On the other hand, results showed that the Turkish education system was not suitable for autonomous learners and did not foster learner autonomy. The findings suggested that the Turkish education system should be designed again in such a way to support the autonomous learners and to foster learner autonomy in all sections of the education.

Autonomous Electrical Vehicles’ Charging Station

OpenAIRE

Józef Paska; Mariusz Kłos; Łukasz Rosłaniec; Rafał Bielas; Magdalena Błędzińska

2016-01-01

This paper presents a model of an autonomous electrical vehicles’ charging station. It consists of renewable energy sources: wind turbine system, photovoltaic cells, as well as an energy storage, load, and EV charging station. In order to optimise the operating conditions, power electronic converters were added to the system. The model was implemented in the Homer Energy programme. The first part of the paper presents the design assumptions and technological solutions. Further in the paper...

Autonomous Motivation and Fruit/Vegetable Intake in Parent–Adolescent Dyads

Science.gov (United States)

Dwyer, Laura A.; Bolger, Niall; Laurenceau, Jean-Philippe; Patrick, Heather; Oh, April Y.; Nebeling, Linda C.; Hennessy, Erin

2017-01-01

Introduction Autonomous motivation (motivation to engage in a behavior because of personal choice, interest, or value) is often associated with health behaviors. The present study contributes to research on motivation and eating behaviors by examining: (1) how autonomous motivation is correlated within parent–adolescent dyads; and (2) whether parent- and adolescent-reported autonomous motivation predicts the parent–adolescent correlation in fruit and vegetable (FV) intake frequency. Methods Data were drawn from the Family Life, Activity, Sun, Health, and Eating (FLASHE) Study, a cross-sectional U.S. survey of parent–adolescent dyads led by the National Cancer Institute and fielded between April and October 2014. In 2016, data were analyzed from dyads who had responses on a six-item self-report measure of daily frequency of FV consumption and a two-item self-report measure of autonomous motivation for consuming FVs. Results Parents' and adolescents' reports of autonomous motivation and FV intake frequency were positively correlated. Both parents' and adolescents' autonomous motivation predicted higher levels of their own FV intake frequency and that of their dyad partner (p-values ≤0.001). These effects of autonomous motivation explained 22.6% of the parent–adolescent correlation in FV intake frequency. Actor effects (one's motivation predicting their own FV intake frequency) were stronger than partner effects (one's motivation predicting their partner's FV intake frequency). Conclusions Parent–adolescent similarity in autonomous motivation for healthy eating may contribute to similarity in eating behaviors. Future research should further examine how individual-level health behavior correlates influence health behaviors within dyads. PMID:28526363

Autonomous Motivation and Fruit/Vegetable Intake in Parent-Adolescent Dyads.

Science.gov (United States)

Dwyer, Laura A; Bolger, Niall; Laurenceau, Jean-Philippe; Patrick, Heather; Oh, April Y; Nebeling, Linda C; Hennessy, Erin

2017-06-01

Autonomous motivation (motivation to engage in a behavior because of personal choice, interest, or value) is often associated with health behaviors. The present study contributes to research on motivation and eating behaviors by examining (1) how autonomous motivation is correlated within parent-adolescent dyads and (2) whether parent- and adolescent-reported autonomous motivation predicts the parent-adolescent correlation in fruit and vegetable (FV) intake frequency. Data were drawn from the Family Life, Activity, Sun, Health, and Eating (FLASHE) Study, a cross-sectional U.S. survey of parent-adolescent dyads led by the National Cancer Institute and fielded between April and October 2014. In 2016, data were analyzed from dyads who had responses on a six-item self-report measure of daily frequency of FV consumption and a two-item self-report measure of autonomous motivation for consuming FVs. Parents' and adolescents' reports of autonomous motivation and FV intake frequency were positively correlated. Both parents' and adolescents' autonomous motivation predicted higher levels of their own FV intake frequency and that of their dyad partner (p-values ≤0.001). These effects of autonomous motivation explained 22.6% of the parent-adolescent correlation in FV intake frequency. Actor effects (one's motivation predicting their own FV intake frequency) were stronger than partner effects (one's motivation predicting their partner's FV intake frequency). Parent-adolescent similarity in autonomous motivation for healthy eating may contribute to similarity in eating behaviors. Future research should further examine how individual-level health behavior correlates influence health behaviors within dyads. Published by Elsevier Inc.

Framing the ultimatum game: gender differences and autonomic responses.

Science.gov (United States)

Sarlo, Michela; Lotto, Lorella; Palomba, Daniela; Scozzari, Simona; Rumiati, Rino

2013-01-01

The present study aimed at investigating whether the way offers are framed in the Ultimatum Game (UG) affects behavioral and autonomic responses in men and women. The "I give you" and "I take" expressions were used as gain and loss frames, respectively. Skin conductance and heart rate were recorded as indices of autonomic activation in response to unfair, mid-value, and fair offers. Acceptance rates were higher in men than in women under the gain frame. Moreover, men showed higher acceptance rates under the gain than under the loss frame with mid-value offers, whereas women's choices were not affected by frame. On the physiological level, men produced differential autonomic response patterns during decision-making when offers were presented under gain and loss framing. The "I take" frame, by acting as a loss frame, elicited in men the characteristic defensive response pattern that is evoked by aversive stimulation, in which increases in skin conductance are coupled with increases in heart rate. On the other hand, the "I give you" frame, by acting as a gain frame, elicited in men increases in skin conductance associated with prevailing heart rate deceleratory responses, reflecting a state of enhanced attention and orienting. In contrast, women's autonomic reactivity was not affected by frame, consistent with behavioral results. Phasic changes in heart rate were crucial in revealing differential functional significance of skin conductance responses under different frames in men, thus questioning the assumption that this autonomic measure can be used as an index of negative emotional arousal in the UG.

Acute urinary retention in a young man secondary to colonic irrigation: a case report

Directory of Open Access Journals (Sweden)

Raheem Omer A

2009-06-01

Full Text Available Abstract Introduction Autonomic innervation of the bladder is complex and regulated by a hierarchy of mechanisms of the central nervous system. Any dysfunction in these regulatory mechanisms can lead to acute urinary retention. Case presentation A 36-year-old Caucasian man presented with acute urinary retention following extensive bowel irrigation. His urinary bladder was decompressed and his normal voiding mechanism was restored thereafter. Conclusion We postulate that prolonged anorectal and sigmoid dilatation can stimulate the recto-vesicourethral reflex and lead to acute urinary retention via autonomic dysfunction.

Autonomous authority in relation to the staff regulations of autonomous parliaments

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Rafael Cano Silva

2018-04-01

Full Text Available The statutes of Autonomous Parliaments are parliamentary administrative norms approved by each legislative chamber by virtue of their parliamentary autonomy. However, the parliamentary autonomy of each autonomous parliament does not have the same normative aspect for these purposes. It is studied in this article as despite having the Constitution as a common element, it is essential the special attribution that each autonomous chamber has and that the jurisprudence, both of the Constitutional Court, and that of the Supreme Court, has put in value, question that is included in the section related to the jurisprudence. In conclusion, the bureaucratic organization, in what refers to personal media, may be substantially different in each one of the legislative assemblies, as analyzed in the conclusions of this study.

A Briefing on Metrics and Risks for Autonomous Decision-Making in Aerospace Applications

Science.gov (United States)

Frost, Susan; Goebel, Kai Frank; Galvan, Jose Ramon

2012-01-01

Significant technology advances will enable future aerospace systems to safely and reliably make decisions autonomously, or without human interaction. The decision-making may result in actions that enable an aircraft or spacecraft in an off-nominal state or with slightly degraded components to achieve mission performance and safety goals while reducing or avoiding damage to the aircraft or spacecraft. Some key technology enablers for autonomous decision-making include: a continuous state awareness through the maturation of the prognostics health management field, novel sensor development, and the considerable gains made in computation power and data processing bandwidth versus system size. Sophisticated algorithms and physics based models coupled with these technological advances allow reliable assessment of a system, subsystem, or components. Decisions that balance mission objectives and constraints with remaining useful life predictions can be made autonomously to maintain safety requirements, optimal performance, and ensure mission objectives. This autonomous approach to decision-making will come with new risks and benefits, some of which will be examined in this paper. To start, an account of previous work to categorize or quantify autonomy in aerospace systems will be presented. In addition, a survey of perceived risks in autonomous decision-making in the context of piloted aircraft and remotely piloted or completely autonomous unmanned autonomous systems (UAS) will be presented based on interviews that were conducted with individuals from industry, academia, and government.

Diaphragm Dysfunction in Critical Illness.

Science.gov (United States)

Supinski, Gerald S; Morris, Peter E; Dhar, Sanjay; Callahan, Leigh Ann

2018-04-01

The diaphragm is the major muscle of inspiration, and its function is critical for optimal respiration. Diaphragmatic failure has long been recognized as a major contributor to death in a variety of systemic neuromuscular disorders. More recently, it is increasingly apparent that diaphragm dysfunction is present in a high percentage of critically ill patients and is associated with increased morbidity and mortality. In these patients, diaphragm weakness is thought to develop from disuse secondary to ventilator-induced diaphragm inactivity and as a consequence of the effects of systemic inflammation, including sepsis. This form of critical illness-acquired diaphragm dysfunction impairs the ability of the respiratory pump to compensate for an increased respiratory workload due to lung injury and fluid overload, leading to sustained respiratory failure and death. This review examines the presentation, causes, consequences, diagnosis, and treatment of disorders that result in acquired diaphragm dysfunction during critical illness. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Sensing and control for autonomous vehicles applications to land, water and air vehicles

CERN Document Server

Pettersen, Kristin; Nijmeijer, Henk

2017-01-01

This edited volume includes thoroughly collected on sensing and control for autonomous vehicles. Guidance, navigation and motion control systems for autonomous vehicles are increasingly important in land-based, marine and aerial operations. Autonomous underwater vehicles may be used for pipeline inspection, light intervention work, underwater survey and collection of oceanographic/biological data. Autonomous unmanned aerial systems can be used in a large number of applications such as inspection, monitoring, data collection, surveillance, etc. At present, vehicles operate with limited autonomy and a minimum of intelligence. There is a growing interest for cooperative and coordinated multi-vehicle systems, real-time re-planning, robust autonomous navigation systems and robust autonomous control of vehicles. Unmanned vehicles with high levels of autonomy may be used for safe and efficient collection of environmental data, for assimilation of climate and environmental models and to complement global satellite sy...

An Investigation of the Relationship between Autonomous Learning and Lifelong Learning

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Cengiz Yurdakul

2016-12-01

Full Text Available The present study aims to investigate the relationship between autonomous learning and lifelong learning. The study group consists of 657 secondary school students enrolled in three public schools, aged 11 – 16 from Sakarya, Turkey. In this study, relationships between the variables of autonomous learning and lifelong learning and the sub-dimensions of autonomous learning were investigated. Pearson Product Moment Correlation, Partial Correlation methods were utilized in order to investigate these relationships. Autonomous Learning Scale (12 items which was developed by Macaskill and Taylor (2010, was adapted to Turkish by Arslan and Yurdakul (2015 was conducted to measure autonomous learning. Lifelong Learning Scale (14 items which was developed by Kirby, Knapper, Lamon and Egnatoff (2010, was adapted to Turkish by Arslan and Akcaalan (2015 was carried out to assess lifelong learning level. In the light of the research findings, it can be purported that autonomous learning and lifelong learning scores were correlating significantly. According to the existing results, it can be argued that autonomous learning which can be defined as the capacity to take charge of one’s own learning, has a positive interaction with lifelong learning which can be found voice in one’s ongoing, voluntary, and self-motivated learning.

Formal Verification of Autonomous Vehicle Platooning

OpenAIRE

Kamali, Maryam; Dennis, Louise A.; McAree, Owen; Fisher, Michael; Veres, Sandor M.

2016-01-01

The coordination of multiple autonomous vehicles into convoys or platoons is expected on our highways in the near future. However, before such platoons can be deployed, the new autonomous behaviors of the vehicles in these platoons must be certified. An appropriate representation for vehicle platooning is as a multi-agent system in which each agent captures the "autonomous decisions" carried out by each vehicle. In order to ensure that these autonomous decision-making agents in vehicle platoo...

Autonomous Landing on Moving Platforms

KAUST Repository

Mendoza Chavez, Gilberto

2016-08-01

This thesis investigates autonomous landing of a micro air vehicle (MAV) on a nonstationary ground platform. Unmanned aerial vehicles (UAVs) and micro air vehicles (MAVs) are becoming every day more ubiquitous. Nonetheless, many applications still require specialized human pilots or supervisors. Current research is focusing on augmenting the scope of tasks that these vehicles are able to accomplish autonomously. Precise autonomous landing on moving platforms is essential for self-deployment and recovery of MAVs, but it remains a challenging task for both autonomous and piloted vehicles. Model Predictive Control (MPC) is a widely used and effective scheme to control constrained systems. One of its variants, output-feedback tube-based MPC, ensures robust stability for systems with bounded disturbances under system state reconstruction. This thesis proposes a MAV control strategy based on this variant of MPC to perform rapid and precise autonomous landing on moving targets whose nominal (uncommitted) trajectory and velocity are slowly varying. The proposed approach is demonstrated on an experimental setup.

Advances in Autonomous Systems for Missions of Space Exploration

Science.gov (United States)

Gross, A. R.; Smith, B. D.; Briggs, G. A.; Hieronymus, J.; Clancy, D. J.

applications. One notable example of such missions are those to explore for the existence of water on planets such as Mars and the moons of Jupiter. It is clear that water does not exist on the surfaces of such bodies, but may well be located at some considerable depth below the surface, thus requiring a subsurface drilling capability. Subsurface drilling on planetary surfaces will require a robust autonomous control and analysis system, currently a major challenge, but within conceivable reach of planned technology developments. This paper will focus on new and innovative software for remote, autonomous, space systems flight operations, including flight test results, lessons learned, and implications for the future. An additional focus will be on technologies for planetary exploration using autonomous systems and astronaut-assistance systems that employ new spoken language technology. Topics to be presented will include a description of key autonomous control concepts, illustrated by the Remote Agent program that commanded the Deep Space 1 spacecraft to new levels of system autonomy, recent advances in distributed autonomous system capabilities, and concepts for autonomous vehicle health management systems. A brief description of teaming spacecraft and rovers for complex exploration missions will also be provided. New software for autonomous science data acquisition for planetary exploration will also be described, as well as advanced systems for safe planetary landings. Current results of autonomous planetary drilling system research will be presented. A key thrust within NASA is to develop technologies that will leverage the capabilities of human astronauts during planetary surface explorations. One such technology is spoken dialogue interfaces, which would allow collaboration with semi-autonomous agents that are engaged in activities that are normally accomplished using language, e.g., astronauts in space suits interacting with groups of semi-autonomous rovers and other

Autonomous Spacecraft Communication Interface for Load Planning

Science.gov (United States)

Dever, Timothy P.; May, Ryan D.; Morris, Paul H.

2014-01-01

Ground-based controllers can remain in continuous communication with spacecraft in low Earth orbit (LEO) with near-instantaneous communication speeds. This permits near real-time control of all of the core spacecraft systems by ground personnel. However, as NASA missions move beyond LEO, light-time communication delay issues, such as time lag and low bandwidth, will prohibit this type of operation. As missions become more distant, autonomous control of manned spacecraft will be required. The focus of this paper is the power subsystem. For present missions, controllers on the ground develop a complete schedule of power usage for all spacecraft components. This paper presents work currently underway at NASA to develop an architecture for an autonomous spacecraft, and focuses on the development of communication between the Mission Manager and the Autonomous Power Controller. These two systems must work together in order to plan future load use and respond to unanticipated plan deviations. Using a nominal spacecraft architecture and prototype versions of these two key components, a number of simulations are run under a variety of operational conditions, enabling development of content and format of the messages necessary to achieve the desired goals. The goals include negotiation of a load schedule that meets the global requirements (contained in the Mission Manager) and local power system requirements (contained in the Autonomous Power Controller), and communication of off-plan disturbances that arise while executing a negotiated plan. The message content is developed in two steps: first, a set of rapid-prototyping "paper" simulations are preformed; then the resultant optimized messages are codified for computer communication for use in automated testing.

Influence of hydrotherapy on clinical and cardiac autonomic function in migraine patients.

Science.gov (United States)

Sujan, M U; Rao, M Raghavendra; Kisan, Ravikiran; Abhishekh, Hulegar A; Nalini, Atchayaram; Raju, Trichur R; Sathyaprabha, T N

2016-01-01

Migraine is associated with autonomic symptoms. The growing body of literature suggests that the dysfunctional autonomic nervous system might play a pivotal role in the pathogenesis of migraine. Thermal therapies have been hypothesized to modulate these changes and alleviate pain. However, data regarding the efficacy of hydrotherapy in migraine remain scant. We evaluated the effect of add on hydrotherapy procedure (a hot arm and foot bath with ice massage to head) in migraine patients. Forty chronic migraine patients fulfilling the International Classification of Headache Disorders II criteria were recruited from the neurology outpatient clinic. Patients were randomized to receive either hydrotherapy plus conventional pharmacological care (n = 20) or conventional medication only (n = 20). Hydrotherapy group received treatment with hot arm and foot bath (103°F to 110°F) and ice massage to head daily for 20 min for 45 days. Patients were assessed using headache impact test (HIT), visual analog scale for pain and cardiac autonomic function by heart rate variability (HRV) before and after intervention period. There was a significant decrease in HIT score, frequency, and intensity of headaches following treatment in both the groups. However, it was more evident in add on hydrotherapy group compared to pharmacological treatment alone group. There was also significant improvement in the HRV parameters. In particular, there was a significant decrease in heart rate (P = 0.017), increase in high frequency (HF) (P = 0.014) and decrease in low frequency/HF ratio (P = 0.004) in add on hydrotherapy group. Our study shows that add on hydrotherapy enhanced the vagal tone in addition to reducing the frequency and intensity of headaches in migraine patients.

Sleep disturbances and autonomic dysfunction in patients with postural orthostatic tachycardia syndrome

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Julia eMallien

2014-07-01

Full Text Available Many patients with Postural Tachycardia Syndrome (PoTS suffer from fatigue, daytime sleepiness and sleeping disturbances. The objective of this study was to compare subjective and objective sleep quality of PoTS patients with a group of healthy controls. All Patients completed a Pittsburgh Sleep Quality Index questionnaire and the Epworth Sleepiness Scale. The patients sleep architecture, heart rate and heart rate variability measurements were taken during one night at the sleep laboratorium. All Data was collected at the Sleep Unit, at Helios Klinikum Wuppertal. 38 patients diagnosed with PoTS were compared to 31 healthy controls, matched in age and gender. Patients with PoTS reached significantly higher scores in sleep questionnaires, which means that they were more sleepy and had a lower sleep qualitiy. Polysomnography showed a significantly higher proportion of stage 2 sleep. The results of heart rate variability analysis in different sleep stages confirmed changes in autonomic activity in both groups. PoTS patients, however, showed a diminished variability of the LF band, HF band and LF/HF ratio in different sleep stages. It can therefore be gathererd that PoTS could be considered as potential differential diagnosis for sleep disturbances since PoTS patients had a subjective diminished sleep quality, reached higher levels of daytime sleepiness and showed a higher proportion of stage 2 sleep. PoTS patients showed furthermore a reduction of LF/HF ratio variability in different sleep stages.

Dysfunctional Brain Networking among Autonomic Regulatory Structures in Temporal Lobe Epilepsy Patients at High Risk of Sudden Unexpected Death in Epilepsy

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Luke A. Allen

2017-10-01

Full Text Available BackgroundSudden unexpected death in epilepsy (SUDEP is common among young people with epilepsy. Individuals who are at high risk of SUDEP exhibit regional brain structural and functional connectivity (FC alterations compared with low-risk patients. However, less is known about network-based FC differences among critical cortical and subcortical autonomic regulatory brain structures in temporal lobe epilepsy (TLE patients at high risk of SUDEP.Methods32 TLE patients were risk-stratified according to the following clinical criteria: age of epilepsy onset, duration of epilepsy, frequency of generalized tonic–clonic seizures, and presence of nocturnal seizures, resulting in 14 high-risk and 18 low-risk cases. Resting-state functional magnetic resonance imaging (rs-fMRI signal time courses were extracted from 11 bilateral cortical and subcortical brain regions involved in autonomic and other regulatory processes. After computing all pairwise correlations, FC matrices were analyzed using the network-based statistic. FC strength among the 11 brain regions was compared between the high- and low-risk patients. Increases and decreases in FC were sought, using high-risk > low-risk and low-risk > high-risk contrasts (with covariates age, gender, lateralization of epilepsy, and presence of hippocampal sclerosis.ResultsHigh-risk TLE patients showed a subnetwork with significantly reduced FC (t = 2.5, p = 0.029 involving the thalamus, brain stem, anterior cingulate, putamen and amygdala, and a second subnetwork with significantly elevated FC (t = 2.1, p = 0.031, which extended to medial/orbital frontal cortex, insula, hippocampus, amygdala, subcallosal cortex, brain stem, thalamus, caudate, and putamen.ConclusionTLE patients at high risk of SUDEP showed widespread FC differences between key autonomic regulatory brain regions compared to those at low risk. The altered FC revealed here may help to shed light on the functional

Dysfunctional Brain Networking among Autonomic Regulatory Structures in Temporal Lobe Epilepsy Patients at High Risk of Sudden Unexpected Death in Epilepsy.

Science.gov (United States)

Allen, Luke A; Harper, Ronald M; Kumar, Rajesh; Guye, Maxime; Ogren, Jennifer A; Lhatoo, Samden D; Lemieux, Louis; Scott, Catherine A; Vos, Sjoerd B; Rani, Sandhya; Diehl, Beate

2017-01-01

Sudden unexpected death in epilepsy (SUDEP) is common among young people with epilepsy. Individuals who are at high risk of SUDEP exhibit regional brain structural and functional connectivity (FC) alterations compared with low-risk patients. However, less is known about network-based FC differences among critical cortical and subcortical autonomic regulatory brain structures in temporal lobe epilepsy (TLE) patients at high risk of SUDEP. 32 TLE patients were risk-stratified according to the following clinical criteria: age of epilepsy onset, duration of epilepsy, frequency of generalized tonic-clonic seizures, and presence of nocturnal seizures, resulting in 14 high-risk and 18 low-risk cases. Resting-state functional magnetic resonance imaging (rs-fMRI) signal time courses were extracted from 11 bilateral cortical and subcortical brain regions involved in autonomic and other regulatory processes. After computing all pairwise correlations, FC matrices were analyzed using the network-based statistic. FC strength among the 11 brain regions was compared between the high- and low-risk patients. Increases and decreases in FC were sought, using high-risk > low-risk and low-risk > high-risk contrasts (with covariates age, gender, lateralization of epilepsy, and presence of hippocampal sclerosis). High-risk TLE patients showed a subnetwork with significantly reduced FC ( t  = 2.5, p  = 0.029) involving the thalamus, brain stem, anterior cingulate, putamen and amygdala, and a second subnetwork with significantly elevated FC ( t  = 2.1, p  = 0.031), which extended to medial/orbital frontal cortex, insula, hippocampus, amygdala, subcallosal cortex, brain stem, thalamus, caudate, and putamen. TLE patients at high risk of SUDEP showed widespread FC differences between key autonomic regulatory brain regions compared to those at low risk. The altered FC revealed here may help to shed light on the functional correlates of autonomic disturbances in epilepsy

Autonomous reinforcement learning with experience replay.

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Wawrzyński, Paweł; Tanwani, Ajay Kumar

2013-05-01

This paper considers the issues of efficiency and autonomy that are required to make reinforcement learning suitable for real-life control tasks. A real-time reinforcement learning algorithm is presented that repeatedly adjusts the control policy with the use of previously collected samples, and autonomously estimates the appropriate step-sizes for the learning updates. The algorithm is based on the actor-critic with experience replay whose step-sizes are determined on-line by an enhanced fixed point algorithm for on-line neural network training. An experimental study with simulated octopus arm and half-cheetah demonstrates the feasibility of the proposed algorithm to solve difficult learning control problems in an autonomous way within reasonably short time. Copyright © 2012 Elsevier Ltd. All rights reserved.

Autonomic Neuropathy in Diabetes Mellitus

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Verrotti, Alberto; Prezioso, Giovanni; Scattoni, Raffaella; Chiarelli, Francesco

2014-01-01

Diabetic autonomic neuropathy (DAN) is a serious and common complication of diabetes, often overlooked and misdiagnosed. It is a systemic-wide disorder that may be asymptomatic in the early stages. The most studied and clinically important form of DAN is cardiovascular autonomic neuropathy defined as the impairment of autonomic control of the cardiovascular system in patients with diabetes after exclusion of other causes. The reported prevalence of DAN varies widely depending on inconsistent ...

A Rare Cause of Hypothalamic Obesity, Rohhad Syndrome: 2 Cases.

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Şiraz, Ülkü Gül; Okdemir, Deniz; Direk, Gül; Akın, Leyla; Hatipoğlu, Nihal; Kendırcı, Mustafa; Kurtoğlu, Selim

2018-03-19

Rapid-onset obesity with hypoventilation, hypothalamic dysfunction and autonomic dysregulation (ROHHAD) syndrome is a rare disease that is difficult to diagnosis and distinguish from genetic obesity syndromes. The underlying causes of the disease has not been fully explained. Hypothalamic dysfunction causes endocrine problems, respiratory dysfunction and autonomic alterations. There are around 80 reported patients due to lack of recognition. We present two female patient suspected of ROHHAD due to weight gain since early childhood. The presented symptoms, respiratory and circulatory dysfunction, hypothalamic hypernatremia, hypothalamo-pituitary hormonal disorders such as santral hypothyrodism, hyperprolactinemia and santral early puberty are completely matched the criteria of ROHHAD syndrome. ROHHAD syndrome should be considered in differential diagnosis since it is difficult to distinguish from causes of monogenic obesity. Early identification of the disease reduces morbidity of the syndrome and patients require regular follow-up by a multidisciplinary approach.

Nonmotor symptoms in patients with Parkinson disease

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Zhang, Tie-mei; Yu, Shu-yang; Guo, Peng; Du, Yang; Hu, Yang; Piao, Ying-shan; Zuo, Li-jun; Lian, Teng-hong; Wang, Rui-dan; Yu, Qiu-jin; Jin, Zhao; Zhang, Wei

2016-01-01

Abstract Parkinson disease (PD) is usually accompanied by numerous nonmotor symptoms (NMS), such as neuropsychiatric symptoms, sleep disorders, autonomic dysfunctions, and sensory disturbances. However, it is not clear that the factors influencing the occurrence of NMS and its sequence with motor symptoms (MS). We conducted comprehensive assessments of NMS by using 13 scales in 1119 PD patients. A total of 70.8% PD patients present NMS. Olfactory dysfunction tends to occur in PD patients with older age, more severe depression, sleep problems, and autonomic dysfunctions. Older patients are more likely to have olfactory dysfunction before MS than younger patients. Rapid eye movement behavior disorder is more prone to happen in patients with older age, older onset age, more severe depression, sleep problems, and autonomic dysfunctions. Patients with rapid eye movement behavior disorder before MS are older in onset age than after group. Olfactory dysfunction, constipation, rapid eye movement behavior disorder, and depression, as early warning NMSs of PD, connected to each other. There is a clinical heterogeneity that older patients are more likely to have NMS before MS, while younger patients are opposite. PMID:27977578

Structural Discrimination and Autonomous Vehicles

DEFF Research Database (Denmark)

Liu, Hin-Yan

2016-01-01

This paper examines the potential for structural discrimination to be woven into the fabric of autonomous vehicle developments, which remain underexplored and undiscussed. The prospect for structural discrimination arises as a result of the coordinated modes of autonomous vehicle behaviour...... individual identity, and potentially relative worth, to autonomous vehicles engaging in a crash damage calculus. At the risk of introducing these ideas into the development of autonomous vehicles, this paper hopes to spark a debate to foreclose these eventualities....... that is prescribed by its code. This leads to the potential for individuated outcomes to be networked and thereby multiplied consistently to any number of vehicles implementing such a code. The aggregated effects of such algorithmic policy preferences will thus cumulate in the reallocation of benefits and burdens...

Auditory Dysfunction in Patients with Cerebrovascular Disease

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Sadaharu Tabuchi

2014-01-01

Full Text Available Auditory dysfunction is a common clinical symptom that can induce profound effects on the quality of life of those affected. Cerebrovascular disease (CVD is the most prevalent neurological disorder today, but it has generally been considered a rare cause of auditory dysfunction. However, a substantial proportion of patients with stroke might have auditory dysfunction that has been underestimated due to difficulties with evaluation. The present study reviews relationships between auditory dysfunction and types of CVD including cerebral infarction, intracerebral hemorrhage, subarachnoid hemorrhage, cerebrovascular malformation, moyamoya disease, and superficial siderosis. Recent advances in the etiology, anatomy, and strategies to diagnose and treat these conditions are described. The numbers of patients with CVD accompanied by auditory dysfunction will increase as the population ages. Cerebrovascular diseases often include the auditory system, resulting in various types of auditory dysfunctions, such as unilateral or bilateral deafness, cortical deafness, pure word deafness, auditory agnosia, and auditory hallucinations, some of which are subtle and can only be detected by precise psychoacoustic and electrophysiological testing. The contribution of CVD to auditory dysfunction needs to be understood because CVD can be fatal if overlooked.

Decentralized Control of Autonomous Vehicles

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2003-01-01

Autonomous Vehicles by John S. Baras, Xiaobo Tan, Pedram Hovareshti CSHCN TR 2003-8 (ISR TR 2003-14) Report Documentation Page Form ApprovedOMB No. 0704...AND SUBTITLE Decentralized Control of Autonomous Vehicles 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT...Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 Decentralized Control of Autonomous Vehicles ∗ John S. Baras, Xiaobo Tan, and Pedram

Public Health, Ethics, and Autonomous Vehicles.

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Fleetwood, Janet

2017-04-01

With the potential to save nearly 30 000 lives per year in the United States, autonomous vehicles portend the most significant advance in auto safety history by shifting the focus from minimization of postcrash injury to collision prevention. I have delineated the important public health implications of autonomous vehicles and provided a brief analysis of a critically important ethical issue inherent in autonomous vehicle design. The broad expertise, ethical principles, and values of public health should be brought to bear on a wide range of issues pertaining to autonomous vehicles.

Endothelial dysfunction and reduced heart rate variability in patients with metabolic syndrome

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Elena Nikolaevna Smirnova

2018-03-01

Full Text Available According to experts of the World Health Organization (WHO, metabolic syndrome (MS can be considered as pandemy of the XXI century, because its prevalence among the population of developed countries is about 25-35%. In this study with the purpose of complex investigation of the autonomic nervous system and endothelial function we included 66 patients with MS between the ages of 25 and 61 (46.9±9.9 years. A comparison group of apparently healthy individuals (16 individuals, average age of 45.3±2.3 years; P>0.05 was studied. To evaluate the response of microvascular tone, we used the method of wavelet analysis of skin temperature oscillations during cooling of the limb. All patients underwent the study of heart rate variability. The levels of insulin, endothelin-1, and vascular endothelial growth factor were determined using enzyme immunoassay. Patients with MS had significant differences in all metabolic parameters. Our study showed that in the group of MS there is a decrease of the variability of heart rhythm compared with the healthy group. Conducting cold test revealed signs of endothelial dysfunction in the MS group, which was manifested by the decrease of the index of vasodilation in the endothelial and neurogenic frequency range. In the study group we determined the increase in biochemical markers of endothelial dysfunction, which correlated with parameters of vasodilation. Also, the presence of endothelial dysfunction significantly correlated with signs of reduction of the variability of the heart rhythm.

MSA Mimic? Rare Occurrence of Anti-Hu Autonomic Failure and Thymoma in a Patient with Parkinsonism: Case Report and Literature Review

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Vito A. G. Ricigliano

2018-01-01

Full Text Available Thymoma is a tumor originating from thymic gland, frequently manifesting with paraneoplastic neurological disorders. Its association with paraneoplastic dysautonomia is relatively uncommon. Here, we describe the challenging case of a 71 year-old female who developed subacute autonomic failure with digestive pseudo-obstruction, dysphagia, urinary tract dysfunction and orthostatic hypotension complicating an underlying extrapyramidal syndrome that had started 3 months before hospital admission. Autonomic symptoms had 2-month course and acutely worsened just before and during hospitalization. Combination of severe dysautonomia and parkinsonism mimicked rapidly progressing multiple system atrophy. However, diagnostic exams showed thymic tumor with positive anti-Hu antibodies on both serum and cerebrospinal fluid. Complete response of dysautonomia to immunoglobulins followed by thymectomy confirmed the diagnosis of anti-Hu-related paraneoplastic neurological syndrome. With regards to extrapyramidal symptoms, despite previous descriptions of paraneoplastic parkinsonism caused by other antineuronal antibodies, in our case no relation between anti-Hu and parkinsonism could be identified. A literature review of published reports describing anti-Hu positivity in thymic neoplasms highlighted that a definite autonomic disease due to anti-Hu antibodies is extremely rare in patients with thymoma but without myasthenia gravis, with only one case published so far.

La autonomía personal y la perspectiva comunitarista

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Álvarez, Silvina

1999-11-01

Full Text Available Not available

El presente artículo analiza el planteamiento que algunos autores comunitaristas han hecho de la noción de autonomía personal. En primer lugar centraré la atención en la formulación kantiana de la autonomía y en las posteriores reformulaciones que se han hecho de la propuesta original. En la segunda parte expondré algunos aspectos generales de la teoría comunitarista para luego desarrollar la propuesta de Charles Taylor, específicamente la ética de la autenticidad. En el análisis se destacan los problemas que surgen de entender la autonomía desde la perspectiva de una ética comprehensiva que concibe al sujeto como continuador de una tradición moral colectiva.

Sex therapy for female sexual dysfunction

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2013-01-01

Introduction About 45% of women suffer from some form of sexual dysfunction. Despite its high prevalence, there are few studies that have systematically evaluated sex therapy in comparison with other interventions. Objective Review randomized clinical trials that present psychotherapeutic interventions for female sexual dysfunctions. Method Through a search in three databases (Medline, Web of Science and PsycInfo), 1419 references were found. After an analysis of the abstracts, twenty-seven articles met the inclusion criteria and composed this review. Results Sex therapy, as proposed by Masters and Johnson and Heiman and LoPiccolo, is still the most commonly used form of therapy for sexual dysfunctions; although it has shown results, the results do not consistently support that this is the best alternative in the treatment of sexual dysfunctions. Conclusion There is a lack of systematic study of many female sexual dysfunctions. Orgasmic disorder and sexual pain (vaginismus and dyspaurenia) are the most extensively studied disorders and those in which sex therapy seems to have better outcomes. PMID:24066697

Close correlation of herpes zoster-induced voiding dysfunction with severity of zoster-related pain: A single faculty retrospective study.

Science.gov (United States)

Fujii, Mizue; Takahashi, Ichiro; Honma, Masaru; Ishida-Yamamoto, Akemi

2015-11-01

Herpes zoster (HZ), a common vesiculo-erythematous skin disease associated with reactivation of varicella zoster virus in the cranial nerve, dorsal root, and autonomic ganglia, is accompanied by several related symptoms represented by postherpetic neuralgia. Among them, involvement of vesicorectal dysfunction is relatively rare. The vesicorectal symptom can usually be recovered in transient course, but is quite important in terms of impaired quality of life. Male individuals affected with HZ and skin lesions on sacral dermatome have been reported as independent risk factors of zoster-related voiding dysfunction. In this study, urinary symptoms were focused upon and six patients with zoster-related voiding dysfunction at a single faculty of dermatology in Japan from 2009 to 2014 were retrospectively analyzed. All patients showed HZ lesions on the sacral area and the urinary symptom recovered in approximately 2 months (14 days to 7 months). The term of treatment for zoster-associated urinary dysfunction was positively correlated with that for zoster-related pain without significance (r = 0.661, P = 0.153). Average treatment term for pain relief of sacral HZ accompanied by voiding dysfunction (91.3 ± 76.44 days) was significantly longer than that of sacral HZ without urinary symptom (18.9 ± 20.42 days) (P = 0.032). These results suggested that zoster-related voiding dysfunction would mainly be involved in sacral HZ and closely associated with severity of zoster-related pain. Dermatologists should be aware that severe zoster-related pain accompanied by sacral HZ, which is related to prolonged treatment of pain relief, can be a predictive factor of voiding dysfunction. © 2015 Japanese Dermatological Association.

A Chinese Decoction, Kuan-Sin-Yin, Improves Autonomic Function and Cancer-Related Symptoms of Metastatic Colon Cancer.

Science.gov (United States)

Chien, Tsai-Ju; Liu, Chia-Yu; Ko, Pin-Hao; Hsu, Chung-Hua

2016-03-01

Kuan-Sin-Yin (KSY) is a traditional Chinese medicine (TCM) decoction, which has been shown to have cytostatic effects on cancer cells and involved in the TCM theory of promoting yin-yang balance.Sonce many cancer patients suffer from autonomic dysfunction (AD), which correspond to yin-yang imbalance in TCM. The aim of this study is to evaluate the possible effect of KSY in metastatic colon cancer (mCRC) patients with AD. We conducted a single-group experiment. Total 52 qualified patients were enrolled. Participants took the KSY daily for 2 weeks. The primary outcome was KSY efficacy as reflected in the heart rate variability (HRV) and electrical conductivity (µA) over 12 meridian points. Autonomic function was examined before and after the KSY intervention. The vagal and sympathetic tone were recorded by HRV; 12 meridian energies were measured using a meridian energy analysis device. Secondary outcomes were cancer-related symptoms and patient quality of life (QoL). The results showed that the KSY intervention improved AD via increasing the vagal tone (HF: P = .041), but not the sympathetic tone (LF: P = .154); total autonomic activity was significantly enhanced (HRV activity: P = .013). Intriguingly, energy increased more over the yin meridian (P = .010) than over the yang meridian (P = .015). Cancer-related symptoms and QoL were significantly improved (P yin-yang concept of energy. © The Author(s) 2015.

Pilot In Command: A Feasibility Assessment of Autonomous Flight Management Operations

Science.gov (United States)

Wing, David J.; Ballin, Mark G.; Krishnamurthy, Karthik

2004-01-01

Several years of NASA research have produced the air traffic management operational concept of Autonomous Flight Management with high potential for operational feasibility, significant system and user benefits, and safety. Among the chief potential benefits are demand-adaptive or scalable capacity, user flexibility and autonomy that may finally enable truly successful business strategies, and compatibility with current-day operations such that the implementation rate can be driven from within the user community. A concept summary of Autonomous Flight Management is provided, including a description of how these operations would integrate in shared airspace with existing ground-controlled flight operations. The mechanisms enabling the primary benefits are discussed, and key findings of a feasibility assessment of airborne autonomous operations are summarized. Concept characteristics that impact safety are presented, and the potential for initially implementing Autonomous Flight Management is discussed.

Terpsichore. ENEA's autonomous robotics project; Progetto Tersycore, la robotica autonoma

Energy Technology Data Exchange (ETDEWEB)

Taraglio, S; Zanela, S; Santini, A; Nanni, V [ENEA, Centro Ricerche Casaccia, Rome (Italy). Div. Robotica e Informatica Avanzata

1999-10-01

The article presents some of the Terpsichore project's results aimed to developed and test algorithms and applications for autonomous robotics. Four applications are described: dynamic mapping of a building's interior through the use of ultrasonic sensors; visual drive of an autonomous robot via a neural network controller; a neural network-based stereo vision system that steers a robot through unknown indoor environments; and the evolution of intelligent behaviours via the genetic algorithm approach.

Enhancing agent safety through autonomous environment adaptation

CSIR Research Space (South Africa)

Rosman, Benjamin S

2015-08-01

Full Text Available limit their ability to interact with and explore their environments. In this work we address this risk through the incorporation of a caregiver robot, and present a model allowing it to autonomously adapt its environment to minimize danger for other...

Algunas consideraciones de la disfunción endotelial en pacientes con hiperprolactinemia Some considerations of endothelial dysfunction in patients presenting with hyperprolactinemia

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Maité Cabrera Gámez

2012-04-01

Full Text Available Se realizó una revisión de las publicaciones a nuestro alcance de la actualidad sobre el tema disfunción endotelial en pacientes con hiperprolactinemia: existencia, mecanismos de producción y consecuencias. Teniendo en cuenta que la hiperprolactinemia tiene hoy un nuevo enfoque relacionado con la disfunción endotelial, nos propusimos realizar la revisión siguiente. La disfunción endotelial es una alteración en la relajación vascular inducida por la reducción de los factores de relajación derivados del endotelio, principalmente el óxido nítrico, que causa un aumento del estímulo vasoconstrictor con tendencia protrombótica de la vasculatura. La resistencia a la insulina actúa como principal factor de disfunción endotelial asociado o no con la diabetes mellitus. Hasta el presente, el estado hiperprolactinémico se asocia con trastornos de la tolerancia a la glucosa (tolerancia a la glucosa disminuida con hiperinsulinemia. Existe disfunción endotelial en mujeres hiperprolactinémicas y puede deberse a su relación con resistencia a la insulina, a la disminución de los estrógenos y a la propia hiperprolactinemia. También se han encontrado marcadores de inflamación (como la proteína C reactiva elevada en pacientes con esta enfermedad. La hiperprolactinemia se asocia con resistencia a la insulina, disfunción endotelial y bajo grado de inflamación, parámetros que son determinantes en el proceso de aterosclerosis, por lo que esta enfermedad puede ser un factor predisponente de aterosclerosis, y por tanto, un riesgo de morbilidad y mortalidad cardiovasculares.A review of the publications available of current situation on the subject related to endothelial dysfunction in patients with hyperprolactinemia: existence, production mechanisms and consequences. Taking into account that the hyperprolactinemia has a new approach related to endothelial dysfunction authors made present review. Above mentioned dysfunction is a alteration in

Multiple organ dysfunction caused by parathyroid adenoma‑induced ...

African Journals Online (AJOL)

We present a 27‑year‑old male with multiple organ dysfunction caused by parathyroid adenoma‑induced primary hyperparathyroidism (PHPT). Initially, the patient experienced a sudden onset of gastrointestinal symptoms, polyuria, polydipsia, bone pain, renal dysfunction, nephrolithiasis, and acute pancreatitis, symptoms ...

Expert system isssues in automated, autonomous space vehicle rendezvous

Science.gov (United States)

Goodwin, Mary Ann; Bochsler, Daniel C.

1987-01-01

The problems involved in automated autonomous rendezvous are briefly reviewed, and the Rendezvous Expert (RENEX) expert system is discussed with reference to its goals, approach used, and knowledge structure and contents. RENEX has been developed to support streamlining operations for the Space Shuttle and Space Station program and to aid definition of mission requirements for the autonomous portions of rendezvous for the Mars Surface Sample Return and Comet Nucleus Sample return unmanned missions. The experience with REMEX to date and recommendations for further development are presented.

Renal tubular dysfunction presenting as recurrent hypokalemic periodic quadriparesis in systemic lupus erythematosus

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D Prasad

2014-01-01

Full Text Available We report recurrent hypokalemic periodic quadriparesis in a 30-year-old woman. Patient had also symptoms of multiple large and small joint pain, recurrent oral ulceration, photosensitivity and hair loss that were persisting since last 6 months and investigations revealed systemic lupus erythematosus (SLE with distal tubular acidosis. Our patient was successfully treated with oral potassium chloride, sodium bicarbonate, hydroxychloroquine and a short course of steroids. Thus, tubular dysfunction should be carefully assessed in patients with SLE.

Behavioural domain knowledge transfer for autonomous agents

CSIR Research Space (South Africa)

Rosman, Benjamin S

2014-11-01

Full Text Available , and Behavior Transfer in Autonomous Robots, AAAI 2014 Fall Symposium Series, 13-15 November 2014 Behavioural Domain Knowledge Transfer for Autonomous Agents Benjamin Rosman Mobile Intelligent Autonomous Systems Modelling and Digital Science Council...

Service recovery following dysfunctional consumer participation

OpenAIRE

Hibbert, SA; Piacentini, Maria; Hogg, Margaret

2012-01-01

This article introduces the notion of dysfunctional consumer participation. It advances a theoretical model of service recovery for contexts in which the smooth functioning of a service has been disrupted by consumers’ dysfunctional contributions, founded on justice theory and cognitive appraisal theory. The model presents perceived justice as the core element of the evaluation of service recovery encounters. Stressful appraisal evokes emotions in consumers and influences the cooperative or re...

Autonomous learning in humanoid robotics through mental imagery.

Science.gov (United States)

Di Nuovo, Alessandro G; Marocco, Davide; Di Nuovo, Santo; Cangelosi, Angelo

2013-05-01

In this paper we focus on modeling autonomous learning to improve performance of a humanoid robot through a modular artificial neural networks architecture. A model of a neural controller is presented, which allows a humanoid robot iCub to autonomously improve its sensorimotor skills. This is achieved by endowing the neural controller with a secondary neural system that, by exploiting the sensorimotor skills already acquired by the robot, is able to generate additional imaginary examples that can be used by the controller itself to improve the performance through a simulated mental training. Results and analysis presented in the paper provide evidence of the viability of the approach proposed and help to clarify the rational behind the chosen model and its implementation. Copyright © 2012 Elsevier Ltd. All rights reserved.

Cardiac autonomic regulation in response to a mixed meal is impaired in obese children and adolescents: the role played by insulin resistance.

Science.gov (United States)

Cozzolino, Domenico; Esposito, Katherine; Palmiero, Giuseppe; De Bellis, Annamaria; Furlan, Raffaello; Perrotta, Silverio; Perrone, Laura; Torella, Daniele; Miraglia del Giudice, Emanuele

2014-09-01

Obesity in children/adolescents has been associated with subtle cardiac abnormalities, including myocardial dysfunction and cardiac autonomic dysregulation at rest, both likely responsible for a higher mortality in adulthood. Food intake induces remarkable adjustments of cardiovascular autonomic activity in healthy subjects. The objective of the study was to evaluate in obese children/adolescents meal-induced cardiac autonomic response and the role played by insulin resistance. Sixty-eight obese and 30 matched normal-weight children/adolescents underwent blood sampling and cardiovascular autonomic analysis while recumbent and 20 minutes after a mixed meal ingestion. Spectrum analysis of the R-R interval and systolic blood pressure (SBP) variability provided the indices of sympathetic [low frequency (LFRR)] and vagal [high frequency (HFRR)] modulation of the sinoatrial node and the low frequency component of SBP. The homeostasis model assessment of insulin resistance served to separate insulin resistant (n = 35) from non insulin resistant (n = 33) obese children/adolescents. At baseline, C-reactive protein, the LFRR to HFRR ratio, SBP, and low frequency oscillatory component of SBP variability in obese children/adolescents were significantly (P meal-induced increase in the LFRR to HFRR ratio was significantly less than in controls and exaggeratedly scanty (or opposite) among insulin resistant subjects. The homeostasis model assessment of insulin resistance index strongly and inversely correlated (r = -0.871; P meal-induced changes in the LFRR to HFRR ratio among obese subjects. Autonomic modulation of the heart was impaired after eating in obese children/adolescents. This abnormality was exaggerated among insulin resistant subjects and strongly correlated with the degree of insulin resistance.

Autonomous Navigation with Constrained Consistency for C-Ranger

Directory of Open Access Journals (Sweden)

Shujing Zhang

2014-06-01

Full Text Available Autonomous underwater vehicles (AUVs have become the most widely used tools for undertaking complex exploration tasks in marine environments. Their synthetic ability to carry out localization autonomously and build an environmental map concurrently, in other words, simultaneous localization and mapping (SLAM, are considered to be pivotal requirements for AUVs to have truly autonomous navigation. However, the consistency problem of the SLAM system has been greatly ignored during the past decades. In this paper, a consistency constrained extended Kalman filter (EKF SLAM algorithm, applying the idea of local consistency, is proposed and applied to the autonomous navigation of the C-Ranger AUV, which is developed as our experimental platform. The concept of local consistency (LC is introduced after an explicit theoretical derivation of the EKF-SLAM system. Then, we present a locally consistency-constrained EKF-SLAM design, LC-EKF, in which the landmark estimates used for linearization are fixed at the beginning of each local time period, rather than evaluated at the latest landmark estimates. Finally, our proposed LC-EKF algorithm is experimentally verified, both in simulations and sea trials. The experimental results show that the LC-EKF performs well with regard to consistency, accuracy and computational efficiency.

Compact autonomous navigation system (CANS)

Science.gov (United States)

Hao, Y. C.; Ying, L.; Xiong, K.; Cheng, H. Y.; Qiao, G. D.

2017-11-01

Autonomous navigation of Satellite and constellation has series of benefits, such as to reduce operation cost and ground station workload, to avoid the event of crises of war and natural disaster, to increase spacecraft autonomy, and so on. Autonomous navigation satellite is independent of ground station support. Many systems are developed for autonomous navigation of satellite in the past 20 years. Along them American MANS (Microcosm Autonomous Navigation System) [1] of Microcosm Inc. and ERADS [2] [3] (Earth Reference Attitude Determination System) of Honeywell Inc. are well known. The systems anticipate a series of good features of autonomous navigation and aim low cost, integrated structure, low power consumption and compact layout. The ERADS is an integrated small 3-axis attitude sensor system with low cost and small volume. It has the Earth center measurement accuracy higher than the common IR sensor because the detected ultraviolet radiation zone of the atmosphere has a brightness gradient larger than that of the IR zone. But the ERADS is still a complex system because it has to eliminate many problems such as making of the sapphire sphere lens, birefringence effect of sapphire, high precision image transfer optical fiber flattener, ultraviolet intensifier noise, and so on. The marginal sphere FOV of the sphere lens of the ERADS is used to star imaging that may be bring some disadvantages., i.e. , the image energy and attitude measurements accuracy may be reduced due to the tilt image acceptance end of the fiber flattener in the FOV. Besides Japan, Germany and Russia developed visible earth sensor for GEO [4] [5]. Do we have a way to develop a cheaper/easier and more accurate autonomous navigation system that can be used to all LEO spacecraft, especially, to LEO small and micro satellites? To return this problem we provide a new type of the system—CANS (Compact Autonomous Navigation System) [6].

Blood pressure normalization post-jugular venous balloon angioplasty.

Science.gov (United States)

Sternberg, Zohara; Grewal, Prabhjot; Cen, Steven; DeBarge-Igoe, Frances; Yu, Jinhee; Arata, Michael

2015-05-01

This study is the first in a series investigating the relationship between autonomic nervous system dysfunction and chronic cerebrospinal venous insufficiency in multiple sclerosis patients. We screened patients for the combined presence of the narrowing of the internal jugular veins and symptoms of autonomic nervous system dysfunction (fatigue, cognitive dysfunction, sleeping disorders, headache, thermal intolerance, bowel/bladder dysfunction) and determined systolic and diastolic blood pressure responses to balloon angioplasty. The criteria for eligibility for balloon angioplasty intervention included ≥ 50% narrowing in one or both internal jugular veins, as determined by the magnetic resonance venography, and ≥ 3 clinical symptoms of autonomic nervous system dysfunction. Blood pressure was measured at baseline and post-balloon angioplasty. Among patients who were screened, 91% were identified as having internal jugular veins narrowing (with obstructing lesions) combined with the presence of three or more symptoms of autonomic nervous system dysfunction. Balloon angioplasty reduced the average systolic and diastolic blood pressure. However, blood pressure categorization showed a biphasic response to balloon angioplasty. The procedure increased blood pressure in multiple sclerosis patients who presented with baseline blood pressure within lower limits of normal ranges (systolic ≤ 105 mmHg, diastolic ≤ 70 mmHg) but decreased blood pressure in patients with baseline blood pressure above normal ranges (systolic ≥ 130 mmHg, diastolic ≥ 80 mmHg). In addition, gender differences in baseline blood pressure subcategories were observed. The coexistence of internal jugular veins narrowing and symptoms of autonomic nervous system dysfunction suggests that the two phenomena may be related. Balloon angioplasty corrects blood pressure deviation in multiple sclerosis patients undergoing internal jugular vein dilation. Further studies should investigate the

High prevalence of sexual dysfunction in a vulvovaginal specialty clinic

Science.gov (United States)

Gordon, Dina; Gardella, Carolyn; Eschenbach, David; Mitchell, Caroline M.

2014-01-01

Objective Our study evaluated the presence and predictors of sexual dysfunction in a vulvovaginal specialty clinic population. Materials & Methods Women who presented to a vulvovaginal specialty clinic were eligible to enroll. Participants completed a questionnaire, including Female Sexual Function Index (FSFI) to assess sexual dysfunction and Patient Health Questionnaire (PHQ)-9 depression screen, and underwent a standardized physical exam, with vaginal swabs collected for wet mount and culture. Logistic regression assessed the relationship between sexual dysfunction and clinical diagnosis. Results We enrolled 161 women, aged 18–80 years (median = 36), presenting with vulvovaginal complaints. Median symptom duration was 24 months; 131 women (81%) reported chronic symptoms (≥12 months). By PHQ-9, 28 (17%) women met depression criteria. In the month prior to assessment, 86 (53%) women experienced sexual dysfunction. Women were primarily diagnosed with vaginitis (n = 46, 29%), vestibulodynia/vulvitis (n = 70; 43%), lichen planus or lichen sclerosus (n = 24; 15%). Controlling for age, sexual dysfunction did not correlate with chronic symptoms (IRR 0.86, 95% CI 0.50–1.48), depression (IRR 1.24; 95% CI 0.59, 2.58), or presence of any of the three main diagnoses (IRR 1.16, 95% CI 0.47, 2.88). Discussion Sexual dysfunction is present in over half of women presenting to a vulvovaginitis referral clinic, more than twice the rate in the wider population. PMID:25259664

Autonomous aerial vehicles : guidance, control, signal and image processing platform

International Nuclear Information System (INIS)

Al-Jarrah, M.; Adiansyah, S.; Marji, Z. M.; Chowdhury, M. S.

2011-01-01

The use of unmanned systems is gaining momentum in civil applications after successful use by the armed forces around the globe. Autonomous aerial vehicles are important for providing assistance in monitoring highways, power grid lines, borders, and surveillance of critical infrastructures. It is envisioned that cargo shipping will be completely handled by UAVs by the 2025. Civil use of unmanned autonomous systems brings serious challenges. The need for cost effectiveness, reliability, operation simplicity, safety, and cooperation with human and with other agents are among these challenges. Aerial vehicles operating in the civilian aerospace is the ultimate goal which requires these systems to achieve the reliability of manned aircraft while maintaining their cost effectiveness. In this presentation the development of an autonomous fixed and rotary wing aerial vehicle will be discussed. The architecture of the system from the mission requirements to low level auto pilot control laws will be discussed. Trajectory tracking and path following guidance and control algorithms commonly used and their implementation using of the shelf low cost components will be presented. Autonomous takeo? landing is a key feature that was implemented onboard the vehicle to complete its degree of autonomy. This is implemented based on accurate air-data system designed and fused with sonar measurements, INS/GPS measurements, and vector field method guidance laws. The outcomes of the proposed research is that the AUS-UAV platform named MAZARI is capable of autonomous takeoff and landing based on a pre scheduled flight path using way point navigation and sensor fusion of the inertial navigation system (INS) and global positioning system (GPS). Several technologies need to be mastered when developing a UAV. The navigation task and the need to fuse sensory information to estimate the location of the vehicle is critical to successful autonomous vehicle. Currently extended Kalman filtering is

Cost-prioritized droop schemes for autonomous microgrids

DEFF Research Database (Denmark)

Nutkani, Inam Ullah; Loh, Poh Chiang; Blaabjerg, Frede

2013-01-01

Droop schemes for parallel source control usually aims for proportional power sharing tuned in accordance to the source ratings. This works fine for sources with close similarity, but not really for an autonomous microgrid where different types of Distributed Generators (DGs) may be present without...

Contour Tracking Control for the REMUS Autonomous Underwater Vehicle

National Research Council Canada - National Science Library

Van Reet, Alan R

2005-01-01

In the interest of enhancing the capabilities of autonomous underwater vehicles used in US Naval Operations, controlling vehicle position to follow depth contours presents exciting potential for navigation...

Impact of malnutrition on cardiac autonomic modulation in children

Directory of Open Access Journals (Sweden)

Gláucia Siqueira Carvalho Barreto

2016-11-01

Conclusion: Malnourished children present changes in cardiac autonomic modulation, characterized by reductions in both sympathetic and parasympathetic activity, as well as increased heart rate and decreased blood pressure.

Hemodynamic, morphometric and autonomic patterns in hypertensive rats - renin-angiotensin system modulation

Directory of Open Access Journals (Sweden)

Fernanda S. Zamo

2010-01-01

Full Text Available BACKGROUND: Spontaneously hypertensive rats develop left ventricular hypertrophy, increased blood pressure and blood pressure variability, which are important determinants of heart damage, like the activation of renin-angiotensin system. AIMS: To investigate the effects of the time-course of hypertension over 1 hemodynamic and autonomic patterns (blood pressure; blood pressure variability; heart rate; 2 left ventricular hypertrophy; and 3 local and systemic Renin-angiotensin system of the spontaneously hypertensive rats. METHODS: Male spontaneously hypertensive rats were randomized into two groups: young (n=13 and adult (n=12. Hemodynamic signals (blood pressure, heart rate, blood pressure variability (BPV and spectral analysis of the autonomic components of blood pressure were analyzed. LEFT ventricular hypertrophy was measured by the ratio of LV mass to body weight (mg/g, by myocyte diameter (μm and by relative fibrosis area (RFA, %. ACE and ACE2 activities were measured by fluorometry (UF/min, and plasma renin activity (PRA was assessed by a radioimmunoassay (ng/mL/h. Cardiac gene expressions of Agt, Ace and Ace2 were quantified by RT-PCR (AU. RESULTS: The time-course of hypertension in spontaneously hypertensive rats increased BPV and reduced the alpha index in adult spontaneously hypertensive rats. Adult rats showed increases in left ventricular hypertrophy and in RFA. Compared to young spontaneously hypertensive rats, adult spontaneously hypertensive rats had lower cardiac ACE and ACE2 activities, and high levels of PRA. No change was observed in gene expression of Renin-angiotensin system components. CONCLUSIONS: The observed autonomic dysfunction and modulation of Renin-angiotensin system activity are contributing factors to end-organ damage in hypertension and could be interacting. Our findings suggest that the management of hypertensive disease must start before blood pressure reaches the highest stable levels and the consequent

Influence of hydrotherapy on clinical and cardiac autonomic function in migraine patients

Directory of Open Access Journals (Sweden)

M U Sujan

2016-01-01

Full Text Available Background: Migraine is associated with autonomic symptoms. The growing body of literature suggests that the dysfunctional autonomic nervous system might play a pivotal role in the pathogenesis of migraine. Thermal therapies have been hypothesized to modulate these changes and alleviate pain. However, data regarding the efficacy of hydrotherapy in migraine remain scant. We evaluated the effect of add on hydrotherapy procedure (a hot arm and foot bath with ice massage to head in migraine patients. Methods: Forty chronic migraine patients fulfilling the International Classification of Headache Disorders II criteria were recruited from the neurology outpatient clinic. Patients were randomized to receive either hydrotherapy plus conventional pharmacological care (n = 20 or conventional medication only (n = 20. Hydrotherapy group received treatment with hot arm and foot bath (103°F to 110°F and ice massage to head daily for 20 min for 45 days. Patients were assessed using headache impact test (HIT, visual analog scale for pain and cardiac autonomic function by heart rate variability (HRV before and after intervention period. Results: There was a significant decrease in HIT score, frequency, and intensity of headaches following treatment in both the groups. However, it was more evident in add on hydrotherapy group compared to pharmacological treatment alone group. There was also significant improvement in the HRV parameters. In particular, there was a significant decrease in heart rate (P = 0.017, increase in high frequency (HF (P = 0.014 and decrease in low frequency/HF ratio (P = 0.004 in add on hydrotherapy group. Conclusion: Our study shows that add on hydrotherapy enhanced the vagal tone in addition to reducing the frequency and intensity of headaches in migraine patients.

Peripheral sympathetic dysfunction in patients with Parkinson's disease without autonomic failure is heart selective and disease specific

International Nuclear Information System (INIS)

Taki, Junichi; Nakajima, Kenichi; Hwang, Eui-Hyo; Matsunari, Ichiro; Tonami, Norihisa; Komai, Kiyonobu; Yoshita, Mitsuhiro; Sakajiri, Kenichi

2000-01-01

The study was undertaken to investigate by means of iodine-123-labelled metaiodobenzylguanidine (MIBG) scintigraphy the peripheral sympathetic function in patients with Parkinson's disease (PD) without autonomic failure and in patients with related neurodegenerative diseases with parkinsonism. Seventy patients (33 men and 37 women, mean age 63±9.7 years) with parkinsonism and ten control subjects underwent MIBG scintigraphy. Of these 70 patients, 41 were diagnosed as having idiopathic PD, 9 multiple system atrophy (MSA), 6 progressive supranuclear palsy (PSP) and 2 corticobasal degeneration (CBD); the remaining 12 were diagnosed as having neurodegenerative disease with parkinsonism (P-nism) that did not meet the diagnostic criteria of any specific disease. Cardiac planar and tomographic imaging studies and subsequent whole-body imaging were performed 20 min and 3 h after the injection of 111 MBq MIBG. The early MIBG heart to mediastinum (H/M) ratio in PD (1.61±0.29) was significantly lower than that in the control group (2.24±0.14, P<0.01), P-nism (2.15±0.31, P<0.01), MSA (2.08±0.31, P<0.05) and PSP (2.30±0.24, P<0.01). The delayed H/M ratio in PD (1.47±0.34) was also significantly lower than that in the control group (2.37±0.14, P<0.01), P-nism (2.13±0.38, P<0.01), PSP (2.36±0.36, P<0.01) and MSA (2.17±0.36, P<0.01). In patients with PD, early and delayed H/M ratios were significantly decreased in disease stages I, II and III (established using the Hoehn and Yahr criteria) as compared with control subjects, and there were no significant differences among the stages. Only PD showed a significantly higher washout rate (WR) than that in the control subjects (27%±8.0% vs 11%±4.2%, P<0.01). Early and delayed uptake ratios of the lung, parotid gland, thyroid gland, liver and femoral muscles in each of the patient groups were not significantly different from those in control subjects. Only the early and delayed uptake ratios of the lower leg muscles in MSA

Energy autonomous sensors in the automobile; Energieautarke Sensorik im Automobil

Energy Technology Data Exchange (ETDEWEB)

Kuehne, Ingo [Hochschule Heilbronn (Germany). Studiengang Energieoekologie; Schreiter, Matthias [Siemens AG, Muenchen (Germany); Li, Xiaoming [Daimler AG, Sindelfingen (Germany); Hehn, Thorsten [Hahn-Schickard-Gesellschaft fuer angewandte Forschung e.V., Freiburg (Germany). HSG-IMIT, Inst. fuer Mikro- und Informationstechnik; Thewes, Marcell; Scholl, Gerd [Helmut-Schmidt-Univ., Univ. der Bundeswehr, Hamburg (Germany); Wagner, Dieter [Continental Automotive GmbH, Regensburg (Germany); Manoli, Yiannos [Univ. Freiburg (Germany). IMTEK; Frey, Alexander [Hochschule Augsburg (Germany). Fakultaet Elektrotechnik

2013-04-01

A brief outline of energy autonomous sensors in the automobile is given. For this purpose the variety of sensors in today's automotive vehicles is reported. The rationale for the deployment of energy autonomous sensors is given. In addition the potential of using environmental energy and the possibilities of their energy conversion are presented. As part of the funded project ASYMOF, two pioneer applications - a tire pressure monitoring and an anti-theft alarm system - are studied and discussed.

Human Supervision of Multiple Autonomous Vehicles

Science.gov (United States)

2013-03-22

AFRL-RH-WP-TR-2013-0143 HUMAN SUPERVISION OF MULTIPLE AUTONOMOUS VEHICLES Heath A. Ruff Ball...REPORT TYPE Interim 3. DATES COVERED (From – To) 09-16-08 – 03-22-13 4. TITLE AND SUBTITLE HUMAN SUPERVISION OF MULTIPLE AUTONOMOUS VEHICLES 5a...Supervision of Multiple Autonomous Vehicles To support the vision of a system that enables a single operator to control multiple next-generation

Salivary Gland Dysfunction and Xerostomia in Sjogren's Syndrome

NARCIS (Netherlands)

Jensen, Siri Beier; Vissink, Arjan

In this article, salivary gland dysfunction and xerostomia in Sjogren's syndrome (SS) are discussed, with a focus on the pathophysiology of salivary dysfunction in SS, the clinical presentation of dry mouth in SS, how to assess salivary gland hypofunction and xerostomia in SS, and the impact of

Overview of the Anatomy, Physiology, and Pharmacology of the Autonomic Nervous System.

Science.gov (United States)

Wehrwein, Erica A; Orer, Hakan S; Barman, Susan M

2016-06-13

Comprised of the sympathetic nervous system, parasympathetic nervous system, and enteric nervous system, the autonomic nervous system (ANS) provides the neural control of all parts of the body except for skeletal muscles. The ANS has the major responsibility to ensure that the physiological integrity of cells, tissues, and organs throughout the entire body is maintained (homeostasis) in the face of perturbations exerted by both the external and internal environments. Many commonly prescribed drugs, over-the-counter drugs, toxins, and toxicants function by altering transmission within the ANS. Autonomic dysfunction is a signature of many neurological diseases or disorders. Despite the physiological relevance of the ANS, most neuroscience textbooks offer very limited coverage of this portion of the nervous system. This review article provides both historical and current information about the anatomy, physiology, and pharmacology of the sympathetic and parasympathetic divisions of the ANS. The ultimate aim is for this article to be a valuable resource for those interested in learning the basics of these two components of the ANS and to appreciate its importance in both health and disease. Other resources should be consulted for a thorough understanding of the third division of the ANS, the enteric nervous system. © 2016 American Physiological Society. Compr Physiol 6:1239-1278, 2016. Copyright © 2016 John Wiley & Sons, Inc.

A Priori User Acceptance and the Perceived Driving Pleasure in Semi-autonomous and Autonomous Vehicles

DEFF Research Database (Denmark)

Bjørner, Thomas

The aim of this minor pilot study is, from a sociological user perspective, to explore a priori user acceptance and the perceived driving pleasure in semi- autonomous and autonomous vehicles. The methods used were 13 in-depth interviews while having participants watch video examples within four...... different scenarios. After each scenario, two different numerical rating scales were used. There was a tendency toward positive attitudes regarding semi- autonomous driving systems, especially the use of a parking assistant and while driving in city traffic congestion. However, there were also major...

Autonomic Closure for Turbulent Flows Using Approximate Bayesian Computation

Science.gov (United States)

Doronina, Olga; Christopher, Jason; Hamlington, Peter; Dahm, Werner

2017-11-01

Autonomic closure is a new technique for achieving fully adaptive and physically accurate closure of coarse-grained turbulent flow governing equations, such as those solved in large eddy simulations (LES). Although autonomic closure has been shown in recent a priori tests to more accurately represent unclosed terms than do dynamic versions of traditional LES models, the computational cost of the approach makes it challenging to implement for simulations of practical turbulent flows at realistically high Reynolds numbers. The optimization step used in the approach introduces large matrices that must be inverted and is highly memory intensive. In order to reduce memory requirements, here we propose to use approximate Bayesian computation (ABC) in place of the optimization step, thereby yielding a computationally-efficient implementation of autonomic closure that trades memory-intensive for processor-intensive computations. The latter challenge can be overcome as co-processors such as general purpose graphical processing units become increasingly available on current generation petascale and exascale supercomputers. In this work, we outline the formulation of ABC-enabled autonomic closure and present initial results demonstrating the accuracy and computational cost of the approach.

Parasympathetic Nervous System Dysfunction, as Identified by Pupil Light Reflex, and Its Possible Connection to Hearing Impairment.

Directory of Open Access Journals (Sweden)

Yang Wang

Full Text Available Although the pupil light reflex has been widely used as a clinical diagnostic tool for autonomic nervous system dysfunction, there is no systematic review available to summarize the evidence that the pupil light reflex is a sensitive method to detect parasympathetic dysfunction. Meanwhile, the relationship between parasympathetic functioning and hearing impairment is relatively unknown.To 1 review the evidence for the pupil light reflex being a sensitive method to evaluate parasympathetic dysfunction, 2 review the evidence relating hearing impairment and parasympathetic activity and 3 seek evidence of possible connections between hearing impairment and the pupil light reflex.Literature searches were performed in five electronic databases. All selected articles were categorized into three sections: pupil light reflex and parasympathetic dysfunction, hearing impairment and parasympathetic activity, pupil light reflex and hearing impairment.Thirty-eight articles were included in this review. Among them, 36 articles addressed the pupil light reflex and parasympathetic dysfunction. We summarized the information in these data according to different types of parasympathetic-related diseases. Most of the studies showed a difference on at least one pupil light reflex parameter between patients and healthy controls. Two articles discussed the relationship between hearing impairment and parasympathetic activity. Both studies reported a reduced parasympathetic activity in the hearing impaired groups. The searches identified no results for pupil light reflex and hearing impairment.As the first systematic review of the evidence, our findings suggest that the pupil light reflex is a sensitive tool to assess the presence of parasympathetic dysfunction. Maximum constriction velocity and relative constriction amplitude appear to be the most sensitive parameters. There are only two studies investigating the relationship between parasympathetic activity and hearing

Parasympathetic Nervous System Dysfunction, as Identified by Pupil Light Reflex, and Its Possible Connection to Hearing Impairment.

Science.gov (United States)

Wang, Yang; Zekveld, Adriana A; Naylor, Graham; Ohlenforst, Barbara; Jansma, Elise P; Lorens, Artur; Lunner, Thomas; Kramer, Sophia E

2016-01-01

Although the pupil light reflex has been widely used as a clinical diagnostic tool for autonomic nervous system dysfunction, there is no systematic review available to summarize the evidence that the pupil light reflex is a sensitive method to detect parasympathetic dysfunction. Meanwhile, the relationship between parasympathetic functioning and hearing impairment is relatively unknown. To 1) review the evidence for the pupil light reflex being a sensitive method to evaluate parasympathetic dysfunction, 2) review the evidence relating hearing impairment and parasympathetic activity and 3) seek evidence of possible connections between hearing impairment and the pupil light reflex. Literature searches were performed in five electronic databases. All selected articles were categorized into three sections: pupil light reflex and parasympathetic dysfunction, hearing impairment and parasympathetic activity, pupil light reflex and hearing impairment. Thirty-eight articles were included in this review. Among them, 36 articles addressed the pupil light reflex and parasympathetic dysfunction. We summarized the information in these data according to different types of parasympathetic-related diseases. Most of the studies showed a difference on at least one pupil light reflex parameter between patients and healthy controls. Two articles discussed the relationship between hearing impairment and parasympathetic activity. Both studies reported a reduced parasympathetic activity in the hearing impaired groups. The searches identified no results for pupil light reflex and hearing impairment. As the first systematic review of the evidence, our findings suggest that the pupil light reflex is a sensitive tool to assess the presence of parasympathetic dysfunction. Maximum constriction velocity and relative constriction amplitude appear to be the most sensitive parameters. There are only two studies investigating the relationship between parasympathetic activity and hearing impairment

Powering Autonomous Sensors An Integral Approach with Focus on Solar and RF Energy Harvesting

CERN Document Server

Penella-López, María Teresa

2011-01-01

Autonomous sensors transmit data and power their electronics without using cables. They can be found in e.g. wireless sensor networks (WSNs) or remote acquisition systems. Although primary batteries provide a simple design for powering autonomous sensors, they present several limitations such as limited capacity and power density, and difficulty in predicting their condition and state of charge. An alternative is to extract energy from the ambient (energy harvesting). However, the reduced dimensions of most autonomous sensors lead to a low level of available power from the energy transducer. Thus, efficient methods and circuits to manage and gather the energy are a must. An integral approach for powering autonomous sensors by considering both primary batteries and energy harvesters is presented. Two rather different forms of energy harvesting are also dealt with: optical (or solar) and radiofrequency (RF). Optical energy provides high energy density, especially outdoors, whereas RF remote powering is possibly...

Association Between Sedentary Lifestyle and Diastolic Dysfunction Among Outpatients With Normal Left Ventricular Systolic Function Presenting to a Tertiary Referral Center in the Middle East.

Science.gov (United States)

Matta, Stephanie; Chammas, Elie; Alraies, Chadi; Abchee, Antoine; AlJaroudi, Wael

2016-05-01

Sedentary lifestyle has become prevalent in our community. Recent data showed controversy on the effect of regular exercise on left ventricular compliance and myocardial relaxation. We sought to assess whether physical inactivity is an independent predictor of diastolic dysfunction in or community, after adjustment for several covariates. Consecutive outpatients presenting to the echocardiography laboratory between July 2013 and June 2014 were prospectively enrolled. Clinical variables were collected prospectively at enrollment. Patients were considered physically active if they exercised regularly ≥3× a week, ≥30 minutes each time. The primary endpoint was presence of diastolic dysfunction. The final cohort included 1356 patients (mean age [SD] 52.9 [17.4] years, 51.3% female). Compared with physically active patients, the 1009 (74.4%) physically inactive patients were older, more often female, and had more comorbidities and worse diastolic function (51.3% vs 38.3%; P < 0.001). On univariate analysis, physical inactivity was associated with 70% increased odds of having diastolic dysfunction (odds ratio: 1.70, 95% confidence interval: 1.32-2.18, P < 0.001). There was significant interaction between physical activity and left ventricular mass index (LVMI; P = 0.026). On multivariate analysis, patients who were physically inactive and had LVMI ≥ median had significantly higher odds of having diastolic dysfunction (odds ratio: 2.82, 95% confidence interval: 1.58-5.05, P < 0.001). In a large, prospectively enrolled cohort from a single tertiary center in the Middle East, physically inactive patients with increased LVMI had 2- to 3-fold increased odds of having diastolic dysfunction after multivariate adjustment. © 2016 Wiley Periodicals, Inc.

Autonomous Star Tracker Algorithms

DEFF Research Database (Denmark)

Betto, Maurizio; Jørgensen, John Leif; Kilsgaard, Søren

1998-01-01

Proposal, in response to an ESA R.f.P., to design algorithms for autonomous star tracker operations.The proposal also included the development of a star tracker breadboard to test the algorithms performances.......Proposal, in response to an ESA R.f.P., to design algorithms for autonomous star tracker operations.The proposal also included the development of a star tracker breadboard to test the algorithms performances....

Autonomous economic operation of grid connected DC microgrid

DEFF Research Database (Denmark)

Nutkani, Inam Ullah; Wang, Peng; Loh, Poh Chiang

2014-01-01

This paper presents an autonomous power sharing scheme for economic operation of grid-connected DC microgrid. Autonomous economic operation approach has already been tested for standalone AC microgrids to reduce the overall generation cost and proven a simple and easier to realize compared...... with the centralized management approach. In this paper, the same concept has been extended to grid-connected DC microgrid. The proposed economic droop scheme takes into consideration the power generation cost of Distributed Generators (DGs) and utility grid tariff and adaptively tunes their respective droop curves...... secondary control. The performance of the proposed scheme has been verified for the example grid-connected DC microgrid....

Physics Simulation Software for Autonomous Propellant Loading and Gas House Autonomous System Monitoring

Science.gov (United States)

Regalado Reyes, Bjorn Constant

2015-01-01

1. Kennedy Space Center (KSC) is developing a mobile launching system with autonomous propellant loading capabilities for liquid-fueled rockets. An autonomous system will be responsible for monitoring and controlling the storage, loading and transferring of cryogenic propellants. The Physics Simulation Software will reproduce the sensor data seen during the delivery of cryogenic fluids including valve positions, pressures, temperatures and flow rates. The simulator will provide insight into the functionality of the propellant systems and demonstrate the effects of potential faults. This will provide verification of the communications protocols and the autonomous system control. 2. The High Pressure Gas Facility (HPGF) stores and distributes hydrogen, nitrogen, helium and high pressure air. The hydrogen and nitrogen are stored in cryogenic liquid state. The cryogenic fluids pose several hazards to operators and the storage and transfer equipment. Constant monitoring of pressures, temperatures and flow rates are required in order to maintain the safety of personnel and equipment during the handling and storage of these commodities. The Gas House Autonomous System Monitoring software will be responsible for constantly observing and recording sensor data, identifying and predicting faults and relaying hazard and operational information to the operators.

Wavefront Propagation and Fuzzy Based Autonomous Navigation

Directory of Open Access Journals (Sweden)

Adel Al-Jumaily

2005-06-01

Full Text Available Path planning and obstacle avoidance are the two major issues in any navigation system. Wavefront propagation algorithm, as a good path planner, can be used to determine an optimal path. Obstacle avoidance can be achieved using possibility theory. Combining these two functions enable a robot to autonomously navigate to its destination. This paper presents the approach and results in implementing an autonomous navigation system for an indoor mobile robot. The system developed is based on a laser sensor used to retrieve data to update a two dimensional world model of therobot environment. Waypoints in the path are incorporated into the obstacle avoidance. Features such as ageing of objects and smooth motion planning are implemented to enhance efficiency and also to cater for dynamic environments.

Reinforcement Learning with Autonomous Small Unmanned Aerial Vehicles in Cluttered Environments

Science.gov (United States)

Tran, Loc; Cross, Charles; Montague, Gilbert; Motter, Mark; Neilan, James; Qualls, Garry; Rothhaar, Paul; Trujillo, Anna; Allen, B. Danette

2015-01-01

We present ongoing work in the Autonomy Incubator at NASA Langley Research Center (LaRC) exploring the efficacy of a data set aggregation approach to reinforcement learning for small unmanned aerial vehicle (sUAV) flight in dense and cluttered environments with reactive obstacle avoidance. The goal is to learn an autonomous flight model using training experiences from a human piloting a sUAV around static obstacles. The training approach uses video data from a forward-facing camera that records the human pilot's flight. Various computer vision based features are extracted from the video relating to edge and gradient information. The recorded human-controlled inputs are used to train an autonomous control model that correlates the extracted feature vector to a yaw command. As part of the reinforcement learning approach, the autonomous control model is iteratively updated with feedback from a human agent who corrects undesired model output. This data driven approach to autonomous obstacle avoidance is explored for simulated forest environments furthering autonomous flight under the tree canopy research. This enables flight in previously inaccessible environments which are of interest to NASA researchers in Earth and Atmospheric sciences.

A study on advanced man-machine interface system for autonomous nuclear power plants

International Nuclear Information System (INIS)

Matsuoka, Takeshi; Numano, Masayoshi; Fukuto, Junji; Sugasawa, Shinobu; Miyazaki, Keiko; Someya, Minoru; Haraki, Nobuo

1994-01-01

A man-machine interface(MMI) system of an autonomous nuclear power plant has an advanced function compared with that of the present nuclear power plants. The MMI has a function model of a plant state, and updates and revises this function model by itself. This paper describes the concept of autonomous nuclear power plants, a plant simulator of an autonomous power plant, a contracted function model of a plant state, three-dimensional color graphic display of a plant state, and an event-tree like expression for plant states. (author)

Mining in the Future: Autonomous Robotics for Safer Mines

CSIR Research Space (South Africa)

Shahdi, A

2012-10-01

Full Text Available ? Require less support infrastructure ? Advanced sensors ? CSIR 2012 Slide 4 Degree of Autonomy ? Teleoperation ? Semi-autonomous ? Autonomous ? CSIR 2012 Slide 5 Mobile Intelligent Autonomous Systems Group ? The Mobile Intelligent Autonomous...

Cognitive-Behavioral Erectile Dysfunction Treatment for Gay Men

Science.gov (United States)

Hart, Trevor A.; Schwartz, Danielle R.

2010-01-01

The purpose of the present paper is to assist cognitive-behavioral therapists who are treating erectile dysfunction among gay men. Little information is available to cognitive-behavioral therapists about the psychological and social effects of erectile dysfunction in this population, or how to incorporate the concerns of gay men with erectile…

From cooperative to autonomous vehicles

NARCIS (Netherlands)

van der Sande, T.P.J.; Nijmeijer, H.; Fossen, T.I.; Pettersen, K.Y.; Nijmeijer, H.

2017-01-01

What defines an autonomous vehicle? In this chapter the authors will try to answer this question and formulate the limitations of driver assistance systems as well as for—conditionally—autonomous vehicles . First a short summary of the levels of automation as provided by the society of automotive

Autonomous Navigation and Obstacle Avoidance of a Micro-Bus

Directory of Open Access Journals (Sweden)

Carlos Fernández

2013-04-01

Full Text Available At present, the topic of automated vehicles is one of the most promising research areas in the field of Intelligent Transportation Systems (ITS. The use of automated vehicles for public transportation also contributes to reductions in congestion levels and to improvements in traffic flow. Moreover, electrical public autonomous vehicles are environmentally friendly, provide better air quality and contribute to energy conservation. The driverless public transportation systems, which are at present operating in some airports and train stations, are restricted to dedicated roads and exhibit serious trouble dynamically avoiding obstacles in the trajectory. In this paper, an electric autonomous mini-bus is presented. All datasets used in this article were collected during the experiments carried out in the demonstration event of the 2012 IEEE Intelligent Vehicles Symposium that took place in Alcalá de Henares (Spain. The demonstration consisted of a route 725 metres long containing a list of latitude-longitude points (waypoints. The mini-bus was capable of driving autonomously from one waypoint to another using a GPS sensor. Furthermore, the vehicle is provided with a multi-beam Laser Imaging Detection and Ranging (LIDAR sensor for surrounding reconstruction and obstacle detection. When an obstacle is detected in the planned path, the planned route is modified in order to avoid the obstacle and continue its way to the end of the mission. On the demonstration day, a total of 196 attendees had the opportunity to get a ride on the vehicles. A total of 28 laps were successfully completed in full autonomous mode in a private circuit located in the National Institute for Aerospace Research (INTA, Spain. In other words, the system completed 20.3 km of driverless navigation and obstacle avoidance.

Operator Informational Needs for Multiple Autonomous Small Vehicles

Science.gov (United States)

Trujillo, Anna C.; Fan, Henry; Cross, Charles D.; Hempley, Lucas E.; Cichella, Venanzio; Puig-Navarro, Javier; Mehdi, Syed Bilal

2015-01-01

With the anticipated explosion of small unmanned aerial vehicles, it is highly likely that operators will be controlling fleets of autonomous vehicles. To fulfill the promise of autonomy, vehicle operators will not be concerned with manual control of the vehicle; instead, they will deal with the overall mission. Furthermore, the one operator to many vehicles is becoming a constant meme with various industries including package delivery, search and rescue, and utility companies. In order for an operator to concurrently control several vehicles, his station must look and behave very differently than the current ground control station instantiations. Furthermore, the vehicle will have to be much more autonomous, especially during non-normal operations, in order to accommodate the knowledge deficit or the information overload of the operator in charge of several vehicles. The expected usage increase of small drones requires presenting the operational information generated by a fleet of heterogeneous autonomous agents to an operator. NASA Langley Research Center's Autonomy Incubator has brought together researchers in various disciplines including controls, trajectory planning, systems engineering, and human factors to develop an integrated system to study autonomy issues. The initial human factors effort is focusing on mission displays that would give an operator the overall status of all autonomous agents involved in the current mission. This paper will discuss the specifics of the mission displays for operators controlling several vehicles.

Central-Approach Surgical Repair of Coarctation of the Aorta with a Back-up Left Ventricular Assist Device for an Infant Presenting with Severe Left Ventricular Dysfunction

Directory of Open Access Journals (Sweden)

Tae Hoon Kim

2015-12-01

Full Text Available A two-month-old infant presented with coarctation of the aorta, severe left ventricular dysfunction, and moderate to severe mitral regurgitation. Through median sternotomy, the aortic arch was repaired under cardiopulmonary bypass and regional cerebral perfusion. The patient was postoperatively supported with a left ventricular assist device for five days. Left ventricular function gradually improved, eventually recovering with the concomitant regression of mitral regurgitation. Prompt surgical repair of coarctation of the aorta is indicated for patients with severe left ventricular dysfunction. A central approach for surgical repair with a back-up left ventricular assist device is a safe and effective treatment strategy for these patients.

Central-Approach Surgical Repair of Coarctation of the Aorta with a Back-up Left Ventricular Assist Device for an Infant Presenting with Severe Left Ventricular Dysfunction.

Science.gov (United States)

Kim, Tae Hoon; Shin, Yu Rim; Kim, Young Sam; Kim, Do Jung; Kim, Hyohyun; Shin, Hong Ju; Htut, Aung Thein; Park, Han Ki

2015-12-01

A two-month-old infant presented with coarctation of the aorta, severe left ventricular dysfunction, and moderate to severe mitral regurgitation. Through median sternotomy, the aortic arch was repaired under cardiopulmonary bypass and regional cerebral perfusion. The patient was postoperatively supported with a left ventricular assist device for five days. Left ventricular function gradually improved, eventually recovering with the concomitant regression of mitral regurgitation. Prompt surgical repair of coarctation of the aorta is indicated for patients with severe left ventricular dysfunction. A central approach for surgical repair with a back-up left ventricular assist device is a safe and effective treatment strategy for these patients.

Autonomous Learner Model Resource Book

Science.gov (United States)

Betts, George T.; Carey, Robin J.; Kapushion, Blanche M.

2016-01-01

"Autonomous Learner Model Resource Book" includes activities and strategies to support the development of autonomous learners. More than 40 activities are included, all geared to the emotional, social, cognitive, and physical development of students. Teachers may use these activities and strategies with the entire class, small groups, or…

La formación del universitario en la autonomía de aprendizaje

OpenAIRE

Ruiz de Zarobe, Leyre

1997-01-01

El objeto del presente trabajo es llevar a cabo una reflexión sobre la denominada autonomía de aprendizaje en ámbito universitario, y presentar alguna experiencia realizada en dicho ámbito, con objeto de sensibilizar a los estudiantes a actividades que pretenden educarles en una mayor autonomía de aprendizaje.

Strengthening exercises improve symptoms and quality of life but do not change autonomic modulation in fibromyalgia: a randomized clinical trial.

Directory of Open Access Journals (Sweden)

Maria Bernadete Renoldi Oliveira Gavi

Full Text Available OBJECTIVE: Autonomic dysfunction is an important mechanism that could explain many symptoms observed in fibromyalgia (FM. Exercise is an effective treatment, with benefits potentially mediated through changes in autonomic modulation. Strengthening is one of the less studied exercises in FM, and the acute and chronic effects of strengthening on the autonomic system remain unknown. The objective of this study was to assess the chronic effects of strengthening exercises (STRE on autonomic modulation, pain perception and the quality of life (QOL of FM patients. METHODS: Eighty sedentary women with FM (ACR 1990 were randomly selected to participate in STRE or flexibility (FLEX exercises in a blinded controlled trial. The intensity of STRE was set at 45% of the estimated load of 1 Repetition Maximum (RM in 12 different exercises. Outcomes were Visual Analog Scale (VAS for pain, Heart Rate Variability (HRV analysis, treadmill test, the sit and reach test (Wells and Dillon's Bench, maximal repetitions test and handgrip dynamometry; and quality of life by the Fibromyalgia Impact Questionnaire (FIQ, the Beck and Idate Trait-State Inventory (IDATE, a short-form health survey (SF-36. RESULTS: The STRE group was more effective to strength gain for all muscles and pain control after 4 and 16 weeks (p<0.05. The FLEX group showed higher improvements in anxiety (p<0.05. Both groups showed improvements in the QOL, and there was no significant difference observed between the groups. There was no change in the HRV of the STRE and FLEX groups. CONCLUSIONS: Strengthening exercises show greater and more rapid improvements in pain and strength than flexibility exercises. Despite the benefits in fitness, pain, depression, anxiety and quality of life, no effect was observed on the autonomic modulation in both groups. This observation suggests that changes in autonomic modulation are not a target tobe clinically achieved in fibromyalgia. TRIAL REGISTRATION: Clinical

Control algorithms for autonomous robot navigation

International Nuclear Information System (INIS)

Jorgensen, C.C.

1985-01-01

This paper examines control algorithm requirements for autonomous robot navigation outside laboratory environments. Three aspects of navigation are considered: navigation control in explored terrain, environment interactions with robot sensors, and navigation control in unanticipated situations. Major navigation methods are presented and relevance of traditional human learning theory is discussed. A new navigation technique linking graph theory and incidental learning is introduced

Epidemiology of sexual dysfunction in the male population.

Science.gov (United States)

Beutel, M E; Weidner, W; Brähler, E

2006-08-01

Sexual dysfunctions have found an increasing attention in recent epidemiological studies of the ageing male. The purpose of this paper is to review the prevalence of sexual dysfunctions and risk factors based on community samples. Studies have not only demonstrated a strong age-related incline of erectile dysfunction (ED), but also of ejaculatory and orgasmic disorders (particularly a reduced or absent ejaculation). Despite a declining sexual desire, sexual interest remains present in old age. Lower urinary tract symptoms have been identified as strong risk factors for ED along with cardiovascular, metabolic, psychiatric disorders and lifestyle factors. The wide range of prevalence rate estimates is likely because of different definitions and criteria of sexual dysfunctions. More research is needed on other dysfunctions besides ED and on the partner relationship as a major determinant of sexual activity and satisfaction. The interrelationship between risk factors calls for interdisciplinary prevention and treatment approaches. As disability-free life expectancy keeps increasing, the need to identify, adequately assess and treat male sexual dysfunction as an important impediment to quality of life most likely will become even more pressing.

Sexual dysfunction within an adult developmental perspective.

Science.gov (United States)

Fagan, P J; Meyer, J K; Schmidt, C W

1986-01-01

The focus of this paper is on the adult who has adequately mastered the oedipal stage of psychosexual development and who presents with a sexual dysfunction. Drawing on the developmental sequence of Erik Erikson, the authors suggest that failure to address adequately an adult psychosocial crisis may result in sexual dysfunction. There may be both adult developmental deficits and regression to adolescent and adult stages previously negotiated. Both may be symptomatically represented by sexual dysfunction. The authors urge that the sexual and marital problems be evaluated within an adult developmental framework and that the therapy address the psychosocial issues which are appropriate to the developmental stage of the patient.

Autonomous spacecraft rendezvous and docking

Science.gov (United States)

Tietz, J. C.; Almand, B. J.

A storyboard display is presented which summarizes work done recently in design and simulation of autonomous video rendezvous and docking systems for spacecraft. This display includes: photographs of the simulation hardware, plots of chase vehicle trajectories from simulations, pictures of the docking aid including image processing interpretations, and drawings of the control system strategy. Viewgraph-style sheets on the display bulletin board summarize the simulation objectives, benefits, special considerations, approach, and results.

Sleep restriction progress to cardiac autonomic imbalance ...

African Journals Online (AJOL)

Since it's more difficult to maintain adequate sleep duration among night watchmen during their working schedule, hence the purpose of our present study was to investigate whether mental stress or fatigue over restricted sleep period in night shift, affects HRV, in order to elucidate on cardiac autonomic modulation among ...

Cybersecurity for aerospace autonomous systems

Science.gov (United States)

Straub, Jeremy

2015-05-01

High profile breaches have occurred across numerous information systems. One area where attacks are particularly problematic is autonomous control systems. This paper considers the aerospace information system, focusing on elements that interact with autonomous control systems (e.g., onboard UAVs). It discusses the trust placed in the autonomous systems and supporting systems (e.g., navigational aids) and how this trust can be validated. Approaches to remotely detect the UAV compromise, without relying on the onboard software (on a potentially compromised system) as part of the process are discussed. How different levels of autonomy (task-based, goal-based, mission-based) impact this remote characterization is considered.

Autonomous Navigation for Autonomous Underwater Vehicles Based on Information Filters and Active Sensing

Directory of Open Access Journals (Sweden)

Tianhong Yan

2011-11-01

Full Text Available This paper addresses an autonomous navigation method for the autonomous underwater vehicle (AUV C-Ranger applying information-filter-based simultaneous localization and mapping (SLAM, and its sea trial experiments in Tuandao Bay (Shangdong Province, P.R. China. Weak links in the information matrix in an extended information filter (EIF can be pruned to achieve an efficient approach-sparse EIF algorithm (SEIF-SLAM. All the basic update formulae can be implemented in constant time irrespective of the size of the map; hence the computational complexity is significantly reduced. The mechanical scanning imaging sonar is chosen as the active sensing device for the underwater vehicle, and a compensation method based on feedback of the AUV pose is presented to overcome distortion of the acoustic images due to the vehicle motion. In order to verify the feasibility of the navigation methods proposed for the C-Ranger, a sea trial was conducted in Tuandao Bay. Experimental results and analysis show that the proposed navigation approach based on SEIF-SLAM improves the accuracy of the navigation compared with conventional method; moreover the algorithm has a low computational cost when compared with EKF-SLAM.

Autonomous navigation for autonomous underwater vehicles based on information filters and active sensing.

Science.gov (United States)

He, Bo; Zhang, Hongjin; Li, Chao; Zhang, Shujing; Liang, Yan; Yan, Tianhong

2011-01-01

This paper addresses an autonomous navigation method for the autonomous underwater vehicle (AUV) C-Ranger applying information-filter-based simultaneous localization and mapping (SLAM), and its sea trial experiments in Tuandao Bay (Shangdong Province, P.R. China). Weak links in the information matrix in an extended information filter (EIF) can be pruned to achieve an efficient approach-sparse EIF algorithm (SEIF-SLAM). All the basic update formulae can be implemented in constant time irrespective of the size of the map; hence the computational complexity is significantly reduced. The mechanical scanning imaging sonar is chosen as the active sensing device for the underwater vehicle, and a compensation method based on feedback of the AUV pose is presented to overcome distortion of the acoustic images due to the vehicle motion. In order to verify the feasibility of the navigation methods proposed for the C-Ranger, a sea trial was conducted in Tuandao Bay. Experimental results and analysis show that the proposed navigation approach based on SEIF-SLAM improves the accuracy of the navigation compared with conventional method; moreover the algorithm has a low computational cost when compared with EKF-SLAM.

Hypothalamic dysfunction following whole-brain irradiation

International Nuclear Information System (INIS)

Mechanick, J.I.; Hochberg, F.H.; LaRocque, A.

1986-01-01

The authors describe 15 cases with evidence of hypothalamic dysfunction 2 to 9 years following megavoltage whole-brain x-irradiation for primary glial neoplasm. The patients received 4000 to 5000 rads in 180- to 200-rad fractions. Dysfunction occurred in the absence of computerized tomography-delineated radiation necrosis or hypothalamic invasion by tumor, and antedated the onset of dementia. Fourteen patients displayed symptoms reflecting disturbances of personality, libido, thirst, appetite, or sleep. Hyperprolactinemia (with prolactin levels up to 70 ng/ml) was present in all of the nine patients so tested. Of seven patients tested with thyrotropin-releasing hormone, one demonstrated an abnormal pituitary gland response consistent with a hypothalamic disorder. Seven patients developed cognitive abnormalities. Computerized tomography scans performed a median of 4 years after tumor diagnosis revealed no hypothalamic tumor or diminished density of the hypothalamus. Cortical atrophy was present in 50% of cases and third ventricular dilatation in 58%. Hypothalamic dysfunction, heralded by endocrine, behavioral, and cognitive impairment, represents a common, subtle form of radiation damage

Evolutionary autonomous agents and the nature of apraxia

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Jin Frank

2005-01-01

Full Text Available Abstract Background Evolutionary autonomous agents are robots or robot simulations whose controller is a dynamical neural network and whose evolution occurs autonomously under the guidance of a fitness function without the detailed or explicit direction of an external programmer. They are embodied agents with a simple neural network controller and as such they provide the optimal forum by which sensorimotor interactions in a specified environment can be studied without the computational assumptions inherent in standard neuroscience. Methods Evolutionary autonomous agents were evolved that were able to perform identical movements under two different contexts, one which represented an automatic movement and one which had a symbolic context. In an attempt to model the automatic-voluntary dissociation frequently seen in ideomotor apraxia, lesions were introduced into the neural network controllers resulting in a behavioral dissociation with loss of the ability to perform the movement which had a symbolic context and preservation of the simpler, automatic movement. Results Analysis of the changes in the hierarchical organization of the networks in the apractic EAAs demonstrated consistent changes in the network dynamics across all agents with loss of longer duration time scales in the network dynamics. Conclusion The concepts of determinate motor programs and perceptual representations that are implicit in the present day understanding of ideomotor apraxia are assumptions inherent in the computational understanding of brain function. The strength of the present study using EAAs to model one aspect of ideomotor apraxia is the absence of these assumptions and a grounding of all sensorimotor interactions in an embodied, autonomous agent. The consistency of the hierarchical changes in the network dynamics across all apractic agents demonstrates that this technique is tenable and will be a valuable adjunct to a computational formalism in the understanding

Cost-Prioritized Droop Schemes for Autonomous AC Microgrids

DEFF Research Database (Denmark)

Nutkani, Inam Ullah; Loh, Poh Chiang; Wang, Peng

2015-01-01

This paper presents two cost-prioritized droop sche- mes for distributed generators (DGs) in a rural or islanded microgrid. Dispatch prioritization of the schemes allows autonomous identification of the appropriate DGs for generation, in accordance to the overall load conditions of the microgrid....

Chronic prostatitis presenting with dysfunctional voiding and effects of pelvic floor biofeedback treatment.

Science.gov (United States)

He, Wei; Chen, Minfeng; Zu, Xiongbing; Li, Yuan; Ning, Keping; Qi, Lin

2010-04-01

To investigate the features of chronic prostatitis presenting with dysfunctional voiding (DV) and the effects of pelvic floor biofeedback (PFB). The study included 21 patients, diagnosed by having symptoms for > or =3 months, including urinary frequency and urgency, voiding difficulty, upper abdominal or perineal discomfort, and with a score of > or =1 on the first and second part of the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI). Patients with bacterial prostatitis, urethritis, interstitial cystitis, urethral stricture and neurogenic bladder were excluded. All patients had a urodynamic examination, to assess the uroflow curve, maximum urinary flow rate (Q(max)), maximum detrusor pressure during the storage phase (P(det.max)), maximum urethral pressure (MUP) and the maximum urethral closure pressure (MUCP) were recorded. PFB was carried out in patients with non-neurogenic detrusor sphincter dyssynergia, and the effects evaluated after 10 weeks. Before and after PFB treatment the mean (sd) Q(max), P(det.max), MUP, MUCP were 8.2 (4.1) vs 15.1 (7.3) mL/s, 125.1 (75.3) vs 86.3 (54.2) cmH(2)O, 124.3 (23.3) vs 65.4 (23.0) cmH(2)O and 101.5 (43.6) vs 43.5 (16.7) cmH(2)O, all significantly different (P PFB had satisfactory short-term effects on these patients.

Morphologic Changes in Autonomic Nerves in Diabetic Autonomic Neuropathy

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Heung Yong Jin

2015-12-01

Full Text Available Diabetic neuropathy is one of the major complications of diabetes, and it increases morbidity and mortality in patients with both type 1 diabetes mellitus (T1DM and type 2 diabetes mellitus (T2DM. Because the autonomic nervous system, for example, parasympathetic axons, has a diffuse and wide distribution, we do not know the morphological changes that occur in autonomic neural control and their exact mechanisms in diabetic patients with diabetic autonomic neuropathy (DAN. Although the prevalence of sympathetic and parasympathetic neuropathy is similar in T1DM versus T2DM patients, sympathetic nerve function correlates with parasympathetic neuropathy only in T1DM patients. The explanation for these discrepancies might be that parasympathetic nerve function was more severely affected among T2DM patients. As parasympathetic nerve damage seems to be more advanced than sympathetic nerve damage, it might be that parasympathetic neuropathy precedes sympathetic neuropathy in T2DM, which was Ewing's concept. This could be explained by the intrinsic morphologic difference. Therefore, the morphological changes in the sympathetic and parasympathetic nerves of involved organs in T1DM and T2DM patients who have DAN should be evaluated. In this review, evaluation methods for morphological changes in the epidermal nerves of skin, and the intrinsic nerves of the stomach will be discussed.

Self-actuated Polymeric Valve for Autonomous Sensing and Mixing

DEFF Research Database (Denmark)

Häfliger, Daniel; Marie, Rodolphe Charly Willy; Boisen, Anja

2005-01-01

We present an autonomously operated microvalve array for chemical sensing and mixing, which gains the actuation energy from a chemical reaction on the valve structure. An 8-μm-thick flapper valve made in SU-8 is coated with stress-loaded Al on one side and Ti on the other side. The metal films ke...... a reservoir. Calculations reveal that valve operation with stress originating from biochemical processes will require considerable enhancement of the actuation efficiency.......We present an autonomously operated microvalve array for chemical sensing and mixing, which gains the actuation energy from a chemical reaction on the valve structure. An 8-μm-thick flapper valve made in SU-8 is coated with stress-loaded Al on one side and Ti on the other side. The metal films keep...

Prevalence of Autonomic Dysreflexia in Patients with Spinal Cord Injury above T6

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Eun Sun Lee

2017-01-01

Full Text Available Objective. To investigate the prevalence of autonomic dysreflexia (AD using ambulatory blood pressure monitoring (ABPM and the autonomic dysfunction following spinal cord injury (ADFSCI questionnaire in patients with spinal cord injury (SCI above T6. Methods. Twenty-eight patients diagnosed with SCI above T6 were enrolled. ABPM and ADFSCI were utilized to assess AD. Using ABPM, systolic blood pressure (SBP, diastolic blood pressure, and heart rate (HR were measured at 30-minute intervals. AD was defined as SBP 20 mmHg higher than basal SBP, and the number of AD events was counted. The ADFSCI questionnaire evaluates the severity and frequency of the AD symptoms. Results. According to the ABPM, AD occurred in 26 patients and AD events occurred 5.8±4.7 times. Average daytime and nighttime SBP were 119.9±18.8 mmHg and 123.8±21.2 mmHg, respectively, and the nighttime mean SBP appeared to be 4 mmHg higher than daytime mean SBP. These findings suggest the loss of nocturnal BP dipping in SCI patients. ADFSCI results revealed that 16 of the patients evaluated were symptomatic while 12 were asymptomatic. Conclusion. AD following SCI above T6 was highly prevalent and several patients seemed asymptomatic. These results suggest the necessity of proper diagnostic and therapeutic interventions for managing AD.

Low-power cryptographic coprocessor for autonomous wireless sensor networks

Science.gov (United States)

Olszyna, Jakub; Winiecki, Wiesław

2013-10-01

The concept of autonomous wireless sensor networks involves energy harvesting, as well as effective management of system resources. Public-key cryptography (PKC) offers the advantage of elegant key agreement schemes with which a secret key can be securely established over unsecure channels. In addition to solving the key management problem, the other major application of PKC is digital signatures, with which non-repudiation of messages exchanges can be achieved. The motivation for studying low-power and area efficient modular arithmetic algorithms comes from enabling public-key security for low-power devices that can perform under constrained environment like autonomous wireless sensor networks. This paper presents a cryptographic coprocessor tailored to the autonomous wireless sensor networks constraints. Such hardware circuit is aimed to support the implementation of different public-key cryptosystems based on modular arithmetic in GF(p) and GF(2m). Key components of the coprocessor are described as GEZEL models and can be easily transformed to VHDL and implemented in hardware.

On-rail solution for autonomous inspections in electrical substations

Science.gov (United States)

Silva, Bruno P. A.; Ferreira, Rafael A. M.; Gomes, Selson C.; Calado, Flavio A. R.; Andrade, Roberto M.; Porto, Matheus P.

2018-05-01

This work presents an alternative solution for autonomous inspections in electrical substations. The autonomous system is a robot that moves on rails, collects infrared and visible images of selected targets, also processes the data and predicts the components lifetime. The robot moves on rails to overcome difficulties found in not paved substations commonly encountered in Brazil. We take advantage of using rails to convey the data by them, minimizing the electromagnetic interference, and at the same time transmitting electrical energy to feed the autonomous system. As part of the quality control process, we compared thermographic inspections made by the robot with inspections made by a trained thermographer using a scientific camera Flir® SC660. The results have shown that the robot achieved satisfactory results, identifying components and measuring temperature accurately. The embodied routine considers the weather changes along the day, providing a standard result of the components thermal response, also gives the uncertainty of temperature measurement, contributing to the quality in the decision making process.

Connected and autonomous vehicles 2040 vision.

Science.gov (United States)

2014-07-01

The Pennsylvania Department of Transportation (PennDOT) commissioned a one-year project, Connected and Autonomous : Vehicles 2040 Vision, with researchers at Carnegie Mellon University (CMU) to assess the implications of connected and : autonomous ve...

Autonomous sensor manager agents (ASMA)

Science.gov (United States)

Osadciw, Lisa A.

2004-04-01

Autonomous sensor manager agents are presented as an algorithm to perform sensor management within a multisensor fusion network. The design of the hybrid ant system/particle swarm agents is described in detail with some insight into their performance. Although the algorithm is designed for the general sensor management problem, a simulation example involving 2 radar systems is presented. Algorithmic parameters are determined by the size of the region covered by the sensor network, the number of sensors, and the number of parameters to be selected. With straight forward modifications, this algorithm can be adapted for most sensor management problems.

Burnout versus work engagement in their effects on 24-hour ambulatory monitored cardiac autonomic function

NARCIS (Netherlands)

L.J.P. van Doornen (Lorenz); J.H. Houtveen (Jan); S. Langelaan (Saar); A.B. Bakker (Arnold); W. van Rhenen (Willem); W.B. Schaufeli (Wilmar)

2009-01-01

textabstractBurnout has been associated with increased risk of cardiovascular disease. This relationship may be mediated by a stress-related disruption in cardiac autonomic activity. The aim of the present study was to assess cardiac autonomic activity (sympathetic and parasympathetic) during a

Exploring the genetics and non-cell autonomous mechanisms underlying ALS/FTLD.

Science.gov (United States)

Chen, Hongbo; Kankel, Mark W; Su, Susan C; Han, Steve W S; Ofengeim, Dimitry

2018-03-01

Although amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease, was first described in 1874, a flurry of genetic discoveries in the last 10 years has markedly increased our understanding of this disease. These findings have not only enhanced our knowledge of mechanisms leading to ALS, but also have revealed that ALS shares many genetic causes with another neurodegenerative disease, frontotemporal lobar dementia (FTLD). In this review, we survey how recent genetic studies have bridged our mechanistic understanding of these two related diseases and how the genetics behind ALS and FTLD point to complex disorders, implicating non-neuronal cell types in disease pathophysiology. The involvement of non-neuronal cell types is consistent with a non-cell autonomous component in these diseases. This is further supported by studies that identified a critical role of immune-associated genes within ALS/FTLD and other neurodegenerative disorders. The molecular functions of these genes support an emerging concept that various non-autonomous functions are involved in neurodegeneration. Further insights into such a mechanism(s) will ultimately lead to a better understanding of potential routes of therapeutic intervention. Facts ALS and FTLD are severe neurodegenerative disorders on the same disease spectrum. Multiple cellular processes including dysregulation of RNA homeostasis, imbalance of proteostasis, contribute to ALS/FTLD pathogenesis. Aberrant function in non-neuronal cell types, including microglia, contributes to ALS/FTLD. Strong neuroimmune and neuroinflammatory components are associated with ALS/FTLD patients. Open Questions Why can patients with similar mutations have different disease manifestations, i.e., why do C9ORF72 mutations lead to motor neuron loss in some patients while others exhibit loss of neurons in the frontotemporal lobe? Do ALS causal mutations result in microglial dysfunction and contribute to ALS/FTLD pathology? How do microglia

Impact of aging on cardiac function in a female rat model of menopause: role of autonomic control, inflammation, and oxidative stress

Science.gov (United States)

Machi, Jacqueline Freire; Dias, Danielle da Silva; Freitas, Sarah Cristina; de Moraes, Oscar Albuquerque; da Silva, Maikon Barbosa; Cruz, Paula Lázara; Mostarda, Cristiano; Salemi, Vera M C; Morris, Mariana; De Angelis, Kátia; Irigoyen, Maria-Cláudia

2016-01-01

Objective The aim of this study was to evaluate the effects of aging on metabolic, cardiovascular, autonomic, inflammatory, and oxidative stress parameters after ovarian hormone deprivation (OVX). Methods Female Wistar rats (3 or 22 months old) were divided into: young controls, young ovariectomized, old controls, and old ovariectomized (bilateral ovaries removal). After a 9-week follow-up, physical capacity, metabolic parameters, and morphometric and cardiac functions were assessed. Subsequently, arterial pressure was recorded and cardiac autonomic control was evaluated. Oxidative stress was measured on the cardiac tissue, while inflammatory profile was assessed in the plasma. Results Aging or OVX caused an increase in body and fat weight and triglyceride concentration and a decrease in both insulin sensitivity and aerobic exercise capacity. Left ventricular diastolic dysfunction and increased cardiac overload (myocardial performance index) were reported in old groups when compared with young groups. Aging and OVX led to an increased sympathetic tonus, and vagal tonus was lower only for the old groups. Tumor necrosis factor-α and interleukin-6 were increased in old groups when compared with young groups. Glutathione redox balance (GSH/GSSG) was reduced in young ovariectomized, old controls, and old ovariectomized groups when compared with young controls, indicating an increased oxidative stress. A negative correlation was found between GSH/GSSG and tumor necrosis factor-α (r=−0.6, P<0.003). Correlations were found between interleukin-6 with adipose tissue (r=0.5, P<0.009) and vagal tonus (r=−0.7, P<0.0002); and among myocardial performance index with interleukin-6 (r=0.65, P<0.0002), sympathetic tonus (r=0.55, P<0.006), and physical capacity (r=−0.55, P<0.003). The findings in this trial showed that ovariectomy aggravated the impairment of cardiac and functional effects of aging in female rats, probably associated with exacerbated autonomic dysfunction

Autonomous Operations System: Development and Application

Science.gov (United States)

Toro Medina, Jaime A.; Wilkins, Kim N.; Walker, Mark; Stahl, Gerald M.

2016-01-01

Autonomous control systems provides the ability of self-governance beyond the conventional control system. As the complexity of mechanical and electrical systems increases, there develops a natural drive for developing robust control systems to manage complicated operations. By closing the bridge between conventional automated systems to knowledge based self-awareness systems, nominal control of operations can evolve into relying on safe critical mitigation processes to support any off-nominal behavior. Current research and development efforts lead by the Autonomous Propellant Loading (APL) group at NASA Kennedy Space Center aims to improve cryogenic propellant transfer operations by developing an automated control and health monitoring system. As an integrated systems, the center aims to produce an Autonomous Operations System (AOS) capable of integrating health management operations with automated control to produce a fully autonomous system.

Salivary gland dysfunction following radioactive iodine therapy

International Nuclear Information System (INIS)

Wiesenfeld, D.; Webster, G.; Cameron, F.; Ferguson, M.M.; MacFadyen, E.E.; MacFarlane, T.W.

1983-01-01

Radioactive iodine is used extensively for the treatment of thyrotoxicosis and thyroid carcinoma. Iodine is actively taken up by the salivary glands and, following its use, salivary dysfunction may result as a consequence of radiation damage. The literature is reviewed and a case is reported in which a patient presented with a significant increase in caries rate attributed to salivary dysfunction following radioactive iodine therapy for a thyroid carcinoma

ROV90 - A prototype autonomous inspection vehicle

Energy Technology Data Exchange (ETDEWEB)

Roedseth, Oe.J.; Hallset, J.O.

1991-04-01

Simple autonomous inspection vehicles are suitable for operations where the cost, danger to humans, or area of operation prohibits the use of conventional underwater technology. Autonomous vehicles are, however, in their infancy and few such vehicles are available. There are still some problems to be overcome before this technology becomes useful in commercial applications. We have built ROV90 to investigate these problems. It is a test bed for experimenting with the different parts of an autonomous underwater vehicle. ROV90 will be able to autonomously follow prominent features in the real world, man made or natural. Examples are pipelines or walls in tunnels. ROV90 is tethered, but we are planning to use experience and results from ROV90 to develop av ''real'' autonomous underwater vehicle (AUV) called PISCIS. 11 refs., 8 figs.

Dysfunctional gaze processing in bipolar disorder

Directory of Open Access Journals (Sweden)

Cristina Berchio

2017-01-01

The present study provides neurophysiological evidence for abnormal gaze processing in BP and suggests dysfunctional processing of direct eye contact as a prominent characteristic of bipolar disorder.

Truly random dynamics generated by autonomous dynamical systems

Science.gov (United States)

González, J. A.; Reyes, L. I.

2001-09-01

We investigate explicit functions that can produce truly random numbers. We use the analytical properties of the explicit functions to show that a certain class of autonomous dynamical systems can generate random dynamics. This dynamics presents fundamental differences with the known chaotic systems. We present real physical systems that can produce this kind of random time-series. Some applications are discussed.

Consensus statement on the definition of neurogenic supine hypertension in cardiovascular autonomic failure by the American Autonomic Society (AAS) and the European Federation of Autonomic Societies (EFAS) : Endorsed by the European Academy of Neurology (EAN) and the European Society of Hypertension (ESH).

Science.gov (United States)

Fanciulli, Alessandra; Jordan, Jens; Biaggioni, Italo; Calandra-Buonaura, Giovanna; Cheshire, William P; Cortelli, Pietro; Eschlboeck, Sabine; Grassi, Guido; Hilz, Max J; Kaufmann, Horacio; Lahrmann, Heinz; Mancia, Giuseppe; Mayer, Gert; Norcliffe-Kaufmann, Lucy; Pavy-Le Traon, Anne; Raj, Satish R; Robertson, David; Rocha, Isabel; Struhal, Walter; Thijs, Roland; Tsioufis, Konstantinos P; van Dijk, J Gert; Wenning, Gregor K

2018-05-15

Patients suffering from cardiovascular autonomic failure often develop neurogenic supine hypertension (nSH), i.e., high blood pressure (BP) in the supine position, which falls in the upright position owing to impaired autonomic regulation. A committee was formed to reach consensus among experts on the definition and diagnosis of nSH in the context of cardiovascular autonomic failure. As a first and preparatory step, a systematic search of PubMed-indexed literature on nSH up to January 2017 was performed. Available evidence derived from this search was discussed in a consensus expert round table meeting in Innsbruck on February 16, 2017. Statements originating from this meeting were further discussed by representatives of the American Autonomic Society and the European Federation of Autonomic Societies and are summarized in the document presented here. The final version received the endorsement of the European Academy of Neurology and the European Society of Hypertension. In patients with neurogenic orthostatic hypotension, nSH is defined as systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg, measured after at least 5 min of rest in the supine position. Three severity degrees are recommended: mild, moderate and severe. nSH may also be present during nocturnal sleep, with reduced-dipping, non-dipping or rising nocturnal BP profiles with respect to mean daytime BP values. Home BP monitoring and 24-h-ambulatory BP monitoring provide relevant information for a customized clinical management. The establishment of expert-based criteria to define nSH should standardize diagnosis and allow a better understanding of its epidemiology, prognosis and, ultimately, treatment.

Development of autonomous vehicles’ testing system

Science.gov (United States)

Ivanov, A. M.; Shadrin, S. S.

2018-02-01

This article describes overview of automated and, in perspective, autonomous vehicles’ (AV) implementation risks. Set of activities, actual before the use of AVs on public roads, minimizing negative technical and social problems of AVs’ implementation is presented. Classification of vehicle’s automated control systems operating conditions is formulated. Groups of tests for AVs are developed and justified, sequence of AVs’ testing system formation is proposed.

Mathematical model of unmanned aerial vehicle used for endurance autonomous monitoring

Energy Technology Data Exchange (ETDEWEB)

Chelaru, Teodor-Viorel, E-mail: teodor.chelaru@upb.ro [University POLITEHNICA of Bucharest - Research Center for Aeronautics and Space, Str. Gheorghe Polizu, no. 1, PC 011061, Sector 1, Bucharest (Romania); Chelaru, Adrian, E-mail: achelaru@incas.ro [INCAS -National Institute for Aerospace Research Elie Carafoli, B-dul Iuliu Maniu 220, 061126, Sector 6, Bucharest (Romania)

2014-12-10

The paper purpose is to present some aspects regarding the control system of unmanned aerial vehicle - UAV, used to local observations, surveillance and monitoring interest area. The calculus methodology allows a numerical simulation of UAV evolution in bad atmospheric conditions by using nonlinear model, as well as a linear one for obtaining guidance command. The UAV model which will be presented has six DOF (degrees of freedom), and autonomous control system. This theoretical development allows us to build stability matrix, command matrix and control matrix and finally to analyse the stability of autonomous UAV flight. A robust guidance system, based on uncoupled state will be evaluated for different fly conditions and the results will be presented. The flight parameters and guidance will be analysed.

Mathematical model of unmanned aerial vehicle used for endurance autonomous monitoring

International Nuclear Information System (INIS)

Chelaru, Teodor-Viorel; Chelaru, Adrian

2014-01-01

The paper purpose is to present some aspects regarding the control system of unmanned aerial vehicle - UAV, used to local observations, surveillance and monitoring interest area. The calculus methodology allows a numerical simulation of UAV evolution in bad atmospheric conditions by using nonlinear model, as well as a linear one for obtaining guidance command. The UAV model which will be presented has six DOF (degrees of freedom), and autonomous control system. This theoretical development allows us to build stability matrix, command matrix and control matrix and finally to analyse the stability of autonomous UAV flight. A robust guidance system, based on uncoupled state will be evaluated for different fly conditions and the results will be presented. The flight parameters and guidance will be analysed

Effects of Kefir on the Cardiac Autonomic Tones and Baroreflex Sensitivity in Spontaneously Hypertensive Rats.

Science.gov (United States)

Klippel, Brunella F; Duemke, Licia B; Leal, Marcos A; Friques, Andreia G F; Dantas, Eduardo M; Dalvi, Rodolfo F; Gava, Agata L; Pereira, Thiago M C; Andrade, Tadeu U; Meyrelles, Silvana S; Campagnaro, Bianca P; Vasquez, Elisardo C

2016-01-01

It has been previously shown that the probiotic kefir (a symbiotic matrix containing acid bacteria and yeasts) attenuated the hypertension and the endothelial dysfunction in spontaneously hypertensive rats (SHR). In the present study, the effect of chronic administration of kefir on the cardiac autonomic control of heart rate (HR) and baroreflex sensitivity (BRS) in SHR was evaluated. SHR were treated with kefir (0.3 mL/100 g body weight) for 60 days and compared with non-treated SHR and with normotensive Wistar-Kyoto rats. Cardiac autonomic vagal (VT) and sympathetic (ST) tones were estimated through the blockade of the cardiac muscarinic receptors (methylatropine) and the blockade of β1-adrenoceptor (atenolol). The BRS was evaluated by the tachycardia and bradycardia responses to vasoactive drug-induced decreases and increases in arterial blood pressure (BP), respectively. Additionally, spontaneous BRS was estimated by autoregressive spectral analysis. Kefir-treated SHR exhibited significant attenuation of basal BP, HR, and cardiac hypertrophy compared to non-treated SHR (12, 13, and 21%, respectively). Cardiac VT and ST were significantly altered in the SHR (~40 and ~90 bpm) compared with Wistar rats (~120 and ~30 bpm) and were partially recovered in SHR-kefir (~90 and ~25 bpm). SHR exhibited an impaired bradycardic BRS (~50%) compared with Wistar rats, which was reduced to ~40% in the kefir-treated SHR and abolished by methylatropine in all groups. SHR also exhibited a significant impairment of the tachycardic BRS (~23%) compared with Wistar rats and this difference was reduced to 8% in the SHR-kefir. Under the action of atenolol the residual reflex tachycardia was smaller in SHR than in Wistar rats and kefir attenuated this abnormality. Spectral analysis revealed increased low frequency components of BP (~3.5-fold) and pulse interval (~2-fold) compared with Wistar rats and these differences were reduced by kefir-treatment to ~1.6- and ~1.5-fold, respectively

Effects of Kefir on the Cardiac Autonomic Tones and Baroreflex Sensitivity in Spontaneously Hypertensive Rats

Science.gov (United States)

Klippel, Brunella F.; Duemke, Licia B.; Leal, Marcos A.; Friques, Andreia G. F.; Dantas, Eduardo M.; Dalvi, Rodolfo F.; Gava, Agata L.; Pereira, Thiago M. C.; Andrade, Tadeu U.; Meyrelles, Silvana S.; Campagnaro, Bianca P.; Vasquez, Elisardo C.

2016-01-01

Aims: It has been previously shown that the probiotic kefir (a symbiotic matrix containing acid bacteria and yeasts) attenuated the hypertension and the endothelial dysfunction in spontaneously hypertensive rats (SHR). In the present study, the effect of chronic administration of kefir on the cardiac autonomic control of heart rate (HR) and baroreflex sensitivity (BRS) in SHR was evaluated. Methods: SHR were treated with kefir (0.3 mL/100 g body weight) for 60 days and compared with non-treated SHR and with normotensive Wistar-Kyoto rats. Cardiac autonomic vagal (VT) and sympathetic (ST) tones were estimated through the blockade of the cardiac muscarinic receptors (methylatropine) and the blockade of β1−adrenoceptor (atenolol). The BRS was evaluated by the tachycardia and bradycardia responses to vasoactive drug-induced decreases and increases in arterial blood pressure (BP), respectively. Additionally, spontaneous BRS was estimated by autoregressive spectral analysis. Results: Kefir-treated SHR exhibited significant attenuation of basal BP, HR, and cardiac hypertrophy compared to non-treated SHR (12, 13, and 21%, respectively). Cardiac VT and ST were significantly altered in the SHR (~40 and ~90 bpm) compared with Wistar rats (~120 and ~30 bpm) and were partially recovered in SHR-kefir (~90 and ~25 bpm). SHR exhibited an impaired bradycardic BRS (~50%) compared with Wistar rats, which was reduced to ~40% in the kefir-treated SHR and abolished by methylatropine in all groups. SHR also exhibited a significant impairment of the tachycardic BRS (~23%) compared with Wistar rats and this difference was reduced to 8% in the SHR-kefir. Under the action of atenolol the residual reflex tachycardia was smaller in SHR than in Wistar rats and kefir attenuated this abnormality. Spectral analysis revealed increased low frequency components of BP (~3.5-fold) and pulse interval (~2-fold) compared with Wistar rats and these differences were reduced by kefir-treatment to ~1

An Experimental Platform for Autonomous Bus Development

Directory of Open Access Journals (Sweden)

Héctor Montes

2017-11-01

Full Text Available Nowadays, with highly developed instrumentation, sensing and actuation technologies, it is possible to foresee an important advance in the field of autonomous and/or semi-autonomous transportation systems. Intelligent Transport Systems (ITS have been subjected to very active research for many years, and Bus Rapid Transit (BRT is one area of major interest. Among the most promising transport infrastructures, the articulated bus is an interesting, low cost, high occupancy capacity and friendly option. In this paper, an experimental platform for research on the automatic control of an articulated bus is presented. The aim of the platform is to allow full experimentation in real conditions for testing technological developments and control algorithms. The experimental platform consists of a mobile component (a commercial articulated bus fully instrumented and a ground test area composed of asphalt roads inside the Consejo Superior de Investigaciones Científicas (CSIC premises. This paper focuses also on the development of a human machine interface to ease progress in control system evaluation. Some experimental results are presented in order to show the potential of the proposed platform.

Neurotoxic impact of mercury on the central nervous system evaluated by neuropsychological tests and on the autonomic nervous system evaluated by dynamic pupillometry.

Science.gov (United States)

Milioni, Ana Luiza V; Nagy, Balázs V; Moura, Ana Laura A; Zachi, Elaine C; Barboni, Mirella T S; Ventura, Dora F

2017-03-01

Mercury vapor is highly toxic to the human body. The present study aimed to investigate the occurrence of neuropsychological dysfunction in former workers of fluorescent lamps factories that were exposed to mercury vapor (years after cessation of exposure), diagnosed with chronic mercurialism, and to investigate the effects of such exposure on the Autonomic Nervous System (ANS) using the non-invasive method of dynamic pupillometry. The exposed group and a control group matched by age and educational level were evaluated by the Beck Depression Inventory and with the computerized neuropsychological battery CANTABeclipse - subtests of working memory (Spatial Span), spatial memory (Spatial Recognition Memory), visual memory (Pattern Recognition Memory) and action planning (Stockings of Cambridge). The ANS was assessed by dynamic pupillometry, which provides information on the operation on both the sympathetic and parasympathetic functions. Depression scores were significantly higher among the former workers when compared with the control group. The exposed group also showed significantly worse performance in most of the cognitive functions assessed. In the dynamic pupillometry test, former workers showed significantly lower response than the control group in the sympathetic response parameter (time of 75% of pupillary recovery at 10cd/m 2 luminance). Our study found indications that are suggestive of cognitive deficits and losses in sympathetic autonomic activity among patients occupationally exposed to mercury vapor. Copyright © 2016 Elsevier B.V. All rights reserved.

Autonomous Science Analysis with the New Millennium Program-Autonomous Sciencecraft Experiment

Science.gov (United States)

Doggett, T.; Davies, A. G.; Castano, R. A.; Baker, V. R.; Dohm, J. M.; Greeley, R.; Williams, K. K.; Chien, S.; Sherwood, R.

2002-12-01

The NASA New Millennium Program (NMP) is a testbed for new, high-risk technologies, including new software and hardware. The Autonomous Sciencecraft Experiment (ASE) will fly on the Air Force Research Laboratory TechSat-21 mission in 2006 is such a NMP mission, and is managed by the Jet Propulsion Laboratory, California Institute of Technology. TechSat-21 consists of three satellites, each equipped with X-band Synthetic Aperture Radar (SAR) that will occupy a 13-day repeat track Earth orbit. The main science objectives of ASE are to demonstrate that process-related change detection and feature identification can be conducted autonomously during space flight, leading to autonomous onboard retargeting of the spacecraft. This mission will observe transient geological and environmental processes using SAR. Examples of geologic processes that may be observed and investigated include active volcanism, the movement of sand dunes and transient features in desert environments, water flooding, and the formation and break-up of lake ice. Science software onboard the spacecraft will allow autonomous processing and formation of SAR images and extraction of scientific information. The subsequent analyses, performed on images formed onboard from the SAR data, will include feature identification using scalable feature "templates" for each target, change detection through comparison of current and archived images, and science discovery, a search for other features of interest in each image. This approach results in obtaining the same science return for a reduced amount of resource use (such as downlink) when compared to that from a mission operating without ASE technology. Redundant data is discarded. The science-driven goals of ASE will evolve during the ASE mission through onboard replanning software that can re-task satellite operations. If necessary, as a result of a discovery made autonomously by onboard science processing, existing observation sequences will be pre-empted to

Rapid-onset obesity with hypothalamic dysregulation, hypoventilation, and autonomic dysregulation (ROHHAD syndrome): A case report and literature review.

Science.gov (United States)

Ibáñez-Micó, S; Marcos Oltra, A M; de Murcia Lemauviel, S; Ruiz Pruneda, R; Martínez Ferrández, C; Domingo Jiménez, R

ROHHAD syndrome (rapid-onset obesity with hypothalamic dysregulation, hypoventilation, and autonomic dysregulation) is a rare and complex disease, presenting in previously healthy children at the age of 2-4 years. Up to 40% of cases are associated with neural crest tumours. We present the case of a 2-year-old girl with symptoms of rapidly progressing obesity, who a few months later developed hypothalamic dysfunction with severe electrolyte imbalance, behaviour disorder, hypoventilation, and severe autonomic dysregulation, among other symptoms. Although the pathophysiology of this syndrome remains unclear, an autoimmune hypothesis has been proposed for ROHHAD. Therefore, after obtaining a limited response to intravenous immunoglobulins, we decided to test the response to a high dose cyclophosphamide (low dose was not effective either). Unfortunately our patient experienced many severe complications (among them central pontine myelinolysis, from which the patient recovered, and failure to wean from the ventilator requiring tracheostomy and long term ventilation) that required a prolonged ICU stay. Although her behaviour improved, our patient unfortunately died suddenly at home at the age of 5 due to respiratory pathology. ROHHAD syndrome is a rare and little-known disease which requires a multidisciplinary approach because it involves complex symptoms and multiple organ system involvement. Alveolar hypoventilation should be identified early and appropriate treatment should be started promptly for the best possible outcome. Immunomodulatory treatment with immunoglobulins, cyclophosphamide, or rituximab has previously resulted in symptom improvement in some cases. Because of the low incidence of the syndrome, multi-centre studies must be carried out in order to gather more accurate information about ROHHAD pathophysiology and design an appropriate therapeutic approach. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All

Autonomous search

CERN Document Server

Hamadi, Youssef; Saubion, Frédéric

2012-01-01

Autonomous combinatorial search (AS) represents a new field in combinatorial problem solving. Its major standpoint and originality is that it considers that problem solvers must be capable of self-improvement operations. This is the first book dedicated to AS.

Trichotillomania In A Patient With Sexual Dysfunction

Directory of Open Access Journals (Sweden)

Aswathi Krishna

2016-10-01

Full Text Available Trichotillomania is a chronic psychiatric disorder characterized by pulling out one's own hair, which results in an obvious loss of hair. Hair pulling was first described in Henri Allopeau in 1889. The term "trichotillomania" comes from the Greek words "thrix" - hair, "tillein" - to pull and "Mania" madness or frenzy. 30 year old man presented with complaints of hairpulling behavior and associated erectile dysfunction. His hairpulling behavior improved on treating his sexual dysfunction.

Perception, Planning, Control, and Coordination for Autonomous Vehicles

Directory of Open Access Journals (Sweden)

Scott Drew Pendleton

2017-02-01

Full Text Available Autonomous vehicles are expected to play a key role in the future of urban transportation systems, as they offer potential for additional safety, increased productivity, greater accessibility, better road efficiency, and positive impact on the environment. Research in autonomous systems has seen dramatic advances in recent years, due to the increases in available computing power and reduced cost in sensing and computing technologies, resulting in maturing technological readiness level of fully autonomous vehicles. The objective of this paper is to provide a general overview of the recent developments in the realm of autonomous vehicle software systems. Fundamental components of autonomous vehicle software are reviewed, and recent developments in each area are discussed.

Mobile autonomous robot for radiological surveys

International Nuclear Information System (INIS)

Dudar, A.M.; Wagner, D.G.; Teese, G.D.

1992-01-01

The robotics development group at the Savannah River Laboratory (SRL) is developing a mobile autonomous robot that performs radiological surveys of potentially contaminated floors. The robot is called SIMON, which stands for Semi-Intelligent Mobile Observing Navigator. Certain areas of SRL are classified as radiologically controlled areas (RCAs). In an RCA, radioactive materials are frequently handled by workers, and thus, the potential for contamination is ever present. Current methods used for floor radiological surveying includes labor-intensive manual scanning or random smearing of certain floor locations. An autonomous robot such as SIMON performs the surveying task in a much more efficient manner and will track down contamination before it is contacted by humans. SIMON scans floors at a speed of 1 in./s and stops and alarms upon encountering contamination. Its environment is well defined, consisting of smooth building floors with wide corridors. The kind of contaminations that SIMON is capable of detecting are alpha and beta-gamma. The contamination levels of interest are low to moderate

Autonomous motivation: a predictor of treatment outcome in bulimia-spectrum eating disorders.

Science.gov (United States)

Mansour, Sandra; Bruce, Kenneth R; Steiger, Howard; Zuroff, David C; Horowitz, Sarah; Anestin, Annelie S; Sycz, Lindsay

2012-05-01

Individuals with eating disorders are said to be highly ambivalent towards change and thus have difficulty maintaining a commitment to, and motivation for, treatment. Self-Determination Theory postulates that autonomous motivation for therapy exists when individuals view their participation as freely chosen. The present study was designed to ascertain whether or not autonomous motivation was associated with treatment response in individuals with bulimia-spectrum eating disorders (BSED). One hundred and fifty-five women with DSM-IV-TR BSED participated in multimodal group therapy and completed measures to assess motivation, eating and comorbid symptoms. Hierarchical multiple regression analyses demonstrated that higher levels of autonomous motivation at pretreatment predicted lower post-treatment scores on measures of eating preoccupations (shape, weight and eating concerns), binge eating, anxiety/depression, relationship to self and others and impulsivity. These results indicate that autonomous motivation may be an important predictor of outcome following treatment for BSED. Copyright © 2012 John Wiley & Sons, Ltd and Eating Disorders Association.

Burden of Sexual Dysfunction.

Science.gov (United States)

Balon, Richard

2017-01-02

Similar to the burden of other diseases, the burden of sexual dysfunction has not been systematically studied. However, there is growing evidence of various burdens (e.g., economic, symptomatic, humanistic) among patients suffering from sexual dysfunctions. The burden of sexual dysfunction has been studied a bit more often in men, namely the burden of erectile dysfunction (ED), premature ejaculation (PE) and testosterone deficiency syndrome (TDS). Erectile dysfunction is frequently associated with chronic conditions such as cardiovascular disease, diabetes, and depression. These conditions could go undiagnosed, and ED could be a marker of those diseases. The only available report from the United Kingdom estimated the total economic burden of ED at £53 million annually in terms of direct costs and lost productivity. The burden of PE includes significant psychological distress: anxiety, depression, lack of sexual confidence, poor self-esteem, impaired quality of life, and interpersonal difficulties. Some suggest that increase in female sexual dysfunction is associated with partner's PE, in addition to significant interpersonal difficulties. The burden of TDS includes depression, sexual dysfunction, mild cognitive impairment, and osteoporosis. One UK estimate of the economic burden of female sexual dysfunctions demonstrated that the average cost per patient was higher than the per annum cost of ED. There are no data on burden of paraphilic disorders. The burden of sexual dysfunctions is underappreciated and not well studied, yet it is significant for both the patients and the society.

Vision Based Autonomous Robot Navigation Algorithms and Implementations

CERN Document Server

Chatterjee, Amitava; Nirmal Singh, N

2013-01-01

This book is devoted to the theory and development of autonomous navigation of mobile robots using computer vision based sensing mechanism. The conventional robot navigation systems, utilizing traditional sensors like ultrasonic, IR, GPS, laser sensors etc., suffer several drawbacks related to either the physical limitations of the sensor or incur high cost. Vision sensing has emerged as a popular alternative where cameras can be used to reduce the overall cost, maintaining high degree of intelligence, flexibility and robustness. This book includes a detailed description of several new approaches for real life vision based autonomous navigation algorithms and SLAM. It presents the concept of how subgoal based goal-driven navigation can be carried out using vision sensing. The development concept of vision based robots for path/line tracking using fuzzy logic is presented, as well as how a low-cost robot can be indigenously developed in the laboratory with microcontroller based sensor systems. The book descri...

Exploration of Risks in Autonomous Decision-Making Applied to Aeronautics

Data.gov (United States)

National Aeronautics and Space Administration — Prior research into metrics and design for autonomy were presented. At this time, the prospect of adding significant autonomous decision-making on a piloted aircraft...

Liver dysfunction and anti-thyroid therapy

Directory of Open Access Journals (Sweden)

Danae A Papachristos

2015-01-01

Full Text Available Thioamides have been used in the management of hyperthyroidism for over 50 years. Liver dysfunction is a rare but important side effect associated with their use. Recently, cases of liver failure associated with propylthiouracil have prompted the Federal Drug Administration to issue a Boxed Warning to the label of propylthiouracil regarding its risk of potentially fatal liver injury and acute liver failure in adults and children. Herein, we present a case to underline the importance of recognising the similar potential for severe hepatic dysfunction with the use of other thioamides.

Autonomes und interkulturelles Lernen im Fremdsprachenunterricht – unvereinbar oder untrennbar?

Directory of Open Access Journals (Sweden)

Klaus-Börge Boeckmann

2015-10-01

The discussion on learner autonomy has intensified considerably in the last two decades, but autonomous learning in the intercultural field has remained a fairly marginal topic. This paper examines  the compatibility of intercultural and autonomous learning and starts by presenting two approaches that come to contradicting conclusions. The hypothesis that both learning fields are compatible, or indeed inseparable, appears better founded and more popular, however. Considering the broad scope of the discussion, the paper continues by focussing on learner-centredness as an important element of autonomy. The rationale for and advantages of learner-centred concepts of teaching and learning are discussed. In reflecting on the application of learner-centred concepts in the field of intercultural competence the emphasis is laid on attitudes as an area of competence. Some examples show how autonomous and intercultural learning can be interlaced in project-type learning tasks.

Performance of a six-legged planetary rover - Power, positioning, and autonomous walking

Science.gov (United States)

Krotkov, Eric; Simmons, Reid

The authors quantify several performance metrics for the Ambler, a six-legged robot configured for autonomous traversal of Mars-like terrain. They present power consumption measures for walking on sandy terrain and for vertical lifts at different velocities. They document the accuracy of a novel dead reckoning approach, and analyze the accuracy. They describe the results of autonomous walking experiments in terms of terrain traversed, walking speed, number of instructions executed and endurance.

Research Institute for Autonomous Precision Guided Systems

National Research Council Canada - National Science Library

Rogacki, John R

2007-01-01

... vehicles, cooperative flight of autonomous aerial vehicles using GPS and vision information, cooperative and sharing of information in search missions involving multiple autonomous agents, multi-scale...

[Quality of life in women with pelvic floor dysfunction].

Science.gov (United States)

Segedi, Ljiljana Mladenović; Ilić, Katarina Parezanović; Curcić, Aleksandar; Visnjevac, Nemanja

2011-11-01

Pelvic floor dysfunction is a frequent problem affecting more than 50% of women in peri- and postmenopause. Considering that ageing and menopause befall in the significant factors causing this issue, as well as the expected longevity of women in the world and in our country, pelvic floor dysfunction prevelence is foreseen to be even higher. The aim of the study was to evaluate impact of the symptoms of pelvic dysfunction on quality of life and examine body image satisfaction in adult women with pelvic organ prolapse presenting to tertiary care clinic for surgical treatment. This prospective case-control study included 50 patients who presented to tertiary care gynecology clinic for surgical treatment and 50 controls with normal pelvic floor support and without urinary incontinence who presented tertiary care gynecology clinic for other reasons. Both, patients and controls, completed two quastionnaires recommended for the evaluation of symptoms (Pelvic floor distress inventory - short forms) and quality of life impact (Pelvic floor impact questionnaire - short form) of pelvic organ prolapse, and Body Image Scale. The patients scored significantly worse on the prolapse, urinary, colorectal scales and overall score of Pelvic floor distress inventory--20 than controls subjects (134.91 vs 78.08; p self-conscious (78% vs 42%; p body. There was a positive correlation between decreased quality of life and body image in women with pelvic dysfunction. Women with pelvic floor dysfunction have decreased quality of life and body image.

Autonomous Aircraft Operations using RTCA Guidelines for Airborne Conflict Management

Science.gov (United States)

Krishnamurthy, Karthik; Wing, David J.; Barmore, Bryan E.; Barhydt, Richard; Palmer, Michael T.; Johnson, Edward J.; Ballin, Mark G.; Eischeid, Todd M.

2003-01-01

A human-in-the-loop experiment was performed at the NASA Langley Research Center to study the feasibility of DAG-TM autonomous aircraft operations in highly constrained airspace. The airspace was constrained by a pair of special-use airspace (SUA) regions on either side of the pilot's planned route. Traffic flow management (TFM) constraints were imposed as a required time of arrival and crossing altitude at an en route fix. Key guidelines from the RTCA Airborne Conflict Management (ACM) concept were applied to autonomous aircraft operations for this experiment. These concepts included the RTCA ACM definitions of distinct conflict detection and collision avoidance zones, and the use of a graded system of conflict alerts for the flight crew. Three studies were conducted in the course of the experiment. The first study investigated the effect of hazard proximity upon pilot ability to meet constraints and solve conflict situations. The second study investigated pilot use of the airborne tools when faced with an unexpected loss of separation (LOS). The third study explored pilot interactions in an over-constrained conflict situation, with and without priority rules dictating who should move first. Detailed results from these studies were presented at the 5th USA/Europe Air Traffic Management R&D Seminar (ATM2003). This overview paper focuses on the integration of the RTCA ACM concept into autonomous aircraft operations in highly constrained situations, and provides an overview of the results presented at the ATM2003 seminar. These results, together with previously reported studies, continue to support the feasibility of autonomous aircraft operations.

Radionuclide power source for artificial heart autonomic apparatus

Energy Technology Data Exchange (ETDEWEB)

Lazarenko, Yu V; Gusev, V V; Pustovalov, A A

1988-02-01

Works on creating autonomous artificial heart devices with radionuclide heat source are described. Calculated and experimental parameters of /sup 238/Pu base radionuclide thermoelectric RITEG generators designed for supplying perspective blood pump electric drives are presented. RITEG structure is described and the prospects of increasing its efficiency are shown.

"Little Helper" - An Autonomous Industrial Mobile Manipulator Concept

Directory of Open Access Journals (Sweden)

Mads Hvilshoj

2011-06-01

Full Text Available This paper presents the concept "autonomous industrial mobile manipulation" (AIMM based on the mobile manipulator "Little Helper" - an ongoing research project at Aalborg University, Denmark, concerning the development of an autonomous and flexible manufacturing assistant. The paper focuses on the contextual aspects and the working principles of AIMM. Furthermore, the paper deals with the design principles and overall hardware and software architectures of "Little Helper" from a functional and modular mechatronics point of view, in order to create a generic AIMM platform. The design challenges faced in the project is to integrate commercial off‐the‐shelf (COTS and dedicated highly integrated systems into an autonomous mobile manipulator system with the ability to perform diverse tasks in industrial environments. We propose an action based domain specific communication language for AIMM for routine and task definition, in order to lower the entry barriers for the users of the technology. To demonstrate the "Little Helper" concept a full‐scale prototype has been built and different application examples carried out. Experiences and knowledge gained from this show promising results regarding industrial integration, exploitation and maturation of the AIMM technology.

An efficient phased mission reliability analysis for autonomous vehicles

Energy Technology Data Exchange (ETDEWEB)

Remenyte-Prescott, R., E-mail: R.Remenyte-Prescott@nottingham.ac.u [Nottingham Transportation Engineering Centre, Faculty of Engineering, University of Nottingham, Nottingham NG7 2RD (United Kingdom); Andrews, J.D. [Nottingham Transportation Engineering Centre, Faculty of Engineering, University of Nottingham, Nottingham NG7 2RD (United Kingdom); Chung, P.W.H. [Department of Computer Science, Loughborough University, Loughborough LE11 3TU (United Kingdom)

2010-03-15

Autonomous systems are becoming more commonly used, especially in hazardous situations. Such systems are expected to make their own decisions about future actions when some capabilities degrade due to failures of their subsystems. Such decisions are made without human input, therefore they need to be well-informed in a short time when the situation is analysed and future consequences of the failure are estimated. The future planning of the mission should take account of the likelihood of mission failure. The reliability analysis for autonomous systems can be performed using the methodologies developed for phased mission analysis, where the causes of failure for each phase in the mission can be expressed by fault trees. Unmanned autonomous vehicles (UAVs) are of a particular interest in the aeronautical industry, where it is a long term ambition to operate them routinely in civil airspace. Safety is the main requirement for the UAV operation and the calculation of failure probability of each phase and the overall mission is the topic of this paper. When components or subsystems fail or environmental conditions throughout the mission change, these changes can affect the future mission. The new proposed methodology takes into account the available diagnostics data and is used to predict future capabilities of the UAV in real time. Since this methodology is based on the efficient BDD method, the quickly provided advice can be used in making decisions. When failures occur appropriate actions are required in order to preserve safety of the autonomous vehicle. The overall decision making strategy for autonomous vehicles is explained in this paper. Some limitations of the methodology are discussed and further improvements are presented based on experimental results.

An efficient phased mission reliability analysis for autonomous vehicles

International Nuclear Information System (INIS)

Remenyte-Prescott, R.; Andrews, J.D.; Chung, P.W.H.

2010-01-01

Autonomous systems are becoming more commonly used, especially in hazardous situations. Such systems are expected to make their own decisions about future actions when some capabilities degrade due to failures of their subsystems. Such decisions are made without human input, therefore they need to be well-informed in a short time when the situation is analysed and future consequences of the failure are estimated. The future planning of the mission should take account of the likelihood of mission failure. The reliability analysis for autonomous systems can be performed using the methodologies developed for phased mission analysis, where the causes of failure for each phase in the mission can be expressed by fault trees. Unmanned autonomous vehicles (UAVs) are of a particular interest in the aeronautical industry, where it is a long term ambition to operate them routinely in civil airspace. Safety is the main requirement for the UAV operation and the calculation of failure probability of each phase and the overall mission is the topic of this paper. When components or subsystems fail or environmental conditions throughout the mission change, these changes can affect the future mission. The new proposed methodology takes into account the available diagnostics data and is used to predict future capabilities of the UAV in real time. Since this methodology is based on the efficient BDD method, the quickly provided advice can be used in making decisions. When failures occur appropriate actions are required in order to preserve safety of the autonomous vehicle. The overall decision making strategy for autonomous vehicles is explained in this paper. Some limitations of the methodology are discussed and further improvements are presented based on experimental results.

Adaptive Control Allocation for Fault Tolerant Overactuated Autonomous Vehicles

Science.gov (United States)

2007-11-01

Tolerant Overactuated Autonomous Vehicles Casavola, A.; Garone, E. (2007) Adaptive Control Allocation for Fault Tolerant Overactuated Autonomous ...Adaptive Control Allocation for Fault Tolerant Overactuated Autonomous Vehicles 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6...Tolerant Overactuated Autonomous Vehicles 3.2 - 2 RTO-MP-AVT-145 UNCLASSIFIED/UNLIMITED Control allocation problem (CAP) - Given a virtual input v(t

Overfeeding, autonomic regulation and metabolic consequences.

NARCIS (Netherlands)

Scheurink, A.J.W.; Balkan, B; Strubbe, J.H.; van Dijk, G.; Steffens, A.B

The autonomic nervous system plays an important role in the regulation of body processes in health and disease. Overfeeding and obesity (a disproportional increase of the fat mass of the body) are often accompanied by alterations in both sympathetic and parasympathetic autonomic functions. The

Interaction of Harsh Weather Operation and Collision Avoidance in Autonomous Navigation

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Hans-Christoph Burmeister

2015-03-01

Full Text Available Taking into account the autonomous navigation system design and today’s state of the art navigation with regards to weather and collision avoidance this paper presents the architecture of the integrated approach, its links to existing rules and regulations and the test scenarios. These demonstrate how safe and efficient navigation of autonomous vessels can be achieved by showing the module's interaction and validating the feasibility of the approach. These analyses will be based on historical traffic data sets as well as simulation results.

Screening for cognitive dysfunction in unipolar depression

DEFF Research Database (Denmark)

Ott, Caroline Vintergaard; Bjertrup, Anne Juul; Jensen, Johan Høy

2016-01-01

BACKGROUND: Persistent cognitive dysfunction in unipolar depression (UD) contributes to socio-occupational impairment, but there are no feasible methods to screen for and monitor cognitive dysfunction in this patient group. The present study investigated the validity of two new instruments...... to screen for cognitive dysfunction in UD, and their associations with socio-occupational capacity. METHOD: Participants (n=53) with UD in partial or full remission and healthy control persons (n=103) were assessed with two new screening instruments, the Danish translations of the Screen for Cognitive...... Impairment in Psychiatry (SCIP-D) and Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA) and with established neuropsychological and self-assessment measures. Depression symptoms and socio-occupational function were rated with the Hamilton Depression Rating Scale and Functional Assessment...

Autonomous mobile robot teams

Science.gov (United States)

Agah, Arvin; Bekey, George A.

1994-01-01

This paper describes autonomous mobile robot teams performing tasks in unstructured environments. The behavior and the intelligence of the group is distributed, and the system does not include a central command base or leader. The novel concept of the Tropism-Based Cognitive Architecture is introduced, which is used by the robots in order to produce behavior transforming their sensory information to proper action. The results of a number of simulation experiments are presented. These experiments include worlds where the robot teams must locate, decompose, and gather objects, and defend themselves against hostile predators, while navigating around stationary and mobile obstacles.

Memory Dysfunction

Science.gov (United States)

Matthews, Brandy R.

2015-01-01

Purpose of Review: This article highlights the dissociable human memory systems of episodic, semantic, and procedural memory in the context of neurologic illnesses known to adversely affect specific neuroanatomic structures relevant to each memory system. Recent Findings: Advances in functional neuroimaging and refinement of neuropsychological and bedside assessment tools continue to support a model of multiple memory systems that are distinct yet complementary and to support the potential for one system to be engaged as a compensatory strategy when a counterpart system fails. Summary: Episodic memory, the ability to recall personal episodes, is the subtype of memory most often perceived as dysfunctional by patients and informants. Medial temporal lobe structures, especially the hippocampal formation and associated cortical and subcortical structures, are most often associated with episodic memory loss. Episodic memory dysfunction may present acutely, as in concussion; transiently, as in transient global amnesia (TGA); subacutely, as in thiamine deficiency; or chronically, as in Alzheimer disease. Semantic memory refers to acquired knowledge about the world. Anterior and inferior temporal lobe structures are most often associated with semantic memory loss. The semantic variant of primary progressive aphasia (svPPA) is the paradigmatic disorder resulting in predominant semantic memory dysfunction. Working memory, associated with frontal lobe function, is the active maintenance of information in the mind that can be potentially manipulated to complete goal-directed tasks. Procedural memory, the ability to learn skills that become automatic, involves the basal ganglia, cerebellum, and supplementary motor cortex. Parkinson disease and related disorders result in procedural memory deficits. Most memory concerns warrant bedside cognitive or neuropsychological evaluation and neuroimaging to assess for specific neuropathologies and guide treatment. PMID:26039844

DYNAMICS OF CLINICAL AND BIOCHEMICAL PARAMETERS AND FUNCTIONAL STATE OF THE AUTONOMIC NERVOUS SYSTEM IN PATIENTS WITH ACUTE HEPATITIS B WITH CHRONIC ALCOHOL USE IN HEPATOTOXIC DOSES

Directory of Open Access Journals (Sweden)

O. O. Furyk

2014-02-01

Full Text Available Relevance of hepatitis B due to the high incidence complexity of pathogenesis, ineffective treatment, severe consequences of the disease. Among combined lesions of the liver, special attention is paid to viral-alcoholic type. One of the mechanisms of chronic hepatitis of different etiology is violation of the functional activity of the autonomic nervous system. The aim of this work- to determine the dynamics of spectral indices of heart rate variability in patients with acute hepatitis B from chronic use of alcohol in hepatotoxic doses. Materials and methods. 133 patients with acute hepatitis B were under observation. Patients were divided into groups taking account the presence or absence of chronic use of alcohol in hepatotoxic doses and using the classification of alcohol consumption based on the frequency and dose of consumed alcohol. I group comprised 52 patients with chronic use of alcohol in the hepatotoxic doses, II group consisted of 81 patient without this factor. Heart rate variability was diagnosed using computer cardiointervalometry performed by electrocardiographic diagnostic system CardioLab-2000. 20 healthy individuals were in the control group. Results and discussion. Prodromal period in patients of the I group was longer (p0,05. However, only patients in group I had marked hemorrhagic manifestations (5,8 % and itching (7.7%. Average serum total bilirubin level was higher (p<0,05 in patients from the I group than in patients from II group. Functional state of autonomic nervous system in patients of both groups were decreased in acute period (vagotonia. Period of convalescence in patients from the I group was accompanied by more severe autonomic dysfunction in 33,6 % (p<0,05. Conclusions. 1. Acute hepatitis B in patients with chronic alcohol use in hepatotoxic doses is characterized by longer (p<0,05 prodrome, cholestatic (7,7% and hemorrhagic manifestations (5,8%, higher levels of hyperbilirubinemia (p<0,05, and during

Tear dysfunction and the cornea: LXVIII Edward Jackson Memorial Lecture.

Science.gov (United States)

Pflugfelder, Stephen C

2011-12-01

To describe the cause and consequence of tear dysfunction-related corneal disease. Perspective on effects of tear dysfunction on the cornea. Evidence is presented on the effects of tear dysfunction on corneal morphology, function, and health, as well as efficacy of therapies for tear dysfunction-related corneal disease. Tear dysfunction is a prevalent eye disease and the most frequent cause for superficial corneal epithelial disease that results in corneal barrier disruption, an irregular optical surface, light scattering, optical aberrations, and exposure and sensitization of pain-sensing nerve endings (nociceptors). Tear dysfunction-related corneal disease causes irritation and visual symptoms such as photophobia and blurred and fluctuating vision that may decrease quality of life. Dysfunction of 1 or more components of the lacrimal functional unit results in changes in tear composition, including elevated osmolarity and increased concentrations of matrix metalloproteinases, inflammatory cytokines, and chemokines. These tear compositional changes promote disruption of tight junctions, alter differentiation, and accelerate death of corneal epithelial cells. Corneal epithelial disease resulting from tear dysfunction causes eye irritation and decreases visual function. Clinical and basic research has improved understanding of the pathogenesis of tear dysfunction-related corneal epithelial disease, as well as treatment outcomes. Copyright © 2011 Elsevier Inc. All rights reserved.

Heat stroke induced cerebellar dysfunction: A “forgotten syndrome”

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Kosgallana, Athula D; Mallik, Shreyashee; Patel, Vishal; Beran, Roy G

2013-01-01

We report a case of heat stroke induced acute cerebellar dysfunction, a rare neurological disease characterized by gross cerebellar dysfunction with no acute radiographic changes, in a 61 years old ship captain presenting with slurred speech and gait ataxia. A systematic review of the literature on heat stroke induced cerebellar dysfunction was performed, with a focus on investigations, treatment and outcomes. After review of the literature and detailed patient investigation it was concluded that this patient suffered heat stroke at a temperature less than that quoted in the literature. PMID:24340279

[Pure trigeminal motor neuropathy presenting with temporo-mandibular joint dysfunction in a patient with HIV and HCV infections].

Science.gov (United States)

Anheim, M; Echaniz-Laguna, A; Rey, D; Tranchant, C

2006-01-01

Pure trigeminal motor neuropathy (PTMN) is a rarely described condition. We report the case of a 41-year-old woman infected with the human immunodeficiency virus (HIV1) and hepatitis C virus who presented with weakness of left temporalis and masseter muscles and painful left temporomandibular joint dysfunction (TMD) a few months after cerebral toxoplasmosis revealing acquired immunodeficiency syndrome (AIDS). Magnetic resonance imaging revealed severe wasting and fat replacement of the left temporalis, pterygoid and masseter muscles and showed neither abnormalities in the left motor nucleus of the trigeminal nerve nor compression of the left trigeminal nerve. Electromyographic examination gave evidence of denervation in the left temporalis, masseter and pterygoid muscles and blink reflex studies were normal, confirming the diagnosis of PTMN which was probably secondary to HIV and HCV co-infection.

[Deficits in medical counseling in olfactory dysfunction].

Science.gov (United States)

Haxel, B R; Nisius, A; Fruth, K; Mann, W J; Muttray, A

2012-05-01

Olfactory dysfunctions are common with a prevalence of up to 20% in the population. An impaired sense of smell can lead to specific dangers, therefore, counseling and warning of hazardous situations to raise patient awareness is an important medical function. In this study 105 patients presenting to the University of Mainz Medical Centre with dysosmia were evaluated using a questionnaire. For quantification of the olfactory dysfunction a standardized olfactory test (Sniffin' Sticks) was used. Of the patients 46% were hyposmic and 40% were functionally anosmic. The median duration of the olfactory impairment was 10 months and the main causes of dysosmia were upper respiratory tract infections and idiopathic disorders. More than 90% of the patients consulted an otorhinolaryngologist and 60% a general practitioner before presenting to the University of Mainz Medical Center. More than two thirds of the patients conducted a professional activity, 95% of patients reported that they had not received any medical counseling and 6% of the subjects were forced to discontinue their profession because of olfactory dysfunction. In patients with olfactory dysfunctions appropriate diagnostics, including olfactometry should be performed. Furthermore, correct medical counseling concerning necessary additional arrangements (e.g. installation of smoke or gas detectors, precautions while cooking or for hygiene) has to be performed. For patients in a profession an analysis of the hazards at work is crucial.

Terpsichore. ENEA's autonomous robotics project; Progetto Tersycore, la robotica autonoma

Energy Technology Data Exchange (ETDEWEB)

Taraglio, S.; Zanela, S.; Santini, A.; Nanni, V. [ENEA, Centro Ricerche Casaccia, Rome (Italy). Div. Robotica e Informatica Avanzata

1999-10-01

The article presents some of the Terpsichore project's results aimed to developed and test algorithms and applications for autonomous robotics. Four applications are described: dynamic mapping of a building's interior through the use of ultrasonic sensors; visual drive of an autonomous robot via a neural network controller; a neural network-based stereo vision system that steers a robot through unknown indoor environments; and the evolution of intelligent behaviours via the genetic algorithm approach.

A Primer on Autonomous Aerial Vehicle Design.

Science.gov (United States)

Coppejans, Hugo H G; Myburgh, Herman C

2015-12-02

There is a large amount of research currently being done on autonomous micro-aerial vehicles (MAV), such as quadrotor helicopters or quadcopters. The ability to create a working autonomous MAV depends mainly on integrating a simultaneous localization and mapping (SLAM) solution with the rest of the system. This paper provides an introduction for creating an autonomous MAV for enclosed environments, aimed at students and professionals alike. The standard autonomous system and MAV automation are discussed, while we focus on the core concepts of SLAM systems and trajectory planning algorithms. The advantages and disadvantages of using remote processing are evaluated, and recommendations are made regarding the viability of on-board processing. Recommendations are made regarding best practices to serve as a guideline for aspirant MAV designers.

Vestibular dysfunction in Turner syndrome: a case report.

Science.gov (United States)

Baxter, Michael; Agrawal, Yuri

2014-02-01

Turner syndrome is a well-known cause of sensorineural hearing loss, and the lack of estrogen has been implicated in cochlear dysfunction. It has never been associated with vestibular dysfunction. We report a case of a patient with Turner syndrome who was found to have bilateral vestibular dysfunction based on video-oculography (VOG) testing. A single patient with a history of Turner syndrome who was found to have significant bilateral vestibular dysfunction. After noticing a deficit in the vestibulo-ocular reflexes on qualitative horizontal head impulse examination, the patient underwent VOG testing. VOG testing quantatively measures angular vestibulo-ocular reflex (AVOR) gain in the horizontal semicircular canal plane. AVOR gain represents the eye movement response to a head movement; in normal individuals the eye movement is fully compensatory and gain values are close to unity. VOG results showed AVOR gains of 0.29 and 0.36 on the right and left sides, respectively. We have presented a case of a woman with Turner syndrome with asymptomatic vestibular dysfunction demonstrated with VOG testing. Although there is a documented relationship between Turner syndrome and sensorineural hearing loss, there are no previous studies or case reports linking Turner syndrome and vestibular dysfunction. Additional research and added vigilance in monitoring Turner syndrome patients may be warranted.

Cyber Security Considerations for Autonomous Tactical Wheeled Vehicles

Science.gov (United States)

2016-04-01

Update Will Enable Autonomous Driving. Retrieved August 6, 2015, from http://spectrum.ieee.org/: http://spectrum.ieee.org/ cars -that-think...Cyber Security Considerations for Autonomous Tactical Wheeled Vehicles 1 UNCLASSIFIED Cyber Security Considerations for... Autonomous Tactical Wheeled Vehicles Sebastian C Iovannitti 4/1/2016 Submitted to Lawrence Technological University College of Management in

Maintenance of Blood-Brain Barrier Integrity in Hypertension: A Novel Benefit of Exercise Training for Autonomic Control

Directory of Open Access Journals (Sweden)

Leila Buttler

2017-12-01

Full Text Available The blood-brain barrier (BBB is a complex multicellular structure acting as selective barrier controlling the transport of substances between these compartments. Accumulating evidence has shown that chronic hypertension is accompanied by BBB dysfunction, deficient local perfusion and plasma angiotensin II (Ang II access into the parenchyma of brain areas related to autonomic circulatory control. Knowing that spontaneously hypertensive rats (SHR exhibit deficient autonomic control and brain Ang II hyperactivity and that exercise training is highly effective in correcting both, we hypothesized that training, by reducing Ang II content, could improve BBB function within autonomic brain areas of the SHR. After confirming the absence of BBB lesion in the pre-hypertensive SHR, but marked fluorescein isothiocyanate dextran (FITC, 10 kD leakage into the brain parenchyma of the hypothalamic paraventricular nucleus (PVN, nucleus of the solitary tract, and rostral ventrolateral medulla during the established phase of hypertension, adult SHR, and age-matched WKY were submitted to a treadmill training (T or kept sedentary (S for 8 weeks. The robust FITC leakage within autonomic areas of the SHR-S was largely reduced and almost normalized since the 2nd week of training (T2. BBB leakage reduction occurred simultaneously and showed strong correlations with both decreased LF/HF ratio to the heart and reduced vasomotor sympathetic activity (power spectral analysis, these effects preceding the appearance of resting bradycardia (T4 and partial pressure fall (T8. In other groups of SHR-T simultaneously infused with icv Ang II or saline (osmotic mini-pumps connected to a lateral ventricle cannula we proved that decreased local availability of this peptide and reduced microglia activation (IBA1 staining are crucial mechanisms conditioning the restoration of BBB integrity. Our data also revealed that Ang II-induced BBB lesion was faster within the PVN (T2, suggesting

Autonomous Mission Operations for Sensor Webs

Science.gov (United States)

Underbrink, A.; Witt, K.; Stanley, J.; Mandl, D.

2008-12-01

We present interim results of a 2005 ROSES AIST project entitled, "Using Intelligent Agents to Form a Sensor Web for Autonomous Mission Operations", or SWAMO. The goal of the SWAMO project is to shift the control of spacecraft missions from a ground-based, centrally controlled architecture to a collaborative, distributed set of intelligent agents. The network of intelligent agents intends to reduce management requirements by utilizing model-based system prediction and autonomic model/agent collaboration. SWAMO agents are distributed throughout the Sensor Web environment, which may include multiple spacecraft, aircraft, ground systems, and ocean systems, as well as manned operations centers. The agents monitor and manage sensor platforms, Earth sensing systems, and Earth sensing models and processes. The SWAMO agents form a Sensor Web of agents via peer-to-peer coordination. Some of the intelligent agents are mobile and able to traverse between on-orbit and ground-based systems. Other agents in the network are responsible for encapsulating system models to perform prediction of future behavior of the modeled subsystems and components to which they are assigned. The software agents use semantic web technologies to enable improved information sharing among the operational entities of the Sensor Web. The semantics include ontological conceptualizations of the Sensor Web environment, plus conceptualizations of the SWAMO agents themselves. By conceptualizations of the agents, we mean knowledge of their state, operational capabilities, current operational capacities, Web Service search and discovery results, agent collaboration rules, etc. The need for ontological conceptualizations over the agents is to enable autonomous and autonomic operations of the Sensor Web. The SWAMO ontology enables automated decision making and responses to the dynamic Sensor Web environment and to end user science requests. The current ontology is compatible with Open Geospatial Consortium (OGC

HOW TO GENERATE AUTONOMOUS QUESTIONING IN SECONDARY MATHEMATICS TEACHING?

DEFF Research Database (Denmark)

Jessen, Britta Eyrich

2017-01-01

In mathematics education it is still a major challenge to find ways to nurture students to pose and pursue their own questions in order to learn mathematics. During the last three decades problem posing has been explored through different approaches and in empirical studies. This paper presents...... the result of an empirical study, where teaching was designed and conducted based on The Anthropological Theory of the Didactic. It is shown how a changed didactic contract and open generating questions posed by the teacher can support students’ autonomous questioning of the taught knowledge. In the study......, students developed knowledge that went beyond curriculum requirements through autonomous activities, which were different from more traditional school and pedagogical culture....

Exact Solutions for Certain Nonlinear Autonomous Ordinary Differential Equations of the Second Order and Families of Two-Dimensional Autonomous Systems

Directory of Open Access Journals (Sweden)

M. P. Markakis

2010-01-01

Full Text Available Certain nonlinear autonomous ordinary differential equations of the second order are reduced to Abel equations of the first kind ((Ab-1 equations. Based on the results of a previous work, concerning a closed-form solution of a general (Ab-1 equation, and introducing an arbitrary function, exact one-parameter families of solutions are derived for the original autonomous equations, for the most of which only first integrals (in closed or parametric form have been obtained so far. Two-dimensional autonomous systems of differential equations of the first order, equivalent to the considered herein autonomous forms, are constructed and solved by means of the developed analysis.

May a unitary autonomic index help assess autonomic cardiac regulation in elite athletes? Preliminary observations on the national Italian Olympic committee team.

Science.gov (United States)

Sala, Roberto; Malacarne, Mara; Tosi, Fabio; Benzi, Manuela; Solaro, Nadia; Tamorri, Stefano; Spataro, Antonio; Pagani, Massimo; Lucini, Daniela

2017-12-01

Long term endurance training, as occurring in elite athletes, is associated to cardiac neural remodeling in favor of cardioprotective vagal mechanisms, resulting in resting bradycardia and augmented contribution of cardiac parasympathetic nerve activity. Autonomic assessment can be performed by way of heart rate variability. This technique however provides multiple indices, and there is not yet complete agreement on their specific significance. Purpose of the study was to assess whether a rank transformation and radar plot could provide a unitary autonomic index, capable to show a correlation between intensity of individual work and quality of autonomic regulation. We studied 711 (23.6±6.2 years) elite athletes that took part in the selection procedure for the 2016 Rio Olympic Games for the National Italian Olympic Committee (CONI). Indices from Heart Rate Variability HRV obtained at rest, during standing up and during recovery from an exercise test were used to compute a percent ranked unitary autonomic index for sport (ANSIs), taken as proxy of quality of autonomic regulation. Within the observed wide range of energy expenditure, the unitary autonomic index ANSIs appears significantly correlated to individual and discipline specific training workloads (r=0.25, P<0.001 and r=0.78, P<0.001, respectively), correcting for possible age and gender bias. ANSIs also positively correlates to lipid profile. Estimated intensity of physical activity correlates with quality of cardiac autonomic regulation, as expressed by a novel unitary index of cardiac autonomic regulation. ANSIs could provide a novel and convenient approach to individual autonomic evaluation in athletes.

Features and Outcome of Autonomous Thyroid Nodules in Children: 31 Consecutive Patients Seen at a Single Center.

Science.gov (United States)

Ly, Samantha; Frates, Mary C; Benson, Carol B; Peters, Hope E; Grant, Frederick D; Drubach, Laura A; Voss, Stephan D; Feldman, Henry A; Smith, Jessica R; Barletta, Justine; Hollowell, Monica; Cibas, Edmund S; Moore, Francis D; Modi, Biren; Shamberger, Robert C; Huang, Stephen A

2016-10-01

Most thyroid nodules are benign and their accurate identification can avoid unnecessary procedures. In adult patients, documentation of nodule autonomy is accepted as reassurance of benign histology and as justification to forgo biopsy or thyroidectomy. In contrast, the negative predictive value of nodule autonomy in children is uncertain. Some recent publications recommend surgical resection as initial management, but few address the degree of TSH suppression or the specific scintigraphic criteria used to diagnose autonomy. The objective of the study was to study the presenting features and cancer risk of children with autonomous nodules. Medical records of all 31 children diagnosed with autonomous nodules at our center from 2003 to 2014 were retrospectively reviewed. All children met full diagnostic criteria for autonomous nodules, defined by both autonomous 123 I uptake into the nodule and the suppression of uptake in the normal thyroid parenchyma on scintigraphy performed during hypothyrotropinemia. The median age of presentation was 15 years (range 3-18 y) with a female to male ratio of 15:1. Fifty-eight percent of patients had solitary nodules and 42% had multiple nodules. The median size of each patient's largest autonomous nodule was 39 mm (range 18-67 mm). Most of the children in this series (68%) had diagnostic biopsies and/or operative pathology of their largest autonomous nodule, which showed benign cytology or histology in all cases. In this pediatric series, the cancer rate observed in biopsied or resected autonomous nodules was 0%. Whereas larger studies are needed to confirm our findings, these results agree with earlier reports suggesting that thyroid cancer is rare in rigorously defined autonomous nodules and support that conservative management may be offered to selected children who meet strict diagnostic criteria for autonomous nodules, deferring definitive therapies until adulthood when the risks of thyroidectomy and 131 I ablation are lower.

Autonomous aerobraking for low-cost interplanetary missions

Science.gov (United States)

Carrelli, David; O'Shaughnessy, Daniel; Strikwerda, Thomas; Kaidy, James; Prince, Jill; Powell, Richard

2014-01-01

Aerobraking has previously been used to reduce the propellant required to deliver an orbiter to its desired final orbit. In principle, aerobraking should be possible around any target planet or moon having sufficient atmosphere to permit atmospheric drag to provide a portion of the mission ΔV, in lieu of supplying all of the required ΔV propulsively. The spacecraft is flown through the upper atmosphere of the target using multiple passes, ensuring that the dynamic pressure and thermal loads remain within the spacecraft's design parameters. NASA has successfully conducted aerobraking operations four times, once at Venus and three times at Mars. While aerobraking reduces the fuel required, it does so at the expense of time (typically 3-6 months), continuous Deep Space Network (DSN) coverage, and a large ground staff. These factors can result in aerobraking being a very expensive operational phase of the mission. However, aerobraking has matured to the point that much of the daily operation could potentially be performed autonomously onboard the spacecraft, thereby reducing the required ground support and attendant aerobraking related costs. To facilitate a lower-risk transition from ground processing to an autonomous capability, the NASA Engineering and Safety Center (NESC) has assembled a team of experts in aerobraking and interplanetary guidance and control to develop a high-fidelity, flight-like simulation. This simulation will be used to demonstrate the overall feasibility while exploring the potential for staff and DSN coverage reductions that autonomous aerobraking might provide. This paper reviews the various elements of autonomous aerobraking and presents an overview of the various models and algorithms that must be transformed from the current ground processing methodology to a flight-like environment. Additionally the high-fidelity flight software test bed, being developed from models used in a recent interplanetary mission, will be summarized.

Impaired NAD+ Metabolism in Neuronal Dysfunction in Critical Conditions

Directory of Open Access Journals (Sweden)

A. V Salmina

2008-01-01

Full Text Available The present views of the pathogenesis of neuronal dysfunction in critical conditions are analyzed, by taking into account of impairments of cellular NAD+ metabolism, the activity of NAD+-converting enzymes, including ADP-ribosyl cyclase/CD38, the possibilities of developing new neuroprotective strategies. Key words: neuronal dysfunction, ADP-rybosyl cyclase/CD38, NAD+, critical condition.

Decreased Heart Rate Variability in HIV Positive Patients Receiving Antiretroviral Therapy: Importance of Blood Glucose and Cholesterol

DEFF Research Database (Denmark)

Askgaard, Gro; Kristoffersen, Ulrik Sloth; Mehlsen, Jesper

2011-01-01

whether autonomic dysfunction is present in an ART treated HIV population and if so to identify factors of importance. METHODS: HIV patients receiving ART for at least 12 months (n¿=¿97) and an age-matched control group of healthy volunteers (n¿=¿52) were included. All were non-diabetic and had never......-intervals (RMSSD) or the percent of differences between adjacent NN intervals greater than 50 ms (pNN50). In the HIV positives, haemoglobin A1c correlated inversely with SDNN, RMSSD and pNN50 (pcorrelated inversely with RMSSD and pNN50 (p...4 cell count nor CD4 nadir correlated with time or phase domain HRV variables. CONCLUSIONS: Moderate autonomic dysfunction is present in HIV positives patients even with suppressed viral load due to ART. The dysfunction is correlated with HbA1c and hypercholesterolemia but not to duration of HIV...

PHM Enabled Autonomous Propellant Loading Operations

Science.gov (United States)

Walker, Mark; Figueroa, Fernando

2017-01-01

The utility of Prognostics and Health Management (PHM) software capability applied to Autonomous Operations (AO) remains an active research area within aerospace applications. The ability to gain insight into which assets and subsystems are functioning properly, along with the derivation of confident predictions concerning future ability, reliability, and availability, are important enablers for making sound mission planning decisions. When coupled with software that fully supports mission planning and execution, an integrated solution can be developed that leverages state assessment and estimation for the purposes of delivering autonomous operations. The authors have been applying this integrated, model-based approach to the autonomous loading of cryogenic spacecraft propellants at Kennedy Space Center.

13th International Conference Intelligent Autonomous Systems

CERN Document Server

Michael, Nathan; Berns, Karsten; Yamaguchi, Hiroaki

2016-01-01

This book describes the latest research accomplishments, innovations, and visions in the field of robotics as presented at the 13th International Conference on Intelligent Autonomous Systems (IAS), held in Padua in July 2014, by leading researchers, engineers, and practitioners from across the world. The contents amply confirm that robots, machines, and systems are rapidly achieving intelligence and autonomy, mastering more and more capabilities such as mobility and manipulation, sensing and perception, reasoning, and decision making. A wide range of research results and applications are covered, and particular attention is paid to the emerging role of autonomous robots and intelligent systems in industrial production, which reflects their maturity and robustness. The contributions have been selected through a rigorous peer-review process and contain many exciting and visionary ideas that will further galvanize the research community, spurring novel research directions. The series of biennial IAS conferences ...

Recognition and Management of Nonrelaxing Pelvic Floor Dysfunction

OpenAIRE

Faubion, Stephanie S.; Shuster, Lynne T.; Bharucha, Adil E.

2012-01-01

Nonrelaxing pelvic floor dysfunction is not widely recognized. Unlike in pelvic floor disorders caused by relaxed muscles (eg, pelvic organ prolapse or urinary incontinence, both of which often are identified readily), women affected by nonrelaxing pelvic floor dysfunction may present with a broad range of nonspecific symptoms. These may include pain and problems with defecation, urination, and sexual function, which require relaxation and coordination of pelvic floor muscles and urinary and ...

STRENGTHENING THE GLUTEUS MAXIMUS IN SUBJECTS WITH SACROILIAC DYSFUNCTION.