Validity of the Pneumonitor for RR intervals acquisition for short-term heart rate variability analysis extended with respiratory data in pediatric cardiac patients.

Background: Breathing pattern alterations change the variability and spectral content of the RR intervals (RRi) on electrocardiogram (ECG). However, there is no method to record and control participants' breathing without influencing its natural rate and depth in heart rate variability (HRV) studies.

Aim: This study aimed to assess the validity of the Pneumonitor for acquisition of short-term (5 minutes) RRi in comparison to the reference ECG method for analysis of heart rate (HR) and HRV parameters in the group of pediatric patients with cardiac disease.

Causality in cardiorespiratory signals in pediatric cardiac patients.

Four different Granger causality-based methods - one linear and three nonlinear (Granger Causality, Kernel Granger Causality, large-scale Nonlinear Granger Causality, and Neural Network Granger Causality) were used for assessment and causal-based quantification of the respiratory sinus arrythmia (RSA) in the group of pediatric cardiac patients, based on the single-lead ECG and impedance pneumography signals (the latter as the tidal volume curve equivalent). Each method was able to detect the dependency (in terms of causal inference) between respiratory and cardiac signals. The correlations between quantified RSA and the demographic parameters were also studied, but the results differ for each method.

Outcomes Following Penetrating Brain Injuries in Military Settings: A Systematic Review and Meta-Analysis.

Objective: While neurosurgeons are experienced in treating penetrating brain injuries (PBIs) in civilian settings, much less is known about management and outcomes of PBIs in military settings.

Methods: A systematic review was performed according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Data extracted included surgical management, age, gender, location/type of injury, initial Glasgow Coma Scale (GCS) score, and outcomes.

Granger causality test with nonlinear neural-network-based methods: Python package and simulation study.

Background And Objective: Causality defined by Granger in 1969 is a widely used concept, particularly in neuroscience and economics. As there is an increasing interest in nonlinear causality research, a Python package with a neural-network-based causality analysis approach was created. It allows performing causality tests using neural networks based on Long Short-Term Memory (LSTM), Gated Recurrent Unit (GRU), or Multilayer Perceptron (MLP).

Device for Controlling Stimulus Self-Application During Autonomic Nervous System Tests.

Assessment of autonomic nervous system (ANS) functioning may be performed non-invasively using autonomic tests which are based on evaluation of response of cardiovascular system to the applied stimuli, such as increased air pressure during Valsalva maneuver, skeletal muscle contraction during static handgrip or deep slow breathing. The cardiovascular response depends, besides ANS reaction and test protocol, also on the way stimulus is self-applied by the test subject. We present a versatile device for controlling stimulus self-application during three ANS tests: Valsalva maneuver, static handgrip, and deep breathing.

Timing and risks of chemoprophylaxis after spinal surgery: a single-center experience with 6869 consecutive patients.

OBJECTIVE Venous thromboembolism (VTE) after spinal surgery is a major cause of morbidity, but chemoprophylactic anticoagulation can prevent it. However, there is variability in the timing and use of chemoprophylactic anticoagulation after spine surgery, particularly given surgeons' concerns for spinal epidural hematomas. The goal of this study was to provide insight into the safety, efficacy, and timing of anticoagulation therapy after spinal surgery.

Thirty-Day Readmission Risk Factors Following Single-Level Transforaminal Lumbar Interbody Fusion (TLIF) for 4992 Patients From the ACS-NSQIP Database.

Study Design: Retrospective cohort study.

Objective: To describe the readmission rate and identify risk factors associated with 30-day readmission after transforaminal lumbar interbody fusion (TLIF) surgery.

Methods: Patients who underwent elective single level TLIF surgery from 2011 to 2013 were identified in the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database.

Assessment of Paraspinal Muscle Cross-sectional Area After Lumbar Decompression: Minimally Invasive Versus Open Approaches.

Study Design: A retrospective, blinded analysis of imaging studies.

Summary Of Background Data: To evaluate changes in paraspinal muscle cross-sectional area (CSA) after surgical treatment for lumbar stenosis and to compare these changes between minimally invasive and standard open approaches. The open approach to lumbar stenosis is effective, but it involves retraction and resection of muscle from the spinous process, which can result in ischemia and denervation of paraspinal musculature and may lead to muscle atrophy and pain.

Body position classification for cardiorespiratory measurement.

Heart activity, or at least heart rate variability, is associated with body position. Our previous studies have confirmed that impedance pneumography may be used to record respiratory function, but the calibration coefficients for this method depend on position. Data were collected from 24 students (12 male, 12 female), who alternated positions between lying (on front, back, and right side), sitting and standing.

Comparing Short-term Complications of Inpatient Versus Outpatient Single-level Anterior Cervical Discectomy and Fusion: An Analysis of 6940 Patients Using the ACS-NSQIP Database.

Study Design: Multicenter propensity score-adjusted retrospective cohort study.

Objective: To determine baseline 30-day complication rates for anterior cervical discectomy and fusion (ACDF) and compare clinical complications for patients undergoing single-level ACDFs between inpatient and outpatient settings.

Summary Of Background Data: ACDF remains the most common procedure in the treatment of a variety of cervical disc pathologies, making it a focus of quality improvement initiatives.

Predictors for Airway Complications Following Single- and Multilevel Anterior Cervical Discectomy and Fusion.

Study Design: A retrospective, multivariate analyses of a prospectively collected multicenter database.

Objective: The aim of this study was to evaluate the risk factors for postoperative airway complications following single- and multilevel anterior cervical discectomy and fusion (ACDF).

Summary Of Background Data: Airway compromise following ACDF may result in catastrophic outcome.

Automatic cough episode detection using a vibroacoustic sensor.

Cough monitoring is an important element of the diagnostics of respiratory diseases. The European Respiratory Society recommends objective assessment of cough episodes and the search for methods of automatic analysis to make obtaining the quantitative parameters possible. The cough "events" could be classified by a microphone and a sensor that measures the vibrations of the chest.

Assessment of calibration methods on impedance pneumography accuracy.

The aim was to assess accuracy of tidal volumes (TV) calculated by impedance pneumography (IP), reproducibility of calibration coefficients (CC) between IP and pneumotachometry (PNT), and their relationship with body posture, breathing rate and depth. Fourteen students performed three sessions of 18 series: normal and deep breathing at 6, 10, 15 breaths/min rates, while supine, sitting and standing; 18 CC were calculated for every session. Session 2 was performed 2 months after session 1, session 3 1-3 days after session 2.

Market-Based Health Care in Specialty Surgery: Finding Patient-Centered Shared Value.

: The US health care system is struggling with rising costs, poor outcomes, waste, and inefficiency. The Patient Protection and Affordable Care Act represents a substantial effort to improve access and emphasizes value-based care. Value in health care has been defined as health outcomes for the patient per dollar spent.

Early hemodynamic response to the tilt test in patients with syncope.

Introduction: Our aim was to evaluate the differences in the early hemodynamic response to the tilt test (HUTT) in patients with and without syncope using impedance cardiography (ICG).

Material And Methods: One hundred twenty-six patients (72 female/48 male; 37 ±17 years) were divided into a group with syncope (HUTT(+), n = 45 patients) and a group without syncope (HUTT(-), n = 81 patients). ECG and ICG signals were continuously recorded during the whole examination, allowing the calculation of heart rate (HR), stroke volume (SV), and cardiac output (CO) for every beat.

Predictors of unplanned readmission in patients undergoing lumbar decompression: multi-institutional analysis of 7016 patients.

Object: Unplanned hospital readmission represents a large financial burden on the Centers for Medicare and Medicaid Services, commercial insurance payers, hospitals, and individual patients, and is a principal target for cost reduction. A large-scale, multi-institutional study that evaluates risk factors for readmission has not been previously performed in patients undergoing lumbar decompression procedures. The goal of this multicenter retrospective study was to find preoperative, intraoperative, and postoperative predictive factors that result in unplanned readmission (UR) after lumbar decompression surgery.

Predictors of thirty-day readmission after anterior cervical fusion.

Study Design: Retrospective cohort study.

Objective: To determine the incidence of and factors predicting 30-day readmission after anterior cervical discectomy and fusion (ACDF).

Summary Of Background Data: ACDF is being performed on an increasing basis on a wider population of patients, which is accompanied by rising costs.

In aged men, central vessel transmural pressure is reduced by brief Valsalva manoeuvre during strength exercise.

A brief Valsalva manoeuvre, lasting 2-3 s, performed by young healthy men during strength exercise reduces transmural pressure acting on intrathoracic arteries. In this study, we sought to verify this finding in older men. Twenty normotensive, prehypertensive and moderately hypertensive otherwise healthy men 46-69 years old performed knee extensions combined with inspiration or with brief Valsalva manoeuvre performed at 10, 20 and 40 mmHg mouth pressure.

Intraoperative neurophysiological monitoring in spine surgery: indications, efficacy, and role of the preoperative checklist.

Spine surgery carries an inherent risk of damage to critical neural structures. Intraoperative neurophysiological monitoring (IONM) is frequently used to improve the safety of spine surgery by providing real-time assessment of neural structures at risk. Evidence-based guidelines for safe and efficacious use of IONM are lacking and its use is largely driven by surgeon preference and medicolegal issues.

Impedance cardiography: recent advancements.

The aim of this paper is the presentation of recent advancements in impedance cardiography regarding methodical approach, applied equipment and clinical or research implementations. The review is limited to the papers which were published over last 17 months (dated 2011 and 2012) in well recognised scientific journals.