The objectives for the first part of this thesis were to describe changes in oxygen saturation (SpO2) and heart rate (HR) in newly born infants in the delivery room (DR) and to illustrate the changes using centile reference charts. The objective of the second part of the thesis was to investigate whether infants < 29 weeks gestation who receive positive pressure ventilation (PPV), immediately after birth with a T-piece have higher SpO2 measurements at five minutes than infants ventilated with a self inflating bag (SIB). / Study Design. A prospective observational study was used to achieve the first objectives. For the second part of the thesis I coordinated a randomised, controlled trial of two devices used for resuscitation of extremely preterm infants in the DR where the primary outcome measure was SpO2. / Patients and methods. In all studies a Masimo Radical pulse oximeter (PO) was placed on the infant’s right hand/wrist immediately after birth. PO data (oxygen saturation, HR and signal quality) were downloaded every 2 sec and analysed only when the signal had no alarm messages (low IQ signal, low perfusion, sensor off, ambient light). / Results. Observational studies: The dataset to develop the reference range charts included 61,650 data points from 468 infants. Infants had a mean (range) gestational age of 38 (25-42) weeks and birthweight 2970 (625-5135) g. For all 468 infants at one minute the 3rd, 10th, 50th, 90th and 97th centiles were 29%, 39%, 66%, 87% and 92%; at two minutes 34%, 46%, 73%, 91% and 95% and at five minutes 59%, 73%, 89%, 97% and 98%. It took a median of 7.9 (IQR 5.0 to 10) minutes to reach a SpO2 > 90%. SpO2 of preterm infants rose more slowly than that of term infants. At one min the median (IQR) HR was 82 (66 to 138) bpm rising at two min and five min to 151 (112 to 169) bpm and 166 (148 to 176) bpm respectively. In preterm infants, the SpO2 and HR rose more slowly than term infants. / Randomised trial: Forty nine infants were randomly allocated to the T-piece and 50 to the SIB. Ten infants did not receive PPV, 4 (8%) in the T-piece group and 6 (12%) in the SIB group and were not included in the analysis. Forty-one infants received PPV with a T-piece and 39 with a SIB. At 5 minutes after birth there was no significant difference between the mean (SD) SpO2 in the T-piece and SIB groups [50 (31)% vs. 53 (25)%, (p=0.73)]. More T-piece infants received oxygen during DR resuscitation (100% vs. 90%, p=0.04). There was no significant difference between the groups in the use of continuous positive airway pressure (CPAP); endotracheal intubation or administration of surfactant in the DR. Fewer of the T-piece group who left the DR on CPAP were intubated in the first 24 hrs after birth. (7% vs. 23%, p=0.05). / Conclusion. The centile charts developed in this thesis provide a reference range for SpO2 and HR in the first 10 minutes after birth for preterm and term infants. In the randomised trial there was no significant difference in SpO2 at five minutes after birth in extremely preterm infants given PPV with a T-piece or a SIB.

The objectives for the first part of this thesis were to describe changes in oxygen saturation (SpO2) and heart rate (HR) in newly born infants in the delivery room (DR) and to illustrate the changes using centile reference charts. The objective of the second part of the thesis was to investigate whether infants < 29 weeks gestation who receive positive pressure ventilation (PPV), immediately after birth with a T-piece have higher SpO2 measurements at five minutes than infants ventilated with a self inflating bag (SIB). / Study Design. A prospective observational study was used to achieve the first objectives. For the second part of the thesis I coordinated a randomised, controlled trial of two devices used for resuscitation of extremely preterm infants in the DR where the primary outcome measure was SpO2. / Patients and methods. In all studies a Masimo Radical pulse oximeter (PO) was placed on the infant’s right hand/wrist immediately after birth. PO data (oxygen saturation, HR and signal quality) were downloaded every 2 sec and analysed only when the signal had no alarm messages (low IQ signal, low perfusion, sensor off, ambient light). / Results. Observational studies: The dataset to develop the reference range charts included 61,650 data points from 468 infants. Infants had a mean (range) gestational age of 38 (25-42) weeks and birthweight 2970 (625-5135) g. For all 468 infants at one minute the 3rd, 10th, 50th, 90th and 97th centiles were 29%, 39%, 66%, 87% and 92%; at two minutes 34%, 46%, 73%, 91% and 95% and at five minutes 59%, 73%, 89%, 97% and 98%. It took a median of 7.9 (IQR 5.0 to 10) minutes to reach a SpO2 > 90%. SpO2 of preterm infants rose more slowly than that of term infants. At one min the median (IQR) HR was 82 (66 to 138) bpm rising at two min and five min to 151 (112 to 169) bpm and 166 (148 to 176) bpm respectively. In preterm infants, the SpO2 and HR rose more slowly than term infants. / Randomised trial: Forty nine infants were randomly allocated to the T-piece and 50 to the SIB. Ten infants did not receive PPV, 4 (8%) in the T-piece group and 6 (12%) in the SIB group and were not included in the analysis. Forty-one infants received PPV with a T-piece and 39 with a SIB. At 5 minutes after birth there was no significant difference between the mean (SD) SpO2 in the T-piece and SIB groups [50 (31)% vs. 53 (25)%, (p=0.73)]. More T-piece infants received oxygen during DR resuscitation (100% vs. 90%, p=0.04). There was no significant difference between the groups in the use of continuous positive airway pressure (CPAP); endotracheal intubation or administration of surfactant in the DR. Fewer of the T-piece group who left the DR on CPAP were intubated in the first 24 hrs after birth. (7% vs. 23%, p=0.05). / Conclusion. The centile charts developed in this thesis provide a reference range for SpO2 and HR in the first 10 minutes after birth for preterm and term infants. In the randomised trial there was no significant difference in SpO2 at five minutes after birth in extremely preterm infants given PPV with a T-piece or a SIB.

Tactile and proprioceptive input provided by weighted vests is thought to decrease sensory modulation dysfunction in children with autism. This study investigated behavioural and physiological effects of weighted vests for ten children with autism, ages 3 to 10, in a classroom setting. A single-case, ABCBC design was used where A =behavioural baseline without vest or heart rate monitor; B = unweighted vest and heart rate monitor; C = vest with 5-10% body weight and heart rate monitor. Observers, blinded to treatment condition, rated targeted behaviours for each participant through video taken during structured table-top activities typical of the classroom routine. Teachers, also blinded to treatment condition, rated each childs behaviour with the Conners Global Index following each phase of the study. Educational aides, not blinded to treatment condition, provided subjective feedback about the effects of the weighted vest for each participant. Heart rate was collected when participants wore the vest. Results were mixed regarding the effects of weighted vests for children with autism. Objective data provided evidence to support the use of weighted vests to decrease off-task behaviours with some, but not all, children with autism and sensory modulation dysfunction. Weighted vests did not decrease motoric stereotyped behaviours in any participant, but did decrease verbal stereotyped behaviours in one participant. Heart rate did not decrease with the weighted vest. Subjectively, all aides reported that weighted vests were effective in improving behaviours in all participants at least some of the time. All teachers and aides reported that weighted vests were appropriate modalities to use in the classroom and wanted to continue using weighted vests following the study. Although weighted vests may be an appropriate modality to include as a component of intervention with some children with autism, results were not strong or consistent across participants. The results do not support the use of weighted vests in isolation to improve classroom function in children with autism. / Rehabilitation Science

Le principal objectif de ce travail est l’étude de l’influence de la pesanteur sur la mécanique respiratoire et le contrôle de la respiration, ainsi que sur les interactions cardio-respiratoires pendant les différents stades du sommeil. Le chapitre introductif présente le contexte général et les objectifs de la thèse. Des sections abordant le sommeil, la respiration, et l’interaction cardio-respiratoire y sont présentées, résumant l’état actuel des connaissances sur les effets de la pesanteur sur chacun de ces systèmes. Dans le deuxième chapitre, l’expérience “Sleep and Breathing in microgravity”, qui constitue la source des données à la base de ce travail, est présentée en détail. L’étude des signaux de longue durée requiert avant tout de disposer d’outils performants d’analyse des signaux. La première partie de la thèse présente en détail deux algorithmes : un algorithme de détection automatique d’événements respiratoires (inspiration / expiration) basé sur des réseaux neuronaux artificiels, et un algorithme de quantification de l’amplitude et de la phase de l’arythmie sinusale pendant le sommeil, utilisant la méthode des ondelettes. La validation de chaque algorithme est présentée, et leur performance évaluée. Cette partie inclut aussi des courtes introductions théoriques aux réseaux de neurones artificiels ainsi qu’aux méthodes d’analyse temps–fréquence (Fourier et ondelettes). Une approche similaire à celle utilisée pour la détection automatique d’événements respiratoires a été appliquée à la détection d’événements dans des signaux de vitesse du sang dans l’artère cérébrale moyenne, mesures obtenues par Doppler transcrânien. Ceci est le sujet de la thèse annexe. Ces deux algorithmes ont été appliqués aux données expérimentales pour extraire des informations physiologiques quant à l’impact de la pesanteur sur la mécanique respiratoire et l’interaction cardio-respiratoire. Ceci constitue la deuxième partie de la thèse. Un chapitre est consacré aux effets de l’apesanteur sur la mécanique respiratoire pendant le sommeil. Ce chapitre a mis en évidence, pour tous les stades de sommeil, une augmentation de la contribution abdominale en microgravité, suivi d’un retour progressif vers des valeurs observées avant le vol. L’augmentation initiale était attendue, mais l’adaptation progressive observée ne peut pas être expliquée par un effet purement mécanique, et nous suggère la présence d’un mécanisme d’adaptation central. Un deuxième chapitre présente les résultats comparant l’arythmie sinusale pendant le sommeil avant le vol, en apesanteur et après le retour sur terre. Le rythme cardiaque pendant le sommeil dans l’espace présente une moindre variabilité. Les différences NREM–REM observées sur terre pour les influences vagales et sympathiques sont accentuées dans l’espace. Aucun changement significatif n’est présent pour le gain et la différence de phase entre les les signaux cardiaque et respiratoire en comparant le sommeil sur terre et en apesanteur. La dissertation termine par une discussion générale du travail effectué, incluant les prin- cipales conclusions ainsi que les perspectives qui en découlent.

Recent research has suggested that boredom is a construct that can be distinguished from similar affective states including apathy, anhedonia, and depression, using self-reports. The current study investigated whether boredom and sadness (an analogue for depression) are distinct in terms of their physiological signatures. State boredom and sadness were induced in a group of healthy participants while their physiological parameters of heart rate (HR), skin conductance (SCL), and cortisol levels were monitored. Results indicated that the autonomic nervous system response for both states can be characterized by directional fractionation, with boredom resulting in increased HR but decreased SCL relative to sadness. Cortisol levels were higher after the boring induction than the sad induction, indicating increased hypothalamic-pituitary-adrenal axis activation for boredom. Overall, boredom appears to have a physiological signature that is distinguishable from a primary symptom of depression.

In recent years, sleep medicine has attracted many interests. Among many sleep disorder problems, the sleep apnea syndrome is of great importance. One of its side effects is its negative influences on cardiovascular system whose function can be monitored by ECG. The regulation of the heart rate is extremely important for human body. In general, the heart rate variability is controlled by the balance of the sympathetic and the parasympathetic systems whose functions can be influenced by sleep apnea. This work tries to establish the relation between the heart rate variability and AHI (Apnea & hypopnea index). Through the statistical methods, we analyze how the sleep apnea influences the low frequency (LF) and high frequency components of the RR intervals. With BMI, age and AHI as the independent variables, we set up the regression model to predict LF/HF Our results demonstrate that, for men, the linear relationship between the LF/HF and AHI is statistically significant when AHI is higher than 45. This results may shed some light on developing HRV based diagnosis method for sleep apnea.

Treadmill is a highly popular fitness equipments. One of the most important purposes of running is to consume redundant energy of the body. A well designed exercise intensity plan can achieve the benefits of exercise while avoiding sport injuries. Calculating the appropriate exercise intensity is therefore a valuable study issue. Current commercially available treadmills cannot provide sufficient physiological data. In particular, in order to measure the ground reaction force (GRF) of the runners, traditional approach is to design treadmill as a rigid body. Such treadmills are thus expensive and heavy. To estimate heart rate (HR), ECG measurement is typically required. However, sweat can cause the patch to loose and the quality of the signal transmission can also be degraded by environmental noises. Thus the aim of this work is to develop a simple and effective method to assess exercise intensity by estimating HR with GRF.. To achieve this goal, this work places load cells under the legs of the treadmill. By constructing the dynamic model of the treadmill via system identification technique, we can estimate the actual GRF from the measurements of the load cells. After computing the TVI (Total Vertical Impulse) index from the GRF, this work then investigates the linear relationship between TVI and running energy consumption by estimating HR from TVI. Based on the known relationship between HR and exercise intensity, we can observe the runner¡¦s condition from the speed of HR recovery and the HR time response during running. By means of linear regression method, it is found that the linear relations between TVI index and these HR measures are statistically significant. The p-value of such statically tests become even smaller when TVI index is normalized.

Acetylcholinesterase inhibition with pyridostigmine has been previously studied in patients with congestive heart failure (CHF), but the effects of this medication on heart rate recovery after exercise and other indices of parasympathetic activity in populations with greater baseline vagal tone has not been fully characterized. Ten healthy, sedentary adults and ten aerobically trained athletes were enrolled in a prospective, double blind, randomized placebo controlled crossover trial. All study subjects were treated with a single dose of oral pyridostigmine 30 mg and matching placebo on separate days. Heart rate variability (HRV) at rest and heart rate recovery (HRR) at one minute after maximal cardiopulmonary exercise stress testing were measured. In sedentary adults, pyridostigmine significantly lowered resting heart rate (mean (SEM) 58.1 (2.4) beats/min versus 66.7 (4.0) beats/min, p = 0.01), increased HRR at one minute (45.1 (2.8) beats/min versus 40.7 (3.4) beats/min, p = 0.02), and lowered both resting mean arterial pressure (80.3 (2.0) mm Hg versus 84.3 (2.7) mm Hg, p = 0.02) and peak exercise mean arterial pressure (103.3 (3.1) mm Hg versus 108.8 (3.2) mm Hg, p < 0.01). In trained athletes, resting heart rate and HRR at one minute were unaffected by pyridostigmine dosing, although a significant increase in VO2 max was observed with the study drug (54.8 (3.5) ml/kg/min versus 53.3 (3.6) ml/kg/min, p = 0.02). Pyridostigmine did not change indices of heart rate variability in either cohort. The difference in resting heart rate and HRR responses to pyridostigmine between athletes and sedentary controls likely reflects training induced modifications of the autonomic nervous system. The inability of acetylcholinesterase inhibition to affect HRV in either sedentary adults or athletes further suggests the improved HRR previously observed in CHF patients treated with pyridostigmine is secondary to parasympathetic augmentation.

Thesis (Ph. D.)--University of Washington, 2001. / Vita. Includes bibliographical references (leaves 60-72).

A substantial body of previous research suggests that the medial prefrontal cortex (MPFC) plays an important role in multiple aspects of emotion. These aspects include, but are not limited to, (1) generating, (2) experiencing, and (3) regulating one's own emotional state, as well as (4) facilitating the use of emotion-related information within goal-directed cognition and action selection. However, there is considerable controversy with regard to the distinct functional roles of various MPFC subregions. In this dissertation, I first provide a review of the theoretical and experimental literature to date in order to defend a plausible model of the hierarchical neural processes associated with each of the aspects of emotion highlighted above. This model proposes that different MPFC subregions each play distinct, but interactive, roles at or near the top of the respective hierarchical systems associated with those aspects of emotion. After reviewing this model, I then provide a description of four experiments that test the predictions of this model's claims regarding the roles of three distinct MPFC subregions: the rostral anterior cingulate cortex (rACC), the dorsomedial prefrontal cortex (DMPFC), and the ventromedial prefrontal cortex (VMPFC). These experiments provide independent support for the claims that (1) rACC plays an important role in representing the conceptual meaning of one's felt emotional reactions, (2) DMPFC plays an important role in maintaining representations of one's own emotions within a consciously accessible state, and (3) VMPFC plays an important role in both appraising the emotional significance of one's current situation and triggering the somatic/visceral reactions associated with the generation of an emotional response. In the concluding section of the dissertation, I then integrate these findings together with the larger model and discuss important directions for future research as well as ways in which the model might be extended to include insights from recent advances in theoretical neuroscience associated with predictive coding.