In addition to social communication deficits, restricted repetitive behaviors (RRBs) are a key diagnostic feature of autism spectrum disorder (ASD). Two theories regarding the etiology of RRBs in ASD have been proposed: the hyper-arousal theory, and the hypo-arousal theory. Both of these theories posit the autonomic nervous system (ANS) as being dysfunctional in ASD, resulting in the occurrence of RRBs. Many studies investigating ANS activity in ASD have focused solely on its relation to social functioning. The few that have addressed RRBs have had inconclusive findings. Not only do the current theories and studies simplify ANS activity to a measure of baseline arousal levels through vague measures such as heart rate (HR) and skin conductance response (SCR), but the literature has also framed the theories as mutually exclusive. This study used respiratory sinus arrhythmia (RSA) patterns in children with and without an ASD diagnosis as an indicator of ANS functioning to analyze its relationship to the manifestation of RRBs. Baseline RSA and RSA reactivity were found to predict RRB severity and exploratory analyses revealed that these measures were associated with specific subgroups of RRBs. These results are discussed in regards to the current behavioral literature on RRBs and the benefits of finding biomarkers for these behaviors. / Master of Science

Current literature suggests neurological (i.e., insula, amygdala) and autonomic (i.e., respiratory sinus arrhythmia; RSA) markers of language, social, and behavioral challenges in autism spectrum disorders (ASD; Bal et al., 2010; DiMartino, Ross, et al., 2009; Lorenzi, Patriquin, & Scarpa, 2011; Patriquin, Scarpa, Friedman, & Porges, 2011), that hypothetically reflect a defensive neurophysiological circuit (i.e., hyper-arousal within the central and autonomic nervous systems). It is unknown how this neurophysiological state contributes to difficulties in ASD. Therefore, the current study quantified peripheral and central nervous system activity and investigated how this neurophysiological circuit may be related to different social and behavioral patterns that characterize ASD. Participants with (n = 16) and without (n = 30) ASD listened to classical music while brain (via functional magnetic resonance imaging) and autonomic (via pulse oximeter and plethysmogram) data were collected. Results indicated that decreased insula and amygdala activity during physiological hyper-aroused states predicted symptoms associated with ASD, and predicted higher levels of comorbid anxiety, stress, and depression. Contrary to hypotheses, no baseline RSA or amygdala differences were noted between ASD and controls groups, suggesting that adults with ASD may have developed effective coping strategies for reducing physiological threat responses. It will be important for future studies to continue to explore and clarify the neural connections of peripheral nervous system activation in individuals with and without ASD, including extending this research to children. / Ph. D.

No description available.

Over the last century, physiological signals have been broadly analyzed and processed not only to assess the function of the human physiology, but also to better diagnose illnesses or injuries and provide treatment options for patients. In particular, Electrocardiogram (ECG), blood pressure (BP) and impedance are among the most important biomedical signals processed and analyzed. The majority of studies that utilize these signals attempt to diagnose important irregularities such as arrhythmia or blood loss by processing one of these signals. However, the relationship between them is not yet fully studied using computational methods. Therefore, a system that extract and combine features from all physiological signals representative of states such as arrhythmia and loss of blood volume to predict the presence and the severity of such complications is of paramount importance for care givers. This will not only enhance diagnostic methods, but also enable physicians to make more accurate decisions; thereby the overall quality of care provided to patients will improve significantly. In the first part of the dissertation, analysis and processing of ECG signal to detect the most important waves i.e. P, QRS, and T, are described. A wavelet-based method is implemented to facilitate and enhance the detection process. The method not only provides high detection accuracy, but also efficient in regards to memory and execution time. In addition, the method is robust against noise and baseline drift, as supported by the results. The second part outlines a method that extract features from ECG signal in order to classify and predict the severity of arrhythmia. Arrhythmia can be life-threatening or benign. Several methods exist to detect abnormal heartbeats. However, a clear criterion to identify whether the detected arrhythmia is malignant or benign still an open problem. The method discussed in this dissertation will address a novel solution to this important issue. In the third part, a classification model that predicts the severity of loss of blood volume by incorporating multiple physiological signals is elaborated. The features are extracted in time and frequency domains after transforming the signals with Wavelet Transformation (WT). The results support the desirable reliability and accuracy of the system.

Heart rate variability (HRV) reflects dynamic variation in sympathetic and parasympathetic nervous system (SNS and PNS) activity. The parasympathetic vagus nerve is responsible for HRV between 0.12 and 0.4 Hz, which is thought to index the capacity for effective coping, and is linked to physical and emotional well-being. Yogic breathing to increase vagal activity is often paced below 0.12 Hz (< 7.2 breaths per minute (BrPM)), where its impact HRV can be due to both sympathetic and parasympathetic mechanisms. Five healthy volunteers completed three pharmacological blockade sessions (placebo, sympathetic blockade with Esmolol, and parasympathetic blockade with Glycopyrrolate) about 48 hours apart, and during each session completed 11 Sudarshan Kriya Yogic breathing exercises at 4-9 BrPM. HRV was the lowest under Glycopyrrolate (p < 0.001), and there was no significant difference between placebo and sympathetic blockade with Esmolol. In addition, the spectral power of specific HRV frequencies was greatest at similar frequencies of breathing, a pattern prevented only by Glycopyrrolate. These findings suggest that heart rate is vagally influenced at all breathing rates, and that the SNS is not the mechanism by which slow breathing increases HRV.

Adverse effects of amiodarone are rarely seen in pediatric patients, but may occur if amiodarone is applied for long-term treatment. Two rather rare phenomena are blue-gray skin pigmentation and pulmonary mass. They represent important differential diagnoses from more common clinical complications like pneumonia and drug-induced toxic skin lesions.

Thesis (MSc)--Stellenbosch University, 2000. / ENGLISH ABSTRACT: Please see fulltext for abstract / AFRIKAANSE OPSOMMING: Sien asb volteks vir opsomming

published_or_final_version / Medicine / Doctoral / Doctor of Philosophy

Repolarization alternans, i.e. beat-to-beat variation of repolarization of action potential, is proposed as a predictor of life-threatening arrhythmias. Restitution relates repolarization duration with its previous relaxation time, i.e. diatstolic interval (DI), and is considered a dominant mechanism for alternans. Previously, we observed that different repolarization durations at the same DI during decelerating and accelerating pacing, i.e. restitution displays hysteresis, which is a measure of “cardiac memory”. Objective of the current study was to investigate in the pig 1) the mechanism for a previously observed hysteresis type phenomenon, where alternans, once started at higher heart rate, persists even when heart rate decreases below its initiating rate, 2) regional differences in expression of hysteresis, i.e. memory in restitution in the heart, and 3) changes in restitution and memory during manipulation of an important repolarization current, the slow delayed rectifier, IKs. Action potentials were recorded in pig ventricular tissues using microelectrodes. Regional differences were explored in endocardial and epicardial tissues from both ventricles. DIs were explicitly controlled in real time to separate restitution mechanism from non-restitution related effects. Stepwise protocols were used to explore the existence in hysteresis in alternans threshold, where DIs were held constant for each step and progressively decreased and then increased. Quantification of cardiac memory was achieved by sinusoidally changing DI protocols, which were used to investigate memory changes among myocytes from different regions of the heart and during IKs manipulation. Results show that during stepwise protocol, hysteresis in alternans still existed, which indicates that restitution is not the only mechanism underlying the hysteresis. When comparing hysteresis obtained from sinusoidally oscillatory DIs among different regions, results show memory is expressed differently with endocardium expressing the most and epicardium the least memory. This provides important implications about the location where arrhythmia would initiate. Results also show that measures for hysteresis loops obtained by sinusoidal DI protocols decreased (increased) after enhancement (attenuation) of IKs, suggesting decreased (increased) hysteresis, i.e. memory in restitution. This effect needs to be considered during drug development.

Loving-kindness meditation (LKM) has the potential to improve intrapersonal and interpersonal functioning. This unique quality of LKM makes it a desirable candidate for buffering the stress of being social evaluated or socially excluded. Using the Trier Social Stress Test and the Cyberball social exclusion paradigm, the present study investigated the effectiveness of a brief LKM session in buffering against social evaluative and social exclusion stress. Three specific questions were addressed: In what domains can LKM exert positive effects? For whom does it work? And, how does it work? One hundred and thirteen participants (N = 113, 49 men) were randomly assigned to either a 10-minute LKM session or a 10-minute visualization control session. Findings showed that even just 10 minutes of LKM had an immediate relaxing effect as evidenced by increased respiratory sinus arrhythmia (RSA), an index of parasympathetic cardiac control, and decreased respiration rate. In addition, the brief LKM intervention led to greater implicit positivity towards the self relative to the control intervention (p = .052). The brief LKM intervention also protected against some of the negative physiological and psychological effects of social stress. The majority of these effects are moderated by trait social anxiety and pre-meditation mood states (or pre-meditation mood state alone). Contrary to expectation, trait social anxiety alone did not moderate any of the LKM effects. Importantly, receiving a brief session of LKM while not being in a positive mood or being in a negative mood led to iatrogenic physiological and psychological effects. Providing an explanation for one of LKM's effects, findings showed that change in RSA during LKM fully mediated the LKM Intervention x Positive Affect interaction effect on change in post-social-stress RSA. In conclusion, findings of the present study have extended our understanding of LKM and have specific implications for future research and practice.