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Relationship between regional hemodynamic activity and simultaneously recorded EEG-theta associated with mental arithmetic-induced workload.

Theta increases with workload and is associated with numerous processes including working memory, problem solving, encoding, or self monitoring. These processes, in turn, involve numerous structures of the brain. However, the relationship between regional brain activity and the occurrence of theta remains unclear. In the present study, simultaneous EEG-fMRI recordings were used to investigate the functional topography of theta. EEG-theta was enhanced by mental arithmetic-induced workload. For the EEG-constrained fMRI analysis, theta-reference time-series were extracted from the EEG, reflecting the strength of theta occurrence during the time course of the experiment. Theta occurrence was mainly associated with activation of the insular cortex, hippocampus, superior temporal areas, cingulate cortex, superior parietal, and frontal areas. Though observation of temporal and insular activation is in accord with the theory that theta specifically reflects encoding processes, the involvement of several other brain regions implies that surface-recorded theta represents comprehensive functional brain states rather than specific processes in the brain. The results provide further evidence for the concept that emergent theta band oscillations represent dynamic functional binding of widely distributed cortical assemblies, essential for cognitive processing. This binding process may form the source of surface-recorded EEG theta.

Adult↗

Nursing workload, medical diagnosis related groups, and nursing diagnoses.

Patient conditions associated with the relative amount of time nurses spent caring for patients were identified in this study. The patient conditions examined were: nursing condition using 37 nursing diagnoses, medical condition using diagnosis-related groups (DRGs), and demographic characteristics of age, sex, and race. Nursing time was estimated using the Rush-Medicus patient classification workload measurement tool. Data were gathered from checklists of nursing diagnoses and the discharge records of 2560 adult inpatients of an acute care community hospital. Using multiple regression analysis nursing condition explained twice the variation in daily nursing workload (52.4%) than medical condition (26.3%). The finding that nursing care time is predicted better by a patient's nursing condition than by either medical condition or demographic characteristics indicates that nursing care is not physician prescribed.

Adolescent↗

Local mitochondrial enzyme activity correlates with myocardial blood flow at basal workloads.

To study whether heterogeneous myocardial blood flow relates to the local oxidative capacity of cardiac muscle, local blood flow at resting cardiac workloads and the activity of the mitochondrial enzyme succinate dehydrogenase (SDH) were determined in small regions of the left ventricle of seven anaesthetized, mechanically ventilated, open-chest pigs (25-35 kg). Following injection of radioactive microspheres (15 microns phi) into the left atrium, the heart was rapidly excised and cut into five transverse slices, which were simultaneously freeze-clamped between two aluminum blocks precooled at -80 degrees C. The left ventricle was then subdivided into 84 samples of about 0.9 g. Myocardial blood flow was 0.88 +/- 0.34 ml/min/g wet weight (ww), and SDH activity 1.46 +/- 0.33 mumol/min/g ww (mean +/- S.D., n = 7). Local data were normalized to their respective mean values in each pig, and then pooled. Local blood flow ranged from 0.32 to 1.63 of the mean, and blood flow heterogeneity characterized by the coefficient of variation (CV = S.D./mean) was 18.4%. Normalized local SDH activity ranged from 0.16 to 1.94, with a CV of 21.8%, significantly exceeding measurement error (CV = 4.5%). Local blood flows and SDH activities did not vary among transmural sublayers of the left ventricle, but variation within each sublayer was considerable. In six of the seven pigs, local blood flow correlated (P < 0.05) with SDH activity, with correlation coefficients (r) ranging from 0.26 to 0.54 (for pooled data: r = 0.27, P < 0.0001). When expressed per gram dry weight, heterogeneity of SDH activity increased (P < 0.05), and here also local blood flow correlated with SDH activity in all pigs (for pooled data: r = 0.45, P < 0.0001). Hence, heterogeneity of mitochondrial capacity within cardiac muscle partly explains the heterogeneity of myocardial blood flow, even though myocardial perfusion at rest was studied in relation with a maximal enzyme rate. The low correlation coefficient clearly indicates that at resting workloads other factors also play a role.

Animals↗

Acute increase of myocardial workload, hemodynamic instability, and myocardial histological changes induced by brain death in the cat.

Brain death-related hemodynamic instability may preclude donor heart procurement. The relationships between the initial changes of myocardial workload, hemodynamic deterioration, and myocardial histological changes caused by acute induction of brain death are unclear. Cats (n = 15) were submitted to brain death by rapid inflation of an intracranial balloon. A further 12 cats served as a sham-operated control group. The changes in heart rate, mean arterial blood pressure, systolic and diastolic arterial blood pressure, left ventricular developed pressure, LV dP/dtmax, rate-pressure product (RPP), and circulating noradrenaline and adrenaline were studied during 240 min after the induction of brain death. Central venous pressure was kept constant. The hearts were histologically examined afterward. Electrocerebral activity disappeared within 30 sec after balloon inflation. At 3 min, noradrenaline and adrenaline levels had increased 75- and 40-fold, respectively, compared to pre-induction levels. The hemodynamic response was characterized by an early and rapid increase of hemodynamic variables at 2.9 +/- 0.2 min. This was followed by a second phase of normalization or deterioration. Two distinct subgroups (n = 9) became hemodynamically unstable (HDU), characterized by a systolic arterial blood pressure < 90 mm Hg, at 108 +/- 29 min, and progressively deteriorated to 67 +/- 8 mm Hg at 240 min after inflation of the balloon. The hemodynamic variables of the other, hemodynamically stable (HDS), subgroup (n = 6) normalized at 60 min after inflation. Hemodynamic deterioration of the HDU subgroup compared to the HDS subgroup was significant at 10 min after induction of brain death. The maximum values of RPP were similar in the two subgroups. Respiratory and metabolic variables at the end of the experiment were not different in both subgroups. Histological evidence of myocardial damage was present in 73% (11/15) of the brain dead cats and absent in the control group. The histological changes were identified both in hearts of HDU (6/9) and HDS (5/6) cats. In the cat, no relationships were demonstrated between the acute increase of myocardial workload, the occurrence of hemodynamic deterioration, and myocardial histological changes after rapid induction of brain death. These results may contribute to the discussion whether hemodynamic instability of the donor is an appropriate exclusion criterion for heart transplantation.

Animals↗

Uncoupling cognitive workload and prefrontal cortical physiology: a PET rCBF study.

Working memory is a fundamental cognitive building block involved in the short-term maintenance and transformation of information. In neuropsychological studies, working memory has been shown to be of limited capacity; however, the neurophysiological concomitants of this capacity limitation have not been explored. In this study we used the [15O] water PET rCBF technique and statistical parametric mapping to examine normal subjects while they performed two cognitive tasks, both individually and simultaneously. One task was the Wisconsin Card Sorting Test, a complex reasoning task involving working memory, and the other was a rapidly paced auditory verbal shadowing task. When both tasks were performed simultaneously, there were significant decrements in performance compared with the individual task performance scores, indicating that cognitive workload had been increased. Analysis of the rCBF maps showed that when the two tasks were performed together, in contrast to when they were performed separately, there was less prefrontal activation. These results suggest that increases in cognitive workload do not necessarily recruit and then sustain cortical neurophysiological resources to a maximum, but rather may actually be accompanied by a diminution in cortical activity.

Adult↗

Critical analysis of the "anaerobic threshold" during exercise at constant workloads.

The method described by Wasserman for anaerobic threshold (AT) determination, based on the recording of ventilatory parameters, was supported by the simultaneous appearance of hyperlactacidemia and hyperventilation during a standardized incremental work test. Our study aimed at testing the AT in another profile of exercise, viz., during exercises at constant workloads. A homogenous population of 66 healthy subjects performed on a treadmill a total of 100 exercises of 20 min duration at constant workloads (43, 48, 52, 57, 63, and 71% VO2 max). The VO2, V, and venous plasma lactic acid (LA) were determined every minute. LA showed an initial transient increase at 43% VO2 max and a steady-state elevated level above 48% VO2 max. In contrast, the hyperventilation threshold (HVT) was only observed above 57% VO2 max, simultaneously with a delayed steady-state VO2 and with a sustained increase of lactate until the end of exercise. The meaning of the simultaneity of these three events must still be studied. However, the dissociation between both early and steady-state lactate thresholds and HVT is not in keeping with the concept of AT. In these conditions, there is no evidence that HVT necessarily represents an AT, viz., a critical intensity of exercise inducing an insufficient oxygen delivery to the muscles. This conclusion does not imply that the measurement of HVT should be rejected as an empirical test of physical fitness.

Adult↗

Changes in blood ammonia, lactate and amino acids in relation to workload during bicycle ergometer exercise in man.

Whole body exercise at intensities up top 50% VO2max has no effect on the concentration of blood ammonia but a threefold rise in blood ammonia is observed at workloads up to maximal. There is a linear relationship between blood ammonia and lactate production during exercise which suggests that the two processes may be linked to a common process of short-term energy provision. Blood glutamine and blood alanine both show rises linearly related to power output during exercise, suggesting that if these amino acids are sinks for ammonia then the process of ammonia incorporation is saturated at high workloads.

Adenine Nucleotides↗

Effects of pyruvate on post-ischemic myocardial recovery at various workloads.

In the present study the hemodynamic and metabolic effects of pyruvate (5 mM), added as cosubstrate to glucose (11 mM) perfused, transiently ischemic, isolated working rat hearts, were evaluated. During 2 h of normoxic perfusion pyruvate improved functional stability, prevented depletion of glycogen and triacylglycerol stores, and increased non-esterified fatty acid (NEFA) levels, even at relatively high workloads. The elevated NEFA levels are in line with the notion that pyruvate competes with endogenously produced fatty acids for oxidative energy production. After 45 min of global ischemia pyruvate was found (a) to affect markedly the relative contribution of ATP, ADP and AMP to the total adenine nucleotide content and (b) to stimulate the degradation of glycogen and to enhance the accumulation of lactate, suggesting enhanced anaerobic ATP production. After restoration of flow pyruvate reduced the incidence of fibrillation and markedly improved recovery of cardiac output at both normal and high workload. Pyruvate did neither attenuate the release of lactate dehydrogenase, a marker for cell death, nor improve the conservation of the total adenine nucleotide and ATP content of hearts reperfused for 30 min. The latter findings indicate that hemodynamic recovery during reperfusion in the presence of pyruvate is neither related to the absolute tissue content of ATP nor to a reduction of irreversible cell damage, and suggest that pyruvate exerts its advantageous hemodynamic effects rather by improving the condition of reversibly damaged cells during reperfusion.

Animals↗

A comparative analysis of physiological responses at submaximal workloads during different laboratory simulations of field cycling.

The purpose of this study was to evaluate the relationships between heart rate (fc), oxygen consumption (VO2), peak force and average force developed at the crank in response to submaximal exercise employing a racing bicycle which was attached to an ergometer (RE), ridden on a treadmill (TC) and ridden on a 400-m track (FC). Eight male trained competitive cyclists rode at three pre-determined work intensities set at a proportion of their maximal oxygen consumption (VO2max): (1) below lactate threshold [work load that produces a VO2 which is 10% less than the lactate threshold VO2 (sub-LT)], (2) lactate threshold VO2 (LT), and (3) above lactate threshold [workload that produces a VO2 which is 10% greater than lactate threshold VO2 (supra-LT)], and equated across exercise modes on the basis of fc. Voltage signals from the crank arm were recorded as FM signals for subsequent representation of peak and average force. Open circuit VO2 measurements were done in the field by Douglas bag gas collection and in the laboratory by automated gas collection and analysis. fc was recorded with a telemeter (Polar Electro Sport Tester, PE3000). Significant differences (P < 0.05) were observed: (1) in VO2 between FC and both laboratory conditions at sub-LT intensity and LT intensities, (2) in peak force between FC and TC at sub-LT intensity, (3) in average force between FC and RE at sub-LT. No significant differences were demonstrated at supra-LT intensity for VO2. Similarly no significant differences were observed in peak and average force for either LT or supra-LT intensities. These data indicate that equating work intensities on the basis of fc measured in laboratory conditions would overestimate the VO2 which would be generated in the field and conversely, that using fc measured in the laboratory to establish field work intensity would underestimate mechanical workload experienced in the field.

Adult↗

Gender-, age-, body composition- and training workload-dependent differences of GH response to a discipline-specific training session in elite athletes: a study on the field.

Ninety-nine Italian elite athletes (61 M, 38 F, mean age +/- SE: 24.1 +/- 0.6 yr, age range: 17-47 yr) of different disciplines volunteered to participate in this investigation. Basal GH concentrations were significantly higher (p<0.0001) in females (6.2 +/- 1.1 ng/ml) vs males (1.9 +/- 0.5 ng/ml). Basal GH values were negatively correlated with age and body mass index (BMI); no significant correlation was found between GH and IGF-I levels. Among female athletes, 8/38 had basal GH values higher than 10 ng/ml [2/8 athletes were taking oral contraceptives (OC)], while among males 6/61 had values higher than 5 ng/ml. In females, training sessions significantly increased (p<0.0001) basal GH concentrations (peak GH: 18.5 +/- 1.9 ng/ml), while in males GH responses were lower than in females (11.8 +/- 1.4 ng/ml, vs F: p<0.005). Six out of 38 female and 6/61 male athletes were considered GH hypo-responders (i.e. negative difference between peak GH and basal GH values), the large majority of them being subjects with elevated basal GH concentrations. In responsive athletes, peak GH values occurred immediately at the end of the training session both in males and in females; GH concentrations rapidly declined during recovery. No significant correlations were found between peak GH and age, body weight and BMI in either gender. GH responses were directly related (p<0.001) to the intensity of the workload during the sessions. In conclusion, the present study demonstrates that: 1) some elite athletes had increased GH concentrations before training, which were however associated with normal IGF-I levels; 2) GH peaks after a discipline-specific training session were significantly higher in females than in males performing the same discipline, gender-related differences disappearing when post-exercise total GH outputs (area under the curve) were compared; 3) peak GH values were directly correlated with training workload; 4) GH concentrations rapidly declined during recovery, values at the end of the post-training GH sampling being generally lower than those found in basal condition.

Adolescent↗

Increased cardiac workload by closure of the ductus arteriosus leads to hypertrophy and apoptosis rather than to hyperplasia in the late fetal period.

It is generally thought that adult mammalian cardiomyocytes compensate for an increased workload by hypertrophy, whereas fetal myocardium grows by cellular proliferation. We analyzed the response of late-fetal rat hearts upon an increased workload imposed by premature constriction of the ductus arteriosus with indomethacin. Initially the fetal heart responds by proliferative growth, as both wet weight and labeling index (bromodeoxyuridine incorporation) of the ventricles increased, whereas neither a change in the fibroblast fraction, ploidy and nucleation in the ventricles is observed. However, this hyperplastic growth is abrogated by a subsequent burst in apoptosis and followed by a hypertrophic response as based on a decrease in DNA and increase in both RNA and protein concentration. This hypertrophic growth was accompanied by a 1.4-fold increase in the volume of the cardiomyocytes. Changes in the molecular phenotype characteristic of pressure-overload hypertrophic growth accompany the process. Thus, the levels of expression of beta-myosin heavy chain and atrial natriuretic factor mRNA increased, of sarcoplasmic/endoplasmic reticulum ATPase (SERCA2) mRNA decreased, and of alpha-myosin heavy chain, phospholamban, and calsequestrin mRNA did not change. In situ hybridization showed that the pattern of mRNA expression changed first in the right ventricular wall and subsequently in the left ventricular free wall as well. It is concluded that pressure-overload imposed on the late-fetal heart induces limited proliferative growth complemented by extensive hypertrophic growth.

Animals↗

Blood lactate changes in men during graded workloads at normal atmospheric pressure (100 kPa) and under simulated caisson conditions (400 kPa).

OBJECTIVES: A hyperbaric environment may influence lactate metabolism due to hyperoxia affecting biochemical pathways. The purpose of our study was to determine the blood lactate levels occurring at high workloads in a sample of professional divers under simulated caisson conditions. The ambient air pressure was equivalent to a diving depth of 30 m of seawater (400 kPa). METHODS: A total of 23 healthy male subjects performed graded bicycle exercise in a dry hyperbaric chamber up to a maximum of 3.5 W kg(-1) body weight at normal (100 kPa) and elevated ambient air pressure (400 kPa). The blood lactate level and the heart rate were measured. RESULTS: In comparison with control conditions, the heart rate and the peripheral blood lactate level were significantly lower at depth for all workloads. CONCLUSIONS: The differences between the normobaric and hyperbaric lactate values may be explained by an overall improvement in lactate metabolism at elevated ambient pressure, especially in the working muscles and the organs responsible for the lactate reduction, i.e., the liver. The reduced heart rate may be an effect of the improved tissue oxygen supply at depth.

Adult↗

Transferability of workload measurements between three different types of ergometer.

The aim of this study was to test the transferability of workload measurements between three different types of bicycle ergometer. Two common ergometers (Lode Excalibur and Avantronic Cyclus 2) were compared with a powermeter (Schoberer SRM system) that enables the measurement of power output during road cycling. Twelve well-trained subjects participated in this study. Within 12 h, each subject carried out three separate graded incremental exercise tests on each of the ergometric devices, and their oxygen uptake (VO2) and heart rate were determined. The three test protocols were identical: after warm-up, four stages of 4 min each at exercise intensities of 100, 150, 200, and 250 W. Pedalling frequency was controlled and there was no difference between the three ergometers. Tests were administered in a random order. Neither VO2 nor heart rate was affected by the type of ergometer used. For a given intensity, the same values were found in the two laboratory tests and in the field test (VO2: P = 0.425; heart rate: P = 0.845). Thus, the transferability of workload measurements between two different laboratory cycling ergometers and an ambulatory device was proven. Equivalency was determined using VO2 and heart rate as indices of metabolic and cardiovascular strain, respectively.

Adult↗

Whither workload?

Although the demands placed on flight deck personnel are not continuously excessive, the short periods of high load combine to produce a cumulative effect at the end of an operation. At the RAF Institute of Aviation Medicine, aircrew are examined on their in-flight workload by a questionnaire method and this is compared with other methods including physiological measurement. The effects of work away from the flight deck, and of factors peripheral to the job situation, are considered, and it is suggested that care must be taken to avoid eliminating job satisfaction with reduction in workload.

Journal Article↗

Workload and ergonomics measures in Swedish professional fishing.

The major types of professional coastal fishery in Sweden were studied. A questionnaire indicated that symptoms from the musculo-skeletal system were common and that certain symptoms related to certain types of fishing. Working tasks inducing severe workload were identified. They concerned handling the fishing gear as well as handling the catch. Ergonomics measures to decrease the workload were suggested and evaluated through ergonomics assessment, measurements of oxygen uptake and working posture analyses. It was found that ergonomics measures can be taken which are efficient in reducing the load on the musculo-skeletal system of the fishermen.

Journal Article↗

The effect of spiked boots on logger safety, productivity and workload.

Analysis of 1657 lost-time logging accidents in the New Zealand logging industry (1985-1991) indicates that 17.5% were as a result of slips, trips and falls and a total of 2870 days were lost. Most (56%) of these slipping, tripping and falling accidents occurred in the felling and delimbing phase of the logging operation, where 37% of the workforce are employed. In an attempt to reduce the number of slipping injuries to loggers employed in felling and delimbing, a study of the effectiveness of spike-soled (caulk) boots was undertaken. Four loggers were intensively observed at work, by continuous time-study methods, while wearing their conventional rubber-soled boots and then spike-soled boots. The number of slips, work methods used, physiological workload and productivity were compared for loggers wearing the two footwear types. Results indicated that spike-soled boots were associated with a significant reduction in the frequency of slips and had no adverse effect on work methods, physiological workload or productivity. Spike-soled boots are now being promoted for use by loggers in New Zealand as a simple method to reduce slipping, tripping and falling accidents.

Journal Article↗

Occlusion as a measure for visual workload: an overview of TNO occlusion research in car driving.

A process-oriented approach by systematically studying driver performance, distraction, and workload is the way to go for assessing safety effects of new telematics applications in vehicles. These systems may strive for drivers' attention and possibly lead to distraction from the primary task. Visual occlusion techniques appear to be an effective means of studying drivers' visual information processing performance. Studies to illustrate this include identifying the minimum visual information drivers need for driving (asking for visual information) and the evaluation of driver support systems such as heading control and adaptive cruise control with respect to visual workload. In other applications the occlusion technique is used to exclude 'visual array' information from the optic flow field. The temporary exclusion of part of the visual field of view was applied in evaluating the effects of different types of driver's side rearview mirrors.

Accidents, Traffic↗

The effect of physical training on workload, upper leg muscle function and muscle areas in patients with chronic heart failure.

OBJECTIVE: To investigate the effect of physical training (PTr) on upper leg muscle area, muscle strength and muscle endurance expressed as upper leg muscle function (ULMF) in relation to exercise performance in CHF. DESIGN: Randomised to a training (TG) or control group (CG). SETTING: Outpatient cardiac rehabilitation centre of community hospital. PATIENTS: 77 CHF patients (59 men and 18 women), NYHA class II/III, age 59.8+/-9.3 years, LVEF 27+/-8%. Sixteen patients dropped out during the intervention period, 61 patients (M/F:46/15) completed the study. INTERVENTION: PTr (combined strength and endurance exercises) four times per week, twice supervised and twice at home, during 26 weeks. MAIN OUTCOME MEASURES: LVEF, body composition, daily physical activity, exercise performance, upper leg muscle area and isokinetic leg muscle variables. RESULTS: Workload and peak oxygen consumption decreased in the CG (-4.1% and -4%) but increased in the TG (+5% and +4%) following PTr (p<0.05, ANOVA repeated measures). Hamstrings area decreased in the CG and did not change in the TG (p<0.05, ANOVA repeated measures). ULMF improved in the TG, but remained unchanged in the CG (+13.0% and 0.0, respectively, p<0.05; ANOVA repeated measures). At baseline and after intervention nearly 60% of the variance in maximal workload was explained by ULMF and quadriceps muscle area (multiple regression analysis). CONCLUSIONS: In CHF patients, home-based training in conjunction with a supervised strength and endurance training program is safe, feasible and effective and does not require complex training equipment. Physical training prevented loss of hamstrings muscle mass and improved exercise performance by enhancing muscle strength and endurance.

Exercise↗