We hypothesized that, associated with the state of anaesthesia, characteristic changes exist in both cardio-respiratory and cerebral oscillator parameters and couplings, perhaps varying with depth of anaesthesia. Electrocardiograms (ECGs), respiration and electroencephalograms (EEGs) were recorded from two groups of 10 rats during the entire course of anaesthesia following the administration of a single bolus of ketamine-xylazine (KX group) or pentobarbital (PB group). The phase dynamics approach was then used to extract the instantaneous frequencies of heart beat, respiration and slow δ-waves (within 0.5-3.5 Hz). The amplitudes of δ-and θ-waves were analysed by use of a time-frequency representation of the EEG signal within 0.5-7.5 Hz obtained by wavelet transformation, using the Morlet mother wavelet. For the KX group, where slow δ-waves constituted the dominant spectral component, the Hilbert transform was applied to obtain the instantaneous δ-frequency. The θ-activity was spread over too wide a spectral range for its phase to be meaningfully defined. For both agents, we observed two distinct phases of anaesthesia, with a marked increase in θ-wave activity occurring on passage from a deeper phase of anaesthesia to a shallower one. In other respects, the effects of the two anaesthetics were very different. For KX anaesthesia, the two phases were separated by a marked change in all three instantaneous frequencies: stable, deep, anaesthesia with small frequency variability was followed by a sharp transition to shallow anaesthesia with large frequency variability, lasting until the animal awoke. The transition occurred 16-76 min after injection of the anaesthetic, with simultaneous reduction in the δ-wave amplitude. For PB anaesthesia, the two epochs were separated by the return of a positive response to the pinch test at 53-94 min, following which it took a further period of 45-70 min for the animal to awaken. δ-Waves were not apparent at any stage of PB anaesthesia. We applied non-linear dynamics and information theory to seek evidence of causal relationships between the cardiac, respiratory and slow δ-oscillations. We demonstrate that, for both groups, respiration drives the cardiac oscillator during deep anaesthesia. During shallow KX anaesthesia the direction either reverses, or the cardio-respiratory interaction becomes insignificant; in the deep phase, there is a unidirectional deterministic interaction of respiration with slow δ-oscillations. For PB anaesthesia, the cardio-respiratory interaction weakens during the second phase but, otherwise, there is no observable change in the interactions. We conclude that non-linear dynamics and information theory can be used to identify different stages of anaesthesia and the effects of different anaesthetics.

One of the current challenges in medicine is monitoring the patients’ depth of general anaesthesia (DGA). Accurate assessment of the depth of anaesthesia contributes to tailoring drug administration to the individual patient, thus preventing awareness or excessive anaesthetic depth and improving patients’ outcomes. In the past decade, there has been a significant increase in the number of studies on the development, comparison and validation of commercial devices that estimate the DGA by analyzing electrical activity of the brain (i.e., evoked potentials or brain waves). In this paper we review the most frequently used sensors and mathematical methods for monitoring the DGA, their validation in clinical practice and discuss the central question of whether these approaches can, compared to other conventional methods, reduce the risk of patient awareness during surgical procedures.

Cold-induced vasodilatation (CIVD) is proposed to be a protective response to prevent cold injuries in the extremities during cold exposure, but the laboratory-based trainability of CIVD responses in the hand remains equivocal. Therefore, we investigated the thermal response across the fingers with repeated local cold exposure of the whole hand, along with the transferability of acclimation to the fingers of the contralateral hand. Nine healthy subjects immersed their right hand up to the styloid process in 8 degrees C water for 30 min daily for 13 days. The left hand was immersed on days 1 and 13. Skin temperature was recorded on the pads of the five fingertips and the dorsal surface of the hand. The presence of CIVD, defined as an increase in finger skin temperature of 0.5 degrees C at any time during cooling, occurred in 98.5% of the 585 (9 subjects x 5 sites x 13 trials) measurements. Seven distinct patterns of thermal responses were evident, including plateaus in finger temperature and superimposed waves. The number (N) of CIVD waves decreased in all digits of the right hand over the acclimation period (P = 0.02), from average (SD) values ranging from 2.7 (1.7) to 3 (1.4) in different digits on day 1, to 1.9 (0.9) and 2.2 (0.7) on day 13. Average (SD) finger skin temperature (T (avg)) ranged from 11.8 (1.4) degrees C in finger 5 to 12.7 (2.8) degrees C in finger 3 on day 1, and then decreased significantly (P < 0.001) over the course of the training immersions, attaining values ranging from 10.8 (0.9) degrees C in finger 4 to 10.9 (0.9) degrees C in finger 2 on day 13. In the contralateral hand, N was reduced from 2.5 to 1.5 (P < 0.01) and T (avg) by approximately 2 degrees C (P < 0.01). No changes were observed in thermal sensation or comfort of the hand over the acclimation. We conclude that, under conditions of whole-hand immersion in cold water, CIVD is not trainable and may lead to systemic attenuation of thermal responses to local cooling.

Cold-induced vasodilatation (CIVD) is a cyclical increase in finger temperature that has been suggested to provide cryoprotective function during cold exposures. Physical fitness has been suggested as a potential factor that could affect CIVD response, possibly via central (increased cardiac output, decreased sympathetic nerve activity) and/or peripheral (increased microcirculation) cardiovascular and neural adaptations to exercise training. Therefore, the purpose of this study was to investigate the effect of endurance exercise training on the CIVD response. Eighteen healthy males trained 1 h d(-1) on a cycle ergometer at 50% of peak power output, 5 days week(-1) for 4-weeks. Pre, Mid, Post, and 10 days after the cessation of training and on separate days, subjects performed an incremental exercise test to exhaustion (.VO(2peak)) and a 30-min hand immersion in 8 degrees C water to examine their CIVD response. The exercise-training regimen significantly increased .VO(2peak) (Pre: 46.0 +/- 5.9, Mid: 52.5 +/- 5.7, Post: 52.1 +/- 6.2, After: 52.6 +/- 7.6 ml kg(-1) min(-1); P < 0.001). There was a significant increase in average finger skin temperature (Pre: 11.9 +/- 2.4, After: 13.5 +/- 2.5 degrees C; P < 0.05), the number of waves (Pre: 1.1 +/- 1.0, After: 1.7 +/- 1.1; P < 0.001) and the thermal sensation (Pre: 1.7 +/- 0.9, After: 2.5 +/- 1.4; P < 0.001), after training. In conclusion, the aforementioned endurance exercise training significantly improved the finger CIVD response during cold-water hand immersion.

One problem evaluating mobile and wearable devices is that they are used in mobile settings, making it hard to collect usability data. We present a study of tap-based selection of on-screen targets whilst walking and sitting, using a PocketPC instrumented with an accelerometer to collect information about user activity at the time of each tap. From these data the user's gait can be derived, and this is then used to investigate preferred tapping behaviour relative to gait phase, and associated tap accuracy. Results showed that users were more accurate sitting than walking. When walking there were phase regions with significantly increased tap likelihood, and these regions had significantly lower error rates, and lower error variability. This work represents an example of accelerometer-instrumented mobile usability analysis, and the results give a quantitative understanding of the detailed interactions taking place when on the move, allowing us to develop better mobile interfaces.