Heart rate changes associated with autonomic dysreflexia in daily life of individuals with chronic spinal cord injury
Bibliographic record
Abstract
ABSTRACT Objective To characterize heart rate (HR) changes during autonomic dysreflexia (AD) in daily life for individuals with chronic spinal cord injury (SCI). Design Data analysis of two prospective clinical studies and one cross-sectional study. Setting Single-center study. Participants Forty-five individuals (including 8 females) with a chronic SCI at or above the sixth thoracic spinal segment with confirmed AD, and a median age and time since injury of 43 years (interquartile range [IQR] 36 – 50) and 17 years (IQR 6 – 23) respectively, were included for analysis. Interventions Not applicable. Main outcome measure Any systolic blood pressure (SBP) increase ≥ 20mmHg from baseline from a 24-hour ambulatory surveillance period was identified and categorized as either confirmed (i.e. known AD trigger), unknown (i.e. no diary entry), and unlikely (i.e. potential physical activity driven SBP increase). SBP-associated HR changes were categorized as either unchanged, increased or decreased compared to baseline. Results A total of 797 episodes of SBP increase above AD threshold were identified and classified as confirmed (n = 250, 31.4%), unknown (n = 472, 59.2%) or unlikely (n = 75, 9.4%). Median SBP changes and median SBP-related HR changes were 37 mmHg and -8 bpm, 28 mmHg and -6 bpm, or 30 mmHg and -4 bpm for confirmed, unknown, or unlikely episodes, respectively. HR-decrease/increase ratio was 3:1 for confirmed and unknown, and 1.5:1 for unlikely episodes. HR changes resulting in brady-/tachycardia were 34.4% / 2.8% for confirmed, 39.6% / 3.4% unknown, and 26.7% / 9.3% for unlikely episodes, respectively. Conclusions Our findings suggest that the majority of confirmed AD episodes are associated with a HR decrease. Further improvements, such as more precise participant diaries combined with the use of 24-hour Holter electrocardiogram and wearable-sensors-derived measures of physical activity could provide a better, more detailed characterization of HR changes during episodes of AD.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".