Open Access Policy refers to a set of principles and guidelines aimed at providing unrestricted access to scholarly research and literature. It promotes the free availability and unrestricted use of research outputs, enabling researchers, students, and the general public to access, read, download, and distribute scholarly articles without financial or legal barriers. In this response, I will provide you with an overview of the history and latest resolutions related to Open Access Policy.
Heart rate variability (HRV), a non-invasive measure of autonomic nervous system (ANS) function reflecting vagus nerve activity, is a promising biomarker in breast cancer (BC) management. This PRISMA-guided systematic review evaluates HRV electrophysiologic data from 5-minute vs. 24-hour ECG recordings in BC diagnosis and therapy follow-up, emphasizing the vagus nerve’s role in inflammation and tumor progression. Completing a search of PubMed, Scopus, Web of Science, and Embase (2009 - 2025), 16 studies (n = 3,412 participants) were inclu...ded. Lower HRV metrics (e.g., SDNN < 50 ms, RMSSD < 20 ms predicted relapse) correlated with advanced BC stages, elevated carcinoembryonic antigen (CEA), and poorer prognosis (HR = 0.62, 95% CI: 0.48 - 0.79). Chemotherapy-induced HRV reductions (e.g., SDNN decrease by 20%) predicted cardiotoxicity, while vagus nerve stimulation (VNS) improved HRV and reduced inflammation. HRV showed diagnostic sensitivity up to 80% with biomarkers. Additionally, meta-analysis was precluded due to significant methodological heterogeneity across studies. A narrative synthesis was conducted due to this heterogeneity; meta-analysis was not feasible due to inconsistent HRV protocols and outcome measures. HRV and vagal interventions hold transformative potential, necessitating standardized protocols and larger studies.
