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Changes in physiological signal entropy in patients with obstructive sleep apnoea: a systematic review. 阻塞性睡眠呼吸暂停患者生理信号熵的变化:系统综述。
IF 3.2 4区 医学 Q3 BIOPHYSICS Pub Date : 2024-09-11 DOI: 10.1088/1361-6579/ad79b4
Nawal Ziyad Alotaibi,Maggie Cheung,Amar Shah,John Hurst,Alireza Mani,Swapna Mandal
Background and Objective Obstructive sleep apnoea (OSA) affects an estimated 936 million people worldwide, yet only 15% receive a definitive diagnosis. Diagnosis of OSA poses challenges due to the dynamic nature of physiological signals such as oxygen saturation (SpO2) and heart rate variability (HRV). Linear analysis methods may not fully capture the irregularities present in these signals. The application of entropy of routine physiological signals offers a promising method to better measure variabilities in dynamic biological data. This review aims to explore entropy changes in physiological signals among individuals with OSA. Methods Keyword and title searches were performed on Medline, Embase, Scopus, and CINAHL databases. Studies had to analyse physiological signals in OSA using entropy. Quality assessment used the Newcastle-Ottawa Scale. Evidence was qualitatively synthesized, considering entropy signals, entropy type, and time-series length. Main results Twenty-two studies were included. Multiple physiological signals related to OSA, including SpO2, HRV, and the oxygen desaturation index (ODI), have been investigated using entropy. Results revealed a significant decrease in HRV entropy in those with OSA compared to control groups. Conversely, SpO2 and ODI entropy values were increased in OSA. Despite variations in entropy types, time scales, and data extraction devices, studies using receiver operating characteristic (ROC) curves demonstrated a high discriminative accuracy (>80% AUC) in distinguishing OSA patients from control groups. Conclusions This review highlights the potential of SpO2 entropy analysis in developing new diagnostic indices for patients with OSA. Further investigation is needed before applying this technique clinically. .
背景和目的 据估计,全球有 9.36 亿人患有阻塞性睡眠呼吸暂停(OSA),但只有 15%的人得到明确诊断。由于血氧饱和度(SpO2)和心率变异性(HRV)等生理信号的动态性质,OSA 的诊断面临挑战。线性分析方法可能无法完全捕捉到这些信号中存在的不规则性。常规生理信号熵的应用为更好地测量动态生物数据中的变异性提供了一种很有前景的方法。本综述旨在探讨 OSA 患者生理信号的熵变化。方法 在 Medline、Embase、Scopus 和 CINAHL 数据库中进行关键词和标题检索。研究必须使用熵分析 OSA 的生理信号。采用纽卡斯尔-渥太华量表进行质量评估。考虑到熵信号、熵类型和时间序列长度,对证据进行了定性综合。使用熵对与 OSA 相关的多种生理信号进行了研究,包括 SpO2、心率变异和氧饱和度指数 (ODI)。结果显示,与对照组相比,OSA 患者的心率变异熵明显下降。相反,SpO2 和 ODI 的熵值在 OSA 患者中有所增加。尽管熵的类型、时间尺度和数据提取设备各不相同,但使用接收器操作特征曲线(ROC)进行的研究表明,在区分 OSA 患者和对照组时,熵的鉴别准确率很高(AUC >80%)。在将此技术应用于临床之前,还需要进一步的研究。
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Methods Keyword and title searches were performed on Medline, Embase, Scopus, and CINAHL databases. Studies had to analyse physiological signals in OSA using entropy. Quality assessment used the Newcastle-Ottawa Scale. Evidence was qualitatively synthesized, considering entropy signals, entropy type, and time-series length.
Main results Twenty-two studies were included. Multiple physiological signals related to OSA, including SpO2, HRV, and the oxygen desaturation index (ODI), have been investigated using entropy. Results revealed a significant decrease in HRV entropy in those with OSA compared to control groups. Conversely, SpO2 and ODI entropy values were increased in OSA. Despite variations in entropy types, time scales, and data extraction devices, studies using receiver operating characteristic (ROC) curves demonstrated a high discriminative accuracy (>80% AUC) in distinguishing OSA patients from control groups. 
Conclusions This review highlights the potential of SpO2 entropy analysis in developing new diagnostic indices for patients with OSA. Further investigation is needed before applying this technique clinically.
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引用次数: 0
Millimeter wave radiation to measure blood flow in healthy human subjects. 用毫米波辐射测量健康人的血流量。
IF 3.2 4区 医学 Q3 BIOPHYSICS Pub Date : 2024-09-10 DOI: 10.1088/1361-6579/ad7931
Julia Louise Nelson,Connor Cobb,Joshua L Keller,Miranda K Traylor,David Arthur Nelson,Christopher Michael Francis
OBJECTIVEPeripheral Artery Disease (PAD) is a progressive cardiovascular condition affecting 8-10 million adults in the United States. PAD elevates the risk of cardiovascular events, but up to 50% of people with PAD are asymptomatic and undiagnosed. In this study, we tested the ability of a device, REFLO (Rapid Electromagnetic FLOw), to identify low blood flow using electromagnetic radiation and dynamic thermography toward a non-invasive PAD diagnostic.APPROACHDuring REFLO radio frequency (RF) irradiation, the rate of temperature increase is a function of the rate of energy absorption and blood flow to the irradiated tissue. For a given rate of RF energy absorption, a slow rate of temperature increase implies a large blood flow rate to the tissue. This is due to the cooling effect of the blood. Post-irradiation, a slow rate of temperature decrease is associated with a low rate of blood flow to the tissue. Here, we performed two cohorts of controlled flow experiments on human calves during baseline, occluded, and post-occluded conditions. Nonlinear regression was used to fit temperature data and obtain the rate constant, which was used as a metric for blood flow.MAIN RESULTSIn the pilot study, (N = 7) REFLO distinguished between baseline and post-occlusion during the irradiation phase, and between baseline and occlusion in the post-irradiation phase. In the reliability study, (N = 5 with 3 visits each), two-way ANOVA revealed that flow and subject significantly affected skin heating and cooling rates, while visit did not.SIGNIFICANCEResults suggest that MMW irradiation can be used to distinguish between blood flow rates in humans. Utilizing the rate of skin cooling rather than heating is more consistent for distinguishing flow. Future modifications and clinical testing will aim to improve REFLO's ability to distinguish between flow rates and evaluate its ability to accurately identify PAD.
目的外周动脉疾病(PAD)是一种渐进性心血管疾病,影响着美国 800 万到 1000 万成年人。PAD 会增加心血管事件的风险,但多达 50% 的 PAD 患者没有症状,也未得到诊断。在这项研究中,我们测试了一种名为 REFLO(Rapid Electromagnetic FLOw)的设备利用电磁辐射和动态热成像技术识别低血流量的能力,以实现对 PAD 的无创诊断。对于给定的射频能量吸收率,温度上升速度慢意味着组织的血流量大。这是由于血液的冷却作用。辐照后,温度下降速度慢则组织血流量低。在此,我们对基线、闭塞和闭塞后条件下的人类小腿进行了两组受控血流实验。主要结果在试验研究中,(N = 7)REFLO 在辐照阶段区分了基线和闭塞后,在辐照后阶段区分了基线和闭塞后。在可靠性研究(5 人,每人 3 次)中,双向方差分析显示,血流和受试者对皮肤加热和冷却速率有显著影响,而访问则没有影响。利用皮肤冷却率而不是加热率来区分血流速度更为一致。未来的修改和临床测试将旨在提高 REFLO 区分血流速度的能力,并评估其准确识别 PAD 的能力。
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引用次数: 0
How to quantify sleepiness during an attempt to sleep? 如何量化试图入睡时的困倦感?
IF 3.2 4区 医学 Q3 BIOPHYSICS Pub Date : 2024-09-10 DOI: 10.1088/1361-6579/ad7930
Arcady Putilov,Dmitry Sveshnikov,Elena Yakunina,Olga Mankaeva,Alexandra Puchkova,Dmitry Shumov,Eugenia Gandina,Anton Taranov,Natalya Ligun,Olga Donskaya,Evgeniy Verevkin,Vladimir Dorokhov
BACKGROUNDSleepiness assessment tools were mostly developed for detection of an elevated sleepiness level in the condition of sleep deprivation and several medical conditions. However, sleepiness occurs in various other conditions including the transition from wakefulness to sleep during an everyday attempt to get sleep.OBJECTIVEWe examined whether objective sleepiness indexes can be implicated in detection of fluctuations in sleepiness level during the polysomnographically-monitored attempt to sleep, i.e., in the absence of self-reports on perceived sleepiness level throughout such an attempt.APPROACHThe polysomnographic signals were recorded in the afternoon throughout 106 90-min napping attempts of 53 university students (28 females). To calculate two objective sleepiness indexes, the electroencephalographic (EEG) spectra were averaged on 30-s epochs of each record, assigned to one of 5 sleep-wake stages, and scored using either the frequency weighting curve for sleepiness substate of wake state or loadings of each frequency on the 2nd principal component of variation in the EEG spectrum (either sleepiness score or PC2 score, respectively).MAIN RESULTSWe showed that statistically significant fluctuations in these two objective sleepiness indexes during epochs assigned to wake stage can be described in terms of the changes in verbally anchored levels of subjective sleepiness assessed by scoring on the 9-step Karolinska Sleepiness Scale.SIGNIFICANCEThe results afford new opportunities to elaborate importance of intermediate substates between wake and sleep states for sleep-wake dynamics in healthy individuals and patients with disturbed sleep.
背景嗜睡评估工具大多是为检测睡眠不足和一些疾病情况下的嗜睡程度而开发的。目的我们研究了客观嗜睡指数是否可用于检测多导睡眠监测仪监测的睡眠尝试过程中的嗜睡水平波动,即在整个睡眠尝试过程中缺乏嗜睡水平自我报告的情况下。为了计算两个客观嗜睡指数,对每条记录的 30 秒时程的脑电图(EEG)频谱进行平均,将其归入 5 个睡眠-觉醒阶段之一,并使用觉醒状态嗜睡子状态的频率加权曲线或脑电图频谱变化的第 2 主成分中每个频率的负荷量进行评分(分别为嗜睡评分或 PC2 评分)。主要结果我们发现,这两个客观嗜睡指数在分配到唤醒阶段的时程中出现的统计学意义上的显著波动,可以通过卡罗林斯卡嗜睡量表 9 级评分所评估的主观嗜睡程度的口头锚定变化来描述。
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引用次数: 0
Comparison of non-invasive magnetomyography to Brink score for assessment of pelvic floor muscle strength. 在评估盆底肌肉力量方面,非侵入性磁测图与布林克评分的比较。
IF 3.2 4区 医学 Q3 BIOPHYSICS Pub Date : 2024-09-09 DOI: 10.1088/1361-6579/ad78a3
Luis Mercado,Sallie Oliphant,Diana Escalona-Vargas,Eric R Siegel,Heather Moody,Hari Eswaran
Levator ani muscles undergo significant stretching and micro-trauma at childbirth. The goal was to assess the neuromuscular integrity of this muscle group by means of magnetomyography and correlate with Brink score - a commonly used digital assessment of pelvic floor muscle strength. Methods: Non-invasive magnetomyography (MMG) data was collected on 22 pregnant women during rest and voluntary contraction of the pelvic-floor muscles (Kegels). The mean amplitude and power spectral density (PSD) of the Kegels were correlated to Brink pressure score. Results: The Brink's scores demonstrated medium correlations (≥0.3) with MMG amplitude and PSD with the average Kegel of medium intensity and rest. Data showed that the "resting state" of the pelvic floor is, in actuality, quite dynamic and may have implications for pelvic floor disorder propensity postpartum. Conclusion: These results confirm the ability of non-invasive magnetomyography to reliably capture pelvic floor contraction as these signals correlate with clinical measure. .
肛提肌在分娩时会受到明显的拉伸和微小创伤。我们的目标是通过磁力造影术评估这组肌肉的神经肌肉完整性,并将其与布林克评分--一种常用的骨盆底肌肉力量数字评估方法--相关联。方法: 我们收集了 22 名孕妇在休息和骨盆底肌肉(Kegels)自主收缩时的无创性磁力造影术(MMG)数据。结果: 布林克评分与中等强度和静止时平均凯格尔运动的 MMG 振幅和 PSD 呈中等相关性(≥0.3)。数据显示,盆底的 "静息状态 "实际上是相当动态的,可能对产后盆底障碍的倾向有影响。结论: 这些结果证实了无创磁测图能够可靠地捕捉盆底收缩,因为这些信号与临床测量结果相关。
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Levator ani muscles undergo significant stretching and micro-trauma at childbirth. The goal was to assess the neuromuscular integrity of this muscle group by means of magnetomyography and correlate with Brink score - a commonly used digital assessment of pelvic floor muscle strength.
Methods:
Non-invasive magnetomyography (MMG) data was collected on 22 pregnant women during rest and voluntary contraction of the pelvic-floor muscles (Kegels). The mean amplitude and power spectral density (PSD) of the Kegels were correlated to Brink pressure score.
Results:
The Brink's scores demonstrated medium correlations (≥0.3) with MMG amplitude and PSD with the average Kegel of medium intensity and rest. Data showed that the \"resting state\" of the pelvic floor is, in actuality, quite dynamic and may have implications for pelvic floor disorder propensity postpartum.
Conclusion:
These results confirm the ability of non-invasive magnetomyography to reliably capture pelvic floor contraction as these signals correlate with clinical measure.&#xD.","PeriodicalId":20047,"journal":{"name":"Physiological measurement","volume":"36 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142178614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Machine learning-enhanced electrical impedance myography to diagnose and track spinal muscular atrophy progression. 机器学习增强型电阻抗肌电图诊断和跟踪脊髓性肌肉萎缩症的进展。
IF 2.3 4区 医学 Q3 BIOPHYSICS Pub Date : 2024-09-06 DOI: 10.1088/1361-6579/ad74d5
Buket Sonbas Cobb, Stephen J Kolb, Seward B Rutkove

Objective.To evaluate electrical impedance myography (EIM) in conjunction with machine learning (ML) to detect infantile spinal muscular atrophy (SMA) and disease progression.Approach. Twenty-six infants with SMA and twenty-seven healthy infants had been enrolled and assessed with EIM as part of the NeuroNEXT SMA biomarker study. We applied a variety of modern, supervised ML approaches to this data, first seeking to differentiate healthy from SMA muscle, and then, using the best method, to track SMA progression.Main Results.Several of the ML algorithms worked well, but linear discriminant analysis (LDA) achieved 88.6% accuracy on subject muscles studied. This contrasts with a maximum of 60% accuracy that could be achieved using the single or multifrequency assessment approaches available at the time. LDA scores were also able to track progression effectively, although a multifrequency reactance-based measure also performed very well in this context.Significance.EIM enhanced with ML promises to be effective for providing effective diagnosis and tracking children and adults with SMA treated with currently available therapies. The normative trends identified here may also inform future applications of the technology in very young children. The basic analyses applied here could also likely be applied to other neuromuscular disorders characterized by muscle atrophy.

目的: 评估电阻抗肌电图(EIM)与机器学习相结合检测小儿脊髓性肌萎缩症(SMA)和疾病进展的效果 方法: 作为 NeuroNEXT SMA 生物标记物研究的一部分,我们对 26 名 SMA 婴儿和 27 名健康婴儿进行了登记和 EIM 评估。我们对这些数据采用了多种现代、有监督的机器学习方法,首先寻求区分健康和 SMA 肌肉,然后使用最佳方法跟踪 SMA 的进展。这与当时使用单频或多频评估方法达到的最高 66% 的准确率形成了鲜明对比。尽管基于多频反应的测量方法在这方面也表现出色,但 LDA 分数也能有效跟踪病情进展。这里确定的标准值和趋势对该技术的其他儿科应用也很有价值。这里应用的基本分析方法也可能适用于其他以肌肉萎缩为特征的神经肌肉疾病。
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引用次数: 0
Neuromuscular disease auxiliary diagnosis using a portable magnetomyographic system. 使用便携式磁测图系统进行神经肌肉疾病辅助诊断。
IF 2.3 4区 医学 Q3 BIOPHYSICS Pub Date : 2024-09-06 DOI: 10.1088/1361-6579/ad65b0
Yutong Wei, Yan Chen, Chaofeng Ye

Objective. The measurement of electromyography (EMG) signals with needle electrodes is widely used in clinical settings for diagnosing neuromuscular diseases. Patients experience pain during needle EMG testing. It is significant to develop alternative diagnostic modalities.Approach. This paper proposes a portable magnetomyography (MMG) measurement system for neuromuscular disease auxiliary diagnosis. Firstly, the design and operating principle of the system are introduced. The feasibility of using the system for auxiliary diagnosis of neuromuscular diseases is then studied. The magnetic signals and needle EMG signals of thirty subjects were collected and compared.Main results. It is found that the amplitude of muscle magnetic field signal increases during mild muscle contraction, and the signal magnitudes of the patients are smaller than those of normal subjects. The diseased muscles tested in the experiment can be distinguished from the normal muscles based on the signal amplitude, using a threshold value of 6 pT. The MMG diagnosis results align well with the needle EMG diagnosis. In addition, the MMG measurement indicates that there is a persistence of spontaneous activity in the diseased muscle.Significance.The experimental results demonstrate that it is feasible to auxiliary diagnose neuromuscular diseases using the portable MMG system, which offers the advantages of non-contact and painless measurements. After more in-depth, systematic, and quantitative research, the portable MMG could potentially be used for auxiliary diagnosis of neuromuscular diseases. The clinical trial registration number is ChiCTR2200067116.

使用针电极测量肌电图(EMG)信号被广泛应用于临床诊断神经肌肉疾病。在进行针式肌电图测试时,患者会感到疼痛。开发替代诊断模式意义重大。本文提出了一种用于神经肌肉疾病辅助诊断的便携式磁测(MMG)测量系统。首先介绍了系统的设计和工作原理。然后研究了该系统用于神经肌肉疾病辅助诊断的可行性。采集并比较了 30 名受试者的磁信号和针肌电信号。结果发现,肌肉轻微收缩时,肌肉磁场信号幅度会增大,患者的信号幅度比正常人小。实验中测试的病变肌肉可根据信号幅度与正常肌肉区分开来,阈值为 6 pT。MMG 诊断结果与针刺肌电图诊断结果非常吻合。此外,MMG 测量结果表明,病变肌肉存在持续的自发活动。实验结果表明,利用便携式 MMG 系统辅助诊断神经肌肉疾病是可行的,该系统具有非接触、无痛测量等优点。经过更深入、系统和定量的研究,便携式 MMG 有可能用于神经肌肉疾病的辅助诊断。
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引用次数: 0
Progression of total training volume in resistance training studies and its application to skeletal muscle growth. 阻力训练研究中总训练量的递增及其在骨骼肌生长中的应用。
IF 2.3 4区 医学 Q3 BIOPHYSICS Pub Date : 2024-09-04 DOI: 10.1088/1361-6579/ad7348
William B Hammert, Ryo Kataoka, Yujiro Yamada, Jun Seob Song, Anna Kang, Robert W Spitz, Jeremy P Loenneke

Progressive overload describes the gradual increase of stress placed on the body during exercise training, and is often quantified (i.e. in resistance training studies) through increases in total training volume (i.e. sets × repetitions × load) from the first to final week of the exercise training intervention. Within the literature, it has become increasingly common for authors to discuss skeletal muscle growth adaptations in the context of increases in total training volume (i.e. the magnitude progression in total training volume). The present manuscript discusses a physiological rationale for progressive overload and then explains why, in our opinion, quantifying the progression of total training volume within research investigations tells very little about muscle growth adaptations to resistance training. Our opinion is based on the following research findings: (1) a noncausal connection between increases in total training volume (i.e. progressively overloading the resistance exercise stimulus) and increases in skeletal muscle size; (2) similar changes in total training volume may not always produce similar increases in muscle size; and (3) the ability to exercise more and consequently amass larger increases in total training volume may not inherently produce more skeletal muscle growth. The methodology of quantifying changes in total training volume may therefore provide a means through which researchers can mathematically determine the total amount of external 'work' performed within a resistance training study. It may not, however, always explain muscle growth adaptations.

渐进性超负荷是指在运动训练过程中身体所承受的压力逐渐增加,通常通过从运动训练干预的第一周到最后一周总训练量(即组数 x 重复次数 x 负荷)的增加来量化(例如,在阻力训练研究中)。在文献中,越来越多的作者结合总训练量的增加(即总训练量的幅度递增)来讨论骨骼肌的生长适应性。本手稿讨论了渐进超负荷的生理学原理,然后解释了为什么我们认为在研究调查中量化总训练量的增长对阻力训练的肌肉生长适应性意义不大。我们的观点基于以下研究结果:(1)总训练量的增加(即逐渐超负荷的阻力训练刺激)与骨骼肌体积的增加之间存在非因果关系;(2)类似的总训练量变化不一定总是会产生类似的肌肉体积增加;以及(3)能够进行更多的锻炼并因此积累更多的总训练量增加可能并不会在本质上产生更多的骨骼肌生长。因此,量化总训练量变化的方法可以为研究人员提供一种手段,通过这种方法,研究人员可以用数学方法确定阻力训练研究中进行的外部 "工作 "总量。但是,这种方法并不能解释肌肉生长的适应性。
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引用次数: 0
Understanding the physiological transmission mechanisms of photoplethysmography signals: a comprehensive review. 了解光敏血压计信号的生理传输机制:全面综述。
IF 2.3 4区 医学 Q3 BIOPHYSICS Pub Date : 2024-08-27 DOI: 10.1088/1361-6579/ad6be4
Kai Li, Jiuai Sun

Objective. The widespread adoption of Photoplethysmography (PPG) as a non-invasive method for detecting blood volume variations and deriving vital physiological parameters reflecting health status has surged, primarily due to its accessibility, cost-effectiveness, and non-intrusive nature. This has led to extensive research around this technique in both daily life and clinical applications. Interestingly, despite the existence of contradictory explanations of the underlying mechanism of PPG signals across various applications, a systematic investigation into this crucial matter has not been conducted thus far. This gap in understanding hinders the full exploitation of PPG technology and undermines its accuracy and reliability in numerous applications.Approach. Building upon a comprehensive review of the fundamental principles and technological advancements in PPG, this paper initially attributes the origin of PPG signals to a combination of physical and physiological transmission processes. Furthermore, three distinct models outlining the concerned physiological transmission processes are synthesized, with each model undergoing critical examination based on theoretical underpinnings, empirical evidence, and constraints.Significance. The ultimate objective is to form a fundamental framework for a better understanding of physiological transmission processes in PPG signal generation and to facilitate the development of more reliable technologies for detecting physiological signals.

作为一种检测血容量变化和得出反映健康状况的重要生理参数的非侵入式方法,光电血压计(PPG)已被广泛采用,这主要归功于它的可及性、成本效益和非侵入性。因此,围绕这项技术在日常生活和临床应用方面开展了广泛的研究。有趣的是,尽管在各种应用中对 PPG 信号的基本机制存在着相互矛盾的解释,但迄今为止尚未对这一关键问题进行过系统的研究。这种认识上的差距阻碍了 PPG 技术的充分应用,并破坏了其在众多应用中的准确性和可靠性。在全面回顾 PPG 的基本原理和技术进步的基础上,本文初步将 PPG 信号的来源归结为物理和生理传输过程的结合。此外,本文还综合了三种不同的模型,概述了相关的生理传输过程,并根据理论基础、经验证据和制约因素对每种模型进行了严格审查。最终目的是形成一个基本框架,以便更好地理解 PPG 信号产生的生理传输过程,并促进开发更可靠的生理信号检测技术。
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引用次数: 0
The role of pulse wave analysis indexes for critically ill patients: a narrative review. 危重病人脉搏波分析指标的作用:综述。
IF 2.3 4区 医学 Q3 BIOPHYSICS Pub Date : 2024-08-22 DOI: 10.1088/1361-6579/ad6acf
Marta Carrara, Riccardo Campitelli, Diletta Guberti, M Ignacio Monge Garcia, Manuela Ferrario

Objective.Arterial pulse wave analysis (PWA) is now established as a powerful tool to investigate the cardiovascular system, and several clinical studies have shown how PWA can provide valuable prognostic information over and beyond traditional cardiovascular risk factors. Typically these techniques are applied to chronic conditions, such as hypertension or aging, to monitor the slow structural changes of the vascular system which lead to important alterations of the arterial PW. However, their application to acute critical illness is not currently widespread, probably because of the high hemodynamic instability and acute dynamic alterations affecting the cardiovascular system of these patients.Approach.In this work we propose a review of the physiological and methodological basis of PWA, describing how it can be used to provide insights into arterial structure and function, cardiovascular biomechanical properties, and to derive information on wave propagation and reflection.Main results.The applicability of these techniques to acute critical illness, especially septic shock, is extensively discussed, highlighting the feasibility of their use in acute critical patients and their role in optimizing therapy administration and hemodynamic monitoring.Significance.The potential for the clinical use of these techniques lies in the ease of computation and availability of arterial blood pressure signals, as invasive arterial lines are commonly used in these patients. We hope that the concepts illustrated in the present review will soon be translated into clinical practice.

目的:动脉脉搏波分析(PWA)现已成为研究心血管系统的有力工具,多项临床研究表明,除了传统的心血管风险因素外,动脉脉搏波分析还能提供有价值的预后信息。这些技术通常应用于高血压或衰老等慢性疾病,以监测血管系统缓慢的结构变化,从而导致动脉脉搏波的重要改变。然而,这些技术目前还没有广泛应用于急性危重病人,这可能是因为这些病人的血流动力学极不稳定,心血管系统会发生急性动态变化:在这项工作中,我们将回顾 PWA 的生理学和方法学基础,介绍如何利用 PWA 深入了解动脉结构和功能、心血管生物力学特性,以及如何获取有关波传播和反射的信息。该报告广泛讨论了这些技术在急性危重病,尤其是脓毒性休克中的适用性,强调了在急性危重病人中使用这些技术的可行性,以及它们在优化治疗管理和血液动力学监测中的作用:这些技术的临床应用潜力在于易于计算和动脉血压信号的可用性,因为这些患者通常使用有创动脉管路。我们希望本综述中阐述的概念能尽快转化为临床实践。
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引用次数: 0
An interpretable ensemble trees method with joint analysis of static and dynamic features for myocardial infarction detection. 利用静态和动态特征联合分析的可解释集合树方法检测心肌梗塞。
IF 2.3 4区 医学 Q3 BIOPHYSICS Pub Date : 2024-08-22 DOI: 10.1088/1361-6579/ad6529
Chunmiao Liang, Qinghua Sun, Jiali Li, Bing Ji, Weiming Wu, Fukai Zhang, Yuguo Chen, Cong Wang

Objective.In recent years, artificial intelligence-based electrocardiogram (ECG) methods have been massively applied to myocardial infarction (MI). However, the joint analysis of static and dynamic features to achieve accurate and interpretable MI detection has not been comprehensively addressed.Approach.This paper proposes a simplified ensemble tree method with a joint analysis of static and dynamic features to solve this issue for MI detection. Initially, the dynamic features are extracted by modeling the intrinsic dynamics of ECG via dynamic learning in addition to extracting classical static features. Secondly, a two-stage feature selection strategy is designed to identify a few significant features, which substitute the original variables that are employed in constructing the ensemble tree. This approach enhances the discriminative ability by selecting significant static and dynamic features. Subsequently, this paper presents an interpretable classification method named StackTree by introducing a stacked ensemble scheme to modify the ensemble tree simplification algorithm. The representative rules of the raw ensemble trees are selected as the intermediate training data that is used to retrain a decision tree with performance close to that of the source ensemble model. Using this scheme, the significant precision and interpretability of MI detection are thus comprehensively addressed.Main results.The effectiveness of our method in detecting MI is evaluated using the Physikalisch-Technische Bundesanstalt (PTB) and clinical database. The findings suggest that our algorithm outperforms the traditional methods based on a single type of feature. Additionally, it is comparable to the conventional random forest, achieving 97.1% accuracy under the inter-patient framework on the PTB database. Furthermore, feature subsets trained on PTB are validated using the clinical database, resulting in an accuracy of 84.5%. The chosen important features demonstrate that both static and dynamic information have crucial roles in MI detection. Crucially, the proposed method provides clear internal workings in an easy-to-understand visual manner.

目的:近年来,基于人工智能的心电图(ECG)方法被大量应用于心肌梗死(MI)。然而,如何通过对静态和动态特征的联合分析来实现准确、可解释的心肌梗死检测,还没有得到全面解决。本文提出了一种联合分析静态和动态特征的简化集合树方法,以解决 MI 检测中的这一问题。首先,在提取经典静态特征的基础上,通过动态学习对心电图的内在动态进行建模,从而提取动态特征。其次,设计了一种两阶段特征选择策略,以识别少数重要特征,这些特征可替代用于构建集合树的原始变量。这种方法通过选择重要的静态和动态特征来增强判别能力。随后,本文通过引入堆叠集合方案来修改集合树简化算法,提出了一种名为 StackTree 的可解释分类方法。原始集合树中具有代表性的规则被选为中间训练数据,用于重新训练一棵性能接近源集合模型的决策树。采用这种方案,可以全面解决 MI 检测的高精度和可解释性问题。我们使用 PTB 和临床数据库评估了我们的方法在检测 MI 方面的有效性。结果表明,我们的算法优于基于单一类型特征的传统方法。此外,在 PTB 数据库的患者间框架下,该算法的准确率达到了 97.1%,与传统的随机森林算法不相上下。此外,使用临床数据库验证了在 PTB 上训练的特征子集,结果准确率达到 84.5%。所选的重要特征表明,静态和动态信息在 MI 检测中都起着至关重要的作用。最重要的是,所提出的方法以易于理解的可视化方式提供了清晰的内部工作原理。
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引用次数: 0
期刊
Physiological measurement
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