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.
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.
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.
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.
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.
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.