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Estimation of the prevalence of isolated inter-scalene compression from simultaneous arterial and venous photoplethysmography in patients referred for suspected thoracic outlet syndrome. 通过对疑似胸廓出口综合征转诊患者同时进行动脉和静脉光电肌电图检查,估算孤立腕骨间压迫的发生率。
IF 2.3 4区 医学 Q3 BIOPHYSICS Pub Date : 2024-08-02 DOI: 10.1088/1361-6579/ad65b1
Simon Lecoq, Jeanne Hersant, Pierre Abraham

Objective.In patients with suspected thoracic outlet syndrome (TOS), diagnosing inter-scalene compression could lead to minimally invasive treatments. During photo-plethysmography, completing a 30 s 90° abduction, external rotation ('surrender' position) by addition of a 15 s 90° antepulsion 'prayer' position, allows quantitative bilateral analysis of both arterial (A-PPG) and venous (V-PPG) results. We aimed at determining the proportion of isolated arterial compression with photo-plethysmography in TOS-suspected patients.Approach.We studied 116 subjects recruited over 4 months (43.3 ± 11.8 years old, 69% females). Fingertip A-PPG and forearm V-PPG were recorded on both sides at 125 Hz and 4 Hz respectively. A-PPG was converted to PPG amplitude and expressed as percentage of resting amplitude (% rest). V-PPG was expressed as percentage of the maximal value (% max) observed during the 'Surrender-Prayer' maneuver. Impairment of arterial inflow during the surrender (As+) or prayer (Ap+) phases were defined as a pulse-amplitude either <5% rest, or <25% rest. Incomplete venous emptying during the surrender (Vs+) or prayer (Vp+) phases were defined as V-PPG values either <70% max, or <87% max.Main results.Of the 16 possible associations of encodings, As - Vs - Ap - Vp- was the most frequent observation assumed to be a normal response. Isolated arterial inflow without venous outflow (As + Vs-) impairment in the surrender position was observed in 10.3% (95%CI: 6.7%-15.0%) to 15.1% (95%CI: 10.7%-20.4%) of limbs.Significance.Simultaneous A-PPG and V-PPG can discriminate arterial from venous compression and then potentially inter-scalene from other levels of compressions. As such, it opens new perspectives in evaluation and treatment of TOS.

目的:对于疑似胸廓出口综合征(TOS)的患者,如果能诊断出椎骨间压迫,就可以进行微创治疗。在进行照相胸廓彩超检查时,完成 30 秒 90° 外展、外旋("投降 "体位),再加上 15 秒 90° 反外展 "祈祷 "体位,可对动脉(A-PPG)和静脉(V-PPG)结果进行双侧定量分析。我们的目的是通过光电搏动图确定疑似 TOS 患者中孤立动脉受压的比例:我们对历时 4 个月招募的 116 名受试者(43.3+/-11.8 岁,69% 为女性)进行了研究。分别以 125 Hz 和 4 Hz 的频率记录两侧指尖 A-PPG 和前臂 V-PPG。A-PPG 被转换为 PPG 振幅,并以静息振幅的百分比(%rest)表示。V-PPG 以 "投降-祈祷 "动作中观察到的最大值的百分比(%max)表示。投降(As+)或祈祷(Ap+)阶段的动脉流入量受损定义为脉搏振幅小于静息时的 5%或小于静息时的 25%。在投降(Vs+)或祈祷(Vp+)阶段,静脉排空不完全的定义是 V-PPG 值低于或低于 25%。
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引用次数: 0
Extracting actigraphy-based walking features with structured functional principal components. 利用结构化功能主成分提取基于行为记录仪的行走特征。
IF 2.3 4区 医学 Q3 BIOPHYSICS Pub Date : 2024-08-02 DOI: 10.1088/1361-6579/ad65b2
Verena Werkmann, Nancy W Glynn, Jaroslaw Harezlak

Objective.We extract walking features from raw accelerometry data while accounting for varying cadence and commonality of features among subjects. Walking is the most performed type of physical activity. Thus, we explore if an individual's physical health is related to these walking features.Approach.We use data collected using ActiGraph GT3X+ devices (sampling rate = 80 Hz) as part of the developmental epidemiologic cohort study,I= 48, age =78.7±5.7years, 45.8% women. We apply structured functional principal component analysis (SFPCA) to extract features from walking signals on both, the subject-specific and the subject-spectrum-specific level of a fast-paced 400 m walk, an indicator of aerobic fitness in older adults. We also use the subject-specific level feature scores to study their associations with age and physical performance measures. Specifically, we transform the raw data into the frequency domain by applying local Fast Fourier Transform to obtain the walking spectra. SFPCA decomposes these spectra into easily interpretable walking features expressed as cadence and acceleration, which can be related to physical performance.Main results.We found that five subject-specific and 19 subject-spectrum-specific level features explained more than 85% of their respective level variation, thus significantly reducing the complexity of the data. Our results show that 54% of the total data variation arises at the subject-specific and 46% at the subject-spectrum-specific level. Moreover, we found that higher acceleration magnitude at the cadence was associated with younger age, lower BMI, faster average cadence and higher short physical performance battery scores. Lower acceleration magnitude at the cadence and higher acceleration magnitude at cadence multiples 2.5 and 3.5 are related to older age and higher blood pressure.Significance.SFPCA extracted subject-specific level empirical walking features which were meaningfully associated with several health indicators and younger age. Thus, an individual's walking pattern could shed light on subclinical stages of somatic diseases.

目的:我们从原始加速度计数据中提取步行特征,同时考虑到受试者之间不同的节奏和特征的共性。步行是最常见的体育活动。因此,我们要探索个人的身体健康是否与这些步行特征有关:我们使用 ActiGraph GT3X+ 设备(采样率=80Hz)收集的数据,这些数据是发育流行病学队列研究(DECOS)的一部分,I=48,年龄=78.7+/-5.7 岁,45.8% 为女性。我们应用结构化功能主成分分析(SFPCA)从快节奏 400 米步行(老年人有氧健身指标)的步行信号中提取特定对象和特定对象频谱水平的特征。我们还利用特定对象水平的特征得分来研究它们与年龄和身体表现指标之间的关联。具体来说,我们通过局部快速傅里叶变换将原始数据转换到频域,从而获得步行频谱。SFPCA 将这些频谱分解成易于解释的行走特征,以步幅和加速度表示,这些特征可与体能表现相关联:我们发现,5 个特定主题和 19 个特定主题频谱水平特征解释了各自水平变化的 85% 以上,从而大大降低了数据的复杂性。我们的结果表明,总数据变化的 54% 来自特定主题,46% 来自特定主题频谱。此外,我们还发现,较高的步频加速度与较年轻的年龄、较低的体重指数、较快的平均步频和较高的短期体能表现电池得分有关。较低的步频加速度和较高的步频倍数 2.5 和 3.5 时的加速度与年龄较大和血压较高有关:SFPCA提取了特定受试者水平的经验步行特征,这些特征与多个健康指标和年轻化有重要关联。因此,个人的行走模式可以揭示躯体疾病的亚临床阶段。
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引用次数: 0
Accelerometer techniques for capturing human movement validated against direct observation: a scoping review. 根据直接观察验证捕捉人体运动的加速度计技术:范围审查。
IF 2.3 4区 医学 Q3 BIOPHYSICS Pub Date : 2024-08-01 DOI: 10.1088/1361-6579/ad45aa
Elyse Letts, Josephine S Jakubowski, Sara King-Dowling, Kimberly Clevenger, Dylan Kobsar, Joyce Obeid

Objective.Accelerometers are devices commonly used to measure human physical activity and sedentary time. Accelerometer capabilities and analytical techniques have evolved rapidly, making it difficult for researchers to keep track of advances and best practices for data processing and analysis. The objective of this scoping review is to determine the existing methods for analyzing accelerometer data for capturing human movement which have been validated against the criterion measure of direct observation.Approach.This scoping review searched 14 academic and 5 grey databases. Two independent raters screened by title and abstract, then full text. Data were extracted using Microsoft Excel and checked by an independent reviewer.Mainresults.The search yielded 1039 papers and the final analysis included 115 papers. A total of 71 unique accelerometer models were used across a total of 4217 participants. While all studies underwent validation from direct observation, most direct observation occurred live (55%) or using recordings (42%). Analysis techniques included machine learning (ML) approaches (22%), the use of existing cut-points (18%), receiver operating characteristic curves to determine cut-points (14%), and other strategies including regressions and non-ML algorithms (8%).Significance.ML techniques are becoming more prevalent and are often used for activity identification. Cut-point methods are still frequently used. Activity intensity is the most assessed activity outcome; however, both the analyses and outcomes assessed vary by wear location. This scoping review provides a comprehensive overview of accelerometer analysis and validation techniques using direct observation and is a useful tool for researchers using accelerometers.

简介加速计是测量人类体力活动和久坐时间的常用设备。加速度计的功能和分析技术发展迅速,使研究人员难以跟踪数据处理和分析的进展和最佳实践:本次范围审查的目的是确定现有的用于捕捉人体运动的加速度计数据分析方法,这些方法已根据直接观察的标准措施进行了验证:本范围界定综述检索了 14 个学术数据库和 5 个灰色数据库。两名独立的评定员先根据标题和摘要进行筛选,然后再筛选全文。使用 Microsoft Excel 提取数据,并由一名独立评审员进行检查:结果:搜索结果包括 1039 篇论文,最终分析包括 115 篇论文。共有 4217 名参与者使用了 71 种不同的加速度计模型。虽然所有研究都通过直接观察进行了验证,但大多数直接观察都是现场进行的(55%)或使用录音进行的(42%)。分析技术包括机器学习方法(22%)、使用现有切点(18%)、ROC 曲线确定切点(14%)以及包括回归和非机器学习算法在内的其他策略(8%):讨论:机器学习技术正变得越来越普遍,并经常用于活动识别。切点法仍经常使用。活动强度是评估最多的活动结果;然而,不同的穿戴地点所评估的分析和结果也不尽相同:本范围综述全面概述了使用直接观察法对加速度计进行分析和验证的技术,是使用加速度计的研究人员的有用工具。
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引用次数: 0
Long-term phase angle muscle imaging under electrical muscle stimulation (EMS) by phase angle electrical impedance tomography. 通过相位角电阻抗断层扫描对肌肉电刺激(EMS)下的肌肉进行长期相位角成像。
IF 2.3 4区 医学 Q3 BIOPHYSICS Pub Date : 2024-08-01 DOI: 10.1088/1361-6579/ad6749
Bo Sun, Prima Asmara Sejati, Tomoyuki Shirai, Masahiro Takei

Objectives. Phase angle muscle imaging has been proposed by phase angle electrical impedance tomography (ΦEIT) under electrical muscle stimulation (EMS) for long-term monitoring of muscle quality improvement, especially focusing on calf muscles.Approach. In the experiments, twenty-four subjects are randomly assigned either to three groups: control group (CG,n= 8), low voltage intensity of EMS training group (LG,n= 8), and optimal voltage intensity of EMS training group (OG,n= 8).Main results. From the experimental results, phase angle distribution imagesФare cleared reconstructed by ФEIT as four muscle compartments over five weeks experiments, which are called theM1muscle compartments composed of gastrocnemius muscle,M2muscle compartments composed of soleus muscle,M3muscle compartments composed of tibialis-posterior muscle, flexor digitorum longus muscle, and flexor pollicis longus muscle, andM4muscle compartment composed of the tibialis anterior muscle, extensor digitorum longus muscle, and peroneus longus muscle.Фis inversely correlated with age, namely theФdecreases with increasing age. A paired samplest-test was conducted to elucidate the statistical significance of spatial-mean phase angle in all domain <Ф>Ωand in each muscle compartment <Ф>Mwith reference to the conventional phase angle Ф by bioelectrical impedance analysis, muscle grey-scaleGmuscleby ultrasound, and maximal dynamic strengthSMaxby one-repetition maximum test.Significance. From thet-test results, <Ф>Ωhave good correlation with Ф andSMax. In the OG, <ФW5>Ω,ФW5, and (SMax)W5were significantly higher than in the first week (n= 8,p< 0.05). A significant increase in the phase angle of bothM1andM4muscle compartments is observed after five weeks in LG and OG groups. Only the OG group shows a significant increase in the phase angle ofM2muscle compartment after five weeks. However, no significant changes in the spatial-mean phase angle ofM3compartment are observed in each group. In conclusion, ФEIT satisfactorily monitors the response of each compartment in calf muscle to long-term EMS training.

相位角肌肉成像是通过 EMS 下的相位角电阻抗断层扫描来实现的,用于长期监测肌肉质量的改善,尤其侧重于小腿肌肉。实验中,24 名受试者被随机分配到三组:对照组(CG,n = 8)、低电压强度 EMS 训练组(LG,n = 8)和最佳电压强度 EMS 训练组(OG,n = 8)。根据实验结果,ФEIT 将五周实验中的相位角分布图像Ф清除重建为四个肌肉区,即由腓肠肌组成的 M1 区,由比目鱼肌组成的 M2 区,由胫骨后肌、趾长屈肌和腓长屈肌组成的 M3 区,以及由胫骨前肌、趾长伸肌和腓骨长肌组成的 M4 区。Ф与年龄成反比,即Ф随着年龄的增加而减少。通过生物电阻抗分析、超声波肌肉灰度 Gmuscle 和单次重复最大测试最大动态力量 SMax,采用配对样本 t 检验来阐明所有结构域 Ω 和各肌肉区 M 的空间平均相位角与常规相位角 Ф 的统计学意义。从 t 检验结果来看,Ω 与 Ф 和 SMax 有很好的相关性。在 OG 中,Ω、ФW5 和 (SMax)W5 显著高于第一周(n = 8,P < 0.05)。在 LG 组和 OG 组中,M1 和 M4 肌区的相位角在 5 周后都有明显增加。只有 OG 组在 5 周后 M2 的相位角有明显增加。然而,各组 M3 的空间平均相位角均无明显变化。总之,ФEIT 可以令人满意地监测小腿肌肉各区对长期 EMS 训练的反应。
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引用次数: 0
Computational modeling for the quantitative assessment of cardiac autonomic response to orthostatic stress. 用于定量评估心脏自律神经对正压力反应的计算模型。
IF 2.3 4区 医学 Q3 BIOPHYSICS Pub Date : 2024-07-29 DOI: 10.1088/1361-6579/ad63ee
Tao Wang, JianKang Wu, Fei Qin, Hong Jiang, Xiang Xiao, ZhiPei Huang

Objective.The autonomic nervous system (ANS) plays a critical role in regulating not only cardiac functions but also various other physiological processes, such as respiratory rate, digestion, and metabolic activities. The ANS is divided into the sympathetic and parasympathetic nervous systems, each of which has distinct but complementary roles in maintaining homeostasis across multiple organ systems in response to internal and external stimuli. Early detection of ANS dysfunctions, such as imbalances between the sympathetic and parasympathetic branches or impairments in the autonomic regulation of bodily functions, is crucial for preventing or slowing the progression of cardiovascular diseases. These dysfunctions can manifest as irregularities in heart rate, blood pressure regulation, and other autonomic responses essential for maintaining cardiovascular health. Traditional methods for analyzing ANS activity, such as heart rate variability (HRV) analysis and muscle sympathetic nerve activity recording, have been in use for several decades. Despite their long history, these techniques face challenges such as poor temporal resolution, invasiveness, and insufficient sensitivity to individual physiological variations, which limit their effectiveness in personalized health assessments.Approach.This study aims to introduce the open-loop Mathematical Model of Autonomic Regulation of the Cardiac System under Supine-to-stand Maneuver (MMARCS) to overcome the limitations of existing ANS analysis methods. The MMARCS model is designed to offer a balance between physiological fidelity and simplicity, focusing on the ANS cardiac control subsystems' input-output curve. The MMARCS model simplifies the complex internal dynamics of ANS cardiac control by emphasizing input-output relationships and utilizing sensitivity analysis and parameter subset selection to increase model specificity and eliminate redundant parameters. This approach aims to enhance the model's capacity for personalized health assessments.Main results.The application of the MMARCS model revealed significant differences in ANS regulation between healthy (14 females and 19 males, age: 42 ± 18) and diabetic subjects (8 females and 6 males, age: 47 ± 14). Parameters indicated heightened sympathetic activity and diminished parasympathetic response in diabetic subjects compared to healthy subjects (p < 0.05). Additionally, the data suggested a more sensitive and potentially more reactive sympathetic response among diabetic subjects (p < 0.05), characterized by increased responsiveness and intensity of the sympathetic nervous system to stimuli, i.e. fluctuations in blood pressure, leading to more pronounced changes in heart rate, these phenomena can be directly reflected by gain parameters and time response parameters of the model.Significance.The MMARCS model represents an innovative computational approach for quantifying ANS functionality. This model gu

自律神经系统(ANS)在调节心脏功能方面起着至关重要的作用。早期发现自律神经系统功能障碍对于预防或减缓心血管疾病的发展至关重要。目前分析 ANS 活动的方法,如心率变异性分析和肌肉交感神经活动记录,面临着时间分辨率低、侵入性强、对个体生理变化不够敏感等挑战,从而限制了个性化健康评估。本研究旨在引入 "仰卧起坐动作下心脏系统自主神经调节开环数学模型"(MMARCS),以克服现有 ANS 分析方法的局限性。MMARCS 模型的设计兼顾了生理逼真性和简便性,重点关注自律神经系统心脏控制子系统的输入-输出曲线。MMARCS 模型通过强调输入输出关系、利用灵敏度分析和参数子集选择来提高模型的特异性并消除冗余参数,从而简化了自律神经系统心脏控制的复杂内部动态。这种方法旨在提高模型的个性化健康评估能力。MMARCS 模型的应用揭示了健康受试者(14 名女性和 19 名男性)与糖尿病受试者(8 名女性和 6 名男性)在自律神经系统调节方面的显著差异。参数显示,与健康受试者相比,糖尿病受试者的交感神经活动增强,副交感神经反应减弱(p
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引用次数: 0
Separation of ventilation and perfusion of electrical impedance tomography image streams using multi-dimensional ensemble empirical mode decomposition. 利用多维集合经验模式分解法分离电阻抗断层扫描图像流中的通气和灌注。
IF 2.3 4区 医学 Q3 BIOPHYSICS Pub Date : 2024-07-26 DOI: 10.1088/1361-6579/ad5c39
Alfred Christian Hülkenberg, Chuong Ngo, Robert Lau, Steffen Leonhardt

Objective.In the future, thoracic electrical impedance tomography (EIT) monitoring may include continuous and simultaneous tracking of both breathing and heart activity. However, an effective way to decompose an EIT image stream into physiological processes as ventilation-related and cardiac-related signals is missing.Approach.This study analyses the potential ofMulti-dimensional Ensemble Empirical Mode Decompositionby application of theComplete Ensemble Empirical Mode Decomposition with Adaptive Noiseand a novel frequency-based combination criterion for detrending, denoising and source separation of EIT image streams, collected from nine healthy male test subjects with similar age and constitution.Main results.In this paper, a novel approach to estimate the lung, the heart and the perfused regions of an EIT image is proposed, which is based on theRoot Mean Square Errorbetween the index of maximal respiratory and cardiac variation to their surroundings. The summation of the indexes of the respective regions reveals physiologically meaningful time signals, separated into the physiological bandwidths of ventilation and heart activity at rest. Moreover, the respective regions were compared with the relative thorax movement and photoplethysmogram (PPG) signal. In linear regression analysis and in the Bland-Altman plot, the beat-to-beat time course of both the ventilation-related signal and the cardiac-related signal showed a high similarity with the respective reference signal.Significance.Analysis of the data reveals a fair separation of ventilatory and cardiac activity realizing the aimed source separation, with optional detrending and denoising. For all performed analyses, a feasible correlation of 0.587 to 0.905 was found between the cardiac-related signal and the PPG signal.

目标:未来,胸部电阻抗断层扫描(EIT)监测可能包括对呼吸和心脏活动的连续、同步跟踪。 方法:本研究分析了多维集合经验模式分解(MEEMD)的潜力,即应用具有自适应噪声的完全集合经验模式分解(CEEMDAN)和基于频率的新型组合准则,对从年龄和体质相似的 9 名健康男性测试者处收集的 EIT 图像流进行去趋势、去噪和源分离。 主要成果:本文提出了一种估算 EIT 图像中肺、心脏和灌注区域的新方法,该方法基于呼吸和心脏最大变化指数与其周围环境之间的均方根误差(RMSE)。将各区域的指数相加,就能显示出具有生理意义的时间信号,并将其分为静息时通气和心脏活动的生理带宽。此外,还将各区域与相对胸廓运动和光电血流图(PPG)信号进行了比较。在线性回归分析和布兰-阿尔特曼图中,通气相关信号和心脏相关信号的逐次搏动时间过程与各自的参考信号高度相似。在所有分析中,心脏相关信号与 PPG 信号之间的相关性为 0.587 至 0.905。
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引用次数: 0
Non-invasive pulse arrival time is associated with cardiac index in pediatric heart transplant patients with normal ejection fraction. 无创脉搏到达时间与射血分数正常的小儿心脏移植患者的心脏指数有关。
IF 2.3 4区 医学 Q3 BIOPHYSICS Pub Date : 2024-07-22 DOI: 10.1088/1361-6579/ad61b9
Soon Bin Kwon, Bennett Weinerman, Daniel Nametz, Murad Megjhani, Isaac Lee, Anthony Habib, Oliver Barry, Soojin Park

Objective.Cardiac Index (CI) is a key physiologic parameter to ensure end organ perfusion in the pediatric intensive care unit (PICU). Determination of CI requires invasive cardiac measurements and is not routinely done at the PICU bedside. To date, there is no gold standard non-invasive means to determine CI. This study aims to use a novel non-invasive methodology, based on routine continuous physiologic data, called Pulse Arrival Time (PAT) as a surrogate for CI in patients with normal Ejection Fraction (EF).Approach.Electrocardiogram (ECG) and photoplethysmogram (PPG) signals were collected from beside monitors at a sampling frequency of 250 samples per second. Continuous PAT, derived from the ECG and PPG waveforms was averaged per patient. Pearson's correlation coefficient was calculated between PAT and CI, PAT and heart rate (HR), and PAT and EF.Main Results.Twenty patients underwent right heart cardiac catheterization. The mean age of patients was 11.7 ± 5.4 years old, ranging from 11 months old to 19 years old, the median age was 13.4 years old. HR in this cohort was 93.8 ± 17.0 beats per minute. The average EF was 54.4 ± 9.6%. The average CI was 3.51 ± 0.72 l min-1m-2, with ranging from 2.6 to 4.77 l min-1m-2. The average PAT was 0.31 ± 0.12 s. Pearson correlation analysis showed a positive correlation between PAT and CI (0.57,p< 0.01). Pearson correlation between HR and CI, and correlation between EF and CI was 0.22 (p= 0.35) and 0.03 (p= 0.23) respectively. The correlation between PAT, when indexed by HR (i.e. PAT × HR), and CI minimally improved to 0.58 (p< 0.01).Significance.This pilot study demonstrates that PAT may serve as a valuable surrogate marker for CI at the bedside, as a non-invasive and continuous modality in the PICU. The use of PAT in clinical practice remains to be thoroughly investigated.

目的:心脏指数(CI)是确保儿科重症监护病房(PICU)末端器官灌注的关键生理参数。确定 CI 需要进行有创心脏测量,但在重症监护病房床旁并不是常规操作。迄今为止,还没有确定 CI 的金标准无创方法。本研究旨在使用一种基于常规连续生理数据的新型无创方法--脉搏到达时间(PAT)--来替代射血分数正常患者的 CI:以每秒 250 个样本的采样频率从旁边的监视器收集心电图(ECG)和光电搏动图(PPG)信号。根据心电图和 PPG 波形得出的连续 PAT 为每位患者的平均值。计算 PAT 与 CI、PAT 与心率(HR)、PAT 与射血分数(EF)之间的皮尔逊相关系数:20 名患者接受了右心导管检查。患者平均年龄为(11.7±5.4)岁,从 11 个月大到 19 岁不等,中位年龄为 13.4 岁。心率为(93.8±17.0)次/分。平均 EF 为 54.4±9.6%。平均 CI 为 3.51±0.72 L/min/m2,范围为 2.6 至 4.77 L/min/m2。平均 PAT 为 0.31±0.12 秒。Pearson 相关性分析表明,PAT 与 CI 呈正相关(0.57,P < 0.01)。HR 与 CI 之间的皮尔逊相关性以及 EF 与 CI 之间的相关性分别为 0.22(p = 0.35)和 0.03(p = 0.23)。以心率(即 PAT × 心率)为指标的 PAT 与 CI 之间的相关性最小提高到 0.58(p < 0.01):这项试点研究表明,PAT 可作为床旁 CI 的重要替代指标,是 PICU 中的一种无创和连续模式。PAT 在临床实践中的应用还有待深入研究。
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引用次数: 0
Unsupervised denoising of the non-invasive fetal electrocardiogram with sparse domain Kalman filtering and vectorcardiographic loop alignment. 利用稀疏域卡尔曼滤波和向量心电图环路配准对无创胎儿心电图进行无监督去噪。
IF 2.3 4区 医学 Q3 BIOPHYSICS Pub Date : 2024-07-17 DOI: 10.1088/1361-6579/ad605c
I R de Vries, J O E H van Laar, M B van der Hout-van der Jagt, R Vullings

Objective.Even though the electrocardiogram (ECG) has potential to be used as a monitoring or diagnostic tool for fetuses, the use of non-invasive fetal ECG is complicated by relatively high amounts of noise and fetal movement during the measurement. Moreover, machine learning-based solutions to this problem struggle with the lack of clean reference data, which is difficult to obtain. To solve these problems, this work aims to incorporate fetal rotation correction with ECG denoising into a single unsupervised end-to-end trainable method.Approach.This method uses the vectorcardiogram (VCG), a three-dimensional representation of the ECG, as an input and extends the previously introduced Kalman-LISTA method with a Kalman filter for the estimation of fetal rotation, applying denoising to the rotation-corrected VCG.Main results.The resulting method was shown to outperform denoising auto-encoders by more than 3 dB while achieving a rotation tracking error of less than 33. Furthermore, the method was shown to be robust to a difference in signal to noise ratio between electrocardiographic leads and different rotational velocities.Significance.This work presents a novel method for the denoising of non-invasive abdominal fetal ECG, which may be trained unsupervised and simultaneously incorporates fetal rotation correction. This method might prove clinically valuable due the denoised fetal ECG, but also due to the method's objective measure for fetal rotation, which in turn might have potential for early detection of fetal complications.

尽管心电图(ECG)具有作为胎儿监测或诊断工具的潜力,但无创胎儿心电图的使用因测量过程中相对较高的噪声和胎儿移动而变得复杂。此外,基于机器学习的解决方案也很难获得干净的参考数据。为了解决这些问题,这项工作旨在将胎儿旋转校正与心电图去噪整合到一个单一的无监督端到端可训练方法中。该方法使用心电图的三维表示法向量心电图(VCG)作为输入,并扩展了之前引入的卡尔曼-LISTA 方法,在估计胎儿旋转时使用卡尔曼滤波器,同时对旋转校正后的向量心电图进行去噪。结果表明,该方法的性能优于去噪自动编码器 3dB 以上,同时旋转跟踪误差小于 33°。此外,该方法还对心电图导联之间的信噪比差异和不同旋转速度具有鲁棒性。今后的工作应着眼于提高该方法的通用性,并评估该方法在研究和临床应用中的价值。这种价值可能不仅来自去噪胎儿心电图,还来自该方法对胎儿旋转的客观测量,因为它有可能早期发现胎儿并发症。
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引用次数: 0
Impact of optimized transcutaneous auricular vagus nerve stimulation on cardiac autonomic profile in healthy subjects and heart failure patients. 优化经皮耳廓迷走神经刺激对健康人和心衰患者心脏自律神经特征的影响。
IF 2.3 4区 医学 Q3 BIOPHYSICS Pub Date : 2024-07-17 DOI: 10.1088/1361-6579/ad5ef6
Roberto Maestri, Gian Domenico Pinna, Elena Robbi, Chiara Cogliati, Arianna Bartoli, Giuseppina Gambino, Giuseppe Rengo, Nicola Montano, Maria Teresa La Rovere

Objective.To determine the optimal frequency and site of stimulation for transcutaneous vagus nerve stimulation (tVNS) to induce acute changes in the autonomic profile (heart rate (HR), heart rate variability (HRV)) in healthy subjects (HS) and patients with heart failure (HF).Approach.We designed three single-blind, randomized, cross-over studies: (1) to compare the acute effect of left tVNS at 25 Hz and 10 Hz (n= 29, age 60 ± 7 years), (2) to compare the acute effect of left and right tVNS at the best frequency identified in study 1 (n= 28 age 61 ± 7 years), and (3) to compare the acute effect of the identified optimal stimulation protocol with sham stimulation in HS and HF patients (n= 30, age 59 ± 5 years, andn= 32, age 63 ± 7 years, respectively).Main results.In study 1, left tragus stimulation at 25 Hz was more effective than stimulation at 10 Hz in decreasing HR (-1.0 ± 1.2 bpm,p< 0.001 and -0.5 ± 1.6 bpm, respectively) and inducing vagal effects (significant increase in RMSSD, and HF power). In study 2, the HR reduction was greater with left than right tragus stimulation (-0.9 ± 1.5 bpm,p< 0.01 and -0.3 ± 1.4 bpm, respectively). In study 3 in HS, left tVNS at 25 Hz significantly reduced HR, whereas sham stimulation did not (-1.1 ± 1.2 bpm,p< 0.01 and -0.2 ± 2.9 bpm, respectively). In HF patients, both active and sham stimulation produced negligible effects.Significance.Left tVNS at 25 Hz is effective in acute modulation of cardiovascular autonomic control (HR, HRV) in HS but not in HF patients (NCT05789147).

目的:确定经皮迷走神经刺激(tVNS)的最佳频率和刺激部位,以诱导健康受试者(HS)和心力衰竭(HF)患者的自律神经特征(心率(HR)、心率变异性(HRV))发生急性变化。我们设计了三项单盲、随机、交叉研究:(1)比较 25 Hz 和 10 Hz 左侧 tVNS 的急性效应(n= 29,年龄 60 ± 7 岁);(2)比较研究 1 中确定的最佳频率下左侧和右侧 tVNS 的急性效应(n= 28,年龄 61 ± 7 岁);(3)比较确定的最佳刺激方案与假刺激对 HS 和 HF 患者的急性效应(分别为 n= 30,年龄 59 ± 5 岁和 n= 32,年龄 63 ± 7 岁)。主要结果:在研究 1 中,在降低心率(分别为 -1.0±1.2bpm,p< 0.001 和 -0.5±1.6bpm)和诱导迷走神经效应(RMSSD 和高频功率显著增加)方面,25 Hz 左侧外耳刺激比 10 Hz 刺激更有效。在研究 2 中,刺激左耳后心率下降幅度大于右耳(分别为 -0.9 ± 1.5 bpm,p< 0.01 和 -0.3 ± 1.4 bpm)。在对 HS 进行的第 3 项研究中,频率为 25 Hz 的左侧 tVNS 能显著降低心率,而假刺激则不能(分别为 -1.1 ± 1.2 bpm,p< 0.01 和 -0.2 ± 2.9 bpm)。意义:25 Hz 的左侧 tVNS 可有效调节 HS 患者的心血管自主神经控制(心率、心率变异),但对 HF 患者无效(NCT05789147)。
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引用次数: 0
Static and dynamic analysis of cerebral blood flow in fifty-six large arterial vessel networks. 对五十六个大动脉血管网络中的脑血流进行静态和动态分析。
IF 2.3 4区 医学 Q3 BIOPHYSICS Pub Date : 2024-07-12 DOI: 10.1088/1361-6579/ad5bbb
Yuan-Chung Chou, Stephen Payne

Objective.The cerebral vasculature is formed of an intricate network of blood vessels over many different length scales. Changes in their structure and connection are implicated in multiple cerebrovascular and neurological disorders. In this study, we present a novel approach to the quantitative analysis of the cerebral macrovasculature using computational and mathematical tools in a large dataset.Approach.We analysed a publicly available vessel dataset from a cohort of 56 (32/24F/M) healthy subjects. This dataset includes digital reconstructions of human brain macrovasculatures. We then propose a new mathematical model to compute blood flow dynamics and pressure distributions within these 56-representative cerebral macrovasculatures and quantify the results across this cohort.Main results.Statistical analysis showed that the steady state level of cerebrovascular resistance (CVR) gradually increases with age in both men and women. These age-related changes in CVR are in good agreement with previously reported values. All subjects were found to have only small phase angles (<6°) between blood pressure and blood flow at the cardiac frequency.Significance.These results showed that the dynamic component of blood flow adds very little phase shift at the cardiac frequency, which implies that the cerebral macrocirculation can be regarded as close to steady state in its behaviour, at least in healthy populations, irrespective of age or sex. This implies that the phase shift observed in measurements of blood flow in cerebral vessels is caused by behaviour further down the vascular bed. This behaviour is important for future statistical models of the dynamic maintenance of oxygen and nutrient supply to the brain.

目的:脑血管是由许多不同长度尺度的血管组成的复杂网络。其结构和连接的变化与多种脑血管和神经系统疾病有关。在这项研究中,我们提出了一种在大型数据集中使用计算和数学工具对脑血管进行定量分析的新方法。我们分析了一个公开的血管数据集,该数据集来自一组 56 名(32/24 名女性/男性)健康受试者。该数据集包括人脑大血管的数字重建。然后,我们提出了一个新的数学模型来计算这 56 个具有代表性的大脑大血管内的血流动态和压力分布,并对整个组群的结果进行量化。统计分析显示,男性和女性的脑血管阻力(CVR)稳态水平都会随着年龄的增长而逐渐增加。这些与年龄有关的 CVR 变化与之前报道的数值非常吻合。所有受试者的血压与心频血流之间的相位角都很小(< 6°)。这些结果表明,血流的动态成分在心脏频率上增加的相移很小,这意味着至少在健康人群中,不论年龄或性别,大脑大循环的行为可被视为接近稳态。这意味着在脑血管血流测量中观察到的相移是由血管床更下方的行为引起的。这种行为对于未来建立动态维持大脑氧气和营养供应的统计模型非常重要。
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Physiological measurement
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