Influence of Baseline Fluctuation Cancellation on Automatic Measurement of Motor Unit Action Potential Duration

The aim of this work is to analyze the influence of a method for baseline fluctuation (BLF) cancellation for electromyographic (EMG) signals on automatic methods for measurement of the motor unit action potential (MUAP) duration. These methods include four conventional automatic methods (CAMs) and a recently published wavelet transform method (WTM). A set of 182 MUAPs from 170 EMG recordings were studied. The CAMs and the WTM were applied to the MUAPs before and after applying BLF cancellation to the recordings. A gold standard of duration marker positions (GSP) ws manually established. The accuracy of each algorithm was estimated as the dfference between its positions and the GSP. Accuracies were compared for the 5 methods and for each method before and after BLF cancellation. A significant difference between accuracy pre- and post-BLF removal was found in two CAMs; markers were closer to the GSP after BLF removal. For all MUAPs, the differences between WTM markers and the GSP were the smallest, and significant differences were not found for the WTM before and after BLF cancellation. The management of BLF is an important issue in EMG signal processing and BLF removal must be considered in extraction and analyse of MUAP waveforms. The BLF removal method improved the performance of two CAMs for MUAP duration measurement. The WTM was the most accurate and was not affected by BLF.

Análisis del proceso de llenado de la señal sEMG a medida que aumenta gradualmente la fuerza en el cuádriceps

Objetivos: No existe una comprensión completa del modo en que la señal EMG de superficie se llena progresivamente de potenciales de unidad motora (MUP) a medida que aumenta la fuerza. Intentamos investigar este proceso de llenado de sEMG. Métodos: Se registraron señales EMG superficiales del cuádriceps de sujetos sanos a medida que la fuerza aumentaba gradualmente de 0 a 40% MVC. El proceso de llenado sEMG se analizó midiendo el factor de llenado EMG (calculado a partir de los momentos no centrales de la señal sEMG rectificada). Resultados: (1) Al aumentar gradualmente la fuerza, aparecieron uno o dos saltos bruscos prominentes en la amplitud del sEMG entre el 0 y el 10% de la fuerza MVC en los vastos lateral y medial. (2) Los saltos de amplitud se originaban cuando aparecían en la señal de sEMG unos pocos MUP de gran amplitud, que destacaban claramente de la actividad de sEMG anterior. (3) Cada vez que se producía un salto brusco en la amplitud del sEMG, se iniciaba una nueva fase de llenado del sEMG. Conclusiones: El proceso de llenado del sEMG tuvo una o dos etapas en los músculos vastos, estando el sEMG casi completamente lleno a fuerzas muy bajas (2-12% MVC). Importancia: El factor de llenado es una herramienta prometedora útil para analizar el proceso de llenado EMG

A methodology for the customized design of colonic stents based on a parametric model

The choice of necessary stent properties depends mainly on the length of the stenosis and degree of occlusion. So a stent design with variable radial stiffness along its longitudinal axis would be a good option. The design proposed corresponds to a tube-based stent with closed diamond-shaped cells made from a NiTi alloy. By acting independently on different geometric factors, variable geometries can be obtained with different radial force reactions. A design adjustment according to specific requirements, in order to get a better fit to ill-duct and reduces complications, is possible. A parametric analysis using finite element has been conducted to determine the influence of slot length, number of circumferential slots, tube thickness and shape-factor on stent mechanical behavior, which allow eliminating the need for extensive experimental work and knowing and quantifying the influence of those factors. The results of finite element simulations have been used, by means of least-squares fit techniques, to obtain analytical expressions for the main mechanical characteristics of the stent (Chronic Expansive Radial Force and Radial Compression Resistance) in terms of the different geometrical factors. This allows the stent geometry to be customized without launching an iterative and costly process of modeling and simulation for each case

Sliding window averaging in normal and pathological motor unit action potential trains

Objective: To evaluate the performance of a recently proposed motor unit action potential (MUAP) averaging method based on a sliding window, and compare it with relevant published methods in normal and pathological muscles. Methods: Three versions of the method (with different window lengths) were compared to three relevant published methods in terms of signal analysis-based merit figures and MUAP waveform parameters used in the clinical practice. 218 MUAP trains recorded from normal, myopathic, subacute neurogenic and chronic neurogenic muscles were analysed. Percentage scores of the cases in which the methods obtained the best performance or a performance not significantly worse than the best were computed. Results: For signal processing figures of merit, the three versions of the new method performed better (with scores of 100, 86.6 and 66.7%) than the other three methods (66.7, 25 and 0%, respectively). In terms of MUAP waveform parameters, the new method also performed better (100, 95.8 and 91.7%) than the other methods (83.3, 37.5 and 25%). Conclusions: For the types of normal and pathological muscle studied, the sliding window approach extracted more accurate and reliable MUAP curves than other existing methods. Significance: The new method can be of service in quantitative EMG

Imaging findings of multisystem inflammatory syndrome in children associated with COVID-19

[Background] A hyperinflammatory immune-mediated shock syndrome has been recognised in children exposed to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19).[Objective] To describe typical imaging findings in children with multisystem inflammatory syndrome associated with COVID-19.[Materials and methods] During the first wave of the COVID-19 pandemic, imaging studies and clinical data from children treated for multisystem inflammatory syndrome were collected from multiple centres. Standardised case templates including demographic, biochemical and imaging information were completed by participating centres and reviewed by paediatric radiologists and paediatricians.[Results] We included 37 children (21 boys; median age 8.0 years). Polymerase chain reaction (PCR) testing was positive for SARS-CoV-2 in 15/37 (41%) children and immunoglobulins in 13/19 children (68%). Common clinical presentations were fever (100%), abdominal pain (68%), rash (54%), conjunctivitis (38%) and cough (32%). Thirty-three children (89%) showed laboratory or imaging findings of cardiac involvement. Thirty of the 37 children (81%) required admission to the intensive care unit, with good recovery in all cases. Chest radiographs demonstrated cardiomegaly in 54% and signs of pulmonary venous hypertension/congestion in 73%. The most common chest CT abnormalities were ground-glass and interstitial opacities (83%), airspace consolidation (58%), pleural effusion (58%) and bronchial wall thickening (42%). Echocardiography revealed impaired cardiac function in half of cases (51%) and coronary artery abnormalities in 14%. Cardiac MRI showed myocardial oedema in 58%, pericardial effusion in 42% and decreased left ventricular function in 25%. Twenty children required imaging for abdominal symptoms, the commonest abnormalities being free fluid (71%) and terminal ileum wall thickening (57%). Twelve children underwent brain imaging, showing abnormalities in two cases.[Conclusion] Children with multisystem inflammatory syndrome showed pulmonary, cardiac, abdominal and brain imaging findings, reflecting the multisystem inflammatory disease. Awareness of the imaging features of this disease is important for early diagnosis and treatment.Peer reviewe

Modelling ozone stomatal flux over wheat under Mediterranean conditions

Correct estimation of leaf-level stomatal conductance (gsto) is central for current ozone (O3) risk assessment of wheat yield loss based on the absorbed O3 phytotoxic dose (POD). The gsto model parameterizations developed in Europe must be checked in the different climatic regions where they are going to be applied in order to reduce the uncertainties associated with the POD approach. This work proposes a new gsto model parameterization for estimating POD of Triticum aestivum and Triticum durum under Mediterranean conditions, based on phenological observations over 25 years and gsto field measurements during 5 growing seasons. Results show that POD in the Mediterranean area might be higher than previously estimated. However, caution must be paid when assessing the risk of yield loss for wheat in this area since field validation of O3 impacts is still limited

M-wave changes caused by brief voluntary and stimulated isometric contractions.

Under isometric conditions, the increase in muscle force is accompanied by a reduction in the fibers' length. The effects of muscle shortening on the compound muscle action potential (M wave) have so far been investigated only by computer simulation. This study was undertaken to assess experimentally the M-wave changes caused by brief voluntary and stimulated isometric contractions. Two different methods of inducing muscle shortening under isometric condition were adopted: (1) applying a brief (1 s) tetanic contraction and (2) performing brief voluntary contractions of different intensities. In both methods, supramaximal stimulation was applied to the brachial plexus and femoral nerves to evoke M waves. In the first method, electrical stimulation (20 Hz) was delivered with the muscle at rest, whereas in the second, stimulation was applied while participants performed 5-s stepwise isometric contractions at 10, 20, 30, 40, 50, 60, 70, and 100% MVC. The amplitude and duration of the first and second M-wave phases were computed. The main findings were: (1) on application of tetanic stimulation, the amplitude of the M-wave first phase decreased (~ 10%, P < 0.05), that of the second phase increased (~ 50%, P < 0.05), and the M-wave duration decreased (~ 20%, P < 0.05) across the first five M waves of the tetanic train and then plateaued for the subsequent responses; (2) when superimposing a single electrical stimulus on muscle contractions of increasing forces, the amplitude of the M-wave first phase decreased (~ 20%, P < 0.05), that of the second phase increased (~ 30%, P < 0.05), and M-wave duration decreased (~ 30%, P < 0.05) as force was raised from 0 to 60-70% MVC force. The present results will help to identify the adjustments in the M-wave profile caused by muscle shortening and also contribute to differentiate these adjustments from those caused by muscle fatigue and/or changes in Na <sup>+</sup> -K <sup>+</sup> pump activity