Characterization and Enhancement of Non-Invasive Recordings of Intestinal Myoelectrical Activity

Non

Feasibility and analysis of bipolar concentric recording of Electrohysterogram with flexible active electrode

The conduction velocity and propagation patterns of Electrohysterogram (EHG) provide fundamental information about uterine electrophysiological condition. The accuracy of these measurements can be impaired by both the poor spatial selectivity and sensitivity to the relative direction of the contraction propagation associated with conventional disc electrodes. Concentric ring electrodes could overcome these limitations the aim of this study was to examine the feasibility of picking up surface EHG signals using a new flexible tripolar concentric ring electrode (TCRE), and to compare it with conventional bipolar recordings. Simultaneous recording of conventional bipolar signals and bipolar concentric EHG (BC-EHG) were carried out on 22 pregnant women. Signal bursts were characterized and compared. No significant differences among channels in either duration or dominant frequency in the Fast Wave High frequency range were found. Nonetheless, the high pass filtering effect of the BC-EHG records resulted in lower frequency content within the range 0.1 to 0.2 Hz than the bipolar ones. Although the BC-EHG signal amplitude was about 5-7 times smaller than that of bipolar recordings, similar signal-to-noise ratio was obtained. These results suggest that the flexible TCRE is able to pick up uterine electrical activity and could provide additional information for deducing uterine electrophysiological condition.The authors are grateful to the Obstetrics Unit of the Hospital Universitario La Fe de Valencia (Valencia, Spain), where the recording sessions were carried out. The work was supported in part by the Ministerio de Ciencia y Tecnologia de Espana (TEC2010-16945), by the Universitat Politecnica de Valencia (PAID SP20120490) and Generalitat Valenciana (GV/2014/029) and by General Electric Healthcare.Ye Lin, Y.; Alberola Rubio, J.; Prats Boluda, G.; Perales Marin, AJ.; Desantes, D.; Garcia Casado, FJ. (2015). 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Pasteless, active, concentric ring sensors for directly obtained laplacian cardiac electrograms. J. Med. Biol. Eng. 22(4):199–203, 2002.Lucovnik, M., W. L. Maner, L. R. Chambliss, R. Blumrick, J. Balducci, Z. Novak-Antolic, and R. E. Garfield. Noninvasive uterine electromyography for prediction of preterm delivery. Am. J. Obstet. Gynecol. 204(3):228.e1–228.e10, 2011.Maner, W. L., and R. E. Garfield. Identification of human term and preterm labor using artificial neural networks on uterine electromyography data. Ann. Biomed. Eng. 35(3):465–473, 2007.Maner, W. L., R. E. Garfield, H. Maul, G. Olson, and G. Saade. Predicting term and preterm delivery with transabdominal uterine electromyography. Obstet. Gynecol. 101(6):1254–1260, 2003.Marque, C., J. M. Duchene, S. Leclercq, G. S. Panczer, and J. Chaumont. Uterine EHG processing for obstetrical monitoring. IEEE Trans. Biomed. Eng. 33(12):1182–1187, 1986.Marque, C. K., J. Terrien, S. Rihana, and G. Germain. 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Diseño, aplicación y valoración de actividades destinadas al trabajo y evaluación de múltiples competencias transversales en grupos numerosos de máster en ingeniería, empleando el aprendizaje basado en proyectos

Society requires graduates to acquire cross-curricular skills during their education since this type of skills is better valued by employers than even degree-specific skills. Active methodologies to develop skills have been successfully implemented in small groups. In contrast,working and objectively evaluating cross-curricular skills in large groups presents a number of additional difficulties such as excessive workload for teachers, which generates resistance to change and lack of experience. The aim of this study is to design, apply and assess training activities with a large number of engineering students, more specifically 288, who were taking a compulsory subject. These training activities used project-based learning and portfolios to work and evaluate multiple cross-curricular skills. The results show that it is feasible to design and develop training activities applicable in large groups that promote the acquisition of multiple cross-curricular skills, allowing for a significant improvement in the knowledge level of the students, without assuming an excessive workload for students and teachers. The results also show that the extent to which students acquired cross-curricular skills after the activities depends mainly on their previous level, and not so much on the time they devoted to the project. However, time reveals itself as an important factor when it comes to the mastery of skills. Finally, 86% of the students have a positive perception of the methodology employed, indicating that it provides a more applied understanding of the subject.La sociedad requiere de los egresados la formación en las competencias transversales que incluso son mejor valoradas por los empleadores que las competencias específicas del grado. Las metodologías activas para desarrollar las competencias se han implantado con éxito en grupos reducidos. En cambio, trabajar y evaluar objetivamente las competencias transversales en grupos numerosos presenta una serie de dificultades añadidas como una excesiva carga de trabajo para el profesorado, con la subsiguiente resistencia al cambio y falta de experiencias. El objetivo de este trabajo es valorar una propuesta formativa que emplea la metodología de aprendizaje basado en proyectos y el portafolio como método para trabajar y evaluar múltiples competencias transversales en grupos numerosos de estudiantes de ingeniería. Los resultados muestran que es factible diseñar y desarrollar actividades formativas aplicables en grupos numerosos, que favorezcan la adquisición de múltiples competencias transversales. Además, han permitido obtener una mejora significativa en el nivel de dominio de las mismas, sin suponer una carga de trabajo adicional excesiva ni para el alumnado ni para el profesorado. Asimismo, los resultados muestran que el nivel de dominio de las competencias transversales alcanzado por el alumno tras las actividades depende principalmente del nivel de dominio previo, y no tanto del tiempo de dedicación al proyecto. No obstante éste último es un factor importante en la mejora en el nivel de dominio de las competencias. Finalmente, el 86% de los alumnos valoran positivamente la metodología empleada, indicando que proporciona una visión más aplicada de la asignatura

Valoración de la actividad muscular asociada al uso de herramientas laparoscópicas mediante EMG. Nueva propuesta de análisis bivariado amplitud-frecuencia

El avance de la medicina dirige las técnicas de intervención hacia aquellas mínimamente invasivas (CMI). Su instrumental, en ocasiones, carece de ergonomía lo que puede provocar lesiones al personal sanitario. El objetivo de este trabajo es evaluar, a través de biomarcadores obtenidos de registros electromiográficos de superficie (sEMG), dos herramientas de laparoscopia: un prototipo y otra empleada en la práctica clínica habitual. Para ello, se dispone de registros de sEMG de 17 sujetos de los músculos bíceps, deltoides, trapecio y flexor radial del carpo, obtenidos mediante un protocolo isométrico. Se han computado parámetros temporales, espectrales y de complejidad como biomarcadores de la actividad muscular determinando la existencia de diferencias estadísticamente significativas entre herramientas y posiciones para cada uno de los biomarcadores. Se ha completado el estudio a través de un Joint Analysis of Spectrum and Amplitude (JASA) tradicional y con una nueva propuesta que considera otros parámetros. Finalmente, los biomarcadores parecen apuntar hacia una menor tendencia a la aparición de fatiga muscular con la herramienta prototipo para el bíceps, deltoides y trapecio, y con la herramienta control para el flexor radial del carpo. Los nuevos análisis bivariados propuestos permiten una caracterización más exhaustiva del estado muscular

Enhancement of the non-invasive electroenterogram to identify intestinal pacemaker activity

Surface recording of electroenterogram (EEnG) is a non-invasive method for monitoring intestinal myoelectrical activity. However, surface EEnG is seriously affected by a variety of interferences: cardiac activity, respiration, very low frequency components and movement artefacts. The aim of this study is to eliminate respiratory interference and very low frequency components from external EEnG recording by means of empirical mode decomposition (EMD), so as to obtain more robust indicators of intestinal pacemaker activity from external EEnG signal. For this purpose, 11 recording sessions were performed in an animal model under fasting conditions and in each individual session the myoelectrical signal was recorded simultaneously in the intestinal serosa and the external abdominal surface in physiological states. Various parameters have been proposed for evaluating the efficacy of the method in reducing interferences: the signal-to-interference ratio (S/I ratio), attenuation of the target and interference signals, the normal slow wave percentage and the stability of the dominant frequency (DF) of the signal. The results show that the S/I ratio of the processed signals is significantly greater than the original values (9.66±4.44 dB vs. 1.23±5.13 dB), while the target signal was barely attenuated (-0.63±1.02 dB). The application of the EMD method also increased the percentage of the normal slow wave to 100% in each individual session and enabled the stability of the DF of the external signal to be increased considerably. Furthermore, the variation coefficient of the DF derived from the external processed signals is comparable to the coefficient obtained using internal recordings. Therefore the EMD method could be a very useful tool to improve the quality of external EEnG recording in the low frequency range, and therefore to obtain more robust indicators of the intestinal pacemaker activity from non invasive EEnG recordingsThe authors would like to thank D Alvarez-Martinez, Dr C Vila and the Veterinary Unit of the Research Centre of 'La Fe' University Hospital (Valencia, Spain), where the surgical interventions and recording sessions were carried out, and the R+D+I Linguistic Assistance Office at the UPV for their help in revising this paper. This research study was sponsored by the Ministerio de Ciencia y Tecnologia de Espana (TEC2007-64278) and by the Universidad Politecnica de Valencia, as part of a UPV research and development Grant Programme.Ye Lin, Y.; Garcia Casado, FJ.; Prats Boluda, G.; Ponce, JL.; Martínez De Juan, JL. (2009). Enhancement of the non-invasive electroenterogram to identify intestinal pacemaker activity. 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Active flexible concentric ring electrode for non-invasive surface bioelectrical recordings

Bioelectrical surface recordings are usually performed by unipolar or bipolar disc electrodes even though they entail the serious disadvantage of having poor spatial resolution. Concentric ring electrodes give improved spatial resolution, although this type of electrode has so far only been implemented in rigid substrates and as they are not adapted to the curvature of the recording surface may provide discomfort to the patient. Moreover, the signals recorded by these electrodes are usually lower in amplitude than conventional disc electrodes. The aim of this work was thus to develop and test a new modular active sensor made up of concentric ring electrodes printed on a flexible substrate by thick-film technology together with a reusable battery-powered signal-conditioning circuit. Simultaneous ECG recording with both flexible and rigid concentric ring electrodes was carried out on ten healthy volunteers at rest and in motion. The results show that flexible concentric ring electrodes not only present lower skin electrode contact impedance and lower baseline wander than rigid electrodes but are also less sensitive to interference and motion artefacts. We believe these electrodes, which allow bioelectric signals to be acquired non-invasively with better spatial resolution than conventional disc electrodes, to be a step forward in the development of new monitoring systems based on Laplacian potential recordings.This research was supported in part by the Ministerio de Ciencia y Tecnologia de Espana (TEC2010-16945) and by the Universitat Politecnica de Valencia (PAID 2009/10-2298). The proof-reading of this paper was funded by the Universitat Politecnica de Valencia, Spain.Prats Boluda, G.; Ye Lin, Y.; García Breijo, E.; Ibáñez Civera, FJ.; Garcia Casado, FJ. (2012). Active flexible concentric ring electrode for non-invasive surface bioelectrical recordings. 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Comparison of electrohysterogram signal measured by surface electrodes with different designs: A computational study with dipole band and abdomen models

Non-invasive measurement of uterine activity using electrohysterogram (EHG) surface electrodes has been attempted to monitor uterine contraction. This study aimed to computationally compare the performance of acquiring EHG signals using monopolar electrode and three types of Laplacian concentric ring electrodes (bipolar, quasi-bipolar and tri-polar). With the implementation of dipole band model and abdomen model, the performances of four electrodes in terms of the local sensitivity were quantifed by potential attenuation. Furthermore, the efects of fat and muscle thickness on potential attenuation were evaluated using the bipolar and tri-polar electrodes with diferent radius. The results showed that all the four types of electrodes detected the simulated EHG signals with consistency. That the bipolar and tri-polar electrodes had greater attenuations than the others, and the shorter distance between the origin and location of dipole band at 20dB attenuation, indicating that they had relatively better local sensitivity. In addition, ANOVA analysis showed that, for all the electrodes with diferent outer ring radius, the efects of fat and muscle on potential attenuation were signifcant (all p<0.01). It is therefore concluded that the bipolar and tri-polar electrodes had higher local sensitivity than the others, indicating that they can be applied to detect EHG efectively

Characterization of the effects of Atosiban on uterine electromyograms recorded in women with threatened preterm labor

[EN] Although research studies using electrohysterography on women without tocolytic therapy have shown its potential for preterm birth diagnosis, tocolytics are usually administered in emergency rooms at the first sign of threatened preterm labor (TPL). Information on the uterine response during tocolytic treatment could prove useful for the development of tools able to predict true preterm deliveries under normal clinical conditions. The aim of this study was thus to analyze the effects of Atosiban on Electrohysterogram (EHG) parameters and to compare its effects on women who delivered preterm (WDP) and at term (WDT). Electrohysterograms recorded in different Atosiban therapy stages (before, during and after drug administration) on 40 WDT and 27 WDP were analyzed by computing linear, and non-linear EHG parameters. Results reveal that Atosiban does not greatly affect the EHG signal amplitude, but does modify its spectral content and reduces the energy associated with the fast wave high component in both WDP and WDT, with a faster response in the latter. EHG signal complexity remained constant in WDT, while it increased in WDP until it reached similar values to WDT during Atosiban treatment. The spectral and complexity parameters were able to separate (p < 0.05) WDT and WDP prior to and during tocolytic treatment and before and after treatment, respectively. The results pave the way for developing better and more reliable medical decision support systems based on EHG for preterm delivery prediction in TPL women in clinical scenarios.This work received financial support from the Spanish Ministry of Economy and Competitiveness and the European Regional Development Fund (DPI2015-68397-R), VLC/Campus (UPV-FE-2018-B03) and by Conselleria de Educación, Investigación, Cultura y Deporte, Generalitat Valenciana (GV/2018/104).Mas-Cabo, J.; Prats-Boluda, G.; Ye Lin, Y.; Alberola Rubio, J.; Perales, A.; Garcia-Casado, J. (2019). Characterization of the effects of Atosiban on uterine electromyograms recorded in women with threatened preterm labor. Biomedical Signal Processing and Control. 52:198-205. https://doi.org/10.1016/j.bspc.2019.04.001S1982055

Uterine electromyography for discrimination of labor imminence in women with threatened preterm labor under tocolytic treatment

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