Assessing cardiovascular stress based on heart rate variability in female shift workers: a multiscale-multifractal analysis approach.

Introduction: Sleep-wake cycle disruption caused by shift work may lead to cardiovascular stress, which is observed as an alteration in the behavior of heart rate variability (HRV). In particular, HRV exhibits complex patterns over different time scales that help to understand the regulatory mechanisms of the autonomic nervous system, and changes in the fractality of HRV may be associated with pathological conditions, including cardiovascular disease, diabetes, or even psychological stress. The main purpose of this study is to evaluate the multifractal-multiscale structure of HRV during sleep in healthy shift and non-shift workers to identify conditions of cardiovascular stress that may be associated with shift work. Methods: The whole-sleep HRV signal was analyzed from female participants: eleven healthy shift workers and seven non-shift workers. The HRV signal was decomposed into intrinsic mode functions (IMFs) using the empirical mode decomposition method, and then the IMFs were analyzed using the multiscale-multifractal detrended fluctuation analysis (MMF-DFA) method. The MMF-DFA was applied to estimate the self-similarity coefficients, α(q, τ), considering moment orders (q) between -5 and +5 and scales (τ) between 8 and 2,048 s. Additionally, to describe the multifractality at each τ in a simple way, a multifractal index, MFI(τ), was computed. Results: Compared to non-shift workers, shift workers presented an increase in the scaling exponent, α(q, τ), at short scales (τ < 64 s) with q < 0 in the high-frequency component (IMF1, 0.15-0.4 Hz) and low-frequency components (IMF2-IMF3, 0.04-0.15 Hz), and with q> 0 in the very low frequencies (IMF4, < 0.04 Hz). In addition, at large scales (τ> 1,024 s), a decrease in α(q, τ) was observed in IMF3, suggesting an alteration in the multifractal dynamic. MFI(τ) showed an increase at small scales and a decrease at large scales in IMFs of shift workers. Conclusion: This study helps to recognize the multifractality of HRV during sleep, beyond simply looking at indices based on means and variances. This analysis helps to identify that shift workers show alterations in fractal properties, mainly on short scales. These findings suggest a disturbance in the autonomic nervous system induced by the cardiovascular stress of shift work.

Assessment of Singularities in the EEG During A-Phases of Sleep Based on Wavelet Decomposition.

Electroencephalography (EEG) signals convey information related to different processes that take place in the brain. From the EEG fluctuations during sleep, it is possible to establish the sleep stages and identify short events, commonly related to a specific physiological process or pathology. Some of these short events (called A-phases) present an organization and build up the concept of the Cyclic Alternating Pattern (CAP) phenomenon. In general, the A-phases abruptly modify the EEG fluctuations, and a singular behavior could occur. With the aim to quantify the abrupt changes during A-phases, in this work the wavelet analysis is considered to compute Hölder exponents, which measure the singularity strength. We considered time windows of 2s outside and 5s inside A-phases onset (or offset). A total number of 5121 A-phases from 9 healthy participants and 10 patients with periodic leg movements were analyzed. Within an A-phase the Hölder numerical value tends to be 0.6, which implies a less abrupt singularity. Whereas outside of A-phases, it is observed that the Hölder value is approximately equal to 0.3, which implies stronger singularities, i.e., a more evident discontinuity in the signal behavior. In addition, it seems that the number of singularities increases inside of A-phases. The numerical results suggest that the EEG naturally conveys singularities modified by the A-phase occurrence, and this information could help to conceptualize the CAP phenomenon from a new perspective based on the sharpness of the EEG instead of the oscillatory way.

Multi-Scale Evaluation of Sleep Quality Based on Motion Signal from Unobtrusive Device.

Sleep disorders are a growing threat nowadays as they are linked to neurological, cardiovascular and metabolic diseases. The gold standard methodology for sleep study is polysomnography (PSG), an intrusive and onerous technique that can disrupt normal routines. In this perspective, m-Health technologies offer an unobtrusive and rapid solution for home monitoring. We developed a multi-scale method based on motion signal extracted from an unobtrusive device to evaluate sleep behavior. Data used in this study were collected during two different acquisition campaigns by using a Pressure Bed Sensor (PBS). The first one was carried out with 22 subjects for sleep problems, and the second one comprises 11 healthy shift workers. All underwent full PSG and PBS recordings. The algorithm consists of extracting sleep quality and fragmentation indexes correlating to clinical metrics. In particular, the method classifies sleep windows of 1-s of the motion signal into: displacement (DI), quiet sleep (QS), disrupted sleep (DS) and absence from the bed (ABS). QS proved to be positively correlated (0.72±0.014) to Sleep Efficiency (SE) and DS/DI positively correlated (0.85±0.007) to the Apnea-Hypopnea Index (AHI). The work proved to be potentially helpful in the early investigation of sleep in the home environment. The minimized intrusiveness of the device together with a low complexity and good performance might provide valuable indications for the home monitoring of sleep disorders and for subjects' awareness.

Raman Spectroscopy Study of Skin Biopsies from Patients with Parkinson's Disease: Trends in Alpha-Synuclein Aggregation from the Amide I Region.

Parkinson's disease (PD) is one of the most common neurological pathologies with a high prevalence worldwide. PD is characterized by Lewy bodies, whose major component is the aggregates of α-synuclein (αSyn) protein. Interestingly, recent works have demonstrated that skin biopsy studies are a promising diagnostic tool for evaluating α-synucleinopathies. In this sense, this work focuses on the detection of αSyn in skin biopsies employing Raman spectroscopy, using three different approaches: (i) the in vitro Raman spectrum of α-synuclein, (ii) the ex vivo Raman spectra of human skin biopsies from healthy and Parkinson's disease patients, and (iii) theoretical calculations of the Raman spectra obtained from different model αSyn fragments using density functional theory (DFT). Significant differences in the intensity and location of Raman active frequencies in the amide I region were found when comparing healthy and PD subjects related to α-synuclein conformational changes and variations in their aggregation behavior. In samples from healthy patients, we identified well-known Raman peaks at 1655, 1664, and 1680 cm-1 associated with the normal state of the protein. In PD subjects, shifted Raman bands and intensity variations were found at 1650, 1670, and 1687 cm-1 associated with aggregated forms of the protein. DFT calculations reveal that the shape of the amide I Raman peak in model αSyn fragments strongly depends on the degree of aggregation. Sizable frequency shifts and intensity variations are found within the highly relevant 1600-1700 cm-1 domain, revealing the sensitivity of the amide I Raman band to the changes in the local atomic environment. Interestingly, we obtain that the presence of surrounding waters also affects the structure of the amide I band, leading to the appearance of new peaks on the low-frequency side and a notable broadening of the Raman spectra. These results strongly suggest that, through Raman spectroscopy, it is possible to infer the presence of aggregated forms of αSyn in skin biopsies, a result that could have important implications for understanding α-synuclein related diseases.

Probabilistic Multiple Sclerosis Lesion Detection using Superpixels and Markov Random Fields / Detección Probabilística de Lesiones de Esclerosis Múltiple usando Superpixeles y Campos Aleatorios de Markov

Abstract Multiple Sclerosis (MS) is the most common neurodegenerative disease among young adults. Diagnosis and monitoring of MS is performed with T2-weighted or T2 FLAIR magnetic resonance imaging, where MS lesions appear as hyperintense spots in the white matter. In recent years, multiple algorithms have been proposed to detect these lesions with varying success rates, which greatly depend on the amount of a priori information required by each algorithm, such as the use of an atlas or the involvement of an expert to guide the segmentation process. In this work, a fully automatic method that does not rely on a priori anatomical information is proposed and evaluated. The proposed algorithm is based on an over-segmentation in superpixels and their classification by means of Gauss-Markov Measure Fields (GMMF). The main advantage of the over-segmentation is that it preserves the borders between tissues, while the GMMF classifier is robust to noise and computationally efficient. The proposed segmentation is then applied in two stages: first to segment the brain region and then to detect hyperintense spots within the brain. The proposed method is evaluated with synthetic images from BrainWeb, as well as real images from MS patients. The proposed method produces competitive results with respect to other algorithms in the state of the art, without requiring user assistance nor anatomical prior information.

Resumen La Esclerosis Múltiple (MS) es una de las enfermedades neurodegenerativas más comunes en adultos jóvenes. El diagnóstico y su monitoreo se realiza generalmente mediante imágenes de resonancia magnética T2 o T2 FLAIR, donde se observan regiones hiperintensas relacionadas a lesiones cerebrales causadas por la MS. En años recientes, múltiples algoritmos han sido propuestos para detectar estas lesiones con diferentes tasas de éxito las cuales dependen en gran medida de la cantidad de información a priori que requiere cada algoritmo, como el uso de un atlas o el involucramiento de un experto que guíe el proceso de segmentación. En este trabajo, se propone un método automático independiente de información anatómica. El algoritmo propuesto está basado en una sobresegmentación en superpixeles y su clasificación mediante un proceso de Campos Aleatorios de Markov de Medidas Gaussianas (GMMF). La principal ventaja de la sobresegmentación es que preserva bordes entre tejidos, además que tiene un costo reducido en tiempo de ejecución, mientras que el clasificador GMMF es robusto a ruido y computacionalmente eficiente. La segmentación propuesta es aplicada en dos etapas: primero para segmentar el cerebro y después para detectar las lesiones en él. El método propuesto es evaluado usando imágenes sintéticas de BrainWeb, así como también imágenes reales de pacientes con MS. Con respecto a los resultados, el método propuesto muestra un desempeño competitivo respecto a otros métodos en el estado del arte, tomando en cuenta que éste no requiere de asistencia o información a priori.

A-phase classification using convolutional neural networks.

A series of short events, called A-phases, can be observed in the human electroencephalogram (EEG) during Non-Rapid Eye Movement (NREM) sleep. These events can be classified in three groups (A1, A2, and A3) according to their spectral contents, and are thought to play a role in the transitions between the different sleep stages. A-phase detection and classification is usually performed manually by a trained expert, but it is a tedious and time-consuming task. In the past two decades, various researchers have designed algorithms to automatically detect and classify the A-phases with varying degrees of success, but the problem remains open. In this paper, a different approach is proposed: instead of attempting to design a general classifier for all subjects, we propose to train ad-hoc classifiers for each subject using as little data as possible, in order to drastically reduce the amount of time required from the expert. The proposed classifiers are based on deep convolutional neural networks using the log-spectrogram of the EEG signal as input data. Results are encouraging, achieving average accuracies of 80.31% when discriminating between A-phases and non A-phases, and 71.87% when classifying among A-phase sub-types, with only 25% of the total A-phases used for training. When additional expert-validated data is considered, the sub-type classification accuracy increases to 78.92%. These results show that a semi-automatic annotation system with assistance from an expert could provide a better alternative to fully automatic classifiers. Graphical abstract A/N Deep Learning Classifier.

Improved Vancouver Raman Algorithm Based on Empirical Mode Decomposition for Denoising Biological Samples.

A novel method based on the Vancouver Raman algorithm (VRA) and empirical mode decomposition (EMD) for denoising Raman spectra of biological samples is presented. The VRA is one of the most used methods for denoising Raman spectroscopy and is composed of two main steps: signal filtering and polynomial fitting. However, the signal filtering step consists in a simple mean filter that could eliminate spectrum peaks with small intensities or merge relatively close spectrum peaks into one single peak. Thus, the result is often sensitive to the order of the mean filter, so the user must choose it carefully to obtain the expected result; this introduces subjectivity in the process. To overcome these disadvantages, we propose a new algorithm, namely the modified-VRA (mVRA) with the following improvements: (1) to replace the mean filter step by EMD as an adaptive parameter-free signal processing method; and (2) to automate the selection of polynomial degree. The denoising capabilities of VRA, EMD, and mVRA were compared in Raman spectra of artificial data based on Teflon material, synthetic material obtained from vitamin E and paracetamol, and biological material of human nails and mouse brain. The correlation coefficient (ρ) was used to compare the performance of the methods. For the artificial Raman spectra, the denoised signal obtained by mVRA (ρ>0.91) outperforms VRA (ρ>0.86) for moderate to high noise levels whereas mVRA outperformed EMD (ρ>0.90) for high noise levels. On the other hand, when it comes to modeling the underlying fluorescence signal of the samples (i.e., the baseline trend), the proposed method mVRA showed consistent results (ρ>0.94). For Raman spectra of synthetic material, good performance of the three methods (ρ=0.99 for VRA, ρ=0.93 for EMD, and ρ=0.99 for mVRA) was obtained. Finally, in the biological material, mVRA and VRA showed similar results (ρ=0.96 for VRA, ρ=0.85 for EMD, and ρ=0.91 for mVRA); however, mVRA retains valuable information corresponding to relevant Raman peaks with small amplitude. Thus, the application of EMD as a filter in the VRA method provides a good alternative for denoising biological Raman spectra, since the information of the Raman peaks is conserved and parameter tuning is not required. Simultaneously, EMD allows the baseline correction to be automated.

Fluorescence background removal method for biological Raman spectroscopy based on empirical mode decomposition.

Raman spectroscopy of biological tissue presents fluorescence background, an undesirable effect that generates false Raman intensities. This paper proposes the application of the Empirical Mode Decomposition (EMD) method to baseline correction. EMD is a suitable approach since it is an adaptive signal processing method for nonlinear and non-stationary signal analysis that does not require parameters selection such as polynomial methods. EMD performance was assessed through synthetic Raman spectra with different signal to noise ratio (SNR). The correlation coefficient between synthetic Raman spectra and the recovered one after EMD denoising was higher than 0.92. Additionally, twenty Raman spectra from skin were used to evaluate EMD performance and the results were compared with Vancouver Raman algorithm (VRA). The comparison resulted in a mean square error (MSE) of 0.001554. High correlation coefficient using synthetic spectra and low MSE in the comparison between EMD and VRA suggest that EMD could be an effective method to remove fluorescence background in biological Raman spectra.

Non-linear analysis of EEG and HRV signals during sleep.

The sleep phenomenon is a complex process that involves fluctuations of autonomic functions such as the blood pressure, temperature and brain function. These fluctuations change their properties through the different sleep stages with specific relations among the different systems. In order to understand the relation between the cardiovascular and central nervous system at the different sleep stages, we applied different non-linear methods to the energy of electroencephalographic signal (EEG) and the heart rate fluctuations. The EEG was divided in the Delta, Theta, Alpha and Beta frequency bands and the mean energy of these bands was computed at each heart rate interval. Thus, the non-linear relation was evaluated between the energy of the EEG bands and the heart rate fluctuations using Cross-Correlation, Cross-Sample Entropy and Recurrence Quantification Analysis in segments of 5 minutes grouped by sleep stage. The results showed that a relation exists between the changes of the energy in the Delta band and the Heart rate fluctuations.

Blind end-member and abundance extraction for multispectral fluorescence lifetime imaging microscopy data.

This paper proposes a new blind end-member and abundance extraction (BEAE) method for multispectral fluorescence lifetime imaging microscopy (m-FLIM) data. The chemometrical analysis relies on an iterative estimation of the fluorescence decay end-members and their abundances. The proposed method is based on a linear mixture model with positivity and sum-to-one restrictions on the abundances and end-members to compensate for signature variability. The synthesis procedure depends on a quadratic optimization problem, which is solved by an alternating least-squares structure over convex sets. The BEAE strategy only assumes that the number of components in the analyzed sample is known a spriori. The proposed method is first validated by using synthetic m-FLIM datasets at 15, 20, and 25 dB signal-to-noise ratios. The samples simulate the mixed response of tissue containing multiple fluorescent intensity decays. Furthermore, the results were also validated with six m-FLIM datasets from fresh postmortem human coronary atherosclerotic plaques. A quantitative evaluation of the BEAE was made against two popular techniques: minimum volume constrained nonnegative matrix factorization (MVC-NMF) and multivariate curve resolution-alternating least-squares (MCR-ALS). Our proposed method (BEAE) was able to provide more accurate estimations of the end-members: 0.32% minimum relative error and 13.82% worst-case scenario, despite different initial conditions in the iterative optimization procedure and noise effect. Meanwhile, MVC-NMF and MCR-ALS presented more variability in estimating the end-members: 0.35% and 0.34% for minimum errors and 15.31% and 13.25% in the worst-case scenarios, respectively. This tendency was also maintained for the abundances, where BEAE obtained 0.05 as the minimum absolute error and 0.12 in the worst-case scenario; MCR-ALS and MVC-NMF achieved 0.04 and 0.06 for the minimum absolute errors, and 0.15 and 0.17 under the worst-case conditions, respectively. In addition, the average computation time was evaluated for the synthetic datasets, where MVC-NMF achieved the fastest time, followed by BEAE and finally MCR-ALS. Consequently, BEAE improved MVC-NMF in convergence to a local optimal solution and robustness against signal variability, and it is roughly 3.6 time faster than MCR-ALS.

Acute effects of autoadjusting and fixed continuous positive airway pressure treatments on cardiorespiratory coupling in obese patients with obstructive sleep apnea.

BACKGROUND: Treatment with positive airway pressure devices improved signs and symptoms of obstructive sleep apnea syndrome (OSA); however, auto-adjusting positive pressure (APAP) device was not as effective as continuous positive airway pressure (CPAP) in reducing arterial blood pressure and insulin resistance. The role played by autonomic cardiac regulation remains to be clarified. We aimed to test the effects of CPAP and APAP on autonomic regulation and cardiorespiratory coupling during sleep. METHODS: We retrospectively analyzed full-night polysomnographic studies. 19 patients newly diagnosed with severe OSA (AHI>30) and 7 obese subjects without OSA (CON) were enrolled. Each OSA subject was assigned to CPAP or APAP treatment and underwent a sleep study after 1 week of treatment. Spectral and cross-spectral analyses of heart rate variability (HRV) and respiration were performed to assess autonomic profile and coherence (K2) between respiration and HF oscillation during sleep in CPAP, APAP and CON groups. RESULTS: In CPAP and CON, LFnu and LF/HF, markers of sympathetic modulation, decreased from N2 to N3 and increased during REM sleep (p<0.001), while in APAP group, sympathetic modulation was significantly higher compared with those of CPAP and CON during all sleep stages. K2 values were lower in APAP compared with those in CPAP and CON. CONCLUSION: APAP treatment was characterized by a greater sympathetic activation and it was associated with a lower cardio-respiratory coupling compared with CPAP. This might account for the different effects on cardiovascular risk factors induced by the two treatments.

Detection of sleep-disordered breating with Pressure Bed Sensor.

A Pressure Bed Sensor (PBS) can offer an unobtrusive method for sleep monitoring. This study focuses on the detection of the sleep related breathing disorders using a PBS in comparison to the methods used in a sleep laboratory. A newly developed PCA modeling approach for the eight sensor signals of the PBS is evaluated using the Reduced Respiratory Amplitude Index (RRAI) as a central measure. The method computes the respiration amplitude with the Hilbert transform, and then detects the events based on a 20% amplitude reduction from the baseline signal. A similar calculation was used for the sleep laboratory RIP measurements, and both PBS and RIP were compared against the reference based on the nasal flow signal. In the reference RRAI method, the respiratory-disordered events were obtained using RemLogic respiration analyzer to detect over 50% amplitude reduction in the nasal respiratory flow, but removing the RemLogic standard hypopnea event associations on the oxygen desaturation events and the sleep arousals. The movement artifacts were automatically detected based on the movement activity signal of the PBS. Twenty-five (25) out of 28 patients were finally analysed. On average 87% of a night measurement has been covered by the system. The correlation coefficient was 0.92 between the PBS and the reference RRAI, and the performance of the PBS was similar with the RIP belts. Classifying the severity of the sleep related breathing by dividing RRAI in groups according to the severity criteria, the sensitivity was 92% and the specificity was 70% for the PBS. The results suggest that PBS recording can provide an easy and un-obstructive alternative method for the detection of the sleep disordered breathing and thus has a great promise for the home monitoring.

Methods for heart rate variability analysis during sleep.

In the last years we have witnessed the growing interest in the heart rate variability (HRV) signal analysis during sleep. The study of the autonomic regulation during sleep allowed developing methods for automatic detection and classification of some sleep characteristics, both in physiological and pathological conditions. The main problems which require to be faced are the presence of frequent non-stationarities in the signal and the need of dealing with long term analysis, in order to provide reliable indices able to describe the whole night of sleep. In the present paper we are presenting some of the methodologies we recently employed in the study of the heart rate variability during sleep, ranging from time-frequency analysis to long time correlation. Some results are also presented, related to different applications, dealing with both physiological and pathological conditions.

EEG segmentation for improving automatic CAP detection.

OBJECTIVE: The aim of this study is to provide an improved method for the automatic classification of the Cyclic Alternating Pattern (CAP) sleep by applying a segmentation technique to the computation of descriptors from the EEG. METHODS: A dataset of 16 polysomnographic recordings from healthy subjects was employed, and the EEG traces underwent first an automatic isolation of NREM sleep portions by means of an Artificial Neural Network and then a segmentation process based on the Spectral Error Measure. The information content of the descriptors was evaluated by means of ROC curves and compared with that of descriptors obtained without the use of segmentation. Finally, the descriptors were used to train a discriminant function for the automatic classification of CAP phases A. RESULTS: A significant improvement with respect to previous scoring methods in terms of both information content carried by the descriptors and accuracy of the classification was obtained. CONCLUSIONS: EEG segmentation proves to be a useful step in the computation of descriptors for CAP scoring. SIGNIFICANCE: This study provides a complete method for CAP analysis, which is entirely automatic and allows the recognition of A phases with a high accuracy thanks to EEG segmentation.

A fully constrained optimization method for time-resolved multispectral fluorescence lifetime imaging microscopy data unmixing.

This paper presents a new unmixing methodology of multispectral fluorescence lifetime imaging microscopy (m-FLIM) data, in which the spectrum is defined as the combination of time-domain fluorescence decays at multiple emission wavelengths. The method is based on a quadratic constrained optimization (CO) algorithm that provides a closed-form solution under equality and inequality restrictions. In this paper, it is assumed that the time-resolved fluorescence spectrum profiles of the constituent components are linearly independent and known a priori. For comparison purposes, the standard least squares (LS) solution and two constrained versions nonnegativity constrained least squares (NCLS) and fully constrained least squares (FCLS) (Heinz and Chang, 2001) are also tested. Their performance was evaluated by using synthetic simulations, as well as imaged samples from fluorescent dyes and ex vivo tissue. In all the synthetic evaluations, the CO obtained the best accuracy in the estimations of the proportional contributions. CO could achieve an improvement ranging between 41% and 59% in the relative error compared to LS, NCLS, and FCLS at different signal-to-noise ratios. A liquid mixture of fluorescent dyes was also prepared and imaged in order to provide a controlled scenario with real data, where CO and FCLS obtained the best performance. The CO and FCLS were also tested with 20 ex vivo samples of human coronary arteries, where the expected concentrations are qualitatively known. A certainty measure was employed to assess the confidence in the estimations made by each algorithm. The experiments confirmed a better performance of CO, since this method is optimal with respect to equality and inequality restrictions in the linear unmixing formulation. Thus, the evaluation showed that CO achieves an accurate characterization of the samples. Furthermore, CO is a computational efficient alternative to estimate the abundance of components in m-FLIM data, since a global optimal solution is always guaranteed in a closed form.

Efficient automatic classifiers for the detection of A phases of the cyclic alternating pattern in sleep.

This study aims to develop an automatic detector of the A phases of the cyclic alternating pattern, periodic activity that generally occurs during non-REM (NREM) sleep. Eight polysomnographic recordings from healthy subjects were examined. From EEG recordings, five band descriptors, an activity descriptor and a variance descriptor were extracted and used to train different machine-learning algorithms. A visual scoring provided by an expert clinician was used as golden standard. Four alternative mathematical machine-learning techniques were implemented: (1) discriminant classifier, (2) support vector machines, (3) adaptive boosting, and (4) supervised artificial neural network. The results of the classification, compared with the visual analysis, showed average accuracies equal to 84.9 and 81.5% for the linear discriminant and the neural network, respectively, while AdaBoost had a slightly lower accuracy, equal to 79.4%. The SVM leads to accuracy of 81.9%. The performance achieved by the automatic classification is encouraging, since an efficient automatic classifier would benefit the practice in everyday clinics, preventing the physician from the time-consuming activity of the visually scoring of the sleep microstructure over whole 8-h sleep recordings. Finally, the classification based on learning algorithms would provide an objective criterion, overcoming the problems of inter-scorer disagreement.

Approximate string matching using phase correlation.

A novel method for approximate string matching with applications to bioinformatics is presented in this paper. Unlike most methods in the literature, the proposed method does not depend on the computation of the edit distance between two sequences, but uses instead a similarity index obtained by applying the phase correlation method. The resulting algorithm provides a finer control over the false positive rate, allowing users to pick out relevant matchings in less time, and can be applied for both offline and online processing.

Mesh-based approach for the 3D analysis of anatomical structures of interest in radiotherapy.

In this paper a method based on mesh surfaces approximations for the 3D analysis of anatomical structures in Radiotherapy (RT) is presented. Parotid glands meshes constructed from Megavoltage CT (MVCT) images were studied in terms of volume, distance between center of mass (distCOM) of the right and left parotids, dice similarity coefficient (DICE), maximum distance between meshes (DMax) and the average symmetric distance (ASD). A comparison with the standard binary images approach was performed. While absence of significant differences in terms of volume, DistCOM and DICE indices suggests that both approaches are comparable, the fact that the ASD showed significant difference (p=0.002) and the DMax was almost significant (p=0.053) suggests that the mesh approach should be adopted to provide accurate comparison between 3D anatomical structures of interest in RT.

Characterization of A phases during the cyclic alternating pattern of sleep.

OBJECTIVE: This study aims to identify, starting from a single EEG trace, quantitative distinctive features characterizing the A phases of the Cyclic Alternating Pattern (CAP). METHODS: The C3-A2 or C4-A1 EEG leads of the night recording of eight healthy adult subjects were used for this analysis. CAP was scored by an expert and the portions relative to NREM were selected. Nine descriptors were computed: band descriptors (low delta, high delta, theta, alpha, sigma and beta); Hjorth activity in the low delta and high delta bands; differential variance of the EEG signal. The information content of each descriptor in recognizing the A phases was evaluated through the computation of the ROC curves and the statistics sensitivity, specificity and accuracy. RESULTS: The ROC curves show that all the descriptors have a certain significance in characterizing A phases. The average accuracy obtained by thresholding the descriptors ranges from 59.89 (sigma descriptor) to 72.44 (differential EEG variance). CONCLUSIONS: The results show that it is possible to attribute a significant quantitative value to the information content of the descriptors. SIGNIFICANCE: This study gives a mathematical confirm to the features of CAP generally described qualitatively, and puts the bases for the creation of automatic detection methods.

Study of Heart Rate Variability in Bipolar Disorder: Linear and Non-Linear Parameters during Sleep.

The aim of the study is to define physiological parameters and vital signs that may be related to the mood and mental status in patients affected by bipolar disorder. In particular we explored the autonomic nervous system through the analysis of the heart rate variability. Many different parameters, in the time and in the frequency domain, linear and non-linear were evaluated during the sleep in a group of normal subject and in one patient in four different conditions. The recording of the signals was performed through a wearable sensorized T-shirt. Heart rate variability (HRV) signal and movement analysis allowed also obtaining sleep staging and the estimation of REM sleep percentage over the total sleep time. A group of eight normal females constituted the control group, on which normality ranges were estimated. The pathologic subject was recorded during four different nights, at time intervals of at least 1 week, and during different phases of the disturbance. Some of the examined parameters (MEANNN, SDNN, RMSSD) confirmed reduced HRV in depression and bipolar disorder. REM sleep percentage was found to be increased. Lempel-Ziv complexity and sample entropy, on the other hand, seem to correlate with the depression level. Even if the number of examined subjects is still small, and the results need further validation, the proposed methodology and the calculated parameters seem promising tools for the monitoring of mood changes in psychiatric disorders.