Nearly all functional magnetic resonance imaging (fMRI) studies are conducted in the supine body posture, which has been discussed as a potential confounder of such examinations. The literature suggests that cognitive functions, such as problem solving or perception, differ between supine and upright postures. However, the effect of posture on many cognitive functions is still unknown. Therefore, the aim of the present study was to investigate the effects of body posture (supine vs. sitting) on one of the most frequently used paradigms in the cognitive sciences: the N-back working memory paradigm. Twenty-two subjects were investigated in a randomized within-subject design. Subjects performed the N-back task on two consecutive days in either the supine or the upright posture. Subjective sleep quality and chronic stress were recorded as covariates. Furthermore, changes in mood dimensions and heart rate variability (HRV) were assessed during the experiment. Results indicate that the quality of sleep strongly affects reaction times when subjects performed a working memory task in a supine posture. These effects, however, could not be observed in the sitting position. The findings can be explained by HRV parameters that indicated differences in autonomic regulation in the upright vs. the supine posture. The finding is of particular relevance for fMRI group comparisons when group differences in sleep quality cannot be ruled out.
Camera-based photoplethysmography (cbPPG) is a measurement technique which enables remote vital sign monitoring by using cameras. To obtain valid plethysmograms, proper regions of interest (ROIs) have to be selected in the video data. Most automated selection methods rely on specific spatial or temporal features limiting a broader application. In this work, we present a new method which overcomes those drawbacks and, therefore, allows cbPPG to be applied in an intraoperative environment. We recorded 41 patients during surgery using an RGB and a near-infrared (NIR) camera. A Bayesian skin classifier was employed to detect suitable regions, and a level set segmentation approach to define and track ROIs based on spatial homogeneity. The results show stable and homogeneously illuminated ROIs. We further evaluated their quality with regards to extracted cbPPG signals. The green channel provided the best results where heart rates could be correctly estimated in 95.6% of cases. The NIR channel yielded the highest contribution in compensating false estimations. The proposed method proved that cbPPG is applicable in intraoperative environments. It can be easily transferred to other settings regardless of which body site is considered.
In multiple sclerosis (MS), gait impairment is one of the most prominent symptoms. For a sensitive assessment of pathological gait patterns, a comprehensive analysis and processing of several gait analysis systems is necessary. The objective of this work was to determine the best diagnostic gait system (DIERS pedogait, GAITRite system, and Mobility Lab) using six machine learning algorithms for the differentiation between people with multiple sclerosis (pwMS) and healthy controls, between pwMS with and without fatigue and between pwMS with mild and moderate impairment. The data of the three gait systems were assessed on 54 pwMS and 38 healthy controls. Gaussian Naive Bayes, Decision Tree, k-Nearest Neighbor, and Support Vector Machines (SVM) with linear, radial basis function (rbf) and polynomial kernel were applied for the detection of subtle walking changes. The best performance for a healthy-sick classification was achieved on the DIERS data with a SVM rbf kernel (κ = 0.49 ± 0.11). For differentiating between pwMS with mild and moderate disability, the GAITRite data with the SVM linear kernel (κ = 0.61 ± 0.06) showed the best performance. This study demonstrates that machine learning methods are suitable for identifying pathologic gait patterns in early MS.
One of the largest problems for the transplantation medicine is the lack of donor grafts.1 Compared to 2010, the rate of postmortem organ donations in Germany has decreased by 29% in 2019, which corresponds to 1210 organs. Despite an improvement with respect to 2017, the need for organs in 2019 (9271 organs required) far exceeds the number of available donor organs (3767 organs transplanted).2 This high demand for donor organs shows in particular the need to increase the number of successfully transplanted organs. Optimal use of the few donor organs is urgently required not only with regard to the individual person to be treated but also from a social and political point of view. The most frequently transplanted organs are kidney, liver, heart, and lung. However, in Germany, the discrepancy between supply and demand in kidney transplantation is alarming. A total of 2291 kidneys has been available for transplantation in 2018, compared to 7526 open transplant recipients at the end of the year.3 Apart from this shortage, the rejection rate for available kidney transplants has been 14.8% in 2019.2 Due to the lack of an accurate predictive organ evaluation strategy, certain organs were rejected although they would still have been suitable for transplantation.4–7 The decision to accept or reject an organ for transplantation depends primarily on the expertise of the transplant team rather than on an objective measurement. In addition in the years 2014 to 2019, intra- or postoperative complications of kidney transplantations requiring a second kidney transplantation have been between 15.3% and 20.4%.2,3,8 Therefore, an optical evaluation tool to monitor organ quality before transplantation would be of great interest.
Facing an ongoing organ shortage in transplant medicine, strategies to increase the use of organs from marginal donors by objective organ assessment are being fostered. In this context, normothermic machine perfusion provides a platform for ex vivo organ evaluation during preservation. Consequently, analytical tools are emerging to determine organ quality. In this study, hyperspectral imaging (HSI) in the wavelength range of 550–995 nm was applied. Classification of 26 kidneys based on HSI was established using KidneyResNet, a convolutional neural network (CNN) based on the ResNet-18 architecture, to predict inulin clearance behavior. HSI preprocessing steps were implemented, including automated region of interest (ROI) selection, before executing the KidneyResNet algorithm. Training parameters and augmentation methods were investigated concerning their influence on the prediction. When classifying individual ROIs, the optimized KidneyResNet model achieved 84% and 62% accuracy in the validation and test set, respectively. With a majority decision on all ROIs of a kidney, the accuracy increased to 96% (validation set) and 100% (test set). These results demonstrate the feasibility of HSI in combination with KidneyResNet for non-invasive prediction of ex vivo kidney function. This knowledge of preoperative renal quality may support the organ acceptance decision.
1 September 2016 in Current Directions in Biomedical Engineering
Camera-based photoplethysmography (cbPPG) is a novel technique that allows the contactless acquisition of cardio-respiratory signals. Previous works on cbPPG most often focused on heart rate extraction. This contribution is directed at the assessment of vasomotor activity by means of cameras. In an experimental study, we show that vasodilation and vasoconstriction both lead to significant changes in cbPPG signals. Our findings underline the potential of cbPPG to monitor vasomotor functions in real-life applications.