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Bai J, Lu Y, Liu H, He F, Guo X. Editorial: New technologies improve maternal and newborn safety. FRONTIERS IN MEDICAL TECHNOLOGY 2024; 6:1372358. [PMID: 38872737 PMCID: PMC11169838 DOI: 10.3389/fmedt.2024.1372358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 05/17/2024] [Indexed: 06/15/2024] Open
Affiliation(s)
- Jieyun Bai
- Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Information Technology, Jinan University, Guangzhou, China
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Yaosheng Lu
- Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Information Technology, Jinan University, Guangzhou, China
| | - Huishu Liu
- Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Fang He
- Department of Obstetrics and Gynecology, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiaohui Guo
- Department of Obstetrics, Shenzhen People’s Hospital, Shenzhen, China
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2
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Fu Z, Xu W, Liu S. Physics-informed kernel function neural networks for solving partial differential equations. Neural Netw 2024; 172:106098. [PMID: 38199153 DOI: 10.1016/j.neunet.2024.106098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 11/27/2023] [Accepted: 01/01/2024] [Indexed: 01/12/2024]
Abstract
This paper proposes an improved version of physics-informed neural networks (PINNs), the physics-informed kernel function neural networks (PIKFNNs), to solve various linear and some specific nonlinear partial differential equations (PDEs). It can also be considered as a novel radial basis function neural network (RBFNN). In the proposed PIKFNNs, it employs one-hidden-layer shallow neural network with the physics-informed kernel functions (PIKFs) as the customized activation functions. The PIKFs fully or partially contain PDE information, which can be chosen as fundamental solutions, green's functions, T-complete functions, harmonic functions, radial Trefftz functions, probability density functions and even the solutions of some linear simplified PDEs and so on. The main difference between the PINNs and the proposed PIKFNNs is that the PINNs add PDE constraints to the loss function, and the proposed PIKFNNs embed PDE information into the activation functions of the neural network. The feasibility and accuracy of the proposed PIKFNNs are validated by some benchmark examples.
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Affiliation(s)
- Zhuojia Fu
- Key Laboratory of Ministry of Education for Coastal Disaster and Protection, Hohai University, Nanjing 210098, China; College of Mechanics and Materials, Hohai University, Nanjing 211100, China.
| | - Wenzhi Xu
- College of Mechanics and Materials, Hohai University, Nanjing 211100, China
| | - Shuainan Liu
- College of Mechanics and Materials, Hohai University, Nanjing 211100, China
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3
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Li W, Xiao Z, Zhao J, Aono K, Pizzella S, Wen Z, Wang Y, Wang C, Chakrabartty S. A Portable and a Scalable Multi-Channel Wireless Recording System for Wearable Electromyometrial Imaging. IEEE TRANSACTIONS ON BIOMEDICAL CIRCUITS AND SYSTEMS 2023; 17:916-927. [PMID: 37204963 PMCID: PMC10871545 DOI: 10.1109/tbcas.2023.3278104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Electromyometrial imaging (EMMI) technology has emerged as one of the promising technology that can be used for non-invasive pregnancy risk stratification and for preventing complications due to pre-term birth. Current EMMI systems are bulky and require a tethered connection to desktop instrumentation, as a result, the system cannot be used in non-clinical and ambulatory settings. In this article, we propose an approach for designing a scalable, portable wireless EMMI recording system that can be used for in-home and remote monitoring. The wearable system uses a non-equilibrium differential electrode multiplexing approach to enhance signal acquisition bandwidth and to reduce the artifacts due to electrode drifts, amplifier 1/f noise, and bio-potential amplifier saturation. A combination of active shielding, a passive filter network, and a high-end instrumentation amplifier ensures sufficient input dynamic range ([Formula: see text]) such that the system can simultaneously acquire different bio-potential signals like maternal electrocardiogram (ECG) in addition to the EMMI electromyogram (EMG) signals. We show that the switching artifacts and the channel cross-talk introduced due to non-equilibrium sampling can be reduced using a compensation technique. This enables the system to be potentially scaled to a large number of channels without significantly increasing the system power dissipation. We demonstrate the feasibility of the proposed approach in a clinical setting using an 8-channel battery-powered prototype which dissipates less than 8 μW per channel for a signal bandwidth of 1 KHz.
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4
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Goldsztejn U, Nehorai A. Estimating uterine activity from electrohysterogram measurements via statistical tensor decomposition. Biomed Signal Process Control 2023. [DOI: 10.1016/j.bspc.2023.104899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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5
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Wang H, Wen Z, Wu W, Sun Z, Kisrieva-Ware Z, Lin Y, Wang S, Gao H, Xu H, Zhao P, Wang Q, Macones GA, Schwartz AL, Cuculich P, Cahill AG, Wang Y. Noninvasive electromyometrial imaging of human uterine maturation during term labor. Nat Commun 2023; 14:1198. [PMID: 36918533 PMCID: PMC10015052 DOI: 10.1038/s41467-023-36440-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 01/23/2023] [Indexed: 03/16/2023] Open
Abstract
Electromyometrial imaging (EMMI) was recently developed to image the three-dimensional (3D) uterine electrical activation during contractions noninvasively and accurately in sheep. Herein we describe the development and application of a human EMMI system to image and evaluate 3D uterine electrical activation patterns at high spatial and temporal resolution during human term labor. We demonstrate the successful integration of the human EMMI system during subjects' clinical visits to generate noninvasively the uterine surface electrical potential maps, electrograms, and activation sequence through an inverse solution using up to 192 electrodes distributed around the abdomen surface. Quantitative indices, including the uterine activation curve, are developed and defined to characterize uterine surface contraction patterns. We thus show that the human EMMI system can provide detailed 3D images and quantification of uterine contractions as well as novel insights into the role of human uterine maturation during labor progression.
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Affiliation(s)
- Hui Wang
- Department of Physics, Washington University, St. Louis, MO, 63130, USA
- Center for Reproductive Health Sciences, Washington University School of Medicine, St. Louis, MO, 63130, USA
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Zichao Wen
- Center for Reproductive Health Sciences, Washington University School of Medicine, St. Louis, MO, 63130, USA
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Wenjie Wu
- Center for Reproductive Health Sciences, Washington University School of Medicine, St. Louis, MO, 63130, USA
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, 63110, USA
- Department of Biomedical Engineering, Washington University, St. Louis, MO, 63130, USA
| | - Zhexian Sun
- Center for Reproductive Health Sciences, Washington University School of Medicine, St. Louis, MO, 63130, USA
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, 63110, USA
- Department of Biomedical Engineering, Washington University, St. Louis, MO, 63130, USA
| | - Zulfia Kisrieva-Ware
- Center for Reproductive Health Sciences, Washington University School of Medicine, St. Louis, MO, 63130, USA
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Yiqi Lin
- Center for Reproductive Health Sciences, Washington University School of Medicine, St. Louis, MO, 63130, USA
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, 63110, USA
- Department of Electrical and Systems Engineering, Washington University, St. Louis, MO, 63130, USA
| | - Sicheng Wang
- Center for Reproductive Health Sciences, Washington University School of Medicine, St. Louis, MO, 63130, USA
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, 63110, USA
- Department of Electrical and Systems Engineering, Washington University, St. Louis, MO, 63130, USA
| | - Hansong Gao
- Center for Reproductive Health Sciences, Washington University School of Medicine, St. Louis, MO, 63130, USA
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, 63110, USA
- Department of Electrical and Systems Engineering, Washington University, St. Louis, MO, 63130, USA
| | - Haonan Xu
- Center for Reproductive Health Sciences, Washington University School of Medicine, St. Louis, MO, 63130, USA
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Peinan Zhao
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Qing Wang
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - George A Macones
- Department of Women's Health, Dell Medical School, The University of Texas at Austin, Austin, TX, 78712, USA
| | - Alan L Schwartz
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Phillip Cuculich
- Department of Cardiology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Alison G Cahill
- Department of Women's Health, Dell Medical School, The University of Texas at Austin, Austin, TX, 78712, USA
| | - Yong Wang
- Center for Reproductive Health Sciences, Washington University School of Medicine, St. Louis, MO, 63130, USA.
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, 63110, USA.
- Department of Biomedical Engineering, Washington University, St. Louis, MO, 63130, USA.
- Department of Electrical and Systems Engineering, Washington University, St. Louis, MO, 63130, USA.
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, 63110, USA.
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6
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Cluitmans MJM, Bayer J, Bear LR, ter Bekke RMA, Heijman J, Coronel R, Volders PGA. The circle of reentry: Characteristics of trigger-substrate interaction leading to sudden cardiac arrest. Front Cardiovasc Med 2023; 10:1121517. [PMID: 37139119 PMCID: PMC10150924 DOI: 10.3389/fcvm.2023.1121517] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 03/28/2023] [Indexed: 05/05/2023] Open
Abstract
Sudden cardiac death is often caused by ventricular arrhythmias driven by reentry. Comprehensive characterization of the potential triggers and substrate in survivors of sudden cardiac arrest has provided insights into the trigger-substrate interaction leading to reentry. Previously, a "Triangle of Arrhythmogenesis", reflecting interactions between substrate, trigger and modulating factors, has been proposed to reason about arrhythmia initiation. Here, we expand upon this concept by separating the trigger and substrate characteristics in their spatial and temporal components. This yields four key elements that are required for the initiation of reentry: local dispersion of excitability (e.g., the presence of steep repolarization time gradients), a critical relative size of the region of excitability and the region of inexcitability (e.g., a sufficiently large region with early repolarization), a trigger that originates at a time when some tissue is excitable and other tissue is inexcitable (e.g., an early premature complex), and which occurs from an excitable region (e.g., from a region with early repolarization). We discuss how these findings yield a new mechanistic framework for reasoning about reentry initiation, the "Circle of Reentry." In a patient case of unexplained ventricular fibrillation, we then illustrate how a comprehensive clinical investigation of these trigger-substrate characteristics may help to understand the associated arrhythmia mechanism. We will also discuss how this reentry initiation concept may help to identify patients at risk, and how similar reasoning may apply to other reentrant arrhythmias.
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Affiliation(s)
- Matthijs J. M. Cluitmans
- Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, Netherlands
- Philips Research, Eindhoven, Netherlands
- Correspondence: Matthijs J. M. Cluitmans
| | | | | | - Rachel M. A. ter Bekke
- Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, Netherlands
| | - Jordi Heijman
- Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, Netherlands
| | - Ruben Coronel
- Department of Experimental Cardiology, Amsterdam University Medical Centre, Amsterdam, Netherlands
| | - Paul G. A. Volders
- Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, Netherlands
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7
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Lo LW, Zhao J, Aono K, Li W, Wen Z, Pizzella S, Wang Y, Chakrabartty S, Wang C. Stretchable Sponge Electrodes for Long-Term and Motion-Artifact-Tolerant Recording of High-Quality Electrophysiologic Signals. ACS NANO 2022; 16:11792-11801. [PMID: 35861486 PMCID: PMC9413418 DOI: 10.1021/acsnano.2c04962] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 07/15/2022] [Indexed: 05/27/2023]
Abstract
Soft electronic devices and sensors have shown great potential for wearable and ambulatory electrophysiologic signal monitoring applications due to their light weight, ability to conform to human skin, and improved wearing comfort, and they may replace the conventional rigid electrodes and bulky recording devices widely used nowadays in clinical settings. Herein, we report an elastomeric sponge electrode that offers greatly reduced electrode-skin contact impedance, an improved signal-to-noise ratio (SNR), and is ideally suited for long-term and motion-artifact-tolerant recording of high-quality biopotential signals. The sponge electrode utilizes a porous polydimethylsiloxane sponge made from a sacrificial template of sugar cubes, and it is subsequently coated with a poly(3,4-ethylenedioxythiophene) polystyrenesulfonate (PEDOT:PSS) conductive polymer using a simple dip-coating process. The sponge electrode contains numerous micropores that greatly increase the skin-electrode contact area and help lower the contact impedance by a factor of 5.25 or 6.7 compared to planar PEDOT:PSS electrodes or gold-standard Ag/AgCl electrodes, respectively. The lowering of contact impedance resulted in high-quality electrocardiogram (ECG) and electromyogram (EMG) recordings with improved SNR. Furthermore, the porous structure also allows the sponge electrode to hold significantly more conductive gel compared to conventional planar electrodes, thereby allowing them to be used for long recording sessions with minimal signal degradation. The conductive gel absorbed into the micropores also serves as a buffer layer to help mitigate motion artifacts, which is crucial for recording on ambulatory patients. Lastly, to demonstrate its feasibility and potential for clinical usage, we have shown that the sponge electrode can be used to monitor uterine contraction activities from a patient in labor. With its low-cost fabrication, softness, and ability to record high SNR biopotential signals, the sponge electrode is a promising platform for long-term wearable health monitoring applications.
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Affiliation(s)
- Li-Wei Lo
- Department
of Electrical & Systems Engineering, Washington University in St. Louis, St. Louis, Missouri 63130, United States
- Institute
of Materials Science and Engineering, Washington
University in St. Louis, St. Louis, Missouri 63130, United States
| | - Junyi Zhao
- Department
of Electrical & Systems Engineering, Washington University in St. Louis, St. Louis, Missouri 63130, United States
| | - Kenji Aono
- Department
of Electrical & Systems Engineering, Washington University in St. Louis, St. Louis, Missouri 63130, United States
| | - Weilun Li
- Department
of Electrical & Systems Engineering, Washington University in St. Louis, St. Louis, Missouri 63130, United States
| | - Zichao Wen
- Department
of Obstetrics & Gynecology, Washington
University in St. Louis, St. Louis, Missouri 63130, United States
| | - Stephanie Pizzella
- Department
of Obstetrics & Gynecology, Washington
University in St. Louis, St. Louis, Missouri 63130, United States
| | - Yong Wang
- Department
of Electrical & Systems Engineering, Washington University in St. Louis, St. Louis, Missouri 63130, United States
- Department
of Obstetrics & Gynecology, Washington
University in St. Louis, St. Louis, Missouri 63130, United States
| | - Shantanu Chakrabartty
- Department
of Electrical & Systems Engineering, Washington University in St. Louis, St. Louis, Missouri 63130, United States
| | - Chuan Wang
- Department
of Electrical & Systems Engineering, Washington University in St. Louis, St. Louis, Missouri 63130, United States
- Institute
of Materials Science and Engineering, Washington
University in St. Louis, St. Louis, Missouri 63130, United States
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8
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Cahill AG, Wen Z, Wang H, Zhao P, Sun Z, Schwartz AL, Wang Y. Analysis of Electrophysiological Activation of the Uterus During Human Labor Contractions. JAMA Netw Open 2022; 5:e2214707. [PMID: 35653158 PMCID: PMC9164003 DOI: 10.1001/jamanetworkopen.2022.14707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/13/2022] [Indexed: 11/14/2022] Open
Affiliation(s)
- Alison G. Cahill
- Department of Women’s Health, Dell Medical School, University of Texas at Austin, Austin
| | - Zichao Wen
- Department of Obstetrics and Gynecology, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Hui Wang
- Department of Obstetrics and Gynecology, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Peinan Zhao
- Department of Obstetrics and Gynecology, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Zhexian Sun
- Department of Obstetrics and Gynecology, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Alan L. Schwartz
- Department of Pediatrics, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Yong Wang
- Department of Obstetrics and Gynecology, Washington University School of Medicine in St Louis, St Louis, Missouri
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9
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10
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Abdul Halim SF, Zakaria Z, Pusppanathan J, Mohd Noor A, Norali AN, Fazalul Rahiman MH, Mohd Muji SZ, Abdul Rahim R, Engku-Husna EI, Ali Hassan MK, Aziz Safar MJ, Salleh AF, Mat Som MH. A Review on Magnetic Induction Spectroscopy Potential for Fetal Acidosis Examination. SENSORS 2022; 22:s22041334. [PMID: 35214235 PMCID: PMC8963069 DOI: 10.3390/s22041334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/24/2021] [Accepted: 01/07/2022] [Indexed: 02/06/2023]
Abstract
Fetal acidosis is one of the main concerns during labor. Currently, fetal blood sampling (FBS) has become the most accurate measurement of acidosis detection. However, it is invasive and does not provide a real time measurement due to laboratory procedures. Delays in diagnosis of acidosis have caused serious injury to the fetus, especially for the brain and the heart. This paper reviews the new technique in diagnosis of acidosis non-invasively. Magnetic Induction Spectroscopy (MIS) has been proposed to be a new device for acidosis detection in recent years. This paper explains the basic principle of MIS and outlines the design specifications and design considerations for a MIS pH probe. It is expected that readers will gain a basic understanding of the development of a MIS pH probe from this review.
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Affiliation(s)
- Siti Fatimah Abdul Halim
- Biomedical Electronic Engineering, Faculty of Electronic Engineering Technology, Universiti Malaysia Perlis, Arau 02600, Perlis, Malaysia; (S.F.A.H.); (A.M.N.); (A.N.N.); (A.F.S.); (M.H.M.S.)
| | - Zulkarnay Zakaria
- Biomedical Electronic Engineering, Faculty of Electronic Engineering Technology, Universiti Malaysia Perlis, Arau 02600, Perlis, Malaysia; (S.F.A.H.); (A.M.N.); (A.N.N.); (A.F.S.); (M.H.M.S.)
- Medical Device & Life Sciences Cluster, Sports Engineering Research Centre (SERC), Universiti Malaysia Perlis, Arau 02600, Perlis, Malaysia; (M.K.A.H.); (M.J.A.S.)
- Correspondence:
| | - Jaysuman Pusppanathan
- Sport Innovation & Technology Centre (SiTC), Institute of Human Centered Engineering (iHumen), Universiti Teknologi Malaysia, Skudai 81310, Johor, Malaysia;
| | - Anas Mohd Noor
- Biomedical Electronic Engineering, Faculty of Electronic Engineering Technology, Universiti Malaysia Perlis, Arau 02600, Perlis, Malaysia; (S.F.A.H.); (A.M.N.); (A.N.N.); (A.F.S.); (M.H.M.S.)
- Medical Device & Life Sciences Cluster, Sports Engineering Research Centre (SERC), Universiti Malaysia Perlis, Arau 02600, Perlis, Malaysia; (M.K.A.H.); (M.J.A.S.)
| | - Ahmad Nasrul Norali
- Biomedical Electronic Engineering, Faculty of Electronic Engineering Technology, Universiti Malaysia Perlis, Arau 02600, Perlis, Malaysia; (S.F.A.H.); (A.M.N.); (A.N.N.); (A.F.S.); (M.H.M.S.)
- Medical Device & Life Sciences Cluster, Sports Engineering Research Centre (SERC), Universiti Malaysia Perlis, Arau 02600, Perlis, Malaysia; (M.K.A.H.); (M.J.A.S.)
| | | | - Siti Zarina Mohd Muji
- Department of Electronic Engineering, Faculty of Electrical and Electronic Engineering, Universiti Tun Hussein Onn Malaysia, Parit Raja, Batu Pahat 86400, Johor, Malaysia;
| | - Ruzairi Abdul Rahim
- School of Electrical Engineering, Faculty of Engineering, Universiti Teknologi Malaysia, Skudai 81310, Johor, Malaysia;
| | - Engku Ismail Engku-Husna
- Department of Obstetrics and Gynaecology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia;
| | - Muhamad Khairul Ali Hassan
- Medical Device & Life Sciences Cluster, Sports Engineering Research Centre (SERC), Universiti Malaysia Perlis, Arau 02600, Perlis, Malaysia; (M.K.A.H.); (M.J.A.S.)
- Faculty of Electrical Engineering Technology, Universiti Malaysia Perlis, Arau 02600, Perlis, Malaysia;
| | - Muhammad Juhairi Aziz Safar
- Medical Device & Life Sciences Cluster, Sports Engineering Research Centre (SERC), Universiti Malaysia Perlis, Arau 02600, Perlis, Malaysia; (M.K.A.H.); (M.J.A.S.)
- Faculty of Electrical Engineering Technology, Universiti Malaysia Perlis, Arau 02600, Perlis, Malaysia;
| | - Ahmad Faizal Salleh
- Biomedical Electronic Engineering, Faculty of Electronic Engineering Technology, Universiti Malaysia Perlis, Arau 02600, Perlis, Malaysia; (S.F.A.H.); (A.M.N.); (A.N.N.); (A.F.S.); (M.H.M.S.)
- Medical Device & Life Sciences Cluster, Sports Engineering Research Centre (SERC), Universiti Malaysia Perlis, Arau 02600, Perlis, Malaysia; (M.K.A.H.); (M.J.A.S.)
| | - Mohd Hanafi Mat Som
- Biomedical Electronic Engineering, Faculty of Electronic Engineering Technology, Universiti Malaysia Perlis, Arau 02600, Perlis, Malaysia; (S.F.A.H.); (A.M.N.); (A.N.N.); (A.F.S.); (M.H.M.S.)
- Medical Device & Life Sciences Cluster, Sports Engineering Research Centre (SERC), Universiti Malaysia Perlis, Arau 02600, Perlis, Malaysia; (M.K.A.H.); (M.J.A.S.)
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11
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Labour classified by cervical dilatation & fetal membrane rupture demonstrates differential impact on RNA-seq data for human myometrium tissues. PLoS One 2021; 16:e0260119. [PMID: 34797869 PMCID: PMC8604334 DOI: 10.1371/journal.pone.0260119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 11/02/2021] [Indexed: 12/13/2022] Open
Abstract
High throughput sequencing has previously identified differentially expressed genes (DEGs) and enriched signalling networks in human myometrium for term (≥37 weeks) gestation labour, when defined as a singular state of activity at comparison to the non-labouring state. However, transcriptome changes that occur during transition from early to established labour (defined as ≤3 and >3 cm cervical dilatation, respectively) and potentially altered by fetal membrane rupture (ROM), when adapting from onset to completion of childbirth, remained to be defined. In the present study, we assessed whether differences for these two clinically observable factors of labour are associated with different myometrial transcriptome profiles. Analysis of our tissue (‘bulk’) RNA-seq data (NCBI Gene Expression Omnibus: GSE80172) with classification of labour into four groups, each compared to the same non-labour group, identified more DEGs for early than established labour; ROM was the strongest up-regulator of DEGs. We propose that lower DEGs frequency for early labour and/or ROM negative myometrium was attributed to bulk RNA-seq limitations associated with tissue heterogeneity, as well as the possibility that processes other than gene transcription are of more importance at labour onset. Integrative analysis with future data from additional samples, which have at least equivalent refined clinical classification for labour status, and alternative omics approaches will help to explain what truly contributes to transcriptomic changes that are critical for labour onset. Lastly, we identified five DEGs common to all labour groupings; two of which (AREG and PER3) were validated by qPCR and not differentially expressed in placenta and choriodecidua.
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12
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Cluitmans MJM, Bear LR, Nguyên UC, van Rees B, Stoks J, Ter Bekke RMA, Mihl C, Heijman J, Lau KD, Vigmond E, Bayer J, Belterman CNW, Abell E, Labrousse L, Rogier J, Bernus O, Haïssaguerre M, Hassink RJ, Dubois R, Coronel R, Volders PGA. Noninvasive detection of spatiotemporal activation-repolarization interactions that prime idiopathic ventricular fibrillation. Sci Transl Med 2021; 13:eabi9317. [PMID: 34788076 DOI: 10.1126/scitranslmed.abi9317] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Matthijs J M Cluitmans
- Cardiovascular Research Institute Maastricht, Maastricht University, 6200 MD Maastricht, Netherlands.,Philips Research, 5656 AE Eindhoven, Netherlands
| | | | - Uyên C Nguyên
- Cardiovascular Research Institute Maastricht, Maastricht University, 6200 MD Maastricht, Netherlands
| | - Bianca van Rees
- Cardiovascular Research Institute Maastricht, Maastricht University, 6200 MD Maastricht, Netherlands
| | - Job Stoks
- Cardiovascular Research Institute Maastricht, Maastricht University, 6200 MD Maastricht, Netherlands
| | - Rachel M A Ter Bekke
- Cardiovascular Research Institute Maastricht, Maastricht University, 6200 MD Maastricht, Netherlands
| | - Casper Mihl
- Cardiovascular Research Institute Maastricht, Maastricht University, 6200 MD Maastricht, Netherlands.,Department of Radiology, Maastricht University Medical Centre, 6200 MD Maastricht, Netherlands
| | - Jordi Heijman
- Cardiovascular Research Institute Maastricht, Maastricht University, 6200 MD Maastricht, Netherlands
| | - Kevin D Lau
- Philips Research, 5656 AE Eindhoven, Netherlands
| | | | | | - Charly N W Belterman
- Department of Experimental Cardiology, Amsterdam University Medical Centre, 1105 AZ Amsterdam, Netherlands
| | | | - Louis Labrousse
- IHU LIRYC, 33600 Pessac, France.,University of Bordeaux, 33000 Bordeaux, France.,Hôpital Haut Lévêque, University Hospital of Bordeaux, 33604 Bordeaux, France
| | - Julien Rogier
- IHU LIRYC, 33600 Pessac, France.,University of Bordeaux, 33000 Bordeaux, France.,Hôpital Haut Lévêque, University Hospital of Bordeaux, 33604 Bordeaux, France
| | - Olivier Bernus
- IHU LIRYC, 33600 Pessac, France.,University of Bordeaux, 33000 Bordeaux, France
| | - Michel Haïssaguerre
- IHU LIRYC, 33600 Pessac, France.,University of Bordeaux, 33000 Bordeaux, France.,Hôpital Haut Lévêque, University Hospital of Bordeaux, 33604 Bordeaux, France
| | - Rutger J Hassink
- Department of Cardiology, University Medical Centre Utrecht, 3584 CX Utrecht, Netherlands
| | | | - Ruben Coronel
- IHU LIRYC, 33600 Pessac, France.,Department of Experimental Cardiology, Amsterdam University Medical Centre, 1105 AZ Amsterdam, Netherlands
| | - Paul G A Volders
- Cardiovascular Research Institute Maastricht, Maastricht University, 6200 MD Maastricht, Netherlands
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13
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Malik M, Roh M, England SK. Uterine contractions in rodent models and humans. Acta Physiol (Oxf) 2021; 231:e13607. [PMID: 33337577 PMCID: PMC8047897 DOI: 10.1111/apha.13607] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 12/07/2020] [Accepted: 12/11/2020] [Indexed: 12/18/2022]
Abstract
Aberrant uterine contractions can lead to preterm birth and other labour complications and are a significant cause of maternal morbidity and mortality. To investigate the mechanisms underlying dysfunctional uterine contractions, researchers have used experimentally tractable small animal models. However, biological differences between humans and rodents change how researchers select their animal model and interpret their results. Here, we provide a general review of studies of uterine excitation and contractions in mice, rats, guinea pigs, and humans, in an effort to introduce new researchers to the field and help in the design and interpretation of experiments in rodent models.
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Affiliation(s)
- Manasi Malik
- Center for Reproductive Health Sciences Department of Obstetrics and Gynecology Washington University School of Medicine St. Louis MO USA
| | - Michelle Roh
- Center for Reproductive Health Sciences Department of Obstetrics and Gynecology Washington University School of Medicine St. Louis MO USA
| | - Sarah K. England
- Center for Reproductive Health Sciences Department of Obstetrics and Gynecology Washington University School of Medicine St. Louis MO USA
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14
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Garfield RE, Murphy L, Gray K, Towe B. Review and Study of Uterine Bioelectrical Waveforms and Vector Analysis to Identify Electrical and Mechanosensitive Transduction Control Mechanisms During Labor in Pregnant Patients. Reprod Sci 2020; 28:838-856. [PMID: 33090378 DOI: 10.1007/s43032-020-00358-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 10/11/2020] [Indexed: 12/15/2022]
Abstract
The bioelectrical signals that produce uterine contractions during parturition are not completely understood. The objectives are as follows: (1) to review the literature and information concerning uterine biopotential waveforms generated by the uterus, known to produce contractions, and evaluate mechanotransduction in pregnant patients using electromyographic (EMG) recording methods and (2) to study a new approach, uterine vector analysis, commonly used for the heart: vectorcardiography analysis. The patients used in this study were as follows: (1) patients at term not in labor (n = 3); (2) patients during the 1st stage of labor at cervical dilations from 2 to 10 cm (n = 30); and (3) patients in the 2nd stage of labor and during delivery (n = 3). We used DC-coupled electrodes and PowerLab hardware (model no. PL2604, ADInstruments, Castle Hill, Australia), with software (LabChart, ADInstruments) for storage and analysis of biopotentials. Uterine and abdominal EMG recordings were made from the surface of each patient using 3 electrode pairs with 1 pair (+ and -, with a 31-cm spacing distance) placed in the right/left position (X position) and with 1 pair placed in an up/down position (Y position, also 31 cm apart) and with the third pair at the front/back (Z position). Using signals from the three X, Y, and Z electrodes, slow (0.03 to 0.1 Hz, high amplitude) and fast wave (0.3 to 1 Hz, low amplitude) biopotentials were recorded. The amplitudes of the slow waves and fast waves were significantly higher during the 2nd stage of labor compared to the 1st stage (respectively, p = 9.54 × e-3 and p = 3.94 × e-7). When 2 channels were used, for example, the X vs. Y, for 2-D vector analysis or 3 channels, X vs. Y vs. Z, for 3-D analysis, are plotted against each other on their axes, this produces a vector electromyometriogram (EMMG) that shows no directionality for fast waves and a downward direction for slow waves. Similarly, during the 2nd stage of labor during abdominal contractions ("pushing"), the slow and fast waves were enlarged. Manual applied pressure was used to evoke bioelectrical activity to examine the mechanosensitivity of the uterus. Conclusions: (1) Phasic contractility of the uterus is a product of slow waves and groups of fast waves (bursts of spikes) to produce myometrial contractile responses. (2) 2-D and 3-D uterine vector analyses (uterine vector electromyometriogram) demonstrate no directionality of small fast waves while the larger slow waves represent the downward direction of biopotentials towards the cervical opening. (3) Myometrial cell action event excitability and subsequent contractility likely amplify slow wave activity input and uterine muscle contractility via mechanotransduction systems. (4) Models illustrate the possible relationships of slow to fast waves and the association of a mechanotransduction system and pacemaker activity as observed for slow waves and pacemakers in gastrointestinal muscle. (5) The interaction of these systems is thought to regulate uterine contractility. (6) This study suggests a potential indicator of delivery time. Such vector approaches might help us predict the progress of gestation and better estimate the timing of delivery, gestational pathologies reflected in bioelectric events, and perhaps the potential for premature delivery drug and mechanical interventions.
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Affiliation(s)
- R E Garfield
- Department of Obstetrics and Gynecology, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA.
| | - Lauren Murphy
- Department of Obstetrics and Gynecology, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA
| | - Kendra Gray
- Department of Obstetrics and Gynecology, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA
| | - Bruce Towe
- Department of Biomedical Engineering, Arizona State University, Tempe, AZ, USA
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15
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Spatial-dependent regularization to solve the inverse problem in electromyometrial imaging. Med Biol Eng Comput 2020; 58:1651-1665. [PMID: 32458384 DOI: 10.1007/s11517-020-02183-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 04/30/2020] [Indexed: 10/24/2022]
Abstract
Recently, electromyometrial imaging (EMMI) was developed to non-invasively image uterine contractions in three dimensions. EMMI collects body surface electromyography (EMG) measurements and uses patient-specific body-uterus geometry generated from magnetic resonance images to reconstruct uterine electrical activity. Currently, EMMI uses the zero-order Tikhonov method with mean composite residual and smoothing operator (CRESO) to stabilize the underlying ill-posed inverse computation. However, this method is empirical and implements a global regularization parameter over all uterine sites, which is sub-optimal for EMMI given the severe eccentricity of body-uterus geometry. To address this limitation, we developed a spatial-dependent (SP) regularization method that considers both body-uterus eccentricity and EMG noise. We used electrical signals simulated with spherical and realistic geometry models to compare the reconstruction accuracy of the SP method to those of the CRESO and the L-Curve methods. The SP method reconstructed electrograms and potential maps more accurately than the other methods, especially in cases of high eccentricity and noise contamination. Thus, the SP method should facilitate clinical use of EMMI and can be used to improve the accuracy of other electrical imaging modalities, such as Electrocardiographic Imaging. Graphical abstract The spatial-dependent regularization (SP) technique was designed to improve the accuracy of Electromyometrial Imaging (EMMI). The top panel shows the eccentricity of body-uterus geometry and four representative body surface electrograms. The bottom panel shows boxplots of correlation coefficients and relative errors for the electrograms reconstructed with SP and two conventional methods, the L-Curve and mean CRESO methods.
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16
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Ma X, Zhao P, Wakle-Prabagaran M, Amazu C, Malik M, Wu W, Wang H, Wang Y, England SK. Microelectrode array analysis of mouse uterine smooth muscle electrical activity†. Biol Reprod 2020; 102:935-942. [PMID: 31768528 DOI: 10.1093/biolre/ioz214] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 10/27/2019] [Accepted: 11/20/2019] [Indexed: 01/02/2023] Open
Abstract
Uterine contractions are important for various functions of the female reproductive cycle. Contractions are generated, in part, by electrical coupling of smooth muscle cells of the myometrium, the main muscle layer of the uterus. Aberrant myometrial electrical activity can lead to uterine dysfunction. To better understand and treat conditions associated with aberrant activity, it is crucial to understand the mechanisms that underlie normal activity. Here, we used microelectrode array (MEA) to simultaneously record and characterize myometrial electrical activities at high spatial and temporal resolution. Mouse myometrial longitudinal muscle tissue was isolated at different stages throughout the estrous cycle and placed on an 8×8 MEA. Electrical activity was recorded for 10 min at a sampling rate of 12.5 kHz. We used a spike-tracking algorithm to independently analyze each channel and developed a pipeline to quantify the amplitude, duration, frequency, and synchronicity of the electrical activities. Electrical activities in estrous were more synchronous, and had shorter duration, higher frequency, and lower amplitude than electrical activities in non-estrous. We conclude that MEA can be used to detect differential patterns of myometrial electrical activity in distinct estrous cycle stages. In the future, this methodology can be used to assess different physiological and pathological states and evaluate therapeutic agents that regulate uterine function.
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Affiliation(s)
- Xiaofeng Ma
- Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri, USA.,Center for Reproductive Health Sciences, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Peinan Zhao
- Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Monali Wakle-Prabagaran
- Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri, USA.,Center for Reproductive Health Sciences, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Chinwendu Amazu
- Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri, USA.,Center for Reproductive Health Sciences, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Manasi Malik
- Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri, USA.,Center for Reproductive Health Sciences, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Wenjie Wu
- Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri, USA.,Center for Reproductive Health Sciences, Washington University in St. Louis, St. Louis, Missouri, USA.,Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Hui Wang
- Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri, USA.,Center for Reproductive Health Sciences, Washington University in St. Louis, St. Louis, Missouri, USA.,Department of Physics, Washington University in St. Louis, St. Louis, Missouri, USA and
| | - Yong Wang
- Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri, USA.,Center for Reproductive Health Sciences, Washington University in St. Louis, St. Louis, Missouri, USA.,Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, Missouri, USA.,Department of Radiology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Sarah K England
- Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri, USA.,Center for Reproductive Health Sciences, Washington University in St. Louis, St. Louis, Missouri, USA
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17
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Abstract
Contractions are produced through a complex interplay of hormonal, mechanical, and electrical factors. In labor, contractions are measured using the Montevideo unit. Clinical considerations in labor wherein contraction assessment becomes paramount include the care of women whose labor is complicated by abnormal progress or tachysystole. In an era of obstetrics in which the high cesarean rate is a major issue of concern, there remain many questions as to how to best incorporate contraction monitoring into practice in order to optimize care. Technological advancement has led to the development on new modalities that can be used to study contraction physiology, and there may be an opportunity in the future to apply these methods for use in the clinical setting. This article also makes a case for the need to reevaluate the current measures of uterine contractile activity and the definition of contraction adequacy using updated definitions of normal labor progress.
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Affiliation(s)
- Stephen E Gee
- Department of Obstetrics & Gynecology, The Ohio State University College of Medicine, 395 W. 12th Ave, 5th floor, 43210 Columbus, OH, United States.
| | - Heather A Frey
- Department of Obstetrics & Gynecology, The Ohio State University College of Medicine, 395 W. 12th Ave, 5th floor, 43210 Columbus, OH, United States
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18
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Electromyometrial imaging dataset of electromyograms and isochrone maps under deformation/electrical noise contaminations. Data Brief 2020; 28:105078. [PMID: 31956675 PMCID: PMC6956746 DOI: 10.1016/j.dib.2019.105078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 12/23/2019] [Indexed: 11/23/2022] Open
Abstract
The dataset presented in this paper is related to the recent work "Accuracy of electromyometrial imaging of uterine contractions in clinical environment" [1]. The dataset including body-uterus geometry obtained from magnetic resonance imaging (MRI), uterine electrograms and isochrone maps reconstructed using Electromyometrial imaging (EMMI) under various levels of deformations and electrical noise contamination in a translational sheep model are reported. The dataset make it possible for detailed evaluation and further improvement of EMMI. In addition, the researchers working on other types of electrophysiology imaging techniques, such as electrocardiographic imaging (ECGI), and Electrogastrography imaging (EGGI) could also adopt our method [1] and employ the dataset to evaluate and improve their imaging techniques.
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19
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Wang H, Wu W, Talcott M, McKinstry RC, Woodard PK, Macones GA, Schwartz AL, Cuculich P, Cahill AG, Wang Y. Accuracy of electromyometrial imaging of uterine contractions in clinical environment. Comput Biol Med 2019; 116:103543. [PMID: 31786490 DOI: 10.1016/j.compbiomed.2019.103543] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 11/06/2019] [Accepted: 11/13/2019] [Indexed: 11/24/2022]
Abstract
Clinically, uterine contractions are monitored with tocodynamometers or intrauterine pressure catheters. In the research setting, electromyography (EMG), which detects electrical activity of the uterus from a few electrodes on the abdomen, is feasible, can provide more accurate data than these other methods, and may be useful for predicting preterm birth. However, EMG lacks sufficient spatial resolution and coverage to reveal where uterine contractions originate, how they propagate, and whether preterm contractions differ between women who do and do not progress to preterm delivery. To address those limitations, electromyometrial imaging (EMMI) was recently developed and validated to non-invasively assess three-dimensional (3D) electrical activation patterns on the entire uterine surface in pregnant sheep. EMMI uses magnetic resonance imaging to obtain subject-specific body-uterus geometry and collects uterine EMG data from up to 256 electrodes on the body surface. EMMI software then solves an ill-posed inverse computation to combine the two datasets and generate maps of electrical activity on the entire 3D uterine surface. Here, we assessed the feasibility to clinically translate EMMI by evaluating EMMI's accuracy under the unavoidable geometrical alterations and electrical noise contamination in a clinical environment. We developed a hybrid experimental-simulation platform to model the effects of fetal kicks, contractions, fetal/maternal movements, and noise contamination caused by maternal respiration and environmental electrical activity. Our data indicate that EMMI can accurately image uterine electrical activity in the presence of geometrical deformations and electrical noise, suggesting that EMMI can be reliably translated to non-invasively image 3D uterine electrical activation in pregnant women.
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Affiliation(s)
- Hui Wang
- Department of Physics, Washington University, St. Louis, MO, 63130, USA; Center for Reproductive Health Sciences, Washington University, St. Louis, MO, 63130, USA; Department of Obstetrics & Gynecology, School of Medicine, St. Louis, MO, 63110, USA.
| | - Wenjie Wu
- Center for Reproductive Health Sciences, Washington University, St. Louis, MO, 63130, USA; Department of Obstetrics & Gynecology, School of Medicine, St. Louis, MO, 63110, USA; Department of Biomedical Engineering, Washington University, St. Louis, MO, 63130, USA
| | - Michael Talcott
- Division of Comparative Medicine, Washington University, St. Louis, MO, 63110, USA
| | - Robert C McKinstry
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Pamela K Woodard
- Department of Biomedical Engineering, Washington University, St. Louis, MO, 63130, USA; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - George A Macones
- Department of Women's Health, University of Texas at Austin, Austin, TX, 78712, USA
| | - Alan L Schwartz
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Phillip Cuculich
- Department of Cardiology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Alison G Cahill
- Department of Women's Health, University of Texas at Austin, Austin, TX, 78712, USA.
| | - Yong Wang
- Center for Reproductive Health Sciences, Washington University, St. Louis, MO, 63130, USA; Department of Obstetrics & Gynecology, School of Medicine, St. Louis, MO, 63110, USA; Department of Biomedical Engineering, Washington University, St. Louis, MO, 63130, USA; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, 63110, USA.
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