Principles, techniques, and limitations of near infrared spectroscopy

Empirically Transformed Energy Patterns: A novel approach for capturing fNIRS signal dynamics in pain assessment

The accurate assessment of pain in clinical settings is challenging due to its subjective nature. In this study, we used functional near-infrared spectroscopy (fNIRS) to measure brain activity by detecting changes in blood oxygenation. Leveraging the AI4Pain Grand Challenge dataset, we aimed to classify pain levels into No Pain (NP), Low Pain (LP), and High Pain (HP) categories using both binary (NP vs. HP) and multiclass (NP vs. LP vs. HP) approaches. This involved collecting a comprehensive dataset of fNIRS data from 65 subjects, with recordings from 24 channels. We proposed novel Empirically Transformed Energy Patterns to extract meaningful bio-information related to pain conditions. An optimised Ensemble Classifier, evaluated using leave-one-subject-out cross-validation, was employed to classify pain levels. Our results demonstrated that this approach outperformed traditional classifiers, achieving 91.41% accuracy in the binary task and 68.20% accuracy in the multiclass task, with high sensitivity and specificity. This study highlights the effectiveness of using optimised machine learning models with fNIRS data for precise pain level classification, which holds significant potential for improving pain management in clinical settings.

Effects to cerebral oxygenation by arteriovenous fistula creation in patients with chronic kidney disease

BACKGROUND

Vascular access, including arteriovenous fistula (AVF), is essential in patients undergoing hemodialysis (HD). However, the presence of AVF is non-physiological in humans and could pose a burden to the systemic circulation or tissue microcirculation, potentially affecting tissue oxygenation, including in the brain. Recently, near-infrared spectroscopy has been used to measure regional oxygen saturation (rSO2) as a marker of cerebral oxygenation in various settings, including in patients undergoing HD. Thus far, no studies have reported changes in cerebral rSO2 before and after AVF creation. This study aimed to monitor the differences in cerebral oxygenation before and after AVF creation and to clarify the clinical factors affecting the changes in cerebral rSO2.

METHODS

Forty-eight patients (34 men, 14 women) with chronic kidney disease (CKD) who were not undergoing dialysis and newly created AVF were recruited. Cerebral rSO2 values before and after AVF creation were evaluated using near-infrared spectroscopy (INVOS 5100c).

RESULTS

Cerebral rSO2 values were significantly changed from 60.3% ± 7.5% to 58.4% ± 6.8% before and after AVF creation in all patients (p < 0.001). Cerebral rSO2 were also lower in patients with diabetes mellitus (DM) than in those without DM (57.5 ± 7.1 vs 63.7 ± 6.5, p = 0.003) before surgery; however, no differences of changes in cerebral rSO2 were observed between the two groups after AVF creation. Additionally, multivariate regression analysis identified changes in HR (standardized coefficient: 0.436) as independent factors associated with changes in cerebral rSO2.

CONCLUSION

Surgically created AVF was associated with the deterioration of cerebral rSO2 in patients with CKD not undergoing dialysis. Notably, AVF could cause cerebral hypoxia, and thus further studies are needed to clarify the clinical factors influencing changes in cerebral oxygenation after AVF creation.

A systematic review of multi-mode analytics for enhanced plant stress evaluation

Introduction

Detecting plant stress is a critical challenge in agriculture, where early intervention is essential to enhance crop resilience and maximize yield. Conventional single-mode approaches often fail to capture the complex interplay of plant health stressors.

Methods

This review integrates findings from recent advancements in Multi-Mode Analytics (MMA), which employs spectral imaging, image-based phenotyping, and adaptive computational techniques. It integrates machine learning, data fusion, and hyperspectral technologies to improve analytical accuracy and efficiency.

Results

MMA approaches have shown substantial improvements in the accuracy and reliability of early interventions. They outperform traditional methods by effectively capturing complex interactions among various abiotic stressors. Recent research highlights the benefits of MMA in enhancing predictive capabilities, which facilitates the development of timely and effective intervention strategies to boost agricultural productivity.

Discussion

The advantages of MMA over conventional single-mode techniques are significant, particularly in the detection and management of plant stress in challenging environments. Integrating advanced analytical methods supports precision agriculture by enabling proactive responses to stress conditions. These innovations are pivotal for enhancing food security in terrestrial and space agriculture, ensuring sustainability and resilience in food production systems.

Advanced aptamer-based sensors for monitoring theophylline

Theophylline is a widely used bronchodilator for treating asthma-related symptoms like shortness of breath and chest tightness. However, its narrow therapeutic plasma range (20-200 μM) necessitates careful monitoring of blood levels to prevent toxicity. Various clinical laboratory techniques have been developed for detecting theophylline, including spectroscopy, high-performance liquid chromatography (HPLC), fluorescence polarization immunoassay, and radioimmunoassay. Despite their utility, these methods are limited by complex sample preparation, long processing times, large sample volumes, and high costs. Aptamer-based biosensors have emerged as a promising alternative, offering superior selectivity and specificity compared to conventional methods. This review evaluates the performance of aptamer-based sensors in terms of sensitivity, specificity, and limit of detection, comparing them to traditional techniques. Recent studies demonstrate the advantages of aptamer-based sensors, including their simplicity, rapid response time, and cost-effectiveness, which make them ideal for point-of-care applications. The review also explores the methodologies used in aptamer-based detection, highlighting key innovations and advances in the field. Findings from the literature show how aptamer-based sensors enhance the monitoring of theophylline levels, overcoming the limitations of traditional techniques. This is the first review dedicated to discussing aptamer-based techniques for theophylline monitoring, addressing a gap in current literature.

The influence of cuff location on the oxygenation and reperfusion of the foot during ischemic preconditioning: A reliability study

Ischemic preconditioning (IPC) involves the application of occlusion cycles, typically prior to exercise. IPC is commonly applied at the arm or thigh for improving exercise performance, which can be combined with near-infrared spectroscopy (NIRS) to assess the microcirculation and tissue oxygenation. Despite the use of NIRS during IPC, few studies have investigated the reliability of NIRS during lower limb IPC with no relevant publications investigating IPC at the ankle. Therefore, the purpose of this study was to investigate the intra-session reliability in the NIRS measurements during repeated IPC at the thigh, ankle and arm. Eighteen participants volunteered. IPC was applied at the thigh (220 mmHg), ankle (individualized arterial occlusion pressure: 212 ± 24 mmHg) and arm (220 mmHg) in a randomized order involving 3 repeated cycles of 5-min occlusion and reperfusion, within a session. NIRS recorded tissue oxygen saturation (SO2), oxygenated (O2Hb) and deoxygenated hemoglobin (HHb) at the abductor hallucis muscle. Reliability was assessed using intraclass correlation coefficients. For all NIRS measurements assessed, there was excellent reliability (All ICC > 0.94) for the average, minimum and maximum values. The results indicate that IPC can successfully be applied at the ankle, offering reliable measures between three repeated occlusions within a session.

Comprehensive comparison on different wavelength selection methods using several near-infrared spectral datasets with different dimensionalities

NIR spectroscopy is widely used in chemical analysis, agricultural science, food safety, and other fields, but its high dimensionality and data redundancy bring analytical challenges. This study aims to compare the performance of different wavelength selection methods in NIR spectral datasets with different dimensionalities to provide a reference for researchers. The wavelength selection methods in this study were classified into four categories according to their principles, which are partial least squares (PLS) parameter-based methods, intelligent optimization algorithms (IOA)-based methods, model population analysis (MPA)-based methods and wavelength interval selection (WIS) methods. The performance of the models was compared in terms of R2C, R2P, root mean square error of calibration (RMSEC), root mean square error of prediction (RMSEP), the number of selected variables, computational time, and the improvement ratio of RMSEP (iRMSEP). The results showed that the models established by MPA-based and WIS methods were more stable and superior to the other categories of wavelength selection methods in most datasets. During the twenty characteristic wavelength selection methods in this study, bootstrapping soft shrinkage (BOSS) and genetic algorithm interval partial least squares (GA-iPLS) show the best performance at the overall level.

Evaluating the Intensity of Muscle Contraction by Near-Infrared Spectroscopy, a Potential Application for Scaling Muscle Spasm

Muscle spasticity, common in conditions such as cerebral palsy, spinal cord injury, and multiple sclerosis, is traditionally assessed using the Modified Ashworth Scale, which lacks consistency. This study evaluates near-infrared spectroscopy (NIRS) as a non-invasive tool for measuring muscle contraction intensity. Thirty-seven healthy adults performed isometric contractions at varying intensities (15%, 30%, 45%, and 60% of maximal voluntary contraction), with NIRS sensors monitoring changes in the Tissue Oxygenation Index (TOI) and electromyography (EMG) measuring muscle activity. Results demonstrated a significant negative correlation between contraction intensity and ΔTOI, indicating that higher contraction levels resulted in greater reductions in muscle oxygenation. Additionally, a multinomial logistic regression model confirmed that TOI could reliably predict contraction intensity (p < 0.001). This technique could provide real-time, objective data for spasticity assessment, potentially improving treatment plans.

Combined effects of weight reduction and hypoxia on physiological and perceptual responses to high-intensity exercise in endurance athletes

INTRODUCTION

This study investigated the effects of body weight (BW) reduction and hypoxia on physiological and perceptual responses during high-intensity interval exercise (HIIE) on the anti-gravity AlterG® treadmill.

MATERIAL & METHODS

Twenty-six participants (12 women, age: 26.2 years, height: 170.4 cm, weight: 67.8 kg, VO2max: 61.1 mL/min/kg) completed a HIIE in 5 randomized conditions: normoxia at 100%BW; normoxia at 80%BW; normoxia at 60%BW; hypoxia (FIO2 = 0.14) at 80%BW; and hypoxia at 60%BW. The HIIE included 3 sets of 8 × 30-s efforts interspersed with 30-s rest at 110% peak treadmill speed. Heart rate (HR), pulse arterial O2 saturation (SpO2), muscle deoxyhemoglobin concentration ([HHb]), and rate of perceived exertion (RPE) were continuously recorded. Blood lactate concentration ([Lac-]) was measured post-session.

RESULTS

BW reduction decreased HR, [Lac-] and RPE compared to control (p < 0.05) and [HHb] in men at the lowest %BW. When hypoxia was added, SpO2 was reduced from 98% to 85%. HR remained lower in all conditions compared to control (p < 0.05). RPE and [HHb] were higher in hypoxia than normoxic equivalent conditions (p < 0.05). [Lac-] was higher in Hyp80% compared to other conditions for men (p < 0.05). Despite subtle differences, men and women responded similarly to this exercise-environment combination.

CONCLUSION

Hypoxia effectively restored physiological stress during HIIE despite BW reduction, primarily impacting systemic rather than local muscular physiological parameters. This combination of methods may be beneficial in the rehabilitation and performance context.

Defecation after magnesium supplementation enhances cognitive performance in triathletes

Constipation is correlated with diminished cognitive function, revealing a possible rectum-brain connection. In this counter-balanced crossover trial, 13 elite triathletes underwent a Stroop test to assess cognitive function and executive control. The Stroop test was conducted both with and without magnesium oxide intake, with a 1-week washout period between sessions. Oxygenation and blood distribution during the cognitive challenge were measured using Near-Infrared Spectroscopy (NIRS). Measurements were taken in both the prefrontal brain and the sub-navel region, where the highest glucose uptake was detected under the 18F-fluorodeoxyglucose Positron Emission Tomography (PET) scan. A significant reduction in completion time for the Stroop test was observed after defecation compared to the non-defecated condition (non-defecation: [27.1 ​± ​1.1] s; non-magnesium defecation: [24.4 ​± ​0.9] s; magnesium defecation: [23.4 ​± ​0.8] s, p ​< ​0.05). Stroop test performance was improved in all (100%, 13/13) of the participants after magnesium-induced defecation and most (69%, 9/13) of the participants after non-magnesium-induced defecation. While no alterations in oxygenation and blood distribution were observed in the prefrontal brain during the Stroop test, decreased oxygenation levels were observed in the sub-navel region under both defecated conditions, without significant changes in blood distribution (p ​< ​0.05). This data suggests an acute increase in oxygen consumption at this specific region. The result of this study suggests an unexplored causal link between the state of the rectum and cognitive performance. Magnesium supplementation to improved rectal emptying presents a novel application for optimizing cognitive function in athletes navigating intricate racing conditions.

Comparison of the muscle oxygenation during submaximal and maximal exercise tests in patients post-coronavirus disease 2019 syndrome with pulmonary involvement

INTRODUCTION

Pulmonary involvement is prevalent in patients with coronavirus disease 2019 (COVID-19). Arterial hypoxemia may reduce oxygen transferred to the skeletal muscles, possibly leading to impaired exercise capacity. Oxygen uptake may vary depending on the increased oxygen demand of the muscles during submaximal and maximal exercise.

OBJECTIVE

This study aimed to compare muscle oxygenation during submaximal and maximal exercise tests in patients with post-COVID-19 syndrome with pulmonary involvement.

METHODS

Thirty-nine patients were included. Pulmonary function (spirometry), peripheral muscle strength (dynamometer), quadriceps femoris (QF) muscle oxygenation (Moxy® device), and submaximal exercise capacity (six-minute walk test (6-MWT)) were tested on the first day, maximal exercise capacity (cardiopulmonary exercise test (CPET)) was tested on the second day. Physical activity level was evaluated using an activity monitor worn for five consecutive days. Cardiopulmonary responses and muscle oxygenation were compared during 6-MWT and CPET.

RESULTS

Patients' minimum and recovery muscle oxygen saturation were significantly decreased; maximum total hemoglobin increased, heart rate, blood pressure, breathing frequency, dyspnea, fatigue, and leg fatigue at the end-of-test and recovery increased in CPET compared to 6-MWT (p < .050). Peak oxygen consumption (VO2peak) was 18.15 ± 4.75 ml/min/kg, VO2peak; percent predicted < 80% was measured in 51.28% patients. Six-MWT distance and QF muscle strength were less than 80% predicted in 58.9% and 76.9% patients, respectively.

CONCLUSIONS

In patients with post-COVID-19 syndrome with pulmonary involvement, muscle deoxygenation of QF is greater during maximal exercise than during submaximal exercise. Specifically, patients with lung impairment should be evaluated for deoxygenation and should be taken into consideration during pulmonary rehabilitation.

Tissue oxygenation in response to low-load and high-load back squats with continuous blood flow restriction in athletes

To determine muscle oxygenation with continuous blood flow restriction (BFR) training in high load (HL), 80% one-repetition maximum (1RM) and low load (LL), 30% 1RM squat exercises. In week-2 of a 4-week resistance training programme as part of their 3-set training routine, two groups of athletes (n = 4 each), one performing HL training with low cuff pressure (20% arterial occlusion pressure (AOP)), the other LL training with high cuff pressure (60% AOP) had muscle oxygenation assessed with near-infrared spectrophotometry (NIRS), arterial oxygen saturation (SPO2), heart rate (HR), barbell velocity and ratings of perceived exertion (RPE) during barbell back squats (BBS). Changes in the vastus lateralis oximetry were compared to pre- and post-training squat (1RM). Across athletes, there were significant associations between two pre-set-3 exercise variables and post-training 1RM, Tissue Saturation Index (TSI) (R2 = 0.92, p < 0.0002) and HHb concentration (R2 = 0.79, p < 0.003). Generalised regression models indicated that TSI % and HHb concentrations before and after set 3 timepoints were significant predictors of post-training 1RM in the LL group (R2 = 0.99, BIC = -24.9). Well-tolerated continuous LL-BFR training provided greater increases in strength than HL-BFR in athletes.

High-intensity interval training with blood-flow restriction enhances sprint and maximal aerobic power in male endurance athletes

High-intensity interval training (HIIT) can improve endurance performance. We investigated the concurrent impact of HIIT and blood-flow restriction (BFR) as a novel approach to further enhance maximal aerobic and anaerobic physiology and performances in trained athletes. In a randomized controlled trial, eighteen endurance-trained males ( V ˙ O2peak 65.6 ± 5.1 mL.min-1.kg-1) included three sessions of HIIT per week (sets of 15 s efforts at 100% maximal aerobic power, interspersed by 15 s recovery) into their usual training for 3 weeks, either with restriction imposed on both lower limbs at 50%-70% of arterial occlusion pressure (BFR group, n = 10) or without (CTL group, n = 8), and were tested for sprint and endurance exercise performance. The total mechanical work developed during a 30 s Wingate test increased only in BFR (3.6%, P = 0.02). During the Wingate, changes in near-infrared spectroscopy-derived vastus lateralis muscle oxygenation (Δ(deoxy[Hb + Mb]), % arterial occlusion) were attenuated after BFR training (-8.8%, P = 0.04). The maximal aerobic power measured during an incremental cycling test increased only in BFR (4.5%, P = 0.0004), but there was no change in V ˙ O2peak among groups. Both groups improved 5 km cycling time trial performance, but BFR displayed a concomitant greater elevation in [H+] (11%, P = 0.02). Changes in other blood variables (e.g., pH, lactate, bicarbonate and potassium ion concentration, and hemoglobin) were not different between groups. Combining short-duration HIIT performed at 100% aerobic power with BFR elicited greater changes in sprint performance and maximal aerobic power in endurance athletes, associated with locomotor muscle metabolic adaptations but no meaningful effect on cardiorespiratory fitness.

Intramuscular pH monitoring before and during exercise in individuals with intermittent claudication compared to healthy controls: A feasibility study

OBJECTIVE

In this feasibility study, firstly, we aimed to assess whether intramuscular pH (IMpH) could be measured with a glass-tipped electrode. Secondly, we aimed to explore whether we could monitor changes in skeletal muscle pH before and throughout static (isometric) and after dynamic (treadmill) exercise, comparing individuals with intermittent claudication (IC) to a group of healthy controls.

METHODS

Forty participants with IC (mean age ± SD) 68 ± 8) and 40 healthy volunteers (63 ± 10) were recruited. Participants in the IC group had an ankle brachial pressure index of <0.7 (mean: 0.62 ± 0.13). The first 20 participants in each group underwent isometric ankle dorsiflexion for 120 s at 30% of maximum voluntary contraction and the remainder underwent treadmill exercise (3.6 km/h, 5° incline) to maximal walking distance. A sterilised reusable 1.5 mm shatterproof, heat strengthened glass tipped pH probe inserted using a peripheral venous cannula and in combination with a pH meter was used to measure IMpH of the tibialis anterior muscle prior to, during and continuously for 1 h after exercise.

RESULTS

Resting IMpH was similar between the groups (median 6.8 (interquartile range (IQR) 6.7-6.9)) for IC individuals and 6.7 (6.6 to 6.8) for controls). Following isometric exercise, the magnitude of the decrease in IMpH was greatest in the IC group (median ΔpH max. in patients -0.2 (IQR: -0.2 to -0.1) versus -0.1 (IQR: -0.2 to -0.1) in the control group (p = 0.002). After treadmill exercise, the magnitude of the decrease in IMpH (ΔpH max) was greatest in individuals with IC (median ΔpH max. in patients -0.3 (IQR: -0.3 to -0.3) versus 0 (IQR: -0.2 to 0) in the control group, p = 0.04.

CONCLUSIONS

IMpH monitoring with a flexible glass probe inserted into the tibialis anterior muscle is viable and changes in IMpH during static and dynamic exercises are detected.

A 6-Minute Limb Function Assessment for Therapeutic Testing in Experimental Peripheral Artery Disease Models

In this study, we present a novel 6-minute limb function test that allows for the congruent assessment of muscular performance and hemodynamics in preclinical models of peripheral artery disease. Using several experimental conditions, the results demonstrate the superior efficacy of the 6-minute limb function test to detect differences in the response to hindlimb ischemia across several interventions, including where traditional perfusion recovery, capillary density, and muscle strength measures were unable to detect interventional differences, thus allowing for more rigorous assessment of preclinical therapies before clinical translation.

A NIRS-Based Technique for Monitoring Brain Tissue Oxygenation in Stroke Patients

Stroke is a global health issue caused by reduced blood flow to the brain, which leads to severe motor disabilities. Measuring oxygen levels in the brain tissue is crucial for understanding the severity and evolution of stroke. While CT or fMRI scans are preferred for confirming a stroke due to their high sensitivity, Near-Infrared Spectroscopy (NIRS)-based systems could be an alternative for monitoring stroke evolution. This study explores the potential of fNIRS signals to assess brain tissue in chronic stroke patients along with rehabilitation therapy. To study the feasibility of this proposal, ten healthy subjects and three stroke patients participated. For signal acquisition, two NIRS sensors were placed on the forehead of the subjects, who were asked to remain in a resting state for 5 min, followed by a 30 s motor task for each hand, which consists of opening and closing the hand at a steady pace, with a 1 min rest period in between. Acomplete protocol for placing sensors and a signal processing algorithm are proposed. In healthy subjects, a measurable change in oxygen saturation was found, with statistically significant differences (females p = 0.016, males p = 0.005) between the resting-state and the hand movement conditions. This work showed the feasibility of the complete proposal, including the NIRS sensor, the placement, the tasks protocol, and signal processing, for monitoring the state of the brain tissue cerebral oxygenation in stroke patients undergoing rehabilitation therapy. Thus this is a non-invasive barin assessment test based on fNIRS with the potential to be implemented in non-controlled clinical environments.

Surfactant administration and cerebral oxygenation and perfusion in preterm neonates - A systematic review of literature

BACKGROUND

Surfactant replacement is standard for preterm neonates with respiratory distress syndrome, improving survival and outcomes. Less invasive surfactant administration (LISA) and intubation-surfactant-extubation (INSURE) are preferred methods for surfactant replacement in spontaneously breathing preterm neonates. Despite the undeniable benefits of surfactant implementation in neonatal care, surfactant administration can affect vital parameters and cerebral oxygenation and perfusion, assessed by near-infrared spectroscopy (NIRS).

OBJECTIVE

This review systematically examined the literature on surfactant administration in preterm neonates and its impact on NIRS-measured cerebral oxygenation.

METHODS

A systematic search of PubMed, Embase, CINAHL, Clinical Trials, and Ovid Medline was conducted using following terms: newborn, infant, neonate, preterm, premature, prematurity, surfactant, LISA, less-invasive surfactant administration, INSURE, near-infrared-spectroscopy, NIRS, oximetry, spectroscopy, cerebral oxygenation, cerebral tissue oxygen saturation (crSO2), crSO2, cerebral perfusion. Only studies in human preterm neonates were included.

RESULTS

Sixteen studies were identified that described cerebral oxygenation measured by NIRS in the context of surfactant administration demonstrating a decrease in crSO2 during surfactant administration, followed by a subsequent increase. Three studies specifically described the course of crSO2 in neonates while receiving LISA, whereby in two of these LISA was compared to INSURE describing differences in crSO2 behaviour. Two additional studies described surfactant administration using the INSURE procedure and the influence on cerebral oxygenation. Ten studies investigated surfactant administration in intubated neonates receiving mechanical ventilation. One study described crSO2 in neonates receiving aerosolised surfactant.

CONCLUSION

This systematic review indicates that surfactant administration is associated with a transient decrease in crSO2 followed by a return to baseline levels, whereby differences between the LISA and INSURE methods were observed.

Emerging nanoprobes for the features visualization of vulnerable atherosclerotic plaques

Atherosclerosis (AS) is a major cause of cardiovascular disease. In particular, the unpredictable rupture of vulnerable atherosclerotic plaques (VASPs) can cause serious cardiovascular events such as myocardial infarction, stroke, and even sudden death. Therefore, early evaluation of the vulnerability of atherosclerotic plaques is of great importance. However, clinical imaging techniques are only marginally useful in the presence of severe anatomical structural changes, making it difficult to evaluate plaque vulnerability at an early stage. With the development of molecular imaging and nanotechnology, specific nanoprobes constructed for the pathological features of VASPs have attracted much attention for their ability to visualize VASPs early and noninvasively at the cellular and molecular levels. Here, we outline the pathological features of VASPs, analyze the superiority and limitations of current clinical imaging techniques, introduce the rational design principles of nanoprobes, and systematically summarize the application of nanoprobes to visualize the features of VASPs at the cellular and molecular levels. In addition, we discussed the prospects and urgent challenges in this field, and we believe it will provide new ideas for the early and accurate diagnosis of cardiovascular diseases.

Glass half full: Non-invasive bladder biosensors for urinary volume monitoring in the neurogenic pediatric population

PurposeThe goal was to elucidate and present the current landscape of bladder biosensor technology for urinary volume monitoring in the management of neurogenic bladder. The need for such technology in managing neurogenic bladder in the pediatric population is discussed, as well as the challenges researchers currently face in advancing individual technologies.MethodsA literature review including 43 articles discussing bladder biosensor and related technology for continuous urinary volume monitoring was conducted. Articles ranged from original research studies to systematic reviews.ResultsVarious continuous bladder urine volume monitoring devices have been proposed and evaluated. These devices utilize principles of ultrasound, electrical impedance tomography, near infrared spectroscopy, pressure biosensor implantation, microwave radar, and frequency modulated continuous wave radar. While several studies have shown promise in correlating device measurements to bladder urinary volume changes, ultimately researchers have not been able to surmount the challenges of optimizing configuration of device components and the impacts of dynamic position, posture, body habitus, bladder location, and urine biochemical properties that demonstrate high interpersonal variability.ConclusionThe need for developing bladder biosensor technology to provide continuous urine volume monitoring in patients with neurogenic bladder remains great. Transitioning from a time-based clean intermittent catheterization approach to a volume-based approach would possibly improve neurogenic bladder patients' quality of life. While technologies face limitations that have stalled translation to clinical practice, there is potential to build upon past work to address current challenges and meet this ever-pressing need.

Alpha-Delta Ratio for Detection of Cerebral Injury and Stroke in Pediatric Extracorporeal Membrane Oxygenation

INTRODUCTION

To assess the alpha-delta ratio (ADR) as a biomarker for cerebral injury and stroke in pediatric extracorporeal membrane oxygenation (ECMO).

METHODS

Retrospective study of children aged >44 weeks gestation to 21 years monitored with continuous electroencephalography during ECMO. The interhemispheric ADR difference between the left and right hemisphere was calculated per hour. A t -test was performed comparing the mean interhemispheric difference between controls and patients with cerebral injury at set intervals (i.e., 1, 3, 6, 9, 12, and 24 hours) from the start of continuous electroencephalography. Injury was established if confirmed by imaging on the same day as ECMO cannulation and acquired if confirmed the day after ECMO or later. Analysis of variance was performed to compare the mean interhemispheric difference in the ADR among control patients to those with early-acquired and late-acquired injury at 24 hours.

RESULTS

We included 49 patients with a median age of 3.4 years (interquartile range [1-10.4]), 47% (23/49) were male, and 73% (36/49) had cardiac arrest. Cerebrovascular injury was detected in 45% (22/49), with focal stroke in 82% (18/22). A significant difference was seen between control patients compared with cerebrovascular injury after 6 hours of continuous electroencephalography (0.016 vs. 0.042) (mean interhemispheric ADR difference) ( P = 0.03). Analysis of variance of control patients to early- and late-acquired injury at 24 hours showed a significant difference ( P = 0.03).

CONCLUSIONS

The ADR is a reliable metric to detect in-ECMO cerebral injury and stroke. Further study is needed to automate and assess this metric for real-time detection of stroke in ECMO.

The effect of haemoglobin and blood transfusion on preterm infant gut perfusion and injury

Introduction

There is significant uncertainty regarding the role that anaemia or red blood cell transfusion (RBCT) plays in the development of gut injury in preterm infants. This study evaluated Near Infrared Spectroscopy (NIRS) together with a range of known biomarkers of gut inflammation to identify their relationship with anaemia and RBCT.

Method

A prospective observational study of preterm infants born at <30 weeks gestation was conducted from birth until either 36 weeks post conceptional age or discharge home. Gut perfusion and biomarkers of gut injury were assessed weekly by: 60 min NIRS measurements (splanchnic tissue oxygenation index [sTOI] and fractional tissue oxygenation extraction [sFTOE]); stool calprotectin; urine intestinal and liver fatty acid binding proteins (I-FABPs and L-FABPs); and trefoil factor 3 (TFF-3). Exclusion criteria included Fetal Growth Restriction (FGR), and abnormal antenatal Dopplers. Haemoglobin (Hb) levels were measured in parallel with NIRS measurements. NIRS, together with urine and stool biomarkers of gut injury, were evaluated up to 72 h pre/post RBCT and pre/post measurements compared.

Results

Forty-eight infants were studied. Median (range) gestational age was 26 + 3 (23 + 0 to 29 + 6) weeks and birthweight 883.5 g (460-1,600). Seven (14.6%) infants developed ≥ Bells stage 2 NEC. 28 (58.3%), 5 (10.4%) and 24 (50%) infants had ECHO confirmed PDA, haemorrhagic parenchymal infarct (HPI) and IVH respectively. There were 22 episodes of sepsis. Infants were in the study for a median of 7.3 (1-13) weeks. There was no significant association between Hb divided into three categories (<80 g/L, 80-111.9 g/L and ≥120 g/L) or continuous values and sTOI, sFTOE or any of the gut injury biomarkers measured (p > 0.05). 283 RBCTs were administered; 117 (41.3%) within the first two weeks of life. Pre and post blood transfusion changes in splanchnic NIRS oxygenation, urine and stool gut injury biomarkers were measured in 165, 195 and 175 episodes of RBCT respectively. There was no significant post RBCT changes in splanchnic NIRS or gut injury biomarker levels (p > 0.05). However, post RBCT calprotectin was significantly reduced during the first 14 days of life (mean difference -114%, CI -185 to -42 & p 0.002).

Conclusion

There was no association between anaemia or RBCT with NIRS measurements of tissue oxygen saturation and biomarkers of intestinal inflammation or gut injury in preterm infants enrolled in this study. Further studies with standardised methods of examining the relationship between anaemia, RBCT and gut injury are needed.

Transcutaneous auricular vagus nerve stimulation improves cognitive decline by alleviating intradialytic cerebral hypoxia in hemodialysis patients: A fNIRS pilot study

Cognitive impairment is common in hemodialysis patients, possibly due to inadequate cerebral blood flow during hemodialysis. No effective non-pharmacological interventions are available. This study investigates the impact of hemodialysis-induced cerebral hypoxia on cognitive decline in hemodialysis patients and the potential of transcutaneous auricular vagus nerve stimulation (taVNS) as a non-pharmacological intervention. A randomized controlled trial with 36 participants showed that cognitive performance and cerebral oxygenation in the dorsolateral prefrontal cortex (DLPFC) significantly declined in the sham group. In contrast, taVNS improved cognitive function by increasing cerebral oxygenation, with significant correlations to reaction times and MoCA scores. The study suggests that Hemodialysis-induced cerebral hypoxia may contribute to persistent cognitive decline in MHD patients. However, taVNS could be an effective intervention to prevent cognitive impairment in hemodialysis patients by alleviating cerebral hypoxia.

Cryotherapy with carbon dioxide hydrate enhances immediate recovery of muscle function from neuromuscular fatigue

This study investigated the effect of cryotherapy with carbon dioxide hydrate (CDH) on fatigue recovery of neuromuscular function and muscle blood circulation. Fourteen young males randomly received three types of 20-min recovery interventions (cryotherapy with CDH [CDH-condition] or normal ice [ICE-condition], or quiet sitting at room temperature [CON-condition]) 5 min following a fatiguing task (50 maximal effort isotonic contractions) on three separate days. The isotonic peak power of the knee extensors at 35 min after the fatiguing task in the CDH-condition (95% of baseline) was greater than that in the other conditions (82-89% of baseline; p ≤ 0.031). In addition, at 25 and 35 min after the fatiguing task, the changes in haemoglobin concentration of the knee extensors from before the fatiguing task in the CON-condition (2.5 and 3.0 μmol/L) were different from those in the ICE-condition (-1.4 and -1.3 μmol/L; p ≤ 0.004) but comparable to those in the CDH-condition (1.1 and 0.7 μmol/L; p ≥ 0.060), respectively. These findings suggest that cryotherapy with CDH did not lower the blood volume following the intervention, unlike that with normal ice, and promoted greater immediate recovery of muscle power from neuromuscular fatigue compared with cryotherapy with ice or passive rest.

Using multivariate partial least squares on fNIRS data to examine load-dependent brain-behaviour relationships in aging

Researchers implementing non-invasive neuroimaging have reported distinct load-dependent brain activity patterns in older adults compared with younger adults. Although findings are mixed, these age-related patterns are often associated with compensatory mechanisms of cognitive decline even in the absence of direct comparisons between brain activity and cognitive performance. This study investigated the effects of cognitive load on brain-behavior relationships in younger and older adults using a data-driven, multivariate partial least squares (PLS) analysis of functional near-infrared spectroscopy (fNIRS) data. We measured bilateral prefrontal brain activity in 31 older and 27 younger adults while they performed single and dual 2-back tasks. Behavioral PLS analysis was used to determine relationships between performance metrics (reaction time and error rate) and brain oxygenation (HbO) and deoxygenation (HbR) patterns across groups and task loads. Results revealed significant age-group differences in brain-behavior relationships. In younger adults, increased brain activity (i.e., increased HbO and decreased HbR) was associated with faster reaction times and better accuracy in the single task, indicating sufficient neural capacity. Conversely, older adults showed a negative correlation between HbR and error rates in the single task; however, in the dual task, they demonstrated a positive relationship between HbO and performance, indicative of compensatory mechanisms under the higher cognitive load. Overall, older adults' showed relationships with either HbR or HbO, but not both, indicating that the robustness of the relationship between brain activity and behavior varies across task load conditions. Our PLS approach revealed distinct load-dependent brain activity between age groups, providing further insight into neurocognitive aging patterns, such as compensatory mechanisms, by emphasizing the variability and complexity of brain-behavior relationships. Our findings also highlight the importance of considering task complexity and cognitive demands in interpreting age-related brain activity patterns.

Near-infrared spectroscopy in the diagnosis and management of acute internal carotid artery occlusion

Acute internal carotid artery occlusion is a neurological emergency that can result in cerebral infarction. Superficial temporal artery to middle cerebral artery bypass is one option to treat a subset of such patients. Near-infrared spectroscopy (NIRS) is an emerging non-invasive technique that holds promise to facilitate the management of carotid occlusion patients by monitoring the oxygen saturation of specific brain areas at risk for hypoperfusion and infarction. This case report describes a man in his 50s who presented with left-sided weakness due to acute right internal carotid artery occlusion. The patient was successfully managed both medically and surgically while incorporating data from NIRS for decision-making.

Reliability and Convergent Validity of Endurance Indices Derived from Near-Infrared Spectroscopy and Electromyography during a Bilateral Hanging Task in Amateur Rock Climbers

Background: The ability to hang for a long time before forearm muscle fatigue is a crucial element of successful rock climbing. Electromyography (EMG) and near-infrared spectroscopy (NIRS) are also useful for measuring hemoglobin oxygenation for determining muscle endurance. In the present study, we aimed to evaluate the reliability and validity of muscle endurance indices derived using EMG and NIRS during a hanging task. Methods: A bilateral hanging task was designed to compare rock climbers and non-climbers in terms of the slopes of changes in the median frequency (MDF) and tissue oxygenation index (TOI) of forearm muscles. Results: A total of 17 participants were included in each of the two groups. The intraclass correlation coefficient (3,1) values derived for the MDF slope, TOI slope, ΔTOI, percentage change in oxygen concentration, and ΔHbt were 0.85, 0.73, 0.65, 0.75, and 0.65, respectively. The MDF slope, TOI slope, and ΔHbt differed significantly between the groups (p < 0.05). The MDF slope, TOI slopes, and ΔHbt were significantly correlated with V-scale levels for climbing (p < 0.05). Conclusions: The satisfactory reliability and observed distinctions between climbers and non-climbers imply that these indices are a valuable tool for assessing muscle endurance.

Can infrared light really be doing what we claim it is doing? Infrared light penetration principles, practices, and limitations

Near infrared (NIR) light has been shown to provide beneficial treatment of traumatic brain injury (TBI) and other neurological problems. This concept has spawned a plethora of commercial entities and practitioners utilizing panels of light emitting diodes (LEDs) and promising to treat patients with TBI and other disorders, who are desperate for some treatment for their untreatable conditions. Unfortunately, an LED intended to deliver photonic energy to the human brain does not necessarily do what an LED pointed at a mouse brain does. There is a problem of scale. Extensive prior research has shown that infrared light from a 0.5-watt LED will not penetrate the scalp and skull of a human. Both the properties of NIR light and the manner in which it interacts with tissue are examined. Based on these principles, the shortcomings of current approaches to treating neurological disorders with NIR light are explored. Claims of clinical benefit from low-level LED-based devices are explored and the proof of concept challenged. To date, that proof is thin with marginal benefits which are largely transient. Extensive research has shown fluence at the level of the target tissue which falls within the range of 0.9 J/cm2 to 15 J/cm2 is most effective in activating the biological processes at the cellular level which underlie direct photobiomodulation. If low-level infrared light from LED devices is not penetrating the scalp and skull, then these devices certainly are not delivering that level of fluence to the neurons of the subjacent brain. Alternative mechanisms, such as remote photobiomodulation, which may underlie the small and transient benefits for TBI symptoms reported for low-power LED-based NIR studies are presented. Actionable recommendations for the field are offered.

Suppression of subgingival bacteria by antimicrobial photodynamic therapy using transgingival irradiation: A randomized clinical trial

BACKGROUND

Antimicrobial photodynamic therapy (aPDT) is an effective method for eradicating bacteria in periodontal therapy. Standard aPDT requires the insertion of a laser tip into a periodontal pocket, in which the direction of irradiation is limited. Therefore, we devised an aPDT method that uses a transgingival near-infrared wavelength and indocyanine green-encapsulated and chitosan-coated nanoparticles as a photosensitizer.

METHODS

Forty patients undergoing supportive periodontal therapy, who had a single root tooth with a pocket of 5 mm or deeper, were used as subjects. In the test group, aPDT was performed by laser irradiation from outside the gingiva using photosensitizer nanoparticles. In the control group, pseudo aPDT without photosensitizer was performed by transgingival irradiation. Subgingival plaque was sampled from inside the pocket before, immediately after, and 1 week after treatment, and evaluated by colony counting and real-time polymerase chain reaction.

RESULTS

There were no significant differences in age, sex, periodontal pocket depth, and bleeding on probing between the test and control groups. Compared with the colony count before treatment, the count in the test group was significantly reduced immediately after treatment. The number of patients with colony reduction to ≤50% and ≤10% was significantly higher in the test group than in the control group. None of the participants reported pain, although one participant reported discomfort.

CONCLUSION

As a bacterial control method for residual pockets in patients undergoing supportive periodontal therapy, transgingival aPDT is a promising treatment strategy that is not generally accompanied by pain or discomfort.

Advancing DIEP Flap Monitoring with Optical Imaging Techniques: A Narrative Review

OBJECTIVES

This review aims to explore recent advancements in optical imaging techniques for monitoring the viability of Deep Inferior Epigastric Perforator (DIEP) flap reconstruction. The objectives include highlighting the principles, applications, and clinical utility of optical imaging modalities such as near-infrared spectroscopy (NIRS), indocyanine green (ICG) fluorescence angiography, laser speckle contrast imaging (LSCI), hyperspectral imaging (HSI), dynamic infrared thermography (DIRT), and short-wave infrared thermography (SWIR) in assessing tissue perfusion and oxygenation. Additionally, this review aims to discuss the potential of these techniques in enhancing surgical outcomes by enabling timely intervention in cases of compromised flap perfusion.

MATERIALS AND METHODS

A comprehensive literature review was conducted to identify studies focusing on optical imaging techniques for monitoring DIEP flap viability. We searched PubMed, MEDLINE, and relevant databases, including Google Scholar, Web of Science, Scopus, PsycINFO, IEEE Xplore, and ProQuest Dissertations & Theses, among others, using specific keywords related to optical imaging, DIEP flap reconstruction, tissue perfusion, and surgical outcomes. This extensive search ensured we gathered comprehensive data for our analysis. Articles discussing the principles, applications, and clinical use of NIRS, ICG fluorescence angiography, LSCI, HSI, DIRT, and SWIR in DIEP flap monitoring were selected for inclusion. Data regarding the techniques' effectiveness, advantages, limitations, and potential impact on surgical decision-making were extracted and synthesized.

RESULTS

Optical imaging modalities, including NIRS, ICG fluorescence angiography, LSCI, HSI, DIRT, and SWIR offer a non- or minimal-invasive, real-time assessment of tissue perfusion and oxygenation in DIEP flap reconstruction. These techniques provide objective and quantitative data, enabling surgeons to monitor flap viability accurately. Studies have demonstrated the effectiveness of optical imaging in detecting compromised perfusion and facilitating timely intervention, thereby reducing the risk of flap complications such as partial or total loss. Furthermore, optical imaging modalities have shown promise in improving surgical outcomes by guiding intraoperative decision-making and optimizing patient care.

CONCLUSIONS

Recent advancements in optical imaging techniques present valuable tools for monitoring the viability of DIEP flap reconstruction. NIRS, ICG fluorescence angiography, LSCI, HSI, DIRT, and SWIR offer a non- or minimal-invasive, real-time assessment of tissue perfusion and oxygenation, enabling accurate evaluation of flap viability. These modalities have the potential to enhance surgical outcomes by facilitating timely intervention in cases of compromised perfusion, thereby reducing the risk of flap complications. Incorporating optical imaging into clinical practice can provide surgeons with objective and quantitative data, assisting in informed decision-making for optimal patient care in DIEP flap reconstruction surgeries.

Cerebral and muscle tissue oxygenation during exercise in healthy adults: A systematic review

BACKGROUND

Near-infrared spectroscopy (NIRS) technology has allowed for the measurement of cerebral and skeletal muscle oxygenation simultaneously during exercise. Since this technology has been growing and is now successfully used in laboratory and sports settings, this systematic review aimed to synthesize the evidence and enhance an integrative understanding of blood flow adjustments and oxygen (O2) changes (i.e., the balance between O2 delivery and O2 consumption) within the cerebral and muscle systems during exercise.

METHODS

A systematic review was conducted using PubMed, Embase, Scopus, and Web of Science databases to search for relevant studies that simultaneously investigated cerebral and muscle hemodynamic changes using the near-infrared spectroscopy system during exercise. This review considered manuscripts written in English and available before February 9, 2023. Each step of screening involved evaluation by 2 independent authors, with disagreements resolved by a third author. The Joanna Briggs Institute Critical Appraisal Checklist was used to assess the methodological quality of the studies.

RESULTS

Twenty studies were included, of which 80% had good methodological quality, and involved 290 young or middle-aged adults. Different types of exercises were used to assess cerebral and muscle hemodynamic changes, such as cycling (n = 11), treadmill (n = 1), knee extension (n = 5), isometric contraction of biceps brachii (n = 3), and duet swim routines (n = 1). The cerebral hemodynamics analysis was focused on the frontal cortex (n = 20), while in the muscle, the analysis involved vastus lateralis (n = 18), gastrocnemius (n = 3), biceps brachii (n = 5), deltoid (n = 1), and intercostal muscle (n = 1). Overall, muscle deoxygenation increases during exercise, reaching a plateau in voluntary exhaustion, while in the brain, oxyhemoglobin concentration increases with exercise intensity, reaching a plateau or declining at the exhaustion point.

CONCLUSION

Muscle and cerebral oxygenation respond differently to exercise, with muscle increasing O2 utilization and cerebral tissue increasing O2 delivery during exercise. However, at the exhaustion point, both muscle and cerebral oxygenation become compromised. This is characterized by a reduction in blood flow and a decrease in O2 extraction in the muscle, while in the brain, oxygenation reaches a plateau or decline, potentially resulting in motor failure during exercise.

Short-term cutaneous vasodilatory and thermosensory effects of topical methyl salicylate

Introduction

Methyl salicylate, the main compound of wintergreen oil, is widely used in topical applications. However, its vascular and thermosensory effects are not fully understood. The primary aim was to investigate the effects of topical methyl salicylate on skin temperature (Tskin), skin microcirculation (MCskin) and muscle oxygen saturation (SmO2) compared to a placebo gel. The secondary aim was to assess thermosensory responses (thermal sensation, thermal comfort) and to explore to which extent these sensations correspond to the physiological responses over time.

Methods

21 healthy women (22.2 ± 2.9 years) participated in this single-blind, randomized controlled trial. Custom-made natural wintergreen oil (12.9%), containing methyl salicylate (>99%) and a placebo gel, 1 g each, were applied simultaneously to two paravertebral skin areas (5 cm × 10 cm, Th4-Th7). Tskin (infrared thermal imaging), MCskin (laser speckle contrast imaging) and SmO2 (deep tissue oxygenation monitoring) and thermosensation (Likert scales) were assessed at baseline (BL) and at 5-min intervals during a 45 min post-application period (T0-T45).

Results

Both gels caused an initial decrease in Tskin, with Tskin(min) at T5 for both methyl salicylate (BL-T5: Δ-3.36°C) and placebo (BL-T5: Δ-3.90°C), followed by a gradual increase (p < .001). Methyl salicylate gel resulted in significantly higher Tskin than placebo between T5 and T40 (p < .05). For methyl salicylate, MCskin increased, with MCskin(max) at T5 (BL-T5: Δ88.7%). For placebo, MCskin decreased (BL-T5: Δ-17.5%), with significantly lower values compared to methyl salicylate between T0 and T45 (p < .05). Both gels had minimal effects on SmO2, with no significant differences between methyl salicylate and placebo (p > .05). Thermal sensation responses to topical methyl salicylate ranged from "cool" to "hot", with more intense sensations reported at T5.

Discussion

The findings indicate that topical methyl salicylate induces short-term cutaneous vasodilation, but it may not enhance skeletal muscle blood flow. This study highlights the complex sensory responses to its application, which may be based on the short-term modulation of thermosensitive transient receptor potential channels.

Altered Functional Connectivity of Temporoparietal Lobe in Obstructive Sleep Apnea: A Resting-State fNIRS Study

Obstructive Sleep Apnea (OSA), a sleep disorder with high prevalence, is normally accompanied by affective, autonomic, and cognitive abnormalities, and is deemed to be linked to functional brain alterations. To investigate alterations in brain functional connectivity properties in patients with OSA, a comparative analysis of global and local topological properties of brain networks was conducted between patients with OSA and healthy controls (HCs), utilizing functional near-infrared spectroscopy (fNIRS) imaging. A total of 148 patients with OSA and 150 healthy individuals were involved. Firstly, quantitative alterations in blood oxygen concentration, changes in functional connectivity, and variations in graph theory-based network topological characteristics were assessed. Then, with Mann-Whitney statistics, this study compared whether there are significant differences in the above characteristics between patients with OSA and HCs. Lastly, the study further examined the correlation between the altered characteristics and the apnea hypopnea index (AHI) using linear regression. Results revealed a higher mean and standard deviation of hemoglobin concentration in the superior temporal gyrus among patients with OSA compared to HCs. Resting-state functional connectivity (RSFC) exhibited a slight increase between the superior temporal gyrus and other specific areas in patients with OSA. Notably, neither patients with OSA nor HCs demonstrated significant small-world network properties. Patients with OSA displayed an elevated clustering coefficient (p < 0.05) and local efficiency (p < 0.05). Additionally, patients with OSA exhibited a tendency towards increased nodal betweenness centrality (p < 0.05) and degree centrality (p < 0.05) in the right supramarginal gyrus, as well as a trend towards higher betweenness centrality (p < 0.05) in the right precentral gyrus. The results of multiple linear regressions indicate that the influence of the AHI on RSFC between the right precentral gyrus and right superior temporal gyrus (p < 0.05), as well as between the right precentral gyrus and right supramarginal gyrus (p < 0.05), are statistically significant. These findings suggest that OSA may compromise functional brain connectivity and network topological properties in affected individuals, serving as a potential neurological mechanism underlying the observed abnormalities in brain function associated with OSA.

[Cerebral oxygen metabolism and brain electrical activity of healthy full-term neonates in high-altitude areas: a multicenter clinical research protocol]

Further evidence is needed to explore the impact of high-altitude environments on the neurologic function of neonates. Non-invasive techniques such as cerebral near-infrared spectroscopy and amplitude-integrated electroencephalography can provide data on cerebral oxygenation and brain electrical activity. This study will conduct multiple cerebral near-infrared spectroscopy and amplitude-integrated electroencephalography monitoring sessions at various time points within the first 3 days postpartum for healthy full-term neonates at different altitudes. The obtained data on cerebral oxygenation and brain electrical activity will be compared between different altitudes, and corresponding reference ranges will be established. The study involves 6 participating centers in the Chinese High Altitude Neonatal Medicine Alliance, with altitude gradients divided into 4 categories: 800 m, 1 900 m, 2 400 m, and 3 500 m, with an anticipated sample size of 170 neonates per altitude gradient. This multicenter prospective cohort study aims to provide evidence supporting the impact of high-altitude environments on early brain function and metabolism in neonates.

A 6-minute Limb Function Assessment for Therapeutic Testing in Experimental Peripheral Artery Disease Models

Background

The translation of promising therapies from pre-clinical models of hindlimb ischemia (HLI) to patients with peripheral artery disease (PAD) has been inadequate. While this failure is multifactorial, primary outcome measures in preclinical HLI models and clinical trials involving patients with PAD are not aligned well. For example, laser Doppler perfusion recovery measured under resting conditions is the most used outcome in HLI studies, whereas clinical trials involving patients with PAD primarily assess walking performance. Here, we sought to develop a 6-min limb function test for preclinical HLI models that assess muscular performance and hemodynamics congruently.

Methods

We developed an in situ 6-min limb function test that involves repeated isotonic (shortening) contractions performed against a submaximal load. Continuous measurement of muscle blood flow was performed using laser Doppler flowmetry. Quantification of muscle power, work, and perfusion are obtained across the test. To assess the efficacy of this test, we performed HLI via femoral artery ligation on several mouse strains: C57BL6J, BALBc/J, and MCK-PGC1α (muscle-specific overexpression of PGC1α). Additional experiments were performed using an exercise intervention (voluntary wheel running) following HLI.

Results

The 6-min limb function test was successful at detecting differences in limb function of C57BL6/J and BALBc/J mice subjected to HLI with effect sizes superior to laser Doppler perfusion recovery. C57BL6/J mice randomized to exercise therapy following HLI had smaller decline in muscle power, greater hyperemia, and performed more work across the 6-min limb function test compared to non-exercise controls with HLI. Mice with muscle-specific overexpression of PGC1α had no differences in perfusion recovery in resting conditions, but exhibited greater capillary density, increased muscle mass and absolute force levels, and performed more work across the 6-min limb function test compared to their wildtype littermates without the transgene.

Conclusion

These results demonstrate the efficacy of the 6-min limb function test to detect differences in the response to HLI across several interventions including where traditional perfusion recovery, capillary density, and muscle strength measures were unable to detect therapeutic differences.

Unveiling the synergy of NIRS and enrichment technologies: A comprehensive review of in-sorbent-based detection and quantification strategies

This comprehensive review paper aims to captivate the applicability of in-sorbent detection, where near-infrared spectroscopy (NIRS) converges with enrichment technologies. For this purpose, we collected and summarized information regarding the combination of several sophisticated analytical enrichment techniques with NIRS to further explore and develop this synergistic approach. Peer-reviewed publications, matching the criteria of in situ NIR measurements prior analyte elution, have been collected, investigated, and concluded within this review. Investigations according to used materials, commercial or self-made, composition, organic or inorganic and applied analytical methodologies have been carried out. Applications extending over a multitude of chemical fields, from environmental to medicinal applications. As this review concludes, the combination of these techniques further expands the applicability of NIRS and moreover tries to solve the long-standing issue of the comparably low sensitivity regarding this vibrational technique.

Non-Invasive Estimation of Intracranial Pressure-Derived Cerebrovascular Reactivity Using Near-Infrared Spectroscopy Sensor Technology in Acute Neural Injury: A Time-Series Analysis

The contemporary monitoring of cerebrovascular reactivity (CVR) relies on invasive intracranial pressure (ICP) monitoring which limits its application. Interest is shifting towards near-infrared spectroscopic regional cerebral oxygen saturation (rSO2)-based indices of CVR which are less invasive and have improved spatial resolution. This study aims to examine and model the relationship between ICP and rSO2-based indices of CVR. Through a retrospective cohort study of prospectively collected physiologic data in moderate to severe traumatic brain injury (TBI) patients, linear mixed effects modeling techniques, augmented with time-series analysis, were utilized to evaluate the ability of rSO2-based indices of CVR to model ICP-based indices. It was found that rSO2-based indices of CVR had a statistically significant linear relationship with ICP-based indices, even when the hierarchical and autocorrelative nature of the data was accounted for. This strengthens the body of literature indicating the validity of rSO2-based indices of CVR and potential greatly expands the scope of CVR monitoring.

A priori free spectral unmixing with periodic absorbance changes: application for auto-calibrated intraoperative functional brain mapping

Spectral unmixing designates techniques that allow to decompose measured spectra into linear or non-linear combination of spectra of all targets (endmembers). This technique was initially developed for satellite applications, but it is now also widely used in biomedical applications. However, several drawbacks limit the use of these techniques with standard optical devices like RGB cameras. The devices need to be calibrated and a a priori on the observed scene is often necessary. We propose a new method for estimating endmembers and their proportion automatically and without calibration of the acquisition device based on near separable non-negative matrix factorization. This method estimates the endmembers on spectra of absorbance changes presenting periodic events. This is very common in in vivo biomedical and medical optical imaging where hemodynamics dominate the absorbance fluctuations. We applied the method for identifying functional brain areas during neurosurgery using four different RGB cameras (an industrial camera, a smartphone and two surgical microscopes). Results obtained with the auto-calibration method were consistent with the intraoperative gold standards. Endmembers estimated with the auto-calibration method were similar to the calibrated endmembers used in the modified Beer-Lambert law. The similarity was particularly strong when both cardiac and respiratory periodic events were considered. This work can allow a widespread use of spectral imaging in the industrial or medical field.

Motion-resistant three-wavelength spatial frequency domain imaging system with ambient light suppression using an 8-tap CMOS image sensor

Significance

We present a motion-resistant three-wavelength spatial frequency domain imaging (SFDI) system with ambient light suppression using an 8-tap complementary metal-oxide semiconductor (CMOS) image sensor (CIS) developed at Shizuoka University. The system addresses limitations in conventional SFDI systems, enabling reliable measurements in challenging imaging scenarios that are closer to real-world conditions.

Aim

Our study demonstrates a three-wavelength SFDI system based on an 8-tap CIS. We demonstrate and evaluate the system's capability of mitigating motion artifacts and ambient light bias through tissue phantom reflectance experiments and in vivo volar forearm experiments.

Approach

We incorporated the Hilbert transform to reduce the required number of projected patterns per wavelength from three to two per spatial frequency. The 8-tap image sensor has eight charge storage diodes per pixel; therefore, simultaneous image acquisition of eight images based on multi-exposure is possible. Taking advantage of this feature, the sensor simultaneously acquires images for planar illumination, sinusoidal pattern projection at three wavelengths, and ambient light. The ambient light bias is eliminated by subtracting the ambient light image from the others. Motion artifacts are suppressed by reducing the exposure and projection time for each pattern while maintaining sufficient signal levels by repeating the exposure. The system is compared to a conventional SFDI system in tissue phantom experiments and then in vivo measurements of human volar forearms.

Results

The 8-tap image sensor-based SFDI system achieved an acquisition rate of 9.4 frame sets per second, with three repeated exposures during each accumulation period. The diffuse reflectance maps of three different tissue phantoms using the conventional SFDI system and the 8-tap image sensor-based SFDI system showed good agreement except for high scattering phantoms. For the in vivo volar forearm measurements, our system successfully measured total hemoglobin concentration, tissue oxygen saturation, and reduced scattering coefficient maps of the subject during motion (16.5 cm/s) and under ambient light (28.9 lx), exhibiting fewer motion artifacts compared with the conventional SFDI.

Conclusions

We demonstrated the potential for motion-resistant three-wavelength SFDI system with ambient light suppression using an 8-tap CIS.

Using multi-channel near-infrared spectroscopy to assess the effect of cupping therapy on the spatial hemodynamic response of the biceps muscle: A preliminary study

BACKGROUND

The local hemodynamic response after cupping therapy has been considered as a contributing factor for improving muscle tissue health; however, the effects of cupping pressure and duration on the spatial hemodynamic response have not been investigated.

OBJECTIVE

The objective of this study was to investigate the hemodynamic response inside and outside the cupping cup under various pressures and durations of cupping therapy.

METHODS

A 3-way factorial design with repeated measures was used to investigate the main and interaction effects of the location (areas inside and outside the cup), pressure (-225 and -300 mmHg) and duration (5 and 10 min) on the hemodynamic response of the biceps muscle. A functional near-infrared spectroscopy was used to assess hemodynamic changes in 18 participants.

RESULTS

A significant three-way interaction of the location, pressure, and duration factors was observed in oxyhemoglobin (p= 0.023), deoxy-hemoglobin (p= 0.013), and blood volume (p= 0.013). A significant increase was observed in oxyhemoglobin, blood volume, and oxygenation compared to pre-cupping (p< 0.05) in the area outside the cup.

CONCLUSION

Our findings indicate that an appropriate combination of cupping pressure and duration can effectively affect the spatial hemodynamic response of the biceps.

In vivocharacterization of the optical and hemodynamic properties of the human sternocleidomastoid muscle through ultrasound-guided hybrid near-infrared spectroscopies

Objective.In this paper, we present a detailedin vivocharacterization of the optical and hemodynamic properties of the human sternocleidomastoid muscle (SCM), obtained through ultrasound-guided near-infrared time-domain and diffuse correlation spectroscopies.Approach.A total of sixty-five subjects (forty-nine females, sixteen males) among healthy volunteers and thyroid nodule patients have been recruited for the study. Their SCM hemodynamic (oxy-, deoxy- and total hemoglobin concentrations, blood flow, blood oxygen saturation and metabolic rate of oxygen extraction) and optical properties (wavelength dependent absorption and reduced scattering coefficients) have been measured by the use of a novel hybrid device combining in a single unit time-domain near-infrared spectroscopy, diffuse correlation spectroscopy and simultaneous ultrasound imaging.Main results.We provide detailed tables of the results related to SCM baseline (i.e. muscle at rest) properties, and reveal significant differences on the measured parameters due to variables such as side of the neck, sex, age, body mass index, depth and thickness of the muscle, allowing future clinical studies to take into account such dependencies.Significance.The non-invasive monitoring of the hemodynamics and metabolism of the sternocleidomastoid muscle during respiration became a topic of increased interest partially due to the increased use of mechanical ventilation during the COVID-19 pandemic. Near-infrared diffuse optical spectroscopies were proposed as potential practical monitors of increased recruitment of SCM during respiratory distress. They can provide clinically relevant information on the degree of the patient's respiratory effort that is needed to maintain an optimal minute ventilation, with potential clinical application ranging from evaluating chronic pulmonary diseases to more acute settings, such as acute respiratory failure, or to determine the readiness to wean from invasive mechanical ventilation.

Muscle specific declines in oxygen saturation during acute ambulation with hands-free and conventional mobility devices

Disuse is associated with reduced muscle oxygen saturation (SmO2). Improving oxygen delivery to tissues is important for healing, preventing muscle atrophy, and reducing the risk of deep vein thrombosis. Mobility devices are used during disuse periods to ambulate and protect the injured limb. This study examined SmO2 in walking and ambulation with various mobility devices. Thirty-eight participants randomly completed four, ten-minute trials which included: (1) walking, (2) medical kneeling scooter (MKS), (3) hands-free crutch (HFC), and (4) axillary crutch (AC). During each trial, near infrared spectroscopy sensors were placed on the vastus lateralis (VL), biceps femoris (BF), and lateral gastrocnemius (LG) of the right limb. Compared to walking, all mobility devices showed a decline in SmO2 in the VL of ∼10% (mean ± SD; 75% ± 12%-65% ± 17%, P < 0.05). In the BF, SmO2 declined ∼9% in AC compared to walking (76% ± 12%-67% ± 17%, P = 0.025). In the LG, SmO2 declined in AC (64% ± 16%) compared to MKS (70% ± 15%, P = 0.005). There were no differences in LG SmO2 compared to walking (69% ± 13%) in MKS (P > 0.05) or HFC (65% ± 15%, P > 0.05). In young, healthy volunteers, the use of mobility devices altered muscle oxygenation in several muscles. AC reduced muscle oxygenation in the VL, BF, and LG; while MKS and HFC maintained BF and LG muscle oxygenation at a level consistent with ambulatory walking.

Neurovascular Hypoxia Trajectories Assessed by Photoacoustic Imaging in a Murine Model of Cardiac Arrest and Resuscitation

Cardiac arrest is a common cause of death annually mainly due to postcardiac arrest syndrome that leads to multiple organ global hypoxia and dysfunction after resuscitation. The ability to quantify vasculature changes and tissue oxygenation is crucial to adapt patient treatment in order to minimize major outcomes after resuscitation. For the first time, we applied high-resolution ultrasound associated with photoacoustic imaging (PAI) to track neurovascular oxygenation and cardiac function trajectories in a murine model of cardiac arrest and resuscitation. We report the preservation of brain oxygenation is greater compared to that in peripheral tissues during the arrest. Furthermore, distinct patterns of cerebral oxygen decay may relate to the support of vital brain functions. In addition, we followed trajectories of cerebral perfusion and cardiac function longitudinally after induced cardiac arrest and resuscitation. Volumetric cerebral oxygen saturation (sO2) decreased 24 h postarrest, but these levels rebounded at one week. However, systolic and diastolic cardiac dysfunction persisted throughout and correlated with cerebral hypoxia. Pathophysiologic biomarker trends, identified via cerebral PAI in preclinical models, could provide new insights into understanding the pathophysiology of cardiac arrest and resuscitation.

Prefrontal NIRS signal is unaffected by forehead Doppler flux during incremental cycling exercise

Near-infrared spectroscopy (NIRS) is used to measure tissue concentrations of oxyhemoglobin (O2 Hb) and deoxyhemoglobin (HHb). In the context of exercise, NIRS confers a higher signal-to-noise ratio than other neuroimaging techniques. However, part of the signal may be influenced by thermoregulatory hyperemia in the superficial cutaneous capillaries of the forehead. The degree to which NIRS signals during exercise reflect cerebral or extracerebral hemodynamic changes is a continuing source of controversy. However, the influence of skin blood flow may be attenuated depending on the NIRS technique (e.g., frequency domain machines with maximal optode separation distances >3.5 cm). The purpose of this study was to compare the changes in forehead skin blood flow and cerebral hemoglobin concentration during incremental exercise versus direct vasodilation of the forehead skin induced by gradual local heating. Thirty participants (12 females, 18 males; age: 20.8 ± 3.2 years; body mass index: 23.8 ± 3.7 kg·m-2 ) participated in the study. Forehead skin blood flow was quantified laser Doppler flux and absolute concentrations of cerebral O2 Hb and HHb were measured by NIRS. Local heating significantly increased the Doppler flux signal across time and these changes were significantly correlated with skin temperature. During incremental exercise, skin temperature, Doppler flux, O2 Hb and HHb increased however, the only significant change that was consistently correlated with Doppler flux was skin temperature. Therefore, a significant change in forehead skin blood flow may not significantly the NIRS hemoglobin data, depending on the type of NIRS device used.

Hybrid Bladder Phantom to Validate Next-Generation Optical Wearables for Neurogenic Bladder Volume Monitoring

PURPOSE

The development of optics-based wearables for bladder volume monitoring has emerged as a significant topic in recent years. Given the innovative nature of this technology, there is currently no bladder phantom available to effectively validate these devices against more established gold standards, such as ultrasound. In this study, we showcase and demonstrate the performance of our hybrid bladder phantom by using an optical device and making comparisons with ultrasound.

METHODS

A series of validation tests, including phantom repeatability, ultrasound scanning, and an optical test, were performed. A near-infrared optical device was utilized to conduct diffuse optical spectroscopy (DOS). Machine learning models were employed to construct predictive models of volume using optical signals.

RESULTS

The size and position of an embedded balloon, serving as an analog for the bladder, were shown to be consistent when infused with 100 mL to 350 mL of water during repeatability testing. For DOS data, we present 7 types of machine learningbased models based on different optical signals. The 2 best-performing models demonstrated an average absolute volume error ranging from 12.7 mL to 19.0 mL.

CONCLUSION

In this study, we introduced a hybrid bladder phantom designed for the validation of near-infrared spectroscopy-based bladder monitoring devices in comparison with ultrasound techniques. By offering a reproducible and robust validation tool, we aim to support the advancement of next-generation optical wearables for bladder volume monitoring.

Assessment of Intercostal Muscle Near-Infrared Spectroscopy for Estimating Respiratory Compensation Point in Trained Endurance Athletes

This study aimed to assess the reliability and validity of estimating the respiratory compensation point (RCP) in trained endurance athletes by analyzing intercostal muscles' NIRS-derived tissue oxygenation dynamics. Seventeen experienced trail runners underwent an incremental treadmill protocol on two separate occasions, with a 7-day gap between assessments. Gas exchange and muscle oxygenation data were collected, and the oxygen saturation breakpoint (SmO2BP) measured in the intercostal muscles was compared to the RCP, which was identified by the increase in the VE/V.CO2 slope and the point at which the PetCO2 started to decrease. No statistically significant differences were observed between the two methods for any of the variables analyzed. Bland-Altman analysis showed significant agreement between the NIRS and gas analyzer methods for speed (r = 0.96, p < 0.05), HR (r = 0.98, p < 0.05), V.O2 relative to body mass (r = 0.99, p < 0.05), and %SmO2 (r = 0.98, p < 0.05). The interclass correlation coefficient values showed moderate to good reliability (0.60 to 0.86), and test-retest analysis revealed mean differences within the confidence intervals for all variables. These findings suggest that the SmO2BP measured using a portable NIRS device in the intercostal muscles is a reliable and valid tool for estimating the RCP for experienced trail runners and might be useful for coaches and athletes to monitor endurance training.

Beyond VO2: the complex cardiopulmonary exercise test

Cardiopulmonary exercise test (CPET) is a valuable diagnostic tool with a specific application in heart failure (HF) thanks to the strong prognostic value of its parameters. The most important value provided by CPET is the peak oxygen uptake (peak VO2), the maximum rate of oxygen consumption attainable during physical exertion. According to the Fick principle, VO2 equals cardiac output (Qc) times the arteriovenous content difference [C(a-v)O2], where Ca is the arterial oxygen and Cv is the mixed venous oxygen content, respectively; therefore, VO2 can be reduced both by impaired O2 delivery (reduced Qc) or extraction (reduced arteriovenous O2 content). However, standard CPET is not capable of discriminating between these different impairments, leading to the need for 'complex' CPET technologies. Among non-invasive methods for Qc measurement during CPET, inert gas rebreathing and thoracic impedance cardiography are the most used techniques, both validated in healthy subjects and patients with HF, at rest and during exercise. On the other hand, the non-invasive assessment of peripheral muscle perfusion is possible with the application of near-infrared spectroscopy, capable of measuring tissue oxygenation. Measuring Qc allows, by having haemoglobin values available, to discriminate how much any VO2 deficit depends on the muscle, anaemia or heart.

Structural and functional impairments of skeletal muscle in patients with postacute sequelae of SARS-CoV-2 infection

Following acute coronavirus disease 2019 (COVID-19), a substantial proportion of patients showed symptoms and sequelae for several months, namely the postacute sequelae of COVID-19 (PASC) syndrome. Major phenomena are exercise intolerance, muscle weakness, and fatigue. We aimed to investigate the physiopathology of exercise intolerance in patients with PASC syndrome by structural and functional analyses of skeletal muscle. At least 3 mo after infection, nonhospitalized patients with PASC (n = 11, age: 54 ± 11 yr; PASC) and patients without long-term symptoms (n = 12, age: 49 ± 9 yr; CTRL) visited the laboratory on four nonconsecutive days. Spirometry, lung diffusion capacity, and quality of life were assessed at rest. A cardiopulmonary incremental exercise test was performed. Oxygen consumption (V̇o2) kinetics were determined by moderate-intensity exercises. Muscle oxidative capacity (k) was assessed by near-infrared spectroscopy. Histochemical analysis, O2 flux (JO2) by high-resolution respirometry, and quantification of key molecular markers of mitochondrial biogenesis and dynamics were performed in vastus lateralis biopsies. Pulmonary and cardiac functions were within normal range in all patients. V̇o2peak was lower in PASC than CTRL (24.7 ± 5.0 vs. 32.9 ± 7.4 mL·min-1·kg-1, respectively, P < 0.05). V̇o2 kinetics was slower in PASC than CTRL (41 ± 12 vs. 30 ± 9 s-1, P < 0.05). k was lower in PASC than CTRL (1.54 ± 0.49 vs. 2.07 ± 0.51 min-1, P < 0.05). Citrate synthase, peroxisome proliferator-activated receptor-γ coactivator (PGC)1α, and JO2 for mitochondrial complex II were significantly lower in PASC vs. CTRL (all P values <0.05). In our cohort of patients with PASC, we showed limited exercise tolerance mainly due to "peripheral" determinants. Substantial reductions were observed for biomarkers of mitochondrial function, content, and biogenesis. PASC syndrome, therefore, appears to negatively impact skeletal muscle function, although the disease is a heterogeneous condition.NEW & NOTEWORTHY Several months after mild acute SARS-CoV-2 infection, a substantial proportion of patients present persisting, and often debilitating, symptoms and sequelae. These patients show reduced quality of life due to exercise intolerance, muscle weakness, and fatigue. The present study supports the hypothesis that "peripheral" impairments at skeletal muscle level, namely, reduced mitochondrial function and markers of mitochondrial biogenesis, are major determinants of exercise intolerance and fatigue, "central" phenomena at respiratory, and cardiac level being less relevant.

The Diagnostic Value of Near-Infrared Spectroscopy to Predict Delayed Cerebral Ischemia and Unfavorable Outcome After Subarachnoid Hemorrhage

OBJECTIVE

Near-infrared spectroscopy (NIRS) is a noninvasive tool to monitor cerebral regional oxygen saturation. Impairment of microvascular circulation with subsequent cerebral hypoxia during delayed cerebral ischemia (DCI) is associated with poor functional outcome after subarachnoid hemorrhage (SAH). Therefore, NIRS could be useful to predict the risk for DCI and functional outcome. However, only limited data are available on NIRS regional cerebral tissue oxygen saturation (rSO2) distribution in SAH. The aim of this study was to compare the distribution of NIRS rSO2 values in patients with nontraumatic SAH with the occurrence of DCI and functional outcome at 2 months. In addition, the predictive value of NIRS rSO2 was compared with the previously validated SAFIRE grade (derived from Size of the aneurysm, Age, FIsher grade, World Federation of Neurosurgical Societies after REsuscitation).

METHODS

In this study, the rSO2 distribution of patients with and without DCI after SAH was compared. The optimal cutoff points to predict DCI and outcome were assessed, and its predictive value was compared with the SAFIRE grade.

RESULTS

Of 41 patients, 12 developed DCI, and 9 had unfavorable outcome at 60 days. Prediction of DCI with NIRS had an area under the curve of 0.77 (95% confidence interval 0.62-0.92; P = 0.0028) with an optimal cutoff point of 65% (sensitivity 1.00; specificity 0.45). Prediction of favorable outcome with NIRS had an area under the curve of 0.86 (95% confidence interval 0.74-0.98; P = 0.0003) with an optimal cutoff point of 63% (sensitivity 1.00; specificity 0.63). Regression analysis showed that NIRS rSO2 score is complementary to the SAFIRE grade.

CONCLUSIONS

NIRS rSO2 monitoring in patients with SAH may improve prediction of DCI and clinical outcome after SAH.

Rapid detection of micronutrient components in infant formula milk powder using near-infrared spectroscopy

In order to achieve rapid detection of galactooligosaccharides (GOS), fructooligosaccharides (FOS), calcium (Ca), and vitamin C (Vc), four micronutrient components in infant formula milk powder, this study employed four methods, namely Standard Normal Variate (SNV), Multiplicative Scatter Correction (MSC), Normalization (Nor), and Savitzky-Golay Smoothing (SG), to preprocess the acquired original spectra of the milk powder. Then, the Competitive Adaptive Reweighted Sampling (CARS) algorithm and Random Frog (RF) algorithm were used to extract representative characteristic wavelengths. Furthermore, Partial Least Squares Regression (PLSR) and Support Vector Regression (SVR) models were established to predict the contents of GOS, FOS, Ca, and Vc in infant formula milk powder. The results indicated that after SNV preprocessing, the original spectra of GOS and FOS could effectively extract feature wavelengths using the CARS algorithm, leading to favorable predictive results through the CARS-SVR model. Similarly, after MSC preprocessing, the original spectra of Ca and Vc could efficiently extract feature wavelengths using the CARS algorithm, resulting in optimal predictive outcomes via the CARS-SVR model. This study provides insights for the realization of online nutritional component detection and optimization control in the production process of infant formula.

Upper body compression wear improves muscle oxygenation following intense video game training: a randomized cross-over study among competitive gamers

BACKGROUND

Esport players require a high number of action moves per minute to play, with substantial contractions of the wrist extensor muscles. Players frequently suffer from acute fatigue. The purpose of this study was to examine the use of below the elbow compression sleeves on Sm02 during intense aim training. Secondly, to examine players' performance and perception with and without compression.

METHODS

This study was conducted at the New York Institute of Technology and enrolled fifteen collegiate esport players, 2 women and 13 men (age 21.2 ± 2.2). All subjects signed written consent. Participants performed 3 high intensity bouts of an aim trainer followed by a 15-minute rest before doing another 3 bouts of high intensity training conducting the other arm of the study. The compression wear order was randomized. The primary outcome included Sm02 of the extensor carpi radialis longus using near-infrared spectrometry. Secondary outcomes included Kills Per Second (KPS), Score, Total Time to Kill (TTK), accuracy, and perceived performance.

RESULTS

Following 15 min of recovery, there was a significant rise in Sm02 while wearing the compression sleeve compared to no compression sleeve (p = 0.004). No change in Sm02 was seen while gaming. In trials 1 and 2, wearing the compression sleeve resulted in a significant increase in KPS and score when compared to not wearing it (p = 0.002,0.006). Although TTK and accuracy did not alter, 46.7% of participants believed the compression sleeve aided their performance.

CONCLUSIONS

This study provides support that wearing below the elbow upper body compression sleeves while performing high intensity gaming may reduce fatigue, improve muscle recovery and gaming performance.

TRIAL REGISTRATION

Clinicaltrials.gov identifier NCT05037071. Registered 08/09/2021. URL: Arm Compression on Muscle Oxygen Saturation - Full Text View - ClinicalTrials.gov.

Differences between Hepatic and Cerebral Regional Tissue Oxygen Saturation at the Onset of Intradialytic Hypotension

BACKGROUND

Intradialytic hypotension (IDH) is a critical pathological condition associated with all-cause mortality in patients undergoing hemodialysis (HD). However, few studies have investigated IDH-related changes in hepatic and cerebral regional tissue oxygen saturation (rSO2). This study investigated IDH-induced changes in hepatic and cerebral rSO2.

METHODS

Hepatic and cerebral rSO2 during HD were measured using an INVOS 5100C oxygen saturation monitor, and their percentage (%) changes during the development of IDH were analyzed. Ninety-one patients undergoing HD were investigated, including twenty with IDH.

RESULTS

In patients with IDH, % changes in hepatic and cerebral rSO2 decreased at the onset of IDH. Additionally, the % change in hepatic rSO2 was significantly larger than that in cerebral rSO2 (p < 0.001). In patients without IDH, no significant differences were found between the % changes in hepatic and cerebral rSO2 at the time of the lowest systolic blood pressure during HD. Multivariable linear regression analysis showed that the difference between the % changes in cerebral and hepatic rSO2 was significantly associated with the development of IDH (p < 0.001) and the ultrafiltration rate (p = 0.010).

CONCLUSIONS

Hepatic and cerebral rSO2 significantly decreased during the development of IDH, and hepatic rSO2 was more significantly decreased than cerebral rSO2 at the onset of IDH.