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Druelle F, Ghislieri M, Molina-Vila P, Rimbaud B, Agostini V, Berillon G. A comparative study of muscle activity and synergies during walking in baboons and humans. J Hum Evol 2024; 189:103513. [PMID: 38401300 DOI: 10.1016/j.jhevol.2024.103513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 02/15/2024] [Accepted: 02/16/2024] [Indexed: 02/26/2024]
Abstract
Bipedal locomotion was a major functional change during hominin evolution, yet, our understanding of this gradual and complex process remains strongly debated. Based on fossil discoveries, it is possible to address functional hypotheses related to bipedal anatomy, however, motor control remains intangible with this approach. Using comparative models which occasionally walk bipedally has proved to be relevant to shed light on the evolutionary transition toward habitual bipedalism. Here, we explored the organization of the neuromuscular control using surface electromyography (sEMG) for six extrinsic muscles in two baboon individuals when they walk quadrupedally and bipedally on the ground. We compared their muscular coordination to five human subjects walking bipedally. We extracted muscle synergies from the sEMG envelopes using the non-negative matrix factorization algorithm which allows decomposing the sEMG data in the linear combination of two non-negative matrixes (muscle weight vectors and activation coefficients). We calculated different parameters to estimate the complexity of the sEMG signals, the duration of the activation of the synergies, and the generalizability of the muscle synergy model across species and walking conditions. We found that the motor control strategy is less complex in baboons when they walk bipedally, with an increased muscular activity and muscle coactivation. When comparing the baboon bipedal and quadrupedal pattern of walking to human bipedalism, we observed that the baboon bipedal pattern of walking is closer to human bipedalism for both baboons, although substantial differences remain. Overall, our findings show that the muscle activity of a non-adapted biped effectively fulfills the basic mechanical requirements (propulsion and balance) for walking bipedally, but substantial refinements are possible to optimize the efficiency of bipedal locomotion. In the evolutionary context of an expanding reliance on bipedal behaviors, even minor morphological alterations, reducing muscle coactivation, could have faced strong selection pressure, ultimately driving bipedal evolution in hominins.
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Affiliation(s)
- François Druelle
- Histoire Naturelle de l'Homme Préhistorique, UMR 7194, CNRS-MNHN-UPVD, Musée de l'Homme, 17 place du Trocadéro, 75116 Paris, France; Primatology Station of the CNRS, UAR 846, 2230 route des quatre tours, 13790 Rousset, France; Functional Morphology Laboratory, University of Antwerp, Campus Drie Eiken (Building D), Universiteitsplein 1, 2610 Antwerp, Belgium.
| | - Marco Ghislieri
- Department of Electronics and Telecommunications, Politecnico di Torino, Corso Duca degli Abruzzi, 24, 10129 Turin, Italy; PoliTo(BIO)Med Lab, Politecnico di Torino, Corso Duca degli Abruzzi, 24, 10129 Turin, Italy
| | - Pablo Molina-Vila
- Primatology Station of the CNRS, UAR 846, 2230 route des quatre tours, 13790 Rousset, France
| | - Brigitte Rimbaud
- Primatology Station of the CNRS, UAR 846, 2230 route des quatre tours, 13790 Rousset, France
| | - Valentina Agostini
- Department of Electronics and Telecommunications, Politecnico di Torino, Corso Duca degli Abruzzi, 24, 10129 Turin, Italy; PoliTo(BIO)Med Lab, Politecnico di Torino, Corso Duca degli Abruzzi, 24, 10129 Turin, Italy
| | - Gilles Berillon
- Histoire Naturelle de l'Homme Préhistorique, UMR 7194, CNRS-MNHN-UPVD, Musée de l'Homme, 17 place du Trocadéro, 75116 Paris, France; Primatology Station of the CNRS, UAR 846, 2230 route des quatre tours, 13790 Rousset, France
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Ghislieri M, Labanca L, Mosca M, Bragonzoni L, Knaflitz M, Benedetti MG, Agostini V. Balance and Muscle Synergies During a Single-Limb Stance Task in Individuals With Chronic Ankle Instability. IEEE Trans Neural Syst Rehabil Eng 2023; 31:4367-4375. [PMID: 37906487 DOI: 10.1109/tnsre.2023.3328933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
The aim of this study was to investigate balance performance and muscle synergies during a Single-Limb Stance (SLS) task in individuals with Chronic Ankle Instability (CAI) and a group of healthy controls. Twenty individuals with CAI and twenty healthy controls were asked to perform a 30-second SLS task in Open-Eyes (OE) and Closed-Eyes (CE) conditions while standing on a force platform with the injured or the dominant limb, respectively. The activation of 13 muscles of the lower limb, hip, and back was recorded by means of surface electromyography. Balance performance was assessed by identifying the number and the duration of SLS epochs, and the Root-Mean-Square (RMS) in Antero-Posterior (AP) and Medio-Lateral (ML) directions of the body-weight normalized ground reaction forces. The optimal number of synergies, weight vectors, and activation coefficients were also analyzed. CAI group showed a higher number and a shorter duration of SLS epochs and augmented ground reaction force RMS in both AP and ML directions compared to controls. Both groups showed an increase in the RMS in AP and ML forces in CE compared to OE. Both groups showed 4 optimal synergies in CE, while controls showed 5 synergies in OE. CAI showed a significantly higher weight of knee flexor muscles in both OE and CE. In conclusion, muscle synergies analysis provided an in-depth knowledge of motor control mechanisms in CAI individuals. They showed worse balance performance, a lower number of muscle synergies in a CE condition and abnormal knee flexor muscle activation compared to healthy controls.
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Ghislieri M, Lanotte M, Knaflitz M, Rizzi L, Agostini V. Muscle synergies in Parkinson's disease before and after the deep brain stimulation of the bilateral subthalamic nucleus. Sci Rep 2023; 13:6997. [PMID: 37117317 PMCID: PMC10147693 DOI: 10.1038/s41598-023-34151-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 04/25/2023] [Indexed: 04/30/2023] Open
Abstract
The aim of this study is to quantitatively assess motor control changes in Parkinson's disease (PD) patients after bilateral deep brain stimulation of the subthalamic nucleus (STN-DBS), based on a novel muscle synergy evaluation approach. A group of 20 PD patients evaluated at baseline (before surgery, T0), at 3 months (T1), and at 12 months (T2) after STN-DBS surgery, as well as a group of 20 age-matched healthy control subjects, underwent an instrumented gait analysis, including surface electromyography recordings from 12 muscles. A smaller number of muscle synergies was found in PD patients (4 muscle synergies, at each time point) compared to control subjects (5 muscle synergies). The neuromuscular robustness of PD patients-that at T0 was smaller with respect to controls (PD T0: 69.3 ± 2.2% vs. Controls: 77.6 ± 1.8%, p = 0.004)-increased at T1 (75.8 ± 1.8%), becoming not different from that of controls at T2 (77.5 ± 1.9%). The muscle synergies analysis may offer clinicians new knowledge on the neuromuscular structure underlying PD motor types of behavior and how they can improve after electroceutical STN-DBS therapy.
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Affiliation(s)
- Marco Ghislieri
- Department of Electronics and Telecommunications, Politecnico di Torino, 10129, Turin, Italy.
- PolitoBIOMed Lab, Politecnico di Torino, 10129, Turin, Italy.
| | - Michele Lanotte
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, 10126, Turin, Italy
- AOU Città della Salute e della Scienza di Torino, 10126, Turin, Italy
| | - Marco Knaflitz
- Department of Electronics and Telecommunications, Politecnico di Torino, 10129, Turin, Italy
- PolitoBIOMed Lab, Politecnico di Torino, 10129, Turin, Italy
| | - Laura Rizzi
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, 10126, Turin, Italy
- AOU Città della Salute e della Scienza di Torino, 10126, Turin, Italy
| | - Valentina Agostini
- Department of Electronics and Telecommunications, Politecnico di Torino, 10129, Turin, Italy
- PolitoBIOMed Lab, Politecnico di Torino, 10129, Turin, Italy
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Agostini V, De Jesus K, Picerno P. Editorial: Fatigue assessment in sport. Front Sports Act Living 2023; 5:1131297. [PMID: 36860735 PMCID: PMC9969127 DOI: 10.3389/fspor.2023.1131297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 01/16/2023] [Indexed: 02/15/2023] Open
Affiliation(s)
- Valentina Agostini
- PolitoBIOMedLab, Department of Electronics and Telecommunications, Polytechnic University of Turin, Turin, Piedmont, Italy,Correspondence: Valentina Agostini
| | - Karla De Jesus
- Human Performance Studies Laboratory, Faculty of Physical Education and Physiotherapy, Federal University of Amazonas, Manaus, Amazonas, Brazil
| | - Pietro Picerno
- SMART Engineering Solutions & Technologies, University of eCampus, Novedrate (CO), Italy
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Fiorillo L, Pedroncelli D, Agostini V, Favaro P, Faraci FD. Multi-Scored Sleep Databases: How to Exploit the Multiple-Labels in Automated Sleep Scoring. Sleep 2023; 46:7034145. [PMID: 36762998 PMCID: PMC10171642 DOI: 10.1093/sleep/zsad028] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 10/16/2022] [Indexed: 02/11/2023] Open
Abstract
STUDY OBJECTIVES Inter-scorer variability in scoring polysomnograms is a well-known problem. Most of the existing automated sleep scoring systems are trained using labels annotated by a single scorer, whose subjective evaluation is transferred to the model. When annotations from two or more scorers are available, the scoring models are usually trained on the scorer consensus. The averaged scorer's subjectivity is transferred into the model, losing information about the internal variability among different scorers. In this study, we aim to insert the multiple-knowledge of the different physicians into the training procedure. The goal is to optimize a model training, exploiting the full information that can be extracted from the consensus of a group of scorers. METHODS We train two lightweight deep learning based models on three different multi-scored databases. We exploit the label smoothing technique together with a soft-consensus (LSSC) distribution to insert the multiple-knowledge in the training procedure of the model. We introduce the averaged cosine similarity metric (ACS) to quantify the similarity between the hypnodensity-graph generated by the models with-LSSC and the hypnodensity-graph generated by the scorer consensus. RESULTS The performance of the models improves on all the databases when we train the models with our LSSC. We found an increase in ACS (up to 6.4%) between the hypnodensity-graph generated by the models trained with-LSSC and the hypnodensity-graph generated by the consensus. CONCLUSION Our approach definitely enables a model to better adapt to the consensus of the group of scorers. Future work will focus on further investigations on different scoring architectures and hopefully large-scale-heterogeneous multi-scored datasets.
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Affiliation(s)
- Luigi Fiorillo
- Institute of Informatics, University of Bern, Bern, Switzerland.,Institute of Digital Technologies for Personalized Healthcare (MeDiTech), Department of Innovative Technologies, University of Applied Sciences and Arts of Southern Switzerland, Lugano, Switzerland
| | - Davide Pedroncelli
- Department of Electronics and Telecommunications, Politecnico di Torino, Torino, Italy
| | - Valentina Agostini
- Department of Electronics and Telecommunications, Politecnico di Torino, Torino, Italy
| | - Paolo Favaro
- Institute of Informatics, University of Bern, Bern, Switzerland
| | - Francesca Dalia Faraci
- Institute of Digital Technologies for Personalized Healthcare (MeDiTech), Department of Innovative Technologies, University of Applied Sciences and Arts of Southern Switzerland, Lugano, Switzerland
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Digo E, Panero E, Agostini V, Gastaldi L. Comparison of IMU set-ups for the estimation of gait spatio-temporal parameters in an elderly population. Proc Inst Mech Eng H 2023; 237:61-73. [PMID: 36377588 DOI: 10.1177/09544119221135051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The increasing average age emphasizes the importance of gait analysis in elderly populations. Inertial Measurement Units (IMUs) represent a suitable wearable technology for the characterization of gait by estimating spatio-temporal parameters (STPs). However, the location of inertial sensors on the human body and the associated algorithms for the estimation of gait STPs play a fundamental role and are still open challenges. Accordingly, the aim of this work was to compare three IMUs set-ups (trunk, shanks, and ankles) and correspondent algorithms to a gold standard optoelectronic system for the estimation of gait STPs in a healthy elderly population. In total, 14 healthy elderly subjects walked barefoot at three different speeds. Gait parameters were assessed for each IMUs set-up and compared to those estimated with the gold standard. A statistical analysis based on Pearson correlation, Root Mean Square Error and Bland Altman plots was conducted to evaluate the accuracy of IMUs. Even though all tested set-ups produced accurate results, the IMU on the trunk performed better in terms of correlation (R ≥ 0.8), RMSE (0.01-0.06 s for temporal parameters, 0.03-0.04 for the limp index), and level of agreement (-0.01 s ≤ mean error ≤ 0.01 s, -0.02 s ≤ standard deviation error ≤ 0.02 s), also allowing simpler preparation of subjects and minor encumbrance during gait. From the promising results, a similar experiment might be conducted in pathological populations in the attempt to verify the accuracy of IMUs set-ups and algorithms also in non-physiological patterns.
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Affiliation(s)
- Elisa Digo
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy.,PoliToBIOMedLab of Politecnico di Torino, Turin, Italy
| | - Elisa Panero
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - Valentina Agostini
- PoliToBIOMedLab of Politecnico di Torino, Turin, Italy.,Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
| | - Laura Gastaldi
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy.,PoliToBIOMedLab of Politecnico di Torino, Turin, Italy
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Leone O, Agostini V, Graziosi M, Rossi C, Pelletti G, Foà A, Guadagnini G, Riefolo M, Ziacchi M, Fais P, Pelotti S, Rapezzi C, Seri M. [Sudden cardiac death in young people and in adults: primary and contributing causes. The experience of the multidisciplinary network in Emilia-Romagna]. G Ital Cardiol (Rome) 2022; 23:200-210. [PMID: 35343501 DOI: 10.1714/3751.37339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND The multidisciplinary network of Emilia-Romagna for the study of juvenile sudden cardiac death (SCD) was started in Bologna in June 2018 in order to: (1) define the spectrum of etiologies and mechanisms of SCD in young people; (ii) standardize diagnostic terminology and categories; (iii) identify potentially hereditary genetic heart diseases and define the contribution of post-mortem genetic analysis (so-called molecular autopsy) to the overall diagnostic process; (iv) identify preclinical forms of the pathologies in the first-degree relatives of the deceased subject using both phenotypic and genotypic evaluation and, where possible, undertake therapeutic/prophylactic measures (primary prevention). METHODS In the first 2 years of activity (01/06/2018-27/08/2020) 50 cases of SCD came to the attention of the Cardiovascular Pathology Unit of the S. Orsola-Malpighi Polyclinic in Bologna, from Centres of Forensic Medicine and Pathological Anatomy in most of the region. RESULTS Sixty-two percent of cases were sent by forensic pathologists, 36% by clinical pathologists and 2% by the family of the deceased. Medico-legal cases were prompted by autopsies requested by the Judicial Authority in 70% of cases; 55.5% of patients referred by pathologists came from the Cardiovascular Tissue Bank, as part of the regional program for the quality and safety control of organs and tissues from multiorgan-multitissue donors. The average age of the subjects was 35 ± 13.6 years (70% male, range: 1-55 years; median: 38 years). The spectrum of the final diagnoses includes: structurally normal hearts 14%, cardiomyopathies 40%, coronary heart disease 23%, Brugada syndrome 6%, aortic dissection 4%, substance abuse 6%, valvular heart disease 2%, mixed causes 2%. CONCLUSIONS The network is necessarily centered on post-mortem pathological activities, but it does not end with these. If in 60% of cases the pathological autopsy examination was decisive in identifying the cause of death, in the other cases a detailed final diagnosis was reached only with more complex pathways involving molecular genetics, clinical genetics, and toxicology.
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Affiliation(s)
- Ornella Leone
- Unità di Patologia Cardiovascolare e Trapiantologica Cardiaca, Dipartimento di Anatomia Patologica, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna
| | - Valentina Agostini
- Unità di Patologia Cardiovascolare e Trapiantologica Cardiaca, Dipartimento di Anatomia Patologica, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna
| | - Maddalena Graziosi
- Istituto di Cardiologia, Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna
| | - Cesare Rossi
- Istituto di Genetica Medica, Dipartimento di Scienze Mediche e Chirurgiche, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Università degli Studi, Bologna
| | - Guido Pelletti
- Medicina Legale, Dipartimento di Scienze Mediche e Chirurgiche, Università degli Studi, Bologna
| | - Alberto Foà
- Istituto di Cardiologia, Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna
| | - Gianni Guadagnini
- S.S. Medicina Legale, Azienda Sanitaria Locale AUSL di Imola, Imola (BO)
| | - Mattia Riefolo
- Unità di Patologia Cardiovascolare e Trapiantologica Cardiaca, Dipartimento di Anatomia Patologica, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna
| | - Matteo Ziacchi
- Istituto di Cardiologia, Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna
| | - Paolo Fais
- Medicina Legale, Dipartimento di Scienze Mediche e Chirurgiche, Università degli Studi, Bologna
| | - Susi Pelotti
- Medicina Legale, Dipartimento di Scienze Mediche e Chirurgiche, Università degli Studi, Bologna
| | - Claudio Rapezzi
- Centro Cardiovascolare, Università degli Studi, Ferrara - Maria Cecilia Hospital, GVM Care & Research, Cotignola (RA)
| | - Marco Seri
- Istituto di Genetica Medica, Dipartimento di Scienze Mediche e Chirurgiche, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Università degli Studi, Bologna
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Labanca L, Ghislieri M, Knaflitz M, Barone G, Bragonzoni L, Agostini V, Benedetti MG. Muscle synergies for the control of single-limb stance with and without visual information in young individuals. BMC Sports Sci Med Rehabil 2021; 13:163. [PMID: 34952624 PMCID: PMC8710023 DOI: 10.1186/s13102-021-00392-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 12/15/2021] [Indexed: 11/21/2022]
Abstract
Purpose Single-limb stance is a demanding postural task featuring a high number of daily living and sporting activities. Thus, it is widely used for training and rehabilitation, as well as for balance assessment. Muscle activations around single joints have been previously described, however, it is not known which are the muscle synergies used to control posture and how they change between conditions of normal and lack of visual information. Methods Twenty-two healthy young participants were asked to perform a 30 s single-limb stance task in open-eyes and closed-eyes condition while standing on a force platform with the dominant limb. Muscle synergies were extracted from the electromyographical recordings of 13 muscles of the lower limb, hip, and back. The optimal number of synergies, together with the average recruitment level and balance control strategies were analyzed and compared between the open- and the closed-eyes condition. Results Four major muscle synergies, two ankle-dominant synergies, one knee-dominant synergy, and one hip/back-dominant synergy were found. No differences between open- and closed-eyes conditions were found for the recruitment level, except for the hip/back synergy, which significantly decreased (p = 0.02) in the closed-eyes compared to the open-eyes condition. A significant increase (p = 0.03) of the ankle balance strategy was found in the closed-eyes compared to the open-eyes condition. Conclusion In healthy young individuals, single-limb stance is featured by four major synergies, both in open- and closed-eyes condition. Future studies should investigate muscle synergies in participants with other age groups, as well as pathological conditions. Supplementary Information The online version contains supplementary material available at 10.1186/s13102-021-00392-z.
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Affiliation(s)
- L Labanca
- Physical Medicine and Rehabilitation Unit, IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy. .,Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
| | - M Ghislieri
- Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy.,PoliToBIOMed Lab, Politecnico di Torino, Turin, Italy
| | - M Knaflitz
- Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy.,PoliToBIOMed Lab, Politecnico di Torino, Turin, Italy
| | - G Barone
- Department of Life Quality Studies, University of Bologna, Bologna, Italy
| | - L Bragonzoni
- Department of Life Quality Studies, University of Bologna, Bologna, Italy
| | - V Agostini
- Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy.,PoliToBIOMed Lab, Politecnico di Torino, Turin, Italy
| | - M G Benedetti
- Physical Medicine and Rehabilitation Unit, IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy.,Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
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Dotti G, Ghislieri M, Rosati S, Agostini V, Knaflitz M, Balestra G. The Effect of Number of Gait Cycles on Principal Activation Extraction. Annu Int Conf IEEE Eng Med Biol Soc 2021; 2021:985-988. [PMID: 34891453 DOI: 10.1109/embc46164.2021.9629818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
To cope with the high intra-subject variability of muscle activation intervals, a large amount of gait cycles is necessary to clearly document physiological or pathological muscle activity patterns during human locomotion. The Clustering for Identification of Muscle Activation Pattern (CIMAP) algorithm has been proposed to help clinicians obtaining a synthetic and clear description of normal and pathological muscle functions in human walking. Moreover, this algorithm allows the extraction of Principal Activations (PAs), defined as those muscle activations that are strictly necessary to perform a specific task and occur in every gait cycle. This contribution aims at assessing the impact of the number of gait cycles on the extraction of the PAs. Results demonstrated no statistically significant differences between PAs extracted considering different numbers of gait cycles, revealing, on average, similarity values higher than 0.88.Clinical Relevance-This contribution demonstrates the potential applicability of the CIMAP algorithm to the analysis of subjects affected by neurological disorders, for whom the assessment of motor functions may be of the uttermost importance and only a reduced number of gait cycles can be acquired.
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Ghislieri M, Cerone GL, Knaflitz M, Agostini V. Long short-term memory (LSTM) recurrent neural network for muscle activity detection. J Neuroeng Rehabil 2021; 18:153. [PMID: 34674720 PMCID: PMC8532313 DOI: 10.1186/s12984-021-00945-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 10/13/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The accurate temporal analysis of muscle activation is of great interest in many research areas, spanning from neurorobotic systems to the assessment of altered locomotion patterns in orthopedic and neurological patients and the monitoring of their motor rehabilitation. The performance of the existing muscle activity detectors is strongly affected by both the SNR of the surface electromyography (sEMG) signals and the set of features used to detect the activation intervals. This work aims at introducing and validating a powerful approach to detect muscle activation intervals from sEMG signals, based on long short-term memory (LSTM) recurrent neural networks. METHODS First, the applicability of the proposed LSTM-based muscle activity detector (LSTM-MAD) is studied through simulated sEMG signals, comparing the LSTM-MAD performance against other two widely used approaches, i.e., the standard approach based on Teager-Kaiser Energy Operator (TKEO) and the traditional approach, used in clinical gait analysis, based on a double-threshold statistical detector (Stat). Second, the effect of the Signal-to-Noise Ratio (SNR) on the performance of the LSTM-MAD is assessed considering simulated signals with nine different SNR values. Finally, the newly introduced approach is validated on real sEMG signals, acquired during both physiological and pathological gait. Electromyography recordings from a total of 20 subjects (8 healthy individuals, 6 orthopedic patients, and 6 neurological patients) were included in the analysis. RESULTS The proposed algorithm overcomes the main limitations of the other tested approaches and it works directly on sEMG signals, without the need for background-noise and SNR estimation (as in Stat). Results demonstrate that LSTM-MAD outperforms the other approaches, revealing higher values of F1-score (F1-score > 0.91) and Jaccard similarity index (Jaccard > 0.85), and lower values of onset/offset bias (average absolute bias < 6 ms), both on simulated and real sEMG signals. Moreover, the advantages of using the LSTM-MAD algorithm are particularly evident for signals featuring a low to medium SNR. CONCLUSIONS The presented approach LSTM-MAD revealed excellent performances against TKEO and Stat. The validation carried out both on simulated and real signals, considering normal as well as pathological motor function during locomotion, demonstrated that it can be considered a powerful tool in the accurate and effective recognition/distinction of muscle activity from background noise in sEMG signals.
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Affiliation(s)
- Marco Ghislieri
- Department of Electronics and Telecommunications, Politecnico Di Torino, 10129, Turin, Italy.
- PoliToBIOMed Lab, Politecnico di Torino, 10129, Turin, Italy.
| | - Giacinto Luigi Cerone
- PoliToBIOMed Lab, Politecnico di Torino, 10129, Turin, Italy
- Laboratory for Engineering of the Neuromuscular System (LISiN), Departement of Electronics and Telecommunications, Politecnico di Torino, 10129, Turin, Italy
| | - Marco Knaflitz
- Department of Electronics and Telecommunications, Politecnico Di Torino, 10129, Turin, Italy
- PoliToBIOMed Lab, Politecnico di Torino, 10129, Turin, Italy
| | - Valentina Agostini
- Department of Electronics and Telecommunications, Politecnico Di Torino, 10129, Turin, Italy
- PoliToBIOMed Lab, Politecnico di Torino, 10129, Turin, Italy
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Pelletti G, Leone O, Gavelli S, Rossi C, Foà A, Agostini V, Pelotti S. Sudden Unexpected Death after a mild trauma: The complex forensic interpretation of cardiac and genetic findings. Forensic Sci Int 2021; 328:111004. [PMID: 34597909 DOI: 10.1016/j.forsciint.2021.111004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 08/20/2021] [Accepted: 09/13/2021] [Indexed: 10/20/2022]
Abstract
A 55-year-old man affected by a psychotic disorder suddenly died during a quarrel with his father. The autopsy excluded traumatic causes of death, and the cardiac examination identified a severe cardiomegaly with biventricular dilatation of very likely multifactorial origin. Toxicological and pharmacogenetic analyses excluded a fatal intoxication and identified the presence of the antipsychotic drug fluphenazine in the therapeutic range in a normal metabolizer. The screening for genetic variations highlighted a novel heterozygous single-nucleotide variant in the exon 36: c 0.4750C>A (p.Pro1584Thr) of the Ryanodine Receptor Type 2 (RYR2) gene. The mutation detected can be classified as Likely Pathogenic according to the American College of Medical Genetics and Genomics (ACMG) criteria. RYR2 variation has been associated to catecholaminergic polymorphic ventricular tachycardia (CPVT), a disease currently recognized as one of the most malignant cardiac channelopathies, expressed mostly in young patients, normally in the absence of structural heart disease. The victim late middle age, compared to juvenile onset of CPVT reported in literature, his clinical history, his structurally altered heart, circumstances at death and the absence of phenotype-related variations of dilated cardiomyopathy genes, suggested that the fatal arrhythmia could have been caused by an acquired form of dilated cardiopathy/cardiomyopathy. However, the contribution of the genetic variant to death cannot be completely ruled out, since the significance of a VUS or of a novel variant depends on the data available at the time of investigation, and should be periodically evaluated. We discuss the contribution of the structural alteration and of the variant detected, as well as the role of the molecular autopsy in forensic examination, which can make a significant contribution for inferring both cause and manner of death.
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Affiliation(s)
- Guido Pelletti
- Unit of Legal Medicine, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
| | - Ornella Leone
- Cardiovascular Pathology Unit, Division of Pathology, IRCCS S.Orsola Hospital and University of Bologna, Bologna, Italy.
| | - Simone Gavelli
- Unit of Legal Medicine, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
| | - Cesare Rossi
- Medical Genetics Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
| | - Alberto Foà
- Cardiology Unit, Department of Experimental Diagnostic and Specialty Medicine, IRCCS S. Orsola Hospital and University of Bologna, Bologna, Italy.
| | - Valentina Agostini
- Cardiovascular Pathology Unit, Division of Pathology, IRCCS S.Orsola Hospital and University of Bologna, Bologna, Italy.
| | - Susi Pelotti
- Unit of Legal Medicine, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
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12
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Labanca L, Mosca M, Ghislieri M, Agostini V, Knaflitz M, Benedetti MG. Muscle activations during functional tasks in individuals with chronic ankle instability: a systematic review of electromyographical studies. Gait Posture 2021; 90:340-373. [PMID: 34564008 DOI: 10.1016/j.gaitpost.2021.09.182] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND It has been reported that individuals with chronic ankle instability (CAI) show motor control abnormalities. The study of muscle activations by means of surface electromyography (sEMG) plays a key role in understanding some of the features of movement abnormalities. RESEARCH QUESTION Do common sEMG activation abnormalities and strategies exists across different functional movements? METHODS Literature review was conducted on PubMed, Web-of-Science and Cochrane databases. Studies published between 2000 and 2020 that assessed muscle activations by means of sEMG during any type of functional task in individuals with CAI, and used healthy individuals as controls, were included. Methodological quality was assessed using the modified Downs&Black checklist. Since the methodologies of different studies were heterogeneous, no meta-analysis was conducted. RESULTS A total of 63 articles investigating muscle activations during gait, running, responses to perturbations, landing and hopping, cutting and turning; single-limb stance, star excursion balance task, forward lunges, ball-kicking, y-balance test and single-limb squatting were considered. Individuals with CAI showed a delayed activation of the peroneus longus in response to sudden inversion perturbations, in transitions between double- and single-limb stance, and in landing on unstable surfaces. Apparently, while walking on ground there are no differences between CAI and controls, walking on a treadmill increases the variability of muscles activations, probably as a "safety strategy" to avoid ankle inversion. An abnormal activation of the tibialis anterior was observed during a number of tasks. Finally, hip/spine muscles were activated before ankle muscles in CAI compared to controls. CONCLUSION Though the methodology of the studies herein considered is heterogeneous, this review shows that the peroneal and tibialis anterior muscles have an abnormal activation in CAI individuals. These individuals also show a proximal muscle activation strategy during the performance of balance challenging tasks. Future studies should investigate whole-body muscle activation abnormalities in CAI individuals.
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Affiliation(s)
- Luciana Labanca
- Physical Medicine and Rehabilitation Unit, IRCCS - Istituto Ortopedico Rizzoli, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
| | - Massimiliano Mosca
- II Clinic of Orthopaedics and Traumatology, IRCCS - Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Marco Ghislieri
- Department of Electronics and Telecommunications, Politecnico di Torino, Torino, Italy; PoliTo(BIO)MedLab, Politecnico di Torino, Torino, Italy
| | - Valentina Agostini
- Department of Electronics and Telecommunications, Politecnico di Torino, Torino, Italy; PoliTo(BIO)MedLab, Politecnico di Torino, Torino, Italy
| | - Marco Knaflitz
- Department of Electronics and Telecommunications, Politecnico di Torino, Torino, Italy; PoliTo(BIO)MedLab, Politecnico di Torino, Torino, Italy
| | - Maria Grazia Benedetti
- Physical Medicine and Rehabilitation Unit, IRCCS - Istituto Ortopedico Rizzoli, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
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13
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Ghislieri M, Agostini V, Rizzi L, Knaflitz M, Lanotte M. Atypical Gait Cycles in Parkinson's Disease. Sensors (Basel) 2021; 21:5079. [PMID: 34372315 PMCID: PMC8347347 DOI: 10.3390/s21155079] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/21/2021] [Accepted: 07/23/2021] [Indexed: 12/15/2022]
Abstract
It is important to find objective biomarkers for evaluating gait in Parkinson's Disease (PD), especially related to the foot and lower leg segments. Foot-switch signals, analyzed through Statistical Gait Analysis (SGA), allow the foot-floor contact sequence to be characterized during a walking session lasting five-minutes, which includes turnings. Gait parameters were compared between 20 PD patients and 20 age-matched controls. PDs showed similar straight-line speed, cadence, and double-support compared to controls, as well as typical gait-phase durations, except for a small decrease in the flat-foot contact duration (-4% of the gait cycle, p = 0.04). However, they showed a significant increase in atypical gait cycles (+42%, p = 0.006), during both walking straight and turning. A forefoot strike, instead of a "normal" heel strike, characterized the large majority of PD's atypical cycles, whose total percentage was 25.4% on the most-affected and 15.5% on the least-affected side. Moreover, we found a strong correlation between the atypical cycles and the motor clinical score UPDRS-III (r = 0.91, p = 0.002), in the subset of PD patients showing an abnormal number of atypical cycles, while we found a moderate correlation (r = 0.60, p = 0.005), considering the whole PD population. Atypical cycles have proved to be a valid biomarker to quantify subtle gait dysfunctions in PD patients.
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Affiliation(s)
- Marco Ghislieri
- Department of Electronics and Telecommunications, Politecnico di Torino, 10129 Turin, Italy; (V.A.); (M.K.)
- PoliToBIOMed Lab, Politecnico di Torino, 10129 Turin, Italy
| | - Valentina Agostini
- Department of Electronics and Telecommunications, Politecnico di Torino, 10129 Turin, Italy; (V.A.); (M.K.)
- PoliToBIOMed Lab, Politecnico di Torino, 10129 Turin, Italy
| | - Laura Rizzi
- Department of Neuroscience “Rita Levi Montalcini”, University of Turin, 10126 Turin, Italy; (L.R.); (M.L.)
- AOU Città della Salute e della Scienza di Torino, 10126 Turin, Italy
| | - Marco Knaflitz
- Department of Electronics and Telecommunications, Politecnico di Torino, 10129 Turin, Italy; (V.A.); (M.K.)
- PoliToBIOMed Lab, Politecnico di Torino, 10129 Turin, Italy
| | - Michele Lanotte
- Department of Neuroscience “Rita Levi Montalcini”, University of Turin, 10126 Turin, Italy; (L.R.); (M.L.)
- AOU Città della Salute e della Scienza di Torino, 10126 Turin, Italy
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14
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Ballarini R, Ghislieri M, Knaflitz M, Agostini V. An Algorithm for Choosing the Optimal Number of Muscle Synergies during Walking. Sensors (Basel) 2021; 21:s21103311. [PMID: 34064615 PMCID: PMC8151057 DOI: 10.3390/s21103311] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/29/2021] [Accepted: 05/07/2021] [Indexed: 11/16/2022]
Abstract
In motor control studies, the 90% thresholding of variance accounted for (VAF) is the classical way of selecting the number of muscle synergies expressed during a motor task. However, the adoption of an arbitrary cut-off has evident drawbacks. The aim of this work is to describe and validate an algorithm for choosing the optimal number of muscle synergies (ChoOSyn), which can overcome the limitations of VAF-based methods. The proposed algorithm is built considering the following principles: (1) muscle synergies should be highly consistent during the various motor task epochs (i.e., remaining stable in time), (2) muscle synergies should constitute a base with low intra-level similarity (i.e., to obtain information-rich synergies, avoiding redundancy). The algorithm performances were evaluated against traditional approaches (threshold-VAF at 90% and 95%, elbow-VAF and plateau-VAF), using both a simulated dataset and a real dataset of 20 subjects. The performance evaluation was carried out by analyzing muscle synergies extracted from surface electromyographic (sEMG) signals collected during walking tasks lasting 5 min. On the simulated dataset, ChoOSyn showed comparable performances compared to VAF-based methods, while, in the real dataset, it clearly outperformed the other methods, in terms of the fraction of correct classifications, mean error (ME), and root mean square error (RMSE). The proposed approach may be beneficial to standardize the selection of the number of muscle synergies between different research laboratories, independent of arbitrary thresholds.
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Affiliation(s)
- Riccardo Ballarini
- Department of Electronics and Telecommunications, Politecnico di Torino, 10129 Turin, Italy; (R.B.); (M.G.); (M.K.)
| | - Marco Ghislieri
- Department of Electronics and Telecommunications, Politecnico di Torino, 10129 Turin, Italy; (R.B.); (M.G.); (M.K.)
- PoliToMed Lab, Politecnico di Torino, 10129 Turin, Italy
| | - Marco Knaflitz
- Department of Electronics and Telecommunications, Politecnico di Torino, 10129 Turin, Italy; (R.B.); (M.G.); (M.K.)
- PoliToMed Lab, Politecnico di Torino, 10129 Turin, Italy
| | - Valentina Agostini
- Department of Electronics and Telecommunications, Politecnico di Torino, 10129 Turin, Italy; (R.B.); (M.G.); (M.K.)
- PoliToMed Lab, Politecnico di Torino, 10129 Turin, Italy
- Correspondence: ; Tel.: +39-011-0904136
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15
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Morbidoni C, Cucchiarelli A, Agostini V, Knaflitz M, Fioretti S, Di Nardo F. Machine-Learning-Based Prediction of Gait Events From EMG in Cerebral Palsy Children. IEEE Trans Neural Syst Rehabil Eng 2021; 29:819-830. [PMID: 33909568 DOI: 10.1109/tnsre.2021.3076366] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Machine-learning techniques are suitably employed for gait-event prediction from only surface electromyographic (sEMG) signals in control subjects during walking. Nevertheless, a reference approach is not available in cerebral-palsy hemiplegic children, likely due to the large variability of foot-floor contacts. This study is designed to investigate a machine-learning-based approach, specifically developed to binary classify gait events and to predict heel-strike (HS) and toe-off (TO) timing from sEMG signals in hemiplegic-child walking. To this objective, sEMG signals are acquired from five hemiplegic-leg muscles in nearly 2500 strides from 20 hemiplegic children, acknowledged as Winters' group 1 and 2. sEMG signals, segmented in overlapping windows of 600 samples (pace = 5 samples), are used to train a multi-layer perceptron model. Intra-subject and inter-subject experimental settings are tested. The best-performing intra-subject approach is able to provide in the hemiplegic population a mean classification accuracy (±SD) of 0.97±0.01 and a suitable prediction of HS and TO events, in terms of average mean absolute error (MAE, 14.8±3.2 ms for HS and 17.6±4.2 ms for TO) and F1-score (0.95±0.03 for HS and 0.92±0.07 for TO). These results outperform previous sEMG-based attempts in cerebral-palsy populations and are comparable with outcomes achieved by reference approaches in control populations. In conclusion, the findings of the study prove the feasibility of neural networks in predicting the two main gait events using surface EMG signals, also in condition of high variability of the signal to predict as in hemiplegic cerebral palsy.
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16
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Ghislieri M, Knaflitz M, Labanca L, Barone G, Bragonzoni L, Benedetti MG, Agostini V. Muscle Synergy Assessment During Single-Leg Stance. IEEE Trans Neural Syst Rehabil Eng 2020; 28:2914-2922. [PMID: 33048669 DOI: 10.1109/tnsre.2020.3030847] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
In the study of muscle synergies during the maintenance of single-leg stance there are several methodological issues that must be taken into account before muscle synergy extraction. In particular, it is important to distinguish between epochs of surface electromyography (sEMG) signals corresponding to "well-balanced" and "unbalanced" single-leg stance, since different motor control strategies could be used to maintain balance. The aim of this work is to present and define a robust procedure to distinguish between "well-balanced" and "unbalanced" single-leg stance to be chosen as input for the algorithm used to extract muscle synergies. Our results demonstrate that the proposed approach for the selection of sEMG epochs relative to "well-balanced" and "unbalanced" single-leg stance is robust with respect to the selection of the segmentation threshold, revealing a high consistency in the number of muscle synergies and high similarity among the weight vectors (correlation values range from 0.75 to 0.97). Moreover, differences in terms of average recruitment levels and balance control strategies were detected, suggesting a slightly different modular organization between "well-balanced" and "unbalanced" single-leg stance. In conclusion, this approach can be successfully used as a pre-processing step before muscle synergy extraction, allowing for a better assessment of motor control strategies during the single-leg stance task.
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17
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Agostini V, Ghislieri M, Rosati S, Balestra G, Knaflitz M. Surface Electromyography Applied to Gait Analysis: How to Improve Its Impact in Clinics? Front Neurol 2020; 11:994. [PMID: 33013656 PMCID: PMC7502709 DOI: 10.3389/fneur.2020.00994] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 07/29/2020] [Indexed: 12/22/2022] Open
Abstract
Surface electromyography (sEMG) is the main non-invasive tool used to record the electrical activity of muscles during dynamic tasks. In clinical gait analysis, a number of techniques have been developed to obtain and interpret the muscle activation patterns of patients showing altered locomotion. However, the body of knowledge described in these studies is very seldom translated into routine clinical practice. The aim of this work is to analyze critically the key factors limiting the extensive use of these powerful techniques among clinicians. A thorough understanding of these limiting factors will provide an important opportunity to overcome limitations through specific actions, and advance toward an evidence-based approach to rehabilitation based on objective findings and measurements.
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Affiliation(s)
- Valentina Agostini
- PoliToBIOMedLab, Politecnico di Torino, Turin, Italy.,Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
| | - Marco Ghislieri
- PoliToBIOMedLab, Politecnico di Torino, Turin, Italy.,Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
| | - Samanta Rosati
- PoliToBIOMedLab, Politecnico di Torino, Turin, Italy.,Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
| | - Gabriella Balestra
- PoliToBIOMedLab, Politecnico di Torino, Turin, Italy.,Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
| | - Marco Knaflitz
- PoliToBIOMedLab, Politecnico di Torino, Turin, Italy.,Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
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18
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Scafa S, Fiorillo L, Lucchini M, Roth C, Agostini V, Vancheri A, Faraci FD. Personalized Sleep Spindle Detection in Whole Night Polysomnography. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2020:1047-1050. [PMID: 33018165 DOI: 10.1109/embc44109.2020.9176136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The present study proposes a new personalized sleep spindle detection algorithm, suggesting the importance of an individualized approach. We identify an optimal set of features that characterize the spindle and exploit a support vector machine to distinguish between spindle and nonspindle patterns. The algorithm is assessed on the open source DREAMS database, that contains only selected part of the polysomnography, and on whole night polysomnography recordings from the SPASH database. We show that on the former database the personalization can boost sensitivity, from 84.2% to 89.8%, with a slight increase in specificity, from 97.6% to 98.1%. On a whole night polysomnography instead, the algorithm reaches a sensitivity of 98.6% and a specificity of 98.1%, thanks to the personalization approach. Future work will address the integration of the spindle detection algorithm within a sleep scoring automated procedure.
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19
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Sbrollini A, Agostini V, Cavallini C, Burattini L, Knaflitz M. Postural data from Stargardt's syndrome patients. Data Brief 2020; 30:105452. [PMID: 32280738 PMCID: PMC7136594 DOI: 10.1016/j.dib.2020.105452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 03/11/2020] [Accepted: 03/12/2020] [Indexed: 11/20/2022] Open
Abstract
The database is a collection of postural data acquired from 10 patients affected by the rare Stargardt's syndrome, all having the ABCA4 gene mutation, and from 10 control healthy subjects. Specifically, the database includes a file (.xlxs) called SubjectsData and 20 datasets (MATLAB structures) containing postural signals. Each subject performed a total of 15 postural tests, 5 postural tests for 3 different conditions (‘C’: eyes-closed; ‘O’: eyes-open, still target fixation; ‘M’: eyes-open, moving target tracking). For each postural test, 11 postural derived signals (the anterior-posterior force, the medio-lateral force, the vertical force, the plate moment about x axis, the plate moment about y axis, the plate moment about z axis, the plate moment about top plate surface about x axis, the plate moment about top plat surface about y axis, the x-coordinate of the center of pressure, the y-coordinate of the center of pressure, and the free moment about z axis) were computed from 8 raw signals, acquired at the Ophthalmic Hospital of Turin, Italy, through an 8-channel Kistler 9286A force platform connected to a Step32 system. Thus, a total of 285 postural signals (120 raw and 165 derived) are available for each subject. The database may be useful to: (1) investigate postural adaptations of patients affected by Stargardt's syndrome; (2) support definition of rehabilitative procedures to reduce postural instability of patients affected by Stargardt's syndrome; and (3) support investigation on visual control of balance in the general population.
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Affiliation(s)
- Agnese Sbrollini
- Cardiovascular Bioengineering Lab, Department of Information Engineering, Università Politecnica delle Marche, Via Brecce Bianche 12, 60131 Ancona, Italy
| | - Valentina Agostini
- Dipartimento di Elettronica e Telecomunicazioni, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Torino, Italy
| | - Chanda Cavallini
- Presidio Sperino, Ospedale Oftalmico di Torino, Via Juvarra 19, 10122 Torino, Italy
| | - Laura Burattini
- Cardiovascular Bioengineering Lab, Department of Information Engineering, Università Politecnica delle Marche, Via Brecce Bianche 12, 60131 Ancona, Italy
- Corresponding author.
| | - Marco Knaflitz
- Dipartimento di Elettronica e Telecomunicazioni, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Torino, Italy
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20
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Ammirati E, Veronese G, Brambatti M, Merlo M, Cipriani M, Potena L, Sormani P, Aoki T, Sugimura K, Sawamura A, Okumura T, Pinney S, Hong K, Shah P, Braun Ö, Van de Heyning CM, Montero S, Petrella D, Huang F, Schmidt M, Raineri C, Lala A, Varrenti M, Foà A, Leone O, Gentile P, Artico J, Agostini V, Patel R, Garascia A, Van Craenenbroeck EM, Hirose K, Isotani A, Murohara T, Arita Y, Sionis A, Fabris E, Hashem S, Garcia-Hernando V, Oliva F, Greenberg B, Shimokawa H, Sinagra G, Adler ED, Frigerio M, Camici PG. Fulminant Versus Acute Nonfulminant Myocarditis in Patients With Left Ventricular Systolic Dysfunction. J Am Coll Cardiol 2020; 74:299-311. [PMID: 31319912 DOI: 10.1016/j.jacc.2019.04.063] [Citation(s) in RCA: 124] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 04/23/2019] [Accepted: 04/29/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Fulminant myocarditis (FM) is a form of acute myocarditis characterized by severe left ventricular systolic dysfunction requiring inotropes and/or mechanical circulatory support. A single-center study found that a patient with FM had better outcomes than those with acute nonfulminant myocarditis (NFM) presenting with left ventricular systolic dysfunction, but otherwise hemodynamically stable. This was recently challenged, so disagreement still exists. OBJECTIVES This study sought to provide additional evidence on the outcome of FM and to ascertain whether patient stratification based on the main histologic subtypes can provide additional prognostic information. METHODS A total of 220 patients (median age 42 years, 46.3% female) with histologically proven acute myocarditis (onset of symptoms <30 days) all presenting with left ventricular systolic dysfunction were included in a retrospective, international registry comprising 16 tertiary hospitals in the United States, Europe, and Japan. The main endpoint was the occurrence of cardiac death or heart transplantation within 60 days from admission and at long-term follow-up. RESULTS Patients with FM (n = 165) had significantly higher rates of cardiac death and heart transplantation compared with those with NFM (n = 55), both at 60 days (28.0% vs. 1.8%, p = 0.0001) and at 7-year follow-up (47.7% vs. 10.4%, p < 0.0001). Using Cox multivariate analysis, the histologic subtype emerged as a further variable affecting the outcome in FM patients, with giant cell myocarditis having a significantly worse prognosis compared with eosinophilic and lymphocytic myocarditis. In a subanalysis including only adults with lymphocytic myocarditis, the main endpoints occurred more frequently in FM compared with in NFM both at 60 days (19.5% vs. 0%, p = 0.005) and at 7-year follow up (41.4% vs. 3.1%, p = 0.0004). CONCLUSIONS This international registry confirms that patients with FM have higher rates of cardiac death and heart transplantation both in the short- and long-term compared with patients with NFM. Furthermore, we provide evidence that the histologic subtype of FM carries independent prognostic value, highlighting the need for timely endomyocardial biopsy in this condition.
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Affiliation(s)
- Enrico Ammirati
- De Gasperis Cardio Center, Niguarda Hospital, Milano, Italy.
| | - Giacomo Veronese
- De Gasperis Cardio Center, Niguarda Hospital, Milano, Italy; Department of Health Sciences, University of Milano-Bicocca, Monza, Italy
| | - Michela Brambatti
- Division of Cardiology, Department of Medicine, University of California San Diego, La Jolla, California
| | - Marco Merlo
- Cardiothoracic Department, Azienda Sanitaria Universitaria Integrata (ASUITS), University of Trieste, Trieste, Italy
| | | | | | - Paola Sormani
- De Gasperis Cardio Center, Niguarda Hospital, Milano, Italy
| | - Tatsuo Aoki
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | | | | | - Sean Pinney
- Icahn School of Medicine at Mount Sinai, New York, New York
| | - Kimberly Hong
- Division of Cardiology, Department of Medicine, University of California San Diego, La Jolla, California
| | - Palak Shah
- Inova Heart and Vascular Institute, Falls Church, Virginia
| | - Öscar Braun
- Department of Cardiology, Clinical Sciences, Lund University and Skåne University Hospital, Lund, Sweden
| | | | - Santiago Montero
- Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute IIB Sant Pau, CIBER-CV, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Medical Intensive Care Unit, Paris Cedex 13, France
| | | | - Florent Huang
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Medical Intensive Care Unit, Paris Cedex 13, France
| | - Matthieu Schmidt
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Medical Intensive Care Unit, Paris Cedex 13, France
| | - Claudia Raineri
- Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Anuradha Lala
- Icahn School of Medicine at Mount Sinai, New York, New York
| | - Marisa Varrenti
- De Gasperis Cardio Center, Niguarda Hospital, Milano, Italy; Department of Health Sciences, University of Milano-Bicocca, Monza, Italy
| | - Alberto Foà
- Academic Hospital S. Orsola-Malpighi, Bologna, Italy
| | - Ornella Leone
- Academic Hospital S. Orsola-Malpighi, Bologna, Italy
| | - Piero Gentile
- Cardiothoracic Department, Azienda Sanitaria Universitaria Integrata (ASUITS), University of Trieste, Trieste, Italy
| | - Jessica Artico
- Cardiothoracic Department, Azienda Sanitaria Universitaria Integrata (ASUITS), University of Trieste, Trieste, Italy
| | | | - Rajiv Patel
- Inova Heart and Vascular Institute, Falls Church, Virginia
| | | | | | | | | | | | - Yoh Arita
- Japan Community Healthcare Organization, Osaka Hospital, Osaka, Japan
| | - Alessandro Sionis
- Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute IIB Sant Pau, CIBER-CV, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Enrico Fabris
- Cardiothoracic Department, Azienda Sanitaria Universitaria Integrata (ASUITS), University of Trieste, Trieste, Italy
| | - Sherin Hashem
- Department of Pathology, University of California, San Diego, La Jolla, California
| | - Victor Garcia-Hernando
- Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute IIB Sant Pau, CIBER-CV, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Fabrizio Oliva
- De Gasperis Cardio Center, Niguarda Hospital, Milano, Italy
| | - Barry Greenberg
- Division of Cardiology, Department of Medicine, University of California San Diego, La Jolla, California
| | | | - Gianfranco Sinagra
- Cardiothoracic Department, Azienda Sanitaria Universitaria Integrata (ASUITS), University of Trieste, Trieste, Italy
| | - Eric D Adler
- Division of Cardiology, Department of Medicine, University of California San Diego, La Jolla, California.
| | - Maria Frigerio
- De Gasperis Cardio Center, Niguarda Hospital, Milano, Italy
| | - Paolo G Camici
- Vita Salute University and San Raffaele Hospital, Milano, Italy
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21
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Abstract
The muscle synergy theory was widely used in literature to assess the modular organization of the central nervous system (CNS) during human locomotion. The extraction of muscle synergies may be strongly influenced by the preprocessing techniques applied to surface electromyographic (sEMG) signals. The aim of this contribution is to assess the robustness improvement in muscle synergy extraction obtained using an innovative pre-processing technique with respect to the standard procedure. The new pre-processing technique that we propose is based on the extraction of principal muscle activation intervals (necessary to accomplish a specific biomechanical task during gait) from the original sEMG signals, discarding the secondary muscle activation intervals (activations that occur only in some strides with auxiliary functions). Results suggest that the extraction of the principal activation intervals from sEMG provide a more consistent and stable description of the modular organization of the CNS with respect to the standard pre-processing procedure.
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22
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Veronese G, Ammirati E, Brambatti M, Merlo M, Cipriani M, Potena L, Sormani P, Aoki T, Sugimura K, Sawamura A, Okumura T, Pinney S, Hong K, Shah P, Braun OÖ, Van de Heyning CM, Montero S, Petrella D, Huang F, Schmidt M, Raineri C, Lala A, Varrenti M, Foà A, Leone O, Gentile P, Artico J, Agostini V, Patel R, Garascia A, Van Craenenbroeck EM, Hirose K, Isotani A, Murohara T, Arita Y, Sionis A, Fabris E, Hashem S, Garcia-Hernando V, Oliva F, Greenberg B, Shimokawa H, Sinagra G, Adler ED, Frigerio M, Camici PG. Viral genome search in myocardium of patients with fulminant myocarditis. Eur J Heart Fail 2020; 22:1277-1280. [PMID: 31926056 DOI: 10.1002/ejhf.1738] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 12/08/2019] [Indexed: 11/09/2022] Open
Affiliation(s)
- Giacomo Veronese
- De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy.,Department of Health Sciences, University of Milano-Bicocca, Monza, Italy
| | | | - Michela Brambatti
- Division of Cardiology, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Marco Merlo
- Cardiothoracic Department, Azienda Sanitaria Universitaria Integrata, University of Trieste, Trieste, Italy
| | | | | | - Paola Sormani
- De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy
| | - Tatsuo Aoki
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | | | | | - Sean Pinney
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kimberly Hong
- Division of Cardiology, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Palak Shah
- Inova Heart and Vascular Institute, Falls Church, VI, USA
| | - Oscar Ö Braun
- Department of Cardiology, Clinical Sciences, Lund University and Skåne University Hospital, Lund, Sweden
| | | | - Santiago Montero
- Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute IIB Sant Pau, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain.,Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Medical Intensive Care Unit, Paris, France
| | | | - Florent Huang
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Medical Intensive Care Unit, Paris, France
| | - Matthieu Schmidt
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Medical Intensive Care Unit, Paris, France
| | | | - Anuradha Lala
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Marisa Varrenti
- De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy.,Department of Health Sciences, University of Milano-Bicocca, Monza, Italy
| | - Alberto Foà
- Academic Hospital S. Orsola-Malpighi, Bologna, Italy
| | - Ornella Leone
- Academic Hospital S. Orsola-Malpighi, Bologna, Italy
| | - Piero Gentile
- Cardiothoracic Department, Azienda Sanitaria Universitaria Integrata, University of Trieste, Trieste, Italy
| | - Jessica Artico
- Cardiothoracic Department, Azienda Sanitaria Universitaria Integrata, University of Trieste, Trieste, Italy
| | | | - Rajiv Patel
- Inova Heart and Vascular Institute, Falls Church, VI, USA
| | | | | | | | | | | | - Yoh Arita
- Japan Community Healthcare Organization, Osaka Hospital, Osaka, Japan
| | - Alessandro Sionis
- Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute IIB Sant Pau, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Enrico Fabris
- Cardiothoracic Department, Azienda Sanitaria Universitaria Integrata, University of Trieste, Trieste, Italy
| | - Sherin Hashem
- Department of Pathology, University of California San Diego, La Jolla, CA, USA
| | - Victor Garcia-Hernando
- Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute IIB Sant Pau, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Fabrizio Oliva
- De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy
| | - Barry Greenberg
- Division of Cardiology, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | | | - Gianfranco Sinagra
- Cardiothoracic Department, Azienda Sanitaria Universitaria Integrata, University of Trieste, Trieste, Italy
| | - Eric D Adler
- Division of Cardiology, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Maria Frigerio
- De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy
| | - Paolo G Camici
- Vita Salute University and San Raffaele Hospital, Milan, Italy
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23
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Ghislieri M, Agostini V, Knaflitz M. Muscle Synergies Extracted Using Principal Activations: Improvement of Robustness and Interpretability. IEEE Trans Neural Syst Rehabil Eng 2020; 28:453-460. [PMID: 31944961 DOI: 10.1109/tnsre.2020.2965179] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The muscle synergy theory has been widely used to assess the modular organization of the central nervous system (CNS) during human locomotion. The pre-processing approach applied to the surface electromyographic (sEMG) signals influences the extraction of muscle synergies. The aim of this contribution is to assess the improvements in muscle synergy extraction obtained by using an innovative pre-processing approach. We evaluate the improvement in terms of the possible variation in the number of muscle synergies, of the intra-subject consistency, of the robustness, and of the interpretability of the results. The pre-processing approach presented in this paper is based on the extraction of the muscle principal activations (muscle activations strictly necessary to accomplish a specific biomechanical task) from the original sEMG signals, to then obtain muscle synergies using principal activations only. The results herein presented show that the application of this novel approach for the extraction of the muscle synergies provides a more robust and easily interpretable description of the modular organization of the CNS with respect to the standard pre-processing approach.
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24
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Graziosi M, Leone O, Foà A, Agostini V, Ditaranto R, Foroni M, Rossi C, Lovato L, Seri M, Rapezzi C. Postmortem diagnosis of left dominant arrhythmogenic cardiomyopathy: the importance of a multidisciplinary network for sudden death victims. “HIC mors gaudet succurere vitae”. Cardiovasc Pathol 2020; 44:107157. [DOI: 10.1016/j.carpath.2019.107157] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 09/17/2019] [Accepted: 09/27/2019] [Indexed: 10/25/2022] Open
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25
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Agostini V, Bailo P, Chiti E, Linarello P, Gentile G, Primignani P, Giriodi M, Piccinini A. Ocular swabs on exhumed bodies: An alternative to the collection of “classical” tissue samples in forensic genetics. Forensic Sci Int Genet 2020; 44:102206. [DOI: 10.1016/j.fsigen.2019.102206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 10/16/2019] [Accepted: 11/15/2019] [Indexed: 10/25/2022]
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26
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Saponara M, Indio V, Pizzi C, Serban ED, Urbini M, Astolfi A, Paolisso P, Suarez SM, Nannini M, Pacini D, Agostini V, Leone O, Ambrosini V, Tarantino G, Fanti S, Niro F, Buia F, Attinà D, Pantaleo MA. Successful multidisciplinary clinical approach and molecular characterization by whole transcriptome sequencing of a cardiac myxofibrosarcoma: A case report. World J Clin Cases 2019; 7:3018-3026. [PMID: 31624749 PMCID: PMC6795718 DOI: 10.12998/wjcc.v7.i19.3018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 07/25/2019] [Accepted: 07/27/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Cardiac tumors are rare and complex entities. Surgery represents the cornerstone of therapy, while the role of adjuvant treatment remains unclear and, in case of relapse or metastatic disease, the prognosis is very poor. Lack of prospective, randomized clinical trials hinders the generation of high level evidence for the optimal diagnostic workup and multimodal treatment of cardiac sarcomas. Herein, we describe the multidisciplinary clinical management and molecular characterization of a rare case of cardiac myxofibrosarcoma in an elderly woman.
CASE SUMMARY A 73-year-old woman presented signs and symptoms of acute left-sided heart failure. Imaging examination revealed a large, left atrial mass. With suspicion of a myxoma, she underwent surgery, and symptoms were promptly relieved. Histology showed a cardiac myxofibrosarcoma, a rare histotype of cardiac sarcoma. Eight months later, disease unfortunately relapsed, and after a multidisciplinary discussion, a chemotherapy with doxorubicin and then gemcitabine was started, achieving partial radiologic and complete metabolic response, which was maintained up to 2 years and is still present. This report is focused on the entire clinical path of our patient from diagnosis to follow-up, through surgery and strategies adopted at relapse. Moreover, due to their rarity, very little is known about the molecular landscape of myxofibrosarcomas. Thus, we also performed and described preliminary genome analysis of the tumor tissue to get further insight on mechanisms involved in tumor growth, and to possibly unveil new clinically actionable targets.
CONCLUSION We report a case of cardiac myxofibrosarcoma that achieved a very good prognosis due to an integrated surgical, cardiac and oncologic treatment strategy.
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Affiliation(s)
- Maristella Saponara
- Department of Specialized, Experimental and Diagnostic Medicine, Medical Oncology Unit, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy
| | - Valentina Indio
- “Giorgio Prodi” Cancer Research Center, University of Bologna, Bologna 40138, Italy
| | - Carmine Pizzi
- Department of Specialized, Experimental and Diagnostic Medicine, Cardiology and Transplantation Unit, Sant’Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy
| | - Elena-Daniela Serban
- Department of Pathology, Cardiovascular Pathology Unit, Sant’Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy
| | - Milena Urbini
- “Giorgio Prodi” Cancer Research Center, University of Bologna, Bologna 40138, Italy
| | - Annalisa Astolfi
- “Giorgio Prodi” Cancer Research Center, University of Bologna, Bologna 40138, Italy
| | - Pasquale Paolisso
- Department of Specialized, Experimental and Diagnostic Medicine, Cardiology and Transplantation Unit, Sant’Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy
| | - Sofia Martin Suarez
- Departments of Cardiovascular Surgery and Transplantation, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy
| | - Margherita Nannini
- Department of Specialized, Experimental and Diagnostic Medicine, Medical Oncology Unit, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy
| | - Davide Pacini
- Departments of Cardiovascular Surgery and Transplantation, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy
| | - Valentina Agostini
- Department of Pathology, Cardiovascular Pathology Unit, Sant’Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy
| | - Ornella Leone
- Department of Pathology, Cardiovascular Pathology Unit, Sant’Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy
| | - Valentina Ambrosini
- Department of Specialized, Experimental and Diagnostic Medicine, Nuclear Medicine Unit, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy
| | - Giuseppe Tarantino
- “Giorgio Prodi” Cancer Research Center, University of Bologna, Bologna 40138, Italy
| | - Stefano Fanti
- Department of Specialized, Experimental and Diagnostic Medicine, Nuclear Medicine Unit, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy
| | - Fabio Niro
- Department of Specialized, Experimental and Diagnostic Medicine, Radiology Unit, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy
| | - Francesco Buia
- Department of Specialized, Experimental and Diagnostic Medicine, Radiology Unit, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy
| | - Domenico Attinà
- Department of Specialized, Experimental and Diagnostic Medicine, Radiology Unit, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy
| | - Maria Abbondanza Pantaleo
- Department of Specialized, Experimental and Diagnostic Medicine, Medical Oncology Unit, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy
- “Giorgio Prodi” Cancer Research Center, University of Bologna, Bologna 40138, Italy
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27
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Rosso V, Agostini V, Takeda R, Tadano S, Gastaldi L. Influence of BMI on Gait Characteristics of Young Adults: 3D Evaluation Using Inertial Sensors. Sensors (Basel) 2019; 19:s19194221. [PMID: 31569372 PMCID: PMC6806343 DOI: 10.3390/s19194221] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 09/12/2019] [Accepted: 09/25/2019] [Indexed: 12/30/2022]
Abstract
Overweight/obesity is a physical condition that affects daily activities, including walking. The main purpose of this study was to identify if there is a relationship between body mass index (BMI) and gait characteristics in young adults. 12 normal weight (NW) and 10 overweight/obese (OW) individuals walked at a self-selected speed along a 14 m indoor path. H-Gait system, combining seven inertial sensors (fixed on pelvis and lower limbs), was used to record gait data. Walking speed, spatio-temporal parameters and joint kinematics in 3D were analyzed. Differences between NW and OW and correlations between BMI and gait parameters were evaluated. Conventional spatio-temporal parameters did not show statistical differences between the two groups or correlations with the BMI. However, significant results were pointed out for the joint kinematics. OW showed greater hip joint angles in frontal and transverse planes, with respect to NW. In the transverse plane, OW showed a greater knee opening angle and a shorter length of knee and ankle trajectories. Correlations were found between BMI and kinematic parameters in the frontal and transverse planes. Despite some phenomena such as soft tissue artifact and kinematics cross-talk, which have to be more deeply assessed, current results show a relationship between BMI and gait characteristics in young adults that should be looked at in osteoarthritis prevention.
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Affiliation(s)
- Valeria Rosso
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Italy, Corso Duca degli Abruzzi 24, 10129 Torino, Italy.
| | - Valentina Agostini
- Department of Electronics and Telecommunications, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Torino, Italy.
| | - Ryo Takeda
- Division of Human Mechanical Systems and Design, Faculty of Engineering, Hokkaido University, Sapporo, Hokkaido 060-8628, Japan.
| | - Shigeru Tadano
- Division of Human Mechanical Systems and Design, Faculty of Engineering, Hokkaido University, Sapporo, Hokkaido 060-8628, Japan.
- National Institute of Technology, Hakodate College, Hakodate 042-8501, Japan.
| | - Laura Gastaldi
- Department of Mathematical Sciences, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Torino, Italy.
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28
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Ghislieri M, Gastaldi L, Pastorelli S, Tadano S, Agostini V. Wearable Inertial Sensors to Assess Standing Balance: A Systematic Review. Sensors (Basel) 2019; 19:E4075. [PMID: 31547181 PMCID: PMC6806601 DOI: 10.3390/s19194075] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 09/12/2019] [Accepted: 09/17/2019] [Indexed: 02/06/2023]
Abstract
Wearable sensors are de facto revolutionizing the assessment of standing balance. The aim of this work is to review the state-of-the-art literature that adopts this new posturographic paradigm, i.e., to analyse human postural sway through inertial sensors directly worn on the subject body. After a systematic search on PubMed and Scopus databases, two raters evaluated the quality of 73 full-text articles, selecting 47 high-quality contributions. A good inter-rater reliability was obtained (Cohen's kappa = 0.79). This selection of papers was used to summarize the available knowledge on the types of sensors used and their positioning, the data acquisition protocols and the main applications in this field (e.g., "active aging", biofeedback-based rehabilitation for fall prevention, and the management of Parkinson's disease and other balance-related pathologies), as well as the most adopted outcome measures. A critical discussion on the validation of wearable systems against gold standards is also presented.
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Affiliation(s)
- Marco Ghislieri
- Department of Electronics and Telecommunications, Politecnico di Torino, 10129 Torino, Italy.
| | - Laura Gastaldi
- Department of Mathematical Sciences, Politecnico di Torino, 10129 Torino, Italy.
| | - Stefano Pastorelli
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, 10129 Torino, Italy.
| | - Shigeru Tadano
- National Institute of Technology, Hakodate College, Hakodatate 042-8501, Japan.
- Division of Human Mechanical Systems and Design, Faculty of Engineering, Hokkaido University, Sapporo 060-0808, Japan.
| | - Valentina Agostini
- Department of Electronics and Telecommunications, Politecnico di Torino, 10129 Torino, Italy.
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29
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Foà A, Agostini V, Rapezzi C, Olivotto I, Corti B, Potena L, Biagini E, Martin Suarez S, Rotellini M, Cecchi F, Stefano P, Coppini R, Ferrantini C, Bacchi Reggiani ML, Leone O. Histopathological comparison of intramural coronary artery remodeling and myocardial fibrosis in obstructive versus end-stage hypertrophic cardiomyopathy. Int J Cardiol 2019; 291:77-82. [PMID: 30979607 DOI: 10.1016/j.ijcard.2019.03.060] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 03/07/2019] [Accepted: 03/27/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND Although imaging techniques have demonstrated the existence of microvascular abnormalities in hypertrophic cardiomyopathy (HCM), a detailed histopathological assessment is lacking as well as a comparison between different phases of the disease. We aimed to compare microvasculopathy and myocardial fibrosis in hypertrophic obstructive cardiomyopathy (HOCM) versus end-stage (ES) HCM. METHODS 27 myectomy specimens of HOCM patients and 30 ES-HCM explanted hearts were analyzed. Myocardial fibrosis was quantitatively determined with dedicated software and qualitatively classified as scar-like or interstitial. Intramural coronary arteries were evaluated separately according to lumen diameter: 100-500 μ versus <100 μ. Microvasculopathy assessment included the description of medial and intimal abnormalities and stenosis grading. The two subgroups were compared considering only the anterobasal septum of ES explanted hearts. RESULTS Median value of fibrosis in the anterobasal septum of explanted hearts was 34.6% as opposed to 10.3% of myectomy specimens (p < 0.001). Scar-like fibrosis was widely found in ES hearts while interstitial fibrosis was distinctive of HOCM (p < 0.001). All slides showed 100-500 μ microvasculopathy without any differences between subgroups in terms of lumen narrowing, extent of the disease and type of parietal involvement. Among ES hearts these lesions were associated with scar-like fibrosis (p = 0.034). <100-μ microvasculopathy was also frequent with no differences between subgroups. CONCLUSIONS Microvasculopathy is an intrinsic feature of HCM with similar characteristics across the natural phases of the disease. Conversely, myocardial fibrosis changes over time with ES hearts showing a three-fold greater amount, mainly scar-like. ES showed a closer association between microvasculopathy and replacement fibrosis.
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Affiliation(s)
- Alberto Foà
- Cardiology, Department of Experimental Diagnostic and Specialty Medicine, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Valentina Agostini
- Cardiovascular Pathology Unit, Department of Pathology, Sant'Orsola-Malpighi University Hospital, Bologna, Italy
| | - Claudio Rapezzi
- Cardiology, Department of Experimental Diagnostic and Specialty Medicine, Alma Mater Studiorum-University of Bologna, Bologna, Italy.
| | - Iacopo Olivotto
- Cardiomyopathy Unit, Careggi University Hospital, Florence, Italy
| | - Barbara Corti
- Cardiovascular Pathology Unit, Department of Pathology, Sant'Orsola-Malpighi University Hospital, Bologna, Italy
| | - Luciano Potena
- Heart Transplant Program, Sant'Orsola-Malpighi University Hospital, Bologna, Italy
| | - Elena Biagini
- Cardiology, Department of Experimental Diagnostic and Specialty Medicine, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Sofia Martin Suarez
- Heart Transplant Program, Sant'Orsola-Malpighi University Hospital, Bologna, Italy
| | - Matteo Rotellini
- Cardiothoracic and Vascular Department, Careggi University Hospital, Florence, Italy
| | - Franco Cecchi
- Cardiothoracic and Vascular Department, Careggi University Hospital, Florence, Italy
| | - Pierluigi Stefano
- Cardiothoracic and Vascular Department, Careggi University Hospital, Florence, Italy
| | | | - Cecilia Ferrantini
- Cardiothoracic and Vascular Department, Careggi University Hospital, Florence, Italy
| | - Maria L Bacchi Reggiani
- Cardiology, Department of Experimental Diagnostic and Specialty Medicine, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Ornella Leone
- Cardiovascular Pathology Unit, Department of Pathology, Sant'Orsola-Malpighi University Hospital, Bologna, Italy
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30
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Abstract
Gait asymmetry is typically evaluated using spatio-temporal or joint kinematics parameters. Only a few studies addressed the problem of defining an asymmetry index directly based on muscle activity, extracting parameters from surface electromyography (sEMG) signals. Moreover, no studies used the extraction of the muscle principal activations (activations that are necessary for accomplishing a specific motor task) as the base to construct an asymmetry index, less affected by the variability of sEMG patterns. The aim of this paper is to define a robust index to quantitatively assess the asymmetry of muscle activations during locomotion, based on the extraction of the principal activations. SEMG signals were analyzed combining statistical gait analysis (SGA) and a clustering algorithm that allows for obtaining the muscle principal activations. We evaluated the asymmetry levels of four lower limb muscles in: (1) healthy subjects of different ages (children, adults, and elderly); (2) different populations of orthopedic patients (adults with megaprosthesis of the knee after bone tumor resection, elderly subjects after total knee arthroplasty, and elderly subjects after total hip arthroplasty); and (3) neurological patients (children with hemiplegic cerebral palsy and elderly subjects affected by idiopathic normal pressure hydrocephalus). The asymmetry index obtained for each pathological population was then compared to that of age-matched controls. We found asymmetry levels consistent with the expected impact of the different pathologies on muscle activation during gait. This suggests that the proposed index can be successfully used in clinics for an objective assessment of the muscle activation asymmetry during locomotion.
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31
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Leone O, Pacini D, Foà A, Corsini A, Agostini V, Corti B, Di Marco L, Leone A, Lorenzini M, Reggiani LB, Di Bartolomeo R, Rapezzi C. Redefining the histopathologic profile of acute aortic syndromes: Clinical and prognostic implications. J Thorac Cardiovasc Surg 2018; 156:1776-1785.e6. [DOI: 10.1016/j.jtcvs.2018.04.086] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 04/09/2018] [Accepted: 04/18/2018] [Indexed: 01/16/2023]
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32
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Foa A, Rapezzi C, Olivotto I, Cecchi F, Coppini R, Ferrantini C, Stefano P, Agostini V, Vitale G, Ditaranto R, Biagini E, Leone O. 1473Microvascular coronary disease and myocardial fibrosis within the spectrum of hypertrophic cardiomyopathy: a histopathologic study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.1473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Foa
- University Hospital Policlinic S. Orsola-Malpighi, Cardiology, Bologna, Italy
| | - C Rapezzi
- University Hospital Policlinic S. Orsola-Malpighi, Cardiology, Bologna, Italy
| | - I Olivotto
- Careggi University Hospital (AOUC), Cardiology, Florence, Italy
| | - F Cecchi
- Careggi University Hospital (AOUC), Cardiology, Florence, Italy
| | - R Coppini
- Careggi University Hospital (AOUC), Cardiology, Florence, Italy
| | - C Ferrantini
- Careggi University Hospital (AOUC), Cardiology, Florence, Italy
| | - P Stefano
- Careggi University Hospital (AOUC), Florence, Italy
| | - V Agostini
- University Hospital Policlinic S. Orsola-Malpighi, Pathology, Bologna, Italy
| | - G Vitale
- University Hospital Policlinic S. Orsola-Malpighi, Cardiology, Bologna, Italy
| | - R Ditaranto
- University Hospital Policlinic S. Orsola-Malpighi, Cardiology, Bologna, Italy
| | - E Biagini
- University Hospital Policlinic S. Orsola-Malpighi, Cardiology, Bologna, Italy
| | - O Leone
- University Hospital Policlinic S. Orsola-Malpighi, Pathology, Bologna, Italy
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Careddu L, Petridis FD, Angeli E, Romano G, Agostini V, Fucà A, Donti A, Gargiulo G. Excision of Congenital Rhabdomyoma of the Left Outflow Tract through the Left Atrium and Mitral Valve. J Neonatal Surg 2018. [DOI: 10.21699/jns.v7i3.749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Primary rhabdomyomas obstructing the right or left outflow tract are uncommon findings in the perinatal period. The presenting symptom may be arrhythmia, cardiac murmur, complete or variable atrioventricular block, pericardial effusion, cardiomegaly, cardiac failure, or sudden death. The variety of symptoms can be explained on the basis of obstruction of blood flow, myocardial involvement, and disturbance of the cardiac rhythm. Commonly, rhabdomyoma spontaneously regresses in the majority of cases, and neonatal surgery is advocated only in case of severe left ventricular outflow tract (LVOT) obstruction or the development of arrhythmias. Herein, we describe the pathologic and clinical characteristics of neonatal presentation of a cardiac rhabdomyoma with a nearly obstructive mass in the LVOT, discovered during pregnancy and operated 4 months after delivery.
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Brandi G, De Rosa F, Bolondi L, Agostini V, Di Girolamo S, Nobili E, Biasco G. Durable Complete Response of Hepatocellular Carcinoma after Metronomic Capecitabine. Tumori 2018. [DOI: 10.1177/548.6527] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background Hepatocellular carcinoma (HCC) is a highly vascular tumor which is poorly responsive to standard systemic chemotherapy. Recently, various antiangiogenic targeted agents have shown promising activity at different levels of evidence in patients with advanced HCC, suggesting that such treatments might be effective. Case report Since chemotherapy administered with metronomic schedules inhibits angiogenesis, we treated a 64-year-old man with advanced HCC with metronomic capecitabine. After only two months of treatment the HCC nodules disappeared on ultrasonography. This finding was confirmed by a computed tomography scan. After more than three years the patient is still in treatment with minimal toxicity and maintains a complete remission. Conclusions Our case report suggests that metronomic capecitabine may be effective in advanced HCC patients while being also well tolerated. This is important, given the frequent comorbidities of HCC patients. Free full text available at www.tumorionline.it
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Affiliation(s)
- Giovanni Brandi
- Department of Hematology and Oncological Sciences “L. e A. Seràgnoli”, University of Bologna, Bologna, Italy
| | - Francesco De Rosa
- Department of Hematology and Oncological Sciences “L. e A. Seràgnoli”, University of Bologna, Bologna, Italy
| | - Luigi Bolondi
- Department of Internal Medicine, Policlinico Sant'Orsola Malpighi, University of Bologna, Bologna, Italy
| | - Valentina Agostini
- Department of Hematology and Oncological Sciences “L. e A. Seràgnoli”, University of Bologna, Bologna, Italy
| | - Stefania Di Girolamo
- Department of Hematology and Oncological Sciences “L. e A. Seràgnoli”, University of Bologna, Bologna, Italy
| | - Elisabetta Nobili
- Department of Hematology and Oncological Sciences “L. e A. Seràgnoli”, University of Bologna, Bologna, Italy
| | - Guido Biasco
- Department of Hematology and Oncological Sciences “L. e A. Seràgnoli”, University of Bologna, Bologna, Italy
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Borgese L, Potena L, Leone O, Agostini V, Reeve J, Masetti M, Russo A, Grigioni F, Halloran P. Improving the Diagnosis of Rejection by Molecular Phenotype of Endomyocardial Biopsies: Single Center Insights from the Interheart Study. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Zaccaria GM, Rosati S, Zema M, Agostini V, Balestra G. An Approach Based on Process Modeling for Implementing a Health Information Technology in Clinical Practice. j med imaging hlth inform 2018. [DOI: 10.1166/jmihi.2018.2353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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37
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Di Nardo F, Strazza A, Mengarelli A, Ercolani S, Morgoni N, Burattini L, Agostini V, Knaflitz M, Fioretti S. Surface EMG patterns for quantification of thigh muscle co-contraction in school-age children: Normative data during walking. Gait Posture 2018; 61:25-33. [PMID: 29294416 DOI: 10.1016/j.gaitpost.2017.12.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 12/20/2017] [Accepted: 12/26/2017] [Indexed: 02/02/2023]
Abstract
Muscle co-contractions are particularly relevant in analyzing children pathologies. To interpret surface electromyography (sEMG) in pathological conditions, reliable normative data in non-pathological children are required for direct comparison. Aim of the study was the quantification of co-contraction activity between quadriceps femoris (QF) and hamstring muscles during walking in healthy children. To this aim, Statistical gait analysis was performed on sEMG signals from rectus femoris (RF), vastus medialis (VM), and lateral hamstrings (LH), in 16401 strides walked by 100 healthy school-age children. Co-contractions were assessed as overlapping period between activation intervals of considered muscles. Results showed full superimpositions of LH with both RF and VL activity from terminal swing, 80-100% of gait cycle, to successive loading response (0-15% of gait cycle), in around 90% of strides, as reported in adults. This indicates that children regularly use a cocontraction activity between QF and hamstring muscles in weight acceptance during walking, supporting the hypothesis of a regulatory role of co-contraction in providing knee joint stability. Concomitant activity of QF and hamstring muscles was detected also during push-off phase (30-50% of gait cycle), showing a large variability intra and inter subjects and a lower occurrence frequency (around 25% of strides). This could be intended for controlling rapid knee flexion and/or stabilizing pelvis during body progression. Present findings represent the first attempt to provide normative sEMG dataset on variability of QF and hamstring muscles co-contractions during child walking, useful for discriminating physiological and pathological behavior and for designing future studies on maturation of gait.
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Affiliation(s)
- Francesco Di Nardo
- Department of Information Engineering Università Politecnica delle Marche, Ancona, Italy.
| | - Annachiara Strazza
- Department of Information Engineering Università Politecnica delle Marche, Ancona, Italy
| | - Alessandro Mengarelli
- Department of Information Engineering Università Politecnica delle Marche, Ancona, Italy
| | - Serena Ercolani
- Department of Information Engineering Università Politecnica delle Marche, Ancona, Italy
| | - Nicole Morgoni
- Department of Information Engineering Università Politecnica delle Marche, Ancona, Italy
| | - Laura Burattini
- Department of Information Engineering Università Politecnica delle Marche, Ancona, Italy
| | - Valentina Agostini
- Department of Electronics and Telecommunications, Politecnico di Torino, Torino, Italy
| | - Marco Knaflitz
- Department of Electronics and Telecommunications, Politecnico di Torino, Torino, Italy
| | - Sandro Fioretti
- Department of Information Engineering Università Politecnica delle Marche, Ancona, Italy
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Rimini D, Agostini V, Knaflitz M. Intra-Subject Consistency during Locomotion: Similarity in Shared and Subject-Specific Muscle Synergies. Front Hum Neurosci 2017; 11:586. [PMID: 29255410 PMCID: PMC5723022 DOI: 10.3389/fnhum.2017.00586] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 11/20/2017] [Indexed: 01/08/2023] Open
Abstract
Human locomotion is a complex motor task. Previous research hypothesized that muscle synergies reflect the modular control of muscle groups operated by the Central Nervous System (CNS). Despite the high stride-to-stride variability characterizing human gait, most studies analyze only a few strides. This may be limiting, because the intra-subject variability of motor output is neglected. This gap could be filled by recording and analyzing many gait cycles during a single walking task. In this way, it can be investigated if CNS recruits the same muscle synergies consistently or if different strategies are adopted during the locomotion task. The aim of this work is to investigate the intra-subject consistency of muscle synergies during overground walking. Twelve young healthy volunteers were instructed to walk for 5 min at their natural pace. On the average, 181 ± 10 gait cycles were analyzed for each subject. Surface electromyography was recorded from 12 muscles of the dominant lower limb and the trunk. Gait cycles were grouped into subgroups containing 10 gait cycles each. The consistency of the muscle synergies extracted during the gait trial was assessed by measuring cosine similarity (CS) of muscle weights vectors, and zero-lag cross-correlation (CC) of activation signals. The average intra-subject CS and CC were 0.94 ± 0.10 and 0.96 ± 0.06, respectively. We found five synergies shared by all the subjects: high consistency values were found for these synergies (CS = 0.96 ± 0.05, CC = 0.97 ± 0.03). In addition, we found 10 subject-specific synergies. These synergies were less consistent (CS = 0.80 ± 0.20, CC = 0.89 ± 0.14). In conclusion, our results demonstrated that shared muscle synergies were highly consistent during walking. Subject-specific muscle synergies were also consistent, although to a lesser extent.
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Affiliation(s)
- Daniele Rimini
- Dipartimento di Elettronica e Telecomunicazioni, Politecnico di Torino, Turin, Italy
| | - Valentina Agostini
- Dipartimento di Elettronica e Telecomunicazioni, Politecnico di Torino, Turin, Italy
| | - Marco Knaflitz
- Dipartimento di Elettronica e Telecomunicazioni, Politecnico di Torino, Turin, Italy
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Rimini D, Agostini V, Rosati S, Castagneri C, Balestra G, Knaflitz M. Influence of pre-processing in the extraction of muscle synergies during human locomotion. Annu Int Conf IEEE Eng Med Biol Soc 2017; 2017:2502-2505. [PMID: 29060407 DOI: 10.1109/embc.2017.8037365] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The extraction of muscle synergies in human locomotion may be biased by the kind of pre-processing applied to electromyographic (EMG) data. The aim of this contribution is to analyze the differences in the muscle synergies extracted using a standard pre-processing procedure and a new procedure. The new procedure is based on the selection of the muscle's principal activations (necessary actuations of the muscle to accomplish its specific biomechanical task during gait), discarding secondary activations (with an auxiliary function in motor control). EMG signals were recorded from 12 muscles of a healthy volunteer who was asked to walk, at self-selected pace, for 5 minutes. A dataset of 193 gait cycles was collected and divided into 19 epochs of 10 concatenated gait cycles. The application of the new pre-processing procedure provided 5 instead of 6 muscle synergies accurately reconstructing the original EMG data matrix, and clearer and more stable neural activation commands. The new preprocessing procedure may be easily extended to the extraction of muscle synergies in other cyclic movements, such as running, stair climbing, cyclo-ergometer exercising, and swimming.
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Agostini V, Gastaldi L, Rosso V, Knaflitz M, Tadano S. A Wearable Magneto-Inertial System for Gait Analysis (H-Gait): Validation on Normal Weight and Overweight/Obese Young Healthy Adults. Sensors (Basel) 2017; 17:s17102406. [PMID: 29065485 PMCID: PMC5677259 DOI: 10.3390/s17102406] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 10/17/2017] [Accepted: 10/19/2017] [Indexed: 11/30/2022]
Abstract
Background: Wearable magneto-inertial sensors are being increasingly used to obtain human motion measurements out of the lab, although their performance in applications requiring high accuracy, such as gait analysis, are still a subject of debate. The aim of this work was to validate a gait analysis system (H-Gait) based on magneto-inertial sensors, both in normal weight (NW) and overweight/obese (OW) subjects. The validation is performed against a reference multichannel recording system (STEP32), providing direct measurements of gait timings (through foot-switches) and joint angles in the sagittal plane (through electrogoniometers). Methods: Twenty-two young male subjects were recruited for the study (12 NW, 10 OW). After positioning body-fixed sensors of both systems, each subject was asked to walk, at a self-selected speed, over a 14-m straight path for 12 trials. Gait signals were recorded, at the same time, with the two systems. Spatio-temporal parameters, ankle, knee, and hip joint kinematics were extracted analyzing an average of 89 ± 13 gait cycles from each lower limb. Intraclass correlation coefficient and Bland-Altmann plots were used to compare H-Gait and STEP32 measurements. Changes in gait parameters and joint kinematics of OW with respect NW were also evaluated. Results: The two systems were highly consistent for cadence, while a lower agreement was found for the other spatio-temporal parameters. Ankle and knee joint kinematics is overall comparable. Joint ROMs values were slightly lower for H-Gait with respect to STEP32 for the ankle (by 1.9° for NW, and 1.6° for OW) and for the knee (by 4.1° for NW, and 1.8° for OW). More evident differences were found for hip joint, with ROMs values higher for H-Gait (by 6.8° for NW, and 9.5° for OW). NW and OW showed significant differences considering STEP32 (p = 0.0004), but not H-Gait (p = 0.06). In particular, overweight/obese subjects showed a higher cadence (55.0 vs. 52.3 strides/min) and a lower hip ROM (23.0° vs. 27.3°) than normal weight subjects. Conclusions: The two systems can be considered interchangeable for what concerns joint kinematics, except for the hip, where discrepancies were evidenced. Differences between normal and overweight/obese subjects were statistically significant using STEP32. The same tendency was observed using H-Gait.
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Affiliation(s)
- Valentina Agostini
- Department of Electronics and Telecommunications, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Torino, Italy.
| | - Laura Gastaldi
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Italy, Corso Duca degli Abruzzi 24, 10129 Torino, Italy.
| | - Valeria Rosso
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Italy, Corso Duca degli Abruzzi 24, 10129 Torino, Italy.
| | - Marco Knaflitz
- Department of Electronics and Telecommunications, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Torino, Italy.
| | - Shigeru Tadano
- Division of Human Mechanical Systems and Design, Faculty of Engineering, Hokkaido University, Sapporo, Hokkaido 060-8628, Japan.
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Affronti G, Agostini V, Brizzi A, Bucci L, De Blasio E, Frigo MG, Giorgini C, Messina M, Ragusa A, Sirimarco F, Svelato A. The daily-practiced post-partum hemorrhage management: an Italian multidisciplinary attended protocol. Clin Ter 2017; 168:e307-e316. [PMID: 29044353 DOI: 10.7417/t.2017.2026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Postpartum hemorrhage (PPH) is one of the most frequent causes of mortality and morbidity in the obstetric population globally, causing about a quarter of maternal deaths yearly, and is the leading cause of maternal death worldwide. The management of PPH remains a topic of great debate, even in view of new diagnostic and therapeutic possibilities in recent years, for which, however, the body of evidence available thus far is still scarce, as the standard values are lacking. The protocol hereby presented was developed after a literature review and during several meetings of an Italian multidisciplinary task group of specialists adopting a modified Delphi method, and is the result of the synthesis of therapeutic operational protocols for the treatment of PPH applied by the different specialties within the team. This protocol is intended to represent a practical proposal to support clinicians in the management of a particularly complex event that requires the intervention of a multidisciplinary team and the implementation of dedicated management protocols.
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Affiliation(s)
- G Affronti
- Past direttore SC Ostetricia e Ginecologia, Ospedale S. Maria della Misericordia, AOU, Perugia
| | - V Agostini
- UO Servizio Immunoematologia e Medicina Trasfusionale, Cesena-Forlì, Officina Trasfusionale Pievesestina; Medicina Trasfusionale Ospedale M. Bufalini, Cesena
| | - A Brizzi
- Anestesia generale e locoregionale, Clinica S. Maria, Bari
| | - L Bucci
- Anestesia e Rianimazione 1, ASST Grande Ospedale Metropolitano Niguarda, Milano
| | - E De Blasio
- UOC Anestesia e Rianimazione, Azienda Ospedaliera G. Rummo, Benevento
| | - M G Frigo
- UOS Anestesia e Rianimazione in Ostetricia, Ospedale Fatebenefratelli S. Giovanni Calibita, Roma
| | - C Giorgini
- SC Anestesia e Rianimazione, Ospedale S. Maria della Misericordia, Azienda Ospedaliero-Universitaria di Perugia
| | - M Messina
- Immunoematologia e medicina trasfusionale, Azienda Ospedaliera OIRM-Sant'Anna, Torino
| | - A Ragusa
- SC UO Ostetricia e ginecologia, Nuovo Ospedale delle Apuane, Massa e Carrara
| | - F Sirimarco
- UO SC Ostetricia e Ginecologia, Azienda Ospedaliera Cardarelli, Napoli, Italia
| | - A Svelato
- SC UO Ostetricia e ginecologia, Nuovo Ospedale delle Apuane, Massa e Carrara
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Leone O, Agostini V, Foà A, Cerbelli B, di Gioia CRT, Aromatario M, Ciallella C, Lucena J, d'Amati G. Cardiac pathologic findings in 3 unusual cases of sudden cardiac death related to anorexiant drugs. Hum Pathol 2017; 69:101-109. [PMID: 29024685 DOI: 10.1016/j.humpath.2017.09.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 09/11/2017] [Accepted: 09/22/2017] [Indexed: 12/23/2022]
Abstract
Amphetamine congeners can be prescribed as anorexiant drugs despite their potential adverse effects, including cardiac toxicity. However, the morphologic features of cardiac damage related to protracted use of these compounds are unknown. We provide a detailed description of cardiac autopsy findings in 3 cases of sudden death associated with protracted use of high doses of phendimetrazine and/or phenylpropanolamine or bupropion prescribed as anorexiants, in association with other compounds. The main cardiac findings were similar in all 3 cases: (1) mild-moderate hypertrophy of the left ventricle and/or the septum; (2) myocardial nonischemic scarring (midmural and/or subepicardial) appearing as discrete foci or with a bandlike morphology; (3) mild-moderate intramural small vessel disease in the absence of significant epicardial coronary artery stenosis; and (4) acute/recent inflammatory lesions consistent with toxic myocarditis. In summary, the detailed pathology examination of the heart in these 3 cases revealed myocardial lesions identical to those reported in catecholamine myocardial damage in all their various stages of evolution. In the presence of a clinical history of long-term intake of anorexiants of this category, it is most important at autopsy to recognize and correctly interpret the acute and chronic myocardial lesions of the type herein described because they represent an anatomical substrate for arrhythmic death.
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Affiliation(s)
- Ornella Leone
- Department of Pathology, S. Orsola-Malpighi University Hospital, Bologna, 40138, Italy.
| | - Valentina Agostini
- Department of Pathology, S. Orsola-Malpighi University Hospital, Bologna, 40138, Italy
| | - Alberto Foà
- Cardiology, Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi University Hospital, Bologna, 40138, Italy
| | - Bruna Cerbelli
- Department of Radiological, Oncological and Pathological Sciences, Sapienza, University of Rome, Rome, 00161, Italy
| | | | - Mariarosaria Aromatario
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza, University of Rome, Rome, 00161, Italy
| | - Costantino Ciallella
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza, University of Rome, Rome, 00161, Italy
| | - Joaquin Lucena
- Department of Forensic Pathology, Institute of Legal Medicine and Forensic Sciences, Seville, 41015, Spain
| | - Giulia d'Amati
- Department of Radiological, Oncological and Pathological Sciences, Sapienza, University of Rome, Rome, 00161, Italy.
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Careddu L, Foà A, Leone O, Agostini V, Gargiulo GD, Rapezzi C, Di Bartolomeo R, Pacini D. Primary Cardiac Leiomyoma Causing Right Ventricular Obstruction and Tricuspid Regurgitation. Ann Thorac Surg 2017; 104:e231-e233. [DOI: 10.1016/j.athoracsur.2017.03.068] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 03/13/2017] [Accepted: 03/27/2017] [Indexed: 10/19/2022]
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Foa' A, Corsini A, Norscini G, Agostini V, Pacini D, Melandri G, Di Bartolomeo R, Leone O, Rapezzi C. P6020Histopathologic substrates and clinical correlations in type A acute aortic syndromes. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Corsini A, Foa' A, Norscini G, Agostini V, Pacini D, Melandri G, Di Bartolomeo R, Leone O, Rapezzi C. P3973Long-term outcome after acute aortic syndromes. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Galati G, Leone O, Pasquale F, Olivotto I, Biagini E, Grigioni F, Pilato E, Lorenzini M, Corti B, Foà A, Agostini V, Cecchi F, Rapezzi C. Histological and Histometric Characterization of Myocardial Fibrosis in End-Stage Hypertrophic Cardiomyopathy: A Clinical-Pathological Study of 30 Explanted Hearts. Circ Heart Fail 2017; 9:CIRCHEARTFAILURE.116.003090. [PMID: 27618852 DOI: 10.1161/circheartfailure.116.003090] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 08/10/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Although noninvasively detected myocardial fibrosis (MF) has clinical implications in hypertrophic cardiomyopathy, the extent, type, and distribution of ventricular MF have never been extensively pathologically characterized. We assessed the overall amount, apex-to-base, circumferential, epicardial-endocardial distribution, pattern, and type of MF in 30 transplanted hearts of end-stage, hypertrophic cardiomyopathy. METHODS AND RESULTS Visual and morphometric histological analyses at basal, midventricular, and apical levels were performed. Overall MF ranged from 23.1% to 55.9% (mean=37.3±8.4%). Prevalent types of MF were as follows: replacement in 53.3%, interstitial-perimyocyte in 13.3%, and mixed in 33.3%. Considering left ventricular base-to-apex distribution, MF was 31.9%, 43%, and 46.2% at basal, midventricular, and apical level, respectively (P<0.001). Circumferential distributions (mean percentage of MF within the section) were as follows: anterior 11.9%, anterolateral 15.8%, inferolateral 7.0%, inferior 24.3%, anteroseptal 11%, midseptal 10.7%, and posteroseptal 11.4%; circumferential distributions for anterior and inferior right ventricular walls were 3.4% and 4.5%, respectively. Epicardial-endocardial distributions were as follows: trabecular 26.1% and subendocardial 20.2%, midwall 33.4%, and subepicardial 20.3%. Main patterns identified were as follows: midwall in 33.3% of the hearts, transmural in 23.3%, midwall-subepicardial in 23.3%, and midwall-subendocardial in 20%. CONCLUSIONS In end-stage, hypertrophic cardiomyopathy patients undergoing transplantation, more than one-third of the left ventricular myocardium was replaced by fibrosis, mainly of replacement type. MF preferentially involved the left ventricular apex and the midwall. Inferior and anterior walls and septum were maximally involved, whereas inferolateral and right ventricular were usually spared. These observations reflect the complex pathophysiology of hypertrophic cardiomyopathy and may provide clues for the timely recognition of disease progression by imaging techniques capable of quantifying MF.
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Affiliation(s)
- Giuseppe Galati
- From the Units of Cardiology (G.G., F.P., E.B., F.G., M.L., A.F., C.R.), Pathology (O.L., B.C., V.A.), Cardiac Surgery (E.P.), Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum-University of Bologna, S.Orsola-Malpighi University Hospital, Italy; and Referral Center for Cardiomyopathies, Cardiothoraco-vascular Department, Careggi University Hospital, Florence, Italy (I.O., F.C.)
| | - Ornella Leone
- From the Units of Cardiology (G.G., F.P., E.B., F.G., M.L., A.F., C.R.), Pathology (O.L., B.C., V.A.), Cardiac Surgery (E.P.), Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum-University of Bologna, S.Orsola-Malpighi University Hospital, Italy; and Referral Center for Cardiomyopathies, Cardiothoraco-vascular Department, Careggi University Hospital, Florence, Italy (I.O., F.C.)
| | - Ferdinando Pasquale
- From the Units of Cardiology (G.G., F.P., E.B., F.G., M.L., A.F., C.R.), Pathology (O.L., B.C., V.A.), Cardiac Surgery (E.P.), Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum-University of Bologna, S.Orsola-Malpighi University Hospital, Italy; and Referral Center for Cardiomyopathies, Cardiothoraco-vascular Department, Careggi University Hospital, Florence, Italy (I.O., F.C.)
| | - Iacopo Olivotto
- From the Units of Cardiology (G.G., F.P., E.B., F.G., M.L., A.F., C.R.), Pathology (O.L., B.C., V.A.), Cardiac Surgery (E.P.), Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum-University of Bologna, S.Orsola-Malpighi University Hospital, Italy; and Referral Center for Cardiomyopathies, Cardiothoraco-vascular Department, Careggi University Hospital, Florence, Italy (I.O., F.C.)
| | - Elena Biagini
- From the Units of Cardiology (G.G., F.P., E.B., F.G., M.L., A.F., C.R.), Pathology (O.L., B.C., V.A.), Cardiac Surgery (E.P.), Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum-University of Bologna, S.Orsola-Malpighi University Hospital, Italy; and Referral Center for Cardiomyopathies, Cardiothoraco-vascular Department, Careggi University Hospital, Florence, Italy (I.O., F.C.)
| | - Francesco Grigioni
- From the Units of Cardiology (G.G., F.P., E.B., F.G., M.L., A.F., C.R.), Pathology (O.L., B.C., V.A.), Cardiac Surgery (E.P.), Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum-University of Bologna, S.Orsola-Malpighi University Hospital, Italy; and Referral Center for Cardiomyopathies, Cardiothoraco-vascular Department, Careggi University Hospital, Florence, Italy (I.O., F.C.)
| | - Emanuele Pilato
- From the Units of Cardiology (G.G., F.P., E.B., F.G., M.L., A.F., C.R.), Pathology (O.L., B.C., V.A.), Cardiac Surgery (E.P.), Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum-University of Bologna, S.Orsola-Malpighi University Hospital, Italy; and Referral Center for Cardiomyopathies, Cardiothoraco-vascular Department, Careggi University Hospital, Florence, Italy (I.O., F.C.)
| | - Massimiliano Lorenzini
- From the Units of Cardiology (G.G., F.P., E.B., F.G., M.L., A.F., C.R.), Pathology (O.L., B.C., V.A.), Cardiac Surgery (E.P.), Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum-University of Bologna, S.Orsola-Malpighi University Hospital, Italy; and Referral Center for Cardiomyopathies, Cardiothoraco-vascular Department, Careggi University Hospital, Florence, Italy (I.O., F.C.)
| | - Barbara Corti
- From the Units of Cardiology (G.G., F.P., E.B., F.G., M.L., A.F., C.R.), Pathology (O.L., B.C., V.A.), Cardiac Surgery (E.P.), Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum-University of Bologna, S.Orsola-Malpighi University Hospital, Italy; and Referral Center for Cardiomyopathies, Cardiothoraco-vascular Department, Careggi University Hospital, Florence, Italy (I.O., F.C.)
| | - Alberto Foà
- From the Units of Cardiology (G.G., F.P., E.B., F.G., M.L., A.F., C.R.), Pathology (O.L., B.C., V.A.), Cardiac Surgery (E.P.), Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum-University of Bologna, S.Orsola-Malpighi University Hospital, Italy; and Referral Center for Cardiomyopathies, Cardiothoraco-vascular Department, Careggi University Hospital, Florence, Italy (I.O., F.C.)
| | - Valentina Agostini
- From the Units of Cardiology (G.G., F.P., E.B., F.G., M.L., A.F., C.R.), Pathology (O.L., B.C., V.A.), Cardiac Surgery (E.P.), Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum-University of Bologna, S.Orsola-Malpighi University Hospital, Italy; and Referral Center for Cardiomyopathies, Cardiothoraco-vascular Department, Careggi University Hospital, Florence, Italy (I.O., F.C.)
| | - Franco Cecchi
- From the Units of Cardiology (G.G., F.P., E.B., F.G., M.L., A.F., C.R.), Pathology (O.L., B.C., V.A.), Cardiac Surgery (E.P.), Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum-University of Bologna, S.Orsola-Malpighi University Hospital, Italy; and Referral Center for Cardiomyopathies, Cardiothoraco-vascular Department, Careggi University Hospital, Florence, Italy (I.O., F.C.)
| | - Claudio Rapezzi
- From the Units of Cardiology (G.G., F.P., E.B., F.G., M.L., A.F., C.R.), Pathology (O.L., B.C., V.A.), Cardiac Surgery (E.P.), Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum-University of Bologna, S.Orsola-Malpighi University Hospital, Italy; and Referral Center for Cardiomyopathies, Cardiothoraco-vascular Department, Careggi University Hospital, Florence, Italy (I.O., F.C.).
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Rosati S, Castagneri C, Agostini V, Knaflitz M, Balestra G. Muscle contractions in cyclic movements: Optimization of CIMAP algorithm. Annu Int Conf IEEE Eng Med Biol Soc 2017; 2017:58-61. [PMID: 29059810 DOI: 10.1109/embc.2017.8036762] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
During cyclic movements, the number of muscle activations and their timing are different from cycle to cycle. In a previous study, the CIMAP algorithm was proposed for grouping cycles showing similar EMG activation intervals, using dendrogram clustering. Even if the algorithm demonstrated good performances on a healthy population, the intra-cluster variability decreased when applied to datasets from pathological subjects. In this work we propose an optimized version of the CIMAP, comparing the performances of 8 different combinations of parameters used for the dendrogram construction. The cut-off point is also modified. The new and the original version of the algorithm are compared, in terms of intra-cluster variability, considering a population of 60 subjects, both healthy and pathological. The results show that the new CIMAP allows for obtaining clusters with lower variability with respect to the original version of the algorithm (p <; 0.001).
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Agostini V, Rosati S, Balestra G, Trucco M, Visconti L, Knaflitz M. Estimation of joint position error. Annu Int Conf IEEE Eng Med Biol Soc 2017; 2017:2474-2477. [PMID: 29060400 DOI: 10.1109/embc.2017.8037358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Joint position error (JPE) is frequently used to assess proprioception in rehabilitation and sport science. During position-reposition tests the subject is asked to replicate a specific target angle (e.g. 30° of knee flexion) for a specific number of times. The aim of this study is to find an effective method to estimate JPE from the joint kinematic signal. Forty healthy subjects were tested to assess knee joint position sense. Three different methods of JPE estimation are described and compared using a hierarchical clustering approach. Overall, the 3 methods showed a high degree of similarity, ranging from 88% to 100%. We concluded that it is preferable to use the more user-independent method, in which the operator does not have to manually place "critical" markers.
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Di Nardo F, Mengarelli A, Strazza A, Agostini V, Knaflitz M, Burattini L, Fioretti S. A new parameter for quantifying the variability of surface electromyographic signals during gait: The occurrence frequency. J Electromyogr Kinesiol 2017; 36:25-33. [PMID: 28688293 DOI: 10.1016/j.jelekin.2017.06.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 05/23/2017] [Accepted: 06/29/2017] [Indexed: 11/30/2022] Open
Abstract
Natural variability of myoelectric activity during walking was recently analyzed considering hundreds of strides. This allowed assessing a parameter seldom considered in classic surface EMG (sEMG) studies: the occurrence frequency, defined as the frequency each muscle activation occurs with, quantified by the number of strides when a muscle is recruited with that specific activation modality. Aim of present study was to propose the occurrence frequency as a new parameter for assessing sEMG-signal variability during walking. Aim was addressed by processing sEMG signals acquired from Gastrocnemius Lateralis, Tibialis Anterior, Rectus Femoris and Biceps femoris in 40 healthy subjects in order to: (1) show that occurrence frequency is not correlated with ON/OFF instants (Rmean=0.11±0.07; P>0.05) and total time of activation (Rmean=0.15±0.08; P>0.05); (2) confirm the above results by two handy examples of application (analysis of gender and age) which highlighted that significant (P<0.05) gender-related and age-related differences within population were detected in occurrence frequency, but not in temporal sEMG parameters. In conclusion, present study demonstrated that occurrence frequency is able to provide further information, besides those supplied by classical temporal sEMG parameters and thus it is suitable to complement them in the evaluation of variability of myoelectric activity during walking.
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Affiliation(s)
- Francesco Di Nardo
- Department of Information Engineering, Università Politecnica delle Marche, 60131 Ancona, Italy.
| | - Alessandro Mengarelli
- Department of Information Engineering, Università Politecnica delle Marche, 60131 Ancona, Italy
| | - Annachiara Strazza
- Department of Information Engineering, Università Politecnica delle Marche, 60131 Ancona, Italy
| | - Valentina Agostini
- Department of Electronics and Telecommunications, Politecnico di Torino, Torino, Italy
| | - Marco Knaflitz
- Department of Electronics and Telecommunications, Politecnico di Torino, Torino, Italy
| | - Laura Burattini
- Department of Information Engineering, Università Politecnica delle Marche, 60131 Ancona, Italy
| | - Sandro Fioretti
- Department of Information Engineering, Università Politecnica delle Marche, 60131 Ancona, Italy
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50
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Borgese L, Gaudenzi A, Agostini V, Masetti M, Corti B, Reeve J, Grigioni F, Leone O, Halloran P, Potena L. Molecular Profiling of Endomyocardial Biopsies and Clinical Phenotype of Graft Dysfunction: Taking Rejection Diagnosis Beyond Pathological Findings. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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