Identification of Human Term and Preterm Labor using Artificial Neural Networks on Uterine Electromyography Data

OBJECTIVE: To use artificial neural networks (ANNs) on uterine electromyography (EMG) data to classify term/preterm labor/non-labor pregnant patients. MATERIALS AND METHODS: A total of 134 term and 51 preterm women (all ultimately delivered spontaneously) were included. Uterine EMG was measured trans-abdominally using surface electrodes. "Bursts" of elevated uterine EMG, corresponding to uterine contractions, were quantified by finding the means and/or standard deviations of the power spectrum (PS) peak frequency, burst duration, number of bursts per unit time, and total burst activity. Measurement-to-delivery (MTD) time was noted for each patient. Term and preterm patient groups were sub-divided, resulting in the following categories: [term-laboring (TL): n = 75; preterm-laboring (PTL): n = 13] and [term-non-laboring (TN): n = 59; preterm-non-laboring (PTN): n = 38], with labor assessed using clinical determinations. ANN was then used on the calculated uterine EMG data to algorithmically and objectively classify patients into labor and non-labor. The percent of correctly categorized patients was found. Comparison between ANN-sorted groups was then performed using Student's t test (with p < 0.05 significant). RESULTS: In total, 59/75 (79%) of TL patients, 12/13 (92%) of PTL patients, 51/59 (86%) of TN patients, and 27/38 (71%) of PTN patients were correctly classified. CONCLUSION: ANNs, used with uterine EMG data, can effectively classify term/preterm labor/non-labor patients.     

Classification of surface EMG signals using optimal wavelet packet method based on Davies-Bouldin criterion

In this paper we present an optimal wavelet packet (OWP) method based on Davies-Bouldin criterion for the classification of surface electromyographic signals. To reduce the feature dimensionality of the outputs of the OWP decomposition, the principle components analysis was employed. Then we chose a neural network classifier to discriminate four types of prosthesis movements. The proposed method achieved a mean classification accuracy of 93.75%, which outperformed the method using the energy of wavelet packet coefficients (with mean classification accuracy 86.25%) and the fuzzy wavelet packet method (87.5%).     

Alveolar soft-part sarcoma of the uterine corpus: Histological,immunocytochemical and ultrastructural study of a case

Summary A case of alveolar soft-part sarcoma located in the uterine corpus is reported. It was an incidental finding in the hysterectomy specimen of a 40-year-old woman. Light and electron microscopic examination revealed periodic-acid-Schiff-positive, diastase-resistant, membrane-bound cytoplasmic granules and crystalloids. Tumour cells expressed immunoreactivity with vimentin, desmin, cytokeratins, NK1/C3 and HMB-45 antibodies. Four years postoperatively, the patient is still alive without evidence of disease. Differential diagnoses, immunocytochemistry and clinical management of uterine alveolar soft-part sarcoma are discussed and the literature reviewed.     

Evaluation of the cytology of uterus, vagina, and clitoris as predictors of uterine condition in the mare

Detection of venereal disease and acute or chronic endometritis can be achieved by cytological examination. The presence of significant numbers of neutrophils in the uterine smear is the best indication for equine endometritis. Uterine function may be evaluated by examining clitoral or vaginal smears. In this study, 20 nonpregnant mares were selected and their reproductive functions were evaluated by rectal palpation. The levels of progesterone were measured by radioimmunoassay (RIA). Cytological smears were prepared from clitoris, vagina, and uterus. A wet swab was applied to the clitoral fossa and the collected material transferred to a microscope slide. Vaginal samples were collected using 30 cm wet swabs. Uterine samples were collected from uterine lavage fluid. There was no significant difference (P≥0.05) between cell densities in the estrus phase (p4<1 ng/ml) compared with the interval between estrus phases (p4>1 ng/ml). Significant differences (P<0.05) were noted in epithelial cell, lymphocyte, and neutrophil densities between diestrus phase (p4≥3.5 ng/ml) and other phases (p4<3.5 ng/ml). Epithelial, neutrophil, and lymphocyte densities were significantly different between clitoral, vaginal and uterine smears (P<0.05). There were significant differences in epithelial cells and neutrophils of vaginal and uterine smears in mares affected by metritis compared with repeat breeder and normal mares. We concluded that the clitoral cytology of mares could not predict uterine physiology but evaluation of vaginal cytology showed more appropriate potential. However, further study is needed to assess vaginal cytology in comparison with other methods for evaluating uterine reproductive physiology.     

Immunohistochemical study of DNA topoisomerase I, p53, and Ki-67 in uterine carcinosarcomas

Uterine carcinosarcomas (UCs) are highly aggressive neoplasms for which no effective adjuvant therapy has been established. The aim of this study was to test potential indicators of UC sensitivity to topoisomerase I (topo I)-targeted drugs. Laboratory studies have shown that the cellular response to topo I-targeted drugs is dependent on topo I expression, DNA replication rate, and activity of the apoptotic pathway. Therefore, this study investigated expression of topo I, a proliferation marker Ki-67, and the apoptosis initiator p53 in 20 cases of UC. Formalin-fixed paraffin-embedded tissue sections were immunostained with monoclonal antibodies against topo I, Ki-67, and p53. The hospital records of all 20 patients with UC were reviewed. Twelve (60%) of 20 cases showed increased expression of topo I. Staining for Ki-67 showed elevated expression in 15 (75%) of 20 cases. Fourteen cases (70%) showed positive staining for p53 in more than 20% of the tumor cells. However, analysis of the relationship between immunohistochemical results and clinical parameters revealed no correlations with topo I expression. There were no significant correlations between the expression of topo I and Ki-67 (P = .704), or topo I and p53 (P = .465). Significantly increased expression of topo I, Ki-67, and p53 in UC tumor cells suggests sensitivity to topo I-targeted drug treatment.     

Prediction and a stationary, structured visual background influence the dynamics of the smooth-pursuit offset in humans

 It is still not clear whether the transition from pursuit eye movements to fixation is mediated by the same system that initiates pursuit, or whether another system, a specialized fixation system, is responsible. To investigate this question we measured smooth-pursuit eye movements and smooth-pursuit termination in five normal subjects using both predictable and unpredictable step-ramp stimuli (velocities 10° and 20°/s) in front of a homogeneous and a structured visual background in order to compare the profile of eye velocity under these different conditions. With the predictable and/or structured visual background there was a gradual transition of eye velocity toward zero. In contrast, with the unpredictable stimulus in front of a homogeneous background, eye velocity during the offset was characterized by an overshoot (on the average, 2.2±1.0°/s for 10°/s ramps) before eye velocity settled at zero. Under this condition, steady-state velocity gain and the deceleration of the offset were significantly higher than during the other paradigm with the same target velocity. The latency of the pursuit offset was significantly shorter when a predictable stimulus was used. The duration of the offset did not depend on the experimental condition used. These findings imply that the pursuit onset and offset have some similarities and may be mediated by the same oculomotor system. Received: 6 February 1998 / Accepted: 8 July 1998     

阴道超声监测宫颈预测早产的初步探讨

目的探讨阴道超声监测宫颈对早产的预测价值。方法采用阴道超声监测53例先兆早产孕妇宫颈长度、前羊膜囊长度、宫颈内口楔形区宽度,同时进行宫颈B ishop评分。结果53例先兆早产孕妇中15例发生早产为早产组,38例未发生早产为非早产组;早产组孕妇宫颈长度(20.8±6.2)mm明显短于非早产组(33.7±5.9)mm(P<0.05),前羊膜囊长度在早产组为(10.3±4.4)mm较非早产组(7.5±2.5)mm明显增加(P<0.05),早产组宫颈评分(7.6±3.7)明显高于非早产组(4.5±2.1)(P<0.05),两组宫颈内口楔形区宽度无明显差异(P>0.05);以宫颈长度≤30mm为临界值,其预测早产的敏感性100%,特异性84%,阳性预测值71%,阴性预测值100%。结论阴道超声监测宫颈长度是预测早产的有效指标。     

Input-output relations in the entorhinal cortex-dentate-hippocampal system: evidence for a non-linear transfer of signals

In the current study we analyzed the input-output relations in the entorhinal-dentate-hippocampal system, a major network involved in long-term memory. In anesthetized guinea pigs, the system was driven by activation of perforant path neurons in the entorhinal cortex (ENT), via presubicular fibers directly stimulated in the dorsal psalterium. Perforant path neuron discharge activated in parallel the dentate gyrus (DG) and hippocampal field CA2. Whereas the output from the DG activated hippocampal field CA3, the output from the sole field CA2 was sufficient for activation of field CA1. Signals from field CA3 operated in concert with CA2, likely contributing to discharge field CA1. These findings indicate the existence of two in parallel disynaptic systems: an ENT-CA2-CA1 and an ENT-DG-CA3 system. The convergence of the latter with the former gives origin the classical trisynaptic circuit, the ENT-DG-CA3-CA1 system. The input-output relations between the population excitatory postsynaptic potentials (pEPSP) evoked in the DG, CA3, CA2 and CA1 and the population spike (PS) evoked in the structure upstream (the input) were described by smooth sigmoid curves. In contrast, the input-output relations of the PS versus the pEPSP within each structure were described by steep sigmoid curves. The net input-output functions of the DG (ENT-DG system), field CA2 (ENT-CA2 system), field CA3 (ENT-DG-CA3 system) and field CA1 (ENT-CA2-CA1&ENT-DG-CA3-CA1 system) were described by sigmoid curves. While the DG and field CA2 exhibited steep sigmoids, fields CA3 and CA1 had less steep sigmoid functions. The present study demonstrates that all structures downstream to the ENT operate according to sigmoid input-output functions, characterized by specific parameters. These different behaviors may contribute to different memory processes. We additionally demonstrate that field CA1 can be activated by field CA2, independently from field CA3. This functional dissociation between CA3 and CA1 may subserve specific roles of each field in memory encoding/retrieval.     

Propagation of electrical activity in uterine muscle during pregnancy: a review

The uterine muscle (the myometrium) plays its most evident role during pregnancy, when quiescence is required for adequate nourishment and development of the foetus, and during labour, when forceful contractions are needed to expel the foetus and the other products of conception. The myometrium is composed of smooth muscle cells. Contraction is initiated by the spontaneous generation of electrical activity at the cell level in the form of action potentials. The mechanisms underlying uterine quiescence during pregnancy and electrical activation during labour remain largely unknown; as a consequence, the clinical management of preterm contractions during pregnancy and inefficient uterine contractility during labour remains suboptimal. In an effort to improve clinical management of uterine contractions, research has focused on understanding the propagation properties of the electrical activity of the uterus. Different perspectives have been undertaken, from animal and in vitro experiments up to clinical studies and dedicated methods for non‐invasive parameter estimation. A comparison of the results is not straightforward due to the wide range of different approaches reported in the literature. However, previous studies unanimously reveal a unique complexity as compared to other organs in the pattern of uterine electrical activity propagation, which necessarily needs to be taken into consideration for future studies to be conclusive. The aim of this review is to structure current variegated knowledge on the properties of the uterus in terms of pacemaker position, pattern, direction and speed of the electrical activity during pregnancy and labour.     

Performance analysis of four nonlinearity analysis methods using a model with variable complexity and application to uterine EMG signals

Several measures have been proposed to detect nonlinear characteristics in time series. Results on time series, multiple surrogates and their z-score are used to statistically test for the presence or absence of non-linearity. The z-score itself has sometimes been used as a measure of nonlinearity. The sensitivity of nonlinear methods to the nonlinearity level and their robustness to noise have rarely been evaluated in the past. While surrogates are important tools to rigorously detect nonlinearity, their usefulness for evaluating the level of nonlinearity is not clear. In this paper we investigate the performance of four methods arising from three families that are widely used in non-linearity detection: statistics (time reversibility), predictability (sample entropy, delay vector variance) and chaos theory (Lyapunov exponents). We used sensitivity to increasing complexity and the mean square error (MSE) of Monte Carlo instances for quantitative comparison of their performances. These methods were applied to a Henon nonlinear synthetic model in which we can vary the complexity degree (CD). This was done first by applying the methods directly to the signal and then using the z-score (surrogates) with and without added noise. The methods were then applied to real uterine EMG signals and used to distinguish between pregnancy and labor contraction bursts. The discrimination performances were compared to linear frequency based methods classically used for the same purpose such as mean power frequency (MPF), peak frequency (PF) and median frequency (MF). The results show noticeable difference between different methods, with a clear superiority of some of the nonlinear methods (time reversibility, Lyapunov exponents) over the linear methods. Applying the methods directly to the signals gave better results than using the z-score, except for sample entropy.     

Diagnosis of toxoplasmic encephalitis in patients with acquired immunodeficiency syndrome by using a new serologic method.

The present study was performed to develop a serological method for diagnosing toxoplasmic encephalitis in patients with acquired immunodeficiency syndrome (AIDS). The trophozoite form of Toxoplasma gondii, fixed with either Formalin or acetone, was used in a modification of an agglutination method previously shown to differentiate between the acute and the chronic (latent) stages of infection with toxoplasma in immunologically normal persons. By using these antigens in separate tests and evaluating the data for statistical significance, 70% of patients with AIDS with biopsy-proven toxoplasmic encephalitis were distinguished from control, ambulatory patients with AIDS with toxoplasma antibodies but without signs or symptoms of central nervous system involvement. In a separate study, the agglutination tests identified from controls 84% of patients with AIDS with two or more brain lesions detected by computed-tomographic or magnetic-resonance-imaging scans and suspected of having toxoplasmic encephalitis. Thus, these agglutination tests should prove valuable for the noninvasive diagnosis of toxoplasmic encephalitis in patients with AIDS.     

A method for simultaneous recording of electrical activities and spectrophotometric signals from brain slice preparations in vitro

Organ spectrophotometry has been applied to analyze cytochrome redox changes in brain slice preparations. An interface-chamber method for maintaining metabolism of brain slice tissues was devised to reduce noise on recording traces of spectrophotometric signals, and then used for continuous monitoring and simultaneous recording of electrical and optical signals from brain slices. With this method, the noise level during the recording of redox states of cytochromes was decreased to 0.0004 A unit.     

A method for assessing muscle fatigue during sprint exercise in humans using a friction-loaded cycle ergometer

This study investigated the mechanical changes induced by muscle fatigue caused by repeated sprints and determined whether a friction-loaded cycle ergometer has any advantages for assessing muscle fatigue. Nine subjects performed 15 sprints, each of 5 s with a 25-s rest, on a friction-loaded cycle ergometer. The averaged force, power and velocity of each push-off were calculated. Maximal power decreased by 17.9%, with a concomittent slowing of muscle contraction, but without any change in the maximal force. These results demonstrated that repeated sprints slow down muscle contraction, leading to a fall in maximal power without any loss of force. This would suggest that fast twitch fibres are selectively fatigued by repeated sprints. However, the ergometer used in the present study made it difficult to evaluate the relative influences of contraction velocity and sprinting time. This was certainly the most important limitation. On the other hand, it showed the advantage of measuring instantaneous power and total work dissipated in the environment simultaneously. It also permitted a force-velocity relationship to be obtained from a single sprint and this relationship is known to be closely related to the muscle fibre composition. Accepted: 5 March 1998     

Characterization of a neutralization-escape variant of SHIVKU-1, a virus that causes acquired immune deficiency syndrome in pig-tailed macaques

A chimeric simian-human immunodeficiency virus (SHIV-4) containing the tat, rev, vpu, and env genes of HIV type 1 (HIV-1) in a genetic background of SIVmac239 was used to develop an animal model in which a primate lentivirus expressing the HIV-1 envelope glycoprotein caused acquired immune deficiency syndrome (AIDS) in macaques. An SHIV-infected pig-tailed macaque that died from AIDS at 24 weeks postinoculation experienced two waves of viremia: one extending from weeks 2-8 and the second extending from week 18 until death. Virus (SHIVKU-1) isolated during the first wave was neutralized by antibodies appearing at the end of the first viremic phase, but the virus (SHIVKU-1b) isolated during the second viremic phase was not neutralized by these antibodies. Inoculation of SHIVKU-1b into 4 pig-tailed macaques resulted in severe CD4(+) T cell loss by 2 weeks postinoculation, and all 4 macaques died from AIDS at 23-34 weeks postinoculation. Because this virus had a neutralization-resistant phenotype, we sequenced the env gene and compared these sequences with those of the env gene of SHIVKU-1 and parental SHIV-4. With reference to SHIV-4, SHIVKU-1b had 18 and 6 consensus amino acid substitutions in the gp120 and gp41 regions of Env, respectively. These compared with 10 and 3 amino acid substitutions in the gp120 and gp41 regions of SHIVKU-1. Our data suggested that SHIVKU-1 and SHIVKU-1b probably evolved from a common ancestor but that SHIVKU-1b did not evolve from SHIVKU-1. A chimeric virus, SHIVKU-1bMC17, constructed with the consensus env from the SHIVKU-1b on a background of SHIV-4, confirmed that amino acid substitutions in Env were responsible for the neutralization-resistant phenotype. These results are consistent with the hypothesis that neutralizing antibodies induced by SHIVKU-1 in pig-tailed macaque resulted in the selection of a neutralization-resistant virus that was responsible for the second wave of viremia.     

Interaction of hypocapnia,hypoxia, brain blood flow,and brain electrical activity in voluntary hyperventilation in humans

Changes in various physiological measures in voluntary hyperventilation lasting three minutes or more in humans were studied and compared. Three-minute hyperventilation, in which the rate of external ventilation increased by an average factor of 4.5-5, produced similar phasic changes in central and brain hemodynamics. The rate of circulation, indicated by rheographic data, initially increased during hyperventilation, reaching a maximum at 1-2 min of the test; there was then a reduction, to a minimum 2-3 min after the end of the test; this was followed by a further slow increase. The rate of cerebral blood flow during all 3 min of hyperventilation remained elevated in most subjects as compared with baseline and decreased during the 5 min following the end of the test. Transcutaneous carbon dioxide tension changed differently - there was a decrease to a minimum (about 25 mmHg) by the end of the test, lasting 1 min from the end of the test, this being followed by an increase to a level of 90% of baseline at 5 min after the test. Blood oxygen saturation remained at 98-100% during the test, decreasing to about 90% 5 min after the test; this, along with the decrease in cerebral blood flow, was a factor producing brain hypoxia. In different subjects, changes in the spectral power of oscillations in different EEG ranges on hyperventilation were "mirrored" to different extents by the dynamics of transcutaneous carbon dioxide tension. The duration and repetition of hyperventilation were important factors for understanding the interaction between brain hemodynamics, hypocapnia, hypoxia, and brain electrical activity. After several repetitions of 3-min hyperventilation over a period of 1 h, the increasing brain blood flow could decrease significantly on the background of relatively small changes in brain electrical activity. The data presented here were assessed from the point of view of the important role of brain tissue oxygen utilization mechanisms in adaptation to hypoxia and hypocapnia.     

Representation of fluctuation features in pathological knee joint vibroarthrographic signals using kernel density modeling method

This article applies advanced signal processing and computational methods to study the subtle fluctuations in knee joint vibroarthrographic (VAG) signals. Two new features are extracted to characterize the fluctuations of VAG signals. The fractal scaling index parameter is computed using the detrended fluctuation analysis algorithm to describe the fluctuations associated with intrinsic correlations in the VAG signal. The averaged envelope amplitude feature measures the difference between the upper and lower envelopes averaged over an entire VAG signal. Statistical analysis with the Kolmogorov–Smirnov test indicates that both of the fractal scaling index (p = 0.0001) and averaged envelope amplitude (p = 0.0001) features are significantly different between the normal and pathological signal groups. The bivariate Gaussian kernels are utilized for modeling the densities of normal and pathological signals in the two-dimensional feature space. Based on the feature densities estimated, the Bayesian decision rule makes better signal classifications than the least-squares support vector machine, with the overall classification accuracy of 88% and the area of 0.957 under the receiver operating characteristic (ROC) curve. Such VAG signal classification results are better than those reported in the state-of-the-art literature. The fluctuation features of VAG signals developed in the present study can provide useful information on the pathological conditions of degenerative knee joints. Classification results demonstrate the effectiveness of the kernel feature density modeling method for computer-aided VAG signal analysis.     

Assessment of adjunctive behaviors in humans using a stringent control procedure

Nine male and eight female undergraduate students played three consecutive games of backgammon. When visual access to the opponent's play was occluded by a curtain during the middle game, eating, drinking, grooming, and restless movement increased over baseline rates prevailing in the first and third games.     

Characterization of the conformational epitope of Guy's 13, a monoclonal antibody that prevents Streptococcus mutans colonization in humans

Guy's 13 is a mouse monoclonal antibody which recognizes streptococcal antigen I/II (SA I/II), a major cell surface glycoprotein of Streptococcus mutans. In a number of clinical trials, this antibody has been shown to prevent colonization in the human oral cavity. The aim of this study was to identify the SA I/II epitope recognized by Guy's 13. The data suggest that the epitope is conformational, delimited by two noncontiguous regions of the antigen: residues 45 to 457, within the N-terminal half of SA I/II, and residues 816 to 983, within the C-terminal half. In fluid-phase immunoassays a strict requirement for the simultaneous presence of both regions was demonstrated for antibody binding. Furthermore, these two regions of SA I/II were shown to have the ability to interact with each other in the absence of Guy's 13 antibody, suggesting that the normal conformation of SA I/II might be determined by the interaction of these two regions.     

Motor unit recruitment strategy of knee antagonist muscles in a step-wise,increasing isometric contraction

The purpose of this study was to determine if differences exist between the control strategies of two antagonist thigh muscles during knee flexion and extension muscular coactivation. Surface myoelectric signal (MES) of the quadriceps (rectus femoris) and the hamstrings (semitendinosus) were obtained from both muscles while performing step-wise increasing contractions during flexion and extension with the knee at 1.57 rad of flexion (90 degrees). The median frequency of the power density spectrum, which is related to the average muscle fiber action potential conduction velocity and therefore to motor unit recruitment, was calculated from each MES. The results suggest that, in all the subjects tested, when the muscle acts as antagonist most motor units are recruited up to 50% of the maximal voluntary force, whereas when the muscle acts as antagonist motor units are recruited up to 40% of the maximal voluntary force. The force range past 40–50% of the maximal force is also characterized by differences between the agonist/antagonist.