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To record all electrical activity of the human brain, an electroencephalogram (EEG) test using electrodes attached to the scalp is conducted. Analysis of EEG signals plays an important role in the diagnosis and treatment of brain diseases in the biomedical field. One of the brain diseases found in early ages include autism. Autistic behaviours are hard to distinguish, varying from mild impairments, to intensive interruption in daily life. The non-linear EEG signals arising from various lobes of the brain have been studied with the help of a robust technique called Detrended Fluctuation Analysis (DFA). Here, we study the EEG signals of Typically Developing (TD) and children with Autism Spectrum Disorder (ASD) using DFA. The Hurst exponents, which are the outputs of DFA, are used to find out the strength of self-similarity in the signals. Our analysis works towards analysing if DFA can be a helpful analysis for the early detection of ASD.

Background Understanding the underlying architecture of mood regulation in bipolar disorder (BD) is important, as we are starting to conceptualize BD as a more complex disorder than one of recurring manic or depressive episodes. Nonlinear techniques are employed to understand and model the behavior of complex systems. Our aim was to assess the underlying nonlinear properties that account for mood and energy fluctuations in patients with BD; and to compare whether these processes were different in healthy controls (HC) and unaffected first-degree relatives (FDR). We used three different nonlinear techniques: Lyapunov exponent, detrended fluctuation analysis and fractal dimension to assess the underlying behavior of mood and energy fluctuations in all groups; and subsequently to assess whether these arise from different processes in each of these groups. Results There was a positive, short-term autocorrelation for both mood and energy series in all three groups. In the mood series, the largest Lyapunov exponent was found in HC (1.84), compared to BD (1.63) and FDR (1.71) groups [F (2, 87) = 8.42, p Conclusions The underlying nature of mood variability is in keeping with that of a chaotic system, which means that fluctuations are generated by deterministic nonlinear process(es) in HC, BD, and FDR. The value of this complex modeling lies in analyzing the nature of the processes involved in mood regulation. It also suggests that the window for episode prediction in BD will be inevitably short.

Myocardial infarction (MI), usually termed as heart attack, is one of the main cardiovascular diseases that occur due to the blockage of coronary arteries. This blockage reduces the blood supply to heart muscles, and a prolonged deficiency of blood supply causes the death of heart muscles leading to a heart attack that may cause death. An electrocardiogram (ECG) is used to diagnose MI as it causes variations like ST-T changes in the recorded ECG. Manual inspection of these variations is a tedious task and also requires expertise as the variations produced by MI are often very short in duration with a low amplitude. Hence, these changes may be misinterpreted, leading to delayed diagnosis and appropriate treatment. Therefore, computer-aided analysis of ECG may help to detect MI automatically. In this study, a robust deep learning model is proposed to detect MI based on heart rate variability (HRV) analysis of ECG signals from a single lead. Ultrashort-term HRV analysis is performed to compute HRV analysis features from time-domain and frequency-domain parameters through power spectral density estimations. Nonlinear HRV parameters are also computed using Poincare Plot, Recurrence Analysis, and Detrended Fluctuation Analysis. A finely tuned customized artificial neural network (ANN) algorithm is applied on 23 HRV features for MI detection and classification. The K-fold validation method is used to avoid any biases in results and reported 99.1% accuracy, 100% sensitivity, 98.1% specificity, and 99.0% F1 for MI detection, whereas 98.85% accuracy, 97.40% sensitivity, 99.05% specificity, and 97.70% F1 score is achieved for classification. Furthermore, the ANN algorithm completed its execution in just 59 seconds that indicates the efficiency of the proposed ANN model. The overall performance in terms of computed evaluation matrices and execution time indicates the robustness and cost-effectiveness of the proposed methodology. Thus, the proposed model can be used for high-performance MI detection, even in wearable devices.

Military personnel in combat roles often perform gait tasks with additional load, which can affect the contributions of joint mechanical work (positive and negative). Furthermore, different locomotion patterns can also affect joint specific work contributions. While mean behavior of joint work is important to understanding gait, changes in joint kinetic modulation, or the regulation/control of stride-to-stride joint work variability is necessary to elucidate locomotor system function. Suboptimal modulation exhibited as a stochastic time-series (large fluctuation followed by an opposite smaller fluctuation) could potentially affect locomotion efficiency and portend injury risk. It remains unclear how the locomotor system responds to a combination of load perturbations and varying locomotion patterns.What are the interactive effects of load magnitude and locomotion pattern on joint positive/negative work and joint work modulation in healthy, active, recruit-aged women?Eleven healthy, active, recruit-aged (18-33 years) women ran and forced-marched (walking at a velocity an individual would typically jog) in bodyweight (BW), an additional 25 % of BW (+25 %BW) and an additional 45 % of BW (+45 %BW) conditions at a velocity above their gait transition velocity. Joint work was calculated as the time integral of joint power. Joint work modulation was assessed with detrended fluctuation analysis (DFA) on consecutive joint work time-series.Joint work contributions shifted proximally for forced-marching demonstrated by lesser (p .001) positive/negative ankle work but greater (p = .001) positive hip work contributions compared to running. Running exhibited optimal positive ankle work modulation compared to forced-marching (p = .040). Knee and ankle negative joint work modulation was adversely impacted compared to the hip during forced-marching (p .001).Employing forced-marching gait while under loads of 25 and 45 % of BW reduces the ability of the plantar-flexors and knee extensors to optimally contribute to energy absorption and propulsion in recruit-aged women, potentially reducing metabolic efficiency and increasing injury risk.

Saliva has emerged as an efficient screening sample for early stage detection of oral cancer (OC) owing to non-invasiveness coupled with high sensitivity and specificity. Although spectroscopic characterization of saliva in oral potentially malignant disorders OPMDs) and OC is extensively studied, its potential as imaging biomarker is sparsely explored. Further, the literature on crystalline pattern of saliva for other diseases or different physiological conditions is mostly qualitative. This paper proposed multifractal based methodology to quantitatively study alteration of the salivary fern pattern in different OPMDs and OC in relation to normal counterpart. The fern pattern of dried saliva is captured by stereo-zoom microscope in reflective mode and an image dataset is developed. We resort to two dimensional multi-fractal detrended fluctuation analysis (2d MFDFA) to elucidate the complexity and heterogeneity of these micro-structured patterns. Existence of multifractal nature embedded in salivary fern has been validated for the first time. Long range spatial correlation is found to be the origin of multifractality. Variation in multi-scale self-similarity of irregular pattern in different study groups is demonstrated by four features extracted from MFDFA. Statistical analysis shows discriminating nature of these features for combinations of pairwise interclass classification. This study sheds light on acceptability of microscopic images of arborized saliva in fast and cost effective screening of different oral lesions.

Altered movement complexity, indicative of system dysfunction, has been demonstrated with increased running velocity and neuromuscular fatigue. The critical velocity (CV) denotes a metabolic and neuromuscular fatigue threshold. It remains unclear whether changes to complexity during running are coupled with the exercise intensity domain in which it is performed. The purpose of this study was to examine whether movement variability and complexity differ exclusively above the CV intensity during running. Ten endurance-trained participants ran at 95%, 100%, 105% and 115% CV for 20 min or to task failure, whichever occurred first. Movement at the hip, knee, and ankle were sampled throughout using 3D motion analysis. Complexity of kinematics in the first and last 30 s were quantified using sample entropy (SampEn) and detrended fluctuation analysis (DFA-α). Variability was determined using standard deviation (SD). SampEn decreased during all trials in knee flexion/extension and it increased in hip internal/external rotation, whilst DFA-α increased in knee internal/external rotation. SD of ankle plantar/dorsiflexion and inversion/eversion, knee internal/external rotation, and hip flexion/extension and abduction/adduction increased during trials. Hip flexion/extension SampEn values were lowest below CV. DFA-α was lower at higher velocities compared to velocities below CV in ankle plantar/dorsiflexion, hip flexion/extension, hip adduction/abduction, hip internal/external rotation. In hip flexion/extension SD was highest at 115% CV. Changes to kinematic complexity over time are consistent between heavy and severe intensity domains. The findings suggest running above CV results in increased movement complexity and variability, particularly at the hip, during treadmill running.

We aimed to analyse the complexity and fractal nature of heartbeat during constant exercise, at three different intensities, and recovery.Fourteen healthy men underwent 4 separate sessions. The first session was an incremental treadmill test to determine ventilatory thresholds (VT1 and VT2) and maximal aerobic speed (MAS). Each subject ran at VT1 and VT2 speeds and MAS (second, third and fourth day). The duration of VT1 and VT2 loads were selected in such a way that the product intensity-duration (training load) was the same. Sample Entropy (SampEn) and slope of Detrended Fluctuation Analysis (DFA α1) were measured during the whole session.DFA α1 declines with exercise, being less in the VT1 trial than in the other two.SampEn shows no significant change during exercise. The three tests induce the same decline in SampEn, but at the highest intensity (MAS) tends to decline during the exercise itself, whereas at lower intensities (VT1, VT2) the decline is delayed (10 min of recovery). Subsequently, SampEn at VT1 gradually recovers, whereas at VT2 and MAS it remains stable during recovery.In conclusion, exercise produces a loss of heartbeat complexity, but not fractal nature, during recovery and it depends on intensity.

The impairment of short-term heart rate regulation in patients with heart failure with preserved ejection fraction (HFpEF) can cause acute hemodynamic collapse. Detrended fluctuation analysis (DFA) is a useful tool for the diagnosis of heart diseases and the prediction of mortality. In DFA, the short-term scaling exponent α is decreased in heart failure. However, its change in HFpEF patients remains unclear.Twenty patients diagnosed with HFpEF [defined as brain natriuretic peptide (BNP)100 pg/mL, ejection fraction (EF) ≥50%, and without significant valvular disease], 20 diagnosed with non-HFpEF (BNP 100 pg/mL and EF 50%), and 20 control subjects generally matched for age and gender were enrolled. Holter electrocardiography was performed, and heart rate variability was calculated. In the DFA, the scaling exponents in 1000 beats were calculated for each 15-min segment and the average of all segments was used. We compared both the short-term (11 beats, α1) and long-term (≥11 beats, α2) scaling exponents among the three groups.In the HFpEF, non-HFpEF, and control groups, α1 was 0.73 ± 0.27, 0.66 ± 0.29, and 1.01 ± 0.20 (p 0.01), and α2 was 0.95 ± 0.08, 0.88 ± 0.11, and 0.96 ± 0.07 (p 0.01), respectively. The α1 exponent was significantly decreased in the HFpEF group (p 0.01 vs. control) and the non-HFpEF group (p 0.01 vs. control), while the α2 exponent was significantly decreased in the non-HFpEF group only (p 0.05 vs. HFpEF and control).Short-term heart rate regulation is impaired in patients with HFpEF, while patients with non-HFpEF have both short-term and long-term impairment.

Background Persons with lower limb amputation often experience decreased physical capacity, difficulty walking, and increased fall risk. To either prevent or recover from a loss of balance, one must effectively regulate their stepping movements. It is therefore critical to identify how well persons with amputation regulate stepping. Here, we used a multi-objective control framework based on Goal Equivalent Manifolds to identify how persons with transtibial amputation (TTA) regulate lateral stepping while walking without and with lateral perturbations. Research question When walking in destabilizing environments, do otherwise healthy persons with TTA exhibit greater difficulty regulating lateral stepping due to impaired control? Or do they instead continue to use similar strategies to regulate lateral stepping despite their amputation? Methods Eight persons with unilateral TTA and thirteen able-bodied (AB) controls walked in a virtual environment under three conditions: no perturbations, laterally oscillating visual field, and laterally oscillating treadmill platform. We analyzed step-to-step time series of step widths and absolute lateral body positions. We computed means, standard deviations and Detrended Fluctuation Analysis scaling exponents for each time series and computed how much participants directly corrected step width and position deviations at each step. We compared our results to computational predictions to identify the underlying causes of our experimental findings. Results All participants exhibited significantly increased variability, decreased scaling exponents, and tighter direct control when perturbed. Simulations from our stepping regulation models revealed that people responded to the increased variability produced by the imposed perturbations by tightening their control of both step width and lateral position. Participants with TTA exhibited only a few minor differences from AB in lateral stepping regulation, even when subjected to substantially destabilizing lateral perturbations. Significance Since control of stepping is intrinsically multi-objective, developing effective interventions to reduce fall risk in persons with amputation will likely require strategies that adopt multi-objective approaches.

Background Time-domain and non-linear methods can be used to quantify beat-to-beat repolarization variability but whether measures of repolarization variability can predict ventricular arrhythmogenesis in mice have never been explored. Methods Left ventricular monophasic action potentials (MAPs) were recorded during constant right ventricular 8 ​Hz pacing in Langendorff-perfused mouse hearts, in the presence or absence of the gap junction and sodium channel inhibitor heptanol (0.1, 0.5, 1 or 2 ​mM). Results Under control conditions, mean action potential duration (APD) was 39.4 ​± ​8.1 ​ms. Standard deviation (SD) of APDs was 0.3 ​± ​0.2 ​ms, coefficient of variation was 0.9 ​± ​0.8% and the root mean square (RMS) of successive differences in APDs was 0.15 ​± ​0.14 ​ms. Poincaré plots of APDn+1 against APDn revealed ellipsoid morphologies with a SD along the line-of-identity (SD2) to SD perpendicular to the line-of-identity (SD1) ratio of 4.6 ​± ​2.1. Approximate and sample entropy were 0.61 ​± ​0.12 and 0.76 ​± ​0.26, respectively. Detrended fluctuation analysis revealed short- and long-term fluctuation slopes of 1.49 ​± ​0.27 and 0.81 ​± ​0.36, respectively. Heptanol at 2 ​mM induced ventricular tachycardia in five out of six hearts. None of the above parameters were altered by heptanol during which reproducible electrical activity was observed (KW-ANOVA, P ​> ​0.05). Contrastingly, SD2/SD1 decreased to 2.03 ​± ​0.41, approximate and sample entropy increased to 0.82 ​± ​0.12 and 1.45 ​± ​0.34, and short-term fluctuation slope decreased to 0.82 ​± ​0.19 during the 20-s period preceding spontaneous ventricular tachy-arrhythmias (n ​= ​6, KW-ANOVA, P ​, Graphical abstract Image 1, Highlights • None of the parameters on variability determined using time-domain or non-linear analyses was altered by heptanol. • In the immediate periods preceding the onset of spontaneous ventricular tachycardia, the following changes were observed. • SD2/SD1 was decreased, approximate and sample entropy were increased, and short-term fluctuation slope was decreased. • These measures of repolarization variability could be used to predict impending ventricular arrhythmias in mouse hearts.

Objective: Aimless movement or wandering may be a symptom of mild cognitive impairment (MCI) that arises as a consequence of confusion and forgetfulness. This paper presents a support vector machine (SVM) framework based on movement analysis for the prediction of the onset and progression of MCI. Methods: Movement data of 22 subjects with MCI, and 22 other healthy subjects, living independently in smart homes were collected for ten years using motion sensors. Features were extracted from the sensor data using movement metrics, including cyclomatic complexity, detrended fluctuation analysis, fractal index, entropy, and room transitions. Two different SVM classification algorithms were trained using the features, first to predict the progression of MCI in the post-transition period, and second to predict the onset of MCI in the pre-transition phase. Results: The two SVMs were able to detect the onset six months earlier than the clinical diagnosis. The model accuracy in classifying MCI increased monotonically from the onset month and reached maximum (81%) at the 11th post-transition month. The features of cyclomatic complexity contributed significantly to the prediction results. Conclusion: Findings support the use of movement complexity measures and machine learning for monitoring cognitive behavior in an independent living environment.

Motivation The quantification of long-range correlation of electroencephalogram (EEG) signals is an important research direction for its relevance in helping understanding the brain activity. Epileptic seizures have been studied in the past years where different non-linear statistical approaches have been employed to understand the relationship between the EEG signal and the epileptic discharge. One of the most widely used method for to analyse long memory processes is the detrended fluctuation analysis (DFA). However, no objective and pragmatic methods have been developed to detect crossover points and reference channels in DFA. Results In this article, we propose: (i) two automatic approaches that successfully detect crossover points in DFA related methods on the log–log plot and (ii) a criteria to choose the reference channel for the log-amplitude function. Moreover, the DFA is applied to EEG signals of 10 epileptic patients collected from the CHB-MIT database, being the log-amplitude function used to compare the different brain hemispheres by making use of the methodology proposed in the article. The existence of long-range power-law correlations is demonstrated and indicates that the EEG signals of epileptic patients present three well-defined regions with the first region showing a 1/f noise (pink noise) for seven subjects and a random walk behaviour for three subjects. The second and third regions show anti-persistence behaviour. Moreover, the results of the log-amplitude function were divided in two groups: the first, including seven subjects, where the increase in the scales results in an increase in the fluctuation in the frontal channels and the second, included three subjects, where the fluctuation for large scales are greater for the parietal channels. Availability and implementation The functions used in this article are available in the R package DFA (Mesquita et al., 2020). Supplementary information Supplementary data are available at Bioinformatics online.

Sudden cardiac death (SCD) is an unexpected death of a person with or without knowing cardiac causes are often occurring in less than an hour after the incidence of symptoms. In the case of physicians' knowledge of this incident, they can make appropriate decisions for the patients at-risk and reduce the number of such deaths significantly. The purpose of this paper is to examine different methods for predicting sudden cardiac death using electrocardiogram (ECG) signal from 1998 to recent years that can contribute to researchers to become familiar with the wide range of research conducted in this field.In this paper, studies using various methods to predict sudden cardiac death that has applied the data from the Physionet and MIT-BIH databases with a sampling frequency of 256 samples per second are reviewed. Both types of data have normal and abnormal sampling labels and the data recording time varies from a few seconds to minutes. In the field of SCD prediction, various studies have addressed the processing of the electrocardiogram (ECG) signal as well as the heart rate variability (HRV) signal in different domains, including time, time-frequency, and nonlinear domain. In time-domain processing the statistical characteristics of time signal such as the mean and standard deviation of heart rate, the mean and standard deviation of RR intervals, and Root Mean Square of the Successive Differences (RSSD) are used. Also, in the frequency domain, the power spectral density (PSD) of the signal energy is used in a very-low-frequency band, low-frequency band and, high-frequency band. Similarly, in the nonlinear domain, features such as Poincare plot, detrended fluctuation analysis (DFA), common entropy, wavelet transform coefficients (WTC), and features of the recursive graph including Lmax, Lmean, correlation dimension (CD), etc. are used. In all of the proposed algorithms so far, researchers have been trying to inform the sudden death alarm in a larger interval than the time of death by separating the signals into different time periods and extracting various features.To evaluate the results of the proposed methods, each of the researchers analyzed the a-few-minute intervals before the SCD. Different classification methods are available to identify the efficiency of the proposed algorithm, such as support vector machine (SVM), multilayer perceptron neural network (MLP), radial base function neural network (RBF), k-nearest neighbor (KNN) and mixture expert (ME). The use of features introduced in different domains and different classifiers has led to the observation of different horizons of prediction in various studies. The results of these predictions are often free from the interpretations of clinical symptoms, and their maximum presented time with acceptable validity eventually reaches 4 minutes before the event, which is not an acceptable time for people who have attacked outside the hospital. Accordingly, the most prominent of these evaluations is the mixture expert methodology in which the best feature extraction methods are used in a new method for selecting the optimal feature space locally. This method makes it possible to select different features every minute before the event by choosing the optimal features for each one-minute interval of the signal as an episode which increases the prediction time from 4 minutes before the death to 12 minutes and allows the interpretation of clinical symptoms in terms of multiplication of the presence of the features per minute.Given the non-linear nature of the HRV signal and the similarity of the ECG signal in many time intervals, the use of the HRV signal has become more popular among scholars. The analysis of various studies shows that by approaching the time of death, linear features (time and frequency) can be predictive of death according to the sensible behavior and variations in patients’ signal. Instead of moving away from the death interval, the use of chaotic and non-linear features is more effective. Therefore, a more precise selection of features in this area can be useful for increasing the horizon of prediction of death.

Background Healthy gait dynamics are characterized by the presence of fractal, persistent stride-to-stride variations, which become more random with Parkinson’s disease (PD). Rhythmic auditory stimulation with fractal beat-to-beat variations can change gait dynamics in people with PD toward more persistence. Research question How does gait in people with PD change when synchronizing steps with fractal melodic metronomes with different step-to-beat ratios, and which stimulus do they prefer? Methods In this cross-sectional study, 15 people with PD and 15 healthy older adults walked over-ground in three conditions: self-paced, paced by a fractal auditory stimulus with a 1:1 step-to-beat ratio (‘metronome’), and fractal auditory stimulus with a 1:2 step-to-beat ratio (‘music’). Gait dynamics were recorded with instrumented insoles, and detrended fluctuation analysis (DFA) was applied to the series of stride time intervals. Stimuli preference was assessed using Likert-like scales and open-ended questions. ANOVAs were used to compare mean, coefficient of variation, α-DFA, and the responses from the continuous Likert scales. Pearson correlations were used to assess the relationship between ‘music’ and ‘metronome’ enjoyment or difficulty with gait outcomes, and to determine the association between baseline α-DFA and changes due to the stimuli. Results Our major findings are that (i) stride-to-stride variations were more persistent with the ‘metronome’ compared to baseline for both groups, (ii) the effect was greater for people with lower α-DFA at baseline (i.e., more random stride-to-stride variations), and (iii) both groups found the ‘metronome’ less difficult to synchronize with. Significance This study showed that people with PD and healthy older adults walk with higher statistical persistence in their stride-to-stride variations when instructed to synchronize their steps with a fractal stimulus. Participants with lower persistence at baseline benefited the most from the fractal ‘metronome’, highlighting the importance to develop patient-centered tests and interventions.

A nonvibrating magnetic granular system is studied by using a time series approach. The system consists of steel balls confined inside a circular wall that surrounds a glass plate. Kinetic energy is provided to the particles by the application of an external vertical time-dependent magnetic field of different amplitudes. We carried out a characterization of the system dynamics through the measurement of the correlations present in the time series of positions, in the x-direction, of each particle. In particular, by performing Fourier spectral analysis, we find that the time series are fractal and scale invariant, in such a way that the corresponding Fourier power spectra follow a power law $$P(f)\propto 1/f^\beta$$P(f)∝1/fβ, with $$00<β<2.5. More specifically, we find that the values of $$\beta$$β, and therefore the strength of the correlations, increase as the magnetic field also increases. In this way, the present system constitutes an experimental model to generate correlated random walks. Additionally, we show how the introduction of a constant magnetic field breaks down this scale invariance property in the positions of each particle. Finally, we confirm the above results by applying detrended fluctuation analysis.

Home‐based measures of lung function, inflammation, symptoms, and medication use are frequently collected in respiratory clinical trials. However, new statistical approaches are needed to make better use of the information contained in these data‐rich variables. In this work, we use data from two phase III asthma clinical trials demonstrating the benefit of benralizumab treatment to develop a novel longitudinal mixed effects model of peak expiratory flow (PEF), a lung function measure easily captured at home using a hand‐held device. The model is based on an extension of the mixed effects modeling framework to incorporate stochastic differential equations and allows for quantification of several statistical properties of a patient's PEF data: the longitudinal trend, long‐term fluctuations, and day‐to‐day variability. These properties are compared between treatment groups and related to a patient's exacerbation risk using a repeated time‐to‐event model. The mixed effects model adequately described the observed data from the two clinical trials, and model parameters were accurately estimated. Benralizumab treatment was shown to improve a patient's average PEF level and reduce long‐term fluctuations. Both of these effects were shown to be associated with a lower exacerbation risk. The day‐to‐day variability was neither significantly affected by treatment nor associated with exacerbation risk. Our work shows the potential of a stochastic model‐based analysis of home‐based lung function measures to support better estimation and understanding of treatment effects and disease stability. The proposed analysis can serve as a complement to descriptive statistics of home‐based measures in the reporting of respiratory clinical trials.

Background Individuals with chronic obstructive pulmonary disease (COPD) commonly experience exacerbations, which may require hospital admission. Early detection of exacerbations, and therefore early treatment, could be crucial in preventing admission and improving outcomes. Our previous research has demonstrated that the pattern analysis of peripheral oxygen saturation (SpO2) fluctuations provides novel insights into the engagement of the respiratory control system in response to physiological stress (hypoxia). Therefore, this pilot study tested the hypothesis that the pattern of SpO2 variations in overnight recordings of individuals with COPD would distinguish between stable and exacerbation phases of the disease. Methods Overnight pulse oximetry data from 11 individuals with COPD, who exhibited exacerbation after a period of stable disease, were examined. Stable phase recordings were conducted overnight and one night prior to exacerbation recordings were also analyzed. Pattern analysis of SpO2 variations was carried examined using sample entropy (for assessment of irregularity), the multiscale entropy (complexity), and detrended fluctuation analysis (self‐similarity). Results SpO2 variations displayed a complex pattern in both stable and exacerbation phases of COPD. During an exacerbation, SpO2 entropy increased (p = 0.029) and long‐term fractal‐like exponent (α2) decreased (p = 0.002) while the mean and standard deviation of SpO2 time series remained unchanged. Through ROC analyses, SpO2 entropy and α2 were both able to classify the COPD phases into either stable or exacerbation phase. With the best positive predictor value (PPV) for sample entropy (PPV = 70%) and a cut‐off value of 0.454. While the best negative predictor value (NPV) was α2 (NPV = 78%) with a cut‐off value of 1.00. Conclusion Alterations in SpO2 entropy and the fractal‐like exponent have the potential to detect exacerbations in COPD. Further research is warranted to examine if SpO2 variability analysis could be used as a novel objective method of detecting exacerbations., This report provides evidence that the pattern of peripheral oxygen saturation (SpO2) fluctuations detects exacerbations in individuals with COPD. The entropy of SpO2 signal increases a day prior to clinical diagnosis of exacerbation in COPD while mean and total variability of SpO2 signals remain unchanged. This finding has potential for development of a non‐invasive method for early detection of exacerbations in COPD.

Analysis of the complexity and variability from the biomedical physiological time series data raises significant interest as a promising and sensitive marker of abnormality or impairment assessment in muscle physiology, especially in electromyography (EMG) signal. This paper aimed to measure subject-specific (i.e., individual) fractal dimension as a quantitative measure of complexity of EMG signal (i.e., detecting long-range correlations in noisy signal) from upper limb bicep brachii (BB) muscle during five elbow joint angles movement (at 0°, 30°, 60°, 90° and 120°). The EMG signal was recorded from ten healthy (mean±SD age: 22.4±1.5 years) participants using wearable sensor. The fractal scaling (α-values) of the EMG time series was assessed using a non-linear technique called detrended fluctuation analysis (DFA). Majority of the results show that DFA α-values at each angle exhibit anti-correlated (i.e., DFA α < 0.05) behavior. Few results show positive correlation (i.e., DFA α between 0.53 to 0.77), but none of the α values have 1.0 (strongly correlated/pink noise). No significant difference exits between the elbow angles except one case, i.e., 0° vs. 30° (p < 0.05). This DFA-based complexity measuring results from EMG signal holds promise for rehabilitation of control of upper limb muscle activation patterns.

Eccentric cycling (ECC) has attracted attention as a method to improve muscle strength and aerobic fitness in populations unable to tolerate conventional methods. However, agreement on exercise prescription targets have been problematic. The current report is an initial exploration of a potentially useful tool, a nonlinear heart rate (HR) variability (HRV) index based on the short-term scaling exponent alpha1 of detrended fluctuation analysis (DFA a1), which has been previously shown to correspond to exercise intensity. Eleven male volunteers performed 45 min of concentric (CON) cycling and ECC separated by 1 month. Work rates were matched for HR (~50% of the maximal HR) during the first 5 min and remained stable thereafter. HRV, HR, oxygen consumption (VO2), and cycling power were monitored and evaluated at elapsed times of 10 (T10) and 45 (T45) minutes duration. HR significantly increased between ECC T10 and ECC T45 (p = 0.003, d = 1.485), while DFA a1 significantly decreased (p = 0.004, d = 1.087). During CON, HR significantly increased (p &lt, 0.001 d = 1.570) without significant DFA a1 change (p = 0.48, d = 0.22). Significantly higher HR was observed at T45 in ECC than in CON (p = 0.047, d = 1.059). A session of unaccustomed ECC lead to decreased values of DFA a1 at T45 in comparison to that seen with CON at similar VO2. ECC lead to altered autonomic nervous system balance as reflected by the loss of correlation properties compared to CON.

The respiratory system reacts instantaneously to intrinsic and extrinsic inputs. This adaptability results in significant fluctuations in breathing parameters, such as respiratory rate, tidal volume, and inspiratory flow profiles. Breathing variability is influenced by several conditions, including sleep, various pulmonary diseases, hypoxia, and anxiety disorders. Recent studies have suggested that weaning failure during mechanical ventilation may be predicted by low respiratory variability. This review describes methods for quantifying breathing variability, summarises the conditions and comorbidities that affect breathing variability, and discusses the potential implications of breathing variability for anaesthesia and intensive care.

In this study, the effect of cardiac resynchronization therapy (CRT) on the relationship between the cardiovascular and respiratory systems in heart failure subjects was examined for the first time. We hypothesized that alterations in cardio-respiratory interactions, after CRT implantation, quantified by signal complexity, could be a marker of a favorable CRT response. Sample entropy and scaling exponents were calculated from synchronously recorded cardiac and respiratory signals 20 min in duration, collected in 47 heart failure patients at rest, before and 9 months after CRT implantation. Further, cross-sample entropy between these signals was calculated. After CRT, all patients had lower heart rate and CRT responders had reduced breathing frequency. Results revealed that higher cardiac rhythm complexity in CRT non-responders was associated with weak correlations of cardiac rhythm at baseline measurement over long scales and over short scales at follow-up recording. Unlike CRT responders, in non-responders, a significant difference in respiratory rhythm complexity between measurements could be consequence of divergent changes in correlation properties of the respiratory signal over short and long scales. Asynchrony between cardiac and respiratory rhythm increased significantly in CRT non-responders during follow-up. Quantification of complexity and synchrony between cardiac and respiratory signals shows significant associations between CRT success and stability of cardio-respiratory coupling.

Although heart rate variability (HRV) indexes have been helpful for monitoring the fatigued state while resting, little data indicate that there is comparable potential during exercise. Since an index of HRV based on fractal correlation properties, alpha 1 of detrended fluctuation analysis (DFA a1) displays overall organismic demands, alteration during exertion may provide insight into physiologic changes accompanying fatigue. Two weeks after collecting baseline demographic and gas exchange data, 11 experienced ultramarathon runners were divided into two groups. Seven runners performed a simulated ultramarathon for 6 h (Fatigue group, FG) and four runners performed daily activity over a similar period (Control group, CG). Before (Pre) and after (Post) the ultramarathon or daily activity, DFA a1, heart rate (HR), running economy (RE) and countermovement jumps (CMJ) were measured while running on a treadmill at 3 m/s. In Pre versus Post comparisons, data showed a decline with large effect size in DFA a1 post intervention only for FG (Pre: 0.71, Post: 0.32; d = 1.34), with minor differences and small effect sizes in HR (d = 0.02) and RE (d = 0.21). CG showed only minor differences with small effect sizes in DFA a1 (d = 0.19), HR (d = 0.15), and RE (d = 0.31). CMJ vertical peak force showed fatigue‐induced decreases with large effect size in FG (d = 0.82) compared to CG (d = 0.02). At the completion of an ultramarathon, DFA a1 decreased with large effect size while running at low intensity compared to pre‐race values. DFA a1 may offer an opportunity for real‐time tracking of physiologic status in terms of monitoring for fatigue and possibly as an early warning signal of systemic perturbation., The aim of this report is to evaluate the change in exercise associated DFA a1 dynamics toward the end of a simulated ultramarathon and compare this to changes in HR and running economy while still performing dynamic exercise. At the completion of an ultramarathon, DFA a1 decreased with large effect size while running at low intensity compared to pre‐race values. Therefore, DFA a1 may offer an opportunity for assessment and real‐time tracking of physiologic status in terms of monitoring for fatigue and possibly as an early warning signal of systemic perturbation.

Early identification and diagnosis of mild cognitive impairment (MCI) in patients with parkinsonism (PDS) are critical. The aim of this study was to identify biomarkers of MCI in PDS using conventional electroencephalogram (EEG) power spectral analysis and detrended fluctuation analysis (DFA). In this retrospective study, patients with PDS who underwent an overnight polysomnography (PSG) study in our hospital from 2019 to 2020 were enrolled. Patients with PDS assessed by clinical examination and questionnaires were divided into two groups: the PDS with normal cognitive function (PDS-NC) group and the PDS with MCI (PDS-MCI) group. Sleep EEG signals were extracted and purified from the PSG and subjected to a conventional power spectral analysis, as well as detrended fluctuation analysis (DFA) during wakefulness, nonrapid eye movement (NREM) sleep, and rapid eye movement (REM) sleep. Forty patients with PDS were enrolled, including 25 with PDS-NC and 15 with PDS-MCI. Results revealed that compared with PDS-NC patients, patients with PDS-MCI had a reduced fast ratio ( alpha + beta / delta + theta ) and increased DFA during NREM sleep. DFA during NREM was diagnostic of PDS-MCI, with an area under the receiver operating characteristic curve of 0.753 (95% CI: 0.592–0.914) ( p < 0.05 ). Mild cognitive dysfunction was positively correlated with NREM-DFA ( r = 0.426 , p = 0.007 ) and negatively correlated with an NREM-fast ratio ( r = − 0.524 , p = 0.001 ). This suggested that altered EEG activity during NREM sleep is associated with MCI in patients with PDS. NREM sleep EEG characteristics of the power spectral analysis and DFA correlate to MCI. Slowing of EEG activity during NREM sleep may reflect contribution to the decline in NREM physiological function and is therefore a marker in patients with PDS-MCI.

Electroencephalogram (EEG) signals are widely used in diagnosis of epilepsy. Accurate classification of seizure types based on EEG signals can provide vital information for diagnosis and treatment. Since visual inspection and interpretation of seizure types are time consuming and prone to errors, a novel classification method combining wavelet packet decomposition (WPD) and local detrended fluctuation analysis (L-DFA) is proposed for the computer-aided diagnostic system. The proposed method is able to classify a wide variety of seizures automatically and accurately. As the first step towards this goal, raw EEG signals are decomposed by WPD according to intrinsic frequency bands of human brain. Then L-DFA is applied to characterise the dynamical fractal structure of sub-band signals. Finally, EEG signals are classified by support vector machine based on the combined fractal spectrum features. The experimental results on Temple University Hospital database show that the proposed method achieves a total classification accuracy of 97.80%, outperforming existing methods based on the same database.

Temporal cardiac properties provide alternative information in analyzing heart rate variability (HRV), which may be disregarded by the standard HRV analyses. Patients with congestive heart failure (CHF) are known to have distinct temporal features from the healthy individuals. However, the underlying mechanism leading to the variation remains unclear. Whether or not these parameters can finely classify the severity for CHF patients is uncertain as well. In this work, an electrocardiogram was monitored in advanced CHF patients using 24-h Holter in four conditions, including baseline, one and three months after atenolol therapy, and healthy individuals. Slope and area under the curve (AUC) of multiscale entropy (MSE) curve over short (scales 1–5) and long (scales 6–20) scales, and detrended fluctuation analysis (DFA) scaling exponents at short (4–11 beats) and intermediate (>11 beats) window sizes were calculated. The results show that short-time scale MSE-derived parameters (slope: −0.08 ± 0.10, −0.03 ± 0.10, 0.02 ± 0.06, 0.08 ± 0.06; AUC: 4.03 ± 2.11, 4.69 ± 1.28, 4.73 ± 0.94, and 6.17 ± 1.23) and short-time scale DFA exponent (0.79 ± 0.16, 0.95 ± 0.22, 1.11 ± 0.19, and 1.35 ± 0.20) can hierarchically classify all four conditions. More importantly, simulated R-R intervals with different fractions and amplitude of respiratory sinus arrhythmia (RSA) components were examined to validate our hypothesis regarding the essentiality of RSA in the improvement of cardiovascular function, and its tight association with unpredictability and fractal property of HRV, which is in line with our hypothesis that RSA contributes significantly to the generation of the unpredictability and fractal behavior of HR dynamics. NEW & NOTEWORTHY Temporal cardiac properties provide useful diagnostic parameters for patients with congestive heart failure (CHF). Our study hierarchically classified CHF patients with β-blocker treatment by using multiscale entropy and detrended fluctuation analysis. Also, we provided the evidence to validate the critical role of respiratory sinus arrhythmia in the fractal properties of heart rate variability.

Early detection of preterm labor is important to avoid neonatal death and mortality. Uterine electromyography (UEMG) or electrohysterography is a non-invasive method of extracting electrical activi...

The process of reading a specific text is considered complex and little known in neuroscience, since it involves the vision, memory, motor control, learning, among others. In this sense, an excellent possibility to study the brain activity in the reading task can be achieved by the analysis of the multi-channel Electroencephalogram (EEG) and also with new statistical methods, like the detrended fluctuation analysis method (DFA). In this paper it will be proposed a model to analyze the brain activity in the reading task, performed by two subjects using a 22-channels EEG (NEUROMAP® model E Q S A 260 ). In order to test our model, two adults subjects (graduates) were tested here. These subjects were arranged in a chair facing a panel with the specific text, excluding involuntary movements that activated regions of the brain that were not being stimulated by reading. For the first subject, chosen at random, the text was presented before the task for understanding and some memorization. For the other subject the text was presented at the time of task. For the signal processing we chose 11 bio-electrodes located at the frontal, parietal, temporal and occipital regions of the brain. Therefore, to treat these non-stationary bio-signals we must apply robust and modern statistical techniques. With this objective, DFA method was applied in order to analyze the F D F A ( n ) fluctuation function in multi-channel EEG bio-sensors, more specifically the difference of its logarithm, i.e., Δ l o g F D F A . The results show that the use of this new function can be useful for brain activities. This paper, as we shall see here, is an initial contribution for EEG data analyze, that would be of medical interest, mainly in neuroscience area.

OBJECTIVES Physiologic signals are typically measured continuously in the critical care unit, but only recorded at intermittent time intervals in the patient health record. Low frequency data collection may not accurately reflect the variability and complexity of these signals or the patient's clinical state. We aimed to characterize how increasing the temporal window size of observation from seconds to hours modifies the measured variability and complexity of basic vital signs. DESIGN Retrospective analysis of signal data acquired between April 1, 2013, and September 30, 2015. SETTING Critical care unit at The Hospital for Sick Children, Toronto. PATIENTS Seven hundred forty-seven patients less than or equal to 18 years old (63,814,869 data values), within seven diagnostic/surgical groups. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Measures of variability (SD and the absolute differences) and signal complexity (multiscale sample entropy and detrended fluctuation analysis [expressed as the scaling component α]) were calculated for systolic blood pressure, heart rate, and oxygen saturation. The variability of all vital signs increases as the window size increases from seconds to hours at the patient and diagnostic/surgical group level. Significant differences in the magnitude of variability for all time scales within and between groups was demonstrated (p < 0.0001). Variability correlated negatively with patient age for heart rate and oxygen saturation, but positively with systolic blood pressure. Changes in variability and complexity of heart rate and systolic blood pressure from time of admission to discharge were found. CONCLUSIONS In critically ill children, the temporal variability of physiologic signals supports higher frequency data capture, and this variability should be accounted for in models of patient state estimation.

One critical issue in brain computer interface (BCI) studies is to extract imaginary movement patterns from electroencephalograph (EEG). In this study, two different techniques —detrended fluctuation analysis (DFA) and discrete wavelet packet transform— are combined (DWPT-DFA) for feature extraction. Both approaches are known as self-similarity quantifier techniques. In wavelet technique, mother wavelets play an important role. Herein, A customized mother wavelet utilizing event related desynchronization (ERD) potential patterns are extracted and updated automatically for individual subjects. Also, three predefined mother wavelets are used, and the results are compared with the customized mother wavelet. The predefined mother wavelets are db4, db8 and coiflet 4. The soft margin support vector machine with the generalized radial basis function (SSVM-GRBF) is employed to classify the DWPT-DFA features. For the efficiency of the method, nine subjects have participated to record EEG based on the imaginary hand movements. The ERDs and features are extracted from FC1 and CP6 channels. Results show that the combination of the DWPT and DFA with the personalize ERD mother wavelet gives the best accuracy of 85.33% with p

Research question The current study investigated stride-to-stride fluctuations of step rate and contact time in response to enforced step frequency perturbations as well as adaptation and de-adaptation behavior. Methods Forty distance runners ran at a self-selected speed and were asked to match five different enforced step frequencies (150, 160, 170, 180, and 190 beats per min). The influence of experience was explored, because running is a skill that presumably gets better with practice, and increased years of running experience is protective against injury. Detrended fluctuation analysis was used to determine the strength of long-range correlations in gait fluctuations at baseline, during the perturbation, and post-perturbation. Adaptive response was measured by the ability to match, rate of matching, and aftereffect of step frequency perturbations. Results The structure of stride-to-stride fluctuations for step rate and contact time did not change during the perturbation or post-perturbation compared to baseline. However, fluctuations in step rate were affected by the level of perturbation. Runners with the most experience had a less persistent structural gait pattern for both step rate and contact time at baseline. Highly experienced runners also demonstrated the best adaptive response. They better matched the enforced step frequency, reached the enforced step frequency sooner, and returned to preferred step frequency more quickly following removal of the perturbation. Significance These findings indicate baseline locomotor flexibility may be beneficial to achieve task demands and return to a stable state once the task is complete. Increased locomotor flexibility may also be a contributing factor for reduced injury risk in experienced runners.

Investigation of the nonlinear dynamics of the heart rate is crucial for understanding the physiological mechanisms of various functional states and understanding the adaptation capacity of the human body. The purpose of this study was to evaluate some quantitative parameters of the nonlinear parameters of resonance in the heart rate variability. The study included 70 healthy students who underwent paced breath training. The heart rate was recorded during breathing at different respiratory rates (spontaneous breathing, 4.5, 5, 5.5, 6, and 6.5 breaths/min). The resonant frequency was determined using heart-rate spectral analysis. Nonlinear analysis of HRV was performed using entropy measures (ApEn, SampEn, and MSE), Correlation dimension, Detrended Fluctuation Analysis (DFA), Recurrence Plot (REC, DET, Lmean, Lmax, and ShanEn), the Poincare plot (SD1 and SD2), and time asymmetry (GI and P). We observed a decrease in the level of complexity, an increase in the self-similarity of the RR intervals, a decrease in the chaotic component, and an increase in rhythm asymmetry during breathing at resonant frequency.

The aim of the present study was to investigate how age and sensory deprivation affect the temporal organization of CoP sway variability and the postural corrective commands during standing balance in typically developing preschoolers. A sample of 57 children aged 3–5 years participated in the study. Structural stabilometric descriptors of sample entropy (SEn), detrended fluctuation analysis (DFA), and sway density curve (SDC) analysis were employed to assess features of center of pressure sway. A force platform was used to collect center of pressure data during standing balance over 40 s in four conditions: standing on rigid and foam surfaces with eyes open and closed. The main results are as follows: (1) sample entropy decreased and DFA_coefficient increased with age, while the SDC variables remained unaltered among the 3-, 4-, and 5-year-old children; (2) as sensory conditions became more challenging, sample entropy decreased and DFA_coefficient increased, while MT and MD decreased and MD increased; age did not influence the responses to sensorial deprivation. In conclusion, 5-year-old children showed decreased variability of CoP sway during standing balance compared with the younger children, but all children used the same corrective torques to control for perturbations. More challenging sensory deprivation conditions resulted in decreased variability of postural sway, higher amplitudes and more frequent correcting torques for stabilization, but age did not influence these behaviors.

The purpose of the study was to compare the effects of a feedback-controlled treadmill (FeedbackTM) to a traditional fixed-speed treadmill (FixedTM) on spatiotemporal gait means, variability, and dynamics. The study also examined inter-session reliability when using the FeedbackTM. Ten young adults walked on the FeedbackTM for a 5-minute familiarization followed by a 16-minute experimental trial. They returned within one week and completed a 5-minute familiarization followed by a 16-minute experimental trial each for FeedbackTM and FixedTM conditions. Mean walking speed and step time, length, width, and speed means and coefficient of variation were calculated from all experimental conditions. Step time, length, width, and speed gait dynamics were analyzed using detrended fluctuation analysis. Mean differences between experimental trials were determined using ANOVAs and reliability between FeedbackTM sessions was determined by intraclass correlation coefficient. No difference was found in mean walking speed nor spatiotemporal variables, with the exception of step width, between the experimental trials. All mean spatiotemporal variables demonstrated good to excellent reliability between sessions, while coefficient of variation was not reliable. Gait dynamics of step time, length, width, and speed were significantly more persistent during the FeedbackTM condition compared to FixedTM, especially step speed. However, gait dynamics demonstrated fair to poor reliability between FeedbackTM sessions. When walking on the FeedbackTM, users maintain a consistent set point, yet the gait dynamics around the mean are different when compared to walking on a FixedTM. In addition, spatiotemporal gait dynamics and variability may not be consistent across separate days when using the FeedbackTM.

Background: Electrical activity of the brain, resulting from electrochemical signaling between neurons, is recorded by electroencephalogram (EEG). The neural network has complex behavior at different levels that strongly confirms the nonlinear nature of interactions in the human brain. This study has been designed and implemented with the aim of determining the effects of religious beliefs and the effect of listening to Holy Quran on electrical activity of the brain of the Iranian Persian-speaking Muslim volunteers. Methods: The brain signals of 47 Persian-speaking Muslim volunteers while listening to the Holy Quran consciously, and while listening to the Holy Quran and the Arabic text unconsciously were used. Therefore, due to the nonlinear nature of EEG signals, these signals are studied using approximate entropy, sample entropy, Hurst exponent, and Detrended Fluctuation Analysis. Results: Statistical analysis of the results has shown that listening to the Holy Quran consciously increases approximate entropy and sample entropy, and decreases Hurst Exponent and Detrended Fluctuation Analysis compared to other cases. Conclusion: Consciously listening to the Holy Quran decreases self-similarity and correlation of brain signal and instead increases complexity and dynamicity in the brain.

Pulmonary hypertension (PH) is a fatal disease—even with state-of-the-art medical treatment. Non-invasive clinical tools for risk stratification are still lacking. The aim of this study was to investigate the clinical utility of heart rhythm complexity in risk stratification for PH patients. We prospectively enrolled 54 PH patients, including 20 high-risk patients (group A, defined as WHO functional class IV or class III with severely compromised hemodynamics), and 34 low-risk patients (group B). Both linear and non-linear heart rate variability (HRV) variables, including detrended fluctuation analysis (DFA) and multiscale entropy (MSE), were analyzed. In linear and non-linear HRV analysis, low frequency and high frequency ratio, DFAα1, MSE slope 5, scale 5, and area 6–20 were significantly lower in group A. Among all HRV variables, MSE scale 5 (AUC: 0.758) had the best predictive power to discriminate the two groups. In multivariable analysis, MSE scale 5 (p = 0.010) was the only significantly predictor of severe PH in all HRV variables. In conclusion, the patients with severe PH had worse heart rhythm complexity. MSE parameters, especially scale 5, can help to identify high-risk PH patients.

Estimates suggest that more than 70% of the world’s rangelands are degraded. The Normalized Difference Vegetation Index (NDVI) is commonly used by ecologists and agriculturalists to monitor vegetation and contribute to more sustainable rangeland management. This paper aims to explore the scaling character of NDVI and NDVI anomaly (NDVIa) time series by applying three fractal analyses: generalized structure function (GSF), multifractal detrended fluctuation analysis (MF-DFA), and Hurst index (HI). The study was conducted in four study areas in Southeastern Spain. Results suggest a multifractal character influenced by different land uses and spatial diversity. MF-DFA indicated an antipersistent character in study areas, while GSF and HI results indicated a persistent character. Different behaviors of generalized Hurst and scaling exponents were found between herbaceous and tree dominated areas. MF-DFA and surrogate and shuffle series allow us to study multifractal sources, reflecting the importance of long-range correlations in these areas. Two types of long-range correlation appear to be in place due to short-term memory reflecting seasonality and longer-term memory based on a time scale of a year or longer. The comparison of these series also provides us with a differentiating profile to distinguish among our four study areas that can improve land use and risk management in arid rangelands.

Alterations in gait cycle i.e stride rate show fractal dynamics and lower limb walking variability between healthy controls and the controls associated to any neurological disorder. The paper proposes a study in which these stride variability changes in neurological functioning linked with individuals with neurocognitive disorder and accumulation of changes happen in the human body with time called ageing. To validate this research work, we compared the participants' gait cycle in time series: 1) healthy young participants and healthy older adults 2) subjects with Parkinson's disease (PD) and disease-free subjects. Using the Detrended Fluctuation Analysis (DFA) method we computedα, a measure of a degree to which one stride time is compared with the previous and the consecutive intervals over a various time span. The scaling exponentαis exigently curtailed in older adults as compared to young healthy participants. The scaling exponentαis also lower in the subjects with PD compared with the disease-free participants. Moreover,αseems linearly correlated to the degree of functional impairment in subjects with PD. These findings demonstrate that stride time fluctuations are more arbitrary in elderly subjects and in subjects with PD. Abnormal fluctuations in the fractal properties of lower limb dynamics are clearly related to functioning in central nervous system control.

Study Objectives Kleine-Levin syndrome (KLS) is a rare recurrent hypersomnia. Our study aimed at monitoring the movements of patients with KLS using actigraphy and evaluating their circadian rhythm. Methods Twenty young patients with KLS and 14 age-matched controls were recruited. Each individual wore an actigraphy for more than 6 months to monitor at least two attacks. Controls kept wearing the device for at least 7 days. The activity counts were averaged in hourly basis and the day-to-night amplitude was quantified by the differences of the averaged activity counts during daytime and nighttime. The hourly activities of different days were aligned and averaged to construct the circadian profile. Parametric and nonparametric estimation of circadian rhythm was calculated. We applied detrended fluctuation analysis to evaluate the temporal correlations beneath the activity fluctuations at multiple time scales. Results Circadian rhythm in asymptomatic period showed no significant difference compared to the controls. During hypersomnia attack, the amplitude of the circadian rest–active rhythms drastically decreased and decreased interdaily stability (IS) was found, as well as significant decreased M10 and short-time fractal correlation (α1). Drastically decreased mean and standard deviation of activity were noted, compared to the pre-attack phase and recovery phase. α1 and M10 increased during the late attack phase, and overcompensated IS was noted in the recovery phase. Conclusions This study confirmed that circadian rest–active rhythms was affected when KLS hypersomnia attack. Several parameters including M10, IS, and α1 may be physiological markers of KLS, which can help to predict the end of hypersomnia episodes.

Recently, measuring the complexity of body movements during sleep has been proven as an objective biomarker of various psychiatric disorders. Although sleep problems are common in children with autism spectrum disorder (ASD) and might exacerbate ASD symptoms, their objectivity as a biomarker remains to be established. Therefore, details of body movement complexity during sleep as estimated by actigraphy were investigated in typically developing (TD) children and in children with ASD. Several complexity analyses were applied to raw and thresholded data of actigraphy from 17 TD children and 17 children with ASD. Determinism, irregularity and unpredictability, and long-range temporal correlation were examined respectively using the false nearest neighbor (FNN) algorithm, information-theoretic analyses, and detrended fluctuation analysis (DFA). Although the FNN algorithm did not reveal determinism in body movements, surrogate analyses identified the influence of nonlinear processes on the irregularity and long-range temporal correlation of body movements. Additionally, the irregularity and unpredictability of body movements measured by expanded sample entropy were significantly lower in ASD than in TD children up to two hours after sleep onset and at approximately six hours after sleep onset. This difference was found especially for the high-irregularity period. Through this study, we characterized details of the complexity of body movements during sleep and demonstrated the group difference of body movement complexity across TD children and children with ASD. Complexity analyses of body movements during sleep have provided valuable insights into sleep profiles. Body movement complexity might be useful as a biomarker for ASD.

Sustained attention is the ability to continually concentrate on task-relevant information, even in the presence of distraction. Understanding the neural mechanisms underlying this ability is critical for comprehending attentional processes as well as neuropsychiatric disorders characterized by attentional deficits, such as attention deficit hyperactivity disorder (ADHD). In this study, we aimed to investigate how trait-like critical oscillations during rest relate to the P300 evoked potential—a biomarker commonly used to assess attentional deficits. We measured long−range temporal correlations (LRTC) in resting-state EEG oscillations as index for criticality of the signal. In addition, the attentional performance of the subjects was assessed as reaction time variability (RTV) in a continuous performance task following an oddball paradigm. P300 amplitude and latencies were obtained from EEG recordings during this task. We found that, after controlling for individual variability in task performance, LRTC were positively associated with P300 amplitudes but not latencies. In line with previous findings, good performance in the sustained attention task was related to higher P300 amplitudes and earlier peak latencies. Unexpectedly, we observed a positive relationship between LRTC in ongoing oscillations during rest and RTV, indicating that greater criticality in brain oscillations during rest relates to worse task performance. In summary, our results show that resting-state neuronal activity, which operates near a critical state, relates to the generation of higher P300 amplitudes. Brain dynamics close to criticality potentially foster a computationally advantageous state which promotes the ability to generate higher event-related potential (ERP) amplitudes.

It has been known that short-time auditory stimulation can contribute to the improvement of the balancing ability of the human body. The present study aims to explore the effects of white Gaussian noise (WGN) of different intensities and frequencies on dynamic balance performance in healthy young adults. A total of 20 healthy young participants were asked to stand at a dynamic balance force platform, which swung along the x-axis with an amplitude of ± 4° and frequency of 1 Hz. Their center of pressure (COP) trajectories were recorded when they were stimulated by WGN of different intensities (block 1) and different frequencies (block 2). A traditional method and detrended fluctuation analysis (DFA) were used for data preprocessing. The authors found that only with 75–85 dB WGN, the COP parameters improved. WGN frequency did not affect the dynamic balance performance of all the participants. The DFA results indicated stimulation with 75 dB WGN enhanced the short-term index and reduced the crossover point. Stimulation with 500 Hz and 2500 Hz WGN significantly enhanced the short-term index. These results suggest that 75 dB WGN and 500 Hz and 2500 Hz WGN improved the participants’ dynamic balance performance. The results of this study indicate that a certain intensity of WGN is indispensable to achieve a remarkable improvement in dynamic balance. The DFA results suggest that WGN only affected the short-term persistence, indicating the potential of WGN being considered as an adjuvant therapy in low-speed rehabilitation training.

Considerable disagreement exists on the linearity of the development of standing balance in children. This study aimed to use different traditional and nonlinear methods to investigate age-related changes in standing balance in preschoolers. A sample of 118 preschoolers took part in this study. A force platform was used to record the center of pressure during standing balance over 15 s in three conditions: eyes open, eyes closed, and/or head extended backward. Detrended fluctuation analysis (DFA), recurrence quantification analysis (RQA), and traditional measures were used to evaluate standing balance. The main results are as follows: (1) Higher range and SD in the anterior-posterior (AP) direction were observed for 5-year-old than for 4-year-old children, while higher DFA coefficient (at shorter time scales) and higher determinism and laminarity in the AP direction were found for 5-year-old children compared to 3- and 4-year-old children; and (2) as sensory conditions became more challenging, all traditional measures increased and DFA coefficients (at shorter and longer time scales) decreased in the AP and mediolateral directions, while determinism and laminarity significantly declined in the AP direction. In conclusion, although increased postural sway, 5-year-old preschool children’s balance performance improved, and their control strategy changed significantly compared with the younger preschoolers. Sensory perturbation (eye closure and/or head extension) changed preschoolers’ balance performance and control strategy. Moreover, both traditional and nonlinear methods provided complementary information on the control of standing balance in preschoolers.

Brain activity is composed of oscillatory and broadband arrhythmic components; however, there is more focus on oscillatory sensorimotor rhythms to study movement, but temporal dynamics of broadband arrhythmic electroencephalography (EEG) remain unexplored. We have previously demonstrated that broadband arrhythmic EEG contains both short- and long-range temporal correlations that change significantly during movement. In this study, we build upon our previous work to gain a deeper understanding of these changes in the long-range temporal correlation (LRTC) in broadband EEG and contrast them with the well-known LRTC in alpha oscillation amplitude typically found in the literature. We investigate and validate changes in LRTCs during five different types of movements and motor imagery tasks using two independent EEG datasets recorded with two different paradigms—our finger tapping dataset with single self-initiated asynchronous finger taps and publicly available EEG dataset containing cued continuous movement and motor imagery of fists and feet. We quantified instantaneous changes in broadband LRTCs by detrended fluctuation analysis on single trial 2 s EEG sliding windows. The broadband LRTC increased significantly (p < 0.05) during all motor tasks as compared to the resting state. In contrast, the alpha oscillation LRTC, which had to be computed on longer stitched EEG segments, decreased significantly (p < 0.05) consistently with the literature. This suggests the complementarity of underlying fast and slow neuronal scale-free dynamics during movement and motor imagery. The single trial broadband LRTC gave high average binary classification accuracy in the range of 70.54±10.03% to 76.07±6.40% for all motor execution and imagery tasks and hence can be used in brain–computer interface (BCI). Thus, we demonstrate generalizability, robustness, and reproducibility of novel motor neural correlate, the single trial broadband LRTC, during different motor execution and imagery tasks in single asynchronous and cued continuous motor-BCI paradigms and its contrasting behavior with LRTC in alpha oscillation amplitude.

OBJECTIVE Favorable neurodevelopmental outcomes in epileptic spasms (ES) are tied to early diagnosis and prompt treatment, but uncertainty in the identification of the disease can delay this process. Therefore, we investigated five categories of computational electroencephalographic (EEG) measures as markers of ES. METHODS We measured 1) amplitude, 2) power spectra, 3) Shannon entropy and permutation entropy, 4) long-range temporal correlations, via detrended fluctuation analysis (DFA) and 5) functional connectivity using cross-correlation and phase lag index (PLI). EEG data were analyzed from ES patients (n = 40 patients) and healthy controls (n = 20 subjects), with multiple blinded measurements during wakefulness and sleep for each patient. RESULTS In ES patients, EEG amplitude was significantly higher in all electrodes when compared to controls. Shannon and permutation entropy were lower in ES patients than control subjects. The DFA intercept values in ES patients were significantly higher than control subjects, while DFA exponent values were not significantly different between the groups. EEG functional connectivity networks in ES patients were significantly stronger than controls when based on both cross-correlation and PLI. Significance for all statistical tests was p < 0.05, adjusted for multiple comparisons using the Benjamini-Hochberg procedure as appropriate. Finally, using logistic regression, a multi-attribute classifier was derived that accurately distinguished cases from controls (area under curve of 0.96). CONCLUSIONS Computational EEG features successfully distinguish ES patients from controls in a large, blinded study. SIGNIFICANCE These objective EEG markers, in combination with other clinical factors, may speed the diagnosis and treatment of the disease, thereby improving long-term outcomes.

Nausea and emesis resulting from disease or drug treatment may be associated with disrupted gastric myoelectric activity (GMA). Conventional analytical techniques can determine the relative degrees of brady-, normo-, and tachygastric power, but lose information relative to the basic slow wave shape. The aim of the present study was to investigate the application of advanced analytical techniques in the analysis of disrupted GMA recorded after administration of sulprostone, a prostaglandin E3/1 agonist, in ferrets. Ferrets were implanted with radiotelemetry devices to record GMA, blood pressure, heart rate (HR) and core body temperature 1 week before the administration of sulprostone (30 μg/kg) or vehicle (saline, 0.5 mL/kg). GMA was initially analyzed using fast Fourier transformations (FFTs) and a conventional power partitioning. Detrended fluctuation analysis (DFA) was also applied to the GMA recordings to reveal information relative to the fluctuation of signals around local trends. Sample entropy (SampEn) analysis was used for examining the regularity of signals. Conventional signal processing techniques revealed that sulprostone increased the dominant frequency (DF) of slow waves, with an increase in the percentage power of the tachygastric range and a decrease in the percentage power of the normogastric range. DFA revealed that sulprostone decreased the fluctuation function, indicative of a loss of the variability of GMA fluctuations around local trends. Sulprostone increased SampEn values, indicating a loss of regularity in the GMA data. Behaviorally, sulprostone induced emesis and caused defecation. It also increased blood pressure and elevated HR, with an associated decrease in HR variability (HRV). Further analysis of HRV revealed a decrease in both low-frequency (LF) and high-frequency (HF) components, with an overall increase in the LF/HF ratio. Sulprostone did not affect core body temperature. In conclusion, DFA and SampEn permit a detailed analysis of GMA, which is necessary to understand the action of sulprostone to modulate gastric function. The action to decrease HRV and increase the LF/HF ratio may be consistent with a shift toward sympathetic nervous system dominance, commonly seen during nausea.

Covid-19 is a dangerous communicable virus which lets down the world economy. Severe respiratory syndrome SARS-COV-2 leads to Corona Virus Disease (COVID-19) and has the capability of transmission through human-to-human and surface-to-human transmission leads the world to catastrophic phase. Computational system based biological signal analysis helps medical officers in handling COVID-19 tasks like ECG monitoring at Intensive care, fatal ventricular fibrillation, etc., This paper is on diagnosing heart dysfunctions such as tachycardia, bradycardia, ventricular fibrillation, cardiac arrhythmia using fuzzy relations and artificial intelligence algorithm. In this study, the heart pulse base signal and features like spectral entropy, largest lyapunov exponent, Poincare plot and detrended fluctuation analysis are extracted and presented for classification purpose. The RR intervals of Poincare plot summarize RR time series obtained from an ECG in one picture, and a time interval quantities derives information duration of HRV. This analysis eases the prediction of heart rate fluctuation due to Covid or other heart disorders. The better accuracy level in diagnosing heart pulse irregularity using Artificial Neural network(ANN) is an integer value (0 to 4)but for Fuzzy Classifier, it is 0.8 to 0.9.The processing time for analyzing heart dysfunctionalties is 0.05 s using ANN which is far better than Fuzzy classifier.

Refereed/Peer-reviewed Immersive virtual reality (VR) can cause acute sickness, visual disturbance, and balance impairment. Some manufacturers recommend intermittent breaks to overcome these issues; however, limited evidence examining whether this is beneficial exists. The aim of this study was to examine whether taking breaks during VR gaming reduced its effect on postural sway during standing balance assessments. Twenty-five people participated in this crossover design study, performing 50 min of VR gaming either continuously or with intermittent 10 min exposure/rest intervals. Standing eyes open, two-legged balance assessments were performed immediately pre-, immediately post- and 40 min post-exposure. The primary outcome measure was total path length; secondary measures included independent axis path velocity, amplitude, standard deviation, discrete and continuous wavelet transform-derived variables, and detrended fluctuation analysis. Total path length was significantly (p < 0.05) reduced immediately post-VR gaming exposure in the intermittent rest break group both in comparison to within-condition baseline values and between-condition timepoint results. Conversely, it remained consistent across timepoints in the continuous exposure group. These changes consisted of a more clustered movement speed pattern about a lower central frequency, evidenced by signal frequency content. These findings indicate that caution is required before recommending rest breaks during VR exposure until we know more about how balance and falls risk are affected

Purpose: Falls are one of the main causes of injuries in older adults. This study evaluated a low-cost footswitch device that was designed to measure gait variability and investigates whether there are any relationships between variability metrics and clinical balance tests for individuals with a history of previous falls. Methods: Sixteen older adults completed a history of falls questionnaire, three functional tests related to fall risk, and walked on a treadmill with the footswitch device. We extracted the stride times from the device and applied two nonlinear variability analyses: coefficient of variation and detrended fluctuation analysis. Results: The temporal variables and variability metrics from the footswitch device correlated with gold-standard measurements based on ground reaction force data. One variability metric (detrended fluctuation analysis) showed a significant relationship with the presence of past falls with a sensitivity of 43%. Conclusion: This feasibility study demonstrates the basis for using low-cost footswitch devices to predict fall risk.