Person: Malanda Trigueros, Armando
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Malanda Trigueros
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Armando
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Ingeniería Eléctrica, Electrónica y de Comunicación
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ISC. Institute of Smart Cities
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0000-0002-3122-9049
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379
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Publication Open Access Association of intrinsic capacity with respiratory disease mortality(Elsevier, 2023) Ramírez Vélez, Robinson; Iriarte-Fernández, María; Santafé Rodrigo, Guzmán; Malanda Trigueros, Armando; Beard, John R.; García Hermoso, Antonio; Izquierdo Redín, Mikel; Ciencias de la Salud; Estadística, Informática y Matemáticas; Ingeniería Eléctrica, Electrónica y de Comunicación; Institute for Advanced Materials and Mathematics - INAMAT2; Osasun Zientziak; Estatistika, Informatika eta Matematika; Ingeniaritza Elektrikoa, Elektronikoaren eta Telekomunikazio IngeniaritzarenThe World Health Organization (WHO) introduced a framework for healthy aging in 2015 that emphasizes functional ability instead of absence of disease. Healthy ageing is defined as “the process of building and maintaining the functional ability that enables well-being”. This framework considers an individual’s intrinsic capacity (IC), environment, and the interaction between them to determine functional ability. In this prospective cohort study, we investigated the link between mortality and various respiratory diseases in almost half a million adults who are part of the UK Biobank. We derived an IC score using measures from 4 of the 5 domains: two for psychological capacity, two for sensory capacity, two for vitality and one for locomotor capacity. The exposure variable in the study was the number of reported factors, which was summed and categorized into IC scores of zero, one, two, three, or at least four. The outcome was respiratory disease-related mortality, which was linked to national mortality records. The follow-up period started from participants’ inclusion in the UK Biobank study (2006–2010) and ended on December 31, 2021, or the participant’s death was censored. The average follow-up was 10.6 years (IQR 10.0; 11.3). During a median follow-up period of 10.6 years, 27,251 deaths were recorded. Out of these, 7.5% (2059) were primarily attributed to respiratory disease. The results showed that a higher IC score (+4 points) was associated with a significantly increased risk of respiratory disease mortality, with HRs of 3.34 [2.64 to 4.23] for men (C-index = 0.83) and 3.87 [2.86 to 5.23] for women (C-index = 0.84), independent of major confounding factors (P < 0.001). Our study provides evidence that lower levels of the WHO’s IC construct are associated with increased risk of mortality and various adverse health outcomes. The IC construct, which is easily and inexpensively measured, holds great promise for transforming geriatric care worldwide, including in regions without established geriatric medicine.Publication Open Access The filling factor of the sEMG signal at low contraction forces in the quadriceps muscles is influenced by the thickness of the subcutaneous layer(Frontiers Media, 2023) Rodríguez Falces, Javier; Malanda Trigueros, Armando; Mariscal Aguilar, Cristina; Navallas Irujo, Javier; Ingeniería Eléctrica, Electrónica y de Comunicación; Institute of Smart Cities - ISC; Ingeniaritza Elektrikoa, Elektronikoaren eta Telekomunikazio IngeniaritzarenIntroduction: It has been shown that, for male subjects, the sEMG activity at low contraction forces is normally 'pulsatile', i.e., formed by a few large-amplitude MUPs, coming from the most superficial motor units. The subcutaneous layer thickness, known to be greater in females than males, influences the electrode detection volume. Here, we investigated the influence of the subcutaneous layer thickness on the type of sEMG activity (pulsatile vs. continuous) at low contraction forces. Methods: Voluntary surface EMG signals were recorded from the quadriceps muscles of healthy males and females as force was gradually increased from 0% to 40% MVC. The sEMG filling process was examined by measuring the EMG filling factor, computed from the non-central moments of the rectified sEMG signal. Results: 1) The sEMG activity at low contraction forces was ¿continuous¿ in the VL, VM and RF of females, whereas this sEMG activity was ¿pulsatile¿ in the VL and VM of males. 2) The filling factor at low contraction forces was lower in males than females for the VL (p = 0.003) and VM (p = 0.002), but not for the RF (p = 0.54). 3) The subcutaneous layer was significantly thicker in females than males for the VL (p = 0.001), VM (p = 0.001), and RF (p = 0.003). 4) A significant correlation was found in the vastus muscles between the subcutaneous layer thickness and the filling factor (p < 0.05). Discussion: The present results indicate that the sEMG activity at low contraction forces in the female quadriceps muscles is 'continuous' due to the thick subcutaneous layer of these muscles, which impedes an accurate assessment of the sEMG filling process.Publication Open Access Association of intrinsic capacity with incidence and mortality of cardiovascular disease: prospective study in UK Biobank(Wiley, 2023) Ramírez Vélez, Robinson; Iriarte-Fernández, María; Santafé Rodrigo, Guzmán; Malanda Trigueros, Armando; Beard, John R.; García Hermoso, Antonio; Izquierdo Redín, Mikel; Ciencias de la Salud; Estadística, Informática y Matemáticas; Ingeniería Eléctrica, Electrónica y de Comunicación; Institute for Advanced Materials and Mathematics - INAMAT2; Osasun Zientziak; Estatistika, Informatika eta Matematika; Ingeniaritza Elektrikoa, Elektronikoaren eta Telekomunikazio Ingeniaritzaren; Universidad Pública de Navarra / Nafarroako Unibertsitate PublikoaBackground: The World Health Organization proposed the concept of intrinsic capacity (IC; the composite of all the physical and mental capacities of the individual) as central for healthy ageing. However, little research has investigated the interaction and joint associations of IC with cardiovascular disease (CVD) incidence and CVD mortality in middle- and older-aged adults. Methods: Using data from 443 130 UK Biobank participants, we analysed seven biomarkers capturing the level of functioning of five domains of IC to calculate a total IC score (ranging from 0 [better IC] to +4 points [poor IC]). Associations between IC score and incidence of six long-term CVD conditions (hypertension, stroke/transient ischaemic attack stroke, peripheral vascular disease, atrial fibrillation/flutter, coronary artery disease and heart failure), and grouped mortality from these conditions were estimated using Cox proportional models, with a 1-year landmark analysis to triangulate the findings. Results: Over 10.6 years of follow-up, CVD morbidity grouped (n = 384 380 participants for the final analytic sample) was associated with IC scores (0 to +4): mean hazard ratio (HR) [95% confidence interval, CI] 1.11 [1.08–1.14], 1.20 [1.16–1.24], 1.29 [1.23–1.36] and 1.56 [1.45–1.59] in men (C-index = 0.68), and 1.17 [1.13–1.20], 1.30 [1.26–1.36], 1.52 [1.45–1.59] and 1.78 [1.67–1.89] in women (C-index = 0.70). In regard to mortality, our results indicated that the higher IC score (+4 points) was associated with a significant increase in subsequent CVD mortality (mean HR [95% CI]: 2.10 [1.81–2.43] in men [C-index = 0.75] and 2.29 [1.85–2.84] in women [C-index = 0.78]). Results of all sensitivity analyses by full sample, sex and age categories were largely consistent independent of major confounding factors (P < 0.001). Conclusions: IC deficit score is a powerful predictor of functional trajectories and vulnerabilities of the individual in relation to CVD incidence and premature death. Monitoring an individual's IC score may provide an early-warning system to initiate preventive efforts.Publication Open Access M-wave changes caused by brief voluntary and stimulated isometric contractions(Springer, 2023) Rodríguez Falces, Javier; Malanda Trigueros, Armando; Navallas Irujo, Javier; Place, Nicolas; Ingeniería Eléctrica, Electrónica y de Comunicación; Ingeniaritza Elektrikoa, Elektronikoaren eta Telekomunikazio Ingeniaritzaren; Universidad Pública de Navarra / Nafarroako Unibertsitate PublikoaIntroduction Under isometric conditions, the increase in muscle force is accompanied by a reduction in the fbers’ length. The efects of muscle shortening on the compound muscle action potential (M wave) have so far been investigated only by computer simulation. This study was undertaken to assess experimentally the M-wave changes caused by brief voluntary and stimulated isometric contractions. Methods Two diferent methods of inducing muscle shortening under isometric condition were adopted: (1) applying a brief (1 s) tetanic contraction and (2) performing brief voluntary contractions of diferent intensities. In both methods, supramaximal stimulation was applied to the brachial plexus and femoral nerves to evoke M waves. In the frst method, electrical stimulation (20 Hz) was delivered with the muscle at rest, whereas in the second, stimulation was applied while participants performed 5-s stepwise isometric contractions at 10, 20, 30, 40, 50, 60, 70, and 100% MVC. The amplitude and duration of the frst and second M-wave phases were computed. Results The main fndings were: (1) on application of tetanic stimulation, the amplitude of the M-wave frst phase decreased (~10%, P<0.05), that of the second phase increased (~50%, P<0.05), and the M-wave duration decreased (~20%, P<0.05) across the frst fve M waves of the tetanic train and then plateaued for the subsequent responses; (2) when superimposing a single electrical stimulus on muscle contractions of increasing forces, the amplitude of the M-wave frst phase decreased (~20%, P<0.05), that of the second phase increased (~30%, P<0.05), and M-wave duration decreased (~30%, P<0.05) as force was raised from 0 to 60–70% MVC force. Conclusions The present results will help to identify the adjustments in the M-wave profle caused by muscle shortening and also contribute to diferentiate these adjustments from those caused by muscle fatigue and/or changes in Na+–K+ pump activity.Publication Open Access EMG probability density function: a new way to look at EMG signal filling from single motor unit potential to full interference pattern(IEEE, 2023) Navallas Irujo, Javier; Eciolaza Ferrando, Adrián; Mariscal Aguilar, Cristina; Malanda Trigueros, Armando; Rodríguez Falces, Javier; Ingeniería Eléctrica, Electrónica y de Comunicación; Ingeniaritza Elektrikoa, Elektronikoaren eta Telekomunikazio IngeniaritzarenAn analytical derivation of the EMG signal's amplitude probability density function (EMG PDF) is presented and used to study how an EMG signal builds-up, or fills, as the degree of muscle contraction increases. The EMG PDF is found to change from a semi-degenerate distribution to a Laplacian-like distribution and finally to a Gaussian-like distribution. We present a measure, the EMG filling factor, to quantify the degree to which an EMG signal has been built-up. This factor is calculated from the ratio of two non-central moments of the rectified EMG signal. The curve of the EMG filling factor as a function of the mean rectified amplitude shows a progressive and mostly linear increase during early recruitment, and saturation is observed when the EMG signal distribution becomes approximately Gaussian. Having presented the analytical tools used to derive the EMG PDF, we demonstrate the usefulness of the EMG filling factor and curve in studies with both simulated signals and real signals obtained from the tibialis anterior muscle of 10 subjects. Both simulated and real EMG filling curves start within the 0.2 to 0.35 range and rapidly rise towards 0.5 (Laplacian) before stabilizing at around 0.637 (Gaussian). Filling curves for the real signals consistently followed this pattern (100% repeatability within trials in 100% of the subjects). The theory of EMG signal filling derived in this work provides (a) an analytically consistent derivation of the EMG PDF as a function of motor unit potentials and motor unit firing patterns; (b) an explanation of the change in the EMG PDF according to degree of muscle contraction; and (c) a way (the EMG filling factor) to quantify the degree to which an EMG signal has been built-up.Publication Open Access Understanding EMG PDF changes with motor unit potential amplitudes, firing rates, and noise level through EMG filling curve analysis(IEEE, 2024-08-30) Navallas Irujo, Javier; Mariscal Aguilar, Cristina; Malanda Trigueros, Armando; Rodríguez Falces, Javier; Ingeniería Eléctrica, Electrónica y de Comunicación; Ingeniaritza Elektrikoa, Elektronikoa eta Telekomunikazio IngeniaritzaEMG filling curve characterizes the EMG filling process and EMG probability density function (PDF) shape change for the entire force range of a muscle.We aim to understand the relation between the physiological and recording variables, and the resulting EMG filling curves. We thereby present an analytical and simulation study to explain how the filling curve patterns relate to specific changes in the motor unit potential (MUP) waveforms and motor unit (MU) firing rates, the two main factors affecting the EMG PDF, but also to recording conditions in terms of noise level. We compare the analytical results with simulated cases verifying a perfect agreement with the analytical model. Finally, we present a set of real EMG filling curves with distinct patterns to explain the information about MUP amplitudes, MU firing rates, and noise level that these patterns provide in the light of the analytical study. Our findings reflect that the filling factor increases when firing rate increases or when newly recruited motor unit have potentials of smaller or equal amplitude than the former ones. On the other hand, the filling factor decreases when newly recruited potentials are larger in amplitude than the previous potentials. Filling curves are shown to be consistent under changes of the MUP waveform, and stretched under MUP amplitude scaling. Our findings also show how additive noise affects the filling curve and can even impede to obtain reliable information from the EMG PDF statistics.Publication Open Access Validation of the filling factor index to study the filling process of the sEMG signal in the quadriceps(Elsevier, 2023) Rodríguez Falces, Javier; Malanda Trigueros, Armando; Mariscal Aguilar, Cristina; Niazi, Imran Khan; Navallas Irujo, Javier; Ingeniería Eléctrica, Electrónica y de Comunicación; Ingeniaritza Elektrikoa, Elektronikoaren eta Telekomunikazio IngeniaritzarenIntroduction: The EMG filling factor is an index to quantify the degree to which an EMG signal has been filled. Here, we tested the validity of such index to analyse the EMG filling process as contraction force was slowly increased. Methods: Surface EMG signals were recorded from the quadriceps muscles of healthy subjects as force was gradually increased from 0 to 40% MVC. The sEMG filling process was analyzed by measuring the EMG filling factor (calculated from the non-central moments of the rectified sEMG). Results: (1) As force was gradually increased, one or two prominent abrupt jumps in sEMG amplitude appeared between 0 and 10% of MVC force in all the vastus lateralis and medialis. (2) The jumps in amplitude were originated when a few large-amplitude MUPs, clearly standing out from previous activity, appeared in the sEMG signal. (3) Every time an abrupt jump in sEMG amplitude occurred, a new stage of sEMG filling was initiated. (4) The sEMG was almost completely filled at 2–12% MVC. (5) The filling factor decreased significantly upon the occurrence of an sEMG amplitude jump, and increased as additional MUPs were added to the sEMG signal. (6) The filling factor curve was highly repeatable across repetitions. Conclusions: It has been validated that the filling factor is a useful, reliable tool to analyse the sEMG filling process. As force was gradually increased in the vastus muscles, the sEMG filling process occurred in one or two stages due to the presence of abrupt jumps in sEMG amplitude.Publication Open Access Masked least-squares averaging in processing of scanning-EMG recordings with multiple-discharges(Springer, 2020) Corera Orzanco, Íñigo; Malanda Trigueros, Armando; Rodríguez Falces, Javier; Navallas Irujo, Javier; Ingeniería Eléctrica y Electrónica; Ingeniaritza Elektrikoa eta ElektronikoaRemoving artifacts from nearby motor units is one of the main objectives when processing scanning-EMG recordings. Methods such as median filtering or masked least-squares smoothing (MLSS) can be used to eliminate artifacts in recordings with just one discharge of the motor unit potential (MUP) at each location. However, more effective artifact removal can be achieved if several discharges per position are recorded. In this case, processing usually involves averaging the discharges available at each position and then applying a median filter in the spatial dimension. The main drawback of this approach is that the median filter tends to distort the signal waveform. In this paper, we present a new algorithm that operates on multiple discharges simultaneously and in the spatial dimension. We refer to this algorithm as the multi masked least-squares smoothing (MMLSS) algorithm: an extension of the MLSS algorithm for the case of multiple discharges. The algorithm is tested using simulated scanning-EMG signals in different recording conditions, i.e., at different levels of muscle contraction and for different numbers of discharges per position. Results demonstrate that the algorithm eliminates artifacts more effectively than any previously available method and does so without distorting the waveform of the signal.Publication Open Access Automatic jitter measurement in needle-detected motor unit potential trains(Elsevier, 2022) Malanda Trigueros, Armando; Stashuk, Daniel W.; Navallas Irujo, Javier; Rodríguez Falces, Javier; Rodríguez Carreño, Ignacio; Valle, César; Garnés Camarena, Óscar; Ingeniería Eléctrica, Electrónica y de Comunicación; Ingeniaritza Elektrikoa, Elektronikoaren eta Telekomunikazio Ingeniaritzaren; Universidad Pública de Navarra / Nafarroako Unibertsitate PublikoaIn an active motor unit (MU), the time intervals between the firings of its muscle fibers vary across successive MU activations. This variability is called jitter and is increased in pathological processes that affect the neuromuscular junctions or terminal axonal segments of MUs. Traditionally, jitter has been measured using single fiber electrodes (SFEs) and a difficult and subjective manual technique. SFEs are expensive and reused, implying a potential risk of patient infection; so, they are being gradually substituted by safer, disposable, concentric needle electrodes (CNEs). As CNEs are larger, voltage contributions from individual fibers of a MU are more difficult to detect, making jitter measurement more difficult. This paper presents an automatic method to estimate jitter from trains of motor unit potentials (MUPs), for both SFE and CNE records. For a MUP train, segments of MUPs generated by single muscle fibers (SF MUP segments) are found and jitter is measured between pairs of these segments. Segments whose estimated jitter values are not reliable, according to several SF MUP segment characteristics, are excluded. The method has been tested in several simulation studies that use mathematical models of muscle fiber potentials. The results are very satisfactory in terms of jitter estimation error (less than 10% in most of the cases studied) and mean number of valid jitter estimates obtained per simulated train (greater than 1.0 in many of the cases and less than 0.5 only in the most complicated). A preliminary study with real signals was also performed, using 19 MUP trains from 3 neuropathic patients. Jitter measurements obtained by the automatic method were compared with those extracted from a commercial system (Keypoint) and the edition and supervision of an expert electromyographer. From these measurements 63% were taken from equivalent interval pair sites within the time span of the MUP trains and, as such, were considered as compatible measurements. Differences in jitter of these compatible measurements were very low (mean value of 1.3 μs, mean of absolute differences of 2.97 μs, 25% and 75% percentile intervals of − 0.85 and 3.82 μs, respectively). Although new tests with larger number of real recordings are still required, the method seems promising for clinical practice.