Publications

by Keyword: Muscles


By year:[ 2020 | 2019 | 2018 | 2017 | 2016 | 2015 | 2014 | 2013 | 2012 | 2011 | 2010 | 2009 | 2008 | 2007 | 2006 | 2005 ]

Estrada-Petrocelli, L., Torres, A., Sarlabous, L., Rafols-de-Urquia, M., Ye-Lin, Y., Prats-Boluda, G., Jané, R., Garcia-Casado, J., (2020). Evaluation of respiratory muscle activity by means of concentric ring electrodes IEEE Transactions on Biomedical Engineering Early publication

Surface electromyography (sEMG) can be used for the evaluation of respiratory muscle activity. Recording sEMG involves the use of surface electrodes in a bipolar configuration. However, electrocardiographic (ECG) interference and electrode orientation represent considerable drawbacks to bipolar acquisition. As an alternative, concentric ring electrodes (CREs) can be used for sEMG acquisition and offer great potential for the evaluation of respiratory muscle activity due to their enhanced spatial resolution and simple placement protocol, which does not depend on muscle fiber orientation. The aim of this work was to analyze the performance of CREs during respiratory sEMG acquisitions. Respiratory muscle sEMG was applied to the diaphragm and sternocleidomastoid muscles using a bipolar and a CRE configuration. Thirty-two subjects underwent four inspiratory load spontaneous breathing tests which was repeated after interchanging the electrode positions. We calculated parameters such as (1) spectral power and (2) median frequency during inspiration, and power ratios of inspiratory sEMG without ECG in relation to (3) basal sEMG without ECG ( Rins/noise ), (4) basal sEMG with ECG ( Rins/cardio ) and (5) expiratory sEMG without ECG ( Rins/exp ). Spectral power, R_ins/noise} and Rins/cardio increased with the inspiratory load. Significantly higher values (p<0.05) of Rins/cardio and significantly higher median frequencies were obtained for CREs. Rins/noise and Rins/exp were higher for the bipolar configuration only in diaphragm sEMG recordings, whereas no significant differences were found in the sternocleidomastoid recordings. Our results suggest that the evaluation of respiratory muscle activity by means of sEMG can benefit from the remarkably reduced influence of cardiac activity, the enhanced detection of the shift in frequency content and the axial isotropy of CREs which facilitates its placement.

Keywords: Concentric ring electrodes, Laplacian potential, Non-invasive respiratory monitoring, Respiratory muscles, Surface electromyography


Estrada-Petrocelli, L., Jané, R., Torres, A., (2020). Neural respiratory drive estimation in respiratory sEMG with cardiac arrhythmias Engineering in Medicine & Biology Society (EMBC) 42nd Annual International Conference of the IEEE , IEEE (Montreal, Canada) , 2748-2751

Neural respiratory drive as measured by the electromyography allows the study of the imbalance between the load on respiratory muscles and its capacity. Surface respiratory electromyography (sEMG) is a non-invasive tool used for indirectly assessment of NRD. It also provides a way to evaluate the level and pattern of respiratory muscle activation. The prevalence of electrocardiographic activity (ECG) in respiratory sEMG signals hinders its proper evaluation. Moreover, the occurrence of abnormal heartbeats or cardiac arrhythmias in respiratory sEMG measures can make even more challenging the NRD estimation. Respiratory sEMG can be evaluated using the fixed sample entropy (fSampEn), a technique which is less affected by cardiac artefacts. The aim of this work was to investigate the performance of the fSampEn, the root mean square (RMS) and the average rectified value (ARV) on respiratory sEMG signals with supraventricular arrhythmias (SVA) for NRD estimation. fSampEn, ARV and RMS parameters increased as the inspiratory load increased during the test. fSampEn was less influenced by ECG with SVAs for the NRD estimation showing a greater response to respiratory sEMG, reflected with a higher percentage increase with increasing load (228 % total increase, compared to 142 % and 135 % for ARV and RMS, respectively).

Keywords: Electrocardiography, Muscles, Electrodes, Estimation, Band-pass filters, Electromyography, Heart beat


Lozano-García, M., Estrada-Petrocelli, L., Moxham, J., Rafferty, G. F., Torres, A., Jolley, C. J., Jané, R. , (2019). Noninvasive assessment of inspiratory muscle neuromechanical coupling during inspiratory threshold loading IEEE Access 7, 183634-183646

Diaphragm neuromechanical coupling (NMC), which reflects the efficiency of conversion of neural activation to transdiaphragmatic pressure (Pdi), is increasingly recognized to be a useful clinical index of diaphragm function and respiratory mechanics in neuromuscular weakness and cardiorespiratory disease. However, the current gold standard assessment of diaphragm NMC requires invasive measurements of Pdi and crural diaphragm electromyography (oesEMGdi), which complicates the measurement of diaphragm NMC in clinical practice. This is the first study to compare invasive measurements of diaphragm NMC (iNMC) using the relationship between Pdi and oesEMGdi, with noninvasive assessment of NMC (nNMC) using surface mechanomyography (sMMGlic) and electromyography (sEMGlic) of lower chest wall inspiratory muscles. Both invasive and noninvasive measurements were recorded in twelve healthy adult subjects during an inspiratory threshold loading protocol. A linear relationship between noninvasive sMMGlic and sEMGlic measurements was found, resulting in little change in nNMC with increasing inspiratory load. By contrast, a curvilinear relationship between invasive Pdi and oesEMGdi measurements was observed, such that there was a progressive increase in iNMC with increasing inspiratory threshold load. Progressive recruitment of lower ribcage muscles, serving to enhance the mechanical advantage of the diaphragm, may explain the more linear relationship between sMMGlic and sEMGlic (both representing lower intercostal plus costal diaphragm activity) than between Pdi and crural oesEMGdi. Noninvasive indices of NMC derived from sEMGlic and sMMGlic may prove to be useful indices of lower chest wall inspiratory muscle NMC, particularly in settings that do not have access to invasive measures of diaphragm function.

Keywords: Cardiovascular system, Diaphragms, Diseases, Electromyography, Medical signal processing, Neurophysiology, Patient monitoring, Pneumodynamics, Inspiratory muscle neuromechanical coupling, Diaphragm neuromechanical coupling, Neural activation, Transdiaphragmatic pressure, Diaphragm function, Respiratory mechanics, Diaphragm NMC, Invasive measurements, Crural diaphragm electromyography, iNMC, Noninvasive assessment, nNMC, Lower chest wall inspiratory muscles, Inspiratory threshold loading protocol, Noninvasive sMMGlic measurements, sEMGlic measurements, oesEMGdi measurements, Inspiratory threshold load, Lower ribcage muscles, Lower intercostal plus costal diaphragm activity, Crural oesEMGdi, Noninvasive indices, sEMGlic sMMGlic, Lower chest wall inspiratory muscle NMC, Surface mechanomyography, Electromyography, Inspiratory threshold loading, Mechanomyography, Neuromechanical coupling, Respiratory muscles


Estrada, L., Sarlabous, L., Lozano-García, M., Jané, R., Torres, A., (2019). Neural offset time evaluation in surface respiratory signals during controlled respiration Engineering in Medicine and Biology Society (EMBC) 41st Annual International Conference of the IEEE , IEEE (Berlín, Germany) , 2344-2347

The electrical activity of the diaphragm measured by surface electromyography (sEMGdi) provides indirect information on neural respiratory drive. Moreover, it allows evaluating the ventilatory pattern from the onset and offset (ntoff) estimation of the neural inspiratory time. sEMGdi amplitude variation was quantified using the fixed sample entropy (fSampEn), a less sensitive method to the interference from cardiac activity. The detection of the ntoff is controversial, since it is located in an intermediate point between the maximum value and the cessation of sEMGdi inspiratory activity, evaluated by the fSampEn. In this work ntoff detection has been analyzed using thresholds between 40% and 100 % of the fSampEn peak. Furthermore, fSampEn was evaluated analyzing the r parameter from 0.05 to 0.6, using a m equal to 1 and a sliding window size equal to 250 ms. The ntoff has been compared to the offset time (toff) obtained from the airflow during a controlled respiratory protocol varying the fractional inspiratory time from 0.54 to 0.18 whilst the respiratory rate was constant at 16 bpm. Results show that the optimal threshold values were between 66.0 % to 77.0 % of the fSampEn peak value. r values between 0.25 to 0.50 were found suitable to be used with the fSampEn.

Keywords: Protocols, Low pass filters, Electrodes, Standards, Band-pass filters, Muscles, Cutoff frequency


Castillo-Escario, Y., Rodríguez-Cañón, M., García-Alías, G., Jané, R., (2019). Onset detection to study muscle activity in reaching and grasping movements in rats Engineering in Medicine and Biology Society (EMBC) 41st Annual International Conference of the IEEE , IEEE (Berlín, Germany) , 5113-5116

EMG signals reflect the neuromuscular activation patterns related to the execution of a certain movement or task. In this work, we focus on reaching and grasping (R&G) movements in rats. Our objective is to develop an automatic algorithm to detect the onsets and offsets of muscle activity and use it to study muscle latencies in R&G maneuvers. We had a dataset of intramuscular EMG signals containing 51 R&G attempts from 2 different animals. Simultaneous video recordings were used for segmentation and comparison. We developed an automatic onset/offset detector based on the ratio of local maxima of Teager-Kaiser Energy (TKE). Then, we applied it to compute muscle latencies and other features related to the muscle activation pattern during R&G cycles. The automatic onsets that we found were consistent with visual inspection and video labels. Despite the variability between attempts and animals, the two rats shared a sequential pattern of muscle activations. Statistical tests confirmed the differences between the latencies of the studied muscles during R&G tasks. This work provides an automatic tool to detect EMG onsets and offsets and conducts a preliminary characterization of muscle activation during R&G movements in rats. This kind of approaches and data processing algorithms can facilitate the studies on upper limb motor control and motor impairment after spinal cord injury or stroke.

Keywords: Muscles, Electromyography, Rats, Low pass filters, Microsoft Windows, Band-pass filters


Estrada, L., Torres, A., Sarlabous, L., Jané, R., (2016). Evaluating respiratory muscle activity using a wireless sensor platform Engineering in Medicine and Biology Society (EMBC) 38th Annual International Conference of the IEEE , IEEE (Orlando, USA) , 5769-5772

Wireless sensors are an emerging technology that allows to assist physicians in the monitoring of patients health status. This approach can be used for the non-invasive recording of the electrical respiratory muscle activity of the diaphragm (EMGdi). In this work, we acquired the EMGdi signal of a healthy subject performing an inspiratory load test. To this end, the EMGdi activity was captured from a single channel of electromyography using a wireless platform which was compared with the EMGdi and the inspiratory mouth pressure (Pmouth) recorded with a conventional lab equipment. From the EMGdi signal we were able to evaluate the neural respiratory drive, a biomarker used for assessing the respiratory muscle function. In addition, we evaluated the breathing movement and the cardiac activity, estimating two cardio-respiratory parameters: the respiratory rate and the heart rate. The correlation between the two EMGdi signals and the Pmouth improved with increasing the respiratory load (Pearson's correlation coefficient ranges from 0.33 to 0.85). The neural respiratory drive estimated from both EMGdi signals showed a positive trend with an increase of the inspiratory load and being higher in the conventional EMGdi recording. The respiratory rate comparison between measurements revealed similar values of around 16 breaths per minute. The heart rate comparison showed a root mean error of less than 0.2 beats per minute which increased when incrementing the inspiratory load. In summary, this preliminary work explores the use of wireless devices to record the muscle respiratory activity to derive several physiological parameters. Its use can be an alternative to conventional measuring systems with the advantage of being portable, lightweight, flexible and operating at low energy. This technology can be attractive for medical staff and may have a positive impact in the way healthcare is being delivered.

Keywords: Biomedical monitoring, Electrodes, Medical services, Monitoring, Muscles, Wireless communication, Wireless sensor networks


Estrada, L., Torres, A., Garcia-Casado, J., Sarlabous, L., Prats-Boluda, G., Jané, R., (2016). Time-frequency representations of the sternocleidomastoid muscle electromyographic signal recorded with concentric ring electrodes Engineering in Medicine and Biology Society (EMBC) 38th Annual International Conference of the IEEE , IEEE (Orlando, USA) , 3785-3788

The use of non-invasive methods for the study of respiratory muscle signals can provide clinical information for the evaluation of the respiratory muscle function. The aim of this study was to evaluate time-frequency characteristics of the electrical activity of the sternocleidomastoid muscle recorded superficially by means of concentric ring electrodes (CREs) in a bipolar configuration. The CREs enhance the spatial resolution, attenuate interferences, as the cardiac activity, and also simplify the orientation problem associated to the electrode location. Five healthy subjects underwent a respiratory load test in which an inspiratory load was imposed during the inspiratory phase. During the test, the electromyographic signal of the sternocleidomastoid muscle (EMGsc) and the inspiratory mouth pressure (Pmouth) were acquired. Time-frequency characteristics of the EMGsc signal were analyzed by means of eight time-frequency representations (TFRs): the spectrogram (SPEC), the Morlet scalogram (SCAL), the Wigner-Ville distribution (WVD), the Choi-Williams distribution (CHWD), two generalized exponential distributions (GED1 and GED2), the Born-Jordan distribution (BJD) and the Cone-Kernel distribution (CKD). The instantaneous central frequency of the EMGsc showed an increasing behavior during the inspiratory cycle and with the increase of the inspiratory load. The bilinear TFRs (WVD, CHWD, GEDs and BJD) were less sensitive to cardiac activity interference than classical TFRs (SPEC and SCAL). The GED2 was the TFR that shown the best results for the characterization of the instantaneous central frequency of the EMGsc.

Keywords: Electrodes, Interference, Kernel, Mouth, Muscles, Spectrogram, Time-frequency analysis


Estrada, L., Torres, A., Sarlabous, L., Jané, R., (2015). EMG-derived respiration signal using the fixed sample entropy during an Inspiratory load protocol Engineering in Medicine and Biology Society (EMBC) 37th Annual International Conference of the IEEE , IEEE (Milan, Italy) , 1703-1706

Extracting clinical information from one single measurement represents a step forward in the assessment of the respiratory muscle function. This attracting idea entails the reduction of the instrumentation and fosters to develop new medical integrated technologies. We present the use of the fixed sample entropy (fSampEn) as a more direct method to non-invasively derive the breathing activity from the diaphragm electromyographic (EMGdi) signal, and thus to extract the respiratory rate, an important vital sign which is cumbersome and time-consuming to be measured by clinicians. fSampEn is a method to evaluate the EMGdi activity that is less sensitive to the cardiac activity (ECG) and its application has proven to be useful to evaluate the load of the respiratory muscles. The behavior of the proposed method was tested in signals from two subjects that performed an inspiratory load protocol, which consists of increments in the inspiratory mouth pressure (Pmouth). Two respiratory signals were derived and compared to the Pmouth signal: the ECG-derived respiration (EDR) signal from the lead-I configuration, and the EMG-derived respiration (EMGDR) signal by applying the fSampEn method over the EMGdi signal. The similitude and the lag between signals were calculated through the cross-correlation between each derived respiratory signal and the Pmouth. The EMGDR signal showed higher correlation and lower lag values (≥ 0.91 and ≤ 0.70 s, respectively) than the EDR signal (≥ 0.83 and ≤0.99 s, respectively). Additionally, the respiratory rate was estimated with the Pmouth, EDR and EMGDR signals showing very similar values. The results from this preliminary work suggest that the fSampEn method can be used to derive the respiration waveform from the respiratory muscle electrical activity.

Keywords: Band-pass filters, Electrocardiography, Electromyography, Entropy, Mouth, Muscles, Protocols


Urra, O., Casals, A., Jané, R., (2015). The impact of visual feedback on the motor control of the upper-limb Engineering in Medicine and Biology Society (EMBC) 37th Annual International Conference of the IEEE , IEEE (Milan, Italy) , 3945-3948

Stroke is a leading cause of adult disability with upper-limb hemiparesis being one of the most frequent consequences. Given that stroke only affects the paretic arm's control structure (the set of synergies and activation vectors needed to perform a movement), we propose that the control structure of the non-affected arm can serve as a physiological reference to rehabilitate the paretic arm. However, it is unclear how rehabilitation can effectively tune the control structure of a patient. The use of Visual Feedback (VF) is recommended to boost stroke rehabilitation, as it is able to positively modify neural mechanisms and improve motor performance. Thus, in this study we investigate whether VF can effectively modify the control structure of the upper-limb. We asked six neurologically intact subjects to perform a complete upper-limb rehabilitation routine comprised of 12 movements in absence and presence of VF. Our results indicate that VF significantly increases interlimb similarity both in terms of synergies and activation coefficients. However, the magnitude of improvement depended upon each subject. In general, VF brings the control structure of the nondominant side closer to the control structure of dominant side, suggesting that VF modifies the control structure towards more optimized motor patterns. This is especially interesting because stroke mainly affects the activation coefficients of patients and because it has been shown that the control of the affected side resembles that of the nondominant side. In conclusion, VF may enhance motor performance by effectively tuning the control-structure. Notably, this finding offers new insights to design improved stroke rehabilitation.

Keywords: Bars, Biomedical engineering, Electrodes, Electromyography, Mirrors, Muscles, Visualization


Estrada, L., Torres, A., Garcia-Casado, J., Prats-Boluda, G., Yiyao, Ye-Lin, Jané, R., (2014). Evaluation of Laplacian diaphragm electromyographic recording in a dynamic inspiratory maneuver Engineering in Medicine and Biology Society (EMBC) 36th Annual International Conference of the IEEE , IEEE (Chicago, USA) , 2201-2204

The analysis of the electromyographic signal of the diaphragm muscle (EMGdi) can provide important information for evaluating the respiratory muscular function. The EMGdi can be recorded using surface Ag/AgCl disc electrodes in monopolar or bipolar configuration. However, these non-invasive EMGdi recordings are usually contaminated by the electrocardiographic (ECG) signal. EMGdi signal can also be noninvasively recorded using concentric ring electrodes in bipolar configuration (CRE) that estimate Laplacian surface potential. Laplacian recordings increase spatial resolution and attenuate distant bioelectric interferences, such as the ECG. Thus, the objective of this work is to compare and to evaluate CRE and traditional bipolar EMGdi recordings in a healthy subject during a dynamic inspiratory maneuver with incremental inspiratory loads. In the conducted study, it was calculated the cumulative percentage of power spectrum of EMGdi recordings to determine the signal bandwidth, and the power ratio between the EMGdi signal segments with and without cardiac activity. The results of this study suggest that EMGdi acquired with CRE electrodes is less affected by the ECG interference, achieves a wider bandwidth and a higher power ratio between segments without cardiac activity and with cardiac activity.

Keywords: Bandwidth, Electric potential, Electrocardiography, Electrodes, Interference, Laplace equations, Muscles


Estrada, L., Torres, A., Sarlabous, L., Fiz, J. A., Jané, R., (2014). Respiratory rate detection by empirical mode decomposition method applied to diaphragm mechanomyographic signals Engineering in Medicine and Biology Society (EMBC) 36th Annual International Conference of the IEEE , IEEE (Chicago, USA) , 3204-3207

Non-invasive evaluation of respiratory activity is an area of increasing research interest, resulting in the appearance of new monitoring techniques, ones of these being based on the analysis of the diaphragm mechanomyographic (MMGdi) signal. The MMGdi signal can be decomposed into two parts: (1) a high frequency activity corresponding to lateral vibration of respiratory muscles, and (2) a low frequency activity related to excursion of the thoracic cage. The purpose of this study was to apply the empirical mode decomposition (EMD) method to obtain the low frequency of MMGdi signal and selecting the intrinsic mode functions related to the respiratory movement. With this intention, MMGdi signals were acquired from a healthy subject, during an incremental load respiratory test, by means of two capacitive accelerometers located at left and right sides of rib cage. Subsequently, both signals were combined to obtain a new signal which contains the contribution of both sides of thoracic cage. Respiratory rate (RR) measured from the mechanical activity (RRMmg) was compared with that measured from inspiratory pressure signal (RRP). Results showed a Pearson's correlation coefficient (r = 0.87) and a good agreement (mean bias = -0.21 with lower and upper limits of -2.33 and 1.89 breaths per minute, respectively) between RRmmg and RRP measurements. In conclusion, this study suggests that RR can be estimated using EMD for extracting respiratory movement from low mechanical activity, during an inspiratory test protocol.

Keywords: Accelerometers, Band-pass filters, Biomedical measurement, Empirical mode decomposition, Estimation, IP networks, Muscles


Sarlabous, L., Torres, A., Fiz, J. A., Morera, J., Jané, R., (2013). Index for estimation of muscle force from mechanomyography based on the Lempel-Ziv algorithm Journal of Electromyography and Kinesiology , 23, (3), 548-557

The study of the amplitude of respiratory muscle mechanomyographic (MMG) signals could be useful in clinical practice as an alternative non-invasive technique to assess respiratory muscle strength. The MMG signal is stochastic in nature, and its amplitude is usually estimated by means of the average rectified value (ARV) or the root mean square (RMS) of the signal. Both parameters can be used to estimate MMG activity, as they correlate well with muscle force. These estimations are, however, greatly affected by the presence of structured impulsive noise that overlaps in frequency with the MMG signal. In this paper, we present a method for assessing muscle activity based on the Lempel-Ziv algorithm: the Multistate Lempel-Ziv (MLZ) index. The behaviour of the MLZ index was tested with synthesised signals, with various amplitude distributions and degrees of complexity, and with recorded diaphragm MMG signals. We found that this index, like the ARV and RMS parameters, is positively correlated with changes in amplitude of the diaphragm MMG components, but is less affected by components that have non-random behaviour (like structured impulsive noise). Therefore, the MLZ index could provide more information to assess the MMG-force relationship.

Keywords: Diaphragm, Electromyography, Lempel-Ziv, Mechanomyography, Muscle force, Respiratory muscles


Sarlabous, L., Torres, A., Fiz, J. A., Morera, J., Jané, R., (2012). Evaluation and adaptive attenuation of the cardiac vibration interference in mechanomyographic signals Engineering in Medicine and Biology Society (EMBC) 34th Annual International Conference of the IEEE , IEEE (San Diego, USA) , 3400-3403

The study of the mechanomyographic signal of the diaphragm muscle (MMGdi) is a promising technique in order to evaluate the respiratory muscles effort. The relationship between amplitude and frequency parameters of this signal with the respiratory effort performed during respiration is of great interest for researchers and physicians due to its diagnostic potentials. However, MMGdi signals are frequently contaminated by a cardiac vibration or mechanocardiographic (MCG) signal. An adaptive noise cancellation (ANC) can be used to reduce the MCG interference in the recorded MMGdi activity. In this paper, it is evaluated the proposed ANC scheme by means of a synthetic MMGdi signal with a controlled MCG interference. The Pearson's correlation coefficient (PCC) between both root mean square (RMS) and mean frequency (fm) of the synthetic MMGdi signal are considerably reduced with the presence of cardiac vibration noise (from 0.95 to 0.87, and from 0.97 to 0.76, respectively). With the ANC algorithm proposed the effect of the MCG noise on the amplitude and frequency of MMG parameters is reduced considerably (PCC of 0.93 and 0.97 for the RMS and fm, respectively). The ANC method proposed in this work is an interesting technique to attenuate the cardiac interference in respiratory MMG signals. Further investigation should be carried out to evaluate the performance of the ANC algorithm in real MMGdi signals.

Keywords: Adaptive filters, Frequency modulation, Interference, Muscles, Noise cancellation, Vibrations, Cardiology, Medical signal processing, Muscle, Signal denoising, ANC algorithm, MCG interference, Pearson correlation coefficient, Adaptive noise cancellation, Cardiac vibration interference, Cardiac vibration noise, Diaphragm muscle, Mechanocardiographic signal, Mechanomyographic signals, Respiratory muscles effort


Orini, Michele, Giraldo, Beatriz F., Bailon, Raquel, Vallverdu, Montserrat, Mainardi, Luca, Benito, Salvador, Diaz, Ivan, Caminal, Pere, (2008). Time-frequency analysis of cardiac and respiratory parameters for the prediction of ventilator weaning IEEE Engineering in Medicine and Biology Society Conference Proceedings 30th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (ed. IEEE), IEEE (Vancouver, Canada) 1-8, 2793-2796

Mechanical ventilators are used to provide life support in patients with respiratory failure. Assessing autonomic control during the ventilator weaning provides information about physiopathological imbalances. Autonomic parameters can be derived and used to predict success in discontinuing from the mechanical support. Time-frequency analysis is used to derive cardiac and respiratory parameters, as well as their evolution in time, during ventilator weaning in 130 patients. Statistically significant differences have been observed in autonomic parameters between patients who are considered ready for spontaneous breathing and patients who are not. A classification based on respiratory frequency, heart rate and heart rate variability spectral components has been proposed and has been able to correctly classify more than 80% of the cases.

Keywords: Automatic Data Processing, Databases, Factual, Electrocardiography, Humans, Models, Statistical, Respiration, Respiration, Artificial, Respiratory Insufficiency, Respiratory Mechanics, Respiratory Muscles, Signal Processing, Computer-Assisted, Time Factors, Ventilator Weaning, Ventilators, Mechanical, Work of Breathing