{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T03:01:07Z","timestamp":1760151667520,"version":"build-2065373602"},"reference-count":48,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2022,3,29]],"date-time":"2022-03-29T00:00:00Z","timestamp":1648512000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology","doi-asserted-by":"publisher","award":["110-2221-E-194-011","103-2221-E-303-002"],"award-info":[{"award-number":["110-2221-E-194-011","103-2221-E-303-002"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Buddhist Tzuchi Medical Foundation Academic Advancement, Hualien, Taiwan","award":["TCMF-A-108-10","TCMF-P-107-12"],"award-info":[{"award-number":["TCMF-A-108-10","TCMF-P-107-12"]}]},{"name":"Hualien Tzu Chi General Hospital","award":["TCRD 108-51"],"award-info":[{"award-number":["TCRD 108-51"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Entropy"],"abstract":"<jats:p>Cardiac autonomic neuropathy (CAN) is a common complication of diabetes mellitus, and can be assessed using heart rate variability (HRV) and the correlations between systolic blood pressure (SBP) and ECG R-R intervals (RRIs), namely baroreflex sensitivity (BRS). In this study, we propose a novel parameter for the nonlinear association between SBP and RRIs based on multiscale cross-approximate entropy (MS-CXApEn). Sixteen male adult Wistar Kyoto rats were equally divided into two groups: streptozotocin-induced diabetes and age-matched controls. RRIs and SBP were acquired in control rats and the diabetic rats at the onset of hyperglycemia and insulin-treated euglycemia to determine HRV by the ratio of low-frequency to high-frequency power (LF\/HF) and Poincar\u00e9 plot as SSR (SD1\/SD2), BRS, and MS-CXApEn. SSR and BRS were not significantly different among the three groups. The LF\/HF was significantly higher in the hyperglycemic diabetics than those in the controls and euglycemic diabetic rats. MS-CXApEn was higher in the diabetic hyperglycemic rats than the control rats from scales 2 to 10, and approached the values of controls in diabetic euglycemic rats at scales 9 and 10. Conclusions: We propose MS-CXApEn as a novel parameter to quantify the dynamic nonlinear interactions between SBP and RRIs that reveals more apparent changes in early diabetic rats. Furthermore, changes in this parameter were related to correction of hyperglycemia and could be useful for detecting and assessing CAN in early diabetes.<\/jats:p>","DOI":"10.3390\/e24040473","type":"journal-article","created":{"date-parts":[[2022,3,29]],"date-time":"2022-03-29T21:44:52Z","timestamp":1648590292000},"page":"473","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Novel Application of Multiscale Cross-Approximate Entropy for Assessing Early Changes in the Complexity between Systolic Blood Pressure and ECG R-R Intervals in Diabetic Rats"],"prefix":"10.3390","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3617-1739","authenticated-orcid":false,"given":"Wei-Min","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Computer Science and Information Engineering, National Chung Cheng University, Chiayi 621301, Taiwan"}]},{"given":"Hsin-Ru","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970473, Taiwan"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5146-0048","authenticated-orcid":false,"given":"Po-Wei","family":"Chen","sequence":"additional","affiliation":[{"name":"Medical Department, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970473, Taiwan"}]},{"given":"Huai-Ren","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970473, Taiwan"},{"name":"School of Medicine, Tzu Chi University, Hualien 970374, Taiwan"}]},{"given":"Chen-Mao","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Computer Science and Information Engineering, National Chung Cheng University, Chiayi 621301, Taiwan"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6249-5238","authenticated-orcid":false,"given":"An-Bang","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Medicine, Tzu Chi University, Hualien 970374, Taiwan"},{"name":"Department of Neurology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970473, Taiwan"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"14790","DOI":"10.1038\/s41598-020-71908-9","article-title":"Global, regional, and national burden and trend of diabetes in 195 countries and territories: An analysis from 1990 to 2025","volume":"10","author":"Lin","year":"2020","journal-title":"Sci. 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