Models and Analysis of Vocal Emissions for Biomedical Applications

The MAVEBA Workshop proceedings, held on a biannual basis, collect the scientific papers presented both as oral and poster contributions, during the conference. The main subjects are: development of theoretical and mechanical models as an aid to the study of main phonatory dysfunctions, as well as the biomedical engineering methods for the analysis of voice signals and images, as a support to clinical diagnosis and classification of vocal pathologies

OBSTRUCTIVE SLEEP APNEA DIAGNOSIS WITH APNEA EVENT DETECTION IN SNORING SOUND USING A CONDITIONAL RANDOM FIELD

Master'sMASTER OF SCIENC

Deep sleep: deep learning methods for the acoustic analysis of sleep-disordered breathing

Sleep-disordered breathing (SDB) is a serious and prevalent condition that results from the collapse of the upper airway during sleep, which leads to oxygen desaturations, unphysiological variations in intrathoracic pressure, and sleep fragmentation. Its most common form is obstructive sleep apnoea (OSA). This has a big impact on quality of life, and is associated with cardiovascular morbidity. Polysomnography, the gold standard for diagnosing SDB, is obtrusive, time-consuming and expensive. Alternative diagnostic approaches have been proposed to overcome its limitations. In particular, acoustic analysis of sleep breathing sounds offers an unobtrusive and inexpensive means to screen for SDB, since it displays symptoms with unique acoustic characteristics. These include snoring, loud gasps, chokes, and absence of breathing. This thesis investigates deep learning methods, which have revolutionised speech and audio technology, to robustly screen for SDB in typical sleep conditions using acoustics. To begin with, the desirable characteristics for an acoustic corpus of SDB, and the acoustic definition of snoring are considered to create corpora for this study. Then three approaches are developed to tackle increasingly complex scenarios. Firstly, with the aim of leveraging a large amount of unlabelled SDB data, unsupervised learning is applied to learn novel feature representations with deep neural networks for the classification of SDB events such as snoring. The incorporation of contextual information to assist the classifier in producing realistic event durations is investigated. Secondly, the temporal pattern of sleep breathing sounds is exploited using convolutional neural networks to screen participants sleeping by themselves for OSA. The integration of acoustic features with physiological data for screening is examined. Thirdly, for the purpose of achieving robustness to bed partner breathing sounds, recurrent neural networks are used to screen a subject and their bed partner for SDB in the same session. Experiments conducted on the constructed corpora show that the developed systems accurately classify SDB events, screen for OSA with high sensitivity and specificity, and screen a subject and their bed partner for SDB with encouraging performance. In conclusion, this thesis makes promising progress in improving access to SDB diagnosis through low-cost and non-invasive methods

Self-help cognitive-behavioral therapy for insomnia (CBT-1): a systematic review of randomized controlled trials

Abstract Theme: Insomnia - new insight into development and manageThis study aimed to review current literature, examine the efficacy, adherence, acceptability, and attrition rate of self-help CBT-I, and to explore possible factors that might contribute to the effectiveness of the treatment. A systematic review was performed up to June 2012 on studies published in 6 major electronic databases. Two researchers performed study identification, data extraction, and methodological quality evaluation. Meta-analyses of self-help CBT-I vs. waiting-list, routine care, or no treatment, therapist-administered CBT-I, and placebo treatment were performed. We identified 20 randomized controlled trials (RCT) that met inclusion criteria. When compared to waiting-list control, self-help CBT-I achieved a moderate to large effect size on improving sleep and reducing sleep-related cognitions and anxiety and depressive symptoms. Therapist-administered CBT-I was slightly better than self-help CBT-I. Subgroup analyses supported the beneficial effect of telephone consultation, but not for “full” multi-component CBT and programs lasting for 6 or more weeks. Treatment adherence, acceptability, perceived usefulness, and credibility were reported as satisfactory. Based on the results of the systematic review, we have designed a Chinese-language self-help CBT-I and now conducting a RCT to evaluate the efficacy of Internet-based self-help CBT-I in Chinese population.postprin

Sleep Breath

PurposeDiagnosis of obstructive sleep apnea by the gold-standard of polysomnography (PSG), or by home sleep testing (HST), requires numerous physical connections to the patient which may restrict use of these tools for early screening. We hypothesized that normal and disturbed breathing may be detected by a consumer smartphone without physical connections to the patient using novel algorithms to analyze ambient sound.MethodsWe studied 91 patients undergoing clinically indicated PSG. Phase I: In a derivation cohort (n = 32), we placed an unmodified Samsung Galaxy S5 without external microphone near the bed to record ambient sounds. We analyzed 12,352 discrete breath/non-breath sounds (386/patient), from which we developed algorithms to remove noise, and detect breaths as envelopes of spectral peaks. Phase II: In a distinct validation cohort (n = 59), we tested the ability of acoustic algorithms to detect AHI 15 on PSG.ResultsSmartphone-recorded sound analyses detected the presence, absence, and types of breath sound. Phase I: In the derivation cohort, spectral analysis identified breaths and apneas with a c-statistic of 0.91, and loud obstruction sounds with c-statistic of 0.95 on receiver operating characteristic analyses, relative to adjudicated events. Phase II: In the validation cohort, automated acoustic analysis provided a c-statistic of 0.87 compared to whole-night PSG.ConclusionsAmbient sounds recorded from a smartphone during sleep can identify apnea and abnormal breathing verified on PSG. Future studies should determine if this approach may facilitate early screening of SDB to identify at-risk patients for definitive diagnosis and therapy.Clinical trialsNCT03288376; clinicaltrials.orgR43 DP006418/DP/NCCDPHP CDC HHS/United States2019-05-24T00:00:00Z30022325PMC65341346307vault:3223

Detection of sleep disordered breathing severity using acoustic biomarker and machine learning techniques

Purpose Breathing sounds during sleep are altered and characterized by various acoustic specificities in patients with sleep disordered breathing (SDB). This study aimed to identify acoustic biomarkers indicative of the severity of SDB by analyzing the breathing sounds collected from a large number of subjects during entire overnight sleep. Methods The participants were patients who presented at a sleep center with snoring or cessation of breathing during sleep. They were subjected to full-night polysomnography (PSG) during which the breathing sound was recorded using a microphone. Then, audio features were extracted and a group of features differing significantly between different SDB severity groups was selected as a potential acoustic biomarker. To assess the validity of the acoustic biomarker, classification tasks were performed using several machine learning techniques. Based on the apnea–hypopnea index of the subjects, four-group classification and binary classification were performed. Results Using tenfold cross validation, we achieved an accuracy of 88.3% in the four-group classification and an accuracy of 92.5% in the binary classification. Experimental evaluation demonstrated that the models trained on the proposed acoustic biomarkers can be used to estimate the severity of SDB. Conclusions Acoustic biomarkers may be useful to accurately predict the severity of SDB based on the patients breathing sounds during sleep, without conducting attended full-night PSG. This study implies that any device with a microphone, such as a smartphone, could be potentially utilized outside specialized facilities as a screening tool for detecting SDB.The work was partly supported by the SNUBH Grant #06-2014-157 and the Bio and Medical Technology Development Program of the National Research Foundation (NRF) funded by the Korean government, Ministry of Science, ICT & Future Planning (MSIP) (NRF-2015M3A9D7066972, NRF-2015M3A9D7066980)

Towards using Cough for Respiratory Disease Diagnosis by leveraging Artificial Intelligence: A Survey

Cough acoustics contain multitudes of vital information about pathomorphological alterations in the respiratory system. Reliable and accurate detection of cough events by investigating the underlying cough latent features and disease diagnosis can play an indispensable role in revitalizing the healthcare practices. The recent application of Artificial Intelligence (AI) and advances of ubiquitous computing for respiratory disease prediction has created an auspicious trend and myriad of future possibilities in the medical domain. In particular, there is an expeditiously emerging trend of Machine learning (ML) and Deep Learning (DL)-based diagnostic algorithms exploiting cough signatures. The enormous body of literature on cough-based AI algorithms demonstrate that these models can play a significant role for detecting the onset of a specific respiratory disease. However, it is pertinent to collect the information from all relevant studies in an exhaustive manner for the medical experts and AI scientists to analyze the decisive role of AI/ML. This survey offers a comprehensive overview of the cough data-driven ML/DL detection and preliminary diagnosis frameworks, along with a detailed list of significant features. We investigate the mechanism that causes cough and the latent cough features of the respiratory modalities. We also analyze the customized cough monitoring application, and their AI-powered recognition algorithms. Challenges and prospective future research directions to develop practical, robust, and ubiquitous solutions are also discussed in detail.Comment: 30 pages, 12 figures, 9 table