Dynamics of Snoring Sounds and Its Connection with Obstructive Sleep Apnea

Snoring is extremely common in the general population and when irregular may indicate the presence of obstructive sleep apnea. We analyze the overnight sequence of wave packets --- the snore sound --- recorded during full polysomnography in patients referred to the sleep laboratory due to suspected obstructive sleep apnea. We hypothesize that irregular snore, with duration in the range between 10 and 100 seconds, correlates with respiratory obstructive events. We find that the number of irregular snores --- easily accessible, and quantified by what we call the snore time interval index (STII) --- is in good agreement with the well-known apnea-hypopnea index, which expresses the severity of obstructive sleep apnea and is extracted only from polysomnography. In addition, the Hurst analysis of the snore sound itself, which calculates the fluctuations in the signal as a function of time interval, is used to build a classifier that is able to distinguish between patients with no or mild apnea and patients with moderate or severe apnea

Algorithm for heart rate extraction in a novel wearable acoustic sensor.

Phonocardiography is a widely used method of listening to the heart sounds and indicating the presence of cardiac abnormalities. Each heart cycle consists of two major sounds - S1 and S2 - that can be used to determine the heart rate. The conventional method of acoustic signal acquisition involves placing the sound sensor at the chest where this sound is most audible. Presented is a novel algorithm for the detection of S1 and S2 heart sounds and the use of them to extract the heart rate from signals acquired by a small sensor placed at the neck. This algorithm achieves an accuracy of 90.73 and 90.69%, with respect to heart rate value provided by two commercial devices, evaluated on more than 38 h of data acquired from ten different subjects during sleep in a pilot clinical study. This is the largest dataset for acoustic heart sound classification and heart rate extraction in the literature to date. The algorithm in this study used signals from a sensor designed to monitor breathing. This shows that the same sensor and signal can be used to monitor both breathing and heart rate, making it highly useful for long-term wearable vital signs monitoring

Protocol of the SOMNIA project : an observational study to create a neurophysiological database for advanced clinical sleep monitoring

Introduction Polysomnography (PSG) is the primary tool for sleep monitoring and the diagnosis of sleep disorders. Recent advances in signal analysis make it possible to reveal more information from this rich data source. Furthermore, many innovative sleep monitoring techniques are being developed that are less obtrusive, easier to use over long time periods and in the home situation. Here, we describe the methods of the Sleep and Obstructive Sleep Apnoea Monitoring with Non-Invasive Applications (SOMNIA) project, yielding a database combining clinical PSG with advanced unobtrusive sleep monitoring modalities in a large cohort of patients with various sleep disorders. The SOMNIA database will facilitate the validation and assessment of the diagnostic value of the new techniques, as well as the development of additional indices and biomarkers derived from new and/or traditional sleep monitoring methods. Methods and analysis We aim to include at least 2100 subjects (both adults and children) with a variety of sleep disorders who undergo a PSG as part of standard clinical care in a dedicated sleep centre. Full-video PSG will be performed according to the standards of the American Academy of Sleep Medicine. Each recording will be supplemented with one or more new monitoring systems, including wrist-worn photoplethysmography and actigraphy, pressure sensing mattresses, multimicrophone recording of respiratory sounds including snoring, suprasternal pressure monitoring and multielectrode electromyography of the diaphragm

DeepCough: A Deep Convolutional Neural Network in A Wearable Cough Detection System

In this paper, we present a system that employs a wearable acoustic sensor and a deep convolutional neural network for detecting coughs. We evaluate the performance of our system on 14 healthy volunteers and compare it to that of other cough detection systems that have been reported in the literature. Experimental results show that our system achieves a classification sensitivity of 95.1% and a specificity of 99.5%.Comment: BioCAS-201

Retrospective study of the association between neutering status and changes secondary to degenerative mitral valve disease

Dissertação de Mestrado Integrado em Medicina VeterináriaMyxomatous mitral valve disease is the most common cardiovascular disease reported in dogs. Although many patients may remain asymptomatic, some of them progress to left-sided congestive heart failure and develop clinical signs. Little has yet been published regarding the possible influence of the neutering status on changes secondary to myxomatous mitral valve disease. This study aims to assess a possible correlation between neutering status and myxomatous mitral valve disease. A retrospective study was conducted and included all the cases diagnosed with myxomatous mitral valve disease, consulted at the Cardiology service of the University of Liverpool. To help assess the association between neutering status and cardiac remodelling, dogs were categorized into four groups: FE (female entire), FN (female neutered), ME (male entire) and MN (male neutered). Retrospective review of echocardiographic data, signalment, and underlying diseases were performed. Echocardiographic measurements were made through offline analysis. Echocardiographic measurements were then compared between groups. Five hundred and eighty-two dogs (n = 582) were included: female entire (n = 24), female neutered (n = 235), male entire (n = 115) and male neutered (n = 208). Left ventricular internal diameter at end diastole (LVIDd), left atrial dimension to the aortic root diameter (LA:Ao) and left atrium maximal dimension to the aortic root dimension (LAmax:Ao) were significantly different between ME and MN, with ME dogs presenting higher mean values for LVIDd and higher median LA:Ao and LAmax:Ao measurements. Left ventricular internal diameter at end systole (LVIDs) was not significantly different between ME and MN. There were no significant differences between FE and FN groups. This study shows that neutering status may influence the development of myxomatous mitral valve disease in male dogs and that entire male dogs could be at higher risk of developing cardiac remodelling secondary to myxomatous mitral valve disease. On the other hand, neutering status doesn’t seem to have an influence on disease progression in female dogs.RESUMO - Estudo retrospetivo da associação entre a esterilização e alterações secundárias à doença mixomatosa da válvula mitral - A doença mixomatosa da válvula mitral é a doença cardiovascular mais prevalente em cães. Apesar da maior parte dos pacientes permanecerem assintomáticos, alguns podem progredir para insuficiência cardíaca esquerda e desenvolver sinais clínicos. Até hoje, existem poucas publicações sobre o possível efeito que a esterilização possa ter no desenvolvimento da doença mixomatosa da válvula mitral. O objetivo deste estudo é avaliar se existe de facto uma relação entre a esterilização e a doença mixomatosa da válvula mitral. Foi realizado um estudo retrospetivo que incluiu todos os casos diagnosticados com doença mixomatosa da válvula mitral consultados no serviço de Cardiologia da Universidade de Liverpool. Para avaliar a relação entre a esterilização e a presença de remodelação cardíaca, os cães foram categorizados em quatro grupos: FE (fêmeas inteiras), FN (fêmeas esterilizadas), ME (machos inteiros) e MN (machos castrados). A história pregressa e os dados ecocardiográficos dos animais foram revistos retrospetivamente e as medidas ecocardiográficas foram obtidas por medição offline. Estas medições foram depois comparadas entre os diferentes grupos. Quinhentos e oitenta e dois cães (n = 582) foram incluídos: fêmeas inteiras (n = 24), fêmeas esterilizadas (n = 235), machos inteiros (n = 115) e machos castrados (n = 208). Nos resultados obtidos, o diâmetro interno do ventrículo esquerdo no final da diástole (LVIDd), o rácio átrio esquerdo-aorta (LA:Ao) e o rácio diâmetro máximo do átrio esquerdo-aorta (LAmax:Ao) foram estatisticamente significativos entre machos inteiros e machos castrados. Os machos inteiros apresentaram não só um LVIDd médio superior, como também uma mediana de LA:Ao e LAmax:Ao superior aos machos castrados. Ao mesmo tempo, o diâmetro interno do ventrículo esquerdo no final da sístole (LVIDs) não mostrou ser estatisticamente significativo entre machos inteiros e machos castrados e nenhum dos parâmetros ecocardiográficos anteriormente referidos revelou ser estatisticamente significativo entre fêmeas inteiras e fêmeas esterilizadas. Este estudo demonstra que a esterilização poderá influenciar o desenvolvimento da doença mixomatosa da válvula mitral e que os cães machos inteiros poderão apresentar um maior risco de desenvolver remodelação cardíaca secundária a esta doença. No entanto, a esterilização não aparenta influenciar a progressão desta doença em cadelas.N/

Model applications of decision support systems in meat hygiene programs : a thesis presented in partial fulfilment of the requirements for the degree of Master of Veterinary Science at Massey University

Current systems to ensure safety of meat are to a large degree based on a "procedural" approach which specifies what inspection actions will be taken to protect human health. Both knowledge and disease priorities have changed substantially over recent decades, and moreover the scale of the problems created by any breakdowns in protection has escalated greatly, as food trading and consumption patterns have changed. It is now recognized that meat hygiene needs to focus primarily on ways by which the risk that product will represent a hazard to human health can be effectively reduced, rather than merely ensuring compliance with a defined set of procedures. In addition to human food safety, meat inspection has the potential to contribute information to improve animal health on a national and a local scale. This thesis examines example issues in order to identify possible approaches to the development of decision support systems which assist in protecting meat consumers and improving the health of livestock on farms. The main areas which were explored for this purpose were respiratory disease in lambs and chemical residues in slaughter animals. A literature review of pneumonia and pleurisy in lambs showed that numerous factors have been proposed as predisposing causes for these diseases, but there was surprisingly little valid experimental or observational research evidence to support such statements. A hazard analysis was performed for the micro-organisms which have been isolated from pneumonic lungs. The major commonly detected organisms did not appear to cause a risk to healthy people. However there were a number of micro-organisms which are isolated on occasion from pneumonic and sometimes from healthy sheep lungs that might cause human disease. A case-control study was carried out as an exploratory means to identify risk factors and to generate hypotheses about causal processes. A number of risk factors were initially identified at univariate level. At the second stage the importance of some of these risk factors was quantified in a logistic regression model. Finally a third stage analysis showed the interactions between the factors in a logistic path model, which consisted of three clusters. One cluster included characteristics of the farm and paddocks, one cluster included the yards and practices in the yards, and a third cluster included the types and number of animals on the farm. Two intervention studies were subsequently carried out to evaluate the effect of making various management modifications on the prevalence of pneumonia and pleurisy at slaughter. One intervention study evaluated the time lambs spent in the yards after weaning and the use or oral or injectable drenches. The second intervention study evaluated the use of oral versus injectable drenches and the use of a shower dip versus a wand. The intervention studies showed an effect of time in the yards on pneumonia. There was some association between time in the yards and acute localised pleurisy but none between the other measures tested and respiratory disease. The studies showed clear temporal patterns with regard to pleurisy and pneumonia and enabled comparisons to be made between farms. A study of inspection for pleurisy at slaughterhouses was analysed. The analysis identified the temporal patterns of certain types of pleurisy. Comparisons were made between four participating premises. The sensitivity and specificity of meat inspection for the various types of pleurisy was analysed. The pleurisy data over an eleven year period of the entire country were analysed. Differences were shown between islands and regions. The potential for development of components of a decision support system for pneumonia and pleurisy was illustrated with a number of examples. An important component was to determine how farmers could be assisted in improving the health of their lambs with regard to pleurisy. Ideas to improve farmer involvement were developed. The principles of a decision support system which evaluated the issue of cross-contamination due to handling of product by the inspector were developed. Epidemiological principles of chemical residues in slaughter animals were investigated. A number of statistical quality control tests were applied to known data sets to evaluate what sample sizes would be required to detect changing trends or spatial paterns. Temporal simulations were performed to determine how well clusters in time could be detected. The Moving Average approach was used and it appeared that with the given data set sample sizes well beyond those feasible to achieve would be required. Spatial analyses with a number of different statistics were performed. In this case also, large sample sizes were required for reliable results. It was concluded that use of a risk analysis model to define a risk-reduction strategy targeted to avoid any significant risk to the consumer offered a much more effective tool than a fixed sampling system. This model combines a range of possible risk reduction measures in various mixes, and determines whether or not each of the tested strategies achieves the goal of making it very improbable that a consumer would be exposed to sufficient levels of chemical residues in food to even constitute some minimal public health risk