Using entropy of snoring, respiratory effort and electrocardiography signals during sleep for OSA detection and severity classification

Study objectives Obstructive sleep apnea (OSA) is a very prevalent disease and its diagnosis is based on polysomnography (PSG). We investigated whether snoring-sound-, very low frequency electrocardiogram (ECG-VLF)- and thoraco-abdominal effort- PSG signal entropy values could be used as surrogate markers for detection of OSA and OSA severity classification. Methods The raw data of the snoring-, ECG- and abdominal and thoracic excursion signal recordings of two consecutive full-night PSGs of 86 consecutive patients (22 female, 53.74 ± 12.4 years) were analyzed retrospectively. Four epochs (30 s each, manually scored according to the American Academy of Sleep Medicine standard) of each sleep stage (N1, N2, N3, REM, awake) were used as the ground truth. Sampling entropy (SampEn) of all the above signals was calculated and group comparisons between the OSA severity groups were performed. In total, (86x4x5 = )1720 epochs/group/night were included in the training set as an input for a support vector machine (SVM) algorithm to classify the OSA severity classes. Analyses were performed for first- and second-night PSG recordings separately. Results Twenty-seven patients had mild (RDI = ≥ 5/h but <15/h), 21 patients moderate (RDI ≥15/h but <30/h) and 23 patients severe OSA (RDI ≥30/h). Fifteen patients had an RDI <5/h and were therefore considered non-OSA. Using SE on the above three PSG signal data and using a SVM pipeline, it was possible to distinguish between the four OSA severity classes. The best metric was snoring signal-SE. The area-under-the-curve (AUC) calculations showed reproducible significant results for both nights of PSG. The second night data were even more significant, with non-OSA (R) vs. light OSA (L) 0.61, R vs. moderate (M) 0.68, R vs. heavy OSA (H) 0.84, L vs. M 0.63, M vs. H 0.65 and L vs. H 0.82. The results were not confounded by age or gender. Conclusions SampEn of either snoring-, very low ECG-frequencies- or thoraco-abdominal effort signals alone may be used as a surrogate marker to diagnose OSA and even predict OSA severity. More specifically, in this exploratory study snoring signal SampEn showed the greatest predictive accuracy for OSA among the three signals. Second night data showed even more accurate results for all three parameters than first-night recordings. Therefore, technologies using only parts of the PSG signal, e.g. sound-recording devices, may be used for OSA screening and OSA severity group classification

A novel quantitative arousal-associated EEG-metric to predict severity of respiratory distress in obstructive sleep apnea patients

Respiratory arousals (RA) on polysomnography (PSG) are an important predictor of obstructive sleep apnea (OSA) disease severity. Additionally, recent reports suggest that more global indices of desaturation such as the hypoxic burden, namely the area under the curve (AUC) of the oxygen saturation (SaO2) PSG trace may better depict the desaturation burden in OSA. Here we investigated possible associations between a new metric, namely the AUC of the respiratory arousal electroencephalographic (EEG) recording, and already established parameters as the apnea/hypopnea index (AHI), arousal index and hypoxic burden in patients with OSA. In this data-driven study, polysomnographic data from 102 patients with OSAS were assessed (32 female; 70 male; mean value of age: 52 years; mean value of Body-Mass-Index-BMI: 31 kg/m2). The marked arousals from the pooled EEG signal (C3 and C4) were smoothed and the AUC was estimated. We used a support vector regressor (SVR) analysis to predict AHI, arousal index and hypoxic burden as captured by the PSG. The SVR with the arousal-AUC metric could quite reliably predict the AHI with a high correlation coefficient (0,58 in the training set, 0,65 in the testing set and 0,64 overall), as well as the hypoxic burden (0,62 in the training set, 0,58 in the testing set and 0,59 overall) and the arousal index (0,58 in the training set, 0,67 in the testing set and 0,66 overall). This novel arousal-AUC metric may predict AHI, hypoxic burden and arousal index with a quite high correlation coefficient and therefore could be used as an additional quantitative surrogate marker in the description of obstructive sleep apnea disease severity

From covariant to canonical formulations of discrete gravity

Starting from an action for discretized gravity we derive a canonical formalism that exactly reproduces the dynamics and (broken) symmetries of the covariant formalism. For linearized Regge calculus on a flat background -- which exhibits exact gauge symmetries -- we derive local and first class constraints for arbitrary triangulated Cauchy surfaces. These constraints have a clear geometric interpretation and are a first step towards obtaining anomaly--free constraint algebras for canonical lattice gravity. Taking higher order dynamics into account the symmetries of the action are broken. This results in consistency conditions on the background gauge parameters arising from the lowest non--linear equations of motion. In the canonical framework the constraints to quadratic order turn out to depend on the background gauge parameters and are therefore pseudo constraints. These considerations are important for connecting path integral and canonical quantizations of gravity, in particular if one attempts a perturbative expansion.Comment: 37 pages, 5 figures (minor modifications, matches published version + updated references

Polynomials, Riemann surfaces, and reconstructing missing-energy events

We consider the problem of reconstructing energies, momenta, and masses in collider events with missing energy, along with the complications introduced by combinatorial ambiguities and measurement errors. Typically, one reconstructs more than one value and we show how the wrong values may be correlated with the right ones. The problem has a natural formulation in terms of the theory of Riemann surfaces. We discuss examples including top quark decays in the Standard Model (relevant for top quark mass measurements and tests of spin correlation), cascade decays in models of new physics containing dark matter candidates, decays of third-generation leptoquarks in composite models of electroweak symmetry breaking, and Higgs boson decay into two tau leptons.Comment: 28 pages, 6 figures; version accepted for publication, with discussion of Higgs to tau tau deca

From the discrete to the continuous - towards a cylindrically consistent dynamics

Discrete models usually represent approximations to continuum physics. Cylindrical consistency provides a framework in which discretizations mirror exactly the continuum limit. Being a standard tool for the kinematics of loop quantum gravity we propose a coarse graining procedure that aims at constructing a cylindrically consistent dynamics in the form of transition amplitudes and Hamilton's principal functions. The coarse graining procedure, which is motivated by tensor network renormalization methods, provides a systematic approximation scheme towards this end. A crucial role in this coarse graining scheme is played by embedding maps that allow the interpretation of discrete boundary data as continuum configurations. These embedding maps should be selected according to the dynamics of the system, as a choice of embedding maps will determine a truncation of the renormalization flow.Comment: 22 page

Quantum mechanics on a circle: Husimi phase space distributions and semiclassical coherent state propagators

We discuss some basic tools for an analysis of one-dimensionalquantum systems defined on a cyclic coordinate space. The basic features of the generalized coherent states, the complexifier coherent states are reviewed. These states are then used to define the corresponding (quasi)densities in phase space. The properties of these generalized Husimi distributions are discussed, in particular their zeros.Furthermore, the use of the complexifier coherent states for a semiclassical analysis is demonstrated by deriving a semiclassical coherent state propagator in phase space.Comment: 29 page

Tilt order parameters, polarity and inversion phenomena in smectic liquid crystals

The order parameters for the phenomenological description of the smectic-{\it A} to smectic-{\it C} phase transition are formulated on the basis of molecular symmetry and structure. It is shown that, unless the long molecular axis is an axis of two-fold or higher rotational symmetry, the ordering of the molecules in the smectic-{\it C} phase gives rise to more than one tilt order parameter and to one or more polar order parameters. The latter describe the indigenous polarity of the smectic-{\it C} phase, which is not related to molecular chirality but underlies the appearance of spontaneous polarisation in chiral smectics. A phenomenological theory of the phase transition is formulated by means of a Landau expansion in two tilt order parameters (primary and secondary) and an indigenous polarity order parameter. The coupling among these order parameters determines the possibility of sign inversions in the temperature dependence of the spontaneous polarisation and of the helical pitch observed experimentally for some chiral smectic-{\it $C^{\ast}$} materials. The molecular interpretation of the inversion phenomena is examined in the light of the new formulation.Comment: 12 pages, 5 figures, RevTe

Distinct EEG‐EMG‐coherence patterns associated with sleep‐disordered breathing severity grade [Abstract]

Objectives/Instruction: We investigated whether using EEG‐EMG‐coherence (EEC) as a feature fed to a support vector machine (SVM) algorithm may allow staging of disease severity among sleep‐disordered‐breathing (SDB) patients. Methods: EEG‐EMG‐coherence data resulted by applying a multitaper processing for estimating the power spectrums separately and calculating the coherence on raw C3‐/C4‐EEG‐ and EMG‐ chin data of polysomnographic (PSG) recordings of 102 SDB patients (33 female; age: 53, ± 12,4 yrs) acquired on the second of two consecutive PSG nights in each patient. Four epochs (30 s each, classified manually by AASM 2012‐ criteria) of each sleep stage (N1, N2, N3, REM) were marked (in total 1632 epochs/night) and were included in the analysis. After multitaper processing, EEC values were fed to a SVM algorithm to classify SDB disease severity based on respiratory disturbance index (RDI). Twenty patients had a mild (RDI ≥ 10/h and < 15/h), 30 patients had a moderate (RDI ≥ 15/h and < 30/h) and 27 patients had a severe OSA (RDI ≥ 30/h). Twenty five patients had a RDI < 10/h. The AUC (area under the curve) value was calculated for each receiver operator characteristic (ROC) curve. Results: EEG‐EMG coherence values could distinguish between SDB‐patients without OSA and OSA patients of the above three severity groups using an SVM algorithm. Using PSG data of the second night, in mild OSA the AUC was 0.616 (p = 0.024), in moderate OSA the AUC was 0.659 (p = 0.003), and in severe OSA the AUC was 0.823 (p < 0.001). Conclusions: Grading disease severity in SDB patients can be performed using PSG‐based multitaper‐processed EEC values processedwith a SVM algorithm. Disclosure: Nothing to disclose

Alongshore currents and mesoscale variability near the shelf edge off northwestern Australia

Shelf break conditions and alongshore flow off northwestern Australia are studied during the strongly evaporative conditions of austral winter 2003. Present results, along with those of previous authors, confirm that a poleward, fresh Leeuwin current core is normally found near the shelf break. Salinity increases alongshore toward the southwest. Although there is no obvious shelf break front, there is a persistent offshore upward tilting of isopycnals in the depth range of 100–150 m. Repeated mesoscale surveys were made at the shelf edge during 8 days when the shelf break flow was equatorward. Waters offshore of the shelf break contain a rich baroclinic ageostrophic eddy field, with typically 10 km length scales, and the eddy patterns in the upper 60 m are uncorrelated with those below 90 m. The two depth horizons yield energy transfers from mean to eddy potential energy and appear to represent distinct finite amplitude instabilities on upper ocean and 180 m mean velocity cores, respectively. A linear stability model supports the existence of the two vertically separated instability types.Keywords: shelf edge, Leeuwin, eddie

Alongshore currents and mesoscale variability near the shelf edge off northwestern Australia

Shelf break conditions and alongshore flow off northwestern Australia are studied during the strongly evaporative conditions of austral winter 2003. Present results, along with those of previous authors, confirm that a poleward, fresh Leeuwin current core is normally found near the shelf break. Salinity increases alongshore toward the southwest. Although there is no obvious shelf break front, there is a persistent offshore upward tilting of isopycnals in the depth range of 100–150 m. Repeated mesoscale surveys were made at the shelf edge during 8 days when the shelf break flow was equatorward. Waters offshore of the shelf break contain a rich baroclinic ageostrophic eddy field, with typically 10 km length scales, and the eddy patterns in the upper 60 m are uncorrelated with those below 90 m. The two depth horizons yield energy transfers from mean to eddy potential energy and appear to represent distinct finite amplitude instabilities on upper ocean and 180 m mean velocity cores, respectively. A linear stability model supports the existence of the two vertically separated instability types