A Noninvasive Test for Vesico-Ureteric Reflux in Children

Objective To report the development and testing of a device for the noninvasive diagnosis of vesico‐ureteric reflux (VUR) which avoids the need for urethral catheterization (currently required to reliably determine the presence of VUR), and which thus avoids the anxiety of parents and patients that causes many families to refuse such evaluation. Patients and methods Fifty‐four children (49 girls and five boys, mean age 7.2 years, range 4–14) previously evaluated as having VUR volunteered to participate; no child was symptomatic at the time of the study. Refluxing units were known to be present by voiding cysto‐urethrography (within 1 year, mean 7 months) in 45 and absent in 16. The device developed acquires electronically processed acoustic signals from the child during an observed urination. The signals are then analysed ‘off‐line’ to determine the presence or absence of VUR. The initial preparation for the test included: (i) a full bladder [at least 0.80 × {(2+age) ×30 mL}] measured by ultrasonography; and (ii) localization of the pelvi‐ureteric junction by ultrasonography to accurately place the device\u27s sensors on the child\u27s back. The children were then positioned at a commode after placing the sensors; the recording was started and continued until voiding occurred. The children were tested with the recording and analysis team unaware of the presence and/or degree of VUR. The first 47 studies were single‐kidney examinations and the remaining seven included simultaneous monitoring of both kidneys. Results Sixty‐one renal units were assessed and interpretable signals were obtained from 54 (89%). There were seven episodes of ‘system failure’ when no interpretable data were obtained. One unit with no VUR had a ‘reflux’ signal; in four kidneys, spontaneous (two) and postsurgical (two) resolution of reflux was predicted by the testing and subsequently verified by cyclic radionuclide cystography. Conclusions This noninvasive diagnostic technique detected VUR in 35 of 37 refluxing units and verified no reflux in 16 of 17 units without VUR. Further refinements may allow this technology to be used in all children with suspected VUR

Adaptive framing based similarity measurement between time warped speech signals using Kalman filter

Similarity measurement between speech signals aims at calculating the degree of similarity using acoustic features that has been receiving much interest due to the processing of large volume of multimedia information. However, dynamic properties of speech signals such as varying silence segments and time warping factor make it more challenging to measure the similarity between speech signals. This manuscript entails further extension of our research towards the adaptive framing based similarity measurement between speech signals using a Kalman filter. Silence removal is enhanced by integrating multiple features for voiced and unvoiced speech segments detection. The adaptive frame size measurement is improved by using the acceleration/deceleration phenomenon of object linear motion. A dominate feature set is used to represent the speech signals along with the pre-calculated model parameters that are set by the offline tuning of a Kalman filter. Performance is evaluated using additional datasets to evaluate the impact of the proposed model and silence removal approach on the time warped speech similarity measurement. Detailed statistical results are achieved indicating the overall accuracy improvement from 91 to 98% that proves the superiority of the extended approach on our previous research work towards the time warped continuous speech similarity measurement