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Obstructive Sleep Apnea (OSA) patients have frequent breathing obstructions and upper airway (UA) collapse during sleep. It is clinically important to estimate OSA severity separately for Rapid Eye Movement (REM) and non-REM (NREM) sleep states, but the task requires Polysomnography (PSG) which uses about 15-20 body contact sensors and subjective assessment. Almost all OSA patients snore. Vibration in narrowed UA muscles cause snoring in OSA. Moreover, as sleep states are associated with distinct breathing patterns and UA muscle tone, REM/NREM specific information must be available via snore/breathing sounds. Our previous works have shown that snoring carries significant information related to REM/NREM sleep states and OSA. We hypothesized that such information from snoring sound could be used to characterize OSA specific to REM/NREM sleep states independent of PSG. We acquired overnight audio recording from 91 patients (56 males and 35 females) undergoing PSG and labeled snore sounds as belonging to REM/NREM stages based on PSG. We then developed features to capture REM/NREM specific information and trained logistic regression (LR) classifier models to map snore features to OSA severity bands. Considering separate LR models for males and females, we achieved 94-100% sensitivity (84-89% specificity) for NREM stages at the OSA severity threshold of 30 events/h. Corresponding sensitivity for REM stages were 92-97% with specificity 83-85%. Results indicate that it is feasible to estimate severe/non-severe OSA in REM/NREM sleep based on snore/breathing sounds alone, acquired using simple bedside sound acquisition devices such as mobile phones.

Snoring is common in Obstructive Sleep Apnea (OSA) patients. Snoring originates from the vibration of soft tissues in the upper airways (UA). Frequent UA collapse in OSA patients leads to sleep disturbances and arousal. In a routine sleep diagnostic procedure, sleep is broadly divided into rapid eye movement (REM), non-REM (NREM) states. These Macro-Sleep States (MSS) are known to be involved with different neuromuscular activities. These differences should influence the UA mechanics in OSA patients as well as the snoring sound (SS). In this paper, we propose a logistic regression model to investigate whether the properties of SS from OSA patients can be separated into REM/NREM group. Analyzing mathematical features of more than 500 SS events from 7 OSA patients, the model achieved 76% (± 0.10) sensitivity and 75% (± 0.10) specificity in categorizing REM and NREM related snores. These results indicate that snoring is affected by REM/NREM states and proposed method has potential in differentiating MSS.

Cough is the most common symptom of the several respiratory diseases containing diagnostic information. It is the best suitable candidate to develop a simplified screening technique for the management of respiratory diseases in timely manner, both in developing and developed countries, particularly in remote areas where medical facilities are limited. However, major issue hindering the development is the non-availability of reliable technique to automatically identify cough events. Medical practitioners still rely on manual counting, which is laborious and time consuming. In this paper we propose a novel method, based on the neural network to automatically identify cough segments, discarding other sounds such a speech, ambient noise etc. We achieved the accuracy of 98% in classifying 13395 segments into two classes, 'cough' and 'other sounds', with the sensitivity of 93.44% and specificity of 94.52%. Our preliminary results indicate that method can develop into a real-time cough identification technique in continuous cough monitoring systems.

Pneumonia kills over 1,800,000 children annually throughout the world. Prompt diagnosis and proper treatment are essential to prevent these unnecessary deaths. Reliable diagnosis of childhood pneumonia in remote regions is fraught with difficulties arising from the lack of field-deployable imaging and laboratory facilities as well as the scarcity of trained community healthcare workers. In this paper, we present a pioneering class of enabling technology addressing both of these problems. Our approach is centered on automated analysis of cough and respiratory sounds, collected via microphones that do not require physical contact with subjects. We collected cough sounds from 91 patients suspected of acute respiratory illness such as pneumonia, bronchiolitis and asthma. We extracted mathematical features from cough sounds and used them to train a Logistic Regression classifier. We used the clinical diagnosis provided by the paediatric respiratory clinician as the gold standard to train and validate our classifier against. The methods proposed in this paper could separate pneumonia from other diseases at a sensitivity and specificity of 94% and 75% respectively, based on parameters extracted from cough sounds alone. Our method has the potential to revolutionize the management of childhood pneumonia in remote regions of the world.

Cough is the most common symptom of several respiratory diseases. It is a defense mechanism of the body to clear the respiratory tract from foreign materials inhaled accidentally or produced internally by infections. The identification of wet and dry cough is an important clinical finding, aiding in the differential diagnosis. Wet coughs are more likely to be associated with bacterial infections. At present, the wet/dry decision is based on the subjective judgment of a physician, during a typical consultation session. It is not available for long term monitoring or in the assessment of treatment efficacy. In this paper we address these issues and develop fully automated technology to classify cough into 'Wet' and 'Dry' categories. We propose novel features and a Logistic regression-based model for the classification of coughs into wet/dry classes. The performance of the method was evaluated on a clinical database of pediatric and adult coughs recorded using a bed-side non-contact microphone. The sensitivity and specificity of the classification were obtained as 79±9% and 72.7±8.7% respectively. These indicate the potential of the method as a useful clinical tool for cough monitoring, especially at home settings.

Cough is a common symptom in a range of respiratory diseases and is considered a natural defense mechanism of the body. Despite its critical importance in the diagnosis of illness, there are no golden methods to objectively assess cough. In a typical consultation session, a physician may briefly listen to the cough sounds using a stethoscope placed against the chest. The physician may also listen to spontaneous cough sounds via naked ears, as they naturally propagate through air. Cough sounds carry vital information on the state of the respiratory system but the field of cough analysis in clinical medicine is in its infancy. All existing cough analysis approaches are severely handicapped by the limitations of the human hearing range and simplified analysis techniques. In this paper, we address these problems, and explore the use of frequencies covering a range well beyond the human perception (up to 90 kHz) and use wavelet analysis to extract diagnostically important information from coughs. Our data set comes from a pediatric respiratory ward in Indonesia, from subjects diagnosed with asthma, pneumonia and rhinopharyngitis. We analyzed over 90 cough samples from 4 patients and explored if high frequencies carried useful information in separating these disease groups. Multiple regression analysis resulted in coefficients of determination (R(2)) of 77-82% at high frequencies (15 kHz-90 kHz) indicating that they carry useful information. When the high frequencies were combined with frequencies below 15kHz, the R(2) performance increased to 85-90%.

Obstructive Sleep Apnea (OSA) is a highly prevalent disease in which upper airways are collapsed during sleep, leading to serious consequences. The standard method of OSA diagnosis is known as Polysomnography (PSG), which requires an overnight stay in a specifically equipped facility, connected to over 15 channels of measurements. PSG requires (i) contact instrumentation and, (ii) the expert human scoring of a vast amount of data based on subjective criteria. PSG is expensive, time consuming and is difficult to use in community screening or pediatric assessment. Snoring is the most common symptom of OSA. Despite the vast potential, however, it is not currently used in the clinical diagnosis of OSA. In this paper, we propose a novel method of snore signal analysis for the diagnosis of OSA. The method is based on a novel feature that quantifies the non-Gaussianity of individual episodes of snoring. The proposed method was evaluated using overnight clinical snore sound recordings of 86 subjects. The recordings were made concurrently with routine PSG, which was used to establish the ground truth via standard clinical diagnostic procedures. The results indicated that the developed method has a detectability accuracy of 97.34%.

Chronic sleepiness is a common symptom in the sleep disorders, such as, Obstructive Sleep Apnea, Periodic leg movement syndrome, narcolepsy etc. It affects 5% of the adult population and is associated with significant morbidity and increased risk to individual and society. MSLT and MWT are the existing tests for measuring sleepiness. Sleep Latency (SL) is the main measures of sleepiness computed in these tests. Existing method of SL computation relies on the visual extraction of specific features in multi-channel electrophysiological data (EEG, EOG, and EMG) using the R&K criteria (1968). This process is cumbersome, time consuming, and prone to inter and intra-scorer variability. In this paper we propose a fully automated, objective sleepiness analysis technique based on the single channel of EEG. The method uses a one-dimensional slice of the EEG Bisprectrum representing a nonlinear transformation of the underlying EEG generator to compute a novel index called Sleepiness Index. The SL is then computed from the SI. A strong correlation (r = 0.93, rho = 0.0001) was found between technician scored SL and that computed via SI. The proposed Sleepiness Index can provide an elegant solution to the problems surrounding manual scoring and objective sleepiness.

Snore sound (SS) is the earliest and the most common symptom of Obstructive Sleep Apnea (OSA) which is a serious disease caused by the collapse of upper airways during sleep. SS should carry vital information on the state of the upper airways and is simple to acquire and rich in features but their analysis is complicated. In this study we use neural network (NN) based method to model SS via a simple second order one-step predictor. We show that the some hidden information/feature of a SS can be conveniently captured in the connection-weight-space (CWS) of the NN, after a process of supervised training. The availability of the proposed method is investigated by performing independent component analysis (ICA) on CWS.

We address the problem of estimating biopotential sources within the brain, based on EEG signals observed on the scalp. This problem, known as the inverse problem of electrophysiology, has no closed-form solution, and requires iterative techniques such as the Levenberg-Marquardt (LM) algorithm. Considering the nonlinear nature of the inverse problem, and the low signal to noise ratio inherent in EEG signals, a backpropagation neural network (BPN) has been recently proposed as a solution. The technique has not been properly compared with classical techniques such as the LM method, or with more recent neural network techniques such as the Radial Basis Function (RBF) network. In this paper, we provide improved strategies based on BPN and consider RBF networks in solving the inverse problem. We compare the performances of BPN, RBF and a hybrid technique with that of the classical LM method.

Ultrasound echoes from organs such as the liver display resolvable periodicity due to regular scattering centers within tissue. The spacing among such scattering centers has been proposed as a signature to characterize diffuse and focal diseases of the liver. Even though it is highly desirable to be able to estimate an inter-scatterer-spacing (ISS) distribution, current methods can estimate only the mean value of scatterer spacing (MSS) over a tissue length. In this paper, we propose a wavelet transform-based technique that is capable of estimating the location of each scattering center, making it possible to obtain the ISS distribution. We represent liver tissue with a point scatterer model, and show, via computer simulations, that the use of multi-scale information in the wavelet scale-space allows us to estimate the locations of regular scattering centers. We show that both the observation noise and random ultrasound returns from unresolvable tissue microstructure can be removed successfully in the wavelet domain via the properties of the modulus maxima sequence of observation across different scales.

In this paper, we propose a novel technique for selective stimulation of nerve fibers. We show that a set of point electrodes arranged in the 3-D space around a nerve trunk can be used to systematically synthesize highly useful activation patterns within the nerve, by exploiting the spatial arrangement of the electrodes and the excitation currents. Using such activation patterns, we present a novel scheme to selectively stimulate nerve fibers, based on the nonlinear properties of action potential generation. We illustrate the developed techniques via computer simulations of a nerve trunk consisting of a large number of nerve fibers. The results indicate that the proposed technique has great potential to achieve position selective stimulation of nerve in FES.

The backpropagation neural network methods have been proposed recently to solve the inverse problem in quantitative electrophysiology. A major advantage of the technique is that once a neural network is trained, it no longer requires iterations or access to sophisticated computations. We propose to use RBF networks for source localization in the brain, and systematically compare their performance to those of Levenberg-Marquardt (LM) algorithms. We show the use of two types of Radial Basis Function Networks (RBF) network: a classic network with fixed number of hidden layer neurons and an improved network, Minimal Resource Allocation Network (MRAN), recently proposed by one of the authors, capable for dynamically configuring its structure so as to obtain a compact topology to match the data presented to it.

The spontaneous changes in the heartbeat provide valuable information regarding serious cardiac pathologies such as Sudden Cardiac Death. Subtle anomalies in the heart rate can be discovered via an analysis of the Heart Rate Variability (HRV) signal, a sequence of numbers representing the instantaneous heart rate over time. The HRV signal is commonly modeled by an integral pulse frequency modulation (IPFM) scheme. Based on the model, several techniques have been proposed in the literature to capture features of the HRV signal. They however, suffer from severe spurious peaks, especially when the HRV signals contain multiple spectral lines. In this paper, we propose a new method to minimize spurious spectral peaks via the technique of phase interpolation.

The authors model tissue as a collection of point scatterers embedded in a uniform media, and show that the higher-order statistics (HOS) of the scatterer spacing distribution can be estimated from digitized radio frequency (RF) scan line segments and be used in obtaining tissue signatures. The authors assume that RF echoes are non-Gaussian, on the grounds of empirical/theoretical justifications presented in the literature. Based on their model for tissue microstructure, the authors develop schemes for the estimation of reasonable periodicity as well as correlations among nonperiodic scatterers, Using HOS of the scattered signal, the authors define as tissue "color" a quantity that describes the scatterer spatial correlations, show how to evaluate it from the higher-order correlations of the digitized RF scan line segments, and investigate its potential as a tissue signature. The tools employed, i.e., HOS, were chosen as the most appropriate ones because they suppress Gaussian processes, such as the one arising from the diffused scatterers. HOS, unlike second-order statistics, also preserve the Fourier-phase of the signature, the color of the tissue response. Working on simulated and clinical data, the authors show that the proposed periodicity estimation technique is superior to the widely used power spectrum and cepstrum techniques in terms of the accuracy of estimations. The authors also show that even when there is no significant periodicity in data, they are still able to characterize tissues using signatures based on the higher-order cumulant structure of the scatterer spacing distribution.

Source localization in the brain remains an ill-posed problem unless further constraints about the type of sources and the head model are imposed. Human head is modeled in various ways depending critically on the computing power available and/or the required level of accuracy. Sophisticated and truly representative models may yield more accurate results in general, but at the cost of prohibitively long computer times and huge memory requirements. In conventional source localization techniques, solution source parameters are taken as those which minimize an index of performance, defined relative to the model-generated and clinically measured voltages. We propose the use of a neural network in the place of commonly employed minimization algorithms such as the Simplex Method and the Marquardt algorithm, which are iterative and time consuming. With the aid of the error-backpropagation technique, a neural network is trained to compute source parameters, starting from a voltage set measured on the scalp. Here we describe the methods of training the neural network and investigate its localization accuracy. Based on the results of extensive studies, we conclude that neural networks are highly feasible as source localizers. A trained neural network's independence of localization speed from the head model, and the rapid localization ability, makes it possible to employ the most complex head model with the ease of the simplest model. No initial parameters need to be guessed in order to start the calculation, implying a possible automation of the entire localization process. One may train the network on experimental data, if available, thereby possibly doing away with head models.