BackgroundIs Impulse Oscillometry System (IOS) a valuable tool to measure respiratory system function in Children?Asthma (A) is the most prevalent chronic respiratory disease in children. Therefore, early and accurate assessment of respiratory function is of tremendous clinical interest in diagnosis, monitoring and treatment of respiratory conditions in this subpopulation.IOS has been successfully used to measure lung function in children with a high degree of sensitivity and specificity to small airway impairments (SAI) and asthma. IOS measures of airway function and equivalent electrical circuit models of the human respiratory system have been developed to quantify the severity of these conditions. Previously, we have evaluated several known respiratory models based on the Mead's model and more parsimonious versions based on fitting IOS data known as extended RIC (eRIC) and augmented RIC (aRIC) models have emerged, which offer advantages over earlier models.MethodsIOS data from twenty-six children were collected and compared during pre-bronchodilation (pre-B) and post- bronchodilation (post-B) conditions over a period of 2 years.Results and DiscussionAre the IOS and model parameters capable of differentiating between healthy children and children with respiratory system distress?Children were classified into two main categories: Healthy (H) and Small Airway-Impaired (SAI). The IOS measures and respiratory model parameters analyzed differed consistently between H and SAI children. SAI children showed smaller trend of "growth" and larger trend of bronchodilator responses than H children.The two model parameters: peripheral compliance (Cp) and peripheral resistance (Rp) tracked IOS indices of small airway function well. Cp was a more sensitive index than Rp. Both eRIC and aRIC Cps and the IOS Reactance Area, AX, (also known as the "Goldman Triangle") showed good correlations.ConclusionsWhat are the most useful IOS and model parameters?In this work we demonstrate that IOS parameters such as resistance at 5 Hz (R5), frequency-dependence of resistance (fdR: R5-R20), reactance area (AX), and parameter estimates of respiratory system such as Cp and Rp provide sensitive indicators of lung function and have the capacity to differentiate between obstructed and non-obstructed airway conditions. They are also capable of demonstrating airway growth-related changes over a two-year period.We conclude that the IOS parameters AX and the eRIC model derived parameter Cp are the most reliable parameters to track lung function in children before and after bronchodilator and over a time period (2 years).Which model is more suitable for interpreting IOS data?IOS data are equally well-modelled by eRIC and aRIC models, based on the close correlations of their corresponding parameters - excluding upper airway shunt compliance. The eRIC model is a more parsimonious and equally powerful model in capturing the differences in IOS indices between SAI and H children. Therefore, it may be considered a clinically-preferred model of lung function.
Automated sleep staging based on EEG signal analysis provides an important quantitative tool to assist neurologists and sleep specialists in the diagnosis and monitoring of sleep disorders as well as evaluation of treatment efficacy. A complete visual inspection of the EEG recordings acquired during nocturnal polysomnography is time consuming, expensive, and often subjective. Therefore, feature extraction is implemented as an essential preprocessing step to achieve significant data reduction and to determine informative measures for automatic sleep staging. However, the analysis of the EEG signal and extraction of sensitive measures from it has been a challenging task due to the complexity and variability of this signal. We present three different schemes to extract features from the EEG signal: relative spectral band energy, harmonic parameters, and Itakura distance. Spectral estimation is performed by using autoregressive (AR) modeling. We then compare the performance of these schemes with the view to select an optimal set of features for specific, sensitive, and accurate neuro-fuzzy classification of sleep stages.
Asthma is the most prevalent chronic respiratory disease in children. Reliable and patient-friendly instruments and methods are required to help pulmonologists accurately detect asthma with acceptable clinical accuracy, specificity and sensitivity. Impulse Oscillometry System (IOS) based on the Forced Oscillation Technique (FOT) has been successfully used to measure lung function in children with a high degree of sensitivity and specificity to small airway dysfunction (SAD). IOS measures the mechanical impedance of the respiratory system. Equivalent electrical circuit models of lung function have been developed that can be used to quantify severity of SAD. It has been shown that impulse oscillometric parameters as well as parameter estimates of these electrical models provide useful indicators of lung function and therefore have the potential to be used as sensitive features for computer-aided classification of pulmonary function in health and disease.
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