Background: Dysphagia is common among stroke and acquired brain injury (ABI) patients and may result in aspiration. To reduce the risk of thin liquid aspiration, patients are often restricted to thickened fluids. Ther...Background: Dysphagia is common among stroke and acquired brain injury (ABI) patients and may result in aspiration. To reduce the risk of thin liquid aspiration, patients are often restricted to thickened fluids. There is considerable clinical interest in the risks and benefits of offering oral water intake, in the form of water protocols, to patients with thin-liquid dysphagia. Objectives: A controlled pilot study of a free water protocol was undertaken at Riverview Health Centre, in Winnipeg, Manitoba to assess benefits, feasibility and possible complications of free water protocol. Methods: The study examined 16 individuals with stroke or ABI who were randomly assigned to either a control group on thickened fluids (six subjects) or a treatment group (ten subjects) that followed a free water protocol. The average length of time in the study was 4.3 weeks with a range of 1 - 17 weeks among all participants. Results: Throughout the study, there was no incidence of pneumonia in any of the sixteen participants. No statistically significant difference was noted in the weekly total liquid intake between the treatment group and the control group. Perceived swallowing related care results suggest statistically significant improvements from initial to final measures for both the treatment group (p = 0.004) and the control group (p = 0.02). However, a comparison of the change in both measures, between the treatment and control groups, shows no statistically significant differences. Conclusion: This pilot study suggests the need for larger scale work in order to more accurately identify the effects of free water protocols.展开更多
Snoring is common in people with obstructive sleep apnea (OSA). Although not every snorer has OSA or vice-versa, many studies attempt to use snoring sounds for classification of people into two groups of OSA and simpl...Snoring is common in people with obstructive sleep apnea (OSA). Although not every snorer has OSA or vice-versa, many studies attempt to use snoring sounds for classification of people into two groups of OSA and simple snorers. This paper discusses the relationship between snorers’ anthropometric parameters and statistical characteristics of snoring sound (SS) and also reports on classification accuracies of methods using SS features for screening OSA from simple snorers when anthropometric parameters are either matched or unmatched. Tracheal respiratory sounds were collected from 60 snorers simultaneously with full-night Polysomnography (PSG). Energy, formant frequency, Skewness and Kurtosis were calculated from the SS segments. We also defined and calculated two features: Median Bifrequency (MBF), and projected MBF (PMBF). The statistical relationship between the extracted features and anthropometric parameters such as height, Body Mass Index (BMI), age, gender, and Apnea-Hypopnea Index (AHI) were investigated. The results showed that the SS features were not only sensitive to AHI but also to height, BMI and gender. Next, we performed two experiments to classify patients with Obstructive Sleep Apnea (OSA) and simple snorers: Experiment A: a small group of participants (22 OSA and 6 simple snorers) with matched height, BMI, and gender were selected and classified using Na?ve Bayes classifier, and Experiment B: the same number of participants with unmatched height, BMI, and gender were chosen for classification. A sensitivity of 93.2% (87.5%) and specificity of 88.4% (86.3%) was achieved for the matched (unmatched) groups.展开更多
文摘Background: Dysphagia is common among stroke and acquired brain injury (ABI) patients and may result in aspiration. To reduce the risk of thin liquid aspiration, patients are often restricted to thickened fluids. There is considerable clinical interest in the risks and benefits of offering oral water intake, in the form of water protocols, to patients with thin-liquid dysphagia. Objectives: A controlled pilot study of a free water protocol was undertaken at Riverview Health Centre, in Winnipeg, Manitoba to assess benefits, feasibility and possible complications of free water protocol. Methods: The study examined 16 individuals with stroke or ABI who were randomly assigned to either a control group on thickened fluids (six subjects) or a treatment group (ten subjects) that followed a free water protocol. The average length of time in the study was 4.3 weeks with a range of 1 - 17 weeks among all participants. Results: Throughout the study, there was no incidence of pneumonia in any of the sixteen participants. No statistically significant difference was noted in the weekly total liquid intake between the treatment group and the control group. Perceived swallowing related care results suggest statistically significant improvements from initial to final measures for both the treatment group (p = 0.004) and the control group (p = 0.02). However, a comparison of the change in both measures, between the treatment and control groups, shows no statistically significant differences. Conclusion: This pilot study suggests the need for larger scale work in order to more accurately identify the effects of free water protocols.
文摘Snoring is common in people with obstructive sleep apnea (OSA). Although not every snorer has OSA or vice-versa, many studies attempt to use snoring sounds for classification of people into two groups of OSA and simple snorers. This paper discusses the relationship between snorers’ anthropometric parameters and statistical characteristics of snoring sound (SS) and also reports on classification accuracies of methods using SS features for screening OSA from simple snorers when anthropometric parameters are either matched or unmatched. Tracheal respiratory sounds were collected from 60 snorers simultaneously with full-night Polysomnography (PSG). Energy, formant frequency, Skewness and Kurtosis were calculated from the SS segments. We also defined and calculated two features: Median Bifrequency (MBF), and projected MBF (PMBF). The statistical relationship between the extracted features and anthropometric parameters such as height, Body Mass Index (BMI), age, gender, and Apnea-Hypopnea Index (AHI) were investigated. The results showed that the SS features were not only sensitive to AHI but also to height, BMI and gender. Next, we performed two experiments to classify patients with Obstructive Sleep Apnea (OSA) and simple snorers: Experiment A: a small group of participants (22 OSA and 6 simple snorers) with matched height, BMI, and gender were selected and classified using Na?ve Bayes classifier, and Experiment B: the same number of participants with unmatched height, BMI, and gender were chosen for classification. A sensitivity of 93.2% (87.5%) and specificity of 88.4% (86.3%) was achieved for the matched (unmatched) groups.
