Staff member

Yolanda Castillo Escario

Staff member publications

Davidson, Clare, Caguana, Osw Antonio, Lozano-García, Manuel, Arita Guevara, Mariela, Estrada-Petrocelli, Luis, Ferrer-Lluis, Ignasi, Castillo-Escario, Yolanda, Ausín, Pilar, Gea, Joaquim, Jané, Raimon, (2023). Differences in acoustic features of cough by pneumonia severity in patients with COVID-19: a cross-sectional study Erj Open Research 9, 00247-2022

BackgroundAcute respiratory syndrome due to coronavirus 2 (SARS-CoV-2) is characterised by heterogeneous levels of disease severity. It is not necessarily apparent whether a patient will develop a severe disease or not. This cross-sectional study explores whether acoustic properties of the cough sound of patients with coronavirus disease (COVID-19), the illness caused by SARS-CoV-2, correlate with their disease and pneumonia severity, with the aim of identifying patients with a severe disease.MethodsVoluntary cough sounds were recorded using a smartphone in 70 COVID-19 patients within the first 24 h of their hospital arrival, between April 2020 and May 2021. Based on gas exchange abnormalities, patients were classified as mild, moderate, or severe. Time- and frequency-based variables were obtained from each cough effort and analysed using a linear mixed-effects modelling approach.ResultsRecords from 62 patients (37% female) were eligible for inclusion in the analysis, with mild, moderate, and severe groups consisting of 31, 14 and 17 patients respectively. 5 of the parameters examined were found to be significantly different in the cough of patients at different disease levels of severity, with a further 2 parameters found to be affected differently by the disease severity in men and women.ConclusionsWe suggest that all these differences reflect the progressive pathophysiological alterations occurring in the respiratory system of COVID-19 patients, and potentially would provide an easy and cost-effective way to initially stratify patients, identifying those with more severe disease, and thereby most effectively allocate healthcare resources.

JTD Keywords: Diagnosis

García-Alén, Loreto, Kumru, Hatice, Castillo-Escario, Yolanda, Benito-Penalva, Jesús, Medina-Casanovas, Josep, Gerasimenko, Yury P., Edgerton, Victor Reggie, García-Alías, Guillermo, Vidal, Joan, (2023). Transcutaneous Cervical Spinal Cord Stimulation Combined with Robotic Exoskeleton Rehabilitation for the Upper Limbs in Subjects with Cervical SCI: Clinical Trial Biomedicines 11, 589

(1) Background: Restoring arm and hand function is a priority for individuals with cervical spinal cord injury (cSCI) for independence and quality of life. Transcutaneous spinal cord stimulation (tSCS) promotes the upper extremity (UE) motor function when applied at the cervical region. The aim of the study was to determine the effects of cervical tSCS, combined with an exoskeleton, on motor strength and functionality of UE in subjects with cSCI. (2) Methods: twenty-two subjects participated in the randomized mix of parallel-group and crossover clinical trial, consisting of an intervention group (n = 15; tSCS exoskeleton) and a control group (n = 14; exoskeleton). The assessment was carried out at baseline, after the last session, and two weeks after the last session. We assessed graded redefined assessment of strength, sensibility, and prehension (GRASSP), box and block test (BBT), spinal cord independence measure III (SCIM-III), maximal voluntary contraction (MVC), ASIA impairment scale (AIS), and WhoQol-Bref; (3) Results: GRASSP, BBT, SCIM III, cylindrical grip force and AIS motor score showed significant improvement in both groups (p ≤ 0.05), however, it was significantly higher in the intervention group than the control group for GRASSP strength, and GRASSP prehension ability (p ≤ 0.05); (4) Conclusion: our findings show potential advantages of the combination of cervical tSCS with an exoskeleton to optimize the outcome for UE.

JTD Keywords: arm function, cervical spinal cord injury, electrical-stimulation, functional walking, functionality, grip force, hand function, individuals, injury, motor function, reliability, robotics, spasticity, transcutaneous electrical spinal cord stimulation, upper extremity, Epidural stimulation, Transcutaneous electrical spinal cord stimulation, Upper extremity

Castillo-Escario Y, Werthen-Brabants L, Groenendaal W, Deschrijver D, Jane R, (2022). Convolutional Neural Networks for Apnea Detection from Smartphone Audio Signals: Effect of Window Size Annu Int Conf Ieee Eng Med Biol Soc 2022, 666-669

Although sleep apnea is one of the most prevalent sleep disorders, most patients remain undiagnosed and untreated. The gold standard for sleep apnea diagnosis, polysomnography, has important limitations such as its high cost and complexity. This leads to a growing need for novel cost-effective systems. Mobile health tools and deep learning algorithms are nowadays being proposed as innovative solutions for automatic apnea detection. In this work, a convolutional neural network (CNN) is trained for the identification of apnea events from the spectrograms of audio signals recorded with a smartphone. A systematic comparison of the effect of different window sizes on the model performance is provided. According to the results, the best models are obtained with 60 s windows (sensitivity-0.72, specilicity-0.89, AUROC = 0.88), For smaller windows, the model performance can be negatively impacted, because the windows become shorter than most apnea events, by which sound reductions can no longer be appreciated. On the other hand, longer windows tend to include multiple or mixed events, that will confound the model. This careful trade-off demonstrates the importance of selecting a proper window size to obtain models with adequate predictive power. This paper shows that CNNs applied to smartphone audio signals can facilitate sleep apnea detection in a realistic setting and is a first step towards an automated method to assist sleep technicians. Clinical Relevance- The results show the effect of the window size on the predictive power of CNNs for apnea detection. Furthermore, the potential of smartphones, audio signals, and deep neural networks for automatic sleep apnea screening is demonstrated.


Castillo-Escario, Yolanda, Kumru, Hatice, Ferrer-Lluis, Ignasi, Vidal, Joan, Jané, Raimon, (2021). Detection of Sleep-Disordered Breathing in Patients with Spinal Cord Injury Using a Smartphone Sensors 21,

Patients with spinal cord injury (SCI) have an increased risk of sleep-disordered breathing (SDB), which can lead to serious comorbidities and impact patients’ recovery and quality of life. However, sleep tests are rarely performed on SCI patients, given their multiple health needs and the cost and complexity of diagnostic equipment. The objective of this study was to use a novel smartphone system as a simple non-invasive tool to monitor SDB in SCI patients. We recorded pulse oximetry, acoustic, and accelerometer data using a smartphone during overnight tests in 19 SCI patients and 19 able-bodied controls. Then, we analyzed these signals with automatic algorithms to detect desaturation, apnea, and hypopnea events and monitor sleep position. The apnea–hypopnea index (AHI) was significantly higher in SCI patients than controls (25 ± 15 vs. 9 ± 7, p < 0.001). We found that 63% of SCI patients had moderate-to-severe SDB (AHI ? 15) in contrast to 21% of control subjects. Most SCI patients slept predominantly in supine position, but an increased occurrence of events in supine position was only observed for eight patients. This study highlights the problem of SDB in SCI and provides simple cost-effective sleep monitoring tools to facilitate the detection, understanding, and management of SDB in SCI patients.

JTD Keywords: apnea syndrome, biomedical signal processing, individuals, mhealth, monitoring, nasal resistance, people, position, prevalence, questionnaire, sample, sleep apnea, sleep position, sleep-disordered breathing, smartphone, time, Apnea-hypopnea indices, Biomedical signal processing, Biomedical signals processing, Cost effectiveness, Diagnosis, Mhealth, Monitoring, Noninvasive medical procedures, Oximeters, Oxygen-saturation, Patient rehabilitation, Simple++, Sleep apnea, Sleep position, Sleep research, Sleep-disordered breathing, Smart phones, Smartphone, Smartphones, Spinal cord injury, Spinal cord injury patients

Castillo-Escario Y, Kumru H, Valls-Solé J, García-Alen L, Jané R, Vidal J, (2021). Quantitative evaluation of trunk function and the StartReact effect during reaching in patients with cervical and thoracic spinal cord injury Journal Of Neural Engineering 18,

Objective. Impaired trunk stability is frequent in spinal cord injury (SCI), but there is a lack of quantitative measures for assessing trunk function. Our objectives were to: (a) evaluate trunk muscle activity and movement patterns during a reaching task in SCI patients, (b) compare the impact of cervical (cSCI) and thoracic (tSCI) injuries in trunk function, and (c) investigate the effects of a startling acoustic stimulus (SAS) in these patients. Approach. Electromyographic (EMG) and smartphone accelerometer data were recorded from 15 cSCI patients, nine tSCI patients, and 24 healthy controls, during a reaching task requiring trunk tilting. We calculated the response time (RespT) until pressing a target button, EMG onset latencies and amplitudes, and trunk tilt, lateral deviation, and other movement features from accelerometry. Statistical analysis was applied to analyze the effects of group (cSCI, tSCI, control) and condition (SAS, non-SAS) in each outcome measure. Main results. SCI patients, especially those with cSCI, presented significantly longer RespT and EMG onset latencies than controls. Moreover, in SCI patients, forward trunk tilt was accompanied by significant lateral deviation. RespT and EMG latencies were remarkably shortened by the SAS (the so-called StartReact effect) in tSCI patients and controls, but not in cSCI patients, who also showed higher variability. Significance. The combination of EMG and smartphone accelerometer data can provide quantitative measures for the assessment of trunk function in SCI. Our results show deficits in postural control and compensatory strategies employed by SCI patients, including delayed responses and higher lateral deviations, possibly to improve sitting balance. This is the first study investigating the StartReact responses in trunk muscles in SCI patients and shows that the SAS significantly accelerates RespT in tSCI, but not in cSCI, suggesting an increased cortical control exerted by these patients.

JTD Keywords: accelerometer, electromyography, impairment, individuals, movements, postural stability, reaction-time, reliability, sitting balance, smartphone, spinal cord injury, startle, startreact, strategies, stroke, trunk, Accelerometer, Electromyography, Sitting balance, Smartphone, Spinal cord injury, Startreact, Trunk

Ferrer-Lluis I, Castillo-Escario Y, Montserrat JM, Jané R, (2021). SleepPos app: An automated smartphone application for angle based high resolution sleep position monitoring and treatment Sensors 21,

Poor sleep quality or disturbed sleep is associated with multiple health conditions. Sleep position affects the severity and occurrence of these complications, and positional therapy is one of the less invasive treatments to deal with them. Sleep positions can be self-reported, which is unreliable, or determined by using specific devices, such as polysomnography, polygraphy or cameras, that can be expensive and difficult to employ at home. The aim of this study is to determine how smartphones could be used to monitor and treat sleep position at home. We divided our research into three tasks: (1) develop an Android smartphone application (‘SleepPos’ app) which monitors angle-based high-resolution sleep position and allows to simultaneously apply positional treatment; (2) test the smartphone application at home coupled with a pulse oximeter; and (3) explore the potential of this tool to detect the positional occurrence of desaturation events. The results show how the ‘SleepPos’ app successfully determined the sleep position and revealed positional patterns of occurrence of desaturation events. The ‘SleepPos’ app also succeeded in applying positional therapy and preventing the subjects from sleeping in the supine sleep position. This study demonstrates how smartphones are capable of reliably monitoring high-resolution sleep position and provide useful clinical information about the positional occurrence of desaturation events.

JTD Keywords: accelerometry, android, apnea patients, app, association, biomedical signal processing, management, mhealth, monitoring, pathophysiology, pilot mhealth, questionnaire, sleep position, smartphone, supine position, time, Accelerometry, Android, App, Biomedical signal processing, Mhealth, Monitoring, Sleep position, Smart-phone, Smartphone, Tennis ball technique

Ferrer-Lluis I, Castillo-Escario Y, Montserrat JM, Jané R, (2021). Enhanced monitoring of sleep position in sleep apnea patients: Smartphone triaxial accelerometry compared with video-validated position from polysomnography Sensors 21,

Poor sleep quality is a risk factor for multiple mental, cardiovascular, and cerebrovascular diseases. Certain sleep positions or excessive position changes can be related to some diseases and poor sleep quality. Nevertheless, sleep position is usually classified into four discrete values: supine, prone, left and right. An increase in sleep position resolution is necessary to better assess sleep position dynamics and to interpret more accurately intermediate sleep positions. This research aims to study the feasibility of smartphones as sleep position monitors by (1) developing algorithms to retrieve the sleep position angle from smartphone accelerometry; (2) monitoring the sleep position angle in patients with obstructive sleep apnea (OSA); (3) comparing the discretized sleep angle versus the four classic sleep positions obtained by the video-validated polysomnography (PSG); and (4) analyzing the presence of positional OSA (pOSA) related to its sleep angle of occurrence. Results from 19 OSA patients reveal that a higher resolution sleep position would help to better diagnose and treat patients with position-dependent diseases such as pOSA. They also show that smartphones are promising mHealth tools for enhanced position monitoring at hospitals and home, as they can provide sleep position with higher resolution than the gold-standard video-validated PSG.

JTD Keywords: accelerometry, actigraphy, association, biomedical signal processing, index, latency, mhealth, monitoring, pathophysiology, quality, questionnaire, score, sleep apnea, sleep position, smartphone, time, Accelerometry, Biomedical signal processing, Mhealth, Monitoring, Sleep apnea, Sleep position, Smartphone, Supine position

Castillo-Escario Y, Kumru H, Valls-Solé J, García-Alen L, Vidal J, Jané R, (2021). Assessment of trunk flexion in arm reaching tasks with electromyography and smartphone accelerometry in healthy human subjects Scientific Reports 11, 5363

Trunk stability is essential to maintain upright posture and support functional movements. In this study, we aimed to characterize the muscle activity and movement patterns of trunk flexion during an arm reaching task in sitting healthy subjects and investigate whether trunk stability is affected by a startling acoustic stimulus (SAS). For these purposes, we calculated the electromyographic (EMG) onset latencies and amplitude parameters in 8 trunk, neck, and shoulder muscles, and the tilt angle and movement features from smartphone accelerometer signals recorded during trunk bending in 33 healthy volunteers. Two-way repeated measures ANOVAs were applied to examine the effects of SAS and target distance (15 cm vs 30 cm). We found that SAS markedly reduced the response time and EMG onset latencies of all muscles, without changing neither movement duration nor muscle recruitment pattern. Longer durations, higher tilt angles, and higher EMG amplitudes were observed at 30 cm compared to 15 cm. The accelerometer signals had a higher frequency content in SAS trials, suggesting reduced movement control. The proposed measures have helped to establish the trunk flexion pattern in arm reaching in healthy subjects, which could be useful for future objective assessment of trunk stability in patients with neurological affections.


Ferrer-Lluís, I., Castillo-Escario, Y., Montserrat, J. M., Jané, R., (2020). Analysis of smartphone triaxial accelerometry for monitoring sleep disordered breathing and sleep position at home IEEE Access 8, 71231 - 71244

Obstructive sleep apnea (OSA) is a sleep disorder in which repetitive upper airway obstructive events occur during sleep. These events can induce hypoxia, which is a risk factor for multiple cardiovascular and cerebrovascular diseases. OSA is also known to be position-dependent in some patients, which is referred to as positional OSA (pOSA). Screening for pOSA is necessary in order to design more personalized and effective treatment strategies. In this article, we propose analyzing accelerometry signals, recorded with a smartphone, to detect and monitor OSA at home. Our objectives were to: (1) develop an algorithm for detecting thoracic movement associated with disordered breathing events; (2) compare the performance of smartphones as OSA monitoring tools with a type 3 portable sleep monitor; and (3) explore the feasibility of using smartphone accelerometry to retrieve reliable patient sleep position data and assess pOSA. Accelerometry signals were collected through simultaneous overnight acquisition using both devices with 13 subjects. The smartphone tool showed a high degree of concordance compared to the portable device and succeeded in estimating the apnea-hypopnea index (AHI) and classifying the severity level in most subjects. To assess the agreement between the two systems, an event-by-event comparison was performed, which found a sensitivity of 90% and a positive predictive value of 80%. It was also possible to identify pOSA by determining the ratio of events occurring in a specific position versus the time spent in that position during the night. These novel results suggest that smartphones are promising mHealth tools for OSA and pOSA monitoring at home.

JTD Keywords: Accelerometry, Biomedical signal processing, mHealth, Monitoring, Sleep apnea, Sleep position, Smartphone

Castillo-Escario, Y., Rodríguez-Cañón, M., García-Alías, G., Jané, R., (2020). Identifying muscle synergies from reaching and grasping movements in rats IEEE Access 8, 62517-62530

Reaching and grasping (R&G) is a skilled voluntary movement which is critical for animals. In this work, we aim to identify muscle synergy patterns from R&G movements in rats and show how these patterns can be used to characterize such movements and investigate their consistency and repeatability. For that purpose, we analyzed the electromyographic (EMG) activity of five forelimb muscles recorded while the animals were engaged in R&G tasks. Our dataset included 200 R&G attempts from three different rats. Non-negative matrix factorization was used to decompose EMG signals and extract muscle synergies. We compared all pairs of attempts and created cross-validated models to study intra- and inter-subject variability. We found that three synergies were enough to accurately reconstruct the EMG envelopes. These muscle synergies and their corresponding activation coefficients were very similar for all the attempts in the database, providing a general pattern to describe the movement. Results suggested that the movement strategy adopted by an individual in its different attempts was highly repetitive, but also resembled the strategies adopted by the other animals. Inter-subject variability was not much higher than intra-subject variability. This study is a proof-of-concept, but the proposed approaches can help to establish whether there is a stereotyped pattern of neuromuscular activity in R&G movement in healthy rats, and the changes that occur in animal models of acute neurological injuries. Research on muscle synergies could elucidate motor control mechanisms, and lead to quantitative tools for evaluating upper limb motor impairment after an injury.

JTD Keywords: Electromyography, Motor control, Muscle synergies, Reaching and grasping, Upper limb

Castillo-Escario, Y., Ferrer-Lluis, I., Montserrat, J. M., Jané, R., (2019). Entropy analysis of acoustic signals recorded with a smartphone for detecting apneas and hypopneas: A comparison with a commercial system for home sleep apnea diagnosis IEEE Access 7, 128224-128241

Obstructive sleep apnea (OSA) is a prevalent disease, but most patients remain undiagnosed and untreated. Here we propose analyzing smartphone audio signals for screening OSA patients at home. Our objectives were to: (1) develop an algorithm for detecting silence events and classifying them into apneas or hypopneas; (2) evaluate the performance of this system; and (3) compare the information provided with a type 3 portable sleep monitor, based mainly on nasal airflow. Overnight signals were acquired simultaneously by both systems in 13 subjects (3 healthy subjects and 10 OSA patients). The sample entropy of audio signals was used to identify apnea/hypopnea events. The apnea-hypopnea indices predicted by the two systems presented a very high degree of concordance and the smartphone correctly detected and stratified all the OSA patients. An event-by-event comparison demonstrated good agreement between silence events and apnea/hypopnea events in the reference system (Sensitivity = 76%, Positive Predictive Value = 82%). Most apneas were detected (89%), but not so many hypopneas (61%). We observed that many hypopneas were accompanied by snoring, so there was no sound reduction. The apnea/hypopnea classification accuracy was 70%, but most discrepancies resulted from the inability of the nasal cannula of the reference device to record oral breathing. We provided a spectral characterization of oral and nasal breathing to correct this effect, and the classification accuracy increased to 82%. This novel knowledge from acoustic signals may be of great interest for clinical practice to develop new non-invasive techniques for screening and monitoring OSA patients at home.

JTD Keywords: Sleep apnea, Acoustics, Monitoring, Entropy, Sensors, Microphones, Acoustics, Biomedical signal processing, mHealth, Monitoring, Sleep apnea, Smartphone

Ferrer-Lluis, I., Castillo-Escario, Y., Montserrat, J. M., Jané, R., (2019). Automatic event detector from smartphone accelerometry: Pilot mHealth study for obstructive sleep apnea monitoring at home Engineering in Medicine and Biology Society (EMBC) 41st Annual International Conference of the IEEE , IEEE (Berlín, Germany) , 4990-4993

Obstructive sleep apnea (OSA) is a common disorder with a low diagnosis ratio, leaving many patients undiagnosed and untreated. In the last decades, accelerometry has been found to be a feasible solution to obtain respiratory activity and a potential tool to monitor OSA. On the other hand, many smartphone-based systems have already been developed to propose solutions for OSA monitoring and treatment. The objective of this work was to develop an automatic event detector based on smartphone accelerometry and pulse oximetry, and to assess its ability to detect thoracic movements. It was validated with a commercial OSA monitoring system at home. Results of this preliminary pilot study showed that the proposed event detector for accelerometry signals is a feasible tool to detect abnormal respiratory events, such as apneas and hypopneas, and has potential to be included in smartphone-based systems for OSA assessment.

JTD Keywords: Sleep apnea, Detectors, Pulse oximetry, Monitoring, Manuals, Band-pass filters, Pulse oximeter

Castillo-Escario, Y., Ferrer-Lluis, I., Montserrat, J. M., Jané, R., (2019). Automatic silence events detector from smartphone audio aignals: A pilot mHealth system for sleep apnea monitoring at home Engineering in Medicine and Biology Society (EMBC) 41st Annual International Conference of the IEEE , IEEE (Berlín, Germany) , 4982-4985

Obstructive sleep apnea (OSA) is a prevalent disease, but most patients remain undiagnosed and untreated. Recently, mHealth tools are being proposed to screen OSA patients at home. In this work, we analyzed full-night audio signals recorded with a smartphone microphone. Our objective was to develop an automatic detector to identify silence events (apneas or hypopneas) and compare its performance to a commercial portable system for OSA diagnosis (ApneaLink™, ResMed). To do that, we acquired signals from three subjects with both systems simultaneously. A sleep specialist marked the events on smartphone and ApneaLink signals. The automatic detector we developed, based on the sample entropy, identified silence events similarly than manual annotation. Compared to ApneaLink, it was very sensitive to apneas (detecting 86.2%) and presented an 83.4% positive predictive value, but it missed about half the hypopnea episodes. This suggests that during some hypopneas the flow reduction is not reflected in sound. Nevertheless, our detector accurately recognizes silence events, which can provide valuable respiratory information related to the disease. These preliminary results show that mHealth devices and simple microphones are promising non-invasive tools for personalized sleep disorders management at home.

JTD Keywords: Detectors, Manuals, Sleep apnea, Microphones, Labeling, Hospitals

Castillo-Escario, Y., Rodríguez-Cañón, M., García-Alías, G., Jané, R., (2019). Onset detection to study muscle activity in reaching and grasping movements in rats Engineering in Medicine and Biology Society (EMBC) 41st Annual International Conference of the IEEE , IEEE (Berlín, Germany) , 5113-5116

EMG signals reflect the neuromuscular activation patterns related to the execution of a certain movement or task. In this work, we focus on reaching and grasping (R&G) movements in rats. Our objective is to develop an automatic algorithm to detect the onsets and offsets of muscle activity and use it to study muscle latencies in R&G maneuvers. We had a dataset of intramuscular EMG signals containing 51 R&G attempts from 2 different animals. Simultaneous video recordings were used for segmentation and comparison. We developed an automatic onset/offset detector based on the ratio of local maxima of Teager-Kaiser Energy (TKE). Then, we applied it to compute muscle latencies and other features related to the muscle activation pattern during R&G cycles. The automatic onsets that we found were consistent with visual inspection and video labels. Despite the variability between attempts and animals, the two rats shared a sequential pattern of muscle activations. Statistical tests confirmed the differences between the latencies of the studied muscles during R&G tasks. This work provides an automatic tool to detect EMG onsets and offsets and conducts a preliminary characterization of muscle activation during R&G movements in rats. This kind of approaches and data processing algorithms can facilitate the studies on upper limb motor control and motor impairment after spinal cord injury or stroke.

JTD Keywords: Muscles, Electromyography, Rats, Low pass filters, Microsoft Windows, Band-pass filters

Castillo, Y., Blanco, D., Whitney, J., Mersky, B., Jané, R., (2017). Characterization of a tooth microphone coupled to an oral appliance device: A new system for monitoring OSA patients Engineering in Medicine and Biology Society (EMBC) 39th Annual International Conference of the IEEE , IEEE (Seogwipo, South Korea) , 1543-1546

Obstructive sleep apnea (OSA) is a highly prevalent chronic disease, especially in elderly and obese populations. Despite constituting a serious health, social and economic problem, most patients remain undiagnosed and untreated due to limitations in current equipment. In this work, we propose a novel method to diagnose OSA and monitor therapy adherence and effectiveness at home in a non-invasive and inexpensive way: combining acoustic analysis of breathing and snoring sounds with oral appliance therapy (OA). Audiodontics has introduced a new sensor, a tooth microphone coupled to an OA device, which is the main pillar of this system. The objective of this work is to characterize the response of this sensor, comparing it with a commercial tracheal microphone (Biopac transducer). Signals containing OSA-related sounds were acquired simultaneously with the two microphones for that purpose. They were processed and analyzed in time, frequency and time-frequency domains, in a custom MATLAB interface. We carried out a single-event approach focused on breaths, snores and apnea episodes. We found that the quality of the signals obtained by both microphones was quite similar, although the tooth microphone spectrum concentrated more energy at the high-frequency band. This opens a new field of study about high-frequency components of snores and breathing sounds. These characteristics, together with its intraoral position, wireless option and combination with customizable OAs, give the tooth microphone a great potential to reduce the impact of sleep disorders, by enabling prompt detection and continuous monitoring of patients at home.

JTD Keywords: Microphones, Teeth, Sleep apnea, Time-frequency analysis, Signal to noise ratio, Monitoring, Acoustics

Castillo, Y., Camara, M. A., Blanco-Almazan, D., Jane, R., (2017). Characterization of microphones for snoring and breathing events analysis in mHealth Engineering in Medicine and Biology Society (EMBC) 39th Annual International Conference of the IEEE , IEEE (Seogwipo, South Korea) , 1547-1550

Obstructive sleep apnea (OSA) is one of the most common sleep disorders, especially in elderly population. Despite its high prevalence and severe consequences, most patients remain undiagnosed due to serious limitations on the existing equipment. Efforts are being done to find cost-effective alternatives and mHealth solutions could play a key role. One promising approach in this context is the acoustic analysis of snoring. The sensor it requires is a microphone, which is widely available in different models and even integrated in smartphones. The objective of this work is to characterize and compare the responses of two commercial tracheal microphones and a mHealth-based microphone, as a proof-of-concept to evaluate their potential as sensors for OSA detection. To do that, we designed an experimental protocol to study OSA-related events (breaths, snores and apneas) simulated by 4 subjects. Test signals were simultaneously recorded with different microphones and posteriorly processed and analyzed. We accurately characterized the frequency response of the two commercial microphones, finding that one of them was too restrictive (bandwidth 50-250 Hz) and thus not suitable as snoring sensor for high-frequency acoustic analysis. Regarding smartphones, we studied the Samsung Galaxy S5 microphone. We found that, when located over the thorax, it provided quality signals comparable to those of tracheal microphones, with a broader frequency response. Further work is required, but this preliminary study suggests that acoustic analysis of snoring through mHealth solutions can be a feasible alternative to screen and monitor OSA patients at home.


Camara, M. A., Castillo, Y., Blanco-Almazan, D., Estrada, L., Jane, R., (2017). MHealth tools for monitoring Obstructive Sleep Apnea patients at home: Proof-of-concept Engineering in Medicine and Biology Society (EMBC) 39th Annual International Conference of the IEEE , IEEE (Seogwipo, South Korea) , 1555-1558

Obstructive Sleep Apnea (OSA) is a sleep disorder that affects mainly the adult and elderly population. Due to the high percentage of patients who remain undiagnosed and untreated because of limitations of current diagnosis methods, the management of OSA is an important social, scientific and economic problem that will be difficult to be assumed by health systems. On the other hand, smartphone platforms (mHealth systems) are being considered as an innovative solution, thanks to the integration of the essential sensors to obtain clinically relevant parameters in the same device or in combination with wireless wearable devices.

JTD Keywords: Sleep apnea, Microphones, Monitoring, Sensors, Accelerometers, Biomedical monitoring, Band-pass filters

Castillo, Y., Blanco, D., Cámara, M.A., Jané, R., (2016). Study of time-frequency characteristics of single snores: extracting new information for sleep apnea diagnosis CASEIB Proceedings XXXIV Congreso Anual de la Sociedad Española de Ingeniería Biomédica (CASEIB 2016) , Sociedad Española de Ingeniería Biomédica (Valencia, Spain) , 105-108

Obstructive sleep apnea (OSA) is a highly prevalent chronic disease, especially in elderly and obese population. Despite constituting a huge health and economic problem, most patients remain undiagnosed due to limitations in current strategies. Therefore, it is essential to find cost-effective diagnostic alternatives. One of these novel approaches is the analysis of acoustic snoring signals. Snoring is an early symptom of OSA which carries pathophysiological information of high diagnostic value. For this reason, the main objective of this work is to study the characteristics of single snores of different types, from healthy and OSA subjects. To do that, we analyzed snoring signals from previous databases and developed an experimental protocol to record simulated OSA-related sounds and characterize the response of two commercial tracheal microphones. Automatic programs for filtering, downsampling, event detection and time-frequency analysis were built in MATLAB. We found that time-frequency maps and spectral parameters (central, mean and peak frequency and energy in the 100-500 Hz band) allow distinguishing regular snores of healthy subjects from non-regular snores and snores of OSA subjects. Regarding the two commercial microphones, we found that one of them was a suitable snoring sensor, while the other had a too restricted frequency response. Future work shall include a higher number of episodes and subjects, but our study has contributed to show how important the differences between regular and non-regular snores can be for OSA diagnosis, and how much clinically relevant information can be extracted from time-frequency maps and spectral parameters of single snores.


Castillo, Y., Gutiérrez, A., (2015). Determining the tertiary structure of an olfactory receptor CASEIB Proceedings XXXIII Congreso Anual de la Sociedad Española de Ingeniería Biomédica (CASEIB 2015) , Sociedad Española de Ingeniería Biomédica (Madrid, Spain) , 245-248

Olfactory receptors (ORs) are transmembrane proteins that interact with odorant molecules, triggering the first step in the mechanism of olfaction. They also occupy a large part of mammalian genome and their dysfunction is involved in some degenerative diseases. Proteins structure is related to their function, but experimentally determining the three-dimensional structure of ORs is tricky. However, recent advances in bioinformatics have made it easier. The objectives of this project were to computationally model several ORs and to study their interactions with odorants. We carried out a comparative modelling process, using Chimera and Modeller programs as alignment, visualization and 3D reconstruction tools. After validating the models by several procedures, we performed docking experiments with DOCK. We predicted binding pockets location and studied which odorants bind which ORs, comparing our results with electrophysiological measures of olfactory neurons activity. At the end, we successfully built six mouse ORs models and tested them against 24 common odorants, obtaining a good correlation with previous studies and thus validating our protocol. Moreover, we reconstructed eight human ORs which had never been modelled before, though their predicted interactions with 63 odorants were not clearly correlated to previous experimental studies. In this way, we have shown the efficiency of these computational algorithms, which can contribute to the research about biological processes such as the mechanism of olfaction. With small improvements, they could be in an early future a suitable alternative to experimental approaches, leading to accurate protein models in a practical, faster and easier way.