Classification of sleep stages using class-dependent sequential feature selection and artificial neural network

Several studies have been conducted for automatic classification of sleep stages to ease time-consuming manual scoring process that can involve a high degree of experience and subjectivity. But none of them has found a practical usage in medical area so far because of their under acceptable success rates. In this study, a different classification scheme is proposed to increase the success rate in automatic sleep stage scoring in which sleep stages were classified as Awake, Non-REM1, Non-REM2, Non-REM3 and REM stages. Using EEG, EMG and EOG recordings of five healthy subjects, a modified version of sequential feature selection method was applied to the sleep epochs in class by class basis and different artificial neural network (ANN) architectures were trained for each class. That is to say, sleep stages were classified with five ANN architectures each of which uses different features and different network parameters for classification. The highest classification accuracy was obtained for REM sleep as 95.13 % in addition to the lowest classification accuracy of 86.42 % for Non-REM3 sleep. The overall accuracy, on the other hand, was recorded as 90.93 %, which is a comparatively good result when the other studies using all stages are taken into account.     

Identification of sleep stages from heart rate variability using a soft-decision wavelet-based technique

This work is concerned with a new technique to find identification factors for the different sleep stages based on a soft-decision wavelet-based estimation of power-spectral density (PSD) contained in the main frequency bands of Heart Rate Variability (HRV).A wavelet-based PSD distribution of HRV in different sleep stages is implemented on an epoch basis. Four sleep stages (S1–S4), “REM sleep” (with “rapid eye movements”), and wakefulness are considered in this work. The data used, including electro-cardiograms and sleep stage monitoring hypnograms, are provided by the sleep laboratory of the department of Psychiatry and Psychotherapy of Christian-Albrechts University Kiel, Germany. The data, taken from 12 healthy people and containing enough epochs of the above 5 different sleep stages plus the wake state, is divided into almost equal sets for training and test.The results show that the PSD of the very-low-frequency (VLF) band and the low-frequency (LF) band are reduced as sleep stages vary from the wake state to REM sleep and further to light sleep (S1–S2) and deep sleep (S3–S4). The variation of the PSD in the high-frequency (HF) band is almost the opposite. The ratio of the VLF/HF PSD is found to be a good identification factor between the different sleep stages, showing better results than other, commonly used factors such as the LF/HF and VLF/LF PSD ratios.     

Effects of an electric blanket on sleep stages and body temperature in young men

The aim of this study was to investigate any effects of electric blanket on sleep stages and body temperature. Nine male subjects slept under two conditions: using the electric blanket (HB); and not using the electric blanket (C). The ambient condition was controlled at 3 degrees C relative humidity 50-80%. Electroencephalography, electrooculography (EOG) and electromyography, rectal temperature, skin temperature and microclimate temperature and humidity were recorded continuously through the night. Body weight was measured before and after sleep. The amount of stage 1 and number of stage 1 and rapid eye movement sleep decreased in HB compared to C. No significant difference was observed in other sleep stages. Rectal temperature was higher in HB compared to C. The thigh, leg and foot skin temperature was higher in HB than C. The microclimate temperature of the foot area was higher in HB compared to C. No significant difference was observed in whole body sweat loss between the conditions. These results suggest that use of an electric blanket under low ambient temperature may decrease cold stress to support sleep stability and thermoregulation during sleep.     

Effects of an electric blanket on sleep stages and body temperature in young men

The aim of this study was to investigate any effects of electric blanket on sleep stages and body temperature. Nine male subjects slept under two conditions: using the electric blanket (HB); and not using the electric blanket (C). The ambient condition was controlled at 3°C relative humidity 50?–?80%. Electroencephalography, electrooculography (EOG) and electromyography, rectal temperature, skin temperature and microclimate temperature and humidity were recorded continuously through the night. Body weight was measured before and after sleep. The amount of stage 1 and number of stage 1 and rapid eye movement sleep decreased in HB compared to C. No significant difference was observed in other sleep stages. Rectal temperature was higher in HB compared to C. The thigh, leg and foot skin temperature was higher in HB than C. The microclimate temperature of the foot area was higher in HB compared to C. No significant difference was observed in whole body sweat loss between the conditions. These results suggest that use of an electric blanket under low ambient temperature may decrease cold stress to support sleep stability and thermoregulation during sleep.     

Role network measures to assess healthcare team adaptation to complex situations: the case of venous thromboembolism prophylaxis

Hospitals are complex environments that rely on clinicians working together to provide appropriate care to patients. These clinical teams adapt their interactions to meet changing situational needs. Venous thromboembolism (VTE) prophylaxis is a complex process that occurs throughout a patient’s hospitalisation, presenting five stages with different levels of complexity: admission, interruption, re-initiation, initiation, and transfer. The objective of our study is to understand how the VTE prophylaxis team adapts as the complexity in the process changes; we do this by using social network analysis (SNA) measures. We interviewed 45 clinicians representing 9 different cases, creating 43 role networks. The role networks were analysed using SNA measures to understand team changes between low and high complexity stages. When comparing low and high complexity stages, we found two team adaptation mechanisms: (1) relative increase in the number of people, team activities, and interactions within the team, or (2) relative increase in discussion among the team, reflected by an increase in reciprocity.

 

Practitioner Summary: The reason for this study was to quantify team adaptation to complexity in a process using social network analysis (SNA). The VTE prophylaxis team adapted to complexity by two different mechanisms, by increasing the roles, activities, and interactions among the team or by increasing the two-way communication and discussion throughout the team. We demonstrated the ability for SNA to identify adaptation within a team.     

Automated detection of cyclic alternating pattern and classification of sleep stages using deep neural network

The visual sleep stages scoring by human experts is the current gold standard for sleep analysis. However, this method is tedious, time-consuming, prone to human errors, and unable to detect microstructure of sleep such as cyclic alternating pattern (CAP) which is an important diagnostic factor for the detection of sleep disorders such as insomnia and obstructive sleep apnea (OSA). The CAP is only observed as subtle changes in the electroencephalogram (EEG) signals during non-rapid eye movement (NREM) sleep, making it very difficult for human experts to discern. Hence, it is important to have an automated system developed using artificial intelligence for accurate and robust detection of CAP and sleep stages classification. In this study, a deep learning model based on 1-dimensional convolutional neural network (1D-CNN) is proposed for CAP detection and homogenous 3-class sleep stages classification, namely wakefulness (W), rapid eye movement (REM) and NREM sleep. The proposed model is developed using standardized EEG recordings. Our developed CNN network achieved good model performance for 3-class sleep stages classification with a classification accuracy of 90.46%. Our proposed model also yielded a classification accuracy of 73.64% using balanced CAP dataset, and sensitivity of 92.06% with unbalanced CAP dataset. Our proposed model correctly identified majority of A-phases which comprised of only 12.6% in the unbalanced dataset. The performance of the developed prototype is ready to be tested with more data before clinical application.

     

Influence of time of day and partial sleep loss on muscle strength in eumenorrheic females

Disrupted sleep is the most common form of sleep deprivation in travellers, shift workers, athletes the night before important competitions and among parents of infants. The influence of partial sleep loss on muscle strength might differ according to the time of testing on the following day. This study was therefore designed to assess the interaction between the effects of partial sleep loss and time of day on muscle strength in females. Eight sedentary eumenorrheic females (mean +/- SD; age 30 +/- 6 years, height 1.62 +/- 0.06 m and body mass 67 +/- 5.0 kg) took part in the study, in a counterbalanced design. Measurements of muscle strength were carried out at 06:00 and 18:00 hours after the one control night (no sleep loss) and the one night of partial sleep loss, during menses. Muscle strength measures included isokinetic (at 1.05, 3.14 rad s(-1); 90 degrees range of motion) and isometric peak torque (at 60 degrees of knee flexion) of knee extensors and flexors (dominant leg). In addition, isometric force of knee extensors with super-imposed electrical twitches (50 Hz, 250 V, 200 mus pulse width) was measured using the same procedure in order to control for motivation. Rectal temperature was measured during the 30 min before muscle strength measurements. Partial sleep loss consisted of allowing 2.5 h sleep (between 03:00 and 05:30 h), whilst in the control condition (no sleep loss) subjects retired between 22:30 and 23:30 h, rising at 05:30 hours. All measurements were conducted at just one phase of the menstrual cycle (menses) to prevent any masking effect due to different phases of the menstrual cycle. In both conditions (with and without partial sleep loss) a diurnal variation was observed in peak torque of knee flexors at 1.05 (F(1,7) = 5.5, p < 0.05) and 3.14 rad s(-1) (F(1,7) = 8.0, p < 0.05); values at 18:00 hours were 4.5 and 5.9% higher than at 06:00 hours, respectively. No significant diurnal variation was observed for the other muscle strength measures. No significant effect of partial sleep loss or interaction effect (sleep x time of day) was observed for muscle strength measures. However, the performance rhythms were in phase with the circadian rhythm in rectal temperature. Partial sleep deprivation over one night did not have any adverse effect on maximal muscle strength, nor on diurnal variations of muscle strength indices. As the effect of time of day was observed with some of the muscle strength measures, it is suggested that, in designing future studies using females, the control of time of day is essential.     

缓冲交叉开关交换结构多播调度算法研究

高性能核心交换设备多播调度受到越来越多的关注·交叉开关结构下的多播调度方案或者性能较差,或者过于复杂,难于应用在高速交换场合·为此,提出一种面向多播的多输入队列缓冲交叉开关体系结构·将多播调度分解为信元分派、输入调度、输出调度3个可分布式并行执行的子问题,并设计了相应的调度算法,降低了算法复杂性·实验结果表明,交叉点缓冲区容量与输入队列数量对多播性能都具有很大的影响·在突发流量到达下,与单多播输入队列的体系结构相比,无论是采用O(1)复杂度的HA-RR-RR还是复杂度更高的调度算法,均能显著提高系统吞吐性能·     

Basic complexity criteria and their impact on manual assembly quality in actual production

Increasing design and assembly complexity are challenges facing the automotive industry today because increasing number of car variants and build options can result in immense difficulties and lead to costly assembly errors and quality losses. In order to remain on the market these conditions must nevertheless be managed by companies in hard competition with other manufacturers.The objective of this study was to analyze the impact of newly developed basic complexity criteria (CXB) on assembly quality and associated costs for corrective measures in manual assembly of cars. Data on error rate and action costs of assembly tasks of different complexity level was collected and analyzed. The inter-relationship between different complexity criteria was analyzed to see whether any criteria had a greater impact than others.The results showed that the action costs/car increased with increasing complexity level and that several complexity criteria together resulted in increased action costs. Some criteria tended to have a greater impact than others but need more research. The results further suggest that if high complexity issues are identified and replaced by low complexity solutions the assembly related action costs in manual assembly are likely to decrease.Relevance to industryBy reduction of basic assembly complexity already in early planning stages in product development significant reduction of costly assembly related action costs in manual assembly can probably be made.     

On visual complexity of 3D shapes

We present an approach to compute the perceived complexity of a given 3D shape using the similarity between its views. Previous studies on 3D shape complexity relied on geometric and/or topological properties of the shape and are not appropriate for incorporating results from human shape perception which claim that humans perceive 3D shapes as organizations of 2D views. Therefore, we base our approach to computing 3D shape complexity on the (dis)similarity matrix of the shape's 2D views. To illustrate the application of our approach, we note that simple shapes lead to similar views whereas complex ones result in different, dissimilar views. This reflected in the View Similarity Graph (VSG) of a shape as tight clusters of points if the shape is simple and increasingly dispersed points as it gets more complex. To get a visual intuition of the VSG, we project it to 2D using Multi-Dimensional Scaling (MDS) and introduce measures to compute shape complexity through point dispersion in the resulting MDS plot. Experiments show that results obtained using our measures alleviate some of the drawbacks present in previous approaches.     

A unified method for evaluating real-time computer controllers and its application

A computer-controlled system is a synergistic coupling of the controlled process and the controller computer. We have defined new performance measures for real-time controller computers based on this coupling. We present a systematic study of a typical critical controlled process in the context of new performance measures that express the performance of both controlled processes and controller computers (taken as a unit) on the basis of a single variable: controller response time. Controller response time is a function of current system state, system failure rate, electrical and/or magnetic interference, etc., and is therefore a random variable. Control overhead is expressed as monotonically nondecreasing function of the response time and the system suffers catastrophic failure, or dynamic failure, if the response time for a control task exceeds the corresponding system hard deadline, if any. The controlled-process chosen for study is an aircraft in the final stages of descent, just prior to landing. Control constraints are particularly severe during this period, and great care must be taken in the design of controllers that handle this process. First, the performance measures for the controller are presented. Second, control algorithms for solving the landing problem are discussed, and finally the impact of our performance measures on the problem is analyzed, showing that the performance measures and the associated estimation method have potential use for designing and/or evaluating real-time controllers and controlled process. In common with all other control techniques, the computational complexity involved in obtaining these measures is susceptible to the curse of dimensionality.     

Self-reported health and well-being amongst night security guards: a comparison with the working population

The present study sought to relate the well-being of night workers to that of the working population in general. One hundred and ninety-seven male permanent night security guards were interviewed with regard to the occurrence of various symptoms during the previous 12-month period. The results were compared with the results from similar interviews with a representative national sample of males (n = 1769) in the Swedish workforce. An age standardized morbidity ratio was computed with control for various background variables. The results showed that the security guards had a 2-3 times higher occurrence of sleep disturbances and fatigue than the national sample. Among the variables not differing from the national sample were gastrointestinal problems, headache, nervous problems, depression, nausea, diarrhoea, and haemorrhoids. It was concluded that sleep/wake disturbances are considerably more usual in permanent night security guards than in the working population as a whole.     

Towards modeling the query processing relevant shape complexity of 2D polygonal spatial objects

The shape complexity of two-dimensional (2D) polygonal spatial objects has implications for how the object can be best represented in a spatial database, and for the query-processing performance of that object. Nevertheless few useful definitions of query-processing relevant spatial complexity are available. A query-processing oriented shape complexity measure is likely to be different from a fractal measure of shape complexity that focused on compression/decompression or a shape complexity measure that would be used for pattern recognition, and should give better performance for the analysis of query processing. It could be used to classify spatial objects, cluster spatial objects in multiprocessor database systems. In a recent paper Brinkhoff et al. (T. Brinkhoff, H-P. Kriegel, R. Shneider, A. Braun, Measuring the complexity of spatial objects, Proceedings of the 3rd ACM International Workshop on Advances in Geographic Information Systems, Baltimore, MD, 1995, pp. 109–117) demonstrated the usefulness of a spatial complexity measure. They did not, however, offer much theoretical justification for their choice of parameters nor for the functional form that they used. In this paper we present a conceptual framework for discussing the query processing oriented shape complexity measures for spatial objects. It is hoped that this will lead to the development of improved measures of spatial complexity.     

Automatic sleep staging: A computer assisted approach for optimal combination of features and polysomnographic channels

To improve applicability of automatic sleep staging an efficient subject-independent method is proposed with application in sleep–wake detection and in multiclass sleep staging (awake, non-rapid eye movement (NREM) sleep and rapid eye movement (REM) sleep). In turn, NREM is further divided into three stages denoted here by N1, N2, and N3. To assess the method, polysomnographic (PSG) records of 40 patients from our ISRUC-Sleep dataset, which was scored by an expert clinician in the central hospital of Coimbra, are used. To find the best combination of PSG signals for automatic sleep staging, six electroencephalographic (EEG), two electrooculographic (EOG), and one electromyographic (EMG) channels are analyzed. An extensive set of feature extraction techniques are applied, covering temporal, frequency and time–frequency domains. The maximum overlap wavelet transform (MODWT), a shift invariant transform, was used to extract the features in time–frequency domain. The extracted feature set is transformed and normalized to reduce the effect of extreme values of features. The most discriminative features are selected through a two-step method composed by a manual selection step based on features’ histogram analysis followed by an automatic feature selector. The selected feature set is classified using support vector machines (SVMs). The system achieved the best performance by combining 6 channels (C3, C4, O1, left EOG (LOC), right EOG (ROC) and chin EMG (X1)) for sleep–wake detection, and 9 channels (C3, C4, O1, O2, F3, F4, LOC, ROC, X1) for multiclass sleep staging.     

Post-lunch nap as a worksite intervention to promote alertness on the job

A worksite study was conducted to examine whether a 15-min nap during a post-lunch rest period would affect subsequent alertness, performance, and nocturnal sleep in eight factory workers under a 3-week protocol. Subjects were asked to take the nap at 12:30?h on a reclining chair during the nap week, and to remain awake during the no-nap week. The order of these 2 weeks was counterbalanced between the subjects. During the third, follow-up week, each subject determined whether or not she/he would nap. Alertness on the job and nocturnal sleep were assessed using a sleep diary. Wrist activity was also recorded during sleep at night. Choice reaction time task (RT) was performed at 10:00 and 15:00?h every day of the nap week and every other day of the no-nap and follow-up weeks. Perceived alertness was significantly higher in the afternoon after nap than after no nap at the end of the week. Similar effects were observed during the follow-up week where almost half of the subjects napped. No significant differences between the three weeks were found for RT performance or nocturnal sleep. Workers' attitudes toward the nap were favourable. Although further intervention research is required, our results suggest that post-lunch napping may have the potential to promote daytime alertness at work.     

Post-lunch nap as a worksite intervention to promote alertness on the job.

A worksite study was conducted to examine whether a 15-min nap during a post-lunch rest period would affect subsequent alertness, performance, and nocturnal sleep in eight factory workers under a 3-week protocol. Subjects were asked to take the nap at 12:30 h on a reclining chair during the nap week, and to remain awake during the no-nap week. The order of these 2 weeks was counterbalanced between the subjects. During the third, follow-up week, each subject determined whether or not she/he would nap. Alertness on the job and nocturnal sleep were assessed using a sleep diary. Wrist activity was also recorded during sleep at night. Choice reaction time task (RT) was performed at 10:00 and 15:00 h every day of the nap week and every other day of the no-nap and follow-up weeks. Perceived alertness was significantly higher in the afternoon after nap than after no nap at the end of the week. Similar effects were observed during the follow-up week where almost half of the subjects napped. No significant differences between the three weeks were found for RT performance or nocturnal sleep. Workers' attitudes toward the nap were favourable. Although further intervention research is required, our results suggest that post-lunch napping may have the potential to promote daytime alertness at work.     

Mental workload measurement for emergency operating procedures in digital nuclear power plants

Mental workload is a major consideration for the design of emergency operation procedures (EOPs) in nuclear power plants. Continuous and objective measures are desired. This paper compares seven mental workload measurement methods (pupil size, blink rate, blink duration, heart rate variability, parasympathetic/sympathetic ratio, total power and (Goals, Operations, Methods, and Section Rules)-(Keystroke Level Model) GOMS-KLM-based workload index) with regard to sensitivity, validity and intrusiveness. Eighteen participants performed two computerised EOPs of different complexity levels, and mental workload measures were collected during the experiment. The results show that the blink rate is sensitive to both the difference in the overall task complexity and changes in peak complexity within EOPs, that the error rate is sensitive to the level of arousal and correlate to the step error rate and that blink duration increases over the task period in both low and high complexity EOPs. Cardiac measures were able to distinguish tasks with different overall complexity. The intrusiveness of the physiological instruments is acceptable. Finally, the six physiological measures were integrated using group method of data handling to predict perceived overall mental workload.

Practitioner Summary: The study compared seven measures for evaluating the mental workload with emergency operation procedure in nuclear power plants. An experiment with simulated procedures was carried out, and the results show that eye response measures are useful for assessing temporal changes of workload whereas cardiac measures are useful for evaluating the overall workload.     

Innovative working schedule: introducing one short nap during the night shift.

In order to test the possible long-term effects of the implementation of a short nap during night shifts, an experiment was conducted over a period of 1 year with 12 volunteer shiftworkers operating in an industrial plant. They were authorized, under certain conditions, to use individual sleeping areas, for a maximum of 1 hour, between 23h30 and 3h30. The participants were asked to fill in a short questionnaire every day during the entire study. The questions concerned the schedule of the main sleep period, the afternoon nap and the night-time nap, if any, as well as the evaluation of mood and the quality of work. This daily questionnaire was supplemented by an extensive questionnaire applied every 2 months in order to assess the main changes introduced in the life of the participants by this new working schedule. Results showed that this new organization introduced a general satisfaction about the quality and the easiness of the work at night. The vigilance level was considered to be higher during the hours following the nap. The efficacy of the nap time progressively increased for most subjects. The general quality of life improved for most subjects. While a few of them considered that falling asleep was less easy on the following morning at home, the statistical analysis did not show any detrimental effect of the short rest period on the length of the immediately consecutive main sleep period. However, different statistical analyses allow us to reveal significant differences between the main sleep durations following the night shift compared with those following both the afternoon shift and the resting period. The main sleep duration following the night shift was not statistically different from that of the morning shift. These results are very encouraging. A short nap during the night shift can be considered as a positive way to counteract the low level of vigilance that normally occurs during the late part of the night.     

Innovative working schedule: introducing one short nap during the night shift

In order to test the possible long-term effects of the implementation of a short nap during night shifts, an experiment was conducted over a period of 1 year with 12 volunteer shiftworkers operating in an industrial plant. They were authorized, under certain conditions, to use individual sleeping areas, for a maximum of 1 hour, between 23h30 and 3h30. The participants were asked to fill in a short questionnaire every day during the entire study. The questions concerned the schedule of the main sleep period, the afternoon nap and the night-time nap, if any, as well as the evaluation of mood and the quality of work. This daily questionnaire was supplemented by an extensive questionnaire applied every 2 months in order to assess the main changes introduced in the life of the participants by this new working schedule. Results showed that this new organization introduced a general satisfaction about the quality and the easiness of the work at night. The vigilance level was considered to be higher during the hours following the nap. The efficacy of the nap time progressively increased for most subjects. The general quality of life improved for most subjects. While a few of them considered that falling asleep was less easy on the following morning at home, the statistical analysis did not show any detrimental effect of the short rest period on the length of the immediately consecutive main sleep period. However, different statistical analyses allow us to reveal significant differences between the main sleep durations following the night shift compared with those following both the afternoon shift and the resting period. The main sleep duration following the night shift was not statistically different from that of the morning shift. These results are very encouraging. A short nap during the night shift can be considered as a positive way to counteract the low level of vigilance that normally occurs during the late part of the night.     

Vigilance on the civil flight deck: incidence of sleepiness and sleep during long-haul flights and associated changes in physiological parameters

The study investigated sleepiness and sleep in aircrew during long-haul flights. The objectives were to identify loss of alertness and to recommend a practical approach to the design of an alerting system to be used by aircrew to prevent involuntary sleep. The flights were between London and Miami, covering both day- and night-time sectors, each with a duration of ~9 h. The subjects were 12 British Airways pilots. Various physiological variables were measured that could potentially be used to indicate the presence of drowsiness and involuntary sleep: brain electrical activity (electroencephalogram, EEG), eye movements via the electro-oculogram (EOG), wrist activity, head movements and galvanic skin resistance. The EEG and EOG identified sleepiness and sleep, as well as being potential measures on which to base an alarm system. Ten pilots either slept or showed evidence of sleepiness as assessed by the EEG and EOG. Many of the episodes of sleepiness lasted < 20 s, which could mean that the subjects were unaware of their occurrence and of the potential consequences on performance and vigilance. All physiological parameters showed changes during sleep, although only the EEG and EOG were modified by sleepiness. During sleep, skin resistance was increased, and wrist activity and head movements were absent for long periods. The study indicated that the measurement of eye movements (either alone or in combination with the EEG), wrist activity or head movement may be used as the basis of an alarm system to prevent involuntary sleep. Skin resistance is considered to be unsuitable, however, being related in a more general way to fatigue rather than to sleep episodes. The optimal way to monitor the onset of sleep would be to measure eye movements; however, this is not feasible in the flight deck environment at the present time due to the intrusive nature of the recording methodology. Wrist activity is therefore recommended as the basis of an alertness alarm. Such a device would alert the pilot after ~4–5 min of wrist inactivity, since this duration has been shown by the present study to be associated with sleep. The possibility that sleep inertia (reduced alertness immediately after awakening from sleep) could follow periods of sleep lasting 5 min needs to be considered. The findings reported here might be applicable to other occupational environments where fatigue and sleepiness are known to occur.