{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T17:32:54Z","timestamp":1793381574815,"version":"4.5.0"},"reference-count":61,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T00:00:00Z","timestamp":1757635200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T00:00:00Z","timestamp":1757635200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001794","name":"The University of Queensland","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001794","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Dysphagia"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The clinical application of acoustic swallowing sound parameters collected from digital cervical auscultation is limited because of the time-consuming manual segmentation required by trained experts. The automated identification of swallowing sounds in children and adults from swallowing sound audio wavefiles using machine learning have accuracies between 76\u201395%. No data exists in preterm neonates. To determine if applying automated machine learning using a transfer learning approach could accurately identify and segment swallows from swallowing sounds collected in preterm neonates. Thin fluid swallow sounds were collected from 78 preterm neonates, median birth age 34\u00a0weeks gestation (range 25\u201336\u00a0weeks, 52.6% males) across 3 Australian special care nurseries. For the base machine learning model, a deep convolutional neural network (DCNN) pre-trained for audio event classification was used. With raw swallow audio data as input, embedding vectors from the base DCNN were generated and used to train a feedforward neural network to determine the presence of a swallow within an audio segment. The model showed high overall accuracy (94%) in identifying preterm swallows. Better model performance on bottle feeding swallows (Sensitivity, 95%; and specificity, 96%) was seen compared with breastfeeding swallows (sensitivity, 95%, specificity 92%). Interpretation: Our novel study demonstrates the successful use of transfer learning to accurately identify and segment digital swallowing sounds in preterm neonates. Application of this model could support the development of a digital CA app to automatically classify swallow sounds and improve objectivity for CA use in clinical practice within special care nurseries.<\/jats:p>","DOI":"10.1007\/s00455-025-10879-3","type":"journal-article","created":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T02:45:32Z","timestamp":1757645132000},"page":"275-284","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Using Machine Learning for the Automated Segmentation and Detection of Swallows Obtained by Digital Cervical Auscultation in Preterm Neonates"],"prefix":"10.1007","volume":"41","author":[{"given":"Stephen","family":"So","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Tadj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Belinda","family":"Schwerin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne B.","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seiji","family":"Humphries","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2724-6919","authenticated-orcid":false,"given":"Thuy T.","family":"Frakking","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,9,12]]},"reference":[{"issue":"6","key":"10879_CR1","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1007\/s002470100456","volume":"31","author":"M-G Mercado-Deane","year":"2001","unstructured":"Mercado-Deane M-G, Burton EM, Harlow SA, et al. Swallowing dysfunction in infants less than 1 year of age. Pediatr Radiol. 2001;31(6):423\u20138.","journal-title":"Pediatr Radiol"},{"issue":"2","key":"10879_CR2","doi-asserted-by":"publisher","first-page":"175","DOI":"10.5535\/arm.2013.37.2.175","volume":"37","author":"KE Uhm","year":"2013","unstructured":"Uhm KE, Yi S-H, Chang HJ, Cheon HJ, Kwon J-Y. Videofluoroscopic swallowing study findings in full-term and preterm infants with dysphagia. Ann Rehabil Med. 2013;37(2):175\u201382.","journal-title":"Ann Rehabil Med"},{"key":"10879_CR3","doi-asserted-by":"publisher","first-page":"110396","DOI":"10.1016\/j.ijporl.2020.110396","volume":"138","author":"T Patel","year":"2020","unstructured":"Patel T, Clemmens C, Bradburn K, et al. Effect of a standardized fluoroscopic procedural approach on fluoroscopy time during infant modified barium swallow studies. Int J Pediatr Otorhinolaryngol. 2020;138:110396\u2013110396.","journal-title":"Int J Pediatr Otorhinolaryngol"},{"issue":"4","key":"10879_CR4","doi-asserted-by":"publisher","first-page":"1190","DOI":"10.1378\/chest.120.4.1190","volume":"120","author":"S Sheikh","year":"2001","unstructured":"Sheikh S, Allen E, Shell R, et al. Chronic aspiration without gastroesophageal reflux as a cause of chronic respiratory symptoms in neurologically normal infants. Chest. 2001;120(4):1190\u20135.","journal-title":"Chest"},{"issue":"5","key":"10879_CR5","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0123125","volume":"10","author":"JD Tutor","year":"2015","unstructured":"Tutor JD, Srinivasan S, Gosa MM, Spentzas T, Stokes DC. Pulmonary function in infants with swallowing dysfunction. PLoS ONE. 2015;10(5): e0123125.","journal-title":"PLoS ONE"},{"key":"10879_CR6","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1016\/j.jpeds.2016.10.065","volume":"181","author":"SRMD Jadcherla","year":"2016","unstructured":"Jadcherla SRMD, Khot TMPH, Moore RRNBSN, Malkar MMDMPH, Gulati IKMD, Slaughter JLMDMPH. Feeding Methods at Discharge Predict Long-Term Feeding and Neurodevelopmental Outcomes in Preterm Infants Referred for Gastrostomy Evaluation. J Pediatr. 2016;181:125\u201330.","journal-title":"J Pediatr"},{"issue":"2","key":"10879_CR7","doi-asserted-by":"publisher","first-page":"622S","DOI":"10.3945\/ajcn.115.110106","volume":"103","author":"S Jadcherla","year":"2016","unstructured":"Jadcherla S. Dysphagia in the high-risk infant: potential factors and mechanisms. Am J Clin Nutr. 2016;103(2):622S-628S.","journal-title":"Am J Clin Nutr"},{"issue":"1","key":"10879_CR8","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1097\/MPG.0b013e3182288766","volume":"54","author":"SR Jadcherla","year":"2012","unstructured":"Jadcherla SR, Peng J, Moore R, et al. Impact of personalized feeding program in 100 Nicu infants: pathophysiology-based approach for better outcomes. J Pediatr Gastroenterol Nutr. 2012;54(1):62\u201370.","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"Suppl 2","key":"10879_CR9","doi-asserted-by":"publisher","first-page":"S9","DOI":"10.1038\/ejcn.2013.224","volume":"67","author":"JC Arvedson","year":"2013","unstructured":"Arvedson JC. Feeding children with cerebral palsy and swallowing difficulties. Eur J Clin Nutr. 2013;67(Suppl 2):S9-12.","journal-title":"Eur J Clin Nutr"},{"issue":"1","key":"10879_CR10","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1007\/s00455-019-10006-z","volume":"35","author":"HW Im","year":"2020","unstructured":"Im HW, Kim SY, Oh BM, Han TR, Seo HG. Radiation dose during videofluoroscopic swallowing studies and associated factors in pediatric patients. Dysphagia. 2020;35(1):84\u20139.","journal-title":"Dysphagia"},{"key":"10879_CR11","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-019-10027-8","author":"J Layly","year":"2019","unstructured":"Layly J, Marmouset F, Chassagnon G, et al. Can we reduce frame rate to 15 images per second in pediatric videofluoroscopic swallow studies? Dysphagia. 2019. https:\/\/doi.org\/10.1007\/s00455-019-10027-8.","journal-title":"Dysphagia"},{"issue":"5","key":"10879_CR12","doi-asserted-by":"publisher","first-page":"E13","DOI":"10.1097\/ANC.0000000000000537","volume":"18","author":"SM Thoyre","year":"2018","unstructured":"Thoyre SM, Pados BF, Shaker CS, Fuller K, Park J. Psychometric properties of the early feeding skills assessment tool. Adv Neonatal Care. 2018;18(5):E13\u201323.","journal-title":"Adv Neonatal Care"},{"issue":"6","key":"10879_CR13","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1136\/archdischild-2017-313787","volume":"104","author":"G Batchelor","year":"2019","unstructured":"Batchelor G, McNaughten B, Bourke T, Dick J, Leonard C, Thompson A. How to use the videofluoroscopy swallow study in paediatric practice. Arch Dis Childhood \u2013 Educ Practice. 2019;104(6):313.","journal-title":"Arch Dis Childhood \u2013 Educ Practice"},{"issue":"5","key":"10879_CR14","doi-asserted-by":"publisher","first-page":"672","DOI":"10.1007\/s00455-016-9726-6","volume":"31","author":"J Frazier","year":"2016","unstructured":"Frazier J, Chestnut AH, Jackson A, Barbon CEA, Steele CM, Pickler L. Understanding the viscosity of liquids used in infant dysphagia management. Dysphagia. 2016;31(5):672\u20139.","journal-title":"Dysphagia"},{"issue":"2","key":"10879_CR15","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1007\/s00455-017-9849-4","volume":"33","author":"A Rumbach","year":"2018","unstructured":"Rumbach A, Coombes C, Doeltgen S. A survey of Australian dysphagia practice patterns. Dysphagia. 2018;33(2):216\u201326.","journal-title":"Dysphagia"},{"issue":"6","key":"10879_CR16","doi-asserted-by":"publisher","first-page":"738","DOI":"10.1007\/s00455-016-9727-5","volume":"31","author":"TT Frakking","year":"2016","unstructured":"Frakking TT, Chang AB, O\u2019Grady KF, David M, Walker-Smith K, Weir KA. The use of cervical auscultation to predict oropharyngeal aspiration in children: a randomized controlled trial. Dysphagia. 2016;31(6):738\u201348.","journal-title":"Dysphagia"},{"issue":"6","key":"10879_CR17","doi-asserted-by":"publisher","first-page":"569","DOI":"10.1080\/17549507.2016.1222452","volume":"19","author":"TT Frakking","year":"2017","unstructured":"Frakking TT, Chang AB, O\u2019Grady KF, David M, Weir KA. Reliability for detecting oropharyngeal aspiration in children using cervical auscultation. Int J Speech Lang Pathol. 2017;19(6):569\u201377.","journal-title":"Int J Speech Lang Pathol"},{"issue":"2","key":"10879_CR18","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1002\/ddrr.16","volume":"14","author":"AL Delaney","year":"2008","unstructured":"Delaney AL, Arvedson JC. Development of swallowing and feeding: prenatal through first year of life. Dev Disabil Res Rev. 2008;14(2):105\u201317.","journal-title":"Dev Disabil Res Rev"},{"key":"10879_CR19","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1016\/j.jpeds.2016.07.044","volume":"178","author":"KB Sanchez","year":"2016","unstructured":"Sanchez KB, Spittle AJP, Slattery JMB, Morgan ATP. Oromotor feeding in children born before 30 weeks\u2019 gestation and term-born peers at 12 months\u2019 corrected age. J Pediatr. 2016;178:113-118.e111.","journal-title":"J Pediatr"},{"issue":"4","key":"10879_CR20","doi-asserted-by":"publisher","first-page":"665","DOI":"10.1016\/j.clp.2013.07.004","volume":"40","author":"ADPNNPBC Mahoney","year":"2013","unstructured":"Mahoney ADPNNPBC, Jain LMDMBA. Respiratory disorders in moderately preterm, late preterm, and early term infants. Clin Perinatol. 2013;40(4):665\u201378.","journal-title":"Clin Perinatol"},{"issue":"11","key":"10879_CR21","doi-asserted-by":"publisher","first-page":"3472","DOI":"10.1002\/ppul.25314","volume":"56","author":"E Rhoads","year":"2021","unstructured":"Rhoads E, Montgomery GS, Ren CL. Wheezing in preterm infants and children. Pediatr Pulmonol. 2021;56(11):3472\u20137.","journal-title":"Pediatr Pulmonol"},{"issue":"1","key":"10879_CR22","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1186\/s12984-015-0110-9","volume":"13","author":"JM Dudik","year":"2016","unstructured":"Dudik JM, Kurosu A, Coyle JL, Sejdi\u0107 E. A statistical analysis of cervical auscultation signals from adults with unsafe airway protection. J Neuroeng Rehabil. 2016;13(1):7\u20137.","journal-title":"J Neuroeng Rehabil"},{"issue":"4","key":"10879_CR23","doi-asserted-by":"publisher","first-page":"635","DOI":"10.1007\/s00455-020-10177-0","volume":"36","author":"C Donohue","year":"2020","unstructured":"Donohue C, Khalifa Y, Perera S, Sejdic E, Coyle JL. A preliminary investigation of whether HRCA signals can differentiate between swallows from healthy people and swallows from people with neurodegenerative diseases. Dysphagia. 2020;36(4):635\u201343.","journal-title":"Dysphagia"},{"issue":"12","key":"10879_CR24","doi-asserted-by":"publisher","first-page":"1001","DOI":"10.1177\/0003489416669953","volume":"125","author":"T Frakking","year":"2016","unstructured":"Frakking T, Chang A, O\u2019Grady K, David M, Weir K. Aspirating and nonaspirating swallow sounds in children: a pilot study. Ann Otol Rhinol Laryngol. 2016;125(12):1001\u20139.","journal-title":"Ann Otol Rhinol Laryngol"},{"issue":"1","key":"10879_CR25","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1186\/1743-0003-9-34","volume":"9","author":"C Merey","year":"2012","unstructured":"Merey C, Kushki A, Sejdi\u0107 E, Berall G, Chau T. Quantitative classification of pediatric swallowing through accelerometry. J Neuroeng Rehabil. 2012;9(1):34\u201334.","journal-title":"J Neuroeng Rehabil"},{"key":"10879_CR26","doi-asserted-by":"publisher","DOI":"10.1186\/1743-0003-3-14","volume":"3","author":"J Lee","year":"2006","unstructured":"Lee J, Blain S, Casas M, Kenny D, Berall G, Chau T. A radial basis classifier for the automatic detection of aspiration in children with dysphagia. J Neuroeng Rehabil. 2006;3: 14.","journal-title":"J Neuroeng Rehabil"},{"issue":"1","key":"10879_CR27","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1016\/j.artmed.2011.03.002","volume":"52","author":"J Lee","year":"2011","unstructured":"Lee J, Steele CM, Chau T. Classification of healthy and abnormal swallows based on accelerometry and nasal airflow signals. Artif Intell Med. 2011;52(1):17\u201325.","journal-title":"Artif Intell Med"},{"issue":"6","key":"10879_CR28","doi-asserted-by":"publisher","first-page":"1482","DOI":"10.1007\/s00455-022-10410-y","volume":"37","author":"TT Frakking","year":"2022","unstructured":"Frakking TT, Chang AB, Carty C, et al. Using an automated speech recognition approach to differentiate between normal and aspirating swallowing sounds recorded from digital cervical auscultation in children. Dysphagia. 2022;37(6):1482\u201392.","journal-title":"Dysphagia"},{"issue":"2","key":"10879_CR29","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1007\/s00455-020-10124-z","volume":"36","author":"C Donohue","year":"2020","unstructured":"Donohue C, Mao S, Sejdic E, Coyle JL. Tracking hyoid bone displacement during swallowing without videofluoroscopy using machine learning of vibratory signals. Dysphagia. 2020;36(2):259\u201369.","journal-title":"Dysphagia"},{"issue":"9","key":"10879_CR30","doi-asserted-by":"publisher","first-page":"1810","DOI":"10.1109\/TNSRE.2019.2935302","volume":"27","author":"Q He","year":"2019","unstructured":"He Q, Perera S, Khalifa Y, et al. The association of high resolution cervical auscultation signal features with hyoid bone displacement during swallowing. IEEE Trans Neural Syst Rehabil Eng. 2019;27(9):1810\u20136.","journal-title":"IEEE Trans Neural Syst Rehabil Eng"},{"key":"10879_CR31","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1109\/JTEHM.2018.2881468","volume":"7","author":"C Rebrion","year":"2019","unstructured":"Rebrion C, Zhang Z, Khalifa Y, et al. High-resolution cervical auscultation signal features reflect vertical and horizontal displacements of the hyoid bone during swallowing. IEEE J Transl Eng Health Med. 2019;7:1\u20139.","journal-title":"IEEE J Transl Eng Health Med"},{"key":"10879_CR32","doi-asserted-by":"publisher","first-page":"610","DOI":"10.1016\/j.future.2020.09.040","volume":"115","author":"S Mao","year":"2021","unstructured":"Mao S, Sabry A, Khalifa Y, Coyle JL, Sejdic E. Estimation of laryngeal closure duration during swallowing without invasive X-rays. Future Gener Comput Syst. 2021;115:610\u20138.","journal-title":"Future Gener Comput Syst"},{"issue":"3","key":"10879_CR33","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1016\/j.apmr.2018.05.038","volume":"100","author":"A Kurosu","year":"2019","unstructured":"Kurosu A, Coyle JL, Dudik JM, Sejdic E. Detection of swallow kinematic events from acoustic high-resolution cervical auscultation signals in patients with stroke. Arch Phys Med Rehabil. 2019;100(3):501\u20138.","journal-title":"Arch Phys Med Rehabil"},{"issue":"9","key":"10879_CR34","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1111\/j.1469-8749.2002.tb00843.x","volume":"44","author":"EW Reynolds","year":"2002","unstructured":"Reynolds EW, Vice FL, Bosma JF, Gewolb IH. Cervical accelerometry in preterm infants. Dev Med Child Neurol. 2002;44(9):587\u201392.","journal-title":"Dev Med Child Neurol"},{"issue":"7","key":"10879_CR35","doi-asserted-by":"publisher","first-page":"442","DOI":"10.1111\/j.1469-8749.2003.tb00938.x","volume":"45","author":"EW Reynolds","year":"2003","unstructured":"Reynolds EW, Vice FL, Gewolb IH. Cervical accelerometry in preterm infants with and without bronchopulmonary dysplasia. Dev Med Child Neurol. 2003;45(7):442\u20136.","journal-title":"Dev Med Child Neurol"},{"issue":"1","key":"10879_CR36","doi-asserted-by":"publisher","first-page":"170","DOI":"10.3390\/ijerph20010170","volume":"20","author":"BP So","year":"2022","unstructured":"So BP, Chan TT, Liu L, et al. Swallow detection with acoustics and accelerometric-based wearable technology: a scoping review. Int J Environ Res Public Health. 2022;20(1):170.","journal-title":"Int J Environ Res Public Health"},{"issue":"1","key":"10879_CR37","doi-asserted-by":"publisher","first-page":"8704","DOI":"10.1038\/s41598-020-65492-1","volume":"10","author":"Y Khalifa","year":"2020","unstructured":"Khalifa Y, Coyle JL, Sejdi\u0107 E. Non-invasive identification of swallows via deep learning in high resolution cervical auscultation recordings. Sci Rep. 2020;10(1):8704\u20138704.","journal-title":"Sci Rep"},{"issue":"5","key":"10879_CR38","doi-asserted-by":"publisher","first-page":"340","DOI":"10.1111\/joor.12264","volume":"42","author":"C Fukuike","year":"2015","unstructured":"Fukuike C, Kodama N, Manda Y, et al. a novel automated detection system for swallowing sounds during eating and speech under everyday conditions. J Oral Rehabil. 2015;42(5):340\u20137.","journal-title":"J Oral Rehabil"},{"issue":"4","key":"10879_CR39","first-page":"313","volume":"30","author":"S Afkari","year":"2007","unstructured":"Afkari S. Measuring frequency of spontaneous swallowing. Australas Phys Eng Sci Med. 2007;30(4):313\u20137.","journal-title":"Australas Phys Eng Sci Med"},{"key":"10879_CR40","doi-asserted-by":"crossref","unstructured":"Fontana JM, Melo PL, Sazonov ES. Swallowing detection by sonic and subsonic frequencies: a comparison. Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference, vol 2011, pp. 6890-6893, 2011.","DOI":"10.1109\/IEMBS.2011.6091735"},{"issue":"3","key":"10879_CR41","doi-asserted-by":"publisher","first-page":"806","DOI":"10.1109\/JSEN.2015.2469095","volume":"16","author":"Y Bi","year":"2016","unstructured":"Bi Y, Lv M, Song C, Xu W, Guan N, Yi W. Autodietary: a wearable acoustic sensor system for food intake recognition in daily life. IEEE Sens J. 2016;16(3):806\u201316.","journal-title":"IEEE Sens J"},{"issue":"2","key":"10879_CR42","doi-asserted-by":"publisher","first-page":"El127","DOI":"10.1121\/1.4812434","volume":"134","author":"MD Skowronski","year":"2013","unstructured":"Skowronski MD, Crary MA, Shrivastav R. acoustic discrimination of healthy swallows from upper airway movements. J Acoust Soc Am. 2013;134(2):El127-132.","journal-title":"J Acoust Soc Am"},{"issue":"9","key":"10879_CR43","doi-asserted-by":"publisher","first-page":"3532","DOI":"10.1109\/JSEN.2019.2894744","volume":"19","author":"Y Kurihara","year":"2019","unstructured":"Kurihara Y, Kaburagi T, Kumagai S, Matsumoto T. Development of swallowing-movement-sensing device and swallowing-state-estimation system. IEEE Sens J. 2019;19(9):3532\u201342.","journal-title":"IEEE Sens J"},{"key":"10879_CR44","doi-asserted-by":"publisher","DOI":"10.3390\/s24103057","author":"S Kimura","year":"2024","unstructured":"Kimura S, Emoto T, Suzuki Y, Shinkai M, Shibagaki A, Shichijo F. Novel approach combining shallow learning and ensemble learning for the automated detection of swallowing sounds in a clinical database. Sensors. 2024. https:\/\/doi.org\/10.3390\/s24103057.","journal-title":"Sensors"},{"key":"10879_CR45","unstructured":"Aboofazeli M, Moussavi Z. 2004. The 26th Annual International Conference of the IEEE Engineering in Medicine and Biology Society."},{"key":"10879_CR46","unstructured":"Yamnet. https:\/\/tfhub.dev\/google\/yamnet\/1. Accessed 3 Jan 2024."},{"key":"10879_CR47","doi-asserted-by":"crossref","unstructured":"Gemmeke JF, Ellis DPW, Freedman D, et al. Audio set: an ontology and human-labeled dataset for audio events. IEEE International Conference on Acoustics, Speech and Signal Processing (ICASSP). pp 776\u2013780. 2017.","DOI":"10.1109\/ICASSP.2017.7952261"},{"issue":"3","key":"10879_CR48","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1053\/j.nainr.2007.06.007","volume":"7","author":"SM Ludwig","year":"2007","unstructured":"Ludwig SM, Waitzman KA. Changing feeding documentation to reflect infant-driven feeding practice. Newborn Infant Nurs Rev. 2007;7(3):155\u201360.","journal-title":"Newborn Infant Nurs Rev"},{"key":"10879_CR49","unstructured":"libsoxr library https:\/\/github.com\/chirlu\/soxr. Accessed 20 May 2025."},{"key":"10879_CR50","volume-title":"Theory and applications of digital speech processing","author":"LR Rabiner","year":"2011","unstructured":"Rabiner LR, Schafer RW. Theory and applications of digital speech processing. 1st ed. Upper Saddle River: Pearson; 2011.","edition":"1"},{"issue":"1","key":"10879_CR51","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1111\/j.1558-5646.1998.tb05158.x","volume":"52","author":"PC Phillips","year":"1998","unstructured":"Phillips PC. Designing experiments to maximize the power of detecting correlations. Evolution. 1998;52(1):251\u20135.","journal-title":"Evolution"},{"issue":"5","key":"10879_CR52","first-page":"1","volume":"1","author":"Y Sasaki","year":"2007","unstructured":"Sasaki Y. The truth of the F-measure. Teach Tutor Mater. 2007;1(5):1\u20135.","journal-title":"Teach Tutor Mater"},{"issue":"2","key":"10879_CR53","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1542\/peds.113.2.361","volume":"113","author":"DT Ramsay","year":"2004","unstructured":"Ramsay DT, Kent JC, Owens RA, Hartmann PE. Ultrasound imaging of milk ejection in the breast of lactating women. Pediatrics. 2004;113(2):361\u20137.","journal-title":"Pediatrics"},{"issue":"2","key":"10879_CR54","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1007\/s00221-017-5139-5","volume":"236","author":"E Kamarunas","year":"2018","unstructured":"Kamarunas E, Mulheren R, Palmore K, Ludlow C. Timing of cortical activation during spontaneous swallowing. Exp Brain Res. 2018;236(2):475\u201384.","journal-title":"Exp Brain Res"},{"issue":"2","key":"10879_CR55","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1007\/s004550011001","volume":"16","author":"SG Hiss","year":"2001","unstructured":"Hiss SG, Treole K, Stuart A. Effects of age, gender, bolus volume, and trial on swallowing apnea duration and swallow\/respiratory phase relationships of normal adults. Dysphagia. 2001;16(2):128\u201335.","journal-title":"Dysphagia"},{"key":"10879_CR56","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1016\/j.physbeh.2014.12.029","volume":"140","author":"AK Al-Toubi","year":"2015","unstructured":"Al-Toubi AK, Doeltgen SH, Daniels SK, Corey DM, Huckabee M-L. Pharyngeal pressure differences between four types of swallowing in healthy participants. Physiol Behav. 2015;140:132\u20138.","journal-title":"Physiol Behav"},{"issue":"1","key":"10879_CR57","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1007\/s00455-017-9836-9","volume":"33","author":"M Hasegawa","year":"2018","unstructured":"Hasegawa M, Kurose M, Okamoto K, et al. Differential response pattern of oropharyngeal pressure by bolus and dry swallows. Dysphagia. 2018;33(1):83\u201390.","journal-title":"Dysphagia"},{"issue":"2","key":"10879_CR58","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1007\/s00455-006-9058-z","volume":"22","author":"JL Miller","year":"2007","unstructured":"Miller JL, Kang SM. Preliminary ultrasound observation of lingual movement patterns during nutritive versus non-nutritive sucking in a premature infant. Dysphagia. 2007;22(2):150\u201360.","journal-title":"Dysphagia"},{"issue":"1","key":"10879_CR59","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1097\/ANC.0000000000000245","volume":"16","author":"J Reynolds","year":"2016","unstructured":"Reynolds J, Carroll S, Sturdivant C. Fiberoptic endoscopic evaluation of swallowing: a multidisciplinary alternative for assessment of infants with dyspahgia in the neonatal intensive care unit. Adv Neonatal Care. 2016;16(1):37\u201343.","journal-title":"Adv Neonatal Care"},{"key":"10879_CR60","doi-asserted-by":"publisher","first-page":"537","DOI":"10.3389\/fped.2020.00537","volume":"8","author":"R Kamity","year":"2020","unstructured":"Kamity R, Ferrara L, Dumpa V, Reynolds J, Islam S, Hanna N. Simultaneous videofluoroscopy and endoscopy for dysphagia evaluation in preterm infants-a pilot study. Front Pediatr. 2020;8:537.","journal-title":"Front Pediatr"},{"issue":"1","key":"10879_CR61","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1080\/17549507.2021.1953592","volume":"24","author":"L Bergstr\u00f6m","year":"2022","unstructured":"Bergstr\u00f6m L, Cichero JAY. Dysphagia management: does structured training improve the validity and reliability of cervical auscultation? Int J Speech Lang Pathol. 2022;24(1):77\u201387.","journal-title":"Int J Speech Lang Pathol"}],"container-title":["Dysphagia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00455-025-10879-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00455-025-10879-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00455-025-10879-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T11:36:07Z","timestamp":1772278567000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00455-025-10879-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,12]]},"references-count":61,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10879"],"URL":"https:\/\/doi.org\/10.1007\/s00455-025-10879-3","relation":{},"ISSN":["0179-051X","1432-0460"],"issn-type":[{"value":"0179-051X","type":"print"},{"value":"1432-0460","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,12]]},"assertion":[{"value":"10 December 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 July 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 September 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors have a patent registration of the original algorithm used in this study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}