Leveraging AI and Machine Learning to Develop and Evaluate a Contextualized User-Friendly Cough Audio Classifier for Detecting Respiratory Diseases: Protocol for a Diagnostic Study in Rural Tanzania

BACKGROUND

Respiratory diseases, including active tuberculosis (TB), asthma, and chronic obstructive pulmonary disease (COPD), constitute substantial global health challenges, necessitating timely and accurate diagnosis for effective treatment and management.

OBJECTIVE

This research seeks to develop and evaluate a noninvasive user-friendly artificial intelligence (AI)-powered cough audio classifier for detecting these respiratory conditions in rural Tanzania.

METHODS

This is a nonexperimental cross-sectional research with the primary objective of collection and analysis of cough sounds from patients with active TB, asthma, and COPD in outpatient clinics to generate and evaluate a noninvasive cough audio classifier. Specialized cough sound recording devices, designed to be nonintrusive and user-friendly, will facilitate the collection of diverse cough sound samples from patients attending outpatient clinics in 20 health care facilities in the Shinyanga region. The collected cough sound data will undergo rigorous analysis, using advanced AI signal processing and machine learning techniques. By comparing acoustic features and patterns associated with TB, asthma, and COPD, a robust algorithm capable of automated disease discrimination will be generated facilitating the development of a smartphone-based cough sound classifier. The classifier will be evaluated against the calculated reference standards including clinical assessments, sputum smear, GeneXpert, chest x-ray, culture and sensitivity, spirometry and peak expiratory flow, and sensitivity and predictive values.

RESULTS

This research represents a vital step toward enhancing the diagnostic capabilities available in outpatient clinics, with the potential to revolutionize the field of respiratory disease diagnosis. Findings from the 4 phases of the study will be presented as descriptions supported by relevant images, tables, and figures. The anticipated outcome of this research is the creation of a reliable, noninvasive diagnostic cough classifier that empowers health care professionals and patients themselves to identify and differentiate these respiratory diseases based on cough sound patterns.

CONCLUSIONS

Cough sound classifiers use advanced technology for early detection and management of respiratory conditions, offering a less invasive and more efficient alternative to traditional diagnostics. This technology promises to ease public health burdens, improve patient outcomes, and enhance health care access in under-resourced areas, potentially transforming respiratory disease management globally.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/54388.

Wolfberry genome database: integrated genomic datasets for studying molecular biology

Wolfberry, also known as goji berry or Lycium barbarum, is a highly valued fruit with significant health benefits and nutritional value. For more efficient and comprehensive usage of published L. barbarum genomic data, we established the Wolfberry database. The utility of the Wolfberry Genome Database (WGDB) is highlighted through the Genome browser, which enables the user to explore the L. barbarum genome, browse specific chromosomes, and access gene sequences. Gene annotation features provide comprehensive information about gene functions, locations, expression profiles, pathway involvement, protein domains, and regulatory transcription factors. The transcriptome feature allows the user to explore gene expression patterns using transcripts per kilobase million (TPM) and fragments per kilobase per million mapped reads (FPKM) metrics. The Metabolism pathway page provides insights into metabolic pathways and the involvement of the selected genes. In addition to the database content, we also introduce six analysis tools developed for the WGDB. These tools offer functionalities for gene function prediction, nucleotide and amino acid BLAST analysis, protein domain analysis, GO annotation, and gene expression pattern analysis. The WGDB is freely accessible at https://cosbi7.ee.ncku.edu.tw/Wolfberry/. Overall, WGDB serves as a valuable resource for researchers interested in the genomics and transcriptomics of L. barbarum. Its user-friendly web interface and comprehensive data facilitate the exploration of gene functions, regulatory mechanisms, and metabolic pathways, ultimately contributing to a deeper understanding of wolfberry and its potential applications in agronomy and nutrition.

Fungal drops: a novel approach for macro- and microscopic analyses of fungal mycelial growth

This study presents an inexpensive approach for the macro- and microscopic observation of fungal mycelial growth. The 'fungal drops' method allows to investigate the development of a mycelial network in filamentous microorganisms at the colony and hyphal scales. A heterogeneous environment is created by depositing 15-20 µl drops on a hydrophobic surface at a fixed distance. This system is akin to a two-dimensional (2D) soil-like structure in which aqueous-pockets are intermixed with air-filled pores. The fungus (spores or mycelia) is inoculated into one of the drops, from which hyphal growth and exploration take place. Hyphal structures are assessed at different scales using stereoscopic and microscopic imaging. The former allows to evaluate the local response of regions within the colony (modular behaviour), while the latter can be used for fractal dimension analyses to describe the hyphal network architecture. The method was tested with several species to underpin the transferability to multiple species. In addition, two sets of experiments were carried out to demonstrate its use in fungal biology. First, mycelial reorganization of Fusarium oxysporum was assessed as a response to patches containing different nutrient concentrations. Second, the effect of interactions with the soil bacterium Pseudomonas putida on habitat colonization by the same fungus was assessed. This method appeared as fast and accessible, allowed for a high level of replication, and complements more complex experimental platforms. Coupled with image analysis, the fungal drops method provides new insights into the study of fungal modularity both macroscopically and at a single-hypha level.

Preferred Characteristics for mHealth Interventions Among Young Sexual Minoritized Men to Support HIV Testing and PrEP Decision-Making: Focus Group Study

BACKGROUND

Epidemiological trends in the United States have shown an increase in HIV cases among young sexual minoritized men. Using mobile health (mHealth), which refers to health services and information delivered or enhanced through the internet and related technologies, is a crucial strategy to address HIV disparities. However, despite its potential, the practical implementation of mHealth remains limited. Additionally, it is important to consider that young individuals may become accustomed to, distracted from, or lose interest in these apps, highlighting the need for regular updates and monitoring of relevant content.

OBJECTIVE

In this study, we sought to highlight the voices of young sexual minoritized men aged 17-24 years and explored preferred mHealth intervention characteristics and willingness to adopt these technologies among a diverse, nationwide sample of young sexual minoritized men.

METHODS

From April to September 2020, we recruited participants through web-based platforms such as social media and geosocial networking apps for men. These individuals were invited to participate in synchronous web-based focus group discussions centered around topics pertaining to HIV testing and prevention and their preferences for mHealth technologies.

RESULTS

A total of 41 young sexual minoritized men, aged between 17 and 24 years, participated in 9 focus group discussions spanning April to September 2020, with 3-7 participants in each group. The findings shed light on three key insights regarding young sexual minoritized men's preferences: (1) the need for personalized and representative content, (2) a preference for mobile and web-based simulation of prevention scenarios, and (3) a preference for digital software with individually tailored content. As expected, preference for mHealth apps was high, which supports the potential and need to develop or adapt interventions that use smartphones as a platform for engaging young sexual minoritized men in HIV prevention. This study expands on previous research in multiple meaningful ways, delving into the use and perceptions of mHealth information amid the COVID-19 pandemic. This study also highlighted the importance of streamlined access to health care providers, especially in light of the barriers faced by young people during the COVID-19 pandemic. In terms of presentation and navigation, participants favored a user-friendly design that was easy to use and appropriate for their age, which was effectively addressed through the implementation of web-based simulations.

CONCLUSIONS

Ultimately, this study provides valuable insight into the preferences of young sexual minoritized men when it comes to mHealth interventions and highlights the need for further research in order to develop effective and tailored HIV prevention tools. A future direction for researchers is to evaluate how best to address participants' desire for personalized content within mHealth apps. Additionally, as technology rapidly evolves, there is a need to re-assess the effectiveness of web-based simulations, particularly those that are used in HIV prevention.

Basic Technology and Recent Trends in Agricultural Formulation and Application Technology

Recent requirements of the pesticide industry have become much severer, and pesticides (formulated products) are required to satisfy higher safety to both human beings and the environment, higher biological efficacy, lower price, and labor-saving. This review explains the outline of basic pesticide formulation technology, followed by recent advances in developing new formulations and application technologies. Labor-saving formulations and application technologies, environmental load reduction technologies, and user-friendly formulations and application technologies are elucidated.

Information and communication technology adoption among the older people: A qualitative approach

Information and communication technology (ICT) can empower the older people and improve their quality of life by sustaining functional independence and effective communication. Nonetheless, in developing countries like India, technology acceptance and use among the older people is limited. Therefore, there is a need to systematically understand the plausible difficulties limiting technology use and the expectations of the older people regarding ICT use. Hence, the present study is a qualitative inquiry to explore the needs, attitudes and perceived limitations of the ICT platforms among the older people. Twenty healthy volunteers across various states of India, between 60 and 75 years were recruited online via purposive sampling. A brief demographic survey was administered online using Google Forms, followed by telephonic semi-structured interviews. Thematic Analysis using inductive and deductive coding was employed to analyse the interview transcripts. Thematic analysis yielded four overarching themes- (i) Usability of ICT, (ii) Anxiety and privacy concerns, (iii) Self-perception of technology use and (iv) Need for technology literacy. The emerging themes reflected the perceptions of the older people towards ICT and identified several psycho-social factors impacting technology acceptance among the older people. The findings suggest that several psychological factors like anxiety, motivation, interest and self-efficacy play a role in technology acceptance among the older people. Additionally, user-friendly interfaces and training on technology use may enhance technology acceptance among older users.

PRES: a webserver for decoding the functional perturbations of RNA editing sites

Rapid progresses in RNA-Seq and computational methods have assisted in quantifying A-to-I RNA editing and altered RNA editing sites have been widely observed in various diseases. Nevertheless, functional characterization of the altered RNA editing sites still remains a challenge. Here, we developed perturbations of RNA editing sites (PRES; http://bio-bigdata.hrbmu.edu.cn/PRES/) as the webserver for decoding functional perturbations of RNA editing sites based on editome profiling. After uploading an editome profile among samples of different groups, PRES will first annotate the editing sites to various genomic elements and detect differential editing sites under the user-selected method and thresholds. Next, the downstream functional perturbations of differential editing sites will be characterized from gain or loss miRNA/RNA binding protein regulation, RNA and protein structure changes, and the perturbed biological pathways. A prioritization module was developed to rank genes based on their functional consequences of RNA editing events. PRES provides user-friendly functionalities, ultra-efficient calculation, intuitive table and figure visualization interface to display the annotated RNA editing events, filtering options and elaborate application notebooks. We anticipate PRES will provide an opportunity for better understanding the regulatory mechanisms of RNA editing in human complex diseases.

An Affordable, User-friendly Telerehabilitation System Assembled Using Existing Technologies for Individuals Isolated With COVID-19: Development and Feasibility Study

Background

Isolation due to a COVID-19 infection can limit activities and cause physical and mental decline, especially in older adults and people with disabilities. However, due to limited contact, adequate rehabilitation is difficult to provide for quarantined patients. Telerehabilitation technology could be a solution; however, issues specific to COVID-19 should be taken into consideration, such as strict quarantine and respiratory symptoms, as well as accessibility to deal with rapid increases in need due to the pandemic.

Objective

This study aims to develop and to investigate the feasibility of a telerehabilitation system for patients who are quarantined due to COVID-19 by combining existing commercial devices and computer applications.

Methods

A multidisciplinary team has identified the requirements for a telerehabilitation system for COVID-19 and developed the system to satisfy those requirements. In the subsequent feasibility study, patients diagnosed with COVID-19 (N=10; mean age 60 years, SD 18 years) were included. A single session of telerehabilitation consisted of stretching exercises, a 15-minute exercise program, and a video exercise program conducted under real-time guidance by a physical therapist through a video call. The system included a tablet computer, a pulse oximeter, videoconferencing software, and remote control software. The feasibility of the system was evaluated using the Telemedicine Satisfaction Questionnaire (TSQ; 14 items) and an additional questionnaire on the telerehabilitation system (5 items). Each item was rated from “1 = strongly disagree” to “5 = strongly agree.”

Results

The telerehabilitation system was developed by combining existing devices and applications, including a pulse oximeter and remote control mechanism, to achieve user-friendliness, affordability, and safety, which were determined as the system requirements. In the feasibility study, 9 out of 10 patients were able to use the telerehabilitation system without any on-site help. On the TSQ, the mean score for each item was 4.7 (SD 0.7), and in the additional items regarding telerehabilitation, the mean score for each item was 4.3 (SD 1.0).

Conclusions

These findings support the feasibility of this simple telerehabilitation system in quarantined patients with COVID-19, encouraging further investigation on the merit of the system’s use in clinical practice.

DscoreApp: A Shiny Web Application for the Computation of the Implicit Association Test D-Score

Several options are available for computing the most common score for the Implicit Association Test, the so-called D-score. However, all these options come with some drawbacks, related to either the need for a license, for being tailored on a specific administration procedure, or for requiring a degree of familiarity with programming. By using the R shiny package, a user-friendly, interactive, and open source web application (DscoreApp) has been created for the D-score computation. This app provides different options for computing the D-score algorithms and for applying different cleaning criteria. Beyond making the D-score computation easier, DscoreApp offers the chance to have an immediate glimpse on the results and to see how they change according to different settings configurations. The resulting D-scores are immediately available and can be seen in easy-readable and interactive graphs, along with meaningful descriptive statistics. Graphical representations, data sets containing the D-scores, and other information on participants' performance are downloadable. In this work, the use of DscoreApp is illustrated on an empirical data set.

Longitudinal IP-10 Serum Levels Are Associated with the Course of Disease Activity and Remission in Patients with Rheumatoid Arthritis

Although rheumatoid arthritis (RA) is a chronic, persistent autoimmune disease, 10 to 15% of RA patients achieve sustained disease-modifying antirheumatic drug (DMARD)-free remission over time. The biological mechanisms underlying the resolution of persistent inflammation in RA are still unidentified, and there is a lack of prognostic markers. It is well established that increased serum levels of gamma interferon-induced protein 10 (IP-10) are associated with (acute) increased inflammatory responses (e.g., in leprosy). In order to assess the potential of IP-10 as a diagnostic tool for inflammatory episodes of RA, we performed a retrospective study and assessed IP-10 levels in longitudinally banked serum samples obtained from patients upon first diagnosis of RA. The selection consisted of 15 persistent RA patients and 19 patients who achieved DMARD-free sustained remission. IP-10 levels, measured by use of a user-friendly quantitative lateral flow assay (LFA), showed up to 170-fold variation interindividually, and baseline IP-10 levels could not be differentiated between the two patient groups. However, a difference in the change in IP-10 levels between the first and last visits (ΔIP-10) was observed (P = 0.003) between DMARD-free (median ΔIP-10, -662 pg/ml [decrease]) and persistent (median ΔIP-10, 468 pg/ml [increase]) RA patients. Moreover, intraindividual changes in IP-10 levels during the course of disease corresponded to the disease activity score (DAS) (P = 0.05). These data indicate that IP-10 is associated with disease activity and perseverance of RA. The association of IP-10 with DAS indicates that this tool may be a practical diagnostic aid to help in monitoring disease progression in RA patients and may also find applications in other chronic diseases with exacerbated inflammatory episodes.

Paper-based point-of-care testing for diagnosis of dengue infections

Dengue endemic is a serious healthcare concern in tropical and subtropical countries. Although well-established laboratory tests can provide early diagnosis of acute dengue infections, access to these tests is limited in developing countries, presenting an urgent need to develop simple, rapid, and robust diagnostic tools. Point-of-care (POC) devices, particularly paper-based POC devices, are typically rapid, cost-effective and user-friendly, and they can be used as diagnostic tools for the prompt diagnosis of dengue at POC settings. Here, we review the importance of rapid dengue diagnosis, current dengue diagnostic methods, and the development of paper-based POC devices for diagnosis of dengue infections at the POC.

The Structural Ceramics Database: Technical Foundations

The development of a computerized database on advanced structural ceramics can play a critical role in fostering the widespread use of ceramics in industry and in advanced technologies. A computerized database may be the most effective means of accelerating technology development by enabling new materials to be incorporated into designs far more rapidly than would have been possible with traditional information transfer processes. Faster, more efficient access to critical data is the basis for creating this technological advantage. Further, a computerized database provides the means for a more consistent treatment of data, greater quality control and product reliability, and improved continuity of research and development programs. A preliminary system has been completed as phase one of an ongoing program to establish the Structural Ceramics Database system. The system is designed to be used on personal computers. Developed in a modular design, the preliminary system is focused on the thermal properties of monolithic ceramics. The initial modules consist of materials specification, thermal expansion, thermal conductivity, thermal diffusivity, specific heat, thermal shock resistance, and a bibliography of data references. Query and output programs also have been developed for use with these modules. The latter program elements, along with the database modules, will be subjected to several stages of testing and refinement in the second phase of this effort. The goal of the refinement process will be the establishment of this system as a user-friendly prototype. Three primary considerations provide the guidelines to the system's development: (1) The user's needs; (2) The nature of materials properties; and (3) The requirements of the programming language. The present report discusses the manner and rationale by which each of these considerations leads to specific features in the design of the system.