Analysis of rule-based and shallow statistical models for COVID-19 cough detection for a preliminary diagnosis

Coronavirus pandemic that has spread all over the world, is one of its kind in the recent past, that has mobilized researchers in areas such as (not limited to) pre-screening solutions, contact tracing, vaccine developments, and crowd estimation. Pre-screening using symptoms identification, cough classification, and contact tracing mobile applications gained significant popularity during the initial outbreak of the pandemic. Audio recordings of coughing individuals are one of the sources that can help in the pre-screening of COVID-19 patients. This research focuses on quantitative analysis of covid cough classification using audio recordings of coughing individuals. For analysis, we used three different publicly available datasets i.e., COUGHVID, NoCoCoDa, and a self-collected dataset through a web application. We observed that wet cough has more correlation with covid cough as opposed to dry cough. However, the classification model trained with wet and dry coughs, both, has similar test performance as that of the model trained with wet cough samples only. We conclude that audio-signal recordings of coughing individuals have the potential as a pre-screening test for COVID-19

Learning fruit class from short wave near infrared spectral features, an AI approach towards determining fruit type

This paper analyzes the potential of using shortwave NIRS (near-infrared spectroscopy) for fruit classification problems. The research focuses on O-H and C-H overtone features of fruit and its correlation with NIRS and therefore opens a new dimension of fruit classification problems using NIRS. Eleven fruits, which include apple, cherry, hass, kiwi, grapes, mango, melon, orange, loquat, plum, and apricot, were used in this study to cover physical characteristics such as peel thinness, pulp, seed thickness, and size. NIR spectral data is collected using the industry-standard F-750 fruit quality meter (wavelength range 300-1100nm) for all fruit mentioned above. Different shallow machine learning architectures were trained to classify fruits using spectral feature vectors. At first, using 83 features vectors within the range of 725-975nm (3nm-resolution) and then using only four features of wavelength 770nm, 840nm, 910nm, and 960nm (corresponding to O-H and C-H overtone features). For the 83 spectral features range as an input, the QDA classifier achieved a cross-validation accuracy of 100% and a test data accuracy of 93.02%. For the four features vector as an input, the QDA classifier achieved a cross-validation accuracy of 97.1% and test data accuracy of 90.38%. The results demonstrate that fruit classification is mainly a function of absorptivity of short wave NIR radiation primarily with respect to O-H and C-H overtones features. An LED-based device mainly having 770nm, 840nm, 910nm, and 960nm range LEDs can be used in applications where automation in fruit classification is required

Perioperative registries in resource-limited settings: The way forward for Pakistan

Capable of improving surgical quality, perioperative registries can allow performance benchmarking, reliable reporting and the development of risk-prediction models. Well established in high-income countries, perioperative registries remain limited in lower- and middle-income countries due to several challenges. First, ensuring comprehensive data entry forums to power the registries is difficult because of limited electronic medical records requiring sustained efforts to develop and integrate these into practice. Second, lack of adequate expertise and resources to develop and maintain registry software necessitates the involvement of software developers and information technology personnel. Third, case ascertainment and item completion are challenging secondary to poor-quality medical records and high loss-to-follow-up rates, requiring telemedicine initiatives as an adjunct to existing care for the assessment of post-discharge outcomes. Lastly, standardised coding of clinical terminology is warranted for ensuring interoperability of the registries for which adaptation of the existing disease and procedural codes can be a sustainable and cost-effective alternative to the development of new codes

Complication rate and diagnostic yield of percutaneous native kidney biopsies: A 10-year experience at a Tertiary Care Hospital in Pakistan

The use of an automated biopsy device, and real-time ultrasound for percutaneous kidney biopsies (PKBs) has improved the likelihood of obtaining adequate tissue for diagnosis and also has reduced the complications associated with the procedure. We aimed to determine the frequency and type of complications associated with PKB and to determine the diagnostic yield. It was a retrospective file-based review of cases who underwent PKB of native kidney between January 2003 and December 2013 at the Aga Khan University Hospital in Karachi, Pakistan. PKBs were performed by trained nephrologists or radiologists using an automated device with a 16/18-gauge needle under real-time ultrasound. The data obtained included age, gender, clinical and histopathological diagnosis, and complications associated with the procedure (minor: hematuria, local infections, and hematoma; major: transfusions, severe infections, surgery, nephrectomy, arteriography, embolism, and death. Yield of the procedure was based on the number of glomeruli obtained. Patients having major complications were compared with the patients who had minor or no complications. A total of 433 native kidney biopsies were performed. The mean age of the patients was 41 ± 15.9 years, and 58% of the patients were male. The main histological findings were membranoproliferative glomerulonephritis (17.6%) followed by focal and segmental glomerulosclerosis (16.4%) and interstitial nephritis (13.9%). Majority of the procedures were performed by nephrologists (67.4%). The overall complication rate was 14.2%. Among those, 21 patients (4.8%) had a major complication while the others had minor complications. Of those who had a major complication, 17 patients required blood transfusion(s) and had hematuria or a major hematoma, three had prolonged hospitalization \u3e24 hours, and one patient required surgical intervention. Only 10 procedures (2.3%) had inadequate tissue to establish the histopathologic diagnosis. PKB under real-time ultrasound guidance is a safe and efficacious procedure to establish the histological diagnosis of the renal disease

New FxLMAT-Based Algorithms for Active Control of Impulsive Noise

In the presence of non-Gaussian impulsive noise (IN) with a heavy tail, active noise control (ANC) algorithms often encounter stability problems. While adaptive filters based on the higher-order error power principle have shown improved filtering capability compared to the least mean square family algorithms for IN, however, the performance of the filtered-x least mean absolute third (FxLMAT) algorithm tends to degrade under high impulses. To address this issue, this paper proposes three modifications to enhance the performance of the FxLMAT algorithm for IN. To improve stability, the first alteration i.e. variable step size FxLMAT (VSSFxLMAT)algorithm is suggested that incorporates the energy of input and error signal but has slow convergence. To improve its convergence, the second modification i.e. filtered x robust normalized least mean absolute third (FxRNLMAT) algorithm is presented but still lacks robustness. Therefore, a third modification i.e. modified filtered-x RNLMAT (MFxRNLMAT) is devised, which is relatively stable when encountered with high impulsive noise. With comparable computational complexity, the proposed MFxRNLMAT algorithm gives better robustness and convergence speed than all variants of the filtered-x least cos hyperbolic algorithm, and filtered-x least mean square algorithm

Towards Sweetness Classification of Orange Cultivars Using Short‑Wave NIR Spectroscopy

The global orange industry constantly faces new technical challenges to meet consumer demands for quality fruits. Instead of traditional subjective fruit quality assessment methods, the interest in the horticulture industry has increased in objective, quantitative, and non-destructive assessment methods. Oranges have a thick peel which makes their non-destructive quality assessment challenging. This paper evaluates the potential of short-wave NIR spectroscopy and direct sweetness classification approach for Pakistani cultivars of orange, i.e., Red-Blood, Mosambi, and Succari. The correlation between quality indices, i.e., Brix, titratable acidity (TA), Brix: TA and BrimA (Brix minus acids), sensory assessment of the fruit, and short-wave NIR spectra, is analysed. Mix cultivar oranges are classified as sweet, mixed, and acidic based on short-wave NIR spectra. Short-wave NIR spectral data were obtained using the industry standard F-750 fruit quality meter (310–1100 nm). Reference Brix and TA measurements were taken using standard destructive testing methods. Reference taste labels i.e., sweet, mix, and acidic, were acquired through sensory evaluation of samples. For indirect fruit classification, partial least squares regression models were developed for Brix, TA, Brix: TA, and BrimA estimation with a correlation coefficient of 0.57, 0.73, 0.66, and 0.55, respectively, on independent test data. The ensemble classifier achieved 81.03% accuracy for three classes (sweet, mixed, and acidic) classification on independent test data for direct fruit classification. A good correlation between NIR spectra and sensory assessment is observed as compared to quality indices. A direct classification approach is more suitable for a machine-learning-based orange sweetness classification using NIR spectroscopy than the estimation of quality indices

Sleep Quality and Its Possible Predictors Among University Students of Islamabad, Pakistan

Objective: To assess sleep quality among Islamabad university students and find predictors of poor sleep quality. Study Design: Cross-sectional analytic study Place and Duration of Study: Capital University of Science and Technology ,Islamabad Pakistan, from Feb to Jun 2019 Methodology: The study population (n=397) was undergraduate students from all eight semesters of four faculties. The dependent variable sleep quality was measured through a standard validated tool, Pittsburgh Sleep Quality Index (PSQI). Results: Out of 397 participants, 158(40%) were hostelities and 239(60%) were day scholars. There were 134(33.5%) students having a good sleep, and 263(66.5%) were having a bad sleep, according to PSQI scores obtained. Association analysis showed a statistically significant association between sleep quality and heavy meals, gadget use, drinking beverages before bedtime,sleeping in a noisy room, and type of residence (p ≤ 0.001). Study findings showed gadget use before bedtime (AOR=4.472,95% CI=2.674-7.478), residence type (AOR=2.323,95% CI=1.4-3.855), sleeping in a noisy room (AOR=2.241,95% CI=1.369-3.665)and heavy meal before bedtime (AOR=1.985,95% CL=1.142-3.451) were significant predictors of poor sleep quality. Conclusion: It was concluded that two out of three students need better sleep quality. Universities should give preparatory assistance for developing and executing health promotion and educational curricula

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: Multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P \u3c 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (β coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation