COVID-19 Diagnosis Using Spectral and Statistical Analysis of Cough Recordings Based on the Combination of SVD and DWT

تستخدم الإشارات الصوتية التي يولدها جسم الإنسان بشكل روتيني من قبل التخصصين في البحوث والتطبيقات الصحية  للمساعدة في تشخيص بعض  الامراض أو تقييم تقدم المرض. وبالنظر إلى التقنيات الجديدة ، من الممكن في الوقت الحاضر جمع الأصوات التي يولدها الإنسان ، مثل السعال. ويمكن بعد ذلك اعتماد تقنيات التعلم الآلي المستندة إلى الصوت من أجل التحليل التلقائي للبيانات التي تم جمعها مما يوفر معلومات قيمة غنية من إشارة السعال واستخراج الميزات الفعالة من فترة زمنية محدودة الطول تتغير كدالة للوقت. في هذا البحث يتم اقتراح وتقديم خوارزمية  للكشف عن COVID-19 وتشخيصه من خلال معالجة السعال الذي يتم جمعه من المرضى الذين يعانون من الأعراض الأكثر شيوعًا لهذا الوباء. تعتمد الطريقة المقترحة على اعتماد مزيج من تحليل القيمة المفردة (SVD) وتحويل المويجات المنفصل (DWT).  وقد أدى الجمع بين هاتين التقنيتين لمعالجة الإشارات إلى اتباع نهج جيد للتعرف على السعال ، حيث يولد ويستخدم الحد الأدنى من الميزات الفعالة. وفي هذه الخوارزمية المقترحة يتم تطبيق الترددات المتوسطة (mean and median)، والمعروفة بأنها أكثر الميزات المفيدة في مجال التردد ، لإنشاء مقياس إحصائي فعال لمقارنة النتائج. بالإضافة إلى الحصول على معدل كشف وتمييز عاليين ، تتميز الخوارزمية المقترحة بكفاءتها حيث يتم تحقيق تخفيض 200 مرة، من حيث عدد العمليات. على الرغم من حقيقة أن أعراض الأشخاص المصابين وغير المصابين في الدراسة بها الكثير من أوجه التشابه ، فإن نتائج التشخيص التي تم الحصول عليها من تطبيق نهجنا تُظهر معدل تشخيص مرتفعًا، والذي تم إثباته من خلال مطابقتها مع اختبارات PCR ذات الصلة. نعتقد أنه يمكن تحقيق أداء أفضل من خلال توسيع مجموعة البيانات ، مع تضمين الأشخاص الأصحاء.Healthcare professionals routinely use audio signals, generated by the human body, to help diagnose disease or assess its progression. With new technologies, it is now possible to collect human-generated sounds, such as coughing. Audio-based machine learning technologies can be adopted for automatic analysis of collected data. Valuable and rich information can be obtained from the cough signal and extracting effective characteristics from a finite duration time interval that changes as a function of time. This article presents a proposed approach to the detection and diagnosis of COVID-19 through the processing of cough collected from patients suffering from the most common symptoms of this pandemic. The proposed method is based on adopting a combination of Singular Value Decomposition (SVD), and Discrete Wavelet Transform (DWT). The combination of these two signal processing techniques is gaining lots of interest in the field of speaker and speech recognition. As a cough recognition approach, we found it well-performing, as it generates and utilizes an efficient minimum number of features. Mean and median frequencies, which are known to be the most useful features in the frequency domain, are applied to generate an effective statistical measure to compare the results. The hybrid structure of DWT and SVD, adopted in this approach adds to its efficiency, where a 200 times reduction, in terms of the number of operations, is achieved. Despite the fact that symptoms of the infected and non-infected people used in the study are having lots of similarities, diagnosis results obtained from the application of the proposed approach show high diagnosis rate, which is proved through the matching with relevant PCR tests.  The proposed approach is open for more improvements with its performance further assured by enlarging the dataset, while including healthy people

The genetic landscape of autism spectrum disorder in the Middle Eastern population

Introduction: Autism spectrum disorder (ASD) is characterized by aberrations in social interaction and communication associated with repetitive behaviors and interests, with strong clinical heterogeneity. Genetic factors play an important role in ASD, but about 75% of ASD cases have an undetermined genetic risk.Methods: We extensively investigated an ASD cohort made of 102 families from the Middle Eastern population of Qatar. First, we investigated the copy number variations (CNV) contribution using genome-wide SNP arrays. Next, we employed Next Generation Sequencing (NGS) to identify de novo or inherited variants contributing to the ASD etiology and its associated comorbid conditions in families with complete trios (affected child and the parents).Results: Our analysis revealed 16 CNV regions located in genomic regions implicated in ASD. The analysis of the 88 ASD cases identified 41 genes in 39 ASD subjects with de novo (n = 24) or inherited variants (n = 22). We identified three novel de novo variants in new candidate genes for ASD (DTX4, ARMC6, and B3GNT3). Also, we have identified 15 de novo variants in genes that were previously implicated in ASD or related neurodevelopmental disorders (PHF21A, WASF1, TCF20, DEAF1, MED13, CREBBP, KDM6B,SMURF1, ADNP, CACNA1G, MYT1L, KIF13B, GRIA2, CHM, and KCNK9). Additionally, we defined eight novel recessive variants (RYR2, DNAH3, TSPYL2, UPF3B KDM5C, LYST, and WNK3), four of which were X-linked.Conclusion: Despite the ASD multifactorial etiology that hinders ASD genetic risk discovery, the number of identified novel or known putative ASD genetic variants was appreciable. Nevertheless, this study represents the first comprehensive characterization of ASD genetic risk in Qatar's Middle Eastern population

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Mortality of emergency abdominal surgery in high-, middle- and low-income countries

Background: Surgical mortality data are collected routinely in high-income countries, yet virtually no low- or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Development Index (HDI). Methods: This was a prospective, multicentre, cohort study. Self-selected hospitals performing emergency surgery submitted prespecified data for consecutive patients from at least one 2-week interval during July to December 2014. Postoperative mortality was analysed by hierarchical multivariable logistic regression. Results: Data were obtained for 10 745 patients from 357 centres in 58 countries; 6538 were from high-, 2889 from middle- and 1318 from low-HDI settings. The overall mortality rate was 1⋅6 per cent at 24 h (high 1⋅1 per cent, middle 1⋅9 per cent, low 3⋅4 per cent; P < 0⋅001), increasing to 5⋅4 per cent by 30 days (high 4⋅5 per cent, middle 6⋅0 per cent, low 8⋅6 per cent; P < 0⋅001). Of the 578 patients who died, 404 (69⋅9 per cent) did so between 24 h and 30 days following surgery (high 74⋅2 per cent, middle 68⋅8 per cent, low 60⋅5 per cent). After adjustment, 30-day mortality remained higher in middle-income (odds ratio (OR) 2⋅78, 95 per cent c.i. 1⋅84 to 4⋅20) and low-income (OR 2⋅97, 1⋅84 to 4⋅81) countries. Surgical safety checklist use was less frequent in low- and middle-income countries, but when used was associated with reduced mortality at 30 days. Conclusion: Mortality is three times higher in low- compared with high-HDI countries even when adjusted for prognostic factors. Patient safety factors may have an important role. Registration number: NCT02179112 (http://www.clinicaltrials.gov)

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Die Inkorporierung des Osmanischen Reiches in den europäischen Weltmarkt

In der vorliegenden Arbeit soll die Entwicklungsgeschichte des Osmanischen Reiches zwischen dem 14. und dem 20. Jahrhundert im Zentrum der Betrachtung stehen, wobei die wirtschaftlichen und politischen Wechselbeziehungen zwischen Okzident und Orient die Orientierungslinie bilden sollen. Mit Hilfe der Weltsystemtheorie von Immanuel Wallerstein sollen dabei die Kategorien des Zentrums, der Semiperipherie und der Peripherie auf die Konstellation der Hauptakteure innerhalb des gewählten Zeitraumes Anwendung finden. Wallerstein nimmt an, mit diesen Klassifikationen die Grundlage der Prozesse, die seiner Meinung nach zur Herausbildung des modernen Weltsystems geführt haben, klarer benennen zu können, die er in der wirtschaftlichen Entwicklung sieht. Darauf aufbauend soll das Verständnis‘ Fernand Braudels von Markt und Antimarkt Anwendung auf die im Wallerstein‘schen Sinne identifizierten staatlichen Protagonisten finden. Diese Darstellungen sollen wiederum vor dem theoretischen Hintergrund eines weiteren Konzepts Braudels zusammengefasst werden: Das drei-Zeiten-Modell soll dieser Arbeit einerseits den zeitlichen Rahmen liefern, indem die Zeitspanne vom 1300-1900 als ‚longue durée‘ verstanden wird. Des Weiteren soll in den drei gewählten Betrachtungsperioden – die Entwicklungen des Osmanischen Reiches vor 1600; die Entwicklungen in Nordwesteuropa um 1600; sowie die Entwicklungen des Osmanischen Reiches nach 1600 – die Differenzierug der ausgewählten Aspekte von der ‚histoire cyclique‘ geleitet sein. Als oberste Schicht der Betrachtung legt die ‚histoire évémentielle‘ das Augenmerk auf die politische Ereignisgeschichte, wobei eine obere Kategorie jeweils von ihrer Unteren eingebettet werden soll. Der Arbeit liegt die Forschungsfrage zu Grunde, welche Zusammenhänge sich zwischen der Eingliederung des Osmanischen Reiches in eine expandierende europäische Weltwirtschaft (erstens), der sogenannten Industrialisierung Nordwesteuropas (zweitens) und dem letztendlichen Niedergang und Zerfall des Osmanenreichs (drittens) zu Beginn des 20. Jahrhunderts herstellen lassen? Hierbei sollen vor allem die wirtschaftspolitische Verfasstheit und soziale Strukturierung des Osmanischen Reiches der klassischen Periode von 1300 bis 1600 jenen der Phase von 1600 bis 1900 gegenübergestellt und die sich ergebenden Unterschiede auf ihre Verbindung zu den Entwicklungen Nordwesteuropas geprüft werden. Die der Frage unterstellte Relevanz leitet sich von der Bedeutung der geopolitischen und weltwirtschaftlichen Lage der arabischen Staaten während des 20. und zu Beginn des 21. Jahrhunderts ab, die ihren Ausgang am Ende des Osmanischen Reiches nahmen.In the present thesis, the focus of attention is the historical developmentof the Ottoman Empire between the 14th and 20th century, concerning mutual economic and political relationships between the Occident and Orient. The world-system theoriy of Immanuel Wallerstein and its categories of the center, the semi-periphery and the periphery and the periphery will be applied to the constellation of the key players within the selected period. Wallerstein assumes that one can explain the processes, that have – in his view – led to the development of the modern world system, by using these classifications to name the basis of these processes. Additionally, the concept of ‚market‘ and ‚antimarket‘ within the conceptions of Fernand Braudelcomplement the identification of the state protagonists in the sense of Wallerstein. The time frame will be set by the model of longue durée also by Braudel. The target of this thesis is a way of explanation what the situation for the state of the arab world after the end of the Ottoman Empire

On dual peak detection UWB receivers in noise and interference dominated environments

We propose the use of a non-coherent dual peak detection architecture for ultra wideband (UWB) receivers. To benchmark our proposed architecture, the performance of non-coherent UWB receivers based on single peak, dual peak, and energy detectors in the presence of noise and interference is analyzed and compared. Theoretical derivations are presented to evaluate the performance in additive white Gaussian noise (AWGN) channels, and simulations are run to verify these results and analyze the detector performance in a multipath fading environments. It is observed that receivers based on peak detection can perform on par or better than receivers based on energy detection in interference dominated environments (such as urban areas) in both AWGN and multi-path fading channels. This allows for the realization of non-coherent UWB receivers with simplified hardware without sacrificing performance. As such, the receiver would operate with increased energy efficiency, making it attractive for low power, low data rate transceivers such as those used in wireless sensor networks. 2015 Elsevier GmbH. All rights reserved.The research work of Tamer Khattab is funded by the National Priorities Research Program, NPRP, award number NPRP 6-1326-2-532 from the Qatar National Research Fund, QNRF, (a member of Qatar Foundation, QF). The statements made herein are solely the responsibility of the authors.Scopu