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Early detection of exacerbations in asthma and chronic obstructive pulmonary disease (COPD) is important for timely intervention. Speech has emerged as a promising tool for continuous, non-invasive respiratory disease monitoring. However, speech signals inherently carry speaker-identifiable attributes that may dominate model predictions, which may compromise both diagnosis performance and patient privacy. Furthermore, the acoustic features associated with respiratory disease and speaker identity remain unclear in respiratory disease monitoring. We propose an adversarial learning architecture that disentangles pathology-related acoustic patterns from speaker-identifiable attributes. The framework optimizes two clinically hierarchical tasks: (i) respiratory status classification (stable vs. exacerbated) and (ii) exacerbation type classification (asthma exacerbation vs. COPD exacerbation). Speaker identity is suppressed through gradient reversal-based adversarial training. To enhance clinical interpretability, we employ SHapley Additive exPlanations (SHAP) to quantify the contributions of acoustic features to pathology-related predictions versus speaker identity. On the TACTICAS datas

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. In the United States, more than 15.7 million Americans have been diagnosed with COPD, with 96% of individuals living with at least one other chronic health condition. It is the 4th leading cause of death in the country. Over 2.2 million patients are admitted to hospitals annually due to COPD exacerbations. Monitoring and predicting patient exacerbations on-time could save their life. This paper presents two different predictive models to predict COPD exacerbation using AI and natural language processing (NLP) approaches. These models use respiration summary notes, symptoms, and vital signs. To train and test these models, data records containing physiologic signals and vital signs time series were used. These records were captured from patient monitors and comprehensive clinical data obtained from hospital medical information systems for tens of thousands of Intensive Care Unit (ICU) patients. We achieved an area under the Receiver operating characteristic (ROC) curve of 0.82 in detection and prediction of COPD exacerbation.

Patients with chronic obstructive pulmonary disease (COPD) have an increased risk of hospitalizations, strongly associated with decreased survival, yet predicting the timing of these events remains challenging and has received limited attention in the literature. In this study, we performed survival analysis to predict hospitalization and death in COPD patients using longitudinal electronic health records (EHRs), comparing statistical models, machine learning (ML), and deep learning (DL) approaches. We analyzed data from more than 150k patients from the SIDIAP database in Catalonia, Spain, from 2013 to 2017, modeling hospitalization as a first event and death as a semi-competing terminal event. Multiple models were evaluated, including Cox proportional hazards, SurvivalBoost, DeepPseudo, SurvTRACE, Dynamic Deep-Hit, and Deep Recurrent Survival Machine. Results showed that DL models utilizing recurrent architectures outperformed both ML and linear approaches in concordance and time-dependent AUC, especially for hospitalization, which proved to be the harder event to predict. This study is, to our knowledge, the first to apply deep survival analysis on longitudinal EHR data to jointl

Chronic Obstructive Pulmonary Disease (COPD), a major chronic respiratory disease with persistent airflow limitation, is a leading global cause of disability and mortality. Respiratory spirogram time series, routinely collected during pulmonary function tests (PFTs), play a critical role in the early detection of respiratory diseases and in monitoring lung function over time. However, most current AI models for COPD diagnosis are limited to outputting classification results without providing a rationale for their diagnostic process, while current Large Language Models (LLMs) cannot understand spirograms yet, which severely limits their clinical trust and adoption. To tackle this challenge, we leverage a cohort of 234,028 individuals from the UK Biobank (UKB) to propose SpiroLLM, the first multimodal large language model that can understand spirogram. The model extracts morphological features from respiratory curves via a SpiroEncoder and aligns them with PFT numerical values in a unified latent space using a SpiroProjector, ultimately empowering a large language model to generate a comprehensive diagnostic report. Experimental results confirm that SpiroLLM achieved a diagnostic AUR

Income inequality is a major contributor to health disparities, yet its effects often vary by geography and are commonly represented as compositional distributions (e.g., proportions of households across income brackets). Existing spatial regression methods struggle in this setting: they typically assume smooth spatial variation, cannot accommodate abrupt spatial heterogeneity, and lack principled treatment of compositional covariates. We propose a geographically weighted penalized compositional regression model that addresses these challenges simultaneously. Our method adopts a pairwise fusion penalty that enables detection of both contiguous and noncontiguous regional clusters with shared regression effects, thereby relaxing strong assumptions of spatial smoothness and geographic contiguity. This allows regions with similar underlying socioeconomic structures to be identified even when they are not geographically adjacent. By incorporating nonconvex penalties, such as the minimax concave penalty (MCP), the approach achieves improved estimation accuracy, interpretability, and scalability in high-dimensional spatial settings. We illustrate the method through an analysis linking U.S

Background: It is fundamental for accurate segmentation and quantification of the pulmonary vessel, particularly smaller vessels, from computed tomography (CT) images in chronic obstructive pulmonary disease (COPD) patients. Objective: The aim of this study was to segment the pulmonary vasculature using a semi-supervised method. Methods: In this study, a self-training framework is proposed by leveraging a teacher-student model for the segmentation of pulmonary vessels. First, the high-quality annotations are acquired in the in-house data by an interactive way. Then, the model is trained in the semi-supervised way. A fully supervised model is trained on a small set of labeled CT images, yielding the teacher model. Following this, the teacher model is used to generate pseudo-labels for the unlabeled CT images, from which reliable ones are selected based on a certain strategy. The training of the student model involves these reliable pseudo-labels. This training process is iteratively repeated until an optimal performance is achieved. Results: Extensive experiments are performed on non-enhanced CT scans of 125 COPD patients. Quantitative and qualitative analyses demonstrate that the p

This study aims to explore the performance of the VAR model in comparison with mel-frequency cepstral coefficient (MFCC) matrices and log-mel spectrograms using deep learning. In pulmonary sound classification, spectrogram-based representations suffer from inconsistent temporal dimensions due to varying respiratory cycle durations. Along with traditional trimming/zero-padding, adaptive-length windowing was presented to fix their temporal dimensions. Their spectral and temporal dimensions were optimized by testing a range of parameters. Different convolutional neural network (CNN) architectures were employed to extract features from the two-dimensional representations obtained over the sub-phases. The extracted sub-phase features were then fused using various strategies including direct concatenation, gated recurrent unit (GRU) network and GRU with attention mechanism. Model performances were assessed through respiratory cycle-based evaluation and subject-based evaluation comprising multiple respiratory cycles. Several data augmentation techniques were also studied to cope with limitations in data size. The best cycle-based F1-score (0.877) was obtained using the MFCC matrices with

Paired inspiratory-expiratory CT scans enable the quantification of gas trapping due to small airway disease and emphysema by analyzing lung tissue motion in COPD patients. Deformable image registration of these scans assesses regional lung volumetric changes. However, variations in reconstruction kernels between paired scans introduce errors in quantitative analysis. This work proposes a two-stage pipeline to harmonize reconstruction kernels and perform deformable image registration using data acquired from the COPDGene study. We use a cycle generative adversarial network (GAN) to harmonize inspiratory scans reconstructed with a hard kernel (BONE) to match expiratory scans reconstructed with a soft kernel (STANDARD). We then deformably register the expiratory scans to inspiratory scans. We validate harmonization by measuring emphysema using a publicly available segmentation algorithm before and after harmonization. Results show harmonization significantly reduces emphysema measurement inconsistencies, decreasing median emphysema scores from 10.479% to 3.039%, with a reference median score of 1.305% from the STANDARD kernel as the target. Registration accuracy is evaluated via Dice

Chronic Obstructive Pulmonary Disease (COPD) is a serious and debilitating disease affecting millions around the world. Its early detection using non-invasive means could enable preventive interventions that improve quality of life and patient outcomes, with speech recently shown to be a valuable biomarker. Yet, its validity across different linguistic groups remains to be seen. To that end, audio data were collected from 96 Danish participants conducting three speech tasks (reading, coughing, sustained vowels). Half of the participants were diagnosed with different levels of COPD and the other half formed a healthy control group. Subsequently, we investigated different baseline models using openSMILE features and learnt x-vector embeddings. We obtained a best accuracy of 67% using openSMILE features and logistic regression. Our findings support the potential of speech-based analysis as a non-invasive, remote, and scalable screening tool as part of future COPD healthcare solutions.

Chronic obstructive pulmonary disease (COPD) is a lung disease that is not fully reversible and one of the leading causes of morbidity and mortality in the world. Early detection and diagnosis of COPD can increase the survival rate and reduce the risk of COPD progression in patients. Currently, the primary examination tool to diagnose COPD is spirometry. However, computed tomography (CT) is used for detecting symptoms and sub-type classification of COPD. Using different imaging modalities is a difficult and tedious task even for physicians and is subjective to inter-and intra-observer variations. Hence, developing meth-ods that can automatically classify COPD versus healthy patients is of great interest. In this paper, we propose a 3D deep learning approach to classify COPD and emphysema using volume-wise annotations only. We also demonstrate the impact of transfer learning on the classification of emphysema using knowledge transfer from a pre-trained COPD classification model.

Understanding factors contributing to premature mortality is critical for public health planning. This study examines the relationships between premature death rates and multiple risk factors across several Texas counties, utilizing EPA air quality data, Census information, and county health records from recent years. We analyze the impact of air quality (PM2.5 levels), socioeconomic factors (median household income), and health conditions (COPD prevalence) through statistical analysis and modeling techniques. Results reveal COPD prevalence as a strong predictor of premature death rates, with higher prevalence associated with a substantial increase in years of potential life lost. While socioeconomic factors show a significant negative correlation, air quality demonstrates more complex indirect relationships. These findings emphasize the need for integrated public health interventions that prioritize key health conditions while addressing underlying socioeconomic disparities.

Chronic Obstructive Pulmonary Disorder (COPD) is an irreversible and progressive disease which is highly heritable. Clinically, COPD is defined using the summary measures derived from a spirometry test but these are not always adequate. Here we show that using the high-dimensional raw spirogram can provide a richer signal compared to just using the summary measures. We design a transformer-based deep learning technique to process the raw spirogram values along with demographic information and predict clinically-relevant endpoints related to COPD. Our method is able to perform better than prior works while being more computationally efficient. Using the weights learned by the model, we make the framework more interpretable by identifying parts of the spirogram that are important for the model predictions. Pairing up with a board-certified pulmonologist, we also provide clinical insights into the different aspects of the spirogram and show that the explanations obtained from the model align with underlying medical knowledge.

In the healthcare industry, researchers have been developing machine learning models to automate diagnosing patients with respiratory illnesses based on their breathing patterns. However, these models do not consider the demographic biases, particularly sex bias, that often occur when models are trained with a skewed patient dataset. Hence, it is essential in such an important industry to reduce this bias so that models can make fair diagnoses. In this work, we examine the bias in models used to detect breathing patterns of two major respiratory diseases, i.e., chronic obstructive pulmonary disease (COPD) and COVID-19. Using decision tree models trained with audio recordings of breathing patterns obtained from two open-source datasets consisting of 29 COPD and 680 COVID-19-positive patients, we analyze the effect of sex bias on the models. With a threshold optimizer and two constraints (demographic parity and equalized odds) to mitigate the bias, we witness 81.43% (demographic parity difference) and 71.81% (equalized odds difference) improvements. These findings are statistically significant.

Chronic obstructive pulmonary disease (COPD) is a serious inflammatory lung disease affecting millions of people around the world. Due to an obstructed airflow from the lungs, it also becomes manifest in patients' vocal behaviour. Of particular importance is the detection of an exacerbation episode, which marks an acute phase and often requires hospitalisation and treatment. Previous work has shown that it is possible to distinguish between a pre- and a post-treatment state using automatic analysis of read speech. In this contribution, we examine whether sustained vowels can provide a complementary lens for telling apart these two states. Using a cohort of 50 patients, we show that the inclusion of sustained vowels can improve performance to up to 79\% unweighted average recall, from a 71\% baseline using read speech. We further identify and interpret the most important acoustic features that characterise the manifestation of COPD in sustained vowels.

Classification of heterogeneous diseases is challenging due to their complexity, variability of symptoms and imaging findings. Chronic Obstructive Pulmonary Disease (COPD) is a prime example, being underdiagnosed despite being the third leading cause of death. Its sparse, diffuse and heterogeneous appearance on computed tomography challenges supervised binary classification. We reformulate COPD binary classification as an anomaly detection task, proposing cOOpD: heterogeneous pathological regions are detected as Out-of-Distribution (OOD) from normal homogeneous lung regions. To this end, we learn representations of unlabeled lung regions employing a self-supervised contrastive pretext model, potentially capturing specific characteristics of diseased and healthy unlabeled regions. A generative model then learns the distribution of healthy representations and identifies abnormalities (stemming from COPD) as deviations. Patient-level scores are obtained by aggregating region OOD scores. We show that cOOpD achieves the best performance on two public datasets, with an increase of 8.2% and 7.7% in terms of AUROC compared to the previous supervised state-of-the-art. Additionally, cOOpD yi

Physical activity plays a significant role in the well-being of individuals with Chronic obstructive Pulmonary Disease (COPD). Specifically, it has been directly associated with changes in hospitalization rates for these patients. However, previous investigations have primarily been conducted in a cross-sectional or longitudinal manner and have not considered a continuous perspective. Using the telEPOC program we use telemonitoring data to analyze the impact of physical activity adopting a functional data approach. However, Traditional functional data methods, including functional regression models, typically assume a consistent data domain. However, the data in the telEPOC program exhibits variable domains, presenting a challenge since the majority of functional data methods, are based on the fact that data are observed in the same domain. To address this challenge, we introduce a novel fully functional methodology tailored to variable domain functional data, eliminating the need for data alignment, which can be computationally taxing. Although models designed for variable domain data are relatively scarce and may have inherent limitations in their estimation methods, our approach

Chronic Obstructive Pulmonary Disorder (COPD) is a prevalent respiratory disease that significantly impacts the quality of life of affected individuals. This paper presents COPDFlowNet, a novel deep-learning framework that leverages a custom Generative Adversarial Network (GAN) to generate synthetic Computational Fluid Dynamics (CFD) velocity flow field images specific to the trachea of COPD patients. These synthetic images serve as a valuable resource for data augmentation and model training. Additionally, COPDFlowNet incorporates a custom Convolutional Neural Network (CNN) architecture to predict the location of the obstruction site.