搜索结果：Paediatric respiratory reviews

Automated stuttering detection (ASD) systems struggle with paediatric speech due to high acoustic variability in developing voices and the subtle distinction between pathological stuttering and typical developmental disfluencies. We introduce Paediatric-HGNN, a framework using a Context-aware Part-whole Interaction Network (CaPIN) tailored for paediatric data. Instead of conventional 1D signal modelling, our approach builds a heterogeneous graph capturing hierarchical relationships between lexical units (word nodes) and fine-grained acoustic segments (frame nodes). Trained on curated paediatric corpora (UCLASS and FluencyBank), Paediatric-HGNN achieves 82.4% weighted accuracy and a Typical Disfluency F1-score of 0.386. Modelling hierarchical lexical-acoustic interactions captures developmental "searching" behaviour, offering a more robust and interpretable tool for early clinical intervention.

Auscultatory analysis using an electronic stethoscope has attracted increasing attention in the clinical diagnosis of respiratory diseases. Recently, neural networks have been applied to assist in respiratory sound classification with achievements. However, it remains challenging due to the scarcity of abnormal respiratory sound. In this paper, we propose a novel architecture, namely Waveform-Logmel audio neural networks (WLANN), which uses both waveform and log-mel spectrogram as the input features and uses Bidirectional Gated Recurrent Units (Bi-GRU) to context model the fused features. Experimental results of our WLANN applied to SPRSound respiratory dataset show that the proposed framework can effectively distinguish pathological respiratory sound classes, outperforming the previous studies, with 90.3% in sensitivity and 93.6% in total score. Our study demonstrates the high effectiveness of the WLANN in the diagnosis of respiratory diseases.

Paediatric obstructive sleep apnoea (OSA) is clinically significant yet difficult to diagnose, as children poorly tolerate sensor-based polysomnography. Acoustic monitoring provides a non-invasive alternative for home-based OSA screening, but limited paediatric data hinders the development of robust deep learning approaches. This paper proposes a transfer learning framework that adapts acoustic models pretrained on adult sleep data to paediatric OSA detection, incorporating SpO2-based desaturation patterns to enhance model training. Using a large adult sleep dataset (157 nights) and a smaller paediatric dataset (15 nights), we systematically evaluate (i) single- versus multi-task learning, (ii) encoder freezing versus full fine-tuning, and (iii) the impact of delaying SpO2 labels to better align them with the acoustics and capture physiologically meaningful features. Results show that fine-tuning with SpO2 integration consistently improves paediatric OSA detection compared with baseline models without adaptation. These findings demonstrate the feasibility of transfer learning for home-based OSA screening in children and offer its potential clinical value for early diagnosis.

Electronic Patient Record (EPR) systems contain valuable clinical information, but much of it is trapped in unstructured text, limiting its use for research and decision-making. Large language models can extract such information but require substantial computational resources to run locally, and sending sensitive clinical data to cloud-based services, even when deidentified, raises significant patient privacy concerns. In this study, we develop a resource-efficient semi-automated annotation workflow using small language models (SLMs) to extract structured information from unstructured EPR data, focusing on paediatric histopathology reports. As a proof-of-concept, we apply the workflow to paediatric renal biopsy reports, a domain chosen for its constrained diagnostic scope and well-defined underlying biology. We develop the workflow iteratively with clinical oversight across three meetings, manually annotating 400 reports from a dataset of 2,111 at Great Ormond Street Hospital as a gold standard, while developing an automated information extraction approach using SLMs. We frame extraction as a Question-Answering task grounded by clinician-guided entity guidelines and few-shot exampl

MRI is preferred over CT in paediatric imaging because it avoids ionising radiation, but its use in spine deformity assessment is largely limited by the lack of automated, high-resolution 3D bony reconstruction, which continues to rely on CT. MRI-based 3D reconstruction remains impractical due to manual workflows and the scarcity of labelled full-spine datasets. This study introduces an AI framework that enables fully automated thoracolumbar spine (T1-L5) segmentation and 3D reconstruction from MRI alone. Historical low-dose CT scans from adolescent idiopathic scoliosis (AIS) patients were converted into MRI-like images using a GAN and combined with existing labelled thoracic MRI data to train a U-Net-based model. The resulting algorithm accurately generated continuous thoracolumbar 3D reconstructions, improved segmentation accuracy (88% Dice score), and reduced processing time from approximately 1 hour to under one minute, while preserving AIS-specific deformity features. This approach enables radiation-free 3D deformity assessment from MRI, supporting clinical evaluation, surgical planning, and navigation in paediatric spine care.

This study investigates the relationship between longitudinal serum creatinine measurements and the risk of adverse kidney outcomes in paediatric patients with auto-immune disorders at Great Ormond Street Hospital for Children NHS Foundation Trust, London. To jointly analyse repeated biomarker measurements and time-to-event outcomes, we employed a joint modelling framework that combines the creatinine trajectories with the time to death or diagnosis of acute kidney injury or chronic kidney disease. Covariates considered in analysis included demographic and clinical characteristics. The results demonstrate a strong association between evolving creatinine profiles and the risk of the composite event. Specifically, treatment with corticosteroids and calcium channel blockers was associated with an increased event risk, whereas immunosuppressive therapy was associated with a reduced risk. The longitudinal component showed that creatinine trajectories were significantly influenced by age and BMI z-score. To demonstrate the practical utility of the proposed framework, dynamic risk predictions were generated using patients' observed creatinine trajectories. Model performance was compared u

Respiratory diseases impose a significant burden on global health, with current diagnostic and management practices primarily reliant on specialist clinical testing. This work aims to develop machine learning-based algorithms to facilitate at-home respiratory disease monitoring and assessment for patients undergoing continuous positive airway pressure (CPAP) therapy. Data were collected from 30 healthy adults, encompassing respiratory pressure, flow, and dynamic thoraco-abdominal circumferential measurements under three breathing conditions: normal, panting, and deep breathing. Various machine learning models, including the random forest classifier, logistic regression, and support vector machine (SVM), were trained to predict breathing types. The random forest classifier demonstrated the highest accuracy, particularly when incorporating breathing rate as a feature. These findings support the potential of AI-driven respiratory monitoring systems to transition respiratory assessments from clinical settings to home environments, enhancing accessibility and patient autonomy. Future work involves validating these models with larger, more diverse populations and exploring additional mac

Respiratory motion limits the accuracy and precision of abdominal percutaneous procedures. In this paper, respiratory motion is compensated robotically using motion estimation models. Additionally, a teleoperated insertion is performed using proximity-based haptic feedback to guide physicians during insertion, enabling a radiation-free remote insertion for the end-user. The study has been validated using a robotic liver phantom, and five insertions were performed. The resulting motion estimation errors were below 3 mm for all directions of motion, and the overall resulting 3D insertion errors were 2.60, 7.75, and 2.86 mm for the superior-inferior, lateral, and anterior-posterior directions of motion, respectively. The proposed approach is expected to minimize the chances of inaccurate treatment or diagnosis due to respiratory-induced motion and reduce radiation exposure.

Paediatric kidney disease varies widely in its presentation and progression, which calls for continuous monitoring of renal function. Using electronic health records collected between 2019 and 2025 at Great Ormond Street Hospital, a leading UK paediatric hospital, we explored a temporal modelling approach that integrates longitudinal laboratory sequences with demographic information. A recurrent neural model trained on these data was used to predict whether a child would record an abnormal serum creatinine value within the following thirty days. Framed as a pilot study, this work provides an initial demonstration that simple temporal representations can capture useful patterns in routine paediatric data and lays the groundwork for future multimodal extensions using additional clinical signals and more detailed renal outcomes.

Pneumonia remains one of the leading causes of death among children worldwide, underscoring a critical need for fast and accurate diagnostic tools. In this paper, we propose an interpretable deep learning model on Residual Networks (ResNets) for automatically diagnosing paediatric pneumonia on chest X-rays. We enhance interpretability through Bayesian Gradient-weighted Class Activation Mapping (BayesGrad-CAM), which quantifies uncertainty in visual explanations, and which offers spatial locations accountable for the decision-making process of the model. Our ResNet-50 model, trained on a large paediatric chest X-rays dataset, achieves high classification accuracy (95.94%), AUC-ROC (98.91%), and Cohen's Kappa (0.913), accompanied by clinically meaningful visual explanations. Our findings demonstrate that high performance and interpretability are not only achievable but critical for clinical AI deployment.

Standardization of data items collected in paediatric clinical trials is an important but challenging issue. The Clinical Data Interchange Standards Consortium (CDISC) data standards are well understood by the pharmaceutical industry but lack the implementation of some paediatric specific concepts. When a paediatric concept is absent within CDISC standards, companies and research institutions take multiple approaches in the collection of paediatric data, leading to different implementations of standards and potentially limited utility for reuse. To overcome these challenges, the conect4children consortium has developed a cross-cutting paediatric data dictionary (CCPDD). The dictionary was built over three phases - scoping (including a survey sent out to ten industrial and 34 academic partners to gauge interest), creation of a longlist and consensus building for the final set of terms. The dictionary was finalized during a workshop with attendees from academia, hospitals, industry and CDISC. The attendees held detailed discussions on each data item and participated in the final vote on the inclusion of the item in the CCPDD. Nine industrial and 34 academic partners responded to the

This paper presents a deep learning system applied for detecting anomalies from respiratory sound recordings. Our system initially performs audio feature extraction using Continuous Wavelet transformation. This transformation converts the respiratory sound input into a two-dimensional spectrogram where both spectral and temporal features are presented. Then, our proposed deep learning architecture inspired by the Inception-residual-based backbone performs the spatial-temporal focusing and multi-head attention mechanism to classify respiratory anomalies. In this work, we evaluate our proposed models on the benchmark SPRSound (The Open-Source SJTU Paediatric Respiratory Sound) database proposed by the IEEE BioCAS 2023 challenge. As regards the Score computed by an average between the average score and harmonic score, our robust system has achieved Top-1 performance with Scores of 0.810, 0.667, 0.744, and 0.608 in Tasks 1-1, 1-2, 2-1, and 2-2, respectively.

This paper presents a deep learning system applied for detecting anomalies from respiratory sound recordings. Initially, our system begins with audio feature extraction using Gammatone and Continuous Wavelet transformation. This step aims to transform the respiratory sound input into a two-dimensional spectrogram where both spectral and temporal features are presented. Then, our proposed system integrates Inception-residual-based backbone models combined with multi-head attention and multi-objective loss to classify respiratory anomalies. Instead of applying a simple concatenation approach by combining results from various spectrograms, we propose a Linear combination, which has the ability to regulate equally the contribution of each individual spectrogram throughout the training process. To evaluate the performance, we conducted experiments over the benchmark dataset of SPRSound (The Open-Source SJTU Paediatric Respiratory Sound) proposed by the IEEE BioCAS 2022 challenge. As regards the Score computed by an average between the average score and harmonic score, our proposed system gained significant improvements of 9.7%, 15.8%, 17.8%, and 16.1% in Task 1-1, Task 1-2, Task 2-1, an

BACKGROUND: Randomized controlled trials (RCTs) are the gold standard design of clinical research to assess interventions. However, RCTs cannot always be applied for practical or ethical reasons. To investigate the current practices in rare diseases, we review evaluations of therapeutic interventions in paediatric multiple sclerosis (MS) and Creutzfeldt-Jakob disease (CJD). In particular, we shed light on the endpoints used, the study designs implemented and the statistical methodologies applied. METHODS: We conducted literature searches to identify relevant primary studies. Data on study design, objectives, endpoints, patient characteristics, randomization and masking, type of intervention, control, withdrawals and statistical methodology were extracted from the selected studies. The risk of bias and the quality of the studies were assessed. RESULTS: Twelve (seven) primary studies on paediatric MS (CJD) were included in the qualitative synthesis. No double-blind, randomized placebo-controlled trial for evaluating interventions in paediatric MS has been published yet. Evidence from one open-label RCT is available. The observational studies are before-after studies or controlled stu

Much of the information of breathing is contained within the photoplethysmography (PPG) signal, through changes in venous blood flow, heart rate and stroke volume. We aim to leverage this fact, by employing a novel deep learning framework which is a based on a repurposed convolutional autoencoder. Our model aims to encode all of the relevant respiratory information contained within photoplethysmography waveform, and decode it into a waveform that is similar to a gold standard respiratory reference. The model is employed on two photoplethysmography data sets, namely Capnobase and BIDMC. We show that the model is capable of producing respiratory waveforms that approach the gold standard, while in turn producing state of the art respiratory rate estimates. We also show that when it comes to capturing more advanced respiratory waveform characteristics such as duty cycle, our model is for the most part unsuccessful. A suggested reason for this, in light of a previous study on in-ear PPG, is that the respiratory variations in finger-PPG are far weaker compared with other recording locations. Importantly, our model can perform these waveform estimates in a fraction of a millisecond, givin

This paper describes a rapid feasibility study of using GPT-4, a large language model (LLM), to (semi)automate data extraction in systematic reviews. Despite the recent surge of interest in LLMs there is still a lack of understanding of how to design LLM-based automation tools and how to robustly evaluate their performance. During the 2023 Evidence Synthesis Hackathon we conducted two feasibility studies. Firstly, to automatically extract study characteristics from human clinical, animal, and social science domain studies. We used two studies from each category for prompt-development; and ten for evaluation. Secondly, we used the LLM to predict Participants, Interventions, Controls and Outcomes (PICOs) labelled within 100 abstracts in the EBM-NLP dataset. Overall, results indicated an accuracy of around 80%, with some variability between domains (82% for human clinical, 80% for animal, and 72% for studies of human social sciences). Causal inference methods and study design were the data extraction items with the most errors. In the PICO study, participants and intervention/control showed high accuracy (>80%), outcomes were more challenging. Evaluation was done manually; scoring

In this study, we investigate how supporting serendipitous discovery and analysis of online product reviews can encourage readers to explore reviews more comprehensively prior to making purchase decisions. We propose two interventions -- Exploration Metrics that can help readers understand and track their exploration patterns through visual indicators and a Bias Mitigation Model that intends to maximize knowledge discovery by suggesting sentiment and semantically diverse reviews. We designed, developed, and evaluated a text analytics system called Serendyze, where we integrated these interventions. We asked 100 crowd workers to use Serendyze to make purchase decisions based on product reviews. Our evaluation suggests that exploration metrics enabled readers to efficiently cover more reviews in a balanced way, and suggestions from the bias mitigation model influenced readers to make confident data-driven decisions. We discuss the role of user agency and trust in text-level analysis systems and their applicability in domains beyond review exploration.

Stress impacts driving-related cognitive functions like attention and decision-making, and may arise in automated vehicles due to non-driving tasks. Unobtrusive relaxation techniques are needed to regulate stress without distracting from driving. Tactile wearables have shown efficacy in stress regulation through respiratory guidance, but individual variations may affect their efficacy. This study assessed slow-breathing tactile guidance under different stress levels on 85 participants. Physiological, behavioral and subjective data were collected. The influence of individual variations (e.g., driving habits and behavior, personality) using logistic regression analysis was explored. Participants could follow the guidance and adjust breathing while driving, but subjective efficacy depended on individual variations linked to different efficiency in using the technique, in relation with its attentional cost. An influence of factors linked to the evaluation of context criticality was also found. The results suggest that considering individual and contextual variations is crucial in designing and using such techniques in demanding driving contexts. In this line some design recommendations

This paper presents a robust deep learning framework developed to detect respiratory diseases from recordings of respiratory sounds. The complete detection process firstly involves front end feature extraction where recordings are transformed into spectrograms that convey both spectral and temporal information. Then a back-end deep learning model classifies the features into classes of respiratory disease or anomaly. Experiments, conducted over the ICBHI benchmark dataset of respiratory sounds, evaluate the ability of the framework to classify sounds. Two main contributions are made in this paper. Firstly, we provide an extensive analysis of how factors such as respiratory cycle length, time resolution, and network architecture, affect final prediction accuracy. Secondly, a novel deep learning based framework is proposed for detection of respiratory diseases and shown to perform extremely well compared to state of the art methods.