StethAid: A Digital Auscultation Platform for Pediatrics.

(1) Background: Mastery of auscultation can be challenging for many healthcare providers. Artificial intelligence (AI)-powered digital support is emerging as an aid to assist with the interpretation of auscultated sounds. A few AI-augmented digital stethoscopes exist but none are dedicated to pediatrics. Our goal was to develop a digital auscultation platform for pediatric medicine. (2) Methods: We developed StethAid-a digital platform for artificial intelligence-assisted auscultation and telehealth in pediatrics-that consists of a wireless digital stethoscope, mobile applications, customized patient-provider portals, and deep learning algorithms. To validate the StethAid platform, we characterized our stethoscope and used the platform in two clinical applications: (1) Still's murmur identification and (2) wheeze detection. The platform has been deployed in four children's medical centers to build the first and largest pediatric cardiopulmonary datasets, to our knowledge. We have trained and tested deep-learning models using these datasets. (3) Results: The frequency response of the StethAid stethoscope was comparable to those of the commercially available Eko Core, Thinklabs One, and Littman 3200 stethoscopes. The labels provided by our expert physician offline were in concordance with the labels of providers at the bedside using their acoustic stethoscopes for 79.3% of lungs cases and 98.3% of heart cases. Our deep learning algorithms achieved high sensitivity and specificity for both Still's murmur identification (sensitivity of 91.9% and specificity of 92.6%) and wheeze detection (sensitivity of 83.7% and specificity of 84.4%). (4) Conclusions: Our team has created a technically and clinically validated pediatric digital AI-enabled auscultation platform. Use of our platform could improve efficacy and efficiency of clinical care for pediatric patients, reduce parental anxiety, and result in cost savings.

Technical characterisation of digital stethoscopes: towards scalable artificial intelligence-based auscultation.

Digital stethoscopes can enable the development of integrated artificial intelligence (AI) systems that can remove the subjectivity of manual auscultation, improve diagnostic accuracy, and compensate for diminishing auscultatory skills. Developing scalable AI systems can be challenging, especially when acquisition devices differ and thus introduce sensor bias. To address this issue, a precise knowledge of these differences, i.e., frequency responses of these devices, is needed, but the manufacturers often do not provide complete device specifications. In this study, we reported an effective methodology for determining the frequency response of a digital stethoscope and used it to characterise three common digital stethoscopes: Littmann 3200, Eko Core, and Thinklabs One. Our results show significant inter-device variability in that the frequency responses of the three studied stethoscopes were distinctly different. A moderate intra-device variability was seen when comparing two separate units of Littmann 3200. The study highlights the need for normalisation across devices for developing successful AI-assisted auscultation and provides a technical characterisation approach as a first step to accomplish it.

Automated identification of innocent Still's murmur using a convolutional neural network.

Background: Still's murmur is the most prevalent innocent heart murmur of childhood. Auscultation is the primary clinical tool to identify this murmur as innocent. Whereas pediatric cardiologists routinely perform this task, primary care providers are less successful in distinguishing Still's murmur from the murmurs of true heart disease. This results in a large number of children with a Still's murmur being referred to pediatric cardiologists. Objectives: To develop a computer algorithm that can aid primary care providers to identify the innocent Still's murmur at the point of care, to substantially decrease over-referral. Methods: The study included Still's murmurs, pathological murmurs, other innocent murmurs, and normal (i.e., non-murmur) heart sounds of 1,473 pediatric patients recorded using a commercial electronic stethoscope. The recordings with accompanying clinical diagnoses provided by a pediatric cardiologist were used to train and test the convolutional neural network-based algorithm. Results: A comparative analysis showed that the algorithm using only the murmur sounds recorded at the lower left sternal border achieved the highest accuracy. The developed algorithm identified Still's murmur with 90.0% sensitivity and 98.3% specificity for the default decision threshold. The area under the receiver operating characteristic curve was 0.943. Conclusions: Still's murmur can be identified with high accuracy with the algorithm we developed. Using this approach, the algorithm could help to reduce the rate of unnecessary pediatric cardiologist referrals and use of echocardiography for a common benign finding.

Soybean cyst nematode detection and management: a review.

Soybeans play a key role in global food security. U.S. soybean yields, which comprise [Formula: see text] of the total soybeans planted in the world, continue to experience unprecedented grain loss due to the soybean cyst nematode (SCN) plant pathogen. SCN remains one of the primary disruptive pests despite the existence of advanced management techniques such as crop rotation and SCN-resistant varieties. SCN detection is a key step in managing this disease; however, early detection is challenging because soybeans do not show any above ground symptoms unless they  are significantly damaged. Direct soil sampling remains the most common method for SCN detection, however, this method has several problems. For example, the threshold damage methods-adopted by most of the laboratories to make recommendations-is not reliable as it does not consider soil pH, N, P, and K values and relies solely on the egg count instead of assessment of the root infection. To overcome the challenges of manual soil sampling methods, deep learning and hyperspectral imaging are important current topics in precision agriculture for plant disease detection and have been proposed as cost-effective and efficient detection methods that can work at scale. We have reviewed more than 150 research papers focusing on soybean cyst nematodes with an emphasis on deep learning techniques for detection and management. First: we describe soybean vegetation and reproduction stages, SCN life cycles, and factors influencing this disease. Second: we highlight the impact of SCN on soybean yield loss and the challenges associated with its detection. Third: we describe direct sampling methods in which the soil samples are procured and analyzed to evaluate SCN egg counts. Fourth: we highlight the advantages and limitations of these direct methods, then review computer vision- and remote sensing-based detection methods: data collection using ground, aerial, and satellite approaches followed by a review of machine learning methods for image analysis-based soybean cyst nematode detection. We highlight the evaluation approaches and the advantages of overall detection workflow in high-performance and big data environments. Lastly, we discuss various management approaches, such as crop rotation, fertilization, SCN resistant varieties such as PI 88788, and SCN's increasing resistance to these strategies. We review machine learning approaches for soybean crop yield forecasting as well as the influence of pesticides, herbicides, and fertilizers on SCN infestation reduction. We provide recommendations for soybean research using deep learning and hyperspectral imaging to accommodate the lack of the ground truth data and training and testing methodologies, such as data augmentation and transfer learning, to achieve a high level of detection accuracy while keeping costs as low as possible.

Neuromorphic Architecture Accelerated Automated Seizure Detection in Multi-Channel Scalp EEG.

Epileptic focal seizures can be localized in the brain using tracer injections during or immediately after the incidence of a seizure. A real-time automated seizure detection system with minimal latency can help time the injection properly to find the seizure origin accurately. Reliable real-time seizure detection systems have not been clinically reported yet. We developed an anomaly detection-based automated seizure detection system, using scalp-electroencephalogram (EEG) data, which can be trained using a few seizure sessions, and implemented it on commercially available hardware with parallel, neuromorphic architecture-the NeuroStack. We extracted nonlinear, statistical, and discrete wavelet decomposition features, and we developed a graphical user interface and traditional feature selection methods to select the most discriminative features. We investigated Reduced Coulomb Energy (RCE) networks and K-Nearest Neighbors (k-NN) for its several advantages, such as fast learning no local minima problem. We obtained a maximum sensitivity of 91.14%±1.77% and a specificity of 98.77%±0.57% with 5 s epoch duration. The system's latency was 12 s, which is within most seizure event windows, which last for an average duration of 60 s. Our results showed that the CD feature consumes large computation resources and excluding it can reduce the latency to 3.6 s but at the cost of lower performance 80% sensitivity and 97% specificity. We demonstrated that the proposed methodology achieves a high specificity and an acceptable sensitivity within a short delay. Our results indicated also that individual-based RCE are superior to population-based RCE. The proposed RCE networks has been compared to SVM and ANN as a baseline for comparison as they are the most common machine learning seizure detection methods. SVM and ANN-based systems were trained on the same data as RCE and K-NN with features optimized specifically for them. RCE nets are superior to SVM and ANN. The proposed model also achieves comparable performance to the state-of-the-art deep learning techniques while not requiring a sizeable database, which is often expensive to build. These numbers indicate that the system is viable as a trigger mechanism for tracer injection.

An Instance Segmentation and Clustering Model for Energy Audit Assessments in Built Environments: A Multi-Stage Approach.

Heat loss quantification (HLQ) is an essential step in improving a building's thermal performance and optimizing its energy usage. While this problem is well-studied in the literature, most of the existing studies are either qualitative or minimally driven quantitative studies that rely on localized building envelope points and are, thus, not suitable for automated solutions in energy audit applications. This research work is an attempt to fill this gap of knowledge by utilizing intensive thermal data (on the order of 100,000 plus images) and constitutes a relatively new area of analysis in energy audit applications. Specifically, we demonstrate a novel process using deep-learning methods to segment more than 100,000 thermal images collected from an unmanned aerial system (UAS). To quantify the heat loss for a building envelope, multiple stages of computations need to be performed: object detection (using Mask-RCNN/Faster R-CNN), estimating the surface temperature (using two clustering methods), and finally calculating the overall heat transfer coefficient (e.g., the U-value). The proposed model was applied to eleven academic campuses across the state of North Dakota. The preliminary findings indicate that Mask R-CNN outperformed other instance segmentation models with an mIOU of 73% for facades, 55% for windows, 67% for roofs, 24% for doors, and 11% for HVACs. Two clustering methods, namely K-means and threshold-based clustering (TBC), were deployed to estimate surface temperatures with TBC providing consistent estimates across all times of the day over K-means. Our analysis demonstrated that thermal efficiency not only depended on the accurate acquisition of thermal images but also relied on other factors, such as the building geometry and seasonal weather parameters, such as the outside/inside building temperatures, wind, time of day, and indoor heating/cooling conditions. Finally, the resultant U-values of various building envelopes were compared with recommendations from the American Society of Heating, Refrigerating, and Air-conditioning Engineers (ASHRAE) building standards.

A Comprehensive Survey on Spectrum Sensing in Cognitive Radio Networks: Recent Advances, New Challenges, and Future Research Directions.

Cognitive radio technology has the potential to address the shortage of available radio spectrum by enabling dynamic spectrum access. Since its introduction, researchers have been working on enabling this innovative technology in managing the radio spectrum. As a result, this research field has been progressing at a rapid pace and significant advances have been made. To help researchers stay abreast of these advances, surveys and tutorial papers are strongly needed. Therefore, in this paper, we aimed to provide an in-depth survey on the most recent advances in spectrum sensing, covering its development from its inception to its current state and beyond. In addition, we highlight the efficiency and limitations of both narrowband and wideband spectrum sensing techniques as well as the challenges involved in their implementation. TV white spaces are also discussed in this paper as the first real application of cognitive radio. Last but by no means least, we discuss future research directions. This survey paper was designed in a way to help new researchers in the field to become familiar with the concepts of spectrum sensing, compressive sensing, and machine learning, all of which are the enabling technologies of the future networks, yet to help researchers further improve the efficiently of spectrum sensing.

Wideband Spectrum Sensing: A Bayesian Compressive Sensing Approach.

Sensing the wideband spectrum is an important process for next-generation wireless communication systems. Spectrum sensing primarily aims at detecting unused spectrum holes over wide frequency bands so that secondary users can use them to meet their requirements in terms of quality-of-service. However, this sensing process requires a great deal of time, which is not acceptable for timely communications. In addition, the sensing measurements are often affected by uncertainty. In this paper, we propose an approach based on Bayesian compressive sensing to speed up the process of sensing and to handle uncertainty. This approach takes only a few measurements using a Toeplitz matrix, recovers the wideband signal from a few measurements using Bayesian compressive sensing via fast Laplace prior, and detects either the presence or absence of the primary user using an autocorrelation-based detection method. The proposed approach was implemented using GNU Radio software and Universal Software Radio Peripheral units and was tested on real-world signals. The results show that the proposed approach speeds up the sensing process by minimizing the number of samples while achieving the same performance as Nyquist-based sensing techniques regarding both the probabilities of detection and false alarm.