Abstract--Background: Automated analysis of lung sound auscultation is essential for monitoring respiratory health, particularly in regions with a shortage of skilled healthcare workers. Although respiratory sound classification has been widely studied in adults, its application in pediatric populations, especially in children under six years of age remains underexplored. Developmental changes in pediatric lungs substantially modify the acoustic properties of respiratory sounds, requiring classification approaches tailored specifically to this age group. Methods: T o address this challenge, we propose a multistage hybrid CNN-Transformer framework that integrates CNN-extracted features with an attention-based architecture for pediatric respiratory disease classification. Scalogram images were generated from both full recordings and individual breath events to capture multi-resolution representations of respiratory sounds. T o mitigate class imbalance, class-wise focal loss was applied during model training. Results: The proposed model achieved an overall score of 0.9039 in binary event classification At the recording level, the model obtained scores of 0.720 for ternary classification and 0.571 for multiclass classification. These results outperform the previous best-performing models by 3.81% and 5.94%, respectively. Conclusion: Our findings demonstrate that the proposed hybrid CNN-Transformer framework effectively captures the unique acoustic features of pediatric lung sounds.

This paper presents an explainable artificial intelligence (XAI)-based framework for the spectral analysis of cough sounds associated with chronic respiratory diseases, with a particular focus on Chronic Obstructive Pulmonary Disease (COPD). A Convolutional Neural Network (CNN) is trained on time-frequency representations of cough signals, and occlusion maps are used to identify diagnostically relevant regions within the spectrograms. These highlighted areas are subsequently decomposed into five frequency subbands, enabling targeted spectral feature extraction and analysis. The results reveal that spectral patterns differ across subbands and disease groups, uncovering complementary and compensatory trends across the frequency spectrum. Noteworthy, the approach distinguishes COPD from other respiratory conditions, and chronic from non-chronic patient groups, based on interpretable spectral markers. These findings provide insight into the underlying pathophysiological characteristics of cough acoustics and demonstrate the value of frequency-resolved, XAI-enhanced analysis for biomedical signal interpretation and translational respiratory disease diagnostics.

This paper proposes an eXplainable Artificial Intelligence (XAI)-driven methodology to enhance the understanding of cough sound analysis for respiratory disease management. We employ occlusion maps to highlight relevant spectral regions in cough spectrograms processed by a Convolutional Neural Network (CNN). Subsequently, spectral analysis of spectrograms weighted by these occlusion maps reveals significant differences between disease groups, particularly in patients with COPD, where cough patterns appear more variable in the identified spectral regions of interest. This contrasts with the lack of significant differences observed when analyzing raw spectrograms. The proposed approach extracts and analyzes several spectral features, demonstrating the potential of XAI techniques to uncover disease-specific acoustic signatures and improve the diagnostic capabilities of cough sound analysis by providing more interpretable results.

The labor-intensive nature of medical data annotation presents a significant challenge for respiratory disease diagnosis, resulting in a scarcity of high-quality labeled datasets in resource-constrained settings. Moreover, patient privacy concerns complicate the direct sharing of local medical data across institutions, and existing centralized data-driven approaches, which rely on amounts of available data, often compromise data privacy. This study proposes a federated few-shot learning framework with privacy-preserving mechanisms to address the issues of limited labeled data and privacy protection in diagnosing respiratory diseases. In particular, a meta-stochastic gradient descent algorithm is proposed to mitigate the overfitting problem that arises from insufficient data when employing traditional gradient descent methods for neural network training. Furthermore, to ensure data privacy against gradient leakage, differential privacy noise from a standard Gaussian distribution is integrated into the gradients during the training of private models with local data, thereby preventing the reconstruction of medical images. Given the impracticality of centralizing respiratory disease data dispersed across various medical institutions, a weighted average algorithm is employed to aggregate local diagnostic models from different clients, enhancing the adaptability of a model across diverse scenarios. Experimental results show that the proposed method yields compelling results with the implementation of differential privacy, while effectively diagnosing respiratory diseases using data from different structures, categories, and distributions.

Respiratory auscultation is crucial for early detection of pediatric pneumonia, a condition that can quickly worsen without timely intervention. In areas with limited physician access, effective auscultation is challenging. We present a smartphone-based system that leverages built-in microphones and advanced deep learning algorithms to detect abnormal respiratory sounds indicative of pneumonia risk. Our end-to-end deep learning framework employs domain generalization to integrate a large electronic stethoscope dataset with a smaller smartphone-derived dataset, enabling robust feature learning for accurate respiratory assessments without expensive equipment. The accompanying mobile application guides caregivers in collecting high-quality lung sound samples and provides immediate feedback on potential pneumonia risks. User studies show strong classification performance and high acceptance, demonstrating the system's ability to facilitate proactive interventions and reduce preventable childhood pneumonia deaths. By seamlessly integrating into ubiquitous smartphones, this approach offers a promising avenue for more equitable and comprehensive remote pediatric care.

Chest X-rays (X-ray images) have been proven to be effective for the diagnosis of chest diseases, including Pneumonia, Lung Opacity, and COVID-19. However, relying on traditional medical methods for diagnosis from X-ray images is prone to delays and inaccuracies because the medical personnel who evaluate the X-ray images may have preconceived biases. For this reason, researchers have proposed the use of deep learning-based techniques to facilitate the diagnosis process. The preeminent method is the use of sophisticated Convolutional Neural Networks (CNNs). In this paper, we propose a novel detection model named \textbf{AttCDCNet} for the task of X-ray image diagnosis, enhancing the popular DenseNet121 model by adding an attention block to help the model focus on the most relevant regions, using focal loss as a loss function to overcome the imbalance of the dataset problem, and utilizing depth-wise convolution to reduce the parameters to make the model lighter. Through extensive experimental evaluations, the proposed model demonstrates exceptional performance, showing better results than the original DenseNet121. The proposed model achieved an accuracy, precision and recall of 94.94%, 95.14% and 94.53%, respectively, on the COVID-19 Radiography Dataset.

Voice signals originating from the respiratory tract are utilized as valuable acoustic biomarkers for the diagnosis and assessment of respiratory diseases. Among the employed acoustic features, Mel Frequency Cepstral Coefficients (MFCC) is widely used for automatic analysis, with MFCC extraction commonly relying on default parameters. However, no comprehensive study has systematically investigated the impact of MFCC extraction parameters on respiratory disease diagnosis. In this study, we address this gap by examining the effects of key parameters, namely the number of coefficients, frame length, and hop length between frames, on respiratory condition examination. Our investigation uses four datasets: the Cambridge COVID-19 Sound database, the Coswara dataset, the Saarbrucken Voice Disorders (SVD) database, and a TACTICAS dataset. The Support Vector Machine (SVM) is employed as the classifier, given its widespread adoption and efficacy. Our findings indicate that the accuracy of MFCC decreases as hop length increases, and the optimal number of coefficients is observed to be approximately 30. The performance of MFCC varies with frame length across the datasets: for the COVID-19 datasets (Cambridge COVID-19 Sound database and Coswara dataset), performance declines with longer frame lengths, while for the SVD dataset, performance improves with increasing frame length (from 50 ms to 500 ms). Furthermore, we investigate the optimized combination of these parameters and observe substantial enhancements in accuracy. Compared to the worst combination, the SVM model achieves an accuracy of 81.1%, 80.6%, and 71.7%, with improvements of 19.6%, 16.10%, and 14.90% for the Cambridge COVID-19 Sound database, the Coswara dataset, and the SVD dataset respectively.

This study aims to develop an auxiliary diagnostic system for classifying abnormal lung respiratory sounds, enhancing the accuracy of automatic abnormal breath sound classification through an innovative multi-label learning approach and multi-head attention mechanism. Addressing the issue of class imbalance and lack of diversity in existing respiratory sound datasets, our study employs a lightweight and highly accurate model, using a two-dimensional label set to represent multiple respiratory sound characteristics. Our method achieved a 59.2% ICBHI score in the four-category task on the ICBHI2017 dataset, demonstrating its advantages in terms of lightweight and high accuracy. This study not only improves the accuracy of automatic diagnosis of lung respiratory sound abnormalities but also opens new possibilities for clinical applications.

In response to the COVID-19 pandemic, the integration of interpretable machine learning techniques has garnered significant attention, offering transparent and understandable insights crucial for informed clinical decision making. This literature review delves into the applications of interpretable machine learning in predicting the prognosis of respiratory diseases, particularly focusing on COVID-19 and its implications for future research and clinical practice. We reviewed various machine learning models that are not only capable of incorporating existing clinical domain knowledge but also have the learning capability to explore new information from the data. These models and experiences not only aid in managing the current crisis but also hold promise for addressing future disease outbreaks. By harnessing interpretable machine learning, healthcare systems can enhance their preparedness and response capabilities, thereby improving patient outcomes and mitigating the impact of respiratory diseases in the years to come.

This paper proposes a weakly-supervised machine learning-based approach aiming at a tool to alert patients about possible respiratory diseases. Various types of pathologies may affect the respiratory system, potentially leading to severe diseases and, in certain cases, death. In general, effective prevention practices are considered as major actors towards the improvement of the patient's health condition. The proposed method strives to realize an easily accessible tool for the automatic diagnosis of respiratory diseases. Specifically, the method leverages Variational Autoencoder architectures permitting the usage of training pipelines of limited complexity and relatively small-sized datasets. Importantly, it offers an accuracy of 57 %, which is in line with the existing strongly-supervised approaches.