Made available in DSpace on 2016-01-26T12:51:21Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-03-31 / Acute respiratory infections, especially upper respiratory tract infections (URTI), are the most frequent causes of infantile morbidity in the world. Day-care facilities are closed, with great circulation of people and infectious agents as well, being therefore prone to the spreading of viral respiratory infections. Mathematical epidemic models are quantitative analysis methods that might be used for understanding and predicting the transmission dynamics of infectious diseases. Objective: Verify the monthly incidence of URTI, of 8 respiratory viruses, and to simulate a mathematical model, evaluating its qualitative and quantitative behavior regarding true data from URTI in school of infantile education in integral period children. Casuistic and Methods: From July 2003 to July 2004, all children (173) in the school of infantile education in integral period were followed from 1.6 to 12 months. Them presenting signs of respiratory infections were examined and their nasopharyngeal aspirate specimen was collected, in a total of 255 analyses. Soon after, specific multiplex trial of reverse transcription, followed by the polymerase chain reaction (multiplex RT-PCR), was accomplished for identification of the 8 viruses related to respiratory infections. Results and Conclusions: The average incidence of URTI was 2.33 episodes per child-year. URTI was observed throughout the year of study, especially in the fall and winter, lowering during spring and presenting few cases in summer. Rhinovirus presented the greatest incidence, being observed throughout the period of study. Influenza B, respiratory syncytial virus (RSV), and metapneumovirus presented lower incidence, especially during fall and winter. URTI caused by other analyzed viruses - influenza A, parainfluenza 1, 2, and 3 were rare. The evaluation of the mathematical model through simulations has provided promising results, as it was possible to get true data reproduction. The model is promising. Having its suppositions adequate, it might be useful for understanding the dynamics and spreading of diseases, planning and evaluating prevention and immunization strategies in epidemics. / As infecções respiratórias agudas, em especial as infecções das vias aeríferas superiores (IVAS), são as causas mais freqüentes de morbidade infantil no mundo. As creches são ambientes fechados, onde há grande circulação de pessoas e também de agentes infecciosos, sendo então favoráveis à disseminação de infecções respiratórias virais. Os modelos epidemiológicos matemáticos são métodos de análise quantitativos e podem ser usados para compreensão e predição da dinâmica de transmissão de uma doença infecciosa. Objetivo: Verificar a incidência mensal de IVAS, de 8 vírus respiratórios, e simular um modelo matemático, avaliando seu comportamento qualitativo e quantitativo em relação aos dados reais de IVAS nas crianças da Escola de Educação Infantil em período integral. Casuística e Método: Todas as crianças (173) que freqüentaram a escola no período de julho de 2003 a julho de 2004 foram acompanhadas por 1,6 a 12 meses. Elas apresentaram sinais de IVAS foram examinadas e tiveram coletado espécime de aspirado de nasofaringe, perfazendo um total de 255 análises. Em seguida, foi realizado ensaio específico multiplex de transcrição reversa seguida da reação em cadeia de polimerase (multiplex RT-PCR) para identificação dos 8 vírus relacionados às IVAS. Resultados e Conclusões: A incidência média de IVAS foi de 2,33 episódios por criança-ano. As IVAS incidiram durante todo o período do estudo, principalmente no outono e inverno, decaindo na primavera e com poucos casos no verão. O rinovírus teve maior incidência tendo sido observado em todos os períodos em que ocorreram episódios de IVAS. Influenza B, vírus sincicial respiratório (VSR) e metapneumovírus ocorreram com menor incidência, principalmente no outono e inverno. IVAS causadas pelos outros vírus analisados influenza A, parainfluenza 1, 2 e 3 foram raras. A avaliação do modelo matemático, por meio de simulações, forneceu resultados animadores, visto que se conseguiu a reprodução dos dados reais. O modelo é promissor. Com a adequação das suas suposições, pode ser útil para a compreensão das dinâmicas de disseminação de doenças, planejamento e avaliação de estratégias de prevenção e de imunização em epidemias.

Made available in DSpace on 2016-01-26T12:51:26Z (GMT). No. of bitstreams: 1 joaobatistasalomaojunior_tese.pdf: 726701 bytes, checksum: be09a3fcaa3d491c8ac2601eb72d7961 (MD5) Previous issue date: 2008-02-08 / Acute lower respiratory tract disease (ALRTD) accounts for high infantile mortality and morbidity rate worldwidely. Respiratory syncytial virus (RSV) is frequently found among pathogens. Objectives: The objectives were: 1) to evaluate the RSV frequency in children from 0 to 6 years hospitalized due to acute lower respiratory disease in São José do Rio Preto, SP; 2) to characterize the virus seasoning in this city and 3) to verify possible association among epidemiologic, clinical and diagnostic data with this viral agent. Casuistic and Method: From May 2004 to September 2005, 278 children aged from 0 to 6 years with ALRTD were studied. They have contracted the disease in the community, hospitalized in the children s ward, emergency room and Pediatric Intensive Care Unit of Hospital de Base, São José do Rio Preto. They were asymptomatic in a 7-day period before the beginning of the disease. Questionnaires were used for the children's characterization and their clinical presentation. Samples of nasopharyngeal secretion were collected to identify RSV, using reverse transcription polymerase chain reaction (RT-PCR). Results: The results showed that in the 290 hospitalizations of ALRTD, RSV was positive in 29.3%. ALRTD was more frequent in infants (average = 13.5 months) and male (57.6%). RSV was more frequent in bronchiolitis cases (64%). RSV+ infections were more frequent in the first year of life (35%). In RSV + infections, pneumonia frequency varied from 19.5 to 26.2% in the studied age groups; acute wheezing was observed in 31.8% of children aged over 2 years; bronchiolitis was registered in 62.5% of the children younger than 1 year; pneumonia with pleural effusion was noticed in 18.7% of the children aged over 2 years. Conclusions: The frequency of RSV in children from 0 to 6 years hospitalized due to ALRTD was 29.3% in São José do Rio Preto, SP. The ALRTD were more frequent between June and November 2004. In 2005, the hospitalizations occurred mainly starting from March decreasing in September. There was RSV prevalence in children younger than 2 years, male and with bronchiolitis. The RSV frequency in the hospitalizations was higher in 2004 than in 2005. In the RSV+ infections, the cases of pneumonia had similar occurrence in the studied age groups. There was reduction of the RSV frequency as age increases in the cases of pneumonia with pleural effusion and increase in the cases of acute wheezing; in bronchiolitis most of the RSV+ cases occurred in children younger than1 year. The clinical and radiological data obtained did not allow the proper identification of the infection by RSV. Laboratory examination by means of RT-PCR was necessary to identify it. / As doenças agudas do aparelho respiratório inferior (DARI) são responsáveis por altos índices de mortalidade e morbidade infantil em todo mundo. Dentre os patógenos predominantes encontra-se o vírus sincicial respiratório (VSR). Objetivos: Os objetivos foram: 1) avaliar a freqüência do VSR em crianças de 0 a 6 anos hospitalizadas por DARI em São José do Rio Preto, SP; 2) caracterizar a sazonalidade do vírus nessa cidade e 3) evidenciar possível associação de dados epidemiológicos, clínicos e diagnósticos e este agente viral. Casuística e Método: No período de maio de 2004 a setembro de 2005 foram estudadas 278 crianças de 0 a 6 anos com DARI adquirida na comunidade, internadas na enfermaria, emergência e Unidade de Terapia Intensiva Pediátrica do Hospital de Base de São José do Rio Preto, que estavam assintomáticas por um período de 7 dias antes do início da doença. Foram utilizados questionários para caracterização das crianças e do quadro clínico. Para identificação do VSR foram coletadas amostras de secreção de nasofaringe, utilizando-se a técnica de Reverse Transcription Polymerase Chain Reaction (RT-PCR). Resultados: Os resultados mostraram que nas 290 internações por DARI, o VSR foi positivo em 29,3%. DARI foi mais freqüente em lactentes (mediana = 13,5 meses) e do gênero masculino (57,6%). O VSR foi mais freqüente nos casos de bronquiolite (64%). As infecções VSR+ foram mais freqüentes no primeiro ano de vida (35%). Nas infecções VSR+, a freqüência de pneumonia variou de 19,5 a 26,2% nas faixas etárias estudadas; em 31,8% das crianças maiores de 2 anos observou-se sibilância aguda; bronquiolite foi registrada em 62,5% das crianças menores de 1 ano; pneumonia com derrame pleural foi notada em 18,7% das crianças maiores de 2 anos. Conclusões: A freqüência do VSR em crianças de 0 a 6 anos hospitalizadas por DARI em São José do Rio Preto, SP, foi 29,3%. As DARI foram mais freqüentes entre junho e novembro de 2004. Em 2005, as internações ocorreram principalmente a partir de março, com queda em setembro. Houve predomínio do VSR em crianças de 0 a 2 anos, do gênero masculino e com bronquiolite. A freqüência do VSR nas internações foi maior em 2004 que em 2005. Nas infecções VSR+ os casos de pneumonia tiveram ocorrência semelhante nas faixas etárias estudadas. Houve redução da freqüência do VSR com aumento da idade nos casos de pneumonia com derrame pleural e aumento nos casos de sibilância aguda; na bronquiolite a maioria dos casos VSR+ ocorreu em crianças menores de 1 ano. Os dados clínicos e radiológicos encontrados não permitiram a identificação correta da infecção pelo VSR, havendo necessidade do exame laboratorial pela técnica RT-PCR para sua identificação.

Para avaliar os benefícios da comunicação rápida ao clínico do diagnóstico de vírus respiratórios, foi analisado a viabilidade econômica de 2 testes, com o tempo de entrega de resultado em 2 horas para teste rápido e 48 horas para Biologia Molecular. As amostras coletadas foram processadas utilizando técnicas convencionais e os testes disponíveis no mercado local. Foram escolhidos dois testes rápidos pelo método de imunocromatografia para quatro parâmetros analíticos: Influenza A, Influenza H1N1, Influenza B e Vírus Sincicial Respiratório (RSV) e em Biologia Molecular um teste de RT-PCR multiplex com 25 patógenos entre vírus e bactérias. O tipo de amostra utilizada foi swab e lavado de nasofaringe. A população escolhida para o estudo foi paciente adulto, em tratamento de câncer, que necessita de uma resposta rápida já que a maioria se encontra com comprometimento do sistema imune por doença ou por tratamento. O estudo foi transversal, realizado entre os anos de 2012 e 2013, para avaliar a viabilidade econômica da introdução de testes de diagnóstico da infecção respiratória aguda de etiologia viral a partir de amostras de nasofaringe em pacientes com câncer atendidos no Centro de Atendimento de Oncologia Intercorrência (CAIO ), do Instituto do Câncer do Estado de São Paulo (ICESP), hospital público que atende exclusivamente Sistema Único de Saúde (SUS) e Hospital A.C. Camargo, que atende tanto a pacientes do SUS como da rede privada. O estudo incluiu 152 pacientes em tratamento para qualquer tipo de câncer, predominantemente do sexo feminino (81 mulheres e 70 homens) com idades entre 18-86 anos. Para participar do estudo o paciente era consultado e o critério para escolha do paciente foi ser portador de câncer, com história de febre (ainda que referida) acompanhada de tosse ou dor de garganta, tosse e sintomas respiratórios agudos, atendidos por protocolo padronizado que inclui avaliação na admissão, seguimento e manejo antimicrobiano. Para a avaliação econômica os pacientes foram classificados de acordo com o estado geral de saúde, se apresentavam bom estado de estado de saúde poderiam receber alta e faziam uso da medicação em casa evitando 5 dias de internação se recebessem algum resultado para Influenza ou RSV, no entanto os pacientes que apresentavam outro vírus, resultado negativo ou o estado geral era ruim permaneciam internados por 7 dias em observação e cuidados com medicação adequada. Foram realizadas análises econômicas em dois âmbitos: o sistema de saúde publico e o privado considerando o fator diminuição de dias de internação. A analise de Custo-benefício foi eficiente no Sistema privado mas inadequada para o SUS assim como, qualquer outra medida monetária já que os valores de reembolso do SUS estão defasados do custo de qualquer internação. A análise de Custo-efetividade que olha para outros fatores além do monetário foi efetiva nos dois sistemas que enfrentam falta de leitos além da condição de saúde do paciente de evitar a ingestão desnecessária de antibióticos, evitar os gastos do acompanhante, perda de dias de trabalho e estudo. Não houve correspondência de resultados dos testes rápidos com o multiplex de Biologia Molecular / To evaluate the benefits of the rapid communication of the respiratory viruses\' diagnosis to the doctor, the economic feasibility of two tests was analyzed, with the result delivery time within 2-hours for the rapid test and 48 hours for Molecular Biology. The samples were processed using conventional techniques and the available tests in the local market. Two rapid tests were selected by the immunochromatography method for four analytical parameters: Influenza A, Influenza A H1N1, Influenza B, and Respiratory Syncytial Virus (RSV) and in Molecular Biology a multiplex RT-PCR assay with 25 pathogens between viruses and bacteria. The type of sample used was swab and nasopharyngeal wash. The population chosen for the study was of adult patients undergoing cancer treatment, which requires a rapid response since most have a compromised immune system due to the disease or treatment. The study, conducted between 2012 and 2013, was cross-sectional to evaluate the economic feasibility of introducing diagnostic tests for acute respiratory infection of viral etiology from nasopharyngeal samples of patients with cancer attended at the Oncology Intercurrence Care Center (CAIO), at the Cancer Institute of the São Paulo State (ICESP), at public hospital that attends exclusively the Unified Health System (SUS) and at AC Camargo hospital, which attends SUS patients as well as the private health system. The study included 152 patients undergoing treatment for any type of cancer, predominantly female (81 women and 70 men) between 18 and 86 years. To participate in the study, the patients were consulted and the criteria for choosing a patient was to be a cancer patient with a history of fever (even if referred) accompanied by cough or sore throat, coughing and acute respiratory symptoms, attended by standardized protocol that includes an evaluation at the admission, tracking and antimicrobial management. For the economic evaluation, patients were classified according to the general health condition. If they were in a good health condition, they could receive medical discharge and make use of the medication at home avoiding five days of hospitalization when receiving a result for influenza or RSV. However, the patients with other viruses, negative results or with bad general condition remained hospitalized for seven days under observation and care with proper medication. Economic analyzes were carried out in two areas: the public health system and private health system considering the factor decreased length of hospital stay. The cost-benefit analysis was efficient in the private system but inadequate for the NHS as well as any other monetary measure since the SUS reimbursement values are too low when compared to the cost of any other hospital. The cost-effectiveness analysis that looks at other factors besides money was effective in both systems that were facing lack of beds in addition to the health condition of the patient to avoid unnecessary intake of antibiotics, avoid the costs of the accompanying person, loss of working and study days. There were no results correspondences of the rapid tests with the Molecular Biology multiplex

Title Best current evidence on chest physiotherapy in non-ventilated paediatric patients (0 to 24 months) with bronchiolitis: a systematic review. Purpose To determine the current scientific evidence for using three chest physiotherapy modalities namely percussion, postural drainage and suctioning in paediatric patients (0 to 24 months). Relevance The field of cardiopulmonary physiotherapy seems to be a neglected area in physiotherapy, with a subsequently limited evidence base. The author observed that in various clinical settings physiotherapists tend to administer routine chest physiotherapy to paediatric patients with bronchiolitis. Findings from this study may assist physiotherapists in their choice of effective treatment options. Sources The following databases were searched for evidence: African Health Line, CINAHL, Cochrane, Ebsco Host, Emerald Host, UP E-theses/dissertations, PEDro, Medline Ovid, Sabinet, Science Direct, Up To Date. Methodology This was a systematic review. The databases were reviewed by making use of a specified search strategy customised for each database. Keywords were: physiotherapy/physical therapy, bronchiolitis and paediatric/pediatric in combination with percussion, postural drainage and suction. The search yielded 10,016 study titles. Studies were chosen from the population of studies using pre-set inclusion and exclusion criteria. These criteria were applied to the titles, abstracts and full-text articles as appropriate. Five full text-articles were appraised and based on the scores from the appraisal three were included in the final sample. Data analysis Appraisal instruments from the National Health System Critical Appraisal Skills Programme (NHS CASP) and the PEDro scale (for randomised controlled trials) were used to evaluate and score the sample. Scoring was done independently by two researchers, and agreement reached through negotiation. The evidence was synthesised and graded according to the Sackett hierarchy of evidence. Results Owing to the heterogeneity of the sample, and the nature of results reported, a meta-analysis was not possible. Results from this study reveal that there is no evidence to support routine chest physiotherapy in uncomplicated viral bronchiolitis amongst the paediatric population. Chest physiotherapy does not decrease length of hospital stay, oxygen requirements or clinical scores indicating distress/morbidity. However, with secondary bacterial respiratory infections, chest physiotherapy may be indicated, depending on the assessment of each individual patient. Conclusion Percussion, postural drainage and suctioning are not effective in the management of bronchiolitis in children, newborn to 24 months old, except in individually assessed cases with secondary bacterial infection. In this subset, physiotherapy must be customised to the patient. Therefore routine physiotherapy is not indicated. Implications Chest physiotherapy should be based on a complete evaluation and on clinical merit, as well as on evidence and patient preference. Education of physiotherapy students at universities as well as doctors regarding the current evidence for chest physiotherapy in paediatric bronchiolitis is essential. Doctors and clinicians need to be made aware that routine chest physiotherapy for paediatric patients with bronchiolitis should not be prescribed. AFRIKAANS : Titel Die beste huidige bewyse aangaande longfistioterapie vir non geventileerde pediatriese pasiënte (0 tot 24 maande) met brongiolitis: 'n sistematiese oorsig. Doel Om huidige wetenskaplike bewyse vir die gebruik van drie long fisioterapietegnieke naamlik beklopping, posturale dreinasie en suiging in pediatriese pasiënte (0 tot 24 maande) te bepaal. Toepaslikheid Die veld van pediatriese fisioterapie blyk 'n verwaarloosde area van navorsing te wees, met gevolglik beperkte bewysbasis. Die navorser het ondervind dat fisioterapeute dikwels in kliniese praktyk roetine longfisioterapie in pediatriese pasiënte met brongiolitis toepas. Bewyslewering vanuit hierdie studie kan fisioterapeute help met die keuse van effektiewe behandelingsprosedures. Bronne Die volgende databasisse is deursoek vir bewyse: African Health Line, CINAHL, Cochrane, Ebsco Host, Emerald Host, UP e-theses and dissertations, PEDro, Medline, Sabinet, Science Direct en Up To Date. Die soektog het 10,016 titels gelewer. Metode 'n Sistematiese oorsig van die data is uitgevoer deur 'n gespesifiseerde soekstrategie, aangepas vir elke databasis, te volg. Sleutelwoorde was: “physiotherapy/physical therapy”, “bronchiolitis” and “paediatric/pediatric” in kombinasie met “percussion”, “postural drainage” and “suction”. Voorafbepaalde insluitings- en uitsluitingskriteria is toegepas op titels, abstrakte en artikels soos toepaslik. Data analise Evalueringsinstrumente van die “National Health System Critical Appraisal Skills programme” (NHS CASP) asook die PEDro skaal (ewekansige gekontroleerde eksperiment) is gebruik vir evaluasie van en puntetoedeling vir die verkose studies. Die puntetoekenning is onafhanklik deur twee navorsers gedoen en konsensus is bereik deur onderhandeling. Die inligting verkry is gesintetiseer en gegradeer aan die hand van die Sackett hiërargie van bewyse. As gevolg van die heterogeniteit van die ingeslote studies en die aard van die resultate was 'n meta-analise nie moontlik nie. Resultate Die studie het bevind dat daar geen bewyse is vir roetine borskasfisioterapie van ongekompliseerde akute virale pediatriese brongiolitis nie. Borskasfisioterapie verminder nie die duur van hospitaalverblyf, suurstofbehoeftes of die kliniese respiratoriese aanduiding van stres in die pasiënte nie. In die geval van sekondêre bakteriële respiratoriese infeksies mag borskasfisoterapie egter geindikeerd wees, afhangend van die evaluasie van elke individuele pasiënt. Gevolgtrekking Beklopping, posturale dreinasie, en suiging as roetine behandeling is nie effektief in die behandeling van brongiolitis in pasgebore tot 24 maand oue pasiënte nie, behalwe individuele gevalle met sekondêre bakteriële infeksies. In hierdie spesifieke subgroep moet borskasfisioterapie aangepas word vir pasiënt. Roetine fisioterapie is dus nie aangedui nie. Implikasies Borskasfisioterapie moet gebasseer wees op 'n volledige evaluasie en kliniese meriete, asook bewyslewering en die pasiënt se voorkeure. Opleiding van fisioterapie studente by universiteite, asook dokters aangaande die huidige bewyslewering vir borskasfisioterapie in pediatriese brongiolitis is belangrik. Dokters en klinici moet bewus gemaak word dat roetine borskasfisioterapie vir pediatriese brongiolitis pasiënte nie voorgeskryf moet word nie. Additional information available on a CD stored at the Merensky Library. / Dissertation (MPhysT)--University of Pretoria, 2011. / Physiotherapy / unrestricted

Les infections virales des voies respiratoires (IVVRs) causées par certains virus comme la grippe et le COVID-19 ont un impact significatif sur la santé publique et l’économie mondiale. Ces infections touchent un nombre important de personnes dans le monde et exercent une pression immense sur les systèmes de santé. Pour atténuer les effets néfastes des IVVRs, il est important de développer des techniques de détection précoce capables d’identifier les personnes infectées même si elles ne présentent aucun symptôme. Une telle détection permet un isolement et raitement rapide, ce qui réduit le risque de transmission et permet des interventions de santé publique ciblées pour limiter la propagation de l’infection. Les méthodes de détection actuelles telles que la réaction en chaîne par polymérase (RCP) démontrent une sensibilité et une spécificité élevées, atteignant des taux de détection de 100% avec certaines méthodes de test disponibles dans le marché. De plus, les approches actuelles d’apprentissage automatique pour la détection des IVVRs, montrent des résultats prometteurs ; cependant, les méthodes actuelles reposent souvent sur l’apparition des symptômes, exigent un équipement coûteux et un personnel formé, et fournissent des résultats relativement retardés. Notre projet vise à étudier la faisabilité de l’utilisation d’un algorithme d’apprentissage automatique entraîné sur des données physiologiques provenant de biocapteurs portables lors d’un protocole de test de marche sur escalier pour prédire le niveau d’inflammation associé aux IVVRs. De plus, l’étude vise à identifier les indicateurs les plus prédictifs des IVVRs. Des participants en bonne santé ont été recrutés et inoculés avec un vaccin antigrippal vivant pour induire une réponse immunitaire. Au cours d’une série de tests d’escalier contrôlés cliniquement, des physiomarqueurs tels que la fréquence respiratoire et la fréquence cardiaque ont été meusurés à l’aide de biocapteurs portables. Les données collectées ont été utilisées pour développer un modèle de prédiction en ayant recours aux algorithmes d’apprentissage automatique, combinés avec un réglage d’hyperparamètres et en écartant un participant à la fois lors de l’entraînement du modèle. L’étude a développé avec succès un modèle prédictif qui démontre des résultats prometteurs dans la prédiction du niveau d’inflammation lié au vaccin induit. Notamment, les caractéristiques de variabilité de la fréquence cardiaque (VFC) dérivées du biocapteur portable présentaient le potentiel le plus élevé pour détecter le niveau d’inflammation, atteignant une sensibilité de 70% et une spécificité de 77%. Les implications du modèle de prédiction développé sont importantes pour les cliniciens et le grand public, notamment en termes d’autosurveillance et d’intervention précoce. Grâce aux algorithmes d’apprentissage automatique et des physiomarqueurs utilisés, en particulier les caractéristiques de VFC, cette approche a le potentiel de faciliter l’administration en temps opportun des traitements appropriés, atténuant ainsi l’impact des futures épidémies des IVVRs. L’intégration de biocapteurs portables et d’algorithmes d’apprentissage automatique fournit une stratégie innovante et efficace de détection précoce, permettant une intervention rapide et réduisant la charge sur les systèmes de santé / Viral respiratory tract infections (VRTIs) caused by certain viruses like influenza and COVID-19, significantly impact public health and the global economy. These infections affect a large number of people worldwide and put immense pressure on healthcare systems. To mitigate the detrimental effects of VRTIs, it is crucial to urgently develop accurate early detection techniques that can identify infected individuals even if they do not exhibit any symptoms. Timely detection allows for prompt isolation and treatment, reducing the risk of transmission and enabling targeted public health interventions to limit the spread of the infection. Current detection methods like polymerase chain reaction (PCR) demonstrate high sensitivity and specificity, reaching 100% detection rates with some commercially available testing methods. Additionally, current machine learning approaches for automatic detection show promising results; however, current methods often rely on symptom onset, demand expensive equipment and trained personnel, and provide delayed results. This study aims to investigate the feasibility of utilizing a machine learning algorithm trained on physiological data from wearable biosensors during a stair stepping task protocol to predict the level of inflammation associated with VRTIs. Additionally, the study aims to identify the most predictive indicators of VRTIs. Healthy participants were recruited and inoculated with a live influenza vaccine to induce an immune response. During a series of clinically controlled stair tests, physiomarkers such as breathing rate and heart rate were monitored using wearable biosensors. The collected data were employed to develop a prediction model through the utilization of gradient boosting machine learning algorithms, which were combined with hyperparameter tuning and a leave-one-subject-out approach for training. The study successfully developed a predictive model that demonstrates promising results in predicting the level of inflammation related to the induced VRTI. Notably, heart rate variability (HRV) features derived from the wearable biosensor exhibited the highest potential in detecting the level of inflammation, achieving a sensitivity of 70% and a specificity of 77%. The implications of the developed prediction model are significant for clinicians and the general public, particularly in terms of self-monitoring and early intervention. By leveraging machine learning algorithms and physiomarkers, specifically HRV features, this approach holds the potential to facilitate the timely administration of appropriate treatments, thereby mitigating the impact of future VRTI outbreaks. The integration of wearable biosensors and machine learning algorithms provides an innovative and effective strategy for early detection, enabling prompt intervention and reducing the burden on healthcare system

The diagnosis and treatment of respiratory tract infections in ambulatory adults is challenging. The prevalence of these conditions outstrips the medical profession's efficiency and effectiveness in dealing with them. However, selecting diagnostic techniques that identify causative organisms and therapeutic agents targeted to those organisms should lead to a reduction in the morbidity and mortality associated with these illnesses.