The human body continuously generates weak, broadband acoustic-mechanical signals that encode rich cardiopulmonary information, yet their reliable capture in real-world settings remains constrained by motion artifacts, limited bandwidth, and suboptimal mechanical coupling. Here, we present a wearable, wireless stethoscope that enables high-fidelity acquisition of heart and respiratory sounds through a mechanically compliant, broadband sensing interface. The system is built on a piezoelectric micromachined ultrasonic transducer (PMUT) engineered to achieve ultrahigh sensitivity (-167.5 dB), a wide operating bandwidth (10 Hz-10 kHz), and a flat frequency response (±0.5 dB), enabling accurate reconstruction of subtle physiological signals across a broad spectral range. Integration with soft, skin-conformal packaging and a robust wireless readout minimizes motion-induced noise and supports stable, long-term monitoring during daily activities. Validation across multiple participants demonstrates strong agreement with clinical-grade systems, including consistent auscultation at standard cardiac sites and accurate heart-rate tracking during dynamic exercise. Furthermore, coupling the sensing platform with a residual neural network enables automated classification of five respiratory states (awake, asleep, apnea, rhonchi, and wheeze) with an accuracy of 98.7%. This work establishes a scalable, low-cost framework for continuous, high-fidelity cardiopulmonary monitoring in real-world environments.

Acute supraglottic edema is an uncommon but potentially fatal cause of upper-airway obstruction. Although dengue infection is associated with diverse systemic manifestations, isolated upper-airway involvement is exceedingly rare and may pose a significant diagnostic challenge. We report an elderly woman who initially presented with features of acute stroke but was subsequently found to have life-threatening airway edema as a manifestation of acute dengue infection. Neuroimaging excluded acute cerebrovascular disease. Within six hours, she rapidly developed inspiratory stridor, hypoxemia, and hypercapnic respiratory failure requiring emergency endotracheal intubation. Flexible fiberoptic laryngoscopy demonstrated diffuse supraglottic and laryngopharyngeal edema, leading to compromised airway. Initial blood investigations revealed thrombocytopenia and a positive dengue NS1 antigen (sent in view of the ongoing dengue endemic), establishing the diagnosis of acute dengue infection. Conservative management comprising mechanical ventilation, corticosteroids, antibiotics, electrolyte correction, and serial fiberoptic airway assessment resulted in complete recovery without tracheostomy. This case highlights the evolving diversity of presenting clinical features associated with dengue infections. The pathophysiology of isolated airway edema in dengue is quite unknown and is beyond the scope of this article, but prompt pharmacological management, along with airway protection, reflects the reversible nature of this symptom and the likelihood of an underlying non-IgE-mediated hypersensitivity-related pathophysiological process. Early recognition of evolving airway compromise and prompt multidisciplinary intervention are essential for favorable outcomes.

AI-assisted digital stethoscopes can classify heart and lung sounds with accuracy comparable to or exceeding that of the average clinician and help the physician in the diagnostic process. With this essay we want to discuss benefits and downsides of this new technology. Will proficiency in auscultation, which brings joy and pride to many stethoscope users, be suffering when interpretation of chest sounds is taken over by AI? And how will recommendations from AI in the diagnostic process influence decision making and the patient-doctor relationship? A tendency toward deskilling of auscultation proficiency can be counteracted when AI-assisted interpretation is used as a reflective tool, comparing machine output against clinical perception to sharpen diagnostic acuity. This concept of a collaboration of humans and AI will be important with regard to keeping AI-algorithms trustworthy. We still need more research on heart and lung sounds, to gain a detailed understanding of the clinical significance of various sound characteristics. The smart stethoscope will be useful for this research. Better knowledge will benefit not only algorithm development but also clinicians using traditional stethoscopes. The traditional stethoscope will probably prevail as the main instruments for chest auscultation in foreseeable future. Smart stethoscopes may become useful tools in the education of their users.

Background and Objectives: The anatomical relationship between nasal cavity dimensions and the pharyngeal airway space (PAS) in simple snoring remains poorly defined. We investigated the association between nasal cavity dimensions and the PAS in adults with simple snoring using computed tomography (CT), focusing on anatomical correlations. Materials and Methods: This cross-sectional study included 83 adults with simple snoring and nasal obstruction and a confirmed apnea-hypopnea index (AHI) < 2, enrolled between 2007 and 2022. Polysomnography and CT were performed to measure nasal and pharyngeal airway dimensions. The minimum cross-sectional areas (mCSAs) of three nasal cavity segments and pharyngeal airway dimensions were measured on awake CT images. Multivariable linear regression, adjusted for age, sex, and BMI, was used to evaluate the association between the nasal and pharyngeal airway dimensions. Results: A larger bilateral narrowest nasal cross-sectional area was significantly associated with a larger PAS mCSA in the full cohort (standardized β = 0.26, p = 0.012), after adjustment for age, sex, and BMI. A 10-mm[2] larger nasal area corresponded to a 3.6% larger PAS mCSA (95% CI, 0.8-6.5%), and the model explained a modest share of the variance (adjusted R[2] = 0.17). The association did not differ by sex (interaction p = 0.25), indicating no evidence of effect modification. Conclusions: In individuals with simple snoring, smaller nasal cavity dimensions were associated with a narrower PAS on static CT imaging, although this association was modest and explained only a small fraction of the variation in pharyngeal calibre. These findings reflect anatomical associations and should not be interpreted as evidence of functional airway collapse or disease progression.

Early identification of children at risk of severe acute respiratory infection remains a clinical challenge. Although C-reactive protein (CRP), procalcitonin (PCT), and white blood cell (WBC) count are commonly assessed at hospital admission, their predictive value for severity assessment remains uncertain. We aimed to evaluate the utility of clinical features, a respiratory multiplex PCR test detecting 23 pathogens, imaging findings, and early inflammatory biomarkers in predicting subsequent supplemental oxygen requirement, used as a marker of severe acute lower respiratory infection (ALRI), among hospitalized children. The primary outcome was the need for supplemental oxygen during hospitalization. We conducted a single-center retrospective cohort study of children admitted to the pediatric department between May 2022 and June 2023 with ALRI or other conditions for which respiratory infection was considered but subsequently excluded. All included patients underwent multiplex respiratory PCR testing. We included 439 children in the analysis [median age, 20 mo (IQR: 5-54); 52.7% males]. Out of them, 178 (40.5%) required supplemental oxygen. The strongest positive association with subsequent supplemental oxygen requirement was observed for low oxygen saturation on admission [OR 8.83 (95% CI, 3.00-26.02; p < 0.001)], although this variable was documented in only about half of the cohort (52.4%). The strongest predictors of subsequent supplemental oxygen requirement in multivariable analysis were age, abnormal auscultatory findings, and the cumulative number of danger signs, including hypoxemia, tachypnea, dyspnea, and increased work of breathing. Among the 23 pathogens tested, respiratory syncytial virus (RSV) was the only pathogen consistently associated with a more severe course: 60.3% of RSV-positive children required supplemental oxygen, compared with 36.9% of RSV-negative children (OR 2.59, 95% CI 1.53-4.40; p < 0.001). For predicting subsequent supplemental oxygen requirement, no single marker had strong utility. These findings support the importance of structured bedside clinical assessment for identifying hospitalized children who may subsequently require supplemental oxygen. Given incomplete documentation of some vital signs, associations involving these variables should be interpreted with caution.

This study aimed to provide a theoretical basis for improving early diagnosis and complication prevention by exploring the latent classes of pediatric bronchial foreign body complications, analyzing their associated factors, and assessing the impact of different latent classes on healthcare resource utilization. Children who underwent bronchoscopic foreign body removal at the Children's Hospital of Chongqing Medical University from January 1, 2018 to July 31, 2023, were retrospectively reviewed. Latent class analysis was performed on complications with an incidence > 10% (including pneumonia, pulmonary emphysema, granulation tissue, bronchial stenosis, atelectasis, and pulmonary consolidation). Logistic regression was used to identify risk factors among different latent complication classes, and comparative analyses compared healthcare resource utilization. Among the 238 included children, complications with an incidence exceeding 10% were analyzed and clustered into four latent classes: the "Pneumonia Group" (C1, 40 cases, 16.8%), the "Pneumonia-Atelectasis Group" (C2, 33 cases, 13.9%), the "Emphysema-Granulation tissue Group" (C3, 106 cases, 44.5%), and the "Bronchial Stenosis-Granulation tissue Group" (C4, 59 cases, 24.8%). Results identified a history of foreign body aspiration, asymmetric breath sounds, C-reactive protein ≥ 8 mg/L, and neutrophil percentage as associated factors (p < 0.05). Healthcare resource utilization was significantly lower in groups C3 and C4 regarding hospital stay, treatment costs, and antibiotic days compared to C1 and C2 (p < 0.05). These latent classes offer theoretical support and practical reference for early diagnosis, complication prevention and diagnosis-related group-based payment optimization.

Sleep-related breathing disorders are common in patients with multiple system atrophy (MSA), typically presenting as laryngeal stridor due to vocal cord abductor paralysis; however, severe respiratory impairment in the early stage is rare. We report the case of an 81-year-old woman with MSA who developed acute respiratory failure associated with severe obstructive sleep apnea syndrome (OSAS) preceding stridor. The patient required intubation. Although extubation was successful after six days, nocturnal hypercapnia persisted, necessitating noninvasive ventilation. Polysomnography confirmed the diagnosis of OSAS, while laryngoscopy revealed mild bilateral vocal cord abductor paresis without stridor. This case highlights that life-threatening respiratory failure may precede the development of laryngeal stridor in patients with MSA.

Some countries have experienced and may continue to experience severe devastation due to wars, epidemics, earthquakes, and other natural catastrophes. When individuals are exposed to specific psychological or physical traumas, they can develop stress-related disorders, which can lead to irreversible changes in the autonomic nervous system and the development of cardiovascular disorders. When subjected to a new stress test, traumatized participants or those previously exposed to trauma may show more pronounced behavioral changes, intolerance, and greater fatigue responses than before trauma exposure. To reduce the recurrence of trauma-associated responses, particularly among young people, it is necessary to implement preventive measures. Alternative approaches, including counseling, medication, phytotherapy, and other interventions, need to be developed. This study aims to examine how individuals cope with trauma-related situations using a biofeedback method that could be developed to manage stress-related responses. The emotional and psychological states of earthquake victims will be assessed using a protocol based on biomedical (neurocardiac) signals and the sound of the participants' hearts. This sound will be delivered at a fixed frequency or in real time with allostatic auditory stimulation. This approach aims to induce a resonance that stabilizes the autonomic nervous system by providing biofeedback to participants.

Geckos are among the few non-avian reptiles that use acoustic signals for territorial defence, mate attraction and distress signalling. Although previously considered inflexible, male tokay geckos exhibit vocal plasticity by switching to longer, louder call types in noisy environmental conditions. However, they seem to face respiratory constraints limiting longer duration calls. To test this hypothesis, we combined acoustic analysis with deep learning-based pose estimation to quantify respiratory dynamics during spontaneous advertisement calling. Calls were produced exclusively during expiration at a constant rate, supporting the hypothesis that respiratory constraints limit call duration. Tokays use two mechanisms to increase bi-note call duration. First, bi-notes contain an inspiratory 'mini-breath'-a feature previously associated only with songbirds. Second, bi-note duration is increased by adding terminal pulses, whose acoustic signatures suggest vocal fold oscillation in the air-efficient vocal fry register. These findings suggest that tokay advertisement calls function as honest signals of respiratory capacity. We also observed slow closure of the ear opening during vocalizations, indicating a mechanism for protecting the auditory system from self-generated loud sounds. Unlike the reflexive auditory attenuation mechanisms of birds and mammals, this response appears tightly coordinated with vocal-respiratory activity, representing an additional evolutionary innovation associated with tympanic hearing.

Subglottic hemangioma (SGH) is a rare but potentially fatal cause of infantile stridor that is frequently misdiagnosed as laryngomalacia, croup, or idiopathic subglottic stenosis. Circumferential involvement is an uncommon and particularly dangerous variant whose endoscopic appearance overlaps with that of other concentric subglottic lesions, including congenital cricoid cartilage malformation and idiopathic subglottic stenosis. We present a two-week-old female with a history of preterm birth (36 5/7 weeks) and progressive biphasic stridor, cyanosis, and increasing respiratory distress. Operative microlaryngoscopy and bronchoscopy demonstrated significant subglottic narrowing of uncertain etiology that was refractory to balloon dilation, and contrast-enhanced MRI of the neck demonstrated nonspecific airway narrowing without an identifiable mass. After multidisciplinary discussion with hematology and neonatology, empiric oral propranolol was initiated for presumed airway hemangioma. The infant's stridor improved dramatically within five days and resolved completely; she was discharged after a one-month neonatal intensive care unit stay and remained asymptomatic at seven-month follow-up. This case illustrates the diagnostic ambiguity that can attend circumferential subglottic narrowing in the neonate and demonstrates that empiric propranolol can serve as both a diagnostic and therapeutic trial when imaging is unrevealing.