DZC DIAG: mobile application based on expert system to aid in the diagnosis of dengue, Zika, and chikungunya.

Dengue, Zika, and chikungunya are epidemic diseases transmitted by the Aedes mosquito. These virus infections can be so severe to the point of bringing on mobility and neurological problems, or even death. Expert systems (ES) can be used as tools for the identification of patterns intended to solve problems in the same way as a professional specialist would. This work aimed to develop an ES in the form of an Android application to serve as a supportive tool in the diagnosis of these arboviruses. The goal is to associate the set of symptoms from a patient to a score related to the likelihood of them having these diseases. To make this possible, we implemented a rule-based ES which considers the presence of symptoms itself and the relation between them to associate the case under analysis to others found in the literature. We performed 96 tests (32 for each illness), and our system had a success rate of 96.88%. Resident physicians of a public hospital also analyzed these clinical cases and achieved an average success rate of 72.92%. Comparing the results of the method proposed and errors made by health professionals, we showed an improvement in the effectiveness of clinical diagnoses. Graphical abstract Figure - DZC DIAG Operating Flowchart: the physicians record patients' data and answer a series of questions related to the patient's symptoms; after all the questions, the result is generated by the expert system (score for dengue, Zika, and chikungunya); and it is saved in the same device where the test was done and uploaded online to a FTP.

Acute effects of incremental inspiratory loads on compartmental chest wall volume and predominant activity frequency of inspiratory muscle.

AIM: This research aims to analyze the acute effect of incremental inspiratory loads on respiratory pattern and on the predominant activity frequency of inspiratory muscle, taking into account differences in gender responses. Optoelectronic Plethysmography was performed during loads in 39 healthy subjects (20 women), placing 89 markers on the thoracic-abdominal wall to obtain total and regional volumes. Surface electromyography (SEMG) was taken simultaneously on the Sternocleidomastoid and Diaphragm muscles, to calculate the predominant muscle activity frequency through wavelet analysis. Inspiratory loads were performed using Threshold(®)with 2 min of breathing at different levels, ranging from a load of 10 cmH(2)O plus 5 cmH(2)O to 40 cmH(2)O or fatigue. RESULTS: Inspiratory Time increased during loads. Total and compartmental volumes increased with different regions, changing at different loads. These changes in volume occur earlier in women (20 cmH(2)O) than in men (30 cmH(2)O). The predominant activity frequency of Sternocleidmastoid muscle decreased at 30 cmH(2)O, while Diaphragm activity decreased at 40 cmH(2)O. CONCLUSION: The acute effects of incremental inspiratory loads are increases of total and regional volumes and inspiratory time. As for muscle activity, the predominant activity frequency declined in Sternocleidomastoid and Diaphragm muscles, but at different loads. Such respiratory and SEMG patterns and gender differences should be considered when clinical interventions are performed.