Addressing the challenge of limited labeled data in clinical settings, particularly in the prediction of fatty liver disease, this study explores the potential of graph representation learning within a semi-supervised learning framework. Leveraging graph neural networks (GNNs), our approach constructs a subject similarity graph to identify risk patterns from health checkup data. The effectiveness of various GNN approaches in this context is demonstrated, even with minimal labeled samples. Central to our methodology is the inclusion of human-centric explanations through explainable GNNs, providing personalized feature importance scores for enhanced interpretability and clinical relevance, thereby underscoring the potential of our approach in advancing healthcare practices with a keen focus on graph representation learning and human-centric explanation.
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Estimating the joint effect of a multivariate, continuous exposure is crucial, particularly in environmental health where interest lies in simultaneously evaluating the impact of multiple environmental pollutants on health. We develop novel methodology that addresses two key issues for estimation of treatment effects of multivariate, continuous exposures. We use nonparametric Bayesian methodology that is flexible to ensure our approach can capture a wide range of data generating processes. Additionally, we allow the effect of the exposures to be heterogeneous with respect to covariates. Treatment effect heterogeneity has not been well explored in the causal inference literature for multivariate, continuous exposures, and therefore we introduce novel estimands that summarize the nature and extent of the heterogeneity, and propose estimation procedures for new estimands related to treatment effect heterogeneity. We provide theoretical support for the proposed models in the form of posterior contraction rates and show that it works well in simulated examples both with and without heterogeneity. We apply our approach to a study of the health effects of simultaneous exposure to the components of PM$_{2.5}$ and find that the negative health effects of exposure to these environmental pollutants is exacerbated by low socioeconomic status and age.
Although robot-assisted cardiovascular catheterization is commonly performed for intervention of cardiovascular diseases, more studies are needed to support the procedure with automated tool segmentation. This can aid surgeons on tool tracking and visualization during intervention. Learning-based segmentation has recently offered state-of-the-art segmentation performances however, generating ground-truth signals for fully-supervised methods is labor-intensive and time consuming for the interventionists. In this study, a weakly-supervised learning method with multi-lateral pseudo labeling is proposed for tool segmentation in cardiac angiograms. The method includes a modified U-Net model with one encoder and multiple lateral-branched decoders that produce pseudo labels as supervision signals under different perturbation. The pseudo labels are self-generated through a mixed loss function and shared consistency in the decoders. We trained the model end-to-end with weakly-annotated data obtained during robotic cardiac catheterization. Experiments with the proposed model shows weakly annotated data has closer performance to when fully annotated data is used. Compared to three existing weakly-supervised methods, our approach yielded higher segmentation performance across three different cardiac angiogram data. With ablation study, we showed consistent performance under different parameters. Thus, we offer a less expensive method for real-time tool segmentation and tracking during robot-assisted cardiac catheterization.
Within colorectal cancer diagnostics, conventional colonoscopy techniques face critical limitations, including a limited field of view and a lack of depth information, which can impede the detection of precancerous lesions. Current methods struggle to provide comprehensive and accurate 3D reconstructions of the colonic surface which can help minimize the missing regions and reinspection for pre-cancerous polyps. Addressing this, we introduce 'Gaussian Pancakes', a method that leverages 3D Gaussian Splatting (3D GS) combined with a Recurrent Neural Network-based Simultaneous Localization and Mapping (RNNSLAM) system. By introducing geometric and depth regularization into the 3D GS framework, our approach ensures more accurate alignment of Gaussians with the colon surface, resulting in smoother 3D reconstructions with novel viewing of detailed textures and structures. Evaluations across three diverse datasets show that Gaussian Pancakes enhances novel view synthesis quality, surpassing current leading methods with a 18% boost in PSNR and a 16% improvement in SSIM. It also delivers over 100X faster rendering and more than 10X shorter training times, making it a practical tool for real-time applications. Hence, this holds promise for achieving clinical translation for better detection and diagnosis of colorectal cancer.
Medical documentation, including discharge notes, is crucial for ensuring patient care quality, continuity, and effective medical communication. However, the manual creation of these documents is not only time-consuming but also prone to inconsistencies and potential errors. The automation of this documentation process using artificial intelligence (AI) represents a promising area of innovation in healthcare. This study directly addresses the inefficiencies and inaccuracies in creating discharge notes manually, particularly for cardiac patients, by employing AI techniques, specifically large language model (LLM). Utilizing a substantial dataset from a cardiology center, encompassing wide-ranging medical records and physician assessments, our research evaluates the capability of LLM to enhance the documentation process. Among the various models assessed, Mistral-7B distinguished itself by accurately generating discharge notes that significantly improve both documentation efficiency and the continuity of care for patients. These notes underwent rigorous qualitative evaluation by medical expert, receiving high marks for their clinical relevance, completeness, readability, and contribution to informed decision-making and care planning. Coupled with quantitative analyses, these results confirm Mistral-7B's efficacy in distilling complex medical information into concise, coherent summaries. Overall, our findings illuminate the considerable promise of specialized LLM, such as Mistral-7B, in refining healthcare documentation workflows and advancing patient care. This study lays the groundwork for further integrating advanced AI technologies in healthcare, demonstrating their potential to revolutionize patient documentation and support better care outcomes.
Matching patients to clinical trials is a key unsolved challenge in bringing new drugs to market. Today, identifying patients who meet a trial's eligibility criteria is highly manual, taking up to 1 hour per patient. Automated screening is challenging, however, as it requires understanding unstructured clinical text. Large language models (LLMs) offer a promising solution. In this work, we explore their application to trial matching. First, we design an LLM-based system which, given a patient's medical history as unstructured clinical text, evaluates whether that patient meets a set of inclusion criteria (also specified as free text). Our zero-shot system achieves state-of-the-art scores on the n2c2 2018 cohort selection benchmark. Second, we improve the data and cost efficiency of our method by identifying a prompting strategy which matches patients an order of magnitude faster and more cheaply than the status quo, and develop a two-stage retrieval pipeline that reduces the number of tokens processed by up to a third while retaining high performance. Third, we evaluate the interpretability of our system by having clinicians evaluate the natural language justifications generated by the LLM for each eligibility decision, and show that it can output coherent explanations for 97% of its correct decisions and 75% of its incorrect ones. Our results establish the feasibility of using LLMs to accelerate clinical trial operations.
Due to the substantial number of clinicians, patients, and data collection environments involved in clinical trials, gathering data of superior quality poses a significant challenge. In clinical trials, patients are assessed based on their speech data to detect and monitor cognitive and mental health disorders. We propose using these speech recordings to verify the identities of enrolled patients and identify and exclude the individuals who try to enroll multiple times in the same trial. Since clinical studies are often conducted across different countries, creating a system that can perform speaker verification in diverse languages without additional development effort is imperative. We evaluate pre-trained TitaNet, ECAPA-TDNN, and SpeakerNet models by enrolling and testing with speech-impaired patients speaking English, German, Danish, Spanish, and Arabic languages. Our results demonstrate that tested models can effectively generalize to clinical speakers, with less than 2.7% EER for European Languages and 8.26% EER for Arabic. This represents a significant step in developing more versatile and efficient speaker verification systems for cognitive and mental health clinical trials that can be used across a wide range of languages and dialects, substantially reducing the effort required to develop speaker verification systems for multiple languages. We also evaluate how speech tasks and number of speakers involved in the trial influence the performance and show that the type of speech tasks impacts the model performance.
Measuring the impact of an environmental point source exposure on the risk of disease, like cancer or childhood asthma, is well-developed. Modeling how an environmental health hazard that is extensive in space, like a wastewater canal, is not. We propose a novel Bayesian generative semiparametric model for characterizing the cumulative spatial exposure to an environmental health hazard that is not well-represented by a single point in space. The model couples a dose-response model with a log-Gaussian Cox process integrated against a distance kernel with an unknown length-scale. We show that this model is a well-defined Bayesian inverse model, namely that the posterior exists under a Gaussian process prior for the log-intensity of exposure, and that a simple integral approximation adequately controls the computational error. We quantify the finite-sample properties and the computational tractability of the discretization scheme in a simulation study. Finally, we apply the model to survey data on household risk of childhood diarrheal illness from exposure to a system of wastewater canals in Mezquital Valley, Mexico.
Ultrasound (US) imaging is widely used in diagnosing and staging abdominal diseases due to its lack of non-ionizing radiation and prevalent availability. However, significant inter-operator variability and inconsistent image acquisition hinder the widespread adoption of extensive screening programs. Robotic ultrasound systems have emerged as a promising solution, offering standardized acquisition protocols and the possibility of automated acquisition. Additionally, these systems enable access to 3D data via robotic tracking, enhancing volumetric reconstruction for improved ultrasound interpretation and precise disease diagnosis. However, the interpretability of 3D US reconstruction of abdominal images can be affected by the patient's breathing motion. This study introduces a method to compensate for breathing motion in 3D US compounding by leveraging implicit neural representations. Our approach employs a robotic ultrasound system for automated screenings. To demonstrate the method's effectiveness, we evaluate our proposed method for the diagnosis and monitoring of abdominal aorta aneurysms as a representative use case. Our experiments demonstrate that our proposed pipeline facilitates robust automated robotic acquisition, mitigating artifacts from breathing motion, and yields smoother 3D reconstructions for enhanced screening and medical diagnosis.
A host of medical conditions, including amputations, diabetes, stroke, and genetic disease, result in loss of touch sensation. Because most types of sensory loss have no pharmacological treatment or rehabilitative therapy, we propose a haptic sensory prosthesis that provides substitutive feedback. The wrist and forearm are compelling locations for feedback due to available skin area and not occluding the hands, but have reduced mechanoreceptor density compared to the fingertips. Focusing on localized pressure as the feedback modality, we hypothesize that we can improve on prior devices by invoking a wider range of stimulus intensity using multiple points of pressure to evoke spatial summation, which is the cumulative perceptual experience from multiple points of stimuli. We conducted a preliminary perceptual test to investigate this idea and found that just noticeable difference is reduced with two points of pressure compared to one, motivating future work using spatial summation in sensory prostheses.
Due to the uncertainty of traffic participants' intentions, generating safe but not overly cautious behavior in interactive driving scenarios remains a formidable challenge for autonomous driving. In this paper, we address this issue by combining a deep learning-based trajectory prediction model with risk potential field-based motion planning. In order to comprehensively predict the possible future trajectories of other vehicles, we propose a target-region based trajectory prediction model(TRTP) which considers every region a vehicle may arrive in the future. After that, we construct a risk potential field at each future time step based on the prediction results of TRTP, and integrate risk value to the objective function of Model Predictive Contouring Control(MPCC). This enables the uncertainty of other vehicles to be taken into account during the planning process. Balancing between risk and progress along the reference path can achieve both driving safety and efficiency at the same time. We also demonstrate the security and effectiveness performance of our method in the CARLA simulator.
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