Stroke patients often experience upper limb impairments that restrict their mobility and daily activities. Physical therapy (PT) is the most effective method to improve impairments, but low patient adherence and participation in PT exercises pose significant challenges. To overcome these barriers, a combination of virtual reality (VR) and robotics in PT is promising. However, few systems effectively integrate VR with robotics, especially for upper limb rehabilitation. This work introduces a new virtual rehabilitation solution that combines VR with robotics and a wearable sensor to analyze elbow joint movements. The framework also enhances the capabilities of a traditional robotic device (KinArm) used for motor dysfunction assessment and rehabilitation. A pilot user study (n = 16) was conducted to evaluate the effectiveness and usability of the proposed VR framework. We used a two-way repeated measures experimental design where participants performed two tasks (Circle and Diamond) with two conditions (VR and VR KinArm). We observed no significant differences in the main effect of conditions for task completion time. However, there were significant differences in both the normalized number of mistakes and recorded elbow joint angles (captured as resistance change values from the wearable sleeve sensor) between the Circle and Diamond tasks. Additionally, we report the system usability, task load, and presence in the proposed VR framework. This system demonstrates the potential advantages of an immersive, multi-sensory approach and provides future avenues for research in developing more cost-effective, tailored, and personalized upper limb solutions for home therapy applications.
The emergence of generative Large Language Models (LLMs) emphasizes the need for accurate and efficient prompting approaches. LLMs are often applied in Few-Shot Learning (FSL) contexts, where tasks are executed with minimal training data. FSL has become popular in many Artificial Intelligence (AI) subdomains, including AI for health. Rare diseases, affecting a small fraction of the population, inherently require FSL techniques due to limited data availability, though manual data collection and annotation is costly and time-consuming. In this paper, we propose Models-Vote Prompting (MVP), a flexible prompting approach for improving the performance of LLM queries in FSL settings. MVP works by prompting numerous LLMs to perform the same tasks and then conducting a majority vote on the resulting outputs. This method achieves improved results to any one model in the ensemble on one-shot rare disease identification and classification tasks. We also release a novel rare disease dataset for FSL, available to those who agreed to the MIMIC-IV Data Use Agreement (DUA). Furthermore, in using MVP, each model is prompted multiple times, substantially increasing the time needed for manual annotation, and to address this, we assess the feasibility of using JSON for automating generative LLM evaluation.
In clinical dictation, utterances after automatic speech recognition (ASR) without explicit punctuation marks may lead to the misunderstanding of dictated reports. To give a precise and understandable clinical report with ASR, automatic punctuation restoration is required. Considering a practical scenario, we propose a fast and light pre-trained model for Chinese medical punctuation restoration based on 'pretraining and fine-tuning' paradigm. In this work, we distill pre-trained models by incorporating supervised contrastive learning and a novel auxiliary pre-training task (Punctuation Mark Prediction) to make it well-suited for punctuation restoration. Our experiments on various distilled models reveal that our model can achieve 95% performance while 10% model size relative to state-of-the-art Chinese RoBERTa.
In recommendation literature, explainability and fairness are becoming two prominent perspectives to consider. However, prior works have mostly addressed them separately, for instance by explaining to consumers why a certain item was recommended or mitigating disparate impacts in recommendation utility. None of them has leveraged explainability techniques to inform unfairness mitigation. In this paper, we propose an approach that relies on counterfactual explanations to augment the set of user-item interactions, such that using them while inferring recommendations leads to fairer outcomes. Modeling user-item interactions as a bipartite graph, our approach augments the latter by identifying new user-item edges that not only can explain the original unfairness by design, but can also mitigate it. Experiments on two public data sets show that our approach effectively leads to a better trade-off between fairness and recommendation utility compared with state-of-the-art mitigation procedures. We further analyze the characteristics of added edges to highlight key unfairness patterns. Source code available at //github.com/jackmedda/RS-BGExplainer/tree/cikm2023.
Studies on semi-supervised medical image segmentation (SSMIS) have seen fast progress recently. Due to the limited labelled data, SSMIS methods mainly focus on effectively leveraging unlabeled data to enhance the segmentation performance. However, despite their promising performance, current state-of-the-art methods often prioritize integrating complex techniques and loss terms rather than addressing the core challenges of semi-supervised scenarios directly. We argue that the key to SSMIS lies in generating substantial and appropriate prediction disagreement on unlabeled data. To this end, we emphasize the crutiality of data perturbation and model stabilization in semi-supervised segmentation, and propose a simple yet effective approach to boost SSMIS performance significantly, dubbed DPMS. Specifically, we first revisit SSMIS from three distinct perspectives: the data, the model, and the loss, and conduct a comprehensive study of corresponding strategies to examine their effectiveness. Based on these examinations, we then propose DPMS, which adopts a plain teacher-student framework with a standard supervised loss and unsupervised consistency loss. To produce appropriate prediction disagreements, DPMS perturbs the unlabeled data via strong augmentations to enlarge prediction disagreements considerably. On the other hand, using EMA teacher when strong augmentation is applied does not necessarily improve performance. DPMS further utilizes a forwarding-twice and momentum updating strategies for normalization statistics to stabilize the training on unlabeled data effectively. Despite its simplicity, DPMS can obtain new state-of-the-art performance on the public 2D ACDC and 3D LA datasets across various semi-supervised settings, e.g. obtaining a remarkable 22.62% improvement against previous SOTA on ACDC with 5% labels.
The fairness issue of clinical data modeling, especially on Electronic Health Records (EHRs), is of utmost importance due to EHR's complex latent structure and potential selection bias. It is frequently necessary to mitigate health disparity while keeping the model's overall accuracy in practice. However, traditional methods often encounter the trade-off between accuracy and fairness, as they fail to capture the underlying factors beyond observed data. To tackle this challenge, we propose a novel model called Fair Longitudinal Medical Deconfounder (FLMD) that aims to achieve both fairness and accuracy in longitudinal Electronic Health Records (EHR) modeling. Drawing inspiration from the deconfounder theory, FLMD employs a two-stage training process. In the first stage, FLMD captures unobserved confounders for each encounter, which effectively represents underlying medical factors beyond observed EHR, such as patient genotypes and lifestyle habits. This unobserved confounder is crucial for addressing the accuracy/fairness dilemma. In the second stage, FLMD combines the learned latent representation with other relevant features to make predictions. By incorporating appropriate fairness criteria, such as counterfactual fairness, FLMD ensures that it maintains high prediction accuracy while simultaneously minimizing health disparities. We conducted comprehensive experiments on two real-world EHR datasets to demonstrate the effectiveness of FLMD. Apart from the comparison of baseline methods and FLMD variants in terms of fairness and accuracy, we assessed the performance of all models on disturbed/imbalanced and synthetic datasets to showcase the superiority of FLMD across different settings and provide valuable insights into its capabilities.
Early surgical treatment of brain tumors is crucial in reducing patient mortality rates. However, brain tissue deformation (called brain shift) occurs during the surgery, rendering pre-operative images invalid. As a cost-effective and portable tool, intra-operative ultrasound (iUS) can track brain shift, and accurate MRI-iUS registration techniques can update pre-surgical plans and facilitate the interpretation of iUS. This can boost surgical safety and outcomes by maximizing tumor removal while avoiding eloquent regions. However, manual assessment of MRI-iUS registration results in real-time is difficult and prone to errors due to the 3D nature of the data. Automatic algorithms that can quantify the quality of inter-modal medical image registration outcomes can be highly beneficial. Therefore, we propose a novel deep-learning (DL) based framework with the Swin UNETR to automatically assess 3D-patch-wise dense error maps for MRI-iUS registration in iUS-guided brain tumor resection and show its performance with real clinical data for the first time.
We propose to learn non-convex regularizers with a prescribed upper bound on their weak-convexity modulus. Such regularizers give rise to variational denoisers that minimize a convex energy. They rely on few parameters (less than 15,000) and offer a signal-processing interpretation as they mimic handcrafted sparsity-promoting regularizers. Through numerical experiments, we show that such denoisers outperform convex-regularization methods as well as the popular BM3D denoiser. Additionally, the learned regularizer can be deployed to solve inverse problems with iterative schemes that provably converge. For both CT and MRI reconstruction, the regularizer generalizes well and offers an excellent tradeoff between performance, number of parameters, guarantees, and interpretability when compared to other data-driven approaches.
Patient portal allows discharged patients to access their personalized discharge instructions in electronic health records (EHRs). However, many patients have difficulty understanding or memorizing their discharge instructions. In this paper, we present PaniniQA, a patient-centric interactive question answering system designed to help patients understand their discharge instructions. PaniniQA first identifies important clinical content from patients' discharge instructions and then formulates patient-specific educational questions. In addition, PaniniQA is also equipped with answer verification functionality to provide timely feedback to correct patients' misunderstandings. Our comprehensive automatic and human evaluation results demonstrate our PaniniQA is capable of improving patients' mastery of their medical instructions through effective interactions
Few-shot Knowledge Graph (KG) completion is a focus of current research, where each task aims at querying unseen facts of a relation given its few-shot reference entity pairs. Recent attempts solve this problem by learning static representations of entities and references, ignoring their dynamic properties, i.e., entities may exhibit diverse roles within task relations, and references may make different contributions to queries. This work proposes an adaptive attentional network for few-shot KG completion by learning adaptive entity and reference representations. Specifically, entities are modeled by an adaptive neighbor encoder to discern their task-oriented roles, while references are modeled by an adaptive query-aware aggregator to differentiate their contributions. Through the attention mechanism, both entities and references can capture their fine-grained semantic meanings, and thus render more expressive representations. This will be more predictive for knowledge acquisition in the few-shot scenario. Evaluation in link prediction on two public datasets shows that our approach achieves new state-of-the-art results with different few-shot sizes.
Ensembles over neural network weights trained from different random initialization, known as deep ensembles, achieve state-of-the-art accuracy and calibration. The recently introduced batch ensembles provide a drop-in replacement that is more parameter efficient. In this paper, we design ensembles not only over weights, but over hyperparameters to improve the state of the art in both settings. For best performance independent of budget, we propose hyper-deep ensembles, a simple procedure that involves a random search over different hyperparameters, themselves stratified across multiple random initializations. Its strong performance highlights the benefit of combining models with both weight and hyperparameter diversity. We further propose a parameter efficient version, hyper-batch ensembles, which builds on the layer structure of batch ensembles and self-tuning networks. The computational and memory costs of our method are notably lower than typical ensembles. On image classification tasks, with MLP, LeNet, and Wide ResNet 28-10 architectures, our methodology improves upon both deep and batch ensembles.