Pulmonary nodules and masses are crucial imaging features in lung cancer screening that require careful management in clinical diagnosis. Despite the success of deep learning-based medical image segmentation, the robust performance on various sizes of lesions of nodule and mass is still challenging. In this paper, we propose a multi-scale neural network with scale-aware test-time adaptation to address this challenge. Specifically, we introduce an adaptive Scale-aware Test-time Click Adaptation method based on effortlessly obtainable lesion clicks as test-time cues to enhance segmentation performance, particularly for large lesions. The proposed method can be seamlessly integrated into existing networks. Extensive experiments on both open-source and in-house datasets consistently demonstrate the effectiveness of the proposed method over some CNN and Transformer-based segmentation methods. Our code is available at //github.com/SplinterLi/SaTTCA
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The effect of public health interventions on an epidemic are often estimated by adding the intervention to epidemic models. During the Covid-19 epidemic, numerous papers used such methods for making scenario predictions. The majority of these papers use Bayesian methods to estimate the parameters of the model. In this paper we show how to use frequentist methods for estimating these effects which avoids having to specify prior distributions. We also use model-free shrinkage methods to improve estimation when there are many different geographic regions. This allows us to borrow strength from different regions while still getting confidence intervals with correct coverage and without having to specify a hierarchical model. Throughout, we focus on a semi-mechanistic model which provides a simple, tractable alternative to compartmental methods.
Precise polyp segmentation is vital for the early diagnosis and prevention of colorectal cancer (CRC) in clinical practice. However, due to scale variation and blurry polyp boundaries, it is still a challenging task to achieve satisfactory segmentation performance with different scales and shapes. In this study, we present a novel Edge-aware Feature Aggregation Network (EFA-Net) for polyp segmentation, which can fully make use of cross-level and multi-scale features to enhance the performance of polyp segmentation. Specifically, we first present an Edge-aware Guidance Module (EGM) to combine the low-level features with the high-level features to learn an edge-enhanced feature, which is incorporated into each decoder unit using a layer-by-layer strategy. Besides, a Scale-aware Convolution Module (SCM) is proposed to learn scale-aware features by using dilated convolutions with different ratios, in order to effectively deal with scale variation. Further, a Cross-level Fusion Module (CFM) is proposed to effectively integrate the cross-level features, which can exploit the local and global contextual information. Finally, the outputs of CFMs are adaptively weighted by using the learned edge-aware feature, which are then used to produce multiple side-out segmentation maps. Experimental results on five widely adopted colonoscopy datasets show that our EFA-Net outperforms state-of-the-art polyp segmentation methods in terms of generalization and effectiveness.
Clinically-Inspired Multi-Agent Transformers for Disease Trajectory Forecasting from Multimodal Data
Deep neural networks are often applied to medical images to automate the problem of medical diagnosis. However, a more clinically relevant question that practitioners usually face is how to predict the future trajectory of a disease. Current methods for prognosis or disease trajectory forecasting often require domain knowledge and are complicated to apply. In this paper, we formulate the prognosis prediction problem as a one-to-many prediction problem. Inspired by a clinical decision-making process with two agents -- a radiologist and a general practitioner -- we predict prognosis with two transformer-based components that share information with each other. The first transformer in this framework aims to analyze the imaging data, and the second one leverages its internal states as inputs, also fusing them with auxiliary clinical data. The temporal nature of the problem is modeled within the transformer states, allowing us to treat the forecasting problem as a multi-task classification, for which we propose a novel loss. We show the effectiveness of our approach in predicting the development of structural knee osteoarthritis changes and forecasting Alzheimer's disease clinical status directly from raw multi-modal data. The proposed method outperforms multiple state-of-the-art baselines with respect to performance and calibration, both of which are needed for real-world applications. An open-source implementation of our method is made publicly available at \url{//github.com/Oulu-IMEDS/CLIMATv2}.
Due to the shortage of available kidney organs for transplants, handling every donor kidney with utmost care is crucial to preserve the organ's health, especially during the organ supply chain where kidneys are prone to deterioration during transportation. Therefore, this research proposes a blockchain platform to aid in managing kidneys in the supply chain. This framework establishes a secure system that meticulously tracks the organ's location and handling, safeguarding the health from donor to recipient. Additionally, a machine-learning algorithm is embedded to monitor organ health in real-time against various metrics for prompt detection of possible kidney damage.
Trajectory generation and trajectory prediction are two critical tasks for autonomous vehicles, which generate various trajectories during development and predict the trajectories of surrounding vehicles during operation, respectively. However, despite significant advances in improving their performance, it remains a challenging problem to ensure that the generated/predicted trajectories are realistic, explainable, and physically feasible. Existing model-based methods provide explainable results, but are constrained by predefined model structures, limiting their capabilities to address complex scenarios. Conversely, existing deep learning-based methods have shown great promise in learning various traffic scenarios and improving overall performance, but they often act as opaque black boxes and lack explainability. In this work, we integrate kinematic knowledge with neural stochastic differential equations (SDE) and develop a variational autoencoder based on a novel latent kinematics-aware SDE (LK-SDE) to generate vehicle motions. Our approach combines the advantages of both model-based and deep learning-based techniques. Experimental results demonstrate that our method significantly outperforms baseline approaches in producing realistic, physically-feasible, and precisely-controllable vehicle trajectories, benefiting both generation and prediction tasks.
Scarcity of health care resources could result in the unavoidable consequence of rationing. For example, ventilators are often limited in supply, especially during public health emergencies or in resource-constrained health care settings, such as amid the pandemic of COVID-19. Currently, there is no universally accepted standard for health care resource allocation protocols, resulting in different governments prioritizing patients based on various criteria and heuristic-based protocols. In this study, we investigate the use of reinforcement learning for critical care resource allocation policy optimization to fairly and effectively ration resources. We propose a transformer-based deep Q-network to integrate the disease progression of individual patients and the interaction effects among patients during the critical care resource allocation. We aim to improve both fairness of allocation and overall patient outcomes. Our experiments demonstrate that our method significantly reduces excess deaths and achieves a more equitable distribution under different levels of ventilator shortage, when compared to existing severity-based and comorbidity-based methods in use by different governments. Our source code is included in the supplement and will be released on Github upon publication.
Automated segmentation of the blood vessels in 3D volumes is an essential step for the quantitative diagnosis and treatment of many vascular diseases. 3D vessel segmentation is being actively investigated in existing works, mostly in deep learning approaches. However, training 3D deep networks requires large amounts of manual 3D annotations from experts, which are laborious to obtain. This is especially the case for 3D vessel segmentation, as vessels are sparse yet spread out over many slices and disconnected when visualized in 2D slices. In this work, we propose a novel method to segment the 3D peripancreatic arteries solely from one annotated 2D projection per training image with depth supervision. We perform extensive experiments on the segmentation of peripancreatic arteries on 3D contrast-enhanced CT images and demonstrate how well we capture the rich depth information from 2D projections. We demonstrate that by annotating a single, randomly chosen projection for each training sample, we obtain comparable performance to annotating multiple 2D projections, thereby reducing the annotation effort. Furthermore, by mapping the 2D labels to the 3D space using depth information and incorporating this into training, we almost close the performance gap between 3D supervision and 2D supervision. Our code is available at: //github.com/alinafdima/3Dseg-mip-depth.
Unsupervised learning of facial representations has gained increasing attention for face understanding ability without heavily relying on large-scale annotated datasets. However, it remains unsolved due to the coupling of facial identities, expressions, and external factors like pose and light. Prior methods primarily focus on 2D factors and pixel-level consistency, leading to incomplete disentangling and suboptimal performance in downstream tasks. In this paper, we propose LatentFace, a novel unsupervised disentangling framework for facial expression and identity representation. We suggest the disentangling problem should be performed in latent space and propose the solution using a 3D-ware latent diffusion model. First, we introduce a 3D-aware autoencoder to encode face images into 3D latent embeddings. Second, we propose a novel representation diffusion model (RDM) to disentangle 3D latent into facial identity and expression. Consequently, our method achieves state-of-the-art performance in facial expression recognition and face verification among unsupervised facial representation learning models.
Human doctors with well-structured medical knowledge can diagnose a disease merely via a few conversations with patients about symptoms. In contrast, existing knowledge-grounded dialogue systems often require a large number of dialogue instances to learn as they fail to capture the correlations between different diseases and neglect the diagnostic experience shared among them. To address this issue, we propose a more natural and practical paradigm, i.e., low-resource medical dialogue generation, which can transfer the diagnostic experience from source diseases to target ones with a handful of data for adaptation. It is capitalized on a commonsense knowledge graph to characterize the prior disease-symptom relations. Besides, we develop a Graph-Evolving Meta-Learning (GEML) framework that learns to evolve the commonsense graph for reasoning disease-symptom correlations in a new disease, which effectively alleviates the needs of a large number of dialogues. More importantly, by dynamically evolving disease-symptom graphs, GEML also well addresses the real-world challenges that the disease-symptom correlations of each disease may vary or evolve along with more diagnostic cases. Extensive experiment results on the CMDD dataset and our newly-collected Chunyu dataset testify the superiority of our approach over state-of-the-art approaches. Besides, our GEML can generate an enriched dialogue-sensitive knowledge graph in an online manner, which could benefit other tasks grounded on knowledge graph.
We study the problem of named entity recognition (NER) from electronic medical records, which is one of the most fundamental and critical problems for medical text mining. Medical records which are written by clinicians from different specialties usually contain quite different terminologies and writing styles. The difference of specialties and the cost of human annotation makes it particularly difficult to train a universal medical NER system. In this paper, we propose a label-aware double transfer learning framework (La-DTL) for cross-specialty NER, so that a medical NER system designed for one specialty could be conveniently applied to another one with minimal annotation efforts. The transferability is guaranteed by two components: (i) we propose label-aware MMD for feature representation transfer, and (ii) we perform parameter transfer with a theoretical upper bound which is also label aware. We conduct extensive experiments on 12 cross-specialty NER tasks. The experimental results demonstrate that La-DTL provides consistent accuracy improvement over strong baselines. Besides, the promising experimental results on non-medical NER scenarios indicate that La-DTL is potential to be seamlessly adapted to a wide range of NER tasks.
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