Many diseases, including cancer and chronic conditions, require extended treatment periods and long-term strategies. Machine learning and AI research focusing on electronic health records (EHRs) have emerged to address this need. Effective treatment strategies involve more than capturing sequential changes in patient test values. It requires an explainable and clinically interpretable model by capturing the patient's internal state over time. In this study, we propose the "deep state-space analysis framework," using time-series unsupervised learning of EHRs with a deep state-space model. This framework enables learning, visualizing, and clustering of temporal changes in patient latent states related to disease progression. We evaluated our framework using time-series laboratory data from 12,695 cancer patients. By estimating latent states, we successfully discover latent states related to prognosis. By visualization and cluster analysis, the temporal transition of patient status and test items during state transitions characteristic of each anticancer drug were identified. Our framework surpasses existing methods in capturing interpretable latent space. It can be expected to enhance our comprehension of disease progression from EHRs, aiding treatment adjustments and prognostic determinations.
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Objective: Neoadjuvant chemotherapy (NACT) is one kind of treatment for advanced stage ovarian cancer patients. However, due to the nature of tumor heterogeneity, the patients' responses to NACT varies significantly among different subgroups. To address this clinical challenge, the purpose of this study is to develop a novel image marker to achieve high accuracy response prediction of the NACT at an early stage. Methods: For this purpose, we first computed a total of 1373 radiomics features to quantify the tumor characteristics, which can be grouped into three categories: geometric, intensity, and texture features. Second, all these features were optimized by principal component analysis algorithm to generate a compact and informative feature cluster. Using this cluster as the input, an SVM based classifier was developed and optimized to create a final marker, indicating the likelihood of the patient being responsive to the NACT treatment. To validate this scheme, a total of 42 ovarian cancer patients were retrospectively collected. A nested leave-one-out cross-validation was adopted for model performance assessment. Results: The results demonstrate that the new method yielded an AUC (area under the ROC [receiver characteristic operation] curve) of 0.745. Meanwhile, the model achieved overall accuracy of 76.2%, positive predictive value of 70%, and negative predictive value of 78.1%. Conclusion: This study provides meaningful information for the development of radiomics based image markers in NACT response prediction.
Several recent contributions in the field of iterative STFT phase retrieval have demonstrated that the performance of the classical Griffin-Lim method can be considerably improved upon. By using the same projection operators as Griffin-Lim, but combining them in innovative ways, these approaches achieve better results in terms of both reconstruction quality and required number of iterations, while retaining a similar computational complexity per iteration. However, like Griffin-Lim, these algorithms operate in an offline manner and thus require an entire spectrogram as input, which is an unrealistic requirement for many real-world speech communication applications. We propose to extend RTISI -- an existing online (frame-by-frame) variant of the Griffin-Lim algorithm -- into a flexible framework that enables straightforward online implementation of any algorithm based on iterative projections. We further employ this framework to implement online variants of the fast Griffin-Lim algorithm, the accelerated Griffin-Lim algorithm, and two algorithms from the optics domain. Evaluation results on speech signals show that, similarly to the offline case, these algorithms can achieve a considerable performance gain compared to RTISI.
Amyotrophic lateral sclerosis is a fatal disease that not only affects movement, speech, and breath but also cognition. Recent studies have focused on the use of language analysis techniques to detect ALS and infer scales for monitoring functional progression. In this paper, we focused on another important aspect, cognitive impairment, which affects 35-50% of the ALS population. In an effort to reach the ALS population, which frequently exhibits mobility limitations, we implemented the digital version of the Edinburgh Cognitive and Behavioral ALS Screen (ECAS) test for the first time. This test which is designed to measure cognitive impairment was remotely performed by 56 participants from the EverythingALS Speech Study. As part of the study, participants (ALS and non-ALS) were asked to describe weekly one picture from a pool of many pictures with complex scenes displayed on their computer at home. We analyze the descriptions performed within +/- 60 days from the day the ECAS test was administered and extract different types of linguistic and acoustic features. We input those features into linear regression models to infer 5 ECAS sub-scores and the total score. Speech samples from the picture description are reliable enough to predict the ECAS subs-scores, achieving statistically significant Spearman correlation values between 0.32 and 0.51 for the model's performance using 10-fold cross-validation.
Adversarial face examples possess two critical properties: Visual Quality and Transferability. However, existing approaches rarely address these properties simultaneously, leading to subpar results. To address this issue, we propose a novel adversarial attack technique known as Adversarial Restoration (AdvRestore), which enhances both visual quality and transferability of adversarial face examples by leveraging a face restoration prior. In our approach, we initially train a Restoration Latent Diffusion Model (RLDM) designed for face restoration. Subsequently, we employ the inference process of RLDM to generate adversarial face examples. The adversarial perturbations are applied to the intermediate features of RLDM. Additionally, by treating RLDM face restoration as a sibling task, the transferability of the generated adversarial face examples is further improved. Our experimental results validate the effectiveness of the proposed attack method.
Renal pathology, as the gold standard of kidney disease diagnosis, requires doctors to analyze a serial of tissue slices stained by H\&E staining and special staining like Masson, PASM, and PAS, respectively. These special staining methods are costly, time-consuming, and hard to standardize for wide use especially in primary hospitals. Advances of supervised learning methods can virtually convert H\&E images into special staining images, but the pixel-to-pixel alignment is hard to achieve for training. As contrast, unsupervised learning methods regarding different stains as different style transferring domains can use unpaired data, but they ignore the spatial inter-domain correlations and thus decrease the trustworthiness of structural details for diagnosis. In this paper, we propose a novel virtual staining framework AGMDT to translate images into other domains by avoiding pixel-level alignment and meanwhile utilizing the correlations among adjacent tissue slices. We first build a high-quality multi-domain renal histological dataset where each specimen case comprises a series of slices stained in various ways. Based on it, the proposed framework AGMDT discovers patch-level aligned pairs across the serial slices of multi-domains through glomerulus detection and bipartite graph matching, and utilizes such correlations to supervise the end-to-end model for multi-domain staining transformation. Experimental results show that the proposed AGMDT achieves a good balance between the precise pixel-level alignment and unpaired domain transfer by exploiting correlations across multi-domain serial pathological slices, and outperforms the state-of-the-art methods in both quantitative measure and morphological details.
End-stage renal disease has many adverse complications associated with it leading to 20-50% higher mortality rates in people than those without the disease. This makes it one of the leading causes of death in the United States. This article analyzes the incidence of end-stage renal disease in 2019 in Florida using a multilevel Conditional Autoregressive model under a Bayesian framework at both the Zip Code Tabulation Area and facility levels. The effects of some social factors and indicators of health on the standardized hospitalization ratio of dialysis facilities are quantified. Additionally, as kidney research studies are posed with a great burden due to missing data, we introduce a novel method to impute missing spatial data using spatial state space modeling. The outcomes of this study offer potentially valuable insights for policymakers aiming to develop strategies that enhance healthcare and service quality for disadvantaged populations.
Deep neural networks (DNN) have demonstrated unprecedented success for medical imaging applications. However, due to the issue of limited dataset availability and the strict legal and ethical requirements for patient privacy protection, the broad applications of medical imaging classification driven by DNN with large-scale training data have been largely hindered. For example, when training the DNN from one domain (e.g., with data only from one hospital), the generalization capability to another domain (e.g., data from another hospital) could be largely lacking. In this paper, we aim to tackle this problem by developing the privacy-preserving constrained domain generalization method, aiming to improve the generalization capability under the privacy-preserving condition. In particular, We propose to improve the information aggregation process on the centralized server-side with a novel gradient alignment loss, expecting that the trained model can be better generalized to the "unseen" but related medical images. The rationale and effectiveness of our proposed method can be explained by connecting our proposed method with the Maximum Mean Discrepancy (MMD) which has been widely adopted as the distribution distance measurement. Experimental results on two challenging medical imaging classification tasks indicate that our method can achieve better cross-domain generalization capability compared to the state-of-the-art federated learning methods.
Health-related acoustic signals, such as cough and breathing sounds, are relevant for medical diagnosis and continuous health monitoring. Most existing machine learning approaches for health acoustics are trained and evaluated on specific tasks, limiting their generalizability across various healthcare applications. In this paper, we leverage a self-supervised learning framework, SimCLR with a Slowfast NFNet backbone, for contrastive learning of health acoustics. A crucial aspect of optimizing Slowfast NFNet for this application lies in identifying effective audio augmentations. We conduct an in-depth analysis of various audio augmentation strategies and demonstrate that an appropriate augmentation strategy enhances the performance of the Slowfast NFNet audio encoder across a diverse set of health acoustic tasks. Our findings reveal that when augmentations are combined, they can produce synergistic effects that exceed the benefits seen when each is applied individually.
Radiologists possess diverse training and clinical experiences, leading to variations in the segmentation annotations of lung nodules and resulting in segmentation uncertainty.Conventional methods typically select a single annotation as the learning target or attempt to learn a latent space comprising multiple annotations. However, these approaches fail to leverage the valuable information inherent in the consensus and disagreements among the multiple annotations. In this paper, we propose an Uncertainty-Aware Attention Mechanism (UAAM) that utilizes consensus and disagreements among multiple annotations to facilitate better segmentation. To this end, we introduce the Multi-Confidence Mask (MCM), which combines a Low-Confidence (LC) Mask and a High-Confidence (HC) Mask.The LC mask indicates regions with low segmentation confidence, where radiologists may have different segmentation choices. Following UAAM, we further design an Uncertainty-Guide Multi-Confidence Segmentation Network (UGMCS-Net), which contains three modules: a Feature Extracting Module that captures a general feature of a lung nodule, an Uncertainty-Aware Module that produces three features for the the annotations' union, intersection, and annotation set, and an Intersection-Union Constraining Module that uses distances between the three features to balance the predictions of final segmentation and MCM. To comprehensively demonstrate the performance of our method, we propose a Complex Nodule Validation on LIDC-IDRI, which tests UGMCS-Net's segmentation performance on lung nodules that are difficult to segment using common methods. Experimental results demonstrate that our method can significantly improve the segmentation performance on nodules that are difficult to segment using conventional methods.
Clinical Named Entity Recognition (CNER) aims to identify and classify clinical terms such as diseases, symptoms, treatments, exams, and body parts in electronic health records, which is a fundamental and crucial task for clinical and translational research. In recent years, deep neural networks have achieved significant success in named entity recognition and many other Natural Language Processing (NLP) tasks. Most of these algorithms are trained end to end, and can automatically learn features from large scale labeled datasets. However, these data-driven methods typically lack the capability of processing rare or unseen entities. Previous statistical methods and feature engineering practice have demonstrated that human knowledge can provide valuable information for handling rare and unseen cases. In this paper, we address the problem by incorporating dictionaries into deep neural networks for the Chinese CNER task. Two different architectures that extend the Bi-directional Long Short-Term Memory (Bi-LSTM) neural network and five different feature representation schemes are proposed to handle the task. Computational results on the CCKS-2017 Task 2 benchmark dataset show that the proposed method achieves the highly competitive performance compared with the state-of-the-art deep learning methods.
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