OPEN: A Benchmark Dataset and Baseline for Older Adult Patient Engagement Recognition in Virtual Rehabilitation Learning Environments

Engagement in virtual learning is essential for participant satisfaction, performance, and adherence, particularly in online education and virtual rehabilitation, where interactive communication plays a key role. Yet, accurately measuring engagement in virtual group settings remains a challenge. There is increasing interest in using artificial intelligence (AI) for large-scale, real-world, automated engagement recognition. While engagement has been widely studied in younger academic populations, research and datasets focused on older adults in virtual and telehealth learning settings remain limited. Existing methods often neglect contextual relevance and the longitudinal nature of engagement across sessions. This paper introduces OPEN (Older adult Patient ENgagement), a novel dataset supporting AI-driven engagement recognition. It was collected from eleven older adults participating in weekly virtual group learning sessions over six weeks as part of cardiac rehabilitation, producing over 35 hours of data, making it the largest dataset of its kind. To protect privacy, raw video is withheld; instead, the released data include facial, hand, and body joint landmarks, along with affective and behavioral features extracted from video. Annotations include binary engagement states, affective and behavioral labels, and context-type indicators, such as whether the instructor addressed the group or an individual. The dataset offers versions with 5-, 10-, 30-second, and variable-length samples. To demonstrate utility, multiple machine learning and deep learning models were trained, achieving engagement recognition accuracy of up to 81 percent. OPEN provides a scalable foundation for personalized engagement modeling in aging populations and contributes to broader engagement recognition research.

Explaining Recovery Trajectories of Older Adults Post Lower-Limb Fracture Using Modality-wise Multiview Clustering and Large Language Models

Interpreting large volumes of high-dimensional, unlabeled data in a manner that is comprehensible to humans remains a significant challenge across various domains. In unsupervised healthcare data analysis, interpreting clustered data can offer meaningful insights into patients' health outcomes, which hold direct implications for healthcare providers. This paper addresses the problem of interpreting clustered sensor data collected from older adult patients recovering from lower-limb fractures in the community. A total of 560 days of multimodal sensor data, including acceleration, step count, ambient motion, GPS location, heart rate, and sleep, alongside clinical scores, were remotely collected from patients at home. Clustering was first carried out separately for each data modality to assess the impact of feature sets extracted from each modality on patients' recovery trajectories. Then, using context-aware prompting, a large language model was employed to infer meaningful cluster labels for the clusters derived from each modality. The quality of these clusters and their corresponding labels was validated through rigorous statistical testing and visualization against clinical scores collected alongside the multimodal sensor data. The results demonstrated the statistical significance of most modality-specific cluster labels generated by the large language model with respect to clinical scores, confirming the efficacy of the proposed method for interpreting sensor data in an unsupervised manner. This unsupervised data analysis approach, relying solely on sensor data, enables clinicians to identify at-risk patients and take timely measures to improve health outcomes.

Supervised Contrastive Learning for Ordinal Engagement Measurement

Student engagement plays a crucial role in the successful delivery of educational programs. Automated engagement measurement helps instructors monitor student participation, identify disengagement, and adapt their teaching strategies to enhance learning outcomes effectively. This paper identifies two key challenges in this problem: class imbalance and incorporating order into engagement levels rather than treating it as mere categories. Then, a novel approach to video-based student engagement measurement in virtual learning environments is proposed that utilizes supervised contrastive learning for ordinal classification of engagement. Various affective and behavioral features are extracted from video samples and utilized to train ordinal classifiers within a supervised contrastive learning framework (with a sequential classifier as the encoder). A key step involves the application of diverse time-series data augmentation techniques to these feature vectors, enhancing model training. The effectiveness of the proposed method was evaluated using a publicly available dataset for engagement measurement, DAiSEE, containing videos of students who participated in virtual learning programs. The results demonstrate the robust ability of the proposed method for the classification of the engagement level. This approach promises a significant contribution to understanding and enhancing student engagement in virtual learning environments.

LOCO-EPI: Leave-one-chromosome-out (LOCO) as a benchmarking paradigm for deep learning based prediction of enhancer-promoter interactions

In mammalian and vertebrate genomes, the promoter regions of the gene and their distal enhancers may be located millions of base-pairs from each other, while a promoter may not interact with the closest enhancer. Since base-pair proximity is not a good indicator of these interactions, there is considerable work toward developing methods for predicting Enhancer-Promoter Interactions (EPI). Several machine learning methods have reported increasingly higher accuracies for predicting EPI. Typically, these approaches randomly split the dataset of Enhancer-Promoter (EP) pairs into training and testing subsets followed by model training. However, the aforementioned random splitting causes information leakage by assigning EP pairs from the same genomic region to both testing and training sets, leading to performance overestimation. In this paper we propose to use a more thorough training and testing paradigm i.e., Leave-one-chromosome-out (LOCO) cross-validation for EPI-prediction. We demonstrate that a deep learning algorithm, which gives higher accuracies when trained and tested on random-splitting setting, drops drastically in performance under LOCO setting, confirming overestimation of performance. We further propose a novel hybrid deep neural network for EPI-prediction that fuses k-mer features of the nucleotide sequence. We show that the hybrid architecture performs significantly better in the LOCO setting, demonstrating it can learn more generalizable aspects of EP interactions. With this paper we are also releasing the LOCO splitting-based EPI dataset. Research data is available in this public repository: https://github.com/malikmtahir/EPI

Multimodal Sensor Dataset for Monitoring Older Adults Post Lower-Limb Fractures in Community Settings

Lower-Limb Fractures (LLF) are a major health concern for older adults, often leading to reduced mobility and prolonged recovery, potentially impairing daily activities and independence. During recovery, older adults frequently face social isolation and functional decline, complicating rehabilitation and adversely affecting physical and mental health. Multi-modal sensor platforms that continuously collect data and analyze it using machine-learning algorithms can remotely monitor this population and infer health outcomes. They can also alert clinicians to individuals at risk of isolation and decline. This paper presents a new publicly available multi-modal sensor dataset, MAISON-LLF, collected from older adults recovering from LLF in community settings. The dataset includes data from smartphone and smartwatch sensors, motion detectors, sleep-tracking mattresses, and clinical questionnaires on isolation and decline. The dataset was collected from ten older adults living alone at home for eight weeks each, totaling 560 days of 24-hour sensor data. For technical validation, supervised machine-learning and deep-learning models were developed using the sensor and clinical questionnaire data, providing a foundational comparison for the research community.

UlcerGPT: A Multimodal Approach Leveraging Large Language and Vision Models for Diabetic Foot Ulcer Image Transcription

Diabetic foot ulcers (DFUs) are a leading cause of hospitalizations and lower limb amputations, placing a substantial burden on patients and healthcare systems. Early detection and accurate classification of DFUs are critical for preventing serious complications, yet many patients experience delays in receiving care due to limited access to specialized services. Telehealth has emerged as a promising solution, improving access to care and reducing the need for in-person visits. The integration of artificial intelligence and pattern recognition into telemedicine has further enhanced DFU management by enabling automatic detection, classification, and monitoring from images. Despite advancements in artificial intelligence-driven approaches for DFU image analysis, the application of large language models for DFU image transcription has not yet been explored. To address this gap, we introduce UlcerGPT, a novel multimodal approach leveraging large language and vision models for DFU image transcription. This framework combines advanced vision and language models, such as Large Language and Vision Assistant and Chat Generative Pre-trained Transformer, to transcribe DFU images by jointly detecting, classifying, and localizing regions of interest. Through detailed experiments on a public dataset, evaluated by expert clinicians, UlcerGPT demonstrates promising results in the accuracy and efficiency of DFU transcription, offering potential support for clinicians in delivering timely care via telemedicine.

Depth-Weighted Detection of Behaviours of Risk in People with Dementia using Cameras

The behavioural and psychological symptoms of dementia, such as agitation and aggression, present a significant health and safety risk in residential care settings. Many care facilities have video cameras in place for digital monitoring of public spaces, which can be leveraged to develop an automated behaviours of risk detection system that can alert the staff to enable timely intervention and prevent the situation from escalating. However, one of the challenges in our previous study was the presence of false alarms due to obstruction of view by activities happening close to the camera. To address this issue, we proposed a novel depth-weighted loss function to train a customized convolutional autoencoder to enforce equivalent importance to the events happening both near and far from the cameras; thus, helping to reduce false alarms and making the method more suitable for real-world deployment. The proposed method was trained using data from nine participants with dementia across three cameras situated in a specialized dementia unit and achieved an area under the curve of receiver operating characteristic of $0.852$, $0.81$ and $0.768$ for the three cameras. Ablation analysis was conducted for the individual components of the proposed method and the performance of the proposed method was investigated for participant-specific and sex-specific behaviours of risk detection. The proposed method performed reasonably well in detecting behaviours of risk in people with dementia motivating further research toward the development of a behaviours of risk detection system suitable for deployment in video surveillance systems in care facilities.

Engagement Measurement Based on Facial Landmarks and Spatial-Temporal Graph Convolutional Networks

Engagement in virtual learning is crucial for a variety of factors including learner satisfaction, performance, and compliance with learning programs, but measuring it is a challenging task. There is therefore considerable interest in utilizing artificial intelligence and affective computing to measure engagement in natural settings as well as on a large scale. This paper introduces a novel, privacy-preserving method for engagement measurement from videos. It uses facial landmarks, which carry no personally identifiable information, extracted from videos via the MediaPipe deep learning solution. The extracted facial landmarks are fed to a Spatial-Temporal Graph Convolutional Network (ST-GCN) to output the engagement level of the learner in the video. To integrate the ordinal nature of the engagement variable into the training process, ST-GCNs undergo training in a novel ordinal learning framework based on transfer learning. Experimental results on two video student engagement measurement datasets show the superiority of the proposed method compared to previous methods with improved state-of-the-art on the EngageNet dataset with a %3.1 improvement in four-class engagement level classification accuracy and on the Online Student Engagement dataset with a %1.5 improvement in binary engagement classification accuracy. The relatively lightweight ST-GCN and its integration with the real-time MediaPipe deep learning solution make the proposed approach capable of being deployed on virtual learning platforms and measuring engagement in real time.

Rehabilitation Exercise Quality Assessment through Supervised Contrastive Learning with Hard and Soft Negatives

Exercise-based rehabilitation programs have proven to be effective in enhancing the quality of life and reducing mortality and rehospitalization rates. AI-driven virtual rehabilitation, which allows patients to independently complete exercises at home, utilizes AI algorithms to analyze exercise data, providing feedback to patients and updating clinicians on their progress. These programs commonly prescribe a variety of exercise types, leading to a distinct challenge in rehabilitation exercise assessment datasets: while abundant in overall training samples, these datasets often have a limited number of samples for each individual exercise type. This disparity hampers the ability of existing approaches to train generalizable models with such a small sample size per exercise. Addressing this issue, our paper introduces a novel supervised contrastive learning framework with hard and soft negative samples that effectively utilizes the entire dataset to train a single model applicable to all exercise types. This model, with a Spatial-Temporal Graph Convolutional Network (ST-GCN) architecture, demonstrated enhanced generalizability across exercises and a decrease in overall complexity. Through extensive experiments on three publicly available rehabilitation exercise assessment datasets, the University of Idaho-Physical Rehabilitation Movement Data (UI-PRMD), IntelliRehabDS (IRDS), and KInematic assessment of MOvement and clinical scores for remote monitoring of physical REhabilitation (KIMORE), our method has shown to surpass existing methods, setting a new benchmark in rehabilitation exercise assessment accuracy.

Domain-Specific Deep Learning Feature Extractor for Diabetic Foot Ulcer Detection

Diabetic Foot Ulcer (DFU) is a condition requiring constant monitoring and evaluations for treatment. DFU patient population is on the rise and will soon outpace the available health resources. Autonomous monitoring and evaluation of DFU wounds is a much-needed area in health care. In this paper, we evaluate and identify the most accurate feature extractor that is the core basis for developing a deep-learning wound detection network. For the evaluation, we used mAP and F1-score on the publicly available DFU2020 dataset. A combination of UNet and EfficientNetb3 feature extractor resulted in the best evaluation among the 14 networks compared. UNet and Efficientnetb3 can be used as the classifier in the development of a comprehensive DFU domain-specific autonomous wound detection pipeline.