Atrial Fibrillation (AF) is a common cardiac arrhythmia. Many AF patients experience complications such as stroke and other cardiovascular issues. Early detection of AF is crucial. Existing algorithms can only distinguish ``AF rhythm in AF patients'' from ``sinus rhythm in normal individuals'' . However, AF patients do not always exhibit AF rhythm, posing a challenge for diagnosis when the AF rhythm is absent. To address this, this paper proposes a novel artificial intelligence (AI) algorithm to distinguish ``sinus rhythm in AF patients'' and ``sinus rhythm in normal individuals'' in beat-level. We introduce beat-level risk interpreters, trend risk interpreters, addressing the interpretability issues of deep learning models and the difficulty in explaining AF risk trends. Additionally, the beat-level information fusion decision is presented to enhance model accuracy. The experimental results demonstrate that the average AUC for single beats used as testing data from CPSC 2021 dataset is 0.7314. By employing 150 beats for information fusion decision algorithm, the average AUC can reach 0.7591. Compared to previous segment-level algorithms, we utilized beats as input, reducing data dimensionality and making the model more lightweight, facilitating deployment on portable medical devices. Furthermore, we draw new and interesting findings through average beat analysis and subgroup analysis, considering varying risk levels.
Long-term fetal heart rate (FHR) monitoring during the antepartum period, increasingly popularized by electronic FHR monitoring, represents a growing approach in FHR monitoring. This kind of continuous monitoring, in contrast to the short-term one, collects an extended period of fetal heart data. This offers a more comprehensive understanding of fetus's conditions. However, the interpretation of long-term antenatal fetal heart monitoring is still in its early stages, lacking corresponding clinical standards. Furthermore, the substantial amount of data generated by continuous monitoring imposes a significant burden on clinical work when analyzed manually. To address above challenges, this study develops an automatic analysis system named LARA (Long-term Antepartum Risk Analysis system) for continuous FHR monitoring, combining deep learning and information fusion methods. LARA's core is a well-established convolutional neural network (CNN) model. It processes long-term FHR data as input and generates a Risk Distribution Map (RDM) and Risk Index (RI) as the analysis results. We evaluate LARA on inner test dataset, the performance metrics are as follows: AUC 0.872, accuracy 0.816, specificity 0.811, sensitivity 0.806, precision 0.271, and F1 score 0.415. In our study, we observe that long-term FHR monitoring data with higher RI is more likely to result in adverse outcomes (p=0.0021). In conclusion, this study introduces LARA, the first automated analysis system for long-term FHR monitoring, initiating the further explorations into its clinical value in the future.
Photoplethysmography (PPG) is a highly promising device due to its advantages in portability, user-friendly operation, and non-invasive capabilities to measure a wide range of physiological information. Recent advancements in deep learning have demonstrated remarkable outcomes by leveraging PPG signals for tasks related to personal health management and other multifaceted applications. In this review, we systematically reviewed papers that applied deep learning models to process PPG data between January 1st of 2017 and July 31st of 2023 from Google Scholar, PubMed and Dimensions. Each paper is analyzed from three key perspectives: tasks, models, and data. We finally extracted 193 papers where different deep learning frameworks were used to process PPG signals. Based on the tasks addressed in these papers, we categorized them into two major groups: medical-related, and non-medical-related. The medical-related tasks were further divided into seven subgroups, including blood pressure analysis, cardiovascular monitoring and diagnosis, sleep health, mental health, respiratory monitoring and analysis, blood glucose analysis, as well as others. The non-medical-related tasks were divided into four subgroups, which encompass signal processing, biometric identification, electrocardiogram reconstruction, and human activity recognition. In conclusion, significant progress has been made in the field of using deep learning methods to process PPG data recently. This allows for a more thorough exploration and utilization of the information contained in PPG signals. However, challenges remain, such as limited quantity and quality of publicly available databases, a lack of effective validation in real-world scenarios, and concerns about the interpretability, scalability, and complexity of deep learning models. Moreover, there are still emerging research areas that require further investigation.
Diffusion models are a new class of generative models, and have dramatically promoted image generation with unprecedented quality and diversity. Existing diffusion models mainly try to reconstruct input image from a corrupted one with a pixel-wise or feature-wise constraint along spatial axes. However, such point-based reconstruction may fail to make each predicted pixel/feature fully preserve its neighborhood context, impairing diffusion-based image synthesis. As a powerful source of automatic supervisory signal, context has been well studied for learning representations. Inspired by this, we for the first time propose ConPreDiff to improve diffusion-based image synthesis with context prediction. We explicitly reinforce each point to predict its neighborhood context (i.e., multi-stride features/tokens/pixels) with a context decoder at the end of diffusion denoising blocks in training stage, and remove the decoder for inference. In this way, each point can better reconstruct itself by preserving its semantic connections with neighborhood context. This new paradigm of ConPreDiff can generalize to arbitrary discrete and continuous diffusion backbones without introducing extra parameters in sampling procedure. Extensive experiments are conducted on unconditional image generation, text-to-image generation and image inpainting tasks. Our ConPreDiff consistently outperforms previous methods and achieves a new SOTA text-to-image generation results on MS-COCO, with a zero-shot FID score of 6.21.
Time series widely exists in real-world applications and many deep learning models have performed well on it. Current research has shown the importance of learning strategy for models, suggesting that the benefit is the order and size of learning samples. However, no effective strategy has been proposed for time series due to its abstract and dynamic construction. Meanwhile, the existing one-shot tasks and continuous tasks for time series necessitate distinct learning processes and mechanisms. No all-purpose approach has been suggested. In this work, we propose a novel Curricular and CyclicaL loss (CRUCIAL) to learn time series for the first time. It is model- and task-agnostic and can be plugged on top of the original loss with no extra procedure. CRUCIAL has two characteristics: It can arrange an easy-to-hard learning order by dynamically determining the sample contribution and modulating the loss amplitude; It can manage a cyclically changed dataset and achieve an adaptive cycle by correlating the loss distribution and the selection probability. We prove that compared with monotonous size, cyclical size can reduce expected error. Experiments on 3 kinds of tasks and 5 real-world datasets show the benefits of CRUCIAL for most deep learning models when learning time series.
This work summarizes two strategies for completing time-series (TS) tasks using today's language model (LLM): LLM-for-TS, design and train a fundamental large model for TS data; TS-for-LLM, enable the pre-trained LLM to handle TS data. Considering the insufficient data accumulation, limited resources, and semantic context requirements, this work focuses on TS-for-LLM methods, where we aim to activate LLM's ability for TS data by designing a TS embedding method suitable for LLM. The proposed method is named TEST. It first tokenizes TS, builds an encoder to embed them by instance-wise, feature-wise, and text-prototype-aligned contrast, and then creates prompts to make LLM more open to embeddings, and finally implements TS tasks. Experiments are carried out on TS classification and forecasting tasks using 8 LLMs with different structures and sizes. Although its results cannot significantly outperform the current SOTA models customized for TS tasks, by treating LLM as the pattern machine, it can endow LLM's ability to process TS data without compromising the language ability. This paper is intended to serve as a foundational work that will inspire further research.
Graph Neural Networks (GNNs) conduct message passing which aggregates local neighbors to update node representations. Such message passing leads to scalability issues in practical latency-constrained applications. To address this issue, recent methods adopt knowledge distillation (KD) to learn computationally-efficient multi-layer perceptron (MLP) by mimicking the output of GNN. However, the existing GNN representation space may not be expressive enough for representing diverse local structures of the underlying graph, which limits the knowledge transfer from GNN to MLP. Here we present a novel framework VQGraph to learn a powerful graph representation space for bridging GNNs and MLPs. We adopt the encoder of a variant of a vector-quantized variational autoencoder (VQ-VAE) as a structure-aware graph tokenizer, which explicitly represents the nodes of diverse local structures as numerous discrete tokens and constitutes a meaningful codebook. Equipped with the learned codebook, we propose a new token-based distillation objective based on soft token assignments to sufficiently transfer the structural knowledge from GNN to MLP. Extensive experiments and analyses demonstrate the strong performance of VQGraph, where we achieve new state-of-the-art performance on GNN-MLP distillation in both transductive and inductive settings across seven graph datasets. We show that VQGraph with better performance infers faster than GNNs by 828x, and also achieves accuracy improvement over GNNs and stand-alone MLPs by 3.90% and 28.05% on average, respectively. Code: https://github.com/YangLing0818/VQGraph.
Out-of-distribution (OOD) graph generalization are critical for many real-world applications. Existing methods neglect to discard spurious or noisy features of inputs, which are irrelevant to the label. Besides, they mainly conduct instance-level class-invariant graph learning and fail to utilize the structural class relationships between graph instances. In this work, we endeavor to address these issues in a unified framework, dubbed Individual and Structural Graph Information Bottlenecks (IS-GIB). To remove class spurious feature caused by distribution shifts, we propose Individual Graph Information Bottleneck (I-GIB) which discards irrelevant information by minimizing the mutual information between the input graph and its embeddings. To leverage the structural intra- and inter-domain correlations, we propose Structural Graph Information Bottleneck (S-GIB). Specifically for a batch of graphs with multiple domains, S-GIB first computes the pair-wise input-input, embedding-embedding, and label-label correlations. Then it minimizes the mutual information between input graph and embedding pairs while maximizing the mutual information between embedding and label pairs. The critical insight of S-GIB is to simultaneously discard spurious features and learn invariant features from a high-order perspective by maintaining class relationships under multiple distributional shifts. Notably, we unify the proposed I-GIB and S-GIB to form our complementary framework IS-GIB. Extensive experiments conducted on both node- and graph-level tasks consistently demonstrate the superior generalization ability of IS-GIB. The code is available at https://github.com/YangLing0818/GraphOOD.
The electrocardiogram (ECG) is one of the most commonly used non-invasive, convenient medical monitoring tools that assist in the clinical diagnosis of heart diseases. Recently, deep learning (DL) techniques, particularly self-supervised learning (SSL), have demonstrated great potential in the classification of ECG. SSL pre-training has achieved competitive performance with only a small amount of annotated data after fine-tuning. However, current SSL methods rely on the availability of annotated data and are unable to predict labels not existing in fine-tuning datasets. To address this challenge, we propose Multimodal ECG-Text Self-supervised pre-training (METS), the first work to utilize the auto-generated clinical reports to guide ECG SSL pre-training. We use a trainable ECG encoder and a frozen language model to embed paired ECG and automatically machine-generated clinical reports separately. The SSL aims to maximize the similarity between paired ECG and auto-generated report while minimize the similarity between ECG and other reports. In downstream classification tasks, METS achieves around 10% improvement in performance without using any annotated data via zero-shot classification, compared to other supervised and SSL baselines that rely on annotated data. Furthermore, METS achieves the highest recall and F1 scores on the MIT-BIH dataset, despite MIT-BIH containing different classes of ECG compared to the pre-trained dataset. The extensive experiments have demonstrated the advantages of using ECG-Text multimodal self-supervised learning in terms of generalizability, effectiveness, and efficiency.
The artificial intelligence (AI) system has achieved expert-level performance in electrocardiogram (ECG) signal analysis. However, in underdeveloped countries or regions where the healthcare information system is imperfect, only paper ECGs can be provided. Analysis of real-world ECG images (photos or scans of paper ECGs) remains challenging due to complex environments or interference. In this study, we present an AI system developed to detect and screen cardiac abnormalities (CAs) from real-world ECG images. The system was evaluated on a large dataset of 52,357 patients from multiple regions and populations across the world. On the detection task, the AI system obtained area under the receiver operating curve (AUC) of 0.996 (hold-out test), 0.994 (external test 1), 0.984 (external test 2), and 0.979 (external test 3), respectively. Meanwhile, the detection results of AI system showed a strong correlation with the diagnosis of cardiologists (cardiologist 1 (R=0.794, p<1e-3), cardiologist 2 (R=0.812, p<1e-3)). On the screening task, the AI system achieved AUCs of 0.894 (hold-out test) and 0.850 (external test). The screening performance of the AI system was better than that of the cardiologists (AI system (0.846) vs. cardiologist 1 (0.520) vs. cardiologist 2 (0.480)). Our study demonstrates the feasibility of an accurate, objective, easy-to-use, fast, and low-cost AI system for CA detection and screening. The system has the potential to be used by healthcare professionals, caregivers, and general users to assess CAs based on real-world ECG images.