Qualifying Chinese Medical Licensing Examination with Knowledge Enhanced Generative Pre-training Model

Generative Pre-Training (GPT) models like ChatGPT have demonstrated exceptional performance in various Natural Language Processing (NLP) tasks. Although ChatGPT has been integrated into the overall workflow to boost efficiency in many domains, the lack of flexibility in the finetuning process hinders its applications in areas that demand extensive domain expertise and semantic knowledge, such as healthcare. In this paper, we evaluate ChatGPT on the China National Medical Licensing Examination (CNMLE) and propose a novel approach to improve ChatGPT from two perspectives: integrating medical domain knowledge and enabling few-shot learning. By using a simple but effective retrieval method, medical background knowledge is extracted as semantic instructions to guide the inference of ChatGPT. Similarly, relevant medical questions are identified and fed as demonstrations to ChatGPT. Experimental results show that directly applying ChatGPT fails to qualify the CNMLE at a score of 51 (i.e., only 51\% of questions are answered correctly). While our knowledge-enhanced model achieves a high score of 70 on CNMLE-2022 which not only passes the qualification but also surpasses the average score of humans (61). This research demonstrates the potential of knowledge-enhanced ChatGPT to serve as versatile medical assistants, capable of analyzing real-world medical problems in a more accessible, user-friendly, and adaptable manner.

M3AE: Multimodal Representation Learning for Brain Tumor Segmentation with Missing Modalities

Multimodal magnetic resonance imaging (MRI) provides complementary information for sub-region analysis of brain tumors. Plenty of methods have been proposed for automatic brain tumor segmentation using four common MRI modalities and achieved remarkable performance. In practice, however, it is common to have one or more modalities missing due to image corruption, artifacts, acquisition protocols, allergy to contrast agents, or simply cost. In this work, we propose a novel two-stage framework for brain tumor segmentation with missing modalities. In the first stage, a multimodal masked autoencoder (M3AE) is proposed, where both random modalities (i.e., modality dropout) and random patches of the remaining modalities are masked for a reconstruction task, for self-supervised learning of robust multimodal representations against missing modalities. To this end, we name our framework M3AE. Meanwhile, we employ model inversion to optimize a representative full-modal image at marginal extra cost, which will be used to substitute for the missing modalities and boost performance during inference. Then in the second stage, a memory-efficient self distillation is proposed to distill knowledge between heterogenous missing-modal situations while fine-tuning the model for supervised segmentation. Our M3AE belongs to the 'catch-all' genre where a single model can be applied to all possible subsets of modalities, thus is economic for both training and deployment. Extensive experiments on BraTS 2018 and 2020 datasets demonstrate its superior performance to existing state-of-the-art methods with missing modalities, as well as the efficacy of its components. Our code is available at: https://github.com/ccarliu/m3ae.

Improving GAN Training via Feature Space Shrinkage

Due to the outstanding capability for data generation, Generative Adversarial Networks (GANs) have attracted considerable attention in unsupervised learning. However, training GANs is difficult, since the training distribution is dynamic for the discriminator, leading to unstable image representation. In this paper, we address the problem of training GANs from a novel perspective, \emph{i.e.,} robust image classification. Motivated by studies on robust image representation, we propose a simple yet effective module, namely AdaptiveMix, for GANs, which shrinks the regions of training data in the image representation space of the discriminator. Considering it is intractable to directly bound feature space, we propose to construct hard samples and narrow down the feature distance between hard and easy samples. The hard samples are constructed by mixing a pair of training images. We evaluate the effectiveness of our AdaptiveMix with widely-used and state-of-the-art GAN architectures. The evaluation results demonstrate that our AdaptiveMix can facilitate the training of GANs and effectively improve the image quality of generated samples. We also show that our AdaptiveMix can be further applied to image classification and Out-Of-Distribution (OOD) detection tasks, by equipping it with state-of-the-art methods. Extensive experiments on seven publicly available datasets show that our method effectively boosts the performance of baselines. The code is publicly available at https://github.com/WentianZhang-ML/AdaptiveMix.

RECIST Weakly Supervised Lesion Segmentation via Label-Space Co-Training

As an essential indicator for cancer progression and treatment response, tumor size is often measured following the response evaluation criteria in solid tumors (RECIST) guideline in CT slices. By marking each lesion with its longest axis and the longest perpendicular one, laborious pixel-wise manual annotation can be avoided. However, such a coarse substitute cannot provide a rich and accurate base to allow versatile quantitative analysis of lesions. To this end, we propose a novel weakly supervised framework to exploit the existing rich RECIST annotations for pixel-wise lesion segmentation. Specifically, a pair of under- and over-segmenting masks are constructed for each lesion based on its RECIST annotation and served as the label for co-training a pair of subnets, respectively, along with the proposed label-space perturbation induced consistency loss to bridge the gap between the two subnets and enable effective co-training. Extensive experiments are conducted on a public dataset to demonstrate the superiority of the proposed framework regarding the RECIST-based weakly supervised segmentation task and its universal applicability to various backbone networks.

Interactive Segmentation as Gaussian Process Classification

Click-based interactive segmentation (IS) aims to extract the target objects under user interaction. For this task, most of the current deep learning (DL)-based methods mainly follow the general pipelines of semantic segmentation. Albeit achieving promising performance, they do not fully and explicitly utilize and propagate the click information, inevitably leading to unsatisfactory segmentation results, even at clicked points. Against this issue, in this paper, we propose to formulate the IS task as a Gaussian process (GP)-based pixel-wise binary classification model on each image. To solve this model, we utilize amortized variational inference to approximate the intractable GP posterior in a data-driven manner and then decouple the approximated GP posterior into double space forms for efficient sampling with linear complexity. Then, we correspondingly construct a GP classification framework, named GPCIS, which is integrated with the deep kernel learning mechanism for more flexibility. The main specificities of the proposed GPCIS lie in: 1) Under the explicit guidance of the derived GP posterior, the information contained in clicks can be finely propagated to the entire image and then boost the segmentation; 2) The accuracy of predictions at clicks has good theoretical support. These merits of GPCIS as well as its good generality and high efficiency are substantiated by comprehensive experiments on several benchmarks, as compared with representative methods both quantitatively and qualitatively.

Exploring Social Media for Early Detection of Depression in COVID-19 Patients

The COVID-19 pandemic has caused substantial damage to global health. Even though three years have passed, the world continues to struggle with the virus. Concerns are growing about the impact of COVID-19 on the mental health of infected individuals, who are more likely to experience depression, which can have long-lasting consequences for both the affected individuals and the world. Detection and intervention at an early stage can reduce the risk of depression in COVID-19 patients. In this paper, we investigated the relationship between COVID-19 infection and depression through social media analysis. Firstly, we managed a dataset of COVID-19 patients that contains information about their social media activity both before and after infection. Secondly,We conducted an extensive analysis of this dataset to investigate the characteristic of COVID-19 patients with a higher risk of depression. Thirdly, we proposed a deep neural network for early prediction of depression risk. This model considers daily mood swings as a psychiatric signal and incorporates textual and emotional characteristics via knowledge distillation. Experimental results demonstrate that our proposed framework outperforms baselines in detecting depression risk, with an AUROC of 0.9317 and an AUPRC of 0.8116. Our model has the potential to enable public health organizations to initiate prompt intervention with high-risk patients

Deep-Learning Tool for Early Identifying Non-Traumatic Intracranial Hemorrhage Etiology based on CT Scan

Background: To develop an artificial intelligence system that can accurately identify acute non-traumatic intracranial hemorrhage (ICH) etiology based on non-contrast CT (NCCT) scans and investigate whether clinicians can benefit from it in a diagnostic setting. Materials and Methods: The deep learning model was developed with 1868 eligible NCCT scans with non-traumatic ICH collected between January 2011 and April 2018. We tested the model on two independent datasets (TT200 and SD 98) collected after April 2018. The model's diagnostic performance was compared with clinicians's performance. We further designed a simulated study to compare the clinicians's performance with and without the deep learning system augmentation. Results: The proposed deep learning system achieved area under the receiver operating curve of 0.986 (95% CI 0.967-1.000) on aneurysms, 0.952 (0.917-0.987) on hypertensive hemorrhage, 0.950 (0.860-1.000) on arteriovenous malformation (AVM), 0.749 (0.586-0.912) on Moyamoya disease (MMD), 0.837 (0.704-0.969) on cavernous malformation (CM), and 0.839 (0.722-0.959) on other causes in TT200 dataset. Given a 90% specificity level, the sensitivities of our model were 97.1% and 90.9% for aneurysm and AVM diagnosis, respectively. The model also shows an impressive generalizability in an independent dataset SD98. The clinicians achieve significant improvements in the sensitivity, specificity, and accuracy of diagnoses of certain hemorrhage etiologies with proposed system augmentation. Conclusions: The proposed deep learning algorithms can be an effective tool for early identification of hemorrhage etiologies based on NCCT scans. It may also provide more information for clinicians for triage and further imaging examination selection.

MADAv2: Advanced Multi-Anchor Based Active Domain Adaptation Segmentation

Unsupervised domain adaption has been widely adopted in tasks with scarce annotated data. Unfortunately, mapping the target-domain distribution to the source-domain unconditionally may distort the essential structural information of the target-domain data, leading to inferior performance. To address this issue, we firstly propose to introduce active sample selection to assist domain adaptation regarding the semantic segmentation task. By innovatively adopting multiple anchors instead of a single centroid, both source and target domains can be better characterized as multimodal distributions, in which way more complementary and informative samples are selected from the target domain. With only a little workload to manually annotate these active samples, the distortion of the target-domain distribution can be effectively alleviated, achieving a large performance gain. In addition, a powerful semi-supervised domain adaptation strategy is proposed to alleviate the long-tail distribution problem and further improve the segmentation performance. Extensive experiments are conducted on public datasets, and the results demonstrate that the proposed approach outperforms state-of-the-art methods by large margins and achieves similar performance to the fully-supervised upperbound, i.e., 71.4% mIoU on GTA5 and 71.8% mIoU on SYNTHIA. The effectiveness of each component is also verified by thorough ablation studies.

FemtoDet: An Object Detection Baseline for Energy Versus Performance Tradeoffs

Efficient detectors for edge devices are often optimized for metrics like parameters or speed counts, which remain weak correlation with the energy of detectors. However, among vision applications of convolutional neural networks (CNNs), some, such as always-on surveillance cameras, are critical for energy constraints. This paper aims to serve as a baseline by designing detectors to reach tradeoffs between energy and performance from two perspectives: 1) We extensively analyze various CNNs to identify low-energy architectures, including the selection of activation functions, convolutions operators, and feature fusion structures on necks. These underappreciated details in past works seriously affect the energy consumption of detectors; 2) To break through the dilemmatic energy-performance problem, we propose a balanced detector driven by energy using discovered low-energy components named \textit{FemtoDet}. In addition to the novel construction, we further improve FemtoDet by considering convolutions and training strategy optimizations. Specifically, we develop a new instance boundary enhancement (IBE) module for convolution optimization to overcome the contradiction between the limited capacity of CNNs and detection tasks in diverse spatial representations, and propose a recursive warm-restart (RecWR) for optimizing training strategy to escape the sub-optimization of light-weight detectors, considering the data shift produced in popular augmentations. As a result, FemtoDet with only 68.77k parameters achieves a competitive score of 46.3 AP50 on PASCAL VOC and power of 7.83W on RTX 3090. Extensive experiments on COCO and TJU-DHD datasets indicate that the proposed method achieves competitive results in diverse scenes.

A New Perspective to Boost Vision Transformer for Medical Image Classification

Transformer has achieved impressive successes for various computer vision tasks. However, most of existing studies require to pretrain the Transformer backbone on a large-scale labeled dataset (e.g., ImageNet) for achieving satisfactory performance, which is usually unavailable for medical images. Additionally, due to the gap between medical and natural images, the improvement generated by the ImageNet pretrained weights significantly degrades while transferring the weights to medical image processing tasks. In this paper, we propose Bootstrap Own Latent of Transformer (BOLT), a self-supervised learning approach specifically for medical image classification with the Transformer backbone. Our BOLT consists of two networks, namely online and target branches, for self-supervised representation learning. Concretely, the online network is trained to predict the target network representation of the same patch embedding tokens with a different perturbation. To maximally excavate the impact of Transformer from limited medical data, we propose an auxiliary difficulty ranking task. The Transformer is enforced to identify which branch (i.e., online/target) is processing the more difficult perturbed tokens. Overall, the Transformer endeavours itself to distill the transformation-invariant features from the perturbed tokens to simultaneously achieve difficulty measurement and maintain the consistency of self-supervised representations. The proposed BOLT is evaluated on three medical image processing tasks, i.e., skin lesion classification, knee fatigue fracture grading and diabetic retinopathy grading. The experimental results validate the superiority of our BOLT for medical image classification, compared to ImageNet pretrained weights and state-of-the-art self-supervised learning approaches.