An Efficient Service-based System for Hierarchical Human Activity Sensing.

In this paper, we propose an end-to-end system, based on SEnsing as Service (SEAS) model, which processes continuous mobility data from multiple sensors on the client edge-device by optimizing the on-device processing pipelines. Thus, reducing the cost of data transfer and CPU usage. We also propose a classification algorithm as a part of the system to recognize Activities of Daily Living (ADL). The results indicate that our proposed system recognizes ADLs with considerable accuracy and flexibility.Clinical relevance- Measurement of Activities of Daily Living has a high correlation with independent living measures for elderly people [1] and post-event rehabilitation where an event may be heart-attack [2], stroke [3], surgical intervention [4], or trauma [5] etc.

Synthetic PPG Signal Generation to Improve Coronary Artery Disease Classification: Study With Physical Model of Cardiovascular System.

This paper presents a novel approach of generating synthetic Photoplethysmogram (PPG) data using a physical model of the cardiovascular system to improve classifier performance with a combination of synthetic and real data. The physical model is an in-silico cardiac computational model, consisting of a four-chambered heart with electrophysiology, hemodynamic, and blood pressure auto-regulation functionality. Starting with a small number of measured PPG data, the cardiac model is used to synthesize healthy as well as PPG time-series pertaining to coronary artery disease (CAD) by varying pathophysiological parameters. A Variational Autoencoder (VAE) structure is proposed to derive a statistical feature space for CAD classification. Results are presented in two perspectives namely, (i) using artificially reduced real disease data and (ii) using all the real disease data. In both cases, by augmenting with the synthetic data for training, the performance (sensitivity, specificity) of the classifier changes from (i) (0.65, 1) to (1, 0.9) and (ii) (1, 0.95) to (1, 1). The proposed hybrid approach of combining physical modelling and statistical feature space selection generates realistic PPG data with pathophysiological interpretation and can outperform a baseline Generative Adversarial Network (GAN) architecture with a relatively small amount of real data for training. This proposed method could aid as a substitution technique for handling the problem of bulk data required for training machine learning algorithms for cardiac health-care applications.

Gaussian mixture copulas for high-dimensional clustering and dependency-based subtyping.

MOTIVATION: The identification of sub-populations of patients with similar characteristics, called patient subtyping, is important for realizing the goals of precision medicine. Accurate subtyping is crucial for tailoring therapeutic strategies that can potentially lead to reduced mortality and morbidity. Model-based clustering, such as Gaussian mixture models, provides a principled and interpretable methodology that is widely used to identify subtypes. However, they impose identical marginal distributions on each variable; such assumptions restrict their modeling flexibility and deteriorates clustering performance. RESULTS: In this paper, we use the statistical framework of copulas to decouple the modeling of marginals from the dependencies between them. Current copula-based methods cannot scale to high dimensions due to challenges in parameter inference. We develop HD-GMCM, that addresses these challenges and, to our knowledge, is the first copula-based clustering method that can fit high-dimensional data. Our experiments on real high-dimensional gene-expression and clinical datasets show that HD-GMCM outperforms state-of-the-art model-based clustering methods, by virtue of modeling non-Gaussian data and being robust to outliers through the use of Gaussian mixture copulas. We present a case study on lung cancer data from TCGA. Clusters obtained from HD-GMCM can be interpreted based on the dependencies they model, that offers a new way of characterizing subtypes. Empirically, such modeling not only uncovers latent structure that leads to better clustering but also meaningful clinical subtypes in terms of survival rates of patients. AVAILABILITY AND IMPLEMENTATION: An implementation of HD-GMCM in R is available at: https://bitbucket.org/cdal/hdgmcm/. SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

Synthetic PPG generation from haemodynamic model with baroreflex autoregulation: a Digital twin of cardiovascular system.

Synthetic data generation has recently emerged as a substitution technique for handling the problem of bulk data needed in training machine learning algorithms. Healthcare, primarily cardiovascular domain is a major area where synthetic physiological data like Photoplethysmogram (PPG), Electrocardiogram (ECG), Phonocardiogram (PCG), etc. are being used to improve accuracy of machine learning algorithm. Conventional synthetic data generation approach using mathematical formulations lack interpretability. Hence, aim of this paper is to generate synthetic PPG signal from a Digital twin platform replicating cardiovascular system. Such system can serve the dual purpose of replicating the physical system, so as to simulate specific `what if' scenarios as well as to generate large scale synthetic data with patho-physiological interpretability. Cardio-vascular Digital twin is modeled with a two chambered heart, haemodynamic equations and a baroreflex based pressure control mechanism to generate blood pressure and flow variations. Synthetic PPG signal is generated from the model for healthy and Atherosclerosis condition. Initial validation of the platform has been made on the basis of efficiency of the platform in clustering Coronary Artery Disease (CAD) and non CAD PPG data by extracting features from the synthetically generated PPG and comparing that with PPG obtained from Physionet data.

Early Detection of Mild Cognitive Impairment using Pervasive Sensing.

Aging in place and independent living for the elderly has gained importance, and so has instrumented homes for ambient assisted living (AAL). In this paper we explore the feasibility of using passive sensors to provide insights into the cognitive and physical well-being of the subject. We derive a novel clustering based tactics to check heterogeneity in terms of movement behaviour among patients, and then provide our feasibility study on detection of mild cognitive impairment based on the results of the clustering.

A dual boundary classifier for predicting acute hypotensive episodes in critical care.

An Acute Hypotensive Episode (AHE) is the sudden onset of a sustained period of low blood pressure and is one among the most critical conditions in Intensive Care Units (ICU). Without timely medical care, it can lead to an irreversible organ damage and death. By identifying patients at risk for AHE early, adequate medical intervention can save lives and improve patient outcomes. In this paper, we design a novel dual-boundary classification based approach for identifying patients at risk for AHE. Our algorithm uses only simple summary statistics of past Blood Pressure measurements and can be used in an online environment facilitating real-time updates and prediction. We perform extensive experiments with more than 4,500 patient records and demonstrate that our method outperforms the previous best approaches of AHE prediction. Our method can identify AHE patients two hours in advance of the onset, giving sufficient time for appropriate clinical intervention with nearly 80% sensitivity and at 95% specificity, thus having very few false positives.

Novel features from autocorrelation and spectrum to classify Phonocardiogram quality.

Phonocardiogram (PCG) or auscultation via a stethoscope forms the basis of preliminary medical screening. But PCG recorded in an uncontrolled environment is inherently noisy. In this paper we have derived novel features from the spectral domain and autocorrelation waveforms. These are used to identify the quality of a PCG recording and accepting only diagnosable quality recordings for further analysis. These features proved to be robust irrespective of variations in devices and in data collection protocols employed to ensure consistent data quality. A freely available, large, diverse, medical-grade PCG dataset was used for creating the training models. Results show that the proposed methodology yields an accuracy score of ~75% on our in-house PCG dataset, collected using a low-cost smartphone-based digital stethoscope.

A robust dataset-agnostic heart disease classifier from Phonocardiogram.

Automatic classification of normal and abnormal heart sounds is a popular area of research. However, building a robust algorithm unaffected by signal quality and patient demography is a challenge. In this paper we have analysed a wide list of Phonocardiogram (PCG) features in time and frequency domain along with morphological and statistical features to construct a robust and discriminative feature set for dataset-agnostic classification of normal and cardiac patients. The large and open access database, made available in Physionet 2016 challenge was used for feature selection, internal validation and creation of training models. A second dataset of 41 PCG segments, collected using our in-house smart phone based digital stethoscope from an Indian hospital was used for performance evaluation. Our proposed methodology yielded sensitivity and specificity scores of 0.76 and 0.75 respectively on the test dataset in classifying cardiovascular diseases. The methodology also outperformed three popular prior art approaches, when applied on the same dataset.

Automated lung sound analysis for detecting pulmonary abnormalities.

Identification of pulmonary diseases comprises of accurate auscultation as well as elaborate and expensive pulmonary function tests. Prior arts have shown that pulmonary diseases lead to abnormal lung sounds such as wheezes and crackles. This paper introduces novel spectral and spectrogram features, which are further refined by Maximal Information Coefficient, leading to the classification of healthy and abnormal lung sounds. A balanced lung sound dataset, consisting of publicly available data and data collected with a low-cost in-house digital stethoscope are used. The performance of the classifier is validated over several randomly selected non-overlapping training and validation samples and tested on separate subjects for two separate test cases: (a) overlapping and (b) non-overlapping data sources in training and testing. The results reveal that the proposed method sustains an accuracy of 80% even for non-overlapping data sources in training and testing.

A statistical model for stroke outcome prediction and treatment planning.

Stroke is a major cause of mortality and long-term disability in the world. Predictive outcome models in stroke are valuable for personalized treatment, rehabilitation planning and in controlled clinical trials. We design a new multi-class classification model to predict outcome in the short-term, the putative therapeutic window for several treatments. Our model addresses the challenges of class imbalance, where the training data is dominated by samples of a single class, and highly correlated predictor and outcome variables, which makes learning the effects of treatments on the outcome difficult. Empirically our model outperforms the best-known previous predictive models and can infer the most effective treatments in improving outcome that have been independently validated in clinical studies.

Predicting postoperative acute respiratory failure in critical care using nursing notes and physiological signals.

Postoperative Acute Respiratory Failure (ARF) is a serious complication in critical care affecting patient morbidity and mortality. In this paper we investigate a novel approach to predicting ARF in critically ill patients. We study the use of two disparate sources of information ­ semi-structured text contained in nursing notes and investigative reports that are regularly recorded and the respiration rate, a physiological signal that is continuously monitored during a patient's ICU stay. Unlike previous works that retrospectively analyze complications, we exclude discharge summaries from our analysis envisaging a real time system that predicts ARF during the ICU stay. Our experiments, on more than 800 patient records from the MIMIC II database, demonstrate that text sources within the ICU contain strong signals for distinguishing between patients who are at risk for ARF from those who are not at risk. These results suggest that large scale systems using both structured and unstructured data recorded in critical care can be effectively used to predict complications, which in turn can lead to preemptive care with potentially improved outcomes, mortality rates and decreased length of stay and cost.