Facial landmark localisation is a prerequisite for developing automated, non-contact neonatal pain assessment methods. Clinicians use pain scales to judge the severity of pain, many of which rely on facial expression. However, facial landmark detectors trained on adult faces perform poorly in neonatal clinical environments due to frequent occlusions caused by medical equipment, varied head poses, and challenging imaging conditions, including motion blur triggered by sudden pain-related movements. We propose an end-to-end facial landmark detector capable of predicting 68 landmarks on neonatal faces in clinical environments. We combined 37,459 single-face images from 11 public datasets, standardised to 68-point markup, with 1,123 manually annotated frames from a neonatal research dataset (totalling over 76,000 landmarks). A YOLO-based keypoint model was adapted to regress the facial landmarks, initialised with weights from a pretrained neonatal face detector. On public datasets, our proposed model achieved state-of-the-art performance: Normalised Mean Error (NME) = 5.37, Failure Rate (FR) = 12.5%, Area Under the Cumulative Error Curve (AUC) at AUC0.08 = 38.00% and AUC0.1 = 48.70%. On
Purpose: To investigate whether contrast-informed data augmentation and domain-adversarial training improve the adult-to-neonatal generalization of the E2E-VarNet. Methods: Three training regimes were investigated: (1) adult-only training with unaugmented adult data, (2) mixed training with paired unaugmented and neonatal-informed augmented adult data, and (3) mixed training with a domain-adversarial objective. Models were trained on retrospectively undersampled multi-coil adult T2-weighted brain MR data and evaluated on neonatal and adult test data at acceleration factors $R=4$ and $R=8$ using quantitative metrics and qualitative evaluation. Feature analyses assessed whether domain-adversarial training altered the latent representations of unaugmented adult, augmented adult, and neonatal test samples. Results: Mixed training (Mixed) and mixed domain-adversarial training (Mixed-DAT) outperformed unaugmented adult-only training (Unaug-Only) when evaluated on neonatal data. At R=4, Mixed-DAT achieved the best performance (SSIM = 0.924 +/- 0.027, PSNR = 33.98 +/- 1.15 dB). At R=8, Mixed-DAT performed best when measured using SSIM (0.848 +/- 0.031 vs. 0.766 +/- 0.037 for Unaug-Only and
Reliable localisation of the neonatal face is the first step for several video-camera based non-contact assessments such as pain and distress related facial expression analysis, pain scoring, cardiorespiratory signal extraction and cessation of breathing alerts. However, major challenges persist in neonatal clinical environments. Cluttered backgrounds, illumination changes and poor lighting conditions can reduce the accuracy of face detection models. Clinical interventions, monitoring equipment and, in some cases, medical devices can obstruct the face, making visual assessment difficult. We propose a one-stage YOLOv11m-based model tailored for face detection of infants in neonatal clinical environments. We combined multiple publicly available datasets (VGGFace2, CelebA, FDDB, WIDER FACE) to train and evaluate our proposed model. We then fine-tuned our model on a neonatal research dataset involving 228 videos from 114 recording sessions of 113 independent infants. Before fine-tuning, our model achieved an AP50 of 0.87, surpassing the performance of three state-of-the-art general face detectors. Performance improved further to an AP50 of 0.96 after clinical-domain adaptation. Evaluat
Remote photoplethysmography (rPPG) enables contact free monitoring of vital signs and is especially valuable for neonates, since conventional methods often require sustained skin contact with adhesive probes that can irritate fragile skin and increase infection control burden. We present VideoPulse, a neonatal dataset and an end to end pipeline that estimates neonatal heart rate and peripheral capillary oxygen saturation (SpO2) from facial video. VideoPulse contains 157 recordings totaling 2.6 hours from 52 neonates with diverse face orientations. Our pipeline performs face alignment and artifact aware supervision using denoised pulse oximeter signals, then applies 3D CNN backbones for heart rate and SpO2 regression with label distribution smoothing and weighted regression for SpO2. Predictions are produced in 2 second windows. On the NBHR neonatal dataset, we obtain heart rate MAE 2.97 bpm using 2 second windows (2.80 bpm at 6 second windows) and SpO2 MAE 1.69 percent. Under cross dataset evaluation, the NBHR trained heart rate model attains 5.34 bpm MAE on VideoPulse, and fine tuning an NBHR pretrained SpO2 model on VideoPulse yields MAE 1.68 percent. These results indicate that
Neonatal jaundice (hyperbilirubinemia) is one of the most common conditions affecting newborns worldwide, with India alone recording roughly 15 million cases per year. Early detection is critical, yet standard diagnosis requires blood tests that are often impractical in rural clinics where laboratory facilities are limited. This paper presents NeoJaundice-AI, a smartphone-based screening system that uses photographs of a baby's skin and sclera (eye white) to estimate jaundice severity and predict serum bilirubin levels in under three seconds without requiring internet connectivity. The proposed system is built on a dual-branch EfficientNet-B0 architecture that independently processes skin and sclera images. Deep features are fused with handcrafted YCbCr color statistics to jointly perform four-class severity classification and continuous bilirubin regression. A key contribution is a synthetic jaundice generation method that simulates bilirubin-induced yellowing through controlled YCbCr channel modifications on normal neonatal skin images. This approach addresses data scarcity, particularly for severe jaundice cases and darker Indian skin tones (Fitzpatrick Types IV to VI). In addit
Sleep plays a crucial role in neonatal development. Monitoring the sleep patterns in neonates in a Neonatal Intensive Care Unit (NICU) is imperative for understanding the maturation process. While polysomnography (PSG) is considered the best practice for sleep classification, its expense and reliance on human annotation pose challenges. Existing research often relies on multichannel EEG signals; however, concerns arise regarding the vulnerability of neonates and the potential impact on their sleep quality. This paper introduces a novel approach to neonatal sleep stage classification using a single-channel gradient boosting algorithm with Hjorth features. The gradient boosting parameters are fine-tuned using random search cross-validation (randomsearchCV), achieving an accuracy of 82.35% for neonatal sleep-wake classification. Validation is conducted through 5-fold cross-validation. The proposed algorithm not only enhances existing neonatal sleep algorithms but also opens avenues for broader applications.
Unaddressed pain in neonates can lead to adverse effects, including delayed development and slower weight gain, emphasising the need for more objective and reliable pain assessment methods. Hence, automated methods using behavioural and physiological pain indicators have been developed to aid healthcare professionals in the Neonatal ICU. Traditional contact-based methods for physiological parameter estimation are unsuitable for long-term monitoring and increase the risk of spreading diseases like COVID-19. We introduce a novel approach using remote photoplethysmography (rPPG) to estimate pulse signals in a non-contact manner and employ them for neonatal pain detection. The temporal signals acquired from regions-of-interest (ROIs) affected by skin deformations may exhibit lower quality and provide erroneous rPPG signals. Therefore, we incorporated a quality parameter to select the temporal signals obtained from ROIs that are least affected by skin deformations. Further, we employed signal-to-noise ratio as a fitness parameter to extract the rPPG signal corresponding to the clip that is least affected by noise. Experimental findings demonstrate that the rPPG signals provide useful in
The neonatal period is critical for survival, requiring accurate and early identification to enable timely interventions such as vaccinations, HIV treatment, and nutrition programs. Biometric solutions offer potential for child protection by helping to prevent baby swaps, locate missing children, and support national identity systems. However, developing effective biometric identification systems for newborns remains a major challenge due to the physiological variability caused by finger growth, weight changes, and skin texture alterations during early development. Current literature has attempted to address these issues by applying scaling factors to emulate growth-induced distortions in minutiae maps, but such approaches fail to capture the complex and non-linear growth patterns of infants. A key barrier to progress in this domain is the lack of comprehensive, longitudinal biometric datasets capturing the evolution of neonatal fingerprints over time. This study addresses this gap by focusing on designing and developing a high-quality biometric database of neonatal fingerprints, acquired at multiple early life stages. The dataset is intended to support the training and evaluation
Portable ultra-low-field MRI (uLF-MRI, 0.064 T) offers accessible neuroimaging for neonatal care but suffers from low signal-to-noise ratio and poor diagnostic quality compared to high-field (HF) MRI. We propose MRIQT, a 3D conditional diffusion framework for image quality transfer (IQT) from uLF to HF MRI. MRIQT combines realistic K-space degradation for physics-consistent uLF simulation, v-prediction with classifier-free guidance for stable image-to-image generation, and an SNR-weighted 3D perceptual loss for anatomical fidelity. The model denoises from a noised uLF input conditioned on the same scan, leveraging volumetric attention-UNet architecture for structure-preserving translation. Trained on a neonatal cohort with diverse pathologies, MRIQT surpasses recent GAN and CNN baselines in PSNR 15.3% with 1.78% over the state of the art, while physicians rated 85% of its outputs as good quality with clear pathology present. MRIQT enables high-fidelity, diffusion-based enhancement of portable ultra-low-field (uLF) MRI for deliable neonatal brain assessment.
Reliable evaluation of machine learning models for neonatal seizure detection is critical for clinical adoption. Current practices often rely on inconsistent and biased metrics, hindering model comparability and interpretability. Expert-level claims about AI performance are frequently made without rigorous validation, raising concerns about their reliability. This study aims to systematically evaluate common performance metrics and propose best practices tailored to the specific challenges of neonatal seizure detection. Using real and synthetic seizure annotations, we assessed standard performance metrics, consensus strategies, and human-expert level equivalence tests under varying class imbalance, inter-rater agreement, and number of raters. Matthews and Pearson's correlation coefficients outperformed the area under the curve in reflecting performance under class imbalance. Consensus types are sensitive to the number of raters and agreement level among them. Among human-expert level equivalence tests, the multi-rater Turing test using Fleiss k best captured expert-level AI performance. We recommend reporting: (1) at least one balanced metric, (2) Sensitivity, specificity, PPV and
Acoustic guidelines for neonatal intensive care units (NICUs) aim to protect vulnerable neonates from noise-induced physiological harm. However, the lack of recognised international standards for measuring neonatal soundscapes has led to inconsistencies in instrumentation and microphone placement in existing literature, raising concerns about the relevance and effectiveness of these guidelines. This study addresses these gaps through long-term acoustic measurements in an operational NICU and a high-dependency ward. We investigate the influence of microphone positioning, bed placement, and ward layout on the assessment of NICU soundscapes. Beyond traditional A-weighted decibel metrics, this study evaluates C-weighted metrics for low-frequency noise, the occurrence of tonal sounds (e.g., alarms), and transient loud events known to disrupt neonates' sleep. Using linear mixed-effects models with aligned ranks transformation ANOVA (LME-ART-ANOVA), our results reveal significant differences in measured noise levels based on microphone placement, highlighting the importance of capturing sound as perceived directly at the neonate's ears. Additionally, bed position and ward layout significa
Bronchopulmonary dysplasia (BPD) is a common complication among preterm neonates, with portable X-ray imaging serving as the standard diagnostic modality in neonatal intensive care units (NICUs). However, lung magnetic resonance imaging (MRI) offers a non-invasive alternative that avoids sedation and radiation while providing detailed insights into the underlying mechanisms of BPD. Leveraging high-resolution 3D MRI data, advanced image processing and semantic segmentation algorithms can be developed to assist clinicians in identifying the etiology of BPD. In this dataset, we present MRI scans paired with corresponding semantic segmentations of the lungs and trachea for 40 neonates, the majority of whom are diagnosed with BPD. The imaging data consist of free-breathing 3D stack-of-stars radial gradient echo acquisitions, known as the StarVIBE series. Additionally, we provide comprehensive clinical data and baseline segmentation models, validated against clinical assessments, to support further research and development in neonatal lung imaging.
The neonatal period is the most vulnerable time for the development of seizures. Seizures in the immature brain lead to detrimental consequences, therefore require early diagnosis. The gold-standard for neonatal seizure detection currently relies on continuous video-EEG monitoring; which involves recording multi-channel electroencephalogram (EEG) alongside real-time video monitoring within a neonatal intensive care unit (NICU). However, video-EEG monitoring technology requires clinical expertise and is often limited to technologically advanced and resourceful settings. Cost-effective new techniques could help the medical fraternity make an accurate diagnosis and advocate treatment without delay. In this work, a novel explainable deep learning model to automate the neonatal seizure detection process with a reduced EEG montage is proposed, which employs convolutional nets, graph attention layers, and fully connected layers. Beyond its ability to detect seizures in real-time with a reduced montage, this model offers the unique advantage of real-time interpretability. By evaluating the performance on the Zenodo dataset with 10-fold cross-validation, the presented model achieves an abso
Neonates are highly susceptible to seizures, often leading to short or long-term neurological impairments. However, clinical manifestations of neonatal seizures are subtle and often lead to misdiagnoses. This increases the risk of prolonged, untreated seizure activity and subsequent brain injury. Continuous video electroencephalogram (cEEG) monitoring is the gold standard for seizure detection. However, this is an expensive evaluation that requires expertise and time. In this study, we propose a convolutional neural network-based model for early prediction of neonatal seizures by distinguishing between interictal and preictal states of the EEG. Our model is patient-independent, enabling generalization across multiple subjects, and utilizes mel-frequency cepstral coefficient matrices extracted from multichannel EEG and electrocardiogram (ECG) signals as input features. Trained and validated on the Helsinki neonatal EEG dataset with 10-fold cross-validation, the proposed model achieved an average accuracy of 97.52%, sensitivity of 98.31%, specificity of 96.39%, and F1-score of 97.95%, enabling accurate seizure prediction up to 30 minutes before onset. The inclusion of ECG alongside E
Neonatal resuscitations demand an exceptional level of attentiveness from providers, who must process multiple streams of information simultaneously. Gaze strongly influences decision making; thus, understanding where a provider is looking during neonatal resuscitations could inform provider training, enhance real-time decision support, and improve the design of delivery rooms and neonatal intensive care units (NICUs). Current approaches to quantifying neonatal providers' gaze rely on manual coding or simulations, which limit scalability and utility. Here, we introduce an automated, real-time, deep learning approach capable of decoding provider gaze into semantic classes directly from first-person point-of-view videos recorded during live resuscitations. Combining state-of-the-art, real-time segmentation with vision-language models (CLIP), our low-shot pipeline attains 91\% classification accuracy in identifying gaze targets without training. Upon fine-tuning, the performance of our gaze-guided vision transformer exceeds 98\% accuracy in gaze classification, approaching human-level precision. This system, capable of real-time inference, enables objective quantification of provider
Diagnosis of adverse neonatal outcomes is crucial for preterm survival since it enables doctors to provide timely treatment. Machine learning (ML) algorithms have been demonstrated to be effective in predicting adverse neonatal outcomes. However, most previous ML-based methods have only focused on predicting a single outcome, ignoring the potential correlations between different outcomes, and potentially leading to suboptimal results and overfitting issues. In this work, we first analyze the correlations between three adverse neonatal outcomes and then formulate the diagnosis of multiple neonatal outcomes as a multi-task learning (MTL) problem. We then propose an MTL framework to jointly predict multiple adverse neonatal outcomes. In particular, the MTL framework contains shared hidden layers and multiple task-specific branches. Extensive experiments have been conducted using Electronic Health Records (EHRs) from 121 preterm neonates. Empirical results demonstrate the effectiveness of the MTL framework. Furthermore, the feature importance is analyzed for each neonatal outcome, providing insights into model interpretability.
Precise parcellation of functional networks (FNs) of early developing human brain is the fundamental basis for identifying biomarker of developmental disorders and understanding functional development. Resting-state fMRI (rs-fMRI) enables in vivo exploration of functional changes, but adult FN parcellations cannot be directly applied to the neonates due to incomplete network maturation. No standardized neonatal functional atlas is currently available. To solve this fundamental issue, we propose TReND, a novel and fully automated self-supervised transformer-autoencoder framework that integrates regularized nonnegative matrix factorization (RNMF) to unveil the FNs in neonates. TReND effectively disentangles spatiotemporal features in voxel-wise rs-fMRI data. The framework integrates confidence-adaptive masks into transformer self-attention layers to mitigate noise influence. A self supervised decoder acts as a regulator to refine the encoder's latent embeddings, which serve as reliable temporal features. For spatial coherence, we incorporate brain surface-based geodesic distances as spatial encodings along with functional connectivity from temporal features. The TReND clustering appr
Purpose: Magnetic Resonance Imaging (MRI) enables non-invasive assessment of brain abnormalities during early life development. Permanent magnet scanners operating in the neonatal intensive care unit (NICU) facilitate MRI of sick infants, but have long scan times due to lower signal-to-noise ratios (SNR) and limited receive coils. This work accelerates in-NICU MRI with diffusion probabilistic generative models by developing a training pipeline accounting for these challenges. Methods: We establish a novel training dataset of clinical, 1 Tesla neonatal MR images in collaboration with Aspect Imaging and Sha'are Zedek Medical Center. We propose a pipeline to handle the low quantity and SNR of our real-world dataset (1) modifying existing network architectures to support varying resolutions; (2) training a single model on all data with learned class embedding vectors; (3) applying self-supervised denoising before training; and (4) reconstructing by averaging posterior samples. Retrospective under-sampling experiments, accounting for signal decay, evaluated each item of our proposed methodology. A clinical reader study with practicing pediatric neuroradiologists evaluated our proposed i
This paper presents an annotated dataset of brain MRI images designed to advance the field of brain symmetry study. Magnetic resonance imaging (MRI) has gained interest in analyzing brain symmetry in neonatal infants, and challenges remain due to the vast size differences between fetal and adult brains. Classification methods for brain structural MRI use scales and visual cues to assess hemisphere symmetry, which can help diagnose neonatal patients by comparing hemispheres and anatomical regions of interest in the brain. Using the Developing Human Connectome Project dataset, this work presents a dataset comprising cerebral images extracted as slices across selected portions of interest for clinical evaluation . All the extracted images are annotated with the brain's midline. All the extracted images are annotated with the brain's midline. From the assumption that a decrease in symmetry is directly related to possible clinical pathologies, the dataset can contribute to a more precise diagnosis because it can be used to train deep learning model application in neonatal cerebral MRI anomaly detection from postnatal infant scans thanks to computer vision. Such models learn to identify
We present the first acquisition-agnostic diffusion generative model for Magnetic Resonance Imaging (MRI) in the neonatal intensive care unit (NICU) to solve a range of inverse problems for shortening scan time and improving motion robustness. In-NICU MRI scanners leverage permanent magnets at lower field-strengths (i.e., below 1.5 Tesla) for non-invasive assessment of potential brain abnormalities during the critical phase of early live development, but suffer from long scan times and motion artifacts. In this setting, training data sizes are small and intrinsically suffer from low signal-to-noise ratio (SNR). This work trains a diffusion probabilistic generative model using such a real-world training dataset of clinical neonatal MRI by applying several novel signal processing and machine learning methods to handle the low SNR and low quantity of data. The model is then used as a statistical image prior to solve various inverse problems at inference time without requiring any retraining. Experiments demonstrate the generative model's utility for three real-world applications of neonatal MRI: accelerated reconstruction, motion correction, and super-resolution.