搜索结果：Maternal-fetal medicine (Wolters Kluwer Health, Inc.)

With the increasing interest in deploying Artificial Intelligence in medicine, we previously introduced HAIM (Holistic AI in Medicine), a framework that fuses multimodal data to solve downstream clinical tasks. However, HAIM uses data in a task-agnostic manner and lacks explainability. To address these limitations, we introduce xHAIM (Explainable HAIM), a novel framework leveraging Generative AI to enhance both prediction and explainability through four structured steps: (1) automatically identifying task-relevant patient data across modalities, (2) generating comprehensive patient summaries, (3) using these summaries for improved predictive modeling, and (4) providing clinical explanations by linking predictions to patient-specific medical knowledge. Evaluated on the HAIM-MIMIC-MM dataset, xHAIM improves average AUC from 79.9% to 90.3% across chest pathology and operative tasks. Importantly, xHAIM transforms AI from a black-box predictor into an explainable decision support system, enabling clinicians to interactively trace predictions back to relevant patient data, bridging AI advancements with clinical utility.

The Oregon Health Insurance Experiment (OHIE) offers a unique opportunity to examine the causal relationship between Medicaid coverage and happiness among low-income adults, using an experimental design. This study leverages data from comprehensive surveys conducted at 0 and 12 months post-treatment. Previous studies based on OHIE have shown that individuals receiving Medicaid exhibited a significant improvement in mental health compared to those who did not receive coverage. The primary objective is to explore how Medicaid coverage impacts happiness, specifically analyzing in which direction variations in healthcare spending significantly improve mental health: higher spending or lower spending after Medicaid. Utilizing instrumental variable (IV) regression, I conducted six separate regressions across subgroups categorized by expenditure levels and happiness ratings, and the results reveal distinct patterns. Enrolling in OHP has significantly decreased the probability of experiencing unhappiness, regardless of whether individuals had high or low medical spending. Additionally, it decreased the probability of being pretty happy and having high medical expenses, while increasing the

The success of precision medicine requires computational models that can effectively process and interpret diverse physiological signals across heterogeneous patient populations. While foundation models have demonstrated remarkable transfer capabilities across various domains, their effectiveness in handling individual-specific physiological signals - crucial for precision medicine - remains largely unexplored. This work introduces a systematic pipeline for rapidly and efficiently evaluating foundation models' transfer capabilities in medical contexts. Our pipeline employs a three-stage approach. First, it leverages physiological simulation software to generate diverse, clinically relevant scenarios, particularly focusing on data-scarce medical conditions. This simulation-based approach enables both targeted capability assessment and subsequent model fine-tuning. Second, the pipeline projects these simulated signals through the foundation model to obtain embeddings, which are then evaluated using linear methods. This evaluation quantifies the model's ability to capture three critical aspects: physiological feature independence, temporal dynamics preservation, and medical scenario d

What does Artificial Intelligence (AI) have to contribute to health care? And what should we be looking out for if we are worried about its risks? In this paper we offer a survey, and initial evaluation, of hopes and fears about the applications of artificial intelligence in medicine. AI clearly has enormous potential as a research tool, in genomics and public health especially, as well as a diagnostic aid. It's also highly likely to impact on the organisational and business practices of healthcare systems in ways that are perhaps under-appreciated. Enthusiasts for AI have held out the prospect that it will free physicians up to spend more time attending to what really matters to them and their patients. We will argue that this claim depends upon implausible assumptions about the institutional and economic imperatives operating in contemporary healthcare settings. We will also highlight important concerns about privacy, surveillance, and bias in big data, as well as the risks of over trust in machines, the challenges of transparency, the deskilling of healthcare practitioners, the way AI reframes healthcare, and the implications of AI for the distribution of power in healthcare ins

Medicine, including fields in healthcare and life sciences, has seen a flurry of quantum-related activities and experiments in the last few years (although biology and quantum theory have arguably been entangled ever since Schrödinger's cat). The initial focus was on biochemical and computational biology problems; recently, however, clinical and medical quantum solutions have drawn increasing interest. The rapid emergence of quantum computing in health and medicine necessitates a mapping of the landscape. In this review, clinical and medical proof-of-concept quantum computing applications are outlined and put into perspective. These consist of over 40 experimental and theoretical studies. The use case areas span genomics, clinical research and discovery, diagnostics, and treatments and interventions. Quantum machine learning (QML) in particular has rapidly evolved and shown to be competitive with classical benchmarks in recent medical research. Near-term QML algorithms have been trained with diverse clinical and real-world data sets. This includes studies in generating new molecular entities as drug candidates, diagnosing based on medical image classification, predicting patient pe

Fetal electrocardiogram (fECG) and Doppler ultrasound provide complementary views of fetal cardiovascular function: fECG captures electrical activity while Doppler reflects mechanical hemodynamics shaped by factors such as placental resistance and vascular compliance. Understanding the recoverable and unrecoverable Doppler components through reconstruction from fECG offers insight into the relative contributions of electrical versus mechanical factors in fetal circulation, thereby informing clinical decisions. In addition, clinical evidence of maternal-fetal cardiac coupling suggests that maternal cardiovascular dynamics may also inform fetal hemodynamics. To computationally model these relationships, we propose a cross-modal generative framework combining dilated convolutions with cross-modal attention to selectively incorporate maternal ECG and self-attention to capture long-range temporal dependencies. Trained on 885 synchronized fetal/maternal ECG and Doppler envelope segments from 39 pregnancies, our model synthesizes Doppler envelopes with power spectral density mean squared error (PSD MSE) of 49.9 +/- 15.8 dB^2 (51% lower than two-channel baseline) and heart-rate error of 4.

Interactive Health (IH) research increasingly engages patients through participatory and user-centred approaches. However, patients' lived experiences are typically treated more as data to be analysed than as knowledge in their own right. In this paper, I argue that 'patient voice' in the field of IH is both an inclusion issue and an epistemic one. More specifically, it concerns how experiential accounts are recognised and circulated. I examine how methodological conventions, authorship norms, review criteria, and publication formats tend to position patients as participants rather than as authors of evidence. Looking to patient-partnered practices in medical publishing, including The BMJ, JAMA, and British Journal of Sports Medicine, I outline a possible infrastructural pathway for supporting patient-authored or patient-led experiential contributions within the field. I present this as a design probe to surface assumptions and trade-offs. I end this paper by inviting the IH community to reflect on how its knowledge infrastructures might accommodate experiential evidence alongside established research forms.

Public health is the most recent of the biomedical sciences to be seduced by the trendy moniker "precision." Advocates for "precision public health" (PPH) call for a data-driven, computational approach to public health, leveraging swaths of genomic "big data" to inform public health decision-making. Yet, like precision medicine, PPH oversells the value of genomic data to determine health outcomes, but on a population-level. A large historical literature has shown that over-emphasizing heredity tends to disproportionately harm underserved minorities and disadvantaged communities. By comparing and contrasting PPH with an earlier attempt at using big data and genetics, in the Progressive era (1890-1920), we highlight some potential risks of a genotype-driven preventive public health. We conclude by suggesting that such risks may be avoided by prioritizing data integration across many levels of analysis, from the molecular to the social.

The Oxford English Dictionary defines precision medicine as "medical care designed to optimize efficiency or therapeutic benefit for particular groups of patients, especially by using genetic or molecular profiling." It is not an entirely new idea: physicians from ancient times have recognized that medical treatment needs to consider individual variations in patient characteristics. However, the modern precision medicine movement has been enabled by a confluence of events: scientific advances in fields such as genetics and pharmacology, technological advances in mobile devices and wearable sensors, and methodological advances in computing and data sciences. This chapter is about bandit algorithms: an area of data science of special relevance to precision medicine. With their roots in the seminal work of Bellman, Robbins, Lai and others, bandit algorithms have come to occupy a central place in modern data science ( Lattimore and Szepesvari, 2020). Bandit algorithms can be used in any situation where treatment decisions need to be made to optimize some health outcome. Since precision medicine focuses on the use of patient characteristics to guide treatment, contextual bandit algorith

Clark Hash is a small method for storing neural embeddings in less space. It normalizes each database vector, applies a deterministic sparse signed Johnson-Lindenstrauss projection, clips the result, and stores a fixed-width scalar-quantized code. Queries stay in floating point and are scored against the stored sketches. In the default 384-dimensional sentence-embedding setting, Clark Hash stores a cosine-search vector in 48 bytes instead of 1536 bytes for dense f32 storage. This is 32x smaller. The method does not need a training pass, learned codebooks, rotations, or corpus statistics before new vectors can be stored. We describe the codec, the Rust implementation, and a multilingual sentence-similarity evaluation on 9,304 labeled pairs from 29 subsets. With a multilingual MiniLM encoder, the 48-byte sketches reached 0.910 and 0.946 macro Pearson correlation with dense cosine scores on STS17 and STS22. Clark Hash is not a new Johnson-Lindenstrauss theorem and it is not a replacement for approximate nearest-neighbor indexes. It is a simple stateless codec for compact embedding storage.

The last decade has seen an explosion in models that describe phenomena in systems medicine. Such models are especially useful for studying signaling pathways, such as the Wnt pathway. In this chapter we use the Wnt pathway to showcase current mathematical and statistical techniques that enable modelers to gain insight into (models of) gene regulation, and generate testable predictions. We introduce a range of modeling frameworks, but focus on ordinary differential equation (ODE) models since they remain the most widely used approach in systems biology and medicine and continue to offer great potential. We present methods for the analysis of a single model, comprising applications of standard dynamical systems approaches such as nondimensionalization, steady state, asymptotic and sensitivity analysis, and more recent statistical and algebraic approaches to compare models with data. We present parameter estimation and model comparison techniques, focusing on Bayesian analysis and coplanarity via algebraic geometry. Our intention is that this (non exhaustive) review may serve as a useful starting point for the analysis of models in systems medicine.

Prenatal maternal stress alters maternal-fetal heart rate coupling, as demonstrated by the Fetal Stress Index derived from bivariate phase-rectified signal averaging. Here, we extend this framework using information-theoretical measures to elucidate underlying mechanisms. In 120 third-trimester pregnancies (58 stressed, 62 control), we computed transfer entropy (TE), entropy rate (ER), and sample entropy (SE) under multiple conditioning paradigms, employing mixed linear models for repeated measures. We identify dual coupling mechanisms at the short-term (0.5 - 2.5 s), but not long-term (2.5 - 5 s) time scales: (1) stress-invariant state-dependent synchronization, with maternal decelerations exerting approximately 60% coupling strength on fetal heart rate complexity - a fundamental coordination conserved across demographics; and (2) stress-sensitive temporal information transfer (TE), showing exploratory associations with maternal cortisol that require replication. A robust sex-by-stress interaction emerged in TE from mixed models, with exploratory female-specific coupling patterns absent in males. Universal acceleration predominance was observed in both maternal and fetal heart rat

Birth weight serves as a fundamental indicator of neonatal health, closely linked to both early medical interventions and long-term developmental risks. Traditional predictive models, often constrained by limited feature selection and incomplete datasets, struggle to achieve overlooking complex maternal and fetal interactions in diverse clinical settings. This research explores machine learning to address these limitations, utilizing a structured methodology that integrates advanced imputation strategies, supervised feature selection techniques, and predictive modeling. Given the constraints of the dataset, the research strengthens the role of data preprocessing in improving the model performance. Among the various methodologies explored, tree-based feature selection methods demonstrated superior capability in identifying the most relevant predictors, while ensemble-based regression models proved highly effective in capturing non-linear relationships and complex maternal-fetal interactions within the data. Beyond model performance, the study highlights the clinical significance of key physiological determinants, offering insights into maternal and fetal health factors that influenc

Medical image analysis plays a key role in precision medicine as it allows the clinicians to identify anatomical abnormalities and it is routinely used in clinical assessment. Data curation and pre-processing of medical images are critical steps in the quantitative medical image analysis that can have a significant impact on the resulting model performance. In this paper, we introduce a precision-medicine-toolbox that allows researchers to perform data curation, image pre-processing and handcrafted radiomics extraction (via Pyradiomics) and feature exploration tasks with Python. With this open-source solution, we aim to address the data preparation and exploration problem, bridge the gap between the currently existing packages, and improve the reproducibility of quantitative medical imaging research.

Hypertensive disorders of pregnancy remain a leading cause of maternal and fetal morbidity worldwide, yet diagnosis relies on intermittent cuff-based blood pressure measurements that are prone to bias and fail to capture continuous physiological dynamics. Growing evidence suggests that fetal cardiovascular activity is associated with maternal-placental hemodynamics and may encode markers of maternal hypertension. To analyze this, we collected a large-scale dataset of fetal one-dimensional Doppler ultrasound recordings paired with maternal blood pressure from 3,255 pregnant women across 8,170 antenatal visits in rural Guatemala. We developed AutoHyPE, a hierarchical attention network that models short- and long-term signal structure, incorporating a novel prototype-based contrastive learning and multi-view strategy to enhance representation robustness under long-tailed class distribution and biological variability. AutoHyPE achieved an AUROC of 0.80 for maternal hypertension detection, outperforming baseline approaches while maintaining balanced performance across classes, with no performance degradation in an edge deployment scenario. Our findings demonstrated that fetal cardiac me

Accurate fetal movement (FM) detection is essential for assessing prenatal health, as abnormal movement patterns can indicate underlying complications such as placental dysfunction or fetal distress. Traditional methods, including maternal perception and cardiotocography (CTG), suffer from subjectivity and limited accuracy. To address these challenges, we propose Contrastive Ultrasound Video Representation Learning (CURL), a novel self-supervised learning framework for FM detection from extended fetal ultrasound video recordings. Our approach leverages a dual-contrastive loss, incorporating both spatial and temporal contrastive learning, to learn robust motion representations. Additionally, we introduce a task-specific sampling strategy, ensuring the effective separation of movement and non-movement segments during self-supervised training, while enabling flexible inference on arbitrarily long ultrasound recordings through a probabilistic fine-tuning approach. Evaluated on an in-house dataset of 92 subjects, each with 30-minute ultrasound sessions, CURL achieves a sensitivity of 78.01% and an AUROC of 81.60%, demonstrating its potential for reliable and objective FM analysis. These

Monitoring maternal and fetal health during pregnancy is crucial for preventing adverse outcomes. While tests such as ultrasound scans offer high accuracy, they can be costly and inconvenient. Telehealth and more accessible body shape information provide pregnant women with a convenient way to monitor their health. This study explores the potential of 3D body scan data, captured during the 18-24 gestational weeks, to predict adverse pregnancy outcomes and estimate clinical parameters. We developed a novel algorithm with two parallel streams which are used for extract body shape features: one for supervised learning to extract sequential abdominal circumference information, and another for unsupervised learning to extract global shape descriptors, alongside a branch for demographic data. Our results indicate that 3D body shape can assist in predicting preterm labor, gestational diabetes mellitus (GDM), gestational hypertension (GH), and in estimating fetal weight. Compared to other machine learning models, our algorithm achieved the best performance, with prediction accuracies exceeding 88% and fetal weight estimation accuracy of 76.74% within a 10% error margin, outperforming conve

Selecting the right monitoring level in Remote Patient Monitoring (RPM) systems for e-healthcare is crucial for balancing patient outcomes, various resources, and patient's quality of life. A prior work has used one-dimensional health representations, but patient health is inherently multidimensional and typically consists of many measurable physiological factors. In this paper, we introduce a multidimensional health state model within the RPM framework and use dynamic programming to study optimal monitoring strategies. Our analysis reveals that the optimal control is characterized by switching curves (for two-dimensional health states) or switching hyper-surfaces (in general): patients switch to intensive monitoring when health measurements cross a specific multidimensional surface. We further study how the optimal switching curve varies for different medical conditions and model parameters. This finding of the optimal control structure provides actionable insights for clinicians and aids in resource planning. The tunable modeling framework enhances the applicability and effectiveness of RPM services across various medical conditions.

Chronic diseases can greatly benefit from bioelectronic medicine approaches. Neuromorphic electronic circuits present ideal characteristics for the development of brain-inspired low-power implantable processing systems that can be interfaced with biological systems. These circuits, therefore, represent a promising additional tool in the tool-set of bioelectronic medicine. In this paper, we describe the main features of neuromorphic circuits that are ideally suited for continuously monitoring the physiological parameters of the body and interact with them in real-time. We propose examples of computational primitives that can be used for real-time pattern generation and present a neuromorphic implementation of neural oscillators for the generation of sequence activation patterns. We demonstrate the features of such systems with an implementation of a three-phase network that models the dynamics of the respiratory Central Pattern Generator (CPG) and the heart chambers rhythm, and that could be used to build an adaptive pacemaker.