Ahmed El-Medany

Gul Rukh Khattak, Konstantinos Patlatzoglou, Joseph Barker et al.

Contrastive learning is a widely adopted self-supervised pretraining strategy, yet its dependence on cohort composition remains underexplored. We present Contrasting by Patient Augmented Electrocardiograms (CAPE) foundation model and pretrain on four cohorts (n = 5,203,352), from diverse populations across three continents (North America, South America, Asia). We systematically assess how cohort demographics, health status, and population diversity influence the downstream performance for prediction tasks also including two additional cohorts from another continent (Europe). We find that downstream performance depends on the distributional properties of the pretraining cohort, including demographics and health status. Moreover, while pretraining with a multi-centre, demographically diverse cohort improves in-distribution accuracy, it reduces out-of-distribution (OOD) generalisation of our contrastive approach by encoding cohort-specific artifacts. To address this, we propose the In-Distribution Batch (IDB) strategy, which preserves intra-cohort consistency during pretraining and enhances OOD robustness. This work provides important insights for developing clinically fair and generalisable foundation models.

Alexander Jenkins, Thiernithi Variddhisai, Ahmed El-Medany et al.

Graph Signal Processing (GSP) provides a powerful framework for analysing complex, interconnected systems by modelling data as signals on graphs. While recent advances have enabled graph topology learning from observed signals, existing methods often struggle with time-varying systems and real-time applications. To address this gap, we introduce AdaCGP, a sparsity-aware adaptive algorithm for dynamic graph topology estimation from multivariate time series. AdaCGP estimates the Graph Shift Operator (GSO) through recursive update formulae designed to address sparsity, shift-invariance, and bias. Through comprehensive simulations, we demonstrate that AdaCGP consistently outperforms multiple baselines across diverse graph topologies, achieving improvements exceeding 83% in GSO estimation compared to state-of-the-art methods while maintaining favourable computational scaling properties. Our variable splitting approach enables reliable identification of causal connections with near-zero false alarm rates and minimal missed edges. Applied to cardiac fibrillation recordings, AdaCGP tracks dynamic changes in propagation patterns more effectively than established methods like Granger causality, capturing temporal variations in graph topology that static approaches miss. The algorithm successfully identifies stability characteristics in conduction patterns that may maintain arrhythmias, demonstrating potential for clinical applications in diagnosis and treatment of complex biomedical systems.