Faezeh Marzbanrad

Ethan Grooby, Chiranjibi Sitaula, Soodeh Ahani et al.

This paper explores automated face and facial landmark detection of neonates, which is an important first step in many video-based neonatal health applications, such as vital sign estimation, pain assessment, sleep-wake classification, and jaundice detection. Utilising three publicly available datasets of neonates in the clinical environment, 366 images (258 subjects) and 89 (66 subjects) were annotated for training and testing, respectively. Transfer learning was applied to two YOLO-based models, with input training images augmented with random horizontal flipping, photo-metric colour distortion, translation and scaling during each training epoch. Additionally, the re-orientation of input images and fusion of trained deep learning models was explored. Our proposed model based on YOLOv7Face outperformed existing methods with a mean average precision of 84.8% for face detection, and a normalised mean error of 0.072 for facial landmark detection. Overall, this will assist in the development of fully automated neonatal health assessment algorithms.

Abdul Jabbar, Ethan Grooby, Yang Yi Poh et al.

Congenital heart disease (CHD) is the most common type of birth defect, impacting about 1% of live births worldwide. Echocardiography, the gold-standard diagnostic method, is costly and inaccessible in low-resource settings. Diagnosis is delayed due to limited skilled experts, whose ability to interpret pathological patterns varies significantly, causing inter- and intra-clinician variability. Therefore, we present a new method for a more accessible diagnostic modality, the digital stethoscope, to detect CHDs. Our method is based on deep feature fusion, integrating deep and handcrafted features for the automated early detection of CHDs. For this work, Phonocardiography (PCG) recordings were obtained from 751 pediatric subjects (Age:1 month- 16 years) in Bangladesh, ranging from infants to adults at four auscultation locations: mitral valve (MV), aortic valve (AV), pulmonary valve (PV), and tricuspid valve (TV). These recordings were labeled based on confirmed diagnoses by cardiologists as either cases of CHD or non-CHD. The results demonstrated that our proposed model achieved an accuracy of 92%, a sensitivity of 91%, and a specificity of 91%, based on a patient-wise split of 70% training, 20% validation, and 10% testing. Furthermore, the Area Under the Receiver Operating Characteristic curve (AUROC) of 96%, and an F1-score of 92%. This model promises efficient real-time remote detection of CHDs as a cost-effective screening tool for low-resource settings.

Chiranjibi Sitaula, Tej Bahadur Shahi, Faezeh Marzbanrad et al.

With the rise of deep learning algorithms nowadays, scene image representation methods have achieved a significant performance boost in classification. However, the performance is still limited because the scene images are mostly complex having higher intra-class dissimilarity and inter-class similarity problems. To deal with such problems, there have been several methods proposed in the literature with their advantages and limitations. A detailed study of previous works is necessary to understand their advantages and disadvantages in image representation and classification problems. In this paper, we review the existing scene image representation methods that are being widely used for image classification. For this, we, first, devise the taxonomy using the seminal existing methods proposed in the literature to this date {using deep learning (DL)-based, computer vision (CV)-based, and search engine (SE)-based methods}. Next, we compare their performance both qualitatively (e.g., quality of outputs, pros/cons, etc.) and quantitatively (e.g., accuracy). Last, we speculate on the prominent research directions in scene image representation tasks using {keyword growth and timeline analysis.} Overall, this survey provides in-depth insights and applications of recent scene image representation methods under three different methods.

Ethan Grooby, Chiranjibi Sitaula, Davood Fattahi et al.

Stethoscope-recorded chest sounds provide the opportunity for remote cardio-respiratory health monitoring of neonates. However, reliable monitoring requires high-quality heart and lung sounds. This paper presents novel Non-negative Matrix Factorisation (NMF) and Non-negative Matrix Co-Factorisation (NMCF) methods for neonatal chest sound separation. To assess these methods and compare with existing single-source separation methods, an artificial mixture dataset was generated comprising of heart, lung and noise sounds. Signal-to-noise ratios were then calculated for these artificial mixtures. These methods were also tested on real-world noisy neonatal chest sounds and assessed based on vital sign estimation error and a signal quality score of 1-5 developed in our previous works. Additionally, the computational cost of all methods was assessed to determine the applicability for real-time processing. Overall, both the proposed NMF and NMCF methods outperform the next best existing method by 2.7dB to 11.6dB for the artificial dataset and 0.40 to 1.12 signal quality improvement for the real-world dataset. The median processing time for the sound separation of a 10s recording was found to be 28.3s for NMCF and 342ms for NMF. Because of stable and robust performance, we believe that our proposed methods are useful to denoise neonatal heart and lung sound in a real-world environment. Codes for proposed and existing methods can be found at: https://github.com/egrooby-monash/Heart-and-Lung-Sound-Separation.

Weitao Tang, Johann Vargas-Calixto, Nasim Katebi et al.

Fetal sleep is a relatively underexplored yet vital aspect of prenatal neurodevelopment. Understanding fetal sleep patterns could provide insights into early brain maturation and help clinicians detect signs of neurological compromise that arise due to fetal hypoxia or fetal growth restriction. This review synthesizes over eight decades of research on the physiological characteristics, ontogeny, and regulation of fetal sleep. We compare sleep-state patterns in humans and large animal models, highlighting species-specific differences and the presence of sleep-state analogs. We review both invasive techniques in animals and non-invasive modalities in humans. Computational methods for sleep-state classification are also examined, including rule-based approaches (with and without clustering-based preprocessing) and state-of-the-art deep learning techniques. Finally, we discuss how intrauterine conditions such as hypoxia and fetal growth restriction can disrupt fetal sleep. This review provides a comprehensive foundation for the development of objective, multimodal, and non-invasive fetal sleep monitoring technologies to support early diagnosis and intervention in prenatal care.

Talha Ilyas, Duong Nhu, Allison Thomas et al.

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 results highlight the potential of self-supervised contrastive learning for fetal movement analysis, paving the way for improved prenatal monitoring and clinical decision-making.

Weitao Tang, Johann Vargas-Calixto, Nasim Katebi et al.

Introduction: This study presents FetalSleepNet, the first published deep learning approach to classifying sleep states from the ovine electroencephalogram (EEG). Fetal EEG is complex to acquire and difficult and laborious to interpret consistently. However, accurate sleep stage classification may aid in the early detection of abnormal brain maturation associated with pregnancy complications (e.g. hypoxia or intrauterine growth restriction). Methods: EEG electrodes were secured onto the ovine dura over the parietal cortices of 24 late gestation fetal sheep. A lightweight deep neural network originally developed for adult EEG sleep staging was trained on the ovine EEG using transfer learning from adult EEG. A spectral equalisation-based domain adaptation strategy was used to reduce cross-domain mismatch. Results: We demonstrated that while direct transfer performed poorly, full fine tuning combined with spectral equalisation achieved the best overall performance (accuracy: 86.6 percent, macro F1-score: 62.5), outperforming baseline models. Conclusions: To the best of our knowledge, FetalSleepNet is the first deep learning framework specifically developed for automated sleep staging from the fetal EEG. Beyond the laboratory, the EEG-based sleep stage classifier functions as a label engine, enabling large scale weak/semi supervised labeling and distillation to facilitate training on less invasive signals that can be acquired in the clinic, such as Doppler Ultrasound or electrocardiogram data. FetalSleepNet's lightweight design makes it well suited for deployment in low power, real time, and wearable fetal monitoring systems.

Abdul Jabbar, Ethan Grooby, Jack Crozier et al.

Congenital heart disease (CHD) is a critical condition that demands early detection, particularly in infancy and childhood. This study presents a deep learning model designed to detect CHD using phonocardiogram (PCG) signals, with a focus on its application in global health. We evaluated our model on several datasets, including the primary dataset from Bangladesh, achieving a high accuracy of 94.1%, sensitivity of 92.7%, specificity of 96.3%. The model also demonstrated robust performance on the public PhysioNet Challenge 2022 and 2016 datasets, underscoring its generalizability to diverse populations and data sources. We assessed the performance of the algorithm for single and multiple auscultation sites on the chest, demonstrating that the model maintains over 85% accuracy even when using a single location. Furthermore, our algorithm was able to achieve an accuracy of 80% on low-quality recordings, which cardiologists deemed non-diagnostic. This research suggests that an AI- driven digital stethoscope could serve as a cost-effective screening tool for CHD in resource-limited settings, enhancing clinical decision support and ultimately improving patient outcomes.

Ethan Grooby, Chiranjibi Sitaula, Kenneth Tan et al.

Neonatal respiratory distress is a common condition that if left untreated, can lead to short- and long-term complications. This paper investigates the usage of digital stethoscope recorded chest sounds taken within 1min post-delivery, to enable early detection and prediction of neonatal respiratory distress. Fifty-one term newborns were included in this study, 9 of whom developed respiratory distress. For each newborn, 1min anterior and posterior recordings were taken. These recordings were pre-processed to remove noisy segments and obtain high-quality heart and lung sounds. The random undersampling boosting (RUSBoost) classifier was then trained on a variety of features, such as power and vital sign features extracted from the heart and lung sounds. The RUSBoost algorithm produced specificity, sensitivity, and accuracy results of 85.0%, 66.7% and 81.8%, respectively.

Ethan Grooby, Chiranjibi Sitaula, Davood Fattahi et al.

Digital stethoscopes in combination with telehealth allow chest sounds to be easily collected and transmitted for remote monitoring and diagnosis. Chest sounds contain important information about a newborn's cardio-respiratory health. However, low-quality recordings complicate the remote monitoring and diagnosis. In this study, a new method is proposed to objectively and automatically assess heart and lung signal quality on a 5-level scale in real-time and to assess the effect of signal quality on vital sign estimation. For the evaluation, a total of 207 10s long chest sounds were taken from 119 preterm and full-term babies. Thirty of the recordings from ten subjects were obtained with synchronous vital signs from the Neonatal Intensive Care Unit (NICU) based on electrocardiogram recordings. As reference, seven annotators independently assessed the signal quality. For automatic quality classification, 400 features were extracted from the chest sounds. After feature selection using minimum redundancy and maximum relevancy algorithm, class balancing, and hyper-parameter optimization, a variety of multi-class and ordinal classification and regression algorithms were trained. Then, heart rate and breathing rate were automatically estimated from the chest sounds using adapted pre-existing methods. The results of subject-wise leave-one-out cross-validation show that the best-performing models had a mean squared error (MSE) of 0.49 and 0.61, and balanced accuracy of 57% and 51% for heart and lung qualities, respectively. The best-performing models for real-time analysis (<200ms) had MSE of 0.459 and 0.67, and balanced accuracy of 57% and 46%, respectively. Our experimental results underscore that increasing the signal quality leads to a reduction in vital sign error, with only high-quality recordings having a mean absolute error of less than 5 beats per minute, as required for clinical usage.

Ethan Grooby, Jinyuan He, Davood Fattahi et al.

Obtaining high-quality heart and lung sounds enables clinicians to accurately assess a newborn's cardio-respiratory health and provide timely care. However, noisy chest sound recordings are common, hindering timely and accurate assessment. A new Non-negative Matrix Co-Factorisation-based approach is proposed to separate noisy chest sound recordings into heart, lung, and noise components to address this problem. This method is achieved through training with 20 high-quality heart and lung sounds, in parallel with separating the sounds of the noisy recording. The method was tested on 68 10-second noisy recordings containing both heart and lung sounds and compared to the current state of the art Non-negative Matrix Factorisation methods. Results show significant improvements in heart and lung sound quality scores respectively, and improved accuracy of 3.6bpm and 1.2bpm in heart and breathing rate estimation respectively, when compared to existing methods.

Chiranjibi Sitaula, Jinyuan He, Archana Priyadarshi et al.

Abdominal auscultation is a convenient, safe and inexpensive method to assess bowel conditions, which is essential in neonatal care. It helps early detection of neonatal bowel dysfunctions and allows timely intervention. This paper presents a neonatal bowel sound detection method to assist the auscultation. Specifically, a Convolutional Neural Network (CNN) is proposed to classify peristalsis and non-peristalsis sounds. The classification is then optimized using a Laplace Hidden Semi-Markov Model (HSMM). The proposed method is validated on abdominal sounds from 49 newborn infants admitted to our tertiary Neonatal Intensive Care Unit (NICU). The results show that the method can effectively detect bowel sounds with accuracy and area under curve (AUC) score being 89.81% and 83.96% respectively, outperforming 13 baseline methods. Furthermore, the proposed Laplace HSMM refinement strategy is proven capable to enhance other bowel sound detection models. The outcomes of this work have the potential to facilitate future telehealth applications for neonatal care. The source code of our work can be found at: https://bitbucket.org/chirudeakin/neonatal-bowel-sound-classification/