Jorge Oliveira

Alberto Gomez, Mihaela Porumb, Angela Mumith et al.

We propose a new method to automatically contour the left ventricle on 2D echocardiographic images. Unlike most existing segmentation methods, which are based on predicting segmentation masks, we focus at predicting the endocardial contour and the key landmark points within this contour (basal points and apex). This provides a representation that is closer to how experts perform manual annotations and hence produce results that are physiologically more plausible. Our proposed method uses a two-headed network based on the U-Net architecture. One head predicts the 7 contour points, and the other head predicts a distance map to the contour. This approach was compared to the U-Net and to a point based approach, achieving performance gains of up to 30\% in terms of landmark localisation (<4.5mm) and distance to the ground truth contour (<3.5mm).

Kit M. Bransby, Woo-jin Cho Kim, Jorge Oliveira et al.

Building an echocardiography view classifier that maintains performance in real-life cases requires diverse multi-site data, and frequent updates with newly available data to mitigate model drift. Simply fine-tuning on new datasets results in "catastrophic forgetting", and cannot adapt to variations of view labels between sites. Alternatively, collecting all data on a single server and re-training may not be feasible as data sharing agreements may restrict image transfer, or datasets may only become available at different times. Furthermore, time and cost associated with re-training grows with every new dataset. We propose a class-incremental learning method which learns an expert network for each dataset, and combines all expert networks with a score fusion model. The influence of ``unqualified experts'' is minimised by weighting each contribution with a learnt in-distribution score. These weights promote transparency as the contribution of each expert is known during inference. Instead of using the original images, we use learned features from each dataset, which are easier to share and raise fewer licensing and privacy concerns. We validate our work on six datasets from multiple sites, demonstrating significant reductions in training time while improving view classification performance.

Kit Mills Bransby, Arian Beqiri, Woo-Jin Cho Kim et al.

Neural networks can learn spurious correlations that lead to the correct prediction in a validation set, but generalise poorly because the predictions are right for the wrong reason. This undesired learning of naive shortcuts (Clever Hans effect) can happen for example in echocardiogram view classification when background cues (e.g. metadata) are biased towards a class and the model learns to focus on those background features instead of on the image content. We propose a simple, yet effective random background augmentation method called BackMix, which samples random backgrounds from other examples in the training set. By enforcing the background to be uncorrelated with the outcome, the model learns to focus on the data within the ultrasound sector and becomes invariant to the regions outside this. We extend our method in a semi-supervised setting, finding that the positive effects of BackMix are maintained with as few as 5% of segmentation labels. A loss weighting mechanism, wBackMix, is also proposed to increase the contribution of the augmented examples. We validate our method on both in-distribution and out-of-distribution datasets, demonstrating significant improvements in classification accuracy, region focus and generalisability. Our source code is available at: https://github.com/kitbransby/BackMix

Alberto Gomez, Jorge Oliveira, Ramon Casero et al.

Ultrasound (US) machines display images on a built-in monitor, but routine transfer to hospital systems relies on DICOM. We propose a self-supervised pipeline to extract the US image from a photograph of the monitor. This removes the DICOM bottleneck and enables rapid testing and prototyping of new algorithms. In a proof-of-concept study, the rectified images retained enough visual fidelity to classify cardiac views with a balanced accuracy of 0.79 with respect to the native DICOMs.

Woo-Jin Cho Kim, Jorge Oliveira, Arian Beqiri et al.

Guidelines for transthoracic echocardiographic examination recommend the acquisition of multiple video clips from different views of the heart, resulting in a large number of clips. Typically, automated methods, for instance disease classifiers, either use one clip or average predictions from all clips. Relying on one clip ignores complementary information available from other clips, while using all clips is computationally expensive and may be prohibitive for clinical adoption. To select the optimal subset of clips that maximize performance for a specific task (image-based disease classification), we propose a method optimized through reinforcement learning. In our method, an agent learns to either keep processing view-specific clips to reduce the disease classification uncertainty, or stop processing if the achieved classification confidence is sufficient. Furthermore, we propose a learnable attention-based aggregation method as a flexible way of fusing information from multiple clips. The proposed method obtains an AUC of 0.91 on the task of detecting cardiac amyloidosis using only 30% of all clips, exceeding the performance achieved from using all clips and from other benchmarks.

Georgios Makridis, George Fragiadakis, Jorge Oliveira et al.

Current conversational AI systems often provide generic, one-size-fits-all interactions that overlook individual user characteristics and lack adaptive dialogue management. To address this gap, we introduce \textbf{HumAIne-chatbot}, an AI-driven conversational agent that personalizes responses through a novel user profiling framework. The system is pre-trained on a diverse set of GPT-generated virtual personas to establish a broad prior over user types. During live interactions, an online reinforcement learning agent refines per-user models by combining implicit signals (e.g. typing speed, sentiment, engagement duration) with explicit feedback (e.g., likes and dislikes). This profile dynamically informs the chatbot dialogue policy, enabling real-time adaptation of both content and style. To evaluate the system, we performed controlled experiments with 50 synthetic personas in multiple conversation domains. The results showed consistent improvements in user satisfaction, personalization accuracy, and task achievement when personalization features were enabled. Statistical analysis confirmed significant differences between personalized and nonpersonalized conditions, with large effect sizes across key metrics. These findings highlight the effectiveness of AI-driven user profiling and provide a strong foundation for future real-world validation.

Nuno Oliveira, Norberto Sousa, Jorge Oliveira et al.

Cyber-physical systems are infrastructures that use digital information such as network communications and sensor readings to control entities in the physical world. Many cyber-physical systems in airports, hospitals and nuclear power plants are regarded as critical infrastructures since a disruption of its normal functionality can result in negative consequences for the society. In the last few years, some security solutions for cyber-physical systems based on artificial intelligence have been proposed. Nevertheless, knowledge domain is required to properly setup and train artificial intelligence algorithms. Our work proposes a novel anomaly detection framework based on error space reconstruction, where genetic algorithms are used to perform hyperparameter optimization of machine learning methods. The proposed method achieved an F1-score of 87.89% in the SWaT dataset.

Agisilaos Chartsias, Shan Gao, Angela Mumith et al.

Analysis of cardiac ultrasound images is commonly performed in routine clinical practice for quantification of cardiac function. Its increasing automation frequently employs deep learning networks that are trained to predict disease or detect image features. However, such models are extremely data-hungry and training requires labelling of many thousands of images by experienced clinicians. Here we propose the use of contrastive learning to mitigate the labelling bottleneck. We train view classification models for imbalanced cardiac ultrasound datasets and show improved performance for views/classes for which minimal labelled data is available. Compared to a naive baseline model, we achieve an improvement in F1 score of up to 26% in those views while maintaining state-of-the-art performance for the views with sufficiently many labelled training observations.

Jorge Oliveira, Francesco Renna, Paulo Dias Costa et al.

Cardiac auscultation is one of the most cost-effective techniques used to detect and identify many heart conditions. Computer-assisted decision systems based on auscultation can support physicians in their decisions. Unfortunately, the application of such systems in clinical trials is still minimal since most of them only aim to detect the presence of extra or abnormal waves in the phonocardiogram signal, i.e., only a binary ground truth variable (normal vs abnormal) is provided. This is mainly due to the lack of large publicly available datasets, where a more detailed description of such abnormal waves (e.g., cardiac murmurs) exists. To pave the way to more effective research on healthcare recommendation systems based on auscultation, our team has prepared the currently largest pediatric heart sound dataset. A total of 5282 recordings have been collected from the four main auscultation locations of 1568 patients, in the process, 215780 heart sounds have been manually annotated. Furthermore, and for the first time, each cardiac murmur has been manually annotated by an expert annotator according to its timing, shape, pitch, grading, and quality. In addition, the auscultation locations where the murmur is present were identified as well as the auscultation location where the murmur is detected more intensively. Such detailed description for a relatively large number of heart sounds may pave the way for new machine learning algorithms with a real-world application for the detection and analysis of murmur waves for diagnostic purposes.

Jorge Oliveira, Margarida Carvalho, Diogo Marcelo Nogueira et al.

Physiological signals, such as the electrocardiogram and the phonocardiogram are very often corrupted by noisy sources. Usually, artificial intelligent algorithms analyze the signal regardless of its quality. On the other hand, physicians use a completely orthogonal strategy. They do not assess the entire recording, instead they search for a segment where the fundamental and abnormal waves are easily detected, and only then a prognostic is attempted. Inspired by this fact, a new algorithm that automatically selects an optimal segment for a post-processing stage, according to a criteria defined by the user is proposed. In the process, a Neural Network is used to compute the output state probability distribution for each sample. Using the aforementioned quantities, a graph is designed, whereas state transition constraints are physically imposed into the graph and a set of constraints are used to retrieve a subset of the recording that maximizes the likelihood function, proposed by the user. The developed framework is tested and validated in two applications. In both cases, the system performance is boosted significantly, e.g in heart sound segmentation, sensitivity increases 2.4% when compared to the standard approaches in the literature.