Junyi Fan

Lingchao Zheng, Yuwei Fan, Jun Li et al.

Quantization is essential for efficient large language model (LLM) inference, yet the dequantization step-converting low-bit weights back to high-precision for matrix multiplication has become a critical bottleneck on modern AI accelerators. On architectures with decoupled compute units (e.g., Ascend NPUs), dequantization operations can consume more cycles than the matrix multiplication itself, leaving the high-throughput tensor cores underutilized. This paper presents Multi-Scale Dequant (MSD), a quantization framework that removes weight/KV dequantization from the GEMM critical path. Instead of lifting low-bit weights to BF16 precision, MSD decomposes high-precision BF16 activations into multiple low-precision components, each of which can be multiplied directly with quantized weights via native hardware-accelerated GEMM. This approach shifts the computational paradigm from precision conversion to multi-scale approximation, avoiding INT8-to-BF16 weight conversion before GEMM. We instantiate MSD for two weight formats and derive tight error bounds for each. For INT8 weights (W4A16), two-pass INT8 decomposition achieves near 16 effective bits. For MXFP4 weights (W4A16), two-pass MXFP4 decomposition yields near 6.6 effective bits with error bound 1/64 per block surpassing single-pass MXFP8(5.24 bits) while maintaining the same effective GEMM compute time. We further derive closed-form latency and HBM traffic models showing that MSD avoids the Vector-Cube pipeline stall caused by dequantization and reduces KV cache HBM traffic by up to 2.5 times in attention. Numerical simulations on matrix multiplication and Flash Attention kernels confirm that MSD does not degrade accuracy compared to dequantization baselines, and in many settings achieves lower L2 error.

Shuheng Chen, Junyi Fan, Elham Pishgar et al.

Background: Sepsis-Associated Acute Kidney Injury (SA-AKI) leads to high mortality in intensive care. This study develops machine learning models using the Medical Information Mart for Intensive Care IV (MIMIC-IV) database to predict Intensive Care Unit (ICU) mortality in SA-AKI patients. External validation is conducted using the eICU Collaborative Research Database. Methods: For 9,474 identified SA-AKI patients in MIMIC-IV, key features like lab results, vital signs, and comorbidities were selected using Variance Inflation Factor (VIF), Recursive Feature Elimination (RFE), and expert input, narrowing to 24 predictive variables. An Extreme Gradient Boosting (XGBoost) model was built for in-hospital mortality prediction, with hyperparameters optimized using GridSearch. Model interpretability was enhanced with SHapley Additive exPlanations (SHAP) and Local Interpretable Model-agnostic Explanations (LIME). External validation was conducted using the eICU database. Results: The proposed XGBoost model achieved an internal Area Under the Receiver Operating Characteristic curve (AUROC) of 0.878 (95% Confidence Interval: 0.859-0.897). SHAP identified Sequential Organ Failure Assessment (SOFA), serum lactate, and respiratory rate as key mortality predictors. LIME highlighted serum lactate, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, total urine output, and serum calcium as critical features. Conclusions: The integration of advanced techniques with the XGBoost algorithm yielded a highly accurate and interpretable model for predicting SA-AKI mortality across diverse populations. It supports early identification of high-risk patients, enhancing clinical decision-making in intensive care. Future work needs to focus on enhancing adaptability, versatility, and real-world applications.

Junyi Fan, Shuheng Chen, Li Sun et al.

Aplastic anemia is a rare, life-threatening hematologic disorder characterized by pancytopenia and bone marrow failure. ICU admission in these patients often signals critical complications or disease progression, making early risk assessment crucial for clinical decision-making and resource allocation. In this study, we used the MIMIC-IV database to identify ICU patients diagnosed with aplastic anemia and extracted clinical features from five domains: demographics, synthetic indicators, laboratory results, comorbidities, and medications. Over 400 variables were reduced to seven key predictors through machine learning-based feature selection. Logistic regression and Cox regression models were constructed to predict 7-, 14-, and 28-day mortality, and their performance was evaluated using AUROC. External validation was conducted using the eICU Collaborative Research Database to assess model generalizability. Among 1,662 included patients, the logistic regression model demonstrated superior performance, with AUROC values of 0.8227, 0.8311, and 0.8298 for 7-, 14-, and 28-day mortality, respectively, compared to the Cox model. External validation yielded AUROCs of 0.7391, 0.7119, and 0.7093. Interactive nomograms were developed based on the logistic regression model to visually estimate individual patient risk. In conclusion, we identified a concise set of seven predictors, led by APS III, to build validated and generalizable nomograms that accurately estimate short-term mortality in ICU patients with aplastic anemia. These tools may aid clinicians in personalized risk stratification and decision-making at the point of care.

Shuheng Chen, Junyi Fan, Armin Abdollahi et al.

Intracerebral hemorrhage (ICH) is a life-risking condition characterized by bleeding within the brain parenchyma. ICU readmission in ICH patients is a critical outcome, reflecting both clinical severity and resource utilization. Accurate prediction of ICU readmission risk is crucial for guiding clinical decision-making and optimizing healthcare resources. This study utilized the Medical Information Mart for Intensive Care (MIMIC-III and MIMIC-IV) databases, which contain comprehensive clinical and demographic data on ICU patients. Patients with ICH were identified from both databases. Various clinical, laboratory, and demographic features were extracted for analysis based on both overview literature and experts' opinions. Preprocessing methods like imputing and sampling were applied to improve the performance of our models. Machine learning techniques, such as Artificial Neural Network (ANN), XGBoost, and Random Forest, were employed to develop predictive models for ICU readmission risk. Model performance was evaluated using metrics such as AUROC, accuracy, sensitivity, and specificity. The developed models demonstrated robust predictive accuracy for ICU readmission in ICH patients, with key predictors including demographic information, clinical parameters, and laboratory measurements. Our study provides a predictive framework for ICU readmission risk in ICH patients, which can aid in clinical decision-making and improve resource allocation in intensive care settings.

Junyi Fan, Li Sun, Shuheng Chen et al.

Background: Vancomycin, a key antibiotic for severe Gram-positive infections in ICUs, poses a high nephrotoxicity risk. Early prediction of kidney injury in critically ill patients is challenging. This study aimed to develop a machine learning model to predict vancomycin-related creatinine elevation using routine ICU data. Methods: We analyzed 10,288 ICU patients (aged 18-80) from the MIMIC-IV database who received vancomycin. Kidney injury was defined by KDIGO criteria (creatinine rise >=0.3 mg/dL within 48h or >=50% within 7d). Features were selected via SelectKBest (top 30) and Random Forest ranking (final 15). Six algorithms were tested with 5-fold cross-validation. Interpretability was evaluated using SHAP, Accumulated Local Effects (ALE), and Bayesian posterior sampling. Results: Of 10,288 patients, 2,903 (28.2%) developed creatinine elevation. CatBoost performed best (AUROC 0.818 [95% CI: 0.801-0.834], sensitivity 0.800, specificity 0.681, negative predictive value 0.900). Key predictors were phosphate, total bilirubin, magnesium, Charlson index, and APSIII. SHAP confirmed phosphate as a major risk factor. ALE showed dose-response patterns. Bayesian analysis estimated mean risk 60.5% (95% credible interval: 16.8-89.4%) in high-risk cases. Conclusions: This machine learning model predicts vancomycin-associated creatinine elevation from routine ICU data with strong accuracy and interpretability, enabling early risk detection and supporting timely interventions in critical care.

Li Sun, Shuheng Chen, Yong Si et al.

Background: Patients with both diabetes mellitus (DM) and atrial fibrillation (AF) face elevated mortality in intensive care units (ICUs), yet models targeting this high-risk group remain limited. Objective: To develop an interpretable machine learning (ML) model predicting 28-day mortality in ICU patients with concurrent DM and AF using early-phase clinical data. Methods: A retrospective cohort of 1,535 adult ICU patients with DM and AF was extracted from the MIMIC-IV database. Data preprocessing involved median/mode imputation, z-score normalization, and early temporal feature engineering. A two-step feature selection pipeline-univariate filtering (ANOVA F-test) and Random Forest-based multivariate ranking-yielded 19 interpretable features. Seven ML models were trained with stratified 5-fold cross-validation and SMOTE oversampling. Interpretability was assessed via ablation and Accumulated Local Effects (ALE) analysis. Results: Logistic regression achieved the best performance (AUROC: 0.825; 95% CI: 0.779-0.867), surpassing more complex models. Key predictors included RAS, age, bilirubin, and extubation. ALE plots showed intuitive, non-linear effects such as age-related risk acceleration and bilirubin thresholds. Conclusion: This interpretable ML model offers accurate risk prediction and clinical insights for early ICU triage in patients with DM and AF.

Tinghuan Li, Shuheng Chen, Junyi Fan et al.

Postoperative stroke remains a critical complication in elderly surgical intensive care unit (SICU) patients, contributing to prolonged hospitalization, elevated healthcare costs, and increased mortality. Accurate early risk stratification is essential to enable timely intervention and improve clinical outcomes. We constructed a combined cohort of 19,085 elderly SICU admissions from the MIMIC-III and MIMIC-IV databases and developed an interpretable machine learning (ML) framework to predict in-hospital stroke using clinical data from the first 24 hours of Intensive Care Unit (ICU) stay. The preprocessing pipeline included removal of high-missingness features, iterative Singular Value Decomposition (SVD) imputation, z-score normalization, one-hot encoding, and class imbalance correction via the Adaptive Synthetic Sampling (ADASYN) algorithm. A two-stage feature selection process-combining Recursive Feature Elimination with Cross-Validation (RFECV) and SHapley Additive exPlanations (SHAP)-reduced the initial 80 variables to 20 clinically informative predictors. Among eight ML models evaluated, CatBoost achieved the best performance with an AUROC of 0.8868 (95% CI: 0.8802--0.8937). SHAP analysis and ablation studies identified prior cerebrovascular disease, serum creatinine, and systolic blood pressure as the most influential risk factors. Our results highlight the potential of interpretable ML approaches to support early detection of postoperative stroke and inform decision-making in perioperative critical care.

Junyi Fan, Yuxuan Han, Jialin Zeng et al.

Efficiently learning equilibria with large state and action spaces in general-sum Markov games while overcoming the curse of multi-agency is a challenging problem. Recent works have attempted to solve this problem by employing independent linear function classes to approximate the marginal $Q$-value for each agent. However, existing sample complexity bounds under such a framework have a suboptimal dependency on the desired accuracy $\varepsilon$ or the action space. In this work, we introduce a new algorithm, Lin-Confident-FTRL, for learning coarse correlated equilibria (CCE) with local access to the simulator, i.e., one can interact with the underlying environment on the visited states. Up to a logarithmic dependence on the size of the state space, Lin-Confident-FTRL learns $ε$-CCE with a provable optimal accuracy bound $O(ε^{-2})$ and gets rids of the linear dependency on the action space, while scaling polynomially with relevant problem parameters (such as the number of agents and time horizon). Moreover, our analysis of Linear-Confident-FTRL generalizes the virtual policy iteration technique in the single-agent local planning literature, which yields a new computationally efficient algorithm with a tighter sample complexity bound when assuming random access to the simulator.

Wenshuo Gao, Junyi Fan, Jiangyue Zeng et al.

Video relighting with background replacement is a challenging task critical for applications in film production and creative media. Existing methods struggle to balance temporal consistency, spatial fidelity, and illumination naturalness. To address these issues, we introduce FlowPortal, a novel training-free flow-based video relighting framework. Our core innovation is a Residual-Corrected Flow mechanism that transforms a standard flow-based model into an editing model, guaranteeing perfect reconstruction when input conditions are identical and enabling faithful relighting when they differ, resulting in high structural consistency. This is further enhanced by a Decoupled Condition Design for precise lighting control and a High-Frequency Transfer mechanism for detail preservation. Additionally, a masking strategy isolates foreground relighting from background pure generation process. Experiments demonstrate that FlowPortal achieves superior performance in temporal coherence, structural preservation, and lighting realism, while maintaining high efficiency. Project Page: https://gaowenshuo.github.io/FlowPortalProject/.

Junyi Fan, Li Sun, Negin Ashrafi et al.

Nursing documentation in intensive care units (ICUs) provides essential clinical intelligence but often suffers from inconsistent terminology, informal styles, and lack of standardization, challenges that are particularly critical in heart failure care. This study applies Direct Preference Optimization (DPO) to adapt Mistral-7B, a locally deployable language model, using 8,838 heart failure nursing notes from the MIMIC-III database and 21,210 preference pairs derived from expert-verified GPT outputs, model generations, and original notes. Evaluation across BLEU, ROUGE, BERTScore, Perplexity, and expert qualitative assessments demonstrates that DPO markedly enhances documentation quality. Specifically, BLEU increased by 84% (0.173 to 0.318), BERTScore improved by 7.6% (0.828 to 0.891), and expert ratings rose across accuracy (+14.4 points), completeness (+14.5 points), logical consistency (+14.1 points), readability (+11.1 points), and structural clarity (+6.0 points). These results indicate that DPO can align lightweight clinical language models with expert standards, supporting privacy-preserving, AI-assisted documentation within electronic health record systems to reduce administrative burden and improve ICU patient safety.

Li Sun, Shuheng Chen, Junyi Fan et al.

Background: Cirrhosis is a progressive liver disease with high mortality and frequent complications, notably acute kidney injury (AKI), which occurs in up to 50% of hospitalized patients and worsens outcomes. AKI stems from complex hemodynamic, inflammatory, and metabolic changes, making early detection essential. Many predictive tools lack accuracy, interpretability, and alignment with intensive care unit (ICU) workflows. This study developed an interpretable machine learning model for early AKI prediction in critically ill patients with cirrhosis. Methods: We conducted a retrospective analysis of the MIMIC-IV v2.2 database, identifying 1240 adult ICU patients with cirrhosis and excluding those with ICU stays under 48 hours or missing key data. Laboratory and physiological variables from the first 48 hours were extracted. The pipeline included preprocessing, missingness filtering, LASSO feature selection, and SMOTE class balancing. Six algorithms-LightGBM, CatBoost, XGBoost, logistic regression, naive Bayes, and neural networks-were trained and evaluated using AUROC, accuracy, F1-score, sensitivity, specificity, and predictive values. Results: LightGBM achieved the best performance (AUROC 0.808, 95% CI 0.741-0.856; accuracy 0.704; NPV 0.911). Key predictors included prolonged partial thromboplastin time, absence of outside-facility 20G placement, low pH, and altered pO2, consistent with known cirrhosis-AKI mechanisms and suggesting actionable targets. Conclusion: The LightGBM-based model enables accurate early AKI risk stratification in ICU patients with cirrhosis using routine clinical variables. Its high negative predictive value supports safe de-escalation for low-risk patients, and interpretability fosters clinician trust and targeted prevention. External validation and integration into electronic health record systems are warranted.

Yong Si, Junyi Fan, Li Sun et al.

Background: Hypertensive kidney disease (HKD) patients in intensive care units (ICUs) face high short-term mortality, but tailored risk prediction tools are lacking. Early identification of high-risk individuals is crucial for clinical decision-making. Methods: We developed a machine learning framework to predict 30-day in-hospital mortality among ICU patients with HKD using early clinical data from the MIMIC-IV v2.2 database. A cohort of 1,366 adults was curated with strict criteria, excluding malignancy cases. Eighteen clinical features-including vital signs, labs, comorbidities, and therapies-were selected via random forest importance and mutual information filtering. Several models were trained and compared with stratified five-fold cross-validation; CatBoost demonstrated the best performance. Results: CatBoost achieved an AUROC of 0.88 on the independent test set, with sensitivity of 0.811 and specificity of 0.798. SHAP values and Accumulated Local Effects (ALE) plots showed the model relied on meaningful predictors such as altered consciousness, vasopressor use, and coagulation status. Additionally, the DREAM algorithm was integrated to estimate patient-specific posterior risk distributions, allowing clinicians to assess both predicted mortality and its uncertainty. Conclusions: We present an interpretable machine learning pipeline for early, real-time risk assessment in ICU patients with HKD. By combining high predictive performance with uncertainty quantification, our model supports individualized triage and transparent clinical decisions. This approach shows promise for clinical deployment and merits external validation in broader critical care populations.

Junyi Fan, Donald Williamson

Speech quality assessment (SQA) is often used to learn a mapping from a high-dimensional input space to a scalar that represents the mean opinion score (MOS) of the perceptual speech quality. Learning such a mapping is challenging for many reasons, but largely because MOS exhibits high levels of inherent variance due to perceptual and experimental-design differences. Many solutions have been proposed, but many approaches do not properly incorporate perceptual factors into their learning algorithms (beyond the MOS label), which could lead to unsatisfactory results. To this end, we propose JSQA, a two-stage framework that pretrains an audio encoder using perceptually-guided contrastive learning on just noticeable difference (JND) pairs, followed by fine-tuning for MOS prediction. We first generate pairs of audio data within JND levels, which are then used to pretrain an encoder to leverage perceptual quality similarity information and map it into an embedding space. The JND pairs come from clean LibriSpeech utterances that are mixed with background noise from CHiME-3, at different signal-to-noise ratios (SNRs). The encoder is later fine-tuned with audio samples from the NISQA dataset for MOS prediction. Experimental results suggest that perceptually-inspired contrastive pretraining significantly improves the model performance evaluated by various metrics when compared against the same network trained from scratch without pretraining. These findings suggest that incorporating perceptual factors into pretraining greatly contributes to the improvement in performance for SQA.