Reza Sameni

LG
h-index16
23papers
377citations
Novelty30%
AI Score44

23 Papers

CVJul 4, 2023Code
ECG-Image-Kit: A Synthetic Image Generation Toolbox to Facilitate Deep Learning-Based Electrocardiogram Digitization

Kshama Kodthalu Shivashankara, Deepanshi, Afagh Mehri Shervedani et al.

Cardiovascular diseases are a major cause of mortality globally, and electrocardiograms (ECGs) are crucial for diagnosing them. Traditionally, ECGs are printed on paper. However, these printouts, even when scanned, are incompatible with advanced ECG diagnosis software that require time-series data. Digitizing ECG images is vital for training machine learning models in ECG diagnosis and to leverage the extensive global archives collected over decades. Deep learning models for image processing are promising in this regard, although the lack of clinical ECG archives with reference time-series data is challenging. Data augmentation techniques using realistic generative data models provide a solution. We introduce ECG-Image-Kit, an open-source toolbox for generating synthetic multi-lead ECG images with realistic artifacts from time-series data. The tool synthesizes ECG images from real time-series data, applying distortions like text artifacts, wrinkles, and creases on a standard ECG paper background. As a case study, we used ECG-Image-Kit to create a dataset of 21,801 ECG images from the PhysioNet QT database. We developed and trained a combination of a traditional computer vision and deep neural network model on this dataset to convert synthetic images into time-series data for evaluation. We assessed digitization quality by calculating the signal-to-noise ratio (SNR) and compared clinical parameters like QRS width, RR, and QT intervals recovered from this pipeline, with the ground truth extracted from ECG time-series. The results show that this deep learning pipeline accurately digitizes paper ECGs, maintaining clinical parameters, and highlights a generative approach to digitization. This toolbox currently supports data augmentation for the 2024 PhysioNet Challenge, focusing on digitizing and classifying paper ECG images.

QMSep 25, 2024Code
ECG-Image-Database: A Dataset of ECG Images with Real-World Imaging and Scanning Artifacts; A Foundation for Computerized ECG Image Digitization and Analysis

Matthew A. Reyna, Deepanshi, James Weigle et al.

We introduce the ECG-Image-Database, a large and diverse collection of electrocardiogram (ECG) images generated from ECG time-series data, with real-world scanning, imaging, and physical artifacts. We used ECG-Image-Kit, an open-source Python toolkit, to generate realistic images of 12-lead ECG printouts from raw ECG time-series. The images include realistic distortions such as noise, wrinkles, stains, and perspective shifts, generated both digitally and physically. The toolkit was applied to 977 12-lead ECG records from the PTB-XL database and 1,000 from Emory Healthcare to create high-fidelity synthetic ECG images. These unique images were subjected to both programmatic distortions using ECG-Image-Kit and physical effects like soaking, staining, and mold growth, followed by scanning and photography under various lighting conditions to create real-world artifacts. The resulting dataset includes 35,595 software-labeled ECG images with a wide range of imaging artifacts and distortions. The dataset provides ground truth time-series data alongside the images, offering a reference for developing machine and deep learning models for ECG digitization and classification. The images vary in quality, from clear scans of clean papers to noisy photographs of degraded papers, enabling the development of more generalizable digitization algorithms. ECG-Image-Database addresses a critical need for digitizing paper-based and non-digital ECGs for computerized analysis, providing a foundation for developing robust machine and deep learning models capable of converting ECG images into time-series. The dataset aims to serve as a reference for ECG digitization and computerized annotation efforts. ECG-Image-Database was used in the PhysioNet Challenge 2024 on ECG image digitization and classification.

SPJan 6, 2023
A Data-Driven Gaussian Process Filter for Electrocardiogram Denoising

Mircea Dumitru, Qiao Li, Erick Andres Perez Alday et al.

Objective: Gaussian Processes (GP)-based filters, which have been effectively used for various applications including electrocardiogram (ECG) filtering can be computationally demanding and the choice of their hyperparameters is typically ad hoc. Methods: We develop a data-driven GP filter to address both issues, using the notion of the ECG phase domain -- a time-warped representation of the ECG beats onto a fixed number of samples and aligned R-peaks, which is assumed to follow a Gaussian distribution. Under this assumption, the computation of the sample mean and covariance matrix is simplified, enabling an efficient implementation of the GP filter in a data-driven manner, with no ad hoc hyperparameters. The proposed filter is evaluated and compared with a state-of-the-art wavelet-based filter, on the PhysioNet QT Database. The performance is evaluated by measuring the signal-to-noise ratio (SNR) improvement of the filter at SNR levels ranging from -5 to 30dB, in 5dB steps, using additive noise. For a clinical evaluation, the error between the estimated QT-intervals of the original and filtered signals is measured and compared with the benchmark filter. Results: It is shown that the proposed GP filter outperforms the benchmark filter for all the tested noise levels. It also outperforms the state-of-the-art filter in terms of QT-interval estimation error bias and variance. Conclusion: The proposed GP filter is a versatile technique for preprocessing the ECG in clinical and research applications, is applicable to ECG of arbitrary lengths and sampling frequencies, and provides confidence intervals for its performance.

SPFeb 1, 2023
Electrode Selection for Noninvasive Fetal Electrocardiogram Extraction using Mutual Information Criteria

Reza Sameni, Frédéric Vrins, Fabienne Parmentier et al.

Blind source separation (BSS) techniques have revealed to be promising approaches for, among other, biomedical signal processing applications. Specifically, for the noninvasive extraction of fetal cardiac signals from maternal abdominal recordings, where conventional filtering schemes have failed to extract the complete fetal ECG components. From previous studies, it is now believed that a carefully selected array of electrodes well-placed over the abdomen of a pregnant woman contains the required `information' for BSS, to extract the complete fetal components. Based on this idea, in previous works array recording systems and sensor selection strategies based on the Mutual Information (MI) criterion have been developed. In this paper the previous works have been extended, by considering the 3-dimensional aspects of the cardiac electrical activity. The proposed method has been tested on simulated and real maternal abdominal recordings. The results show that the new sensor selection strategy together with the MI criterion, can be effectively used to select the channels containing the most `information' concerning the fetal ECG components from an array of 72 recordings. The method is hence believed to be useful for the selection of the most informative channels in online applications, considering the different fetal positions and movements.

SPNov 15, 2023
Point-of-Care Real-Time Signal Quality for Fetal Doppler Ultrasound Using a Deep Learning Approach

Mohsen Motie-Shirazi, Reza Sameni, Peter Rohloff et al.

In this study, we present a deep learning framework designed to integrate with our previously developed system that facilitates large-scale 1D fetal Doppler data collection, aiming to enhance data quality. This system, tailored for traditional Indigenous midwives in low-resource communities, leverages a cost-effective Android phone to improve the quality of recorded signals. We have shown that the Doppler data can be used to identify fetal growth restriction, hypertension, and other concerning issues during pregnancy. However, the quality of the signal is dependent on many factors, including radio frequency interference, position of the fetus, maternal body habitus, and usage of the Doppler by the birth attendants. In order to provide instant feedback to allow correction of the data at source, a signal quality metric is required that can run in real-time on the mobile phone. In this study, 191 DUS signals with durations mainly in the range between 5 to 10 minutes were evaluated for quality and classified into five categories: Good, Poor, (Radiofrequency) Interference, Talking, and Silent, at a resolution of 3.75 seconds. A deep neural network was trained on each 3.75-second segment from these recordings and validated using five-fold cross-validation. An average micro F1 = 97.4\% and macro F1 = 94.2\% were achieved, with F1 = 99.2\% for `Good' quality data. These results indicate that the algorithm, which will now be implemented in the midwives' app, should allow a significant increase in the quality of data at the time of capture.

MED-PHJun 14, 2023
A Survey on Blood Pressure Measurement Technologies: Addressing Potential Sources of Bias

Seyedeh Somayyeh Mousavi, Matthew A. Reyna, Gari D. Clifford et al.

Regular blood pressure (BP) monitoring in clinical and ambulatory settings plays a crucial role in the prevention, diagnosis, treatment, and management of cardiovascular diseases. Recently, the widespread adoption of ambulatory BP measurement devices has been driven predominantly by the increased prevalence of hypertension and its associated risks and clinical conditions. Recent guidelines advocate for regular BP monitoring as part of regular clinical visits or even at home. This increased utilization of BP measurement technologies has brought up significant concerns, regarding the accuracy of reported BP values across settings. In this survey, focusing mainly on cuff-based BP monitoring technologies, we highlight how BP measurements can demonstrate substantial biases and variances due to factors such as measurement and device errors, demographics, and body habitus. With these inherent biases, the development of a new generation of cuff-based BP devices which use artificial-intelligence (AI) has significant potential. We present future avenues where AI-assisted technologies can leverage the extensive clinical literature on BP-related studies together with the large collections of BP records available in electronic health records. These resources can be combined with machine learning approaches, including deep learning and Bayesian inference, to remove BP measurement biases and to provide individualized BP-related cardiovascular risk indexes.

SPApr 24
Multi-View Hierarchical Representation Learning of Fetal Hemodynamics for Maternal Hypertension Detection at the Edge

Alireza Rafiei, Anahí Venzor Strader, Esteban Castro Aragón et al.

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 mechanical activity contains hemodynamic features indicative of maternal hypertension status. This supports a promising paradigm shift toward continuous, objective monitoring of maternal health using existing, low-cost ultrasound technology and introduces a complementary approach to traditional methods based on blood pressure measurements, advancing scalable prenatal care.

ASJan 10, 2022Code
Noisy Neonatal Chest Sound Separation for High-Quality Heart and Lung Sounds

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.

LGJul 21, 2023
Beyond Convergence: Identifiability of Machine Learning and Deep Learning Models

Reza Sameni

Machine learning (ML) and deep learning models are extensively used for parameter optimization and regression problems. However, not all inverse problems in ML are ``identifiable,'' indicating that model parameters may not be uniquely determined from the available data and the data model's input-output relationship. In this study, we investigate the notion of model parameter identifiability through a case study focused on parameter estimation from motion sensor data. Utilizing a bipedal-spring mass human walk dynamics model, we generate synthetic data representing diverse gait patterns and conditions. Employing a deep neural network, we attempt to estimate subject-wise parameters, including mass, stiffness, and equilibrium leg length. The results show that while certain parameters can be identified from the observation data, others remain unidentifiable, highlighting that unidentifiability is an intrinsic limitation of the experimental setup, necessitating a change in data collection and experimental scenarios. Beyond this specific case study, the concept of identifiability has broader implications in ML and deep learning. Addressing unidentifiability requires proven identifiable models (with theoretical support), multimodal data fusion techniques, and advancements in model-based machine learning. Understanding and resolving unidentifiability challenges will lead to more reliable and accurate applications across diverse domains, transcending mere model convergence and enhancing the reliability of machine learning models.

LGOct 2, 2025
Detection of Chagas Disease from the ECG: The George B. Moody PhysioNet Challenge 2025

Matthew A. Reyna, Zuzana Koscova, Jan Pavlus et al.

Objective: Chagas disease is a parasitic infection that is endemic to South America, Central America, and, more recently, the U.S., primarily transmitted by insects. Chronic Chagas disease can cause cardiovascular diseases and digestive problems. Serological testing capacities for Chagas disease are limited, but Chagas cardiomyopathy often manifests in ECGs, providing an opportunity to prioritize patients for testing and treatment. Approach: The George B. Moody PhysioNet Challenge 2025 invites teams to develop algorithmic approaches for identifying Chagas disease from electrocardiograms (ECGs). Main results: This Challenge provides multiple innovations. First, we leveraged several datasets with labels from patient reports and serological testing, provided a large dataset with weak labels and smaller datasets with strong labels. Second, we augmented the data to support model robustness and generalizability to unseen data sources. Third, we applied an evaluation metric that captured the local serological testing capacity for Chagas disease to frame the machine learning problem as a triage task. Significance: Over 630 participants from 111 teams submitted over 1300 entries during the Challenge, representing diverse approaches from academia and industry worldwide.

QMFeb 2, 2024
Learning from Two Decades of Blood Pressure Data: Demography-Specific Patterns Across 75 Million Patient Encounters

Seyedeh Somayyeh Mousavi, Yuting Guo, Abeed Sarker et al.

Hypertension is a global health concern with an increasing prevalence, underscoring the need for effective monitoring and analysis of blood pressure (BP) dynamics. We analyzed a substantial BP dataset comprising 75,636,128 records from 2,054,462 unique patients collected between 2000 and 2022 at Emory Healthcare in Georgia, USA, representing a demographically diverse population. We examined and compared population-wide statistics of bivariate changes in systolic BP (SBP) and diastolic BP (DBP) across sex, age, and race/ethnicity. The analysis revealed that males have higher BP levels than females and exhibit a distinct BP profile with age. Notably, average SBP consistently rises with age, whereas average DBP peaks in the forties age group. Among the ethnic groups studied, Blacks have marginally higher BPs and a greater standard deviation. We also discovered a significant correlation between SBP and DBP at the population level, a phenomenon not previously researched. These results emphasize the importance of demography-specific BP analysis for clinical diagnosis and provide valuable insights for developing personalized, demography-specific healthcare interventions.

LGApr 2, 2025
On the Geometry of Receiver Operating Characteristic and Precision-Recall Curves

Reza Sameni

We study the geometry of Receiver Operating Characteristic (ROC) and Precision-Recall (PR) curves in binary classification problems. The key finding is that many of the most commonly used binary classification metrics are merely functions of the composition function $G := F_p \circ F_n^{-1}$, where $F_p(\cdot)$ and $F_n(\cdot)$ are the class-conditional cumulative distribution functions of the classifier scores in the positive and negative classes, respectively. This geometric perspective facilitates the selection of operating points, understanding the effect of decision thresholds, and comparison between classifiers. It also helps explain how the shapes and geometry of ROC/PR curves reflect classifier behavior, providing objective tools for building classifiers optimized for specific applications with context-specific constraints. We further explore the conditions for classifier dominance, present analytical and numerical examples demonstrating the effects of class separability and variance on ROC and PR geometries, and derive a link between the positive-to-negative class leakage function $G(\cdot)$ and the Kullback--Leibler divergence. The framework highlights practical considerations, such as model calibration, cost-sensitive optimization, and operating point selection under real-world capacity constraints, enabling more informed approaches to classifier deployment and decision-making.

MED-PHOct 25, 2024
Electromechanical Dynamics of the Heart: A Study of Cardiac Hysteresis During Physical Stress Test

Sajjad Karimi, Shirin Karimi, Amit J. Shah et al.

Cardiovascular diseases are best diagnosed using multiple modalities that assess both the heart's electrical and mechanical functions. While effective, imaging techniques like echocardiography and nuclear imaging are costly and not widely accessible. More affordable technologies, such as simultaneous electrocardiography (ECG) and phonocardiography (PCG), may provide valuable insights into electromechanical coupling and could be useful for prescreening in low-resource settings. Using physical stress test data from the EPHNOGRAM ECG-PCG dataset, collected from 23 healthy male subjects (age: 25.4+/-1.9 yrs), we investigated electromechanical intervals (RR, QT, systolic, and diastolic) and their interactions during exercise, along with hysteresis between cardiac electrical activity and mechanical responses. Time delay analysis revealed distinct temporal relationships between QT, systolic, and diastolic intervals, with RR as the primary driver. The diastolic interval showed near-synchrony with RR, while QT responded to RR interval changes with an average delay of 10.5s, and the systolic interval responded more slowly, with an average delay of 28.3s. We examined QT-RR, systolic-RR, and diastolic-RR hysteresis, finding narrower loops for diastolic RR and wider loops for systolic RR. Significant correlations (average:0.75) were found between heart rate changes and hysteresis loop areas, suggesting the equivalent circular area diameter as a promising biomarker for cardiac function under exercise stress. Deep learning models, including Long Short-Term Memory and Convolutional Neural Networks, estimated the QT, systolic, and diastolic intervals from RR data, confirming the nonlinear relationship between RR and other intervals. Findings highlight a significant cardiac memory effect, linking ECG and PCG morphology and timing to heart rate history.

LGMar 12, 2025
Edge AI for Real-time Fetal Assessment in Rural Guatemala

Nasim Katebi, Mohammad Ahmad, Mohsen Motie-Shirazi et al.

Perinatal complications, defined as conditions that arise during pregnancy, childbirth, and the immediate postpartum period, represent a significant burden on maternal and neonatal health worldwide. Factors contributing to these disparities include limited access to quality healthcare, socioeconomic inequalities, and variations in healthcare infrastructure. Addressing these issues is crucial for improving health outcomes for mothers and newborns, particularly in underserved communities. To mitigate these challenges, we have developed an AI-enabled smartphone application designed to provide decision support at the point-of-care. This tool aims to enhance health monitoring during pregnancy by leveraging machine learning (ML) techniques. The intended use of this application is to assist midwives during routine home visits by offering real-time analysis and providing feedback based on collected data. The application integrates TensorFlow Lite (TFLite) and other Python-based algorithms within a Kotlin framework to process data in real-time. It is designed for use in low-resource settings, where traditional healthcare infrastructure may be lacking. The intended patient population includes pregnant women and new mothers in underserved areas and the developed system was piloted in rural Guatemala. This ML-based solution addresses the critical need for accessible and quality perinatal care by empowering healthcare providers with decision support tools to improve maternal and neonatal health outcomes.

LGJun 11, 2025
Cross-Learning Between ECG and PCG: Exploring Common and Exclusive Characteristics of Bimodal Electromechanical Cardiac Waveforms

Sajjad Karimi, Amit J. Shah, Gari D. Clifford et al.

Simultaneous electrocardiography (ECG) and phonocardiogram (PCG) provide a comprehensive, multimodal perspective on cardiac function by capturing the heart's electrical and mechanical activities, respectively. However, the distinct and overlapping information content of these signals, as well as their potential for mutual reconstruction and biomarker extraction, remains incompletely understood, especially under varying physiological conditions and across individuals. In this study, we systematically investigate the common and exclusive characteristics of ECG and PCG using the EPHNOGRAM dataset of simultaneous ECG-PCG recordings during rest and exercise. We employ a suite of linear and nonlinear machine learning models, including non-causal LSTM networks, to reconstruct each modality from the other and analyze the influence of causality, physiological state, and cross-subject variability. Our results demonstrate that nonlinear models, particularly non-causal LSTM, provide superior reconstruction performance, with reconstructing ECG from PCG proving more tractable than the reverse. Exercise and cross-subject scenarios present significant challenges, but envelope-based modeling that utilizes instantaneous amplitude features substantially improves cross-subject generalizability for cross-modal learning. Furthermore, we demonstrate that clinically relevant ECG biomarkers, such as fiducial points and QT intervals, can be estimated from PCG in cross-subject settings. These findings advance our understanding of the relationship between electromechanical cardiac modalities, in terms of both waveform characteristics and the timing of cardiac events, with potential applications in novel multimodal cardiac monitoring technologies.

CLFeb 2, 2024
Leveraging Large Language Models for Analyzing Blood Pressure Variations Across Biological Sex from Scientific Literature

Yuting Guo, Seyedeh Somayyeh Mousavi, Reza Sameni et al.

Hypertension, defined as blood pressure (BP) that is above normal, holds paramount significance in the realm of public health, as it serves as a critical precursor to various cardiovascular diseases (CVDs) and significantly contributes to elevated mortality rates worldwide. However, many existing BP measurement technologies and standards might be biased because they do not consider clinical outcomes, comorbidities, or demographic factors, making them inconclusive for diagnostic purposes. There is limited data-driven research focused on studying the variance in BP measurements across these variables. In this work, we employed GPT-35-turbo, a large language model (LLM), to automatically extract the mean and standard deviation values of BP for both males and females from a dataset comprising 25 million abstracts sourced from PubMed. 993 article abstracts met our predefined inclusion criteria (i.e., presence of references to blood pressure, units of blood pressure such as mmHg, and mention of biological sex). Based on the automatically-extracted information from these articles, we conducted an analysis of the variations of BP values across biological sex. Our results showed the viability of utilizing LLMs to study the BP variations across different demographic factors.

LGDec 28, 2021
Mythological Medical Machine Learning: Boosting the Performance of a Deep Learning Medical Data Classifier Using Realistic Physiological Models

Ismail Sadiq, Erick A. Perez-Alday, Amit J. Shah et al.

Objective: To determine if a realistic, but computationally efficient model of the electrocardiogram can be used to pre-train a deep neural network (DNN) with a wide range of morphologies and abnormalities specific to a given condition - T-wave Alternans (TWA) as a result of Post-Traumatic Stress Disorder, or PTSD - and significantly boost performance on a small database of rare individuals. Approach: Using a previously validated artificial ECG model, we generated 180,000 artificial ECGs with or without significant TWA, with varying heart rate, breathing rate, TWA amplitude, and ECG morphology. A DNN, trained on over 70,000 patients to classify 25 different rhythms, was modified the output layer to a binary class (TWA or no-TWA, or equivalently, PTSD or no-PTSD), and transfer learning was performed on the artificial ECG. In a final transfer learning step, the DNN was trained and cross-validated on ECG from 12 PTSD and 24 controls for all combinations of using the three databases. Main results: The best performing approach (AUROC = 0.77, Accuracy = 0.72, F1-score = 0.64) was found by performing both transfer learning steps, using the pre-trained arrhythmia DNN, the artificial data and the real PTSD-related ECG data. Removing the artificial data from training led to the largest drop in performance. Removing the arrhythmia data from training provided a modest, but significant, drop in performance. The final model showed no significant drop in performance on the artificial data, indicating no overfitting. Significance: In healthcare, it is common to only have a small collection of high-quality data and labels, or a larger database with much lower quality (and less relevant) labels. The paradigm presented here, involving model-based performance boosting, provides a solution through transfer learning on a large realistic artificial database, and a partially relevant real database.

QMDec 24, 2021
Noninvasive Fetal Electrocardiography: Models, Technologies and Algorithms

Reza Sameni

The fetal electrocardiogram (fECG) was first recorded from the maternal abdominal surface in the early 1900s. During the past fifty years, the most advanced electronics technologies and signal processing algorithms have been used to convert noninvasive fetal electrocardiography into a reliable technology for fetal cardiac monitoring. In this chapter, the major signal processing techniques, which have been developed for the modeling, extraction and analysis of the fECG from noninvasive maternal abdominal recordings are reviewed and compared with one another in detail. The major topics of the chapter include: 1) the electrophysiology of the fECG from the signal processing viewpoint, 2) the mathematical model of the maternal volume conduction media and the waveform models of the fECG acquired from body surface leads, 3) the signal acquisition requirements, 4) model-based techniques for fECG noise and interference cancellation, including adaptive filters and semi-blind source separation techniques, and 5) recent algorithmic advances for fetal motion tracking and online fECG extraction from few number of channels.

ASSep 29, 2021
Real-Time Multi-Level Neonatal Heart and Lung Sound Quality Assessment for Telehealth Applications

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.

SPAug 20, 2021
Temporally Nonstationary Component Analysis; Application to Noninvasive Fetal Electrocardiogram Extraction

Fahimeh Jamshidian-Tehrani, Reza Sameni, Christian Jutten

Objective: Mixtures of temporally nonstationary signals are very common in biomedical applications. The nonstationarity of the source signals can be used as a discriminative property for signal separation. Herein, a semi-blind source separation algorithm is proposed for the extraction of temporally nonstationary components from linear multichannel mixtures of signals and noises. Methods: A hypothesis test is proposed for the detection and fusion of temporally nonstationary events, by using ad hoc indexes for monitoring the first and second order statistics of the innovation process. As proof of concept, the general framework is customized and tested over noninvasive fetal cardiac recordings acquired from the maternal abdomen, over publicly available datasets, using two types of nonstationarity detectors: 1) a local power variations detector, and 2) a model-deviations detector using the innovation process properties of an extended Kalman filter. Results: The performance of the proposed method is assessed in presence of white and colored noise, in different signal-to-noise ratios. Conclusion and Significance: The proposed scheme is general and it can be used for the extraction of nonstationary events and sample deviations from a presumed model in multivariate data, which is a recurrent problem in many machine learning applications.

QMAug 2, 2021
The CirCor DigiScope Dataset: From Murmur Detection to Murmur Classification

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.

ARMay 15, 2021
Hardware Synthesis of State-Space Equations; Application to FPGA Implementation of Shallow and Deep Neural Networks

Amir-Hossein Kiamarzi, Pezhman Torabi, Reza Sameni

Nowadays, shallow and deep Neural Networks (NNs) have vast applications including biomedical engineering, image processing, computer vision, and speech recognition. Many researchers have developed hardware accelerators including field-programmable gate arrays (FPGAs) for implementing high-performance and energy efficient NNs. Apparently, the hardware architecture design process is specific and time-consuming for each NN. Therefore, a systematic way to design, implement and optimize NNs is highly demanded. The paper presents a systematic approach to implement state-space models in register transfer level (RTL), with special interest for NN implementation. The proposed design flow is based on the iterative nature of state-space models and the analogy between state-space formulations and finite-state machines. The method can be used in linear/nonlinear and time-varying/time-invariant systems. It can also be used to implement either intrinsically iterative systems (widely used in various domains such as signal processing, numerical analysis, computer arithmetic, and control engineering), or systems that could be rewritten in equivalent iterative forms. The implementation of recurrent NNs such as long short-term memory (LSTM) NNs, which have intrinsic state-space forms, are another major applications for this framework. As a case study, it is shown that state-space systems can be used for the systematic implementation and optimization of NNs (as nonlinear and time-varying dynamic systems). An RTL code generating software is also provided online, which simplifies the automatic generation of NNs of arbitrary size.

SPMay 14, 2021
A Hypothesis Testing Approach to Nonstationary Source Separation

Reza Sameni, Christian Jutten

The extraction of nonstationary signals from blind and semi-blind multivariate observations is a recurrent problem. Numerous algorithms have been developed for this problem, which are based on the exact or approximate joint diagonalization of second or higher order cumulant matrices/tensors of multichannel data. While a great body of research has been dedicated to joint diagonalization algorithms, the selection of the diagonalized matrix/tensor set remains highly problem-specific. Herein, various methods for nonstationarity identification are reviewed and a new general framework based on hypothesis testing is proposed, which results in a classification/clustering perspective to semi-blind source separation of nonstationary components. The proposed method is applied to noninvasive fetal ECG extraction, as case study.