SynEHRgy: Synthesizing Mixed-Type Structured Electronic Health Records using Decoder-Only Transformers

Generating synthetic Electronic Health Records (EHRs) offers significant potential for data augmentation, privacy-preserving data sharing, and improving machine learning model training. We propose a novel tokenization strategy tailored for structured EHR data, which encompasses diverse data types such as covariates, ICD codes, and irregularly sampled time series. Using a GPT-like decoder-only transformer model, we demonstrate the generation of high-quality synthetic EHRs. Our approach is evaluated using the MIMIC-III dataset, and we benchmark the fidelity, utility, and privacy of the generated data against state-of-the-art models.

Systolic Arrays and Structured Pruning Co-design for Efficient Transformers in Edge Systems

Efficient deployment of resource-intensive transformers on edge devices necessitates cross-stack optimization. We thus study the interrelation between structured pruning and systolic acceleration, matching the size of pruned blocks with the systolic array dimensions. In this setting, computations of pruned weight blocks can be skipped, reducing run-time and energy consumption, but potentially impacting quality of service (QoS). To evaluate the trade-offs between systolic array size and sparsity opportunities, we present a novel co-design framework that integrates algorithmic optimization, system simulation, and hardware design. Targeting speech recognition using transformers as a case study, we analyze how configuration choices across the stack affect performance metrics. Results demonstrate that structured pruning on systems featuring systolic array acceleration can effectively increase performance, while maintaining high QoS levels. Up to 26% system-wide speedups due to structured pruning were measured, with only 1.4% word error rate degradation on the standard Librispeech dataset.

Enabling Efficient Wearables: An Analysis of Low-Power Microcontrollers for Biomedical Applications

Breakthroughs in ultra-low-power chip technology are transforming biomedical wearables, making it possible to monitor patients in real time with devices operating on mere {\mu}W. Although many studies have examined the power performance of commercial microcontrollers, it remains unclear which ones perform best across diverse application profiles and which hardware features are most crucial for minimizing energy consumption under varying computational loads. Identifying these features for typical wearable applications and understanding their effects on performance and energy efficiency are essential for optimizing deployment strategies and informing future hardware designs. In this work, we conduct an in-depth study of state-of-the-art (SoA) micro-controller units(MCUs) in terms of processing capability and energy efficiency using representative end-to-end SoA wearable applications. We systematically benchmark each platform across three primary application phases: idle, data acquisition, and processing, allowing a holistic assessment of the platform processing capability and overall energy efficiency across varying patient-monitoring application profiles. Our detailed analysis of performance and energy discrepancies across different platforms reveals key strengths and limitations of the current low-power hardware design and pinpoints the strengths and weaknesses of SoA MCUs. We conclude with actionable insights for wearable application designers and hardware engineers, aiming to inform future hardware design improvements and support optimal platform selection for energy-constrained biomedical applications.

Cough-E: A multimodal, privacy-preserving cough detection algorithm for the edge

Continuous cough monitors can greatly aid doctors in home monitoring and treatment of respiratory diseases. Although many algorithms have been proposed, they still face limitations in data privacy and short-term monitoring. Edge-AI offers a promising solution by processing privacy-sensitive data near the source, but challenges arise in deploying resource-intensive algorithms on constrained devices. From a suitable selection of audio and kinematic signals, our methodology aims at the optimal selection of features via Recursive Feature Elimination with Cross-Validation (RFECV), which exploits the explainability of the selected XGB model. Additionally, it analyzes the use of Mel spectrogram features, instead of the more common MFCC. Moreover, a set of hyperparameters for a multimodal implementation of the classifier is explored. Finally, it evaluates the performance based on clinically relevant event-based metrics. We apply our methodology to develop Cough-E, an energy-efficient, multimodal and edge AI cough detection algorithm. It exploits audio and kinematic data in two distinct classifiers, jointly cooperating for a balanced energy and performance trade-off. We demonstrate that our algorithm can be executed in real-time on an ARM Cortex M33 microcontroller. Cough-E achieves a 70.56\% energy saving when compared to the audio-only approach, at the cost of a 1.26\% relative performance drop, resulting in a 0.78 F1-score. Both Cough-E and the edge-aware model optimization methodology are publicly available as open-source code. This approach demonstrates the benefits of the proposed hardware-aware methodology to enable privacy-preserving cough monitors on the edge, paving the way to efficient cough monitoring.

Don't Think It Twice: Exploit Shift Invariance for Efficient Online Streaming Inference of CNNs

Deep learning time-series processing often relies on convolutional neural networks with overlapping windows. This overlap allows the network to produce an output faster than the window length. However, it introduces additional computations. This work explores the potential to optimize computational efficiency during inference by exploiting convolution's shift-invariance properties to skip the calculation of layer activations between successive overlapping windows. Although convolutions are shift-invariant, zero-padding and pooling operations, widely used in such networks, are not efficient and complicate efficient streaming inference. We introduce StreamiNNC, a strategy to deploy Convolutional Neural Networks for online streaming inference. We explore the adverse effects of zero padding and pooling on the accuracy of streaming inference, deriving theoretical error upper bounds for pooling during streaming. We address these limitations by proposing signal padding and pooling alignment and provide guidelines for designing and deploying models for StreamiNNC. We validate our method in simulated data and on three real-world biomedical signal processing applications. StreamiNNC achieves a low deviation between streaming output and normal inference for all three networks (2.03 - 3.55% NRMSE). This work demonstrates that it is possible to linearly speed up the inference of streaming CNNs processing overlapping windows, negating the additional computation typically incurred by overlapping windows.

MetaWearS: A Shortcut in Wearable Systems Lifecycle with Only a Few Shots

Wearable systems provide continuous health monitoring and can lead to early detection of potential health issues. However, the lifecycle of wearable systems faces several challenges. First, effective model training for new wearable devices requires substantial labeled data from various subjects collected directly by the wearable. Second, subsequent model updates require further extensive labeled data for retraining. Finally, frequent model updating on the wearable device can decrease the battery life in long-term data monitoring. Addressing these challenges, in this paper, we propose MetaWearS, a meta-learning method to reduce the amount of initial data collection required. Moreover, our approach incorporates a prototypical updating mechanism, simplifying the update process by modifying the class prototype rather than retraining the entire model. We explore the performance of MetaWearS in two case studies, namely, the detection of epileptic seizures and the detection of atrial fibrillation. We show that by fine-tuning with just a few samples, we achieve 70% and 82% AUC for the detection of epileptic seizures and the detection of atrial fibrillation, respectively. Compared to a conventional approach, our proposed method performs better with up to 45% AUC. Furthermore, updating the model with only 16 minutes of additional labeled data increases the AUC by up to 5.3%. Finally, MetaWearS reduces the energy consumption for model updates by 456x and 418x for epileptic seizure and AF detection, respectively.

DC is all you need: describing ReLU from a signal processing standpoint

Non-linear activation functions are crucial in Convolutional Neural Networks. However, until now they have not been well described in the frequency domain. In this work, we study the spectral behavior of ReLU, a popular activation function. We use the ReLU's Taylor expansion to derive its frequency domain behavior. We demonstrate that ReLU introduces higher frequency oscillations in the signal and a constant DC component. Furthermore, we investigate the importance of this DC component, where we demonstrate that it helps the model extract meaningful features related to the input frequency content. We accompany our theoretical derivations with experiments and real-world examples. First, we numerically validate our frequency response model. Then we observe ReLU's spectral behavior on two example models and a real-world one. Finally, we experimentally investigate the role of the DC component introduced by ReLU in the CNN's representations. Our results indicate that the DC helps to converge to a weight configuration that is close to the initial random weights.

BiomedBench: A benchmark suite of TinyML biomedical applications for low-power wearables

The design of low-power wearables for the biomedical domain has received a lot of attention in recent decades, as technological advances in chip manufacturing have allowed real-time monitoring of patients using low-complexity ML within the mW range. Despite advances in application and hardware design research, the domain lacks a systematic approach to hardware evaluation. In this work, we propose BiomedBench, a new benchmark suite composed of complete end-to-end TinyML biomedical applications for real-time monitoring of patients using wearable devices. Each application presents different requirements during typical signal acquisition and processing phases, including varying computational workloads and relations between active and idle times. Furthermore, our evaluation of five state-of-the-art low-power platforms in terms of energy efficiency shows that modern platforms cannot effectively target all types of biomedical applications. BiomedBench will be released as an open-source suite to enable future improvements in the entire domain of bioengineering systems and TinyML application design.

How to Count Coughs: An Event-Based Framework for Evaluating Automatic Cough Detection Algorithm Performance

Chronic cough disorders are widespread and challenging to assess because they rely on subjective patient questionnaires about cough frequency. Wearable devices running Machine Learning (ML) algorithms are promising for quantifying daily coughs, providing clinicians with objective metrics to track symptoms and evaluate treatments. However, there is a mismatch between state-of-the-art metrics for cough counting algorithms and the information relevant to clinicians. Most works focus on distinguishing cough from non-cough samples, which does not directly provide clinically relevant outcomes such as the number of cough events or their temporal patterns. In addition, typical metrics such as specificity and accuracy can be biased by class imbalance. We propose using event-based evaluation metrics aligned with clinical guidelines on significant cough counting endpoints. We use an ML classifier to illustrate the shortcomings of traditional sample-based accuracy measurements, highlighting their variance due to dataset class imbalance and sample window length. We also present an open-source event-based evaluation framework to test algorithm performance in identifying cough events and rejecting false positives. We provide examples and best practice guidelines in event-based cough counting as a necessary first step to assess algorithm performance with clinical relevance.

Acoustical Features as Knee Health Biomarkers: A Critical Analysis

Acoustical knee health assessment has long promised an alternative to clinically available medical imaging tools, but this modality has yet to be adopted in medical practice. The field is currently led by machine learning models processing acoustical features, which have presented promising diagnostic performances. However, these methods overlook the intricate multi-source nature of audio signals and the underlying mechanisms at play. By addressing this critical gap, the present paper introduces a novel causal framework for validating knee acoustical features. We argue that current machine learning methodologies for acoustical knee diagnosis lack the required assurances and thus cannot be used to classify acoustic features as biomarkers. Our framework establishes a set of essential theoretical guarantees necessary to validate this claim. We apply our methodology to three real-world experiments investigating the effect of researchers' expectations, the experimental protocol and the wearable employed sensor. This investigation reveals latent issues such as underlying shortcut learning and performance inflation. This study is the first independent result reproduction study in the field of acoustical knee health evaluation. We conclude with actionable insights from our findings, offering valuable guidance to navigate these crucial limitations in future research.