Prognosis and Health Management (PHM), critical for ensuring task completion by complex systems and preventing unexpected failures, is widely adopted in aerospace, manufacturing, maritime, rail, energy, etc. However, PHM's development is constrained by bottlenecks like generalization, interpretation and verification abilities. Presently, generative artificial intelligence (AI), represented by Large Model, heralds a technological revolution with the potential to fundamentally reshape traditional technological fields and human production methods. Its capabilities, including strong generalization, reasoning, and generative attributes, present opportunities to address PHM's bottlenecks. To this end, based on a systematic analysis of the current challenges and bottlenecks in PHM, as well as the research status and advantages of Large Model, we propose a novel concept and three progressive paradigms of Prognosis and Health Management Large Model (PHM-LM) through the integration of the Large Model with PHM. Subsequently, we provide feasible technical approaches for PHM-LM to bolster PHM's core capabilities within the framework of the three paradigms. Moreover, to address core issues confronting PHM, we discuss a series of technical challenges of PHM-LM throughout the entire process of construction and application. This comprehensive effort offers a holistic PHM-LM technical framework, and provides avenues for new PHM technologies, methodologies, tools, platforms and applications, which also potentially innovates design, research & development, verification and application mode of PHM. And furthermore, a new generation of PHM with AI will also capably be realized, i.e., from custom to generalized, from discriminative to generative, and from theoretical conditions to practical applications.

Human-AI collaboration to identify and correct perceptual errors in chest radiographs has not been previously explored. This study aimed to develop a collaborative AI system, CoRaX, which integrates eye gaze data and radiology reports to enhance diagnostic accuracy in chest radiology by pinpointing perceptual errors and refining the decision-making process. Using public datasets REFLACX and EGD-CXR, the study retrospectively developed CoRaX, employing a large multimodal model to analyze image embeddings, eye gaze data, and radiology reports. The system's effectiveness was evaluated based on its referral-making process, the quality of referrals, and performance in collaborative diagnostic settings. CoRaX was tested on a simulated error dataset of 271 samples with 28% (93 of 332) missed abnormalities. The system corrected 21% (71 of 332) of these errors, leaving 7% (22 of 312) unresolved. The Referral-Usefulness score, indicating the accuracy of predicted regions for all true referrals, was 0.63 (95% CI 0.59, 0.68). The Total-Usefulness score, reflecting the diagnostic accuracy of CoRaX's interactions with radiologists, showed that 84% (237 of 280) of these interactions had a score above 0.40. In conclusion, CoRaX efficiently collaborates with radiologists to address perceptual errors across various abnormalities, with potential applications in the education and training of novice radiologists.

Multi-phase computed tomography (CT) has been widely used for the preoperative diagnosis of kidney cancer due to its non-invasive nature and ability to characterize renal lesions. However, since enhancement patterns of renal lesions across CT phases are different even for the same lesion type, the visual assessment by radiologists suffers from inter-observer variability in clinical practice. Although deep learning-based approaches have been recently explored for differential diagnosis of kidney cancer, they do not explicitly model the relationships between CT phases in the network design, limiting the diagnostic performance. In this paper, we propose a novel lesion-aware cross-phase attention network (LACPANet) that can effectively capture temporal dependencies of renal lesions across CT phases to accurately classify the lesions into five major pathological subtypes from time-series multi-phase CT images. We introduce a 3D inter-phase lesion-aware attention mechanism to learn effective 3D lesion features that are used to estimate attention weights describing the inter-phase relations of the enhancement patterns. We also present a multi-scale attention scheme to capture and aggregate temporal patterns of lesion features at different spatial scales for further improvement. Extensive experiments on multi-phase CT scans of kidney cancer patients from the collected dataset demonstrate that our LACPANet outperforms state-of-the-art approaches in diagnostic accuracy.

Despite the high diagnostic accuracy of Magnetic Resonance Imaging (MRI), using MRI as a Point-of-Care (POC) disease identification tool poses significant accessibility challenges due to the use of high magnetic field strength and lengthy acquisition times. We ask a simple question: Can we dynamically optimise acquired samples, at the patient level, according to an (automated) downstream decision task, while discounting image reconstruction? We propose an ML-based framework that learns an active sampling strategy, via reinforcement learning, at a patient-level to directly infer disease from undersampled k-space. We validate our approach by inferring Meniscus Tear in undersampled knee MRI data, where we achieve diagnostic performance comparable with ML-based diagnosis, using fully sampled k-space data. We analyse task-specific sampling policies, showcasing the adaptability of our active sampling approach. The introduced frugal sampling strategies have the potential to reduce high field strength requirements that in turn strengthen the viability of MRI-based POC disease identification and associated preliminary screening tools.

Chest pain symptoms are highly prevalent in emergency departments (EDs), where acute aortic syndrome (AAS) is a catastrophic cardiovascular emergency with a high fatality rate, especially when timely and accurate treatment is not administered. However, current triage practices in the ED can cause up to approximately half of patients with AAS to have an initially missed diagnosis or be misdiagnosed as having other acute chest pain conditions. Subsequently, these AAS patients will undergo clinically inaccurate or suboptimal differential diagnosis. Fortunately, even under these suboptimal protocols, nearly all these patients underwent non-contrast CT covering the aorta anatomy at the early stage of differential diagnosis. In this study, we developed an artificial intelligence model (DeepAAS) using non-contrast CT, which is highly accurate for identifying AAS and provides interpretable results to assist in clinical decision-making. Performance was assessed in two major phases: a multi-center retrospective study (n = 20,750) and an exploration in real-world emergency scenarios (n = 137,525). In the multi-center cohort, DeepAAS achieved a mean area under the receiver operating characteristic curve of 0.958 (95% CI 0.950-0.967). In the real-world cohort, DeepAAS detected 109 AAS patients with misguided initial suspicion, achieving 92.6% (95% CI 76.2%-97.5%) in mean sensitivity and 99.2% (95% CI 99.1%-99.3%) in mean specificity. Our AI model performed well on non-contrast CT at all applicable early stages of differential diagnosis workflows, effectively reduced the overall missed diagnosis and misdiagnosis rate from 48.8% to 4.8% and shortened the diagnosis time for patients with misguided initial suspicion from an average of 681.8 (74-11,820) mins to 68.5 (23-195) mins. DeepAAS could effectively fill the gap in the current clinical workflow without requiring additional tests.

This paper considers "model diagnosis", which we formulate as a classification problem. Given a pre-trained neural network (NN), the goal is to predict the source of failure from a set of failure modes (such as a wrong hyperparameter, inadequate model size, and insufficient data) without knowing the training configuration of the pre-trained NN. The conventional diagnosis approach uses training and validation errors to determine whether the model is underfitting or overfitting. However, we show that rich information about NN performance is encoded in the optimization loss landscape, which provides more actionable insights than validation-based measurements. Therefore, we propose a diagnosis method called MD tree based on loss landscape metrics and experimentally demonstrate its advantage over classical validation-based approaches. We verify the effectiveness of MD tree in multiple practical scenarios: (1) use several models trained on one dataset to diagnose a model trained on another dataset, essentially a few-shot dataset transfer problem; (2) use small models (or models trained with small data) to diagnose big models (or models trained with big data), essentially a scale transfer problem. In a dataset transfer task, MD tree achieves an accuracy of 87.7%, outperforming validation-based approaches by 14.88%. Our code is available at https://github.com/YefanZhou/ModelDiagnosis.

Background: The adherence of clinicians to clinical practice guidelines is known to be low, including for the management of COVID-19, due to their difficult use at the point of care and their complexity. Clinical decision support systems have been proposed to implement guidelines and improve adherence. One approach is to permit the navigation inside the recommendations, presented as a decision tree, but the size of the tree often limits this approach and may cause erroneous navigation, especially when it does not fit in a single screen. Methods: We proposed an innovative visual interface to allow clinicians easily navigating inside decision trees for the management of COVID-19 patients. It associates a multi-path tree model with the use of the fisheye visual technique, allowing the visualization of large decision trees in a single screen. To evaluate the impact of this tool on guideline adherence, we conducted a randomized controlled trial in a near-real simulation setting, comparing the decisions taken by medical students using Orient-COVID with those taken with paper guidelines or without guidance, when performing on six realistic clinical cases. Results: The results show that paper guidelines had no impact (p=0.97), while Orient-COVID significantly improved the guideline adherence compared to both other groups (p<0.0003). A significant impact of Orient-COVID was identified on several key points during the management of COVID-19: ordering troponin lab tests, prescribing anticoagulant and oxygen therapy. A multifactor analysis showed no difference between male and female participants. Conclusions: The use of an interactive decision tree for the management of COVID-19 significantly improved the clinician adherence to guidelines. Future works will focus on the integration of the system to electronic health records and on the adaptation of the system to other clinical conditions.

Fault detection and diagnosis (FDD) is a crucial task for ensuring the safety and efficiency of industrial processes. We propose a novel FDD methodology for the Tennessee Eastman Process (TEP), a widely used benchmark for chemical process control. The model employs two separate Transformer branches, enabling independent processing of input data and potential extraction of diverse information. A novel attention mechanism, Gated Dynamic Learnable Attention (GDLAttention), is introduced which integrates a gating mechanism and dynamic learning capabilities. The gating mechanism modulates the attention weights, allowing the model to focus on the most relevant parts of the input. The dynamic learning approach adapts the attention strategy during training, potentially leading to improved performance. The attention mechanism uses a bilinear similarity function, providing greater flexibility in capturing complex relationships between query and key vectors. In order to assess the effectiveness of our approach, we tested it against 21 and 18 distinct fault scenarios in TEP, and compared its performance with several established FDD techniques. The outcomes indicate that the method outperforms others in terms of accuracy, false alarm rate, and misclassification rate. This underscores the robustness and efficacy of the approach for FDD in intricate industrial processes.

Rolling bearing fault detection has developed rapidly in the field of fault diagnosis technology, and it occupies a very important position in this field. Deep learning-based bearing fault diagnosis models have achieved significant success. At the same time, with the continuous improvement of new signal processing technologies such as Fourier transform, wavelet transform and empirical mode decomposition, the fault diagnosis technology of rolling bearings has also been greatly developed, and it can be said that it has entered a new research stage. However, most of the existing methods are limited to varying degrees in the industrial field. The main ones are fast feature extraction and computational complexity. The key to this paper is to propose a lightweight bearing fault diagnosis model DKDL-Net to solve these challenges. The model is trained on the CWRU data set by decoupling knowledge distillation and low rank adaptive fine tuning. Specifically, we built and trained a teacher model based on a 6-layer neural network with 69,626 trainable parameters, and on this basis, using decoupling knowledge distillation (DKD) and Low-Rank adaptive (LoRA) fine-tuning, we trained the student sag model DKDL-Net, which has only 6838 parameters. Experiments show that DKDL-Net achieves 99.48% accuracy in computational complexity on the test set while maintaining model performance, which is 0.58% higher than the state-of-the-art (SOTA) model, and our model has lower parameters. Our code is available at Github link: https://github.com/SPBU-LiPengyi/DKDL-Net.git.

Synthetic datasets generated by structural causal models (SCMs) are commonly used for benchmarking causal structure learning algorithms. However, the variances and pairwise correlations in SCM data tend to increase along the causal ordering. Several popular algorithms exploit these artifacts, possibly leading to conclusions that do not generalize to real-world settings. Existing metrics like $\operatorname{Var}$-sortability and $\operatorname{R^2}$-sortability quantify these patterns, but they do not provide tools to remedy them. To address this, we propose internally-standardized structural causal models (iSCMs), a modification of SCMs that introduces a standardization operation at each variable during the generative process. By construction, iSCMs are not $\operatorname{Var}$-sortable, and as we show experimentally, not $\operatorname{R^2}$-sortable either for commonly-used graph families. Moreover, contrary to the post-hoc standardization of data generated by standard SCMs, we prove that linear iSCMs are less identifiable from prior knowledge on the weights and do not collapse to deterministic relationships in large systems, which may make iSCMs a useful model in causal inference beyond the benchmarking problem studied here.