With the rapid development of edge intelligence (EI) and machine learning (ML), the applications of Cyber-Physical Systems (CPS) have been discovered in all aspects of the life world. As one of its most essential branches, Medical CPS (MCPS) determines human health and medical treatment in the Internet of Everything (IOE) era. Knowledge sharing is the critical point of MCPS and has also been humanity's best dream through the ages. This paper explores a novel knowledge-sharing model in MCPS and takes a pulmonary nodule detection task as a significant case for building an Unet-based mask generator. A Classification-guided Module (CGM)-based discriminator with knowledge from EMRs is set against a generator to offer a promising result for each mask from the inexperienced participant of federated ML. After an iterative communication between the federated server and its clients for knowledge sharing, the segmented sub-image owns a coincident attribute distribution with that of the EMRs from the experts. Besides, the adversarial network augment the data to normalize the data distribution for all the clients as a remission for none independent identically distributed (non-IID) data problem. We implement a detection framework on the simulated EI environment following an existing adaptive synchronization strategy based on data sharing and median loss function. On 1304 scans of the merged dataset, our proposed framework can help boost the detection performance for most of the existing methods of pulmonary nodule detection.

Virtual standard patient (VSP) is in high demand for medical students' diagnosis ability training in an efficient manner. Different from the traditional conversation system in medical dialogue generation, VSP needs a novel conversation paradigm to act as the patient instead of the doctor. However, existing conversation techniques still have limited ability in terms of generation of symptoms exhibited by patients with the personalized and knowledge-centered expressions. To alleviate these problems, we propose to construct a novel oral knowledge graph, which sufficiently provides medical clues of the certain disease. Accordingly, the VSP could accurately interact with the dentists for their underlying intention and express the symptoms characters in a natural style. To efficiently retrieve the related disease clues, the symptoms descriptions of the oral diseases are encoded into the oral knowledge graph, which could well organize the disease-centered symptom entities and speaking styles. Moreover, to transfer the common sense knowledge from existing large scale of medical knowledge graph to the specific oral knowledge graph, a coupled pre-trained Bert models is further designed to learn the related medical knowledge from coarse-level to fine-level hierarchically. Finally, a series of well-designed personalized templates are proposed to generate plausible and realistic answers in condition of the certain disease. We also conduct extensive user studies to demonstrate that the VSP satisfies the medical students' diagnosis practice requirement in terms of naturalness, realism, and topic relevance.

Obstructive sleep apnea (OSA) syndrome is a common sleep disorder and a key cause of cardiovascular and cerebrovascular diseases that seriously affect the lives and health of people. The development of Internet of Medical Things (IoMT) has enabled the remote diagnosis of OSA. The physiological signals of human sleep are sent to the cloud or medical facilities through Internet of Things, after which diagnostic models are employed for OSA detection. In order to improve the detection accuracy of OSA, in this study, a novel OSA detection system based on manually generated features and utilizing a parallel heterogeneous deep learning model in the context of IoMT is proposed, and the accuracy of the proposed diagnostic model is investigated. The OSA recognition scheme used in our model is based on short-term heart rate variability (HRV) signals extracted from ECG signals. First, the HRV signals and the linear and nonlinear features of HRV are combined into a one-dimensional (1-D) sequence. Simultaneously, a two-dimensional (2-D) HRV time-frequency spectrum image is obtained. The 1-D data sequences and 2-D images are coded in different branches of the proposed deep learning network for OSA diagnosis. To validate the performance of the proposed scheme, the Physionet Apnea-ECG public database is used. The proposed scheme outperforms the existing methods in terms of accuracy and provides a novel direction for OSA recognition.

This paper proposes a two-way multi-ringed forest (TMR-Forest) to estimating the malignancy of the pulmonary nodules for false positive reduction (FPR). Based on our previous work of deep decision framework, named MR-Forest, we generate a growing path mode on predefined pseudo-timeline of L time slots to build pseudo-spatiotemporal features. It synchronously works with FPR based on MR-Forest to help predict the labels from a dynamic perspective. Concretely, Mask R-CNN is first used to recommend the bounding boxes of ROIs and classify their pathological features. Afterward, hierarchical attribute matching is introduced to obtain the input ROIs' attribute layouts and select the candidates for their growing path generation. The selected ROIs can replace the fixed-sized ROIs' fitting results at different time slots for data augmentation. A two-stage counterfactual path elimination is used to screen out the input paths of the cascade forest. Finally, a simple label selection strategy is executed to output the predicted label to point out the input nodule's malignancy. On 1034 scans of the merged dataset, the framework can report more accurate malignancy labels to achieve a better CPM score of 0.912, which exceeds those of MR-Forest and 3DDCNNs about 2.8% and 4.7%, respectively.

Geometric modeling and haptic simulation of pathological changes is an important topic for high-fidelity surgical simulators. In this paper, we introduce a constraint-based six degree-of-freedom (DOF) haptic simulation method incorporating multi-contact friction. We use this method to simulate periodontal operations on typical pathological tissues, including periodontal pocket and two kinds of calculi. A continuous collision detection method based on sphere-trees is proposed to avoid the pop-through phenomenon during tool manipulation against thin objects (such as small sized calculus adhered to the surface of the target tooth). For particle shaped calculus, a friction model is adapted to simulate decreasing frictions during the removal of the calculus. Experiments using a Phantom Premium 3.0 6DOF were carried out to validate the performance of our method. Stable haptic rendering and about 1 kHz update rate was maintained for all the operations, including depth measurement of the periodontal pocket and removal of the invisible block-shaped and particle-shaped calculi.