Calibration of Time-Series Forecasting Transformers: Detecting and Adapting Context-Driven Distribution Shift

Recent years have witnessed the success of introducing Transformers to time series forecasting. From a data generation perspective, we illustrate that existing Transformers are susceptible to distribution shifts driven by temporal contexts, whether observed or unobserved. Such context-driven distribution shift (CDS) introduces biases in predictions within specific contexts and poses challenges for conventional training paradigm. In this paper, we introduce a universal calibration methodology for the detection and adaptation of CDS with a trained Transformer model. To this end, we propose a novel CDS detector, termed the "residual-based CDS detector" or "Reconditionor", which quantifies the model's vulnerability to CDS by evaluating the mutual information between prediction residuals and their corresponding contexts. A high Reconditionor score indicates a severe susceptibility, thereby necessitating model adaptation. In this circumstance, we put forth a straightforward yet potent adapter framework for model calibration, termed the "sample-level contextualized adapter" or "SOLID". This framework involves the curation of a contextually similar dataset to the provided test sample and the subsequent fine-tuning of the model's prediction layer with a limited number of steps. Our theoretical analysis demonstrates that this adaptation strategy is able to achieve an optimal equilibrium between bias and variance. Notably, our proposed Reconditionor and SOLID are model-agnostic and readily adaptable to a wide range of Transformers. Extensive experiments show that SOLID consistently enhances the performance of current SOTA Transformers on real-world datasets, especially on cases with substantial CDS detected by the proposed Reconditionor, thus validate the effectiveness of the calibration approach

Transportation Density Reduction Caused by City Lockdowns Across the World during the COVID-19 Epidemic: From the View of High-resolution Remote Sensing Imagery

As the COVID-19 epidemic began to worsen in the first months of 2020, stringent lockdown policies were implemented in numerous cities throughout the world to control human transmission and mitigate its spread. Although transportation density reduction inside the city was felt subjectively, there has thus far been no objective and quantitative study of its variation to reflect the intracity population flows and their corresponding relationship with lockdown policy stringency from the view of remote sensing images with the high resolution under 1m. Accordingly, we here provide a quantitative investigation of the transportation density reduction before and after lockdown was implemented in six epicenter cities (Wuhan, Milan, Madrid, Paris, New York, and London) around the world during the COVID-19 epidemic, which is accomplished by extracting vehicles from the multi-temporal high-resolution remote sensing images. A novel vehicle detection model combining unsupervised vehicle candidate extraction and deep learning identification was specifically proposed for the images with the resolution of 0.5m. Our results indicate that transportation densities were reduced by an average of approximately 50% (and as much as 75.96%) in these six cities following lockdown. The influences on transportation density reduction rates are also highly correlated with policy stringency, with an R^2 value exceeding 0.83. Even within a specific city, the transportation density changes differed and tended to be distributed in accordance with the city's land-use patterns. Considering that public transportation was mostly reduced or even forbidden, our results indicate that city lockdown policies are effective at limiting human transmission within cities.Comment: 14 pages, 7 figures, submitted to IEEE JSTAR

Excess Deaths of Gastrointestinal, Liver, and Pancreatic Diseases During the COVID-19 Pandemic in the United States

Objectives: To evaluate excess deaths of gastrointestinal, liver, and pancreatic diseases in the United States during the COVID-19 pandemic.Methods: We retrieved weekly death counts from National Vital Statistics System and fitted them with a quasi-Poisson regression model. Cause-specific excess deaths were calculated by the difference between observed and expected deaths with adjustment for temporal trend and seasonality. Demographic disparities and temporal-spatial patterns were evaluated for different diseases.Results: From March 2020 to September 2022, the increased mortality (measured by excess risks) for Clostridium difficile colitis, gastrointestinal hemorrhage, and acute pancreatitis were 35.9%; 24.8%; and 20.6% higher than the expected. For alcoholic liver disease, fibrosis/cirrhosis, and hepatic failure, the excess risks were 1.4–2.8 times higher among younger inhabitants than older inhabitants. The excess deaths of selected diseases were persistently observed across multiple epidemic waves with fluctuating trends for gastrointestinal hemorrhage and fibrosis/cirrhosis and an increasing trend for C. difficile colitis.Conclusion: The persistently observed excess deaths of digestive diseases highlights the importance for healthcare authorities to develop sustainable strategies in response to the long-term circulating of SARS-CoV-2 in the community

A Clinical Decision Support Framework for Heterogeneous Data Sources

To keep pace with the developments in medical informatics, health medical data is being collected continually. But, owing to the diversity of its categories and sources, medical data has become so complicated in many hospitals that it now needs a clinical decision support (CDS) system for its management. To effectively utilize the accumulating health data, we propose a CDS framework that can integrate heterogeneous health data from different sources such as laboratory test results, basic information of patients, and health records into a consolidated representation of features of all patients. Using the electronic health medical data so created, multilabel classification was employed to recommend a list of diseases and thus assist physicians in diagnosing or treating their patients' health issues more efficiently. Once the physician diagnoses the disease of a patient, the next step is to consider the likely complications of that disease, which can lead to more diseases. Previous studies reveal that correlations do exist among some diseases. Considering these correlations, a k-nearest neighbors algorithm is improved for multilabel learning by using correlations among labels (CML-kNN). The CML- kNN algorithm first exploits the dependence between every two labels to update the origin label matrix and then performs multilabel learning to estimate the probabilities of labels by using the integrated features. Finally, it recommends the top N diseases to the physicians. Experimental results on real health medical data establish the effectiveness and practicability of the proposed CDS framework

Smoking and Influenza-associated Morbidity and Mortality: A Systematic Review and Meta-analysis

Background: Although smoking has been recognized as a risk factor for many respiratory diseases, its effects of influenza-associated morbidity and mortality remain controversial. We conducted a systematic review and meta-analysis to assess the impact of smoking on influenza-associated hospital admissions, intensive care unit (ICU) admissions, and deaths. Methods: We searched the databases of PubMed, CINAHL, EMBASE, and the China National Knowledge Infrastructure for all observational studies published between 1 January 2000 and 30 November 2017 on ever-active/secondhand smoking and influenza-associated hospital admissions, ICU admissions, and deaths. We pooled data using random effect models. Results: The initial search retrieved 7495 articles, of which 20 studies were included for systematic review, and 12 studies (eight case-control studies, two cohort studies, and two cross-sectional studies) with 18612 subjects were included in meta-analysis. The overall quality of selected studies was moderate. Ever-active smokers had higher odds of hospital admissions (odds ratio [OR] = 1.5; 95% confidence interval [CI] = 1.3, 1.7) and ICU admissions (OR 2.2; 95% CI = 1.4, 3.4) after influenza infections, as compared with never smokers. No association was observed between ever-active smoking and influenza-associated deaths. We found a positive association between secondhand smoking and influenza-associated hospital admissions, but only in children below 15 years of age. Conclusions: The literature evidence showed that smoking was consistently associated with higher risk of hospital admissions after influenza infection, but the results for ICU admissions and deaths were less conclusive because of the limited number of studies.</p

Excess Deaths of Gastrointestinal, Liver, and Pancreatic Diseases During the COVID-19 Pandemic in the United States.

Peer reviewed: TrueObjectives: To evaluate excess deaths of gastrointestinal, liver, and pancreatic diseases in the United States during the COVID-19 pandemic. Methods: We retrieved weekly death counts from National Vital Statistics System and fitted them with a quasi-Poisson regression model. Cause-specific excess deaths were calculated by the difference between observed and expected deaths with adjustment for temporal trend and seasonality. Demographic disparities and temporal-spatial patterns were evaluated for different diseases. Results: From March 2020 to September 2022, the increased mortality (measured by excess risks) for Clostridium difficile colitis, gastrointestinal hemorrhage, and acute pancreatitis were 35.9%; 24.8%; and 20.6% higher than the expected. For alcoholic liver disease, fibrosis/cirrhosis, and hepatic failure, the excess risks were 1.4-2.8 times higher among younger inhabitants than older inhabitants. The excess deaths of selected diseases were persistently observed across multiple epidemic waves with fluctuating trends for gastrointestinal hemorrhage and fibrosis/cirrhosis and an increasing trend for C. difficile colitis. Conclusion: The persistently observed excess deaths of digestive diseases highlights the importance for healthcare authorities to develop sustainable strategies in response to the long-term circulating of SARS-CoV-2 in the community

Impact of climate change on dengue fever epidemics in South and Southeast Asian settings: A modelling study

The potential for dengue fever epidemic due to climate change remains uncertain in tropical areas. This study aims to assess the impact of climate change on dengue fever transmission in four South and Southeast Asian settings. We collected weekly data of dengue fever incidence, daily mean temperature and rainfall from 2012 to 2020 in Singapore, Colombo, Selangor, and Chiang Mai. Projections for temperature and rainfall were drawn for three Shared Socioeconomic Pathways (SSP126, SSP245, and SSP585) scenarios. Using a disease transmission model, we projected the dengue fever epidemics until 2090s and determined the changes in annual peak incidence, peak time, epidemic size, and outbreak duration. A total of 684,639 dengue fever cases were reported in the four locations between 2012 and 2020. The projected change in dengue fever transmission would be most significant under the SSP585 scenario. In comparison to the 2030s, the peak incidence would rise by 1.29 times in Singapore, 2.25 times in Colombo, 1.36 times in Selangor, and >10 times in Chiang Mai in the 2090s under SSP585. Additionally, the peak time was projected to be earlier in Singapore, Colombo, and Selangor, but be later in Chiang Mai under the SSP585 scenario. Even in a milder emission scenario of SSP126, the epidemic size was projected to increase by 5.94%, 10.81%, 12.95%, and 69.60% from the 2030s–2090s in Singapore, Colombo, Selangor, and Chiang Mai, respectively. The outbreak durations in the four settings were projected to be prolonged over this century under SSP126 and SSP245, while a slight decrease is expected in 2090s under SSP585. The results indicate that climate change is expected to increase the risk of dengue fever transmission in tropical areas of South and Southeast Asia. Limiting greenhouse gas emissions could be crucial in reducing the transmission of dengue fever in the future