Authors: Abdullah Bin-Obaid, Maria M. Cobo, Rebeccah Slater, Lionel Tarassenko, Mauricio Villarroel
Organizations: Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, United Kingdom · Department of Paediatrics, University of Oxford, Oxford, United Kingdom · Universidad San Francisco de Quito USFQ, Colegio de Ciencias Biologicas y Ambientales, Quito, Ecuador
Facial landmark localisation is a prerequisite for developing automated, non-contact neonatal pain assessment methods. Clinicians use pain scales to judge the severity of pain, many of which rely on facial expression. However, facial landmark detectors trained on adult faces perform poorly in neonatal clinical environments due to frequent occlusions caused by medical equipment, varied head poses, and challenging imaging conditions, including motion blur triggered by sudden pain-related movements. We propose an end-to-end facial landmark detector capable of predicting 68 landmarks on neonatal faces in clinical environments. We combined 37,459 single-face images from 11 public datasets, standardised to 68-point markup, with 1,123 manually annotated frames from a neonatal research dataset (totalling over 76,000 landmarks). A YOLO-based keypoint model was adapted to regress the facial landmarks, initialised with weights from a pretrained neonatal face detector. On public datasets, our proposed model achieved state-of-the-art performance: Normalised Mean Error (NME) = 5.37, Failure Rate (FR) = 12.5%, Area Under the Cumulative Error Curve (AUC) at AUC0.08 = 38.00% and AUC0.1 = 48.70%. On the clinical neonatal test set, before fine-tuning, the model achieved the lowest Detection Failure Rate (DFR) = 5.3% among all baselines and showed strong generalisation. After fine-tuning, performance improved further to NME = 6.36, FR = 22.30%, DFR = 1.77%, AUC0.08 = 29.24% and AUC0.1 = 40.25%. To the best of our knowledge, this represents the first end-to-end 68-point neonatal facial landmark detection model. With further dataset expansion and refinement, it could support downstream tasks in neonatal health monitoring and pain-related facial analysis.
Reliable localisation of the neonatal face is the first step for several video-camera based non-contact assessments such as pain and distress related facial expression analysis, pain scoring, cardiorespiratory signal extraction and cessation of breathing alerts. However, major challenges persist in neonatal clinical environments. Cluttered backgrounds, illumination changes and poor lighting conditions can reduce the accuracy of face detection models. Clinical interventions, monitoring equipment and, in some cases, medical devices can obstruct the face, making visual assessment difficult. We propose a one-stage YOLOv11m-based model tailored for face detection of infants in neonatal clinical environments. We combined multiple publicly available datasets (VGGFace2, CelebA, FDDB, WIDER FACE) to train and evaluate our proposed model. We then fine-tuned our model on a neonatal research dataset involving 228 videos from 114 recording sessions of 113 independent infants. Before fine-tuning, our model achieved an AP50 of 0.87, surpassing the performance of three state-of-the-art general face detectors. Performance improved further to an AP50 of 0.96 after clinical-domain adaptation. Evaluating face detection performance across different datasets remains a challenge due to the lack of publicly available neonatal datasets. Prioritising the creation of such datasets, while upholding appropriate privacy safeguards and ethical standards in their creation and use, would greatly support further progress in this field.
Abdullah Bin-Obaid, Maria M. Cobo, Rebeccah Slater +2
Unaddressed pain in neonates can lead to adverse effects, including delayed development and slower weight gain, emphasising the need for more objective and reliable pain assessment methods. Hence, automated methods using behavioural and physiological pain indicators have been developed to aid healthcare professionals in the Neonatal ICU. Traditional contact-based methods for physiological parameter estimation are unsuitable for long-term monitoring and increase the risk of spreading diseases like COVID-19. We introduce a novel approach using remote photoplethysmography (rPPG) to estimate pulse signals in a non-contact manner and employ them for neonatal pain detection. The temporal signals acquired from regions-of-interest (ROIs) affected by skin deformations may exhibit lower quality and provide erroneous rPPG signals. Therefore, we incorporated a quality parameter to select the temporal signals obtained from ROIs that are least affected by skin deformations. Further, we employed signal-to-noise ratio as a fitness parameter to extract the rPPG signal corresponding to the clip that is least affected by noise. Experimental findings demonstrate that the rPPG signals provide useful information for neonatal pain detection, and signals extracted from the blue colour channel outperform those extracted from other colour channels. We also show that combining rPPG and audio features provides better results than individual modalities.
Although advancements in face landmark detection (FLD) methods continue to push performance boundaries, they overlook two major functional limitations: (1) different network parameters need to be trained independently for each $N$-point'' benchmark dataset, and (2) a model trained on an N-point'' dataset reliably outputs only the N landmarks. In our work, we first conceptualize Face Part-Anchored Landmark Positions (FPALPs), wherein each landmark is treated as a progression value between zero (start) and one (end) along a face part's contour. Every landmark can be expressed in the FPALP format, irrespective of its source dataset, hence unlocking the ability to unify all $N$-point'' datasets into a single dataset. Secondly, we represent each landmark with an FPALP-based query, refine it progressively with a cross-modality decoder, and predict its coordinates based on the final representation. Our approach, called Unified Dynamic FLD, embodies these two design choices and streamlines the landmark detection pipeline by enabling (1) a single model to learn on any number of N-point'' datasets, and (2) yield any number of specific landmark predictions by loading the designated landmark queries at runtime. Extensive experiments on multiple benchmark datasets show that our method delivers these benefits while remaining competitive with, and in several cases outperforming existing state-of-the-art methods.
Sebastian Regalado, Varshanth R. Rao, Ruowei Jiang +2