Daily Papers

We present a novel Automatic Speech Recognition (ASR) dataset for the Oromo language, a widely spoken language in Ethiopia and neighboring regions. The dataset was collected through a crowd-sourcing initiative, encompassing a diverse range of speakers and phonetic variations. It consists of 100 hours of real-world audio recordings paired with transcriptions, covering read speech in both clean and noisy environments. This dataset addresses the critical need for ASR resources for the Oromo language which is underrepresented. To show its applicability for the ASR task, we conducted experiments using the Conformer model, achieving a Word Error Rate (WER) of 15.32% with hybrid CTC and AED loss and WER of 18.74% with pure CTC loss. Additionally, fine-tuning the Whisper model resulted in a significantly improved WER of 10.82%. These results establish baselines for Oromo ASR, highlighting both the challenges and the potential for improving ASR performance in Oromo. The dataset is publicly available at https://github.com/turinaf/sagalee and we encourage its use for further research and development in Oromo speech processing.

Photoplethysmogram (PPG) and electrocardiogram (ECG) are commonly recorded in intesive care unit (ICU) and operating room (OR). However, the high incidence of poor, incomplete, and inconsistent signal quality, can lead to false alarms or diagnostic inaccuracies. The methods explored so far suffer from limited generalizability, reliance on extensive labeled data, and poor cross-task transferability. To overcome these challenges, we introduce QualityFM, a novel multimodal foundation model for these physiological signals, designed to acquire a general-purpose understanding of signal quality. Our model is pre-trained on an large-scale dataset comprising over 21 million 30-second waveforms and 179,757 hours of data. Our approach involves a dual-track architecture that processes paired physiological signals of differing quality, leveraging a self-distillation strategy where an encoder for high-quality signals is used to guide the training of an encoder for low-quality signals. To efficiently handle long sequential signals and capture essential local quasi-periodic patterns, we integrate a windowed sparse attention mechanism within our Transformer-based model. Furthermore, a composite loss function, which combines direct distillation loss on encoder outputs with indirect reconstruction loss based on power and phase spectra, ensures the preservation of frequency-domain characteristics of the signals. We pre-train three models with varying parameter counts (9.6 M to 319 M) and demonstrate their efficacy and practical value through transfer learning on three distinct clinical tasks: false alarm of ventricular tachycardia detection, the identification of atrial fibrillation and the estimation of arterial blood pressure (ABP) from PPG and ECG signals.

Accurate interpretation of Electrocardiogram (ECG) signals is pivotal for diagnosing cardiovascular diseases. Integrating ECG signals with their accompanying textual reports holds immense potential to enhance clinical diagnostics through the combination of physiological data and qualitative insights. However, this integration faces significant challenges due to inherent modality disparities and the scarcity of labeled data for robust cross-modal learning. To address these obstacles, we propose C-MELT, a novel framework that pre-trains ECG and text data using a contrastive masked auto-encoder architecture. C-MELT uniquely combines the strengths of generative with enhanced discriminative capabilities to achieve robust cross-modal representations. This is accomplished through masked modality modeling, specialized loss functions, and an improved negative sampling strategy tailored for cross-modal alignment. Extensive experiments on five public datasets across diverse downstream tasks demonstrate that C-MELT significantly outperforms existing methods, achieving 15% and 2% increases in linear probing and zero-shot performance over state-of-the-art models, respectively. These results highlight the effectiveness of C-MELT, underscoring its potential to advance automated clinical diagnostics through multi-modal representations.

The two most common paradigms for end-to-end speech recognition are connectionist temporal classification (CTC) and attention-based encoder-decoder (AED) models. It has been argued that the latter is better suited for learning an implicit language model. We test this hypothesis by measuring temporal context sensitivity and evaluate how the models perform when we constrain the amount of contextual information in the audio input. We find that the AED model is indeed more context sensitive, but that the gap can be closed by adding self-attention to the CTC model. Furthermore, the two models perform similarly when contextual information is constrained. Finally, in contrast to previous research, our results show that the CTC model is highly competitive on WSJ and LibriSpeech without the help of an external language model.

Objective: To determine if a realistic, but computationally efficient model of the electrocardiogram can be used to pre-train a deep neural network (DNN) with a wide range of morphologies and abnormalities specific to a given condition - T-wave Alternans (TWA) as a result of Post-Traumatic Stress Disorder, or PTSD - and significantly boost performance on a small database of rare individuals. Approach: Using a previously validated artificial ECG model, we generated 180,000 artificial ECGs with or without significant TWA, with varying heart rate, breathing rate, TWA amplitude, and ECG morphology. A DNN, trained on over 70,000 patients to classify 25 different rhythms, was modified the output layer to a binary class (TWA or no-TWA, or equivalently, PTSD or no-PTSD), and transfer learning was performed on the artificial ECG. In a final transfer learning step, the DNN was trained and cross-validated on ECG from 12 PTSD and 24 controls for all combinations of using the three databases. Main results: The best performing approach (AUROC = 0.77, Accuracy = 0.72, F1-score = 0.64) was found by performing both transfer learning steps, using the pre-trained arrhythmia DNN, the artificial data and the real PTSD-related ECG data. Removing the artificial data from training led to the largest drop in performance. Removing the arrhythmia data from training provided a modest, but significant, drop in performance. The final model showed no significant drop in performance on the artificial data, indicating no overfitting. Significance: In healthcare, it is common to only have a small collection of high-quality data and labels, or a larger database with much lower quality (and less relevant) labels. The paradigm presented here, involving model-based performance boosting, provides a solution through transfer learning on a large realistic artificial database, and a partially relevant real database.

The first ACM/IEEE TinyML Design Contest (TDC) held at the 41st International Conference on Computer-Aided Design (ICCAD) in 2022 is a challenging, multi-month, research and development competition. TDC'22 focuses on real-world medical problems that require the innovation and implementation of artificial intelligence/machine learning (AI/ML) algorithms on implantable devices. The challenge problem of TDC'22 is to develop a novel AI/ML-based real-time detection algorithm for life-threatening ventricular arrhythmia over low-power microcontrollers utilized in Implantable Cardioverter-Defibrillators (ICDs). The dataset contains more than 38,000 5-second intracardiac electrograms (IEGMs) segments over 8 different types of rhythm from 90 subjects. The dedicated hardware platform is NUCLEO-L432KC manufactured by STMicroelectronics. TDC'22, which is open to multi-person teams world-wide, attracted more than 150 teams from over 50 organizations. This paper first presents the medical problem, dataset, and evaluation procedure in detail. It further demonstrates and discusses the designs developed by the leading teams as well as representative results. This paper concludes with the direction of improvement for the future TinyML design for health monitoring applications.

In contrast to Connectionist Temporal Classification (CTC) approaches, Sequence-To-Sequence (S2S) models for Handwritten Text Recognition (HTR) suffer from errors such as skipped or repeated words which often occur at the end of a sequence. In this paper, to combine the best of both approaches, we propose to use the CTC-Prefix-Score during S2S decoding. Hereby, during beam search, paths that are invalid according to the CTC confidence matrix are penalised. Our network architecture is composed of a Convolutional Neural Network (CNN) as visual backbone, bidirectional Long-Short-Term-Memory-Cells (LSTMs) as encoder, and a decoder which is a Transformer with inserted mutual attention layers. The CTC confidences are computed on the encoder while the Transformer is only used for character-wise S2S decoding. We evaluate this setup on three HTR data sets: IAM, Rimes, and StAZH. On IAM, we achieve a competitive Character Error Rate (CER) of 2.95% when pretraining our model on synthetic data and including a character-based language model for contemporary English. Compared to other state-of-the-art approaches, our model requires about 10-20 times less parameters. Access our shared implementations via this link to GitHub: https://github.com/Planet-AI-GmbH/tfaip-hybrid-ctc-s2s.

Heart failure is a leading cause of global mortality, necessitating improved diagnostic strategies. Classical machine learning models struggle with challenges such as high-dimensional data, class imbalances, poor feature representations, and a lack of interpretability. While quantum machine learning holds promise, current hybrid models have not fully exploited quantum advantages. In this paper, we propose the Kolmogorov-Arnold Classical-Quantum Dual-Channel Neural Network (KACQ-DCNN), a novel hybrid architecture that replaces traditional multilayer perceptrons with Kolmogorov-Arnold Networks (KANs), enabling learnable univariate activation functions. Our KACQ-DCNN 4-qubit, 1-layer model outperforms 37 benchmark models, including 16 classical and 12 quantum neural networks, achieving an accuracy of 92.03%, with macro-average precision, recall, and F1 scores of 92.00%. It also achieved a ROC-AUC of 94.77%, surpassing other models by significant margins, as validated by paired t-tests with a significance threshold of 0.0056 (after Bonferroni correction). Ablation studies highlight the synergistic effect of classical-quantum integration, improving performance by about 2% over MLP variants. Additionally, LIME and SHAP explainability techniques enhance feature interpretability, while conformal prediction provides robust uncertainty quantification. Our results demonstrate that KACQ-DCNN improves cardiovascular diagnostics by combining high accuracy with interpretability and uncertainty quantification.

Deep learning-based electrocardiogram (ECG) classification has shown impressive performance but clinical adoption has been slowed by the lack of transparent and faithful explanations. Post hoc methods such as saliency maps may fail to reflect a model's true decision process. Prototype-based reasoning offers a more transparent alternative by grounding decisions in similarity to learned representations of real ECG segments, enabling faithful, case-based explanations. We introduce ProtoECGNet, a prototype-based deep learning model for interpretable, multi-label ECG classification. ProtoECGNet employs a structured, multi-branch architecture that reflects clinical interpretation workflows: it integrates a 1D CNN with global prototypes for rhythm classification, a 2D CNN with time-localized prototypes for morphology-based reasoning, and a 2D CNN with global prototypes for diffuse abnormalities. Each branch is trained with a prototype loss designed for multi-label learning, combining clustering, separation, diversity, and a novel contrastive loss that encourages appropriate separation between prototypes of unrelated classes while allowing clustering for frequently co-occurring diagnoses. We evaluate ProtoECGNet on all 71 diagnostic labels from the PTB-XL dataset, demonstrating competitive performance relative to state-of-the-art black-box models while providing structured, case-based explanations. To assess prototype quality, we conduct a structured clinician review of the final model's projected prototypes, finding that they are rated as representative and clear. ProtoECGNet shows that prototype learning can be effectively scaled to complex, multi-label time-series classification, offering a practical path toward transparent and trustworthy deep learning models for clinical decision support.

This study presents a systematic comparison between hybrid quantum-classical neural networks and purely classical models across three benchmark datasets (MNIST, CIFAR100, and STL10) to evaluate their performance, efficiency, and robustness. The hybrid models integrate parameterized quantum circuits with classical deep learning architectures, while the classical counterparts use conventional convolutional neural networks (CNNs). Experiments were conducted over 50 training epochs for each dataset, with evaluations on validation accuracy, test accuracy, training time, computational resource usage, and adversarial robustness (tested with epsilon=0.1 perturbations).Key findings demonstrate that hybrid models consistently outperform classical models in final accuracy, achieving {99.38\% (MNIST), 41.69\% (CIFAR100), and 74.05\% (STL10) validation accuracy, compared to classical benchmarks of 98.21\%, 32.25\%, and 63.76\%, respectively. Notably, the hybrid advantage scales with dataset complexity, showing the most significant gains on CIFAR100 (+9.44\%) and STL10 (+10.29\%). Hybrid models also train 5--12times faster (e.g., 21.23s vs. 108.44s per epoch on MNIST) and use 6--32\% fewer parameters} while maintaining superior generalization to unseen test data.Adversarial robustness tests reveal that hybrid models are significantly more resilient on simpler datasets (e.g., 45.27\% robust accuracy on MNIST vs. 10.80\% for classical) but show comparable fragility on complex datasets like CIFAR100 (sim1\% robustness for both). Resource efficiency analyses indicate that hybrid models consume less memory (4--5GB vs. 5--6GB for classical) and lower CPU utilization (9.5\% vs. 23.2\% on average).These results suggest that hybrid quantum-classical architectures offer compelling advantages in accuracy, training efficiency, and parameter scalability, particularly for complex vision tasks.

Recent advancements in Large Language Models (LLMs) have drawn increasing attention since the learned embeddings pretrained on large-scale datasets have shown powerful ability in various downstream applications. However, whether the learned knowledge by LLMs can be transferred to clinical cardiology remains unknown. In this work, we aim to bridge this gap by transferring the knowledge of LLMs to clinical Electrocardiography (ECG). We propose an approach for cardiovascular disease diagnosis and automatic ECG diagnosis report generation. We also introduce an additional loss function by Optimal Transport (OT) to align the distribution between ECG and language embedding. The learned embeddings are evaluated on two downstream tasks: (1) automatic ECG diagnosis report generation, and (2) zero-shot cardiovascular disease detection. Our approach is able to generate high-quality cardiac diagnosis reports and also achieves competitive zero-shot classification performance even compared with supervised baselines, which proves the feasibility of transferring knowledge from LLMs to the cardiac domain.

Optical Coherence Tomography (OCT) is essential for diagnosing conditions such as glaucoma, diabetic retinopathy, and age-related macular degeneration. Accurate retinal layer segmentation enables quantitative biomarkers critical for clinical decision-making, but manual segmentation is time-consuming and variable, while conventional deep learning models often lack interpretability. This work proposes an improved SegNet-based deep learning framework for automated and interpretable retinal layer segmentation. Architectural innovations, including modified pooling strategies, enhance feature extraction from noisy OCT images, while a hybrid loss function combining categorical cross-entropy and Dice loss improves performance for thin and imbalanced retinal layers. Gradient-weighted Class Activation Mapping (Grad-CAM) is integrated to provide visual explanations, allowing clinical validation of model decisions. Trained and validated on the Duke OCT dataset, the framework achieved 95.77% validation accuracy, a Dice coefficient of 0.9446, and a Jaccard Index (IoU) of 0.8951. Class-wise results confirmed robust performance across most layers, with challenges remaining for thinner boundaries. Grad-CAM visualizations highlighted anatomically relevant regions, aligning segmentation with clinical biomarkers and improving transparency. By combining architectural improvements, a customized hybrid loss, and explainable AI, this study delivers a high-performing SegNet-based framework that bridges the gap between accuracy and interpretability. The approach offers strong potential for standardizing OCT analysis, enhancing diagnostic efficiency, and fostering clinical trust in AI-driven ophthalmic tools.

In clinical practice, electrocardiography (ECG) remains the gold standard for cardiac monitoring, providing crucial insights for diagnosing a wide range of cardiovascular diseases (CVDs). However, its reliance on specialized equipment and trained personnel limits feasibility for continuous routine monitoring. Photoplethysmography (PPG) offers accessible, continuous monitoring but lacks definitive electrophysiological information, preventing conclusive diagnosis. Generative models present a promising approach to translate PPG into clinically valuable ECG signals, yet current methods face substantial challenges, including the misalignment of physiological semantics in generative models and the complexity of modeling in high-dimensional signals. To this end, we propose PPGFlowECG, a two-stage framework that aligns PPG and ECG in a shared latent space via the CardioAlign Encoder and employs latent rectified flow to generate ECGs with high fidelity and interpretability. To the best of our knowledge, this is the first study to experiment on MCMED, a newly released clinical-grade dataset comprising over 10 million paired PPG-ECG samples from more than 118,000 emergency department visits with expert-labeled cardiovascular disease annotations. Results demonstrate the effectiveness of our method for PPG-to-ECG translation and cardiovascular disease detection. Moreover, cardiologist-led evaluations confirm that the synthesized ECGs achieve high fidelity and improve diagnostic reliability, underscoring our method's potential for real-world cardiovascular screening.

Non-contact remote photoplethysmography (rPPG) technology enables heart rate measurement from facial videos. However, existing network models still face challenges in accu racy, robustness, and generalization capability under complex scenarios. This paper proposes an end-to-end rPPG extraction network that employs 3D convolutional neural networks to reconstruct accurate rPPG signals from raw facial videos. We introduce a differential frame fusion module that integrates differential frames with original frames, enabling frame-level representations to capture blood volume pulse (BVP) variations. Additionally, we incorporate Temporal Shift Module (TSM) with self-attention mechanisms, which effectively enhance rPPG features with minimal computational overhead. Furthermore, we propose a novel dynamic hybrid loss function that provides stronger supervision for the network, effectively mitigating over fitting. Comprehensive experiments were conducted on not only the PURE and UBFC-rPPG datasets but also the challenging MMPD dataset under complex scenarios, involving both intra dataset and cross-dataset evaluations, which demonstrate the superior robustness and generalization capability of our network. Specifically, after training on PURE, our model achieved a mean absolute error (MAE) of 7.58 on the MMPD test set, outperforming the state-of-the-art models.

Electrocardiography (ECG) serves as an indispensable diagnostic tool in clinical practice, yet existing multimodal large language models (MLLMs) remain unreliable for ECG interpretation, often producing plausible but clinically incorrect analyses. To address this, we propose ECG-R1, the first reasoning MLLM designed for reliable ECG interpretation via three innovations. First, we construct the interpretation corpus using Protocol-Guided Instruction Data Generation, grounding interpretation in measurable ECG features and monograph-defined quantitative thresholds and diagnostic logic. Second, we present a modality-decoupled architecture with Interleaved Modality Dropout to improve robustness and cross-modal consistency when either the ECG signal or ECG image is missing. Third, we present Reinforcement Learning with ECG Diagnostic Evidence Rewards to strengthen evidence-grounded ECG interpretation. Additionally, we systematically evaluate the ECG interpretation capabilities of proprietary, open-source, and medical MLLMs, and provide the first quantitative evidence that severe hallucinations are widespread, suggesting that the public should not directly trust these outputs without independent verification. Code and data are publicly available at https://github.com/PKUDigitalHealth/ECG-R1{here}, and an online platform can be accessed at http://ai.heartvoice.com.cn/ECG-R1/{here}.

Accurate and contrast-free Major Adverse Cardiac Events (MACE) prediction from Cine MRI sequences remains a critical challenge. Existing methods typically necessitate supervised learning based on human-refined masks in the ventricular myocardium, which become impractical without contrast agents. We introduce a self-supervised framework, namely Codebook-based Temporal-Spatial Learning (CTSL), that learns dynamic, spatiotemporal representations from raw Cine data without requiring segmentation masks. CTSL decouples temporal and spatial features through a multi-view distillation strategy, where the teacher model processes multiple Cine views, and the student model learns from reduced-dimensional Cine-SA sequences. By leveraging codebook-based feature representations and dynamic lesion self-detection through motion cues, CTSL captures intricate temporal dependencies and motion patterns. High-confidence MACE risk predictions are achieved through our model, providing a rapid, non-invasive solution for cardiac risk assessment that outperforms traditional contrast-dependent methods, thereby enabling timely and accessible heart disease diagnosis in clinical settings.

Transducer and Attention based Encoder-Decoder (AED) are two widely used frameworks for speech-to-text tasks. They are designed for different purposes and each has its own benefits and drawbacks for speech-to-text tasks. In order to leverage strengths of both modeling methods, we propose a solution by combining Transducer and Attention based Encoder-Decoder (TAED) for speech-to-text tasks. The new method leverages AED's strength in non-monotonic sequence to sequence learning while retaining Transducer's streaming property. In the proposed framework, Transducer and AED share the same speech encoder. The predictor in Transducer is replaced by the decoder in the AED model, and the outputs of the decoder are conditioned on the speech inputs instead of outputs from an unconditioned language model. The proposed solution ensures that the model is optimized by covering all possible read/write scenarios and creates a matched environment for streaming applications. We evaluate the proposed approach on the MuST-C dataset and the findings demonstrate that TAED performs significantly better than Transducer for offline automatic speech recognition (ASR) and speech-to-text translation (ST) tasks. In the streaming case, TAED outperforms Transducer in the ASR task and one ST direction while comparable results are achieved in another translation direction.

Every prediction from a generative medical event model is bounded by how clinical events are tokenized, yet input representation is rarely isolated from other system and architectural choices. We evaluate how representation decisions affect downstream prediction after a shared one-epoch pretraining budget. We train 28 matched transformers on MIMIC-IV and evaluate them on 30 clinical outcomes in three experiments: (1) quantization granularity, reference-range anchoring, and code-value fusion; (2) value encoding (hard bins, soft discretization, code-normalized xVal) crossed with temporal encoding (event order, time tokens, admission-relative RoPE); and (3) native MIMIC laboratory/vital codes versus the Common Longitudinal ICU Format (CLIF)-remapped laboratory/vital codes with compression-preserving perturbation arms. In Experiment 1, fused code-value tokenization improves mortality AUROC from 0.891 to 0.915 (BH-adjusted p < 0.001), hospital length-of-stay AUROC from 0.763 to 0.788 (BH-adjusted p < 0.001), and, for the decile fused-vs-unfused comparison, mean regression Spearman rho across the 13 regression outcomes from 0.414 to 0.494. Across the three temporal encodings, event order only and admission-relative RoPE match or exceed inserting time tokens on average while shortening sequences by 11%. CLIF remapping preserves downstream performance in our single-site setting while yielding a smaller, clinically interpretable token set compatible with multi-site use. Finer-than-decile quantization, reference-range anchoring, and soft discretization help in selective outcomes, while code-normalized xVal remains well below the discrete and soft families, consistent with near-median suppression that persists after the affine variant.

Twelve-lead electrocardiograms (ECGs) are the clinical gold standard for cardiac diagnosis, providing comprehensive spatial coverage of the heart necessary to detect conditions such as myocardial infarction (MI). However, their lack of portability limits continuous and large-scale use. Three-lead ECG systems are widely used in wearable devices due to their simplicity and mobility, but they often fail to capture pathologies in unmeasured regions. To address this, we propose WearECG, a Variational Autoencoder (VAE) method that reconstructs twelve-lead ECGs from three leads: II, V1, and V5. Our model includes architectural improvements to better capture temporal and spatial dependencies in ECG signals. We evaluate generation quality using MSE, MAE, and Frechet Inception Distance (FID), and assess clinical validity via a Turing test with expert cardiologists. To further validate diagnostic utility, we fine-tune ECGFounder, a large-scale pretrained ECG model, on a multi-label classification task involving over 40 cardiac conditions, including six different myocardial infarction locations, using both real and generated signals. Experiments on the MIMIC dataset show that our method produces physiologically realistic and diagnostically informative signals, with robust performance in downstream tasks. This work demonstrates the potential of generative modeling for ECG reconstruction and its implications for scalable, low-cost cardiac screening.

Accurate detection of cardiac abnormalities from electrocardiogram recordings is regarded as essential for clinical diagnostics and decision support. Traditional deep learning models such as residual networks and transformer architectures have been applied successfully to this task, but their performance has been limited when long sequential signals are processed. Recently, state space models have been introduced as an efficient alternative. In this study, a hybrid framework named One Dimensional Convolutional Neural Network Electrocardiogram Mamba is introduced, in which convolutional feature extraction is combined with Mamba, a selective state space model designed for effective sequence modeling. The model is built upon Vision Mamba, a bidirectional variant through which the representation of temporal dependencies in electrocardiogram data is enhanced. Comprehensive experiments on the PhysioNet Computing in Cardiology Challenges of 2020 and 2021 were conducted, and superior performance compared with existing methods was achieved. Specifically, the proposed model achieved substantially higher AUPRC and AUROC scores than those reported by the best previously published algorithms on twelve lead electrocardiograms. These results demonstrate the potential of Mamba-based architectures to advance reliable ECG classification. This capability supports early diagnosis and personalized treatment, while enhancing accessibility in telemedicine and resource-constrained healthcare systems.

The label scarcity problem is the main challenge that hinders the wide application of deep learning systems in automatic cardiovascular diseases (CVDs) detection using electrocardiography (ECG). Tuning pre-trained models alleviates this problem by transferring knowledge learned from large datasets to downstream small datasets. However, bottlenecks in computational efficiency and detection performance limit its clinical applications. It is difficult to improve the detection performance without significantly sacrificing the computational efficiency during model training. Here, we propose a computation-efficient semi-supervised learning paradigm (CE-SSL) for robust and computation-efficient CVDs detection using ECG. It enables a robust adaptation of pre-trained models on downstream datasets with limited supervision and high computational efficiency. First, a random-deactivation technique is developed to achieve robust and fast low-rank adaptation of pre-trained weights. Subsequently, we propose a one-shot rank allocation module to determine the optimal ranks for the update matrices of the pre-trained weights. Finally, a lightweight semi-supervised learning pipeline is introduced to enhance model performance by leveraging labeled and unlabeled data with high computational efficiency. Extensive experiments on four downstream datasets demonstrate that CE-SSL not only outperforms the state-of-the-art methods in multi-label CVDs detection but also consumes fewer GPU footprints, training time, and parameter storage space. As such, this paradigm provides an effective solution for achieving high computational efficiency and robust detection performance in the clinical applications of pre-trained models under limited supervision. Code and Supplementary Materials are available at https://github.com/KAZABANA/CE-SSL

Connectionist Temporal Classification (CTC) is a widely used method for automatic speech recognition (ASR), renowned for its simplicity and computational efficiency. However, it often falls short in recognition performance. In this work, we propose the Consistency-Regularized CTC (CR-CTC), which enforces consistency between two CTC distributions obtained from different augmented views of the input speech mel-spectrogram. We provide in-depth insights into its essential behaviors from three perspectives: 1) it conducts self-distillation between random pairs of sub-models that process different augmented views; 2) it learns contextual representation through masked prediction for positions within time-masked regions, especially when we increase the amount of time masking; 3) it suppresses the extremely peaky CTC distributions, thereby reducing overfitting and improving the generalization ability. Extensive experiments on LibriSpeech, Aishell-1, and GigaSpeech datasets demonstrate the effectiveness of our CR-CTC. It significantly improves the CTC performance, achieving state-of-the-art results comparable to those attained by transducer or systems combining CTC and attention-based encoder-decoder (CTC/AED). We release our code at https://github.com/k2-fsa/icefall.

Hybrid methods have been shown to outperform pure statistical and pure deep learning methods at forecasting tasks and quantifying the associated uncertainty with those forecasts (prediction intervals). One example is Exponential Smoothing Recurrent Neural Network (ES-RNN), a hybrid between a statistical forecasting model and a recurrent neural network variant. ES-RNN achieves a 9.4\% improvement in absolute error in the Makridakis-4 Forecasting Competition. This improvement and similar outperformance from other hybrid models have primarily been demonstrated only on univariate datasets. Difficulties with applying hybrid forecast methods to multivariate data include (i) the high computational cost involved in hyperparameter tuning for models that are not parsimonious, (ii) challenges associated with auto-correlation inherent in the data, as well as (iii) complex dependency (cross-correlation) between the covariates that may be hard to capture. This paper presents Multivariate Exponential Smoothing Long Short Term Memory (MES-LSTM), a generalized multivariate extension to ES-RNN, that overcomes these challenges. MES-LSTM utilizes a vectorized implementation. We test MES-LSTM on several aggregated coronavirus disease of 2019 (COVID-19) morbidity datasets and find our hybrid approach shows consistent, significant improvement over pure statistical and deep learning methods at forecast accuracy and prediction interval construction.

Electrocardiography (ECG) offers critical cardiovascular insights, such as identifying arrhythmias and myocardial ischemia, but enabling automated systems to answer complex clinical questions directly from ECG signals (ECG-QA) remains a significant challenge. Current approaches often lack robust multimodal reasoning capabilities or rely on generic architectures ill-suited for the nuances of physiological signals. We introduce Q-Heart, a novel multimodal framework designed to bridge this gap. Q-Heart leverages a powerful, adapted ECG encoder and integrates its representations with textual information via a specialized ECG-aware transformer-based mapping layer. Furthermore, Q-Heart leverages dynamic prompting and retrieval of relevant historical clinical reports to guide tuning the language model toward knowledge-aware ECG reasoning. Extensive evaluations on the benchmark ECG-QA dataset show Q-Heart achieves state-of-the-art performance, outperforming existing methods by a 4% improvement in exact match accuracy. Our work demonstrates the effectiveness of combining domain-specific architectural adaptations with knowledge-augmented LLM instruction tuning for complex physiological ECG analysis, paving the way for more capable and potentially interpretable clinical patient care systems.

Photoplethysmography (PPG) signals, which measure changes in blood volume in the skin using light, have recently gained attention in biometric authentication because of their non-invasive acquisition, inherent liveness detection, and suitability for low-cost wearable devices. However, PPG signal quality is challenged by motion artifacts, illumination changes, and inter-subject physiological variability, making robust feature extraction and classification crucial. This study proposes a lightweight and cost-effective biometric authentication framework based on PPG signals extracted from low-frame-rate fingertip videos. The CFIHSR dataset, comprising PPG recordings from 46 subjects at a sampling rate of 14 Hz, is employed for evaluation. The raw PPG signals undergo a standard preprocessing pipeline involving baseline drift removal, motion artifact suppression using Principal Component Analysis (PCA), bandpass filtering, Fourier-based resampling, and amplitude normalization. To generate robust representations, each one-dimensional PPG segment is converted into a two-dimensional time-frequency scalogram via the Continuous Wavelet Transform (CWT), effectively capturing transient cardiovascular dynamics. We developed a hybrid deep learning model, termed CVT-ConvMixer-LSTM, by combining spatial features from the Convolutional Vision Transformer (CVT) and ConvMixer branches with temporal features from a Long Short-Term Memory network (LSTM). The experimental results on 46 subjects demonstrate an authentication accuracy of 98%, validating the robustness of the model to noise and variability between subjects. Due to its efficiency, scalability, and inherent liveness detection capability, the proposed system is well-suited for real-world mobile and embedded biometric security applications.

Pulmonary embolism (PE) is a life-threatening condition where rapid and accurate diagnosis is imperative yet difficult due to predominantly atypical symptomatology. Computed tomography pulmonary angiography (CTPA) is acknowledged as the gold standard imaging tool in clinics, yet it can be contraindicated for emergency department (ED) patients and represents an onerous procedure, thus necessitating PE identification through non-contrast CT (NCT) scans. In this work, we explore the feasibility of applying a deep-learning approach to NCT scans for PE identification. We propose a novel Cross-Phase Mutual learNing framework (CPMN) that fosters knowledge transfer from CTPA to NCT, while concurrently conducting embolism segmentation and abnormality classification in a multi-task manner. The proposed CPMN leverages the Inter-Feature Alignment (IFA) strategy that enhances spatial contiguity and mutual learning between the dual-pathway network, while the Intra-Feature Discrepancy (IFD) strategy can facilitate precise segmentation of PE against complex backgrounds for single-pathway networks. For a comprehensive assessment of the proposed approach, a large-scale dual-phase dataset containing 334 PE patients and 1,105 normal subjects has been established. Experimental results demonstrate that CPMN achieves the leading identification performance, which is 95.4\% and 99.6\% in patient-level sensitivity and specificity on NCT scans, indicating the potential of our approach as an economical, accessible, and precise tool for PE identification in clinical practice.

Heart disease remains a significant threat to human health. As a non-invasive diagnostic tool, the electrocardiogram (ECG) is one of the most widely used methods for cardiac screening. However, the scarcity of high-quality ECG data, driven by privacy concerns and limited medical resources, creates a pressing need for effective ECG signal generation. Existing approaches for generating ECG signals typically rely on small training datasets, lack comprehensive evaluation frameworks, and overlook potential applications beyond data augmentation. To address these challenges, we propose DiffuSETS, a novel framework capable of generating ECG signals with high semantic alignment and fidelity. DiffuSETS accepts various modalities of clinical text reports and patient-specific information as inputs, enabling the creation of clinically meaningful ECG signals. Additionally, to address the lack of standardized evaluation in ECG generation, we introduce a comprehensive benchmarking methodology to assess the effectiveness of generative models in this domain. Our model achieve excellent results in tests, proving its superiority in the task of ECG generation. Furthermore, we showcase its potential to mitigate data scarcity while exploring novel applications in cardiology education and medical knowledge discovery, highlighting the broader impact of our work.

We propose the Signal Dice Similarity Coefficient (SDSC), a structure-aware metric function for time series self-supervised representation learning. Most Self-Supervised Learning (SSL) methods for signals commonly adopt distance-based objectives such as mean squared error (MSE), which are sensitive to amplitude, invariant to waveform polarity, and unbounded in scale. These properties hinder semantic alignment and reduce interpretability. SDSC addresses this by quantifying structural agreement between temporal signals based on the intersection of signed amplitudes, derived from the Dice Similarity Coefficient (DSC).Although SDSC is defined as a structure-aware metric, it can be used as a loss by subtracting from 1 and applying a differentiable approximation of the Heaviside function for gradient-based optimization. A hybrid loss formulation is also proposed to combine SDSC with MSE, improving stability and preserving amplitude where necessary. Experiments on forecasting and classification benchmarks demonstrate that SDSC-based pre-training achieves comparable or improved performance over MSE, particularly in in-domain and low-resource scenarios. The results suggest that structural fidelity in signal representations enhances the semantic representation quality, supporting the consideration of structure-aware metrics as viable alternatives to conventional distance-based methods.

International Classification of Disease (ICD) coding procedure which refers to tagging medical notes with diagnosis codes has been shown to be effective and crucial to the billing system in medical sector. Currently, ICD codes are assigned to a clinical note manually which is likely to cause many errors. Moreover, training skilled coders also requires time and human resources. Therefore, automating the ICD code determination process is an important task. With the advancement of artificial intelligence theory and computational hardware, machine learning approach has emerged as a suitable solution to automate this process. In this project, we apply a transformer-based architecture to capture the interdependence among the tokens of a document and then use a code-wise attention mechanism to learn code-specific representations of the entire document. Finally, they are fed to separate dense layers for corresponding code prediction. Furthermore, to handle the imbalance in the code frequency of clinical datasets, we employ a label distribution aware margin (LDAM) loss function. The experimental results on the MIMIC-III dataset show that our proposed model outperforms other baselines by a significant margin. In particular, our best setting achieves a micro-AUC score of 0.923 compared to 0.868 of bidirectional recurrent neural networks. We also show that by using the code-wise attention mechanism, the model can provide more insights about its prediction, and thus it can support clinicians to make reliable decisions. Our code is available online (https://github.com/biplob1ly/TransICD)

Synthetic electrocardiogram generation serves medical AI applications requiring privacy-preserving data sharing and training dataset augmentation. Current diffusion-based methods achieve high generation quality but require hundreds of neural network evaluations during sampling, creating computational bottlenecks for clinical deployment. We propose FlowECG, a flow matching approach that adapts the SSSD-ECG architecture by replacing the iterative diffusion process with continuous flow dynamics. Flow matching learns direct transport paths from noise to data distributions through ordinary differential equation solving. We evaluate our method on the PTB-XL dataset using Dynamic Time Warping, Wasserstein distance, Maximum Mean Discrepancy, and spectral similarity metrics. FlowECG matches SSSD-ECG performance at 200 neural function evaluations, outperforming the baseline on three metrics. The key finding shows that FlowECG maintains generation quality with substantially fewer sampling steps, achieving comparable results with 10-25 evaluations compared to 200 for diffusion methods. This efficiency improvement reduces computational requirements by an order of magnitude while preserving physiologically realistic 12-lead ECG characteristics. The approach enables practical deployment in resource-limited clinical settings where real-time generation or large-scale synthetic data creation is needed.

Alzheimer's disease (AD) is a common neurodegenerative disease among the elderly. Early prediction and timely intervention of its prodromal stage, mild cognitive impairment (MCI), can decrease the risk of advancing to AD. Combining information from various modalities can significantly improve predictive accuracy. However, challenges such as missing data and heterogeneity across modalities complicate multimodal learning methods as adding more modalities can worsen these issues. Current multimodal fusion techniques often fail to adapt to the complexity of medical data, hindering the ability to identify relationships between modalities. To address these challenges, we propose an innovative multimodal approach for predicting MCI conversion, focusing specifically on the issues of missing positron emission tomography (PET) data and integrating diverse medical information. The proposed incomplete triple-modal MCI conversion prediction network is tailored for this purpose. Through the missing modal generation module, we synthesize the missing PET data from the magnetic resonance imaging and extract features using specifically designed encoders. We also develop a channel aggregation module and a triple-modal co-attention fusion module to reduce feature redundancy and achieve effective multimodal data fusion. Furthermore, we design a loss function to handle missing modality issues and align cross-modal features. These components collectively harness multimodal data to boost network performance. Experimental results on the ADNI1 and ADNI2 datasets show that our method significantly surpasses existing unimodal and other multimodal models. Our code is available at https://github.com/justinhxy/ITFC.

This paper presents a novel hybrid model that integrates long-short-term memory (LSTM) networks and Graph Neural Networks (GNNs) to significantly enhance the accuracy of stock market predictions. The LSTM component adeptly captures temporal patterns in stock price data, effectively modeling the time series dynamics of financial markets. Concurrently, the GNN component leverages Pearson correlation and association analysis to model inter-stock relational data, capturing complex nonlinear polyadic dependencies influencing stock prices. The model is trained and evaluated using an expanding window validation approach, enabling continuous learning from increasing amounts of data and adaptation to evolving market conditions. Extensive experiments conducted on historical stock data demonstrate that our hybrid LSTM-GNN model achieves a mean square error (MSE) of 0.00144, representing a substantial reduction of 10.6% compared to the MSE of the standalone LSTM model of 0.00161. Furthermore, the hybrid model outperforms traditional and advanced benchmarks, including linear regression, convolutional neural networks (CNN), and dense networks. These compelling results underscore the significant potential of combining temporal and relational data through a hybrid approach, offering a powerful tool for real-time trading and financial analysis.

Interpreting electrocardiograms (ECGs) and generating comprehensive reports remain challenging tasks in cardiology, often requiring specialized expertise and significant time investment. To address these critical issues, we propose ECG-ReGen, a retrieval-based approach for ECG-to-text report generation and question answering. Our method leverages a self-supervised learning for the ECG encoder, enabling efficient similarity searches and report retrieval. By combining pre-training with dynamic retrieval and Large Language Model (LLM)-based refinement, ECG-ReGen effectively analyzes ECG data and answers related queries, with the potential of improving patient care. Experiments conducted on the PTB-XL and MIMIC-IV-ECG datasets demonstrate superior performance in both in-domain and cross-domain scenarios for report generation. Furthermore, our approach exhibits competitive performance on ECG-QA dataset compared to fully supervised methods when utilizing off-the-shelf LLMs for zero-shot question answering. This approach, effectively combining self-supervised encoder and LLMs, offers a scalable and efficient solution for accurate ECG interpretation, holding significant potential to enhance clinical decision-making.

We present a simple and efficient auxiliary loss function for automatic speech recognition (ASR) based on the connectionist temporal classification (CTC) objective. The proposed objective, an intermediate CTC loss, is attached to an intermediate layer in the CTC encoder network. This intermediate CTC loss well regularizes CTC training and improves the performance requiring only small modification of the code and small and no overhead during training and inference, respectively. In addition, we propose to combine this intermediate CTC loss with stochastic depth training, and apply this combination to a recently proposed Conformer network. We evaluate the proposed method on various corpora, reaching word error rate (WER) 9.9% on the WSJ corpus and character error rate (CER) 5.2% on the AISHELL-1 corpus respectively, based on CTC greedy search without a language model. Especially, the AISHELL-1 task is comparable to other state-of-the-art ASR systems based on auto-regressive decoder with beam search.

Recent end-to-end Automatic Speech Recognition (ASR) systems demonstrated the ability to outperform conventional hybrid DNN/ HMM ASR. Aside from architectural improvements in those systems, those models grew in terms of depth, parameters and model capacity. However, these models also require more training data to achieve comparable performance. In this work, we combine freely available corpora for German speech recognition, including yet unlabeled speech data, to a big dataset of over 1700h of speech data. For data preparation, we propose a two-stage approach that uses an ASR model pre-trained with Connectionist Temporal Classification (CTC) to boot-strap more training data from unsegmented or unlabeled training data. Utterances are then extracted from label probabilities obtained from the network trained with CTC to determine segment alignments. With this training data, we trained a hybrid CTC/attention Transformer model that achieves 12.8% WER on the Tuda-DE test set, surpassing the previous baseline of 14.4% of conventional hybrid DNN/HMM ASR.

Electrocardiography (ECG) signal generation has been heavily explored using generative adversarial networks (GAN) because the implementation of 12-lead ECGs is not always feasible. The GAN models have achieved remarkable results in reproducing ECG signals but are only designed for multiple lead inputs and the features the GAN model preserves have not been identified-limiting the generated signals use in cardiovascular disease (CVD)-predictive models. This paper presents ECGNet which is a procedure that generates a complete set of 12-lead ECG signals from any single lead input using a GAN framework with a bidirectional long short-term memory (LSTM) generator and a convolutional neural network (CNN) discriminator. Cross and auto-correlation analysis performed on the generated signals identifies features conserved during the signal generation-i.e., features that can characterize the unique-nature of each signal and thus likely indicators of CVD. Finally, by using ECG signals annotated with the CVD-indicative features detailed by the correlation analysis as inputs for a CVD-onset-predictive CNN model, we overcome challenges preventing the prediction of multiple-CVD targets. Our models are experimented on 15s 12-lead ECG dataset recorded using MyoVista's wavECG. Functional outcome data for each patient is recorded and used in the CVD-predictive model. Our best GAN model achieves state-of-the-art accuracy with Frechet Distance (FD) scores of 4.73, 4.89, 5.18, 4.77, 4.71, and 5.55 on the V1-V6 pre-cordial leads respectively and shows strength in preserving the P-Q segments and R-peaks in the generated signals. To the best of our knowledge, ECGNet is the first to predict all of the remaining eleven leads from the input of any single lead.

Convolutional Neural Networks (CNNs) have advanced existing medical systems for automatic disease diagnosis. However, there are still concerns about the reliability of deep medical diagnosis systems against the potential threats of adversarial attacks since inaccurate diagnosis could lead to disastrous consequences in the safety realm. In this study, we propose a highly robust yet efficient CNN-Transformer hybrid model which is equipped with the locality of CNNs as well as the global connectivity of vision Transformers. To mitigate the high quadratic complexity of the self-attention mechanism while jointly attending to information in various representation subspaces, we construct our attention mechanism by means of an efficient convolution operation. Moreover, to alleviate the fragility of our Transformer model against adversarial attacks, we attempt to learn smoother decision boundaries. To this end, we augment the shape information of an image in the high-level feature space by permuting the feature mean and variance within mini-batches. With less computational complexity, our proposed hybrid model demonstrates its high robustness and generalization ability compared to the state-of-the-art studies on a large-scale collection of standardized MedMNIST-2D datasets.

This study aims to explore the implementation of Natural Language Processing (NLP) and machine learning (ML) techniques to automate the coding of medical letters with visualised explainability and light-weighted local computer settings. Currently in clinical settings, coding is a manual process that involves assigning codes to each condition, procedure, and medication in a patient's paperwork (e.g., 56265001 heart disease using SNOMED CT code). There are preliminary research on automatic coding in this field using state-of-the-art ML models; however, due to the complexity and size of the models, the real-world deployment is not achieved. To further facilitate the possibility of automatic coding practice, we explore some solutions in a local computer setting; in addition, we explore the function of explainability for transparency of AI models. We used the publicly available MIMIC-III database and the HAN/HLAN network models for ICD code prediction purposes. We also experimented with the mapping between ICD and SNOMED CT knowledge bases. In our experiments, the models provided useful information for 97.98\% of codes. The result of this investigation can shed some light on implementing automatic clinical coding in practice, such as in hospital settings, on the local computers used by clinicians , project page https://github.com/Glenj01/Medical-Coding.

Deep neural networks remain highly vulnerable to adversarial perturbations, limiting their reliability in security- and safety-critical applications. To address this challenge, we introduce QShield, a modular hybrid quantum-classical neural network (HQCNN) architecture designed to enhance the adversarial robustness of classical deep learning models. QShield integrates a conventional convolutional neural network (CNN) backbone for feature extraction with a quantum processing module that encodes the extracted features into quantum states, applies structured entanglement operations under realistic noise models, and outputs a hybrid prediction through a dynamically weighted fusion mechanism implemented via a lightweight multilayer perceptron (MLP). We systematically evaluate both classical and hybrid quantum-classical models on the MNIST, OrganAMNIST, and CIFAR-10 datasets, using a comprehensive set of robustness, efficiency, and computational performance metrics. Our results demonstrate that classical models are highly vulnerable to adversarial attacks, whereas the proposed hybrid models with entanglement patterns maintain high predictive accuracy while substantially reducing attack success rates across a wide range of adversarial attacks. Furthermore, the proposed hybrid architecture significantly increased the computational cost required to generate adversarial examples, thereby introducing an additional layer of defense. These findings indicate that the proposed modular hybrid architecture achieves a practical balance between predictive accuracy and adversarial robustness, positioning it as a promising approach for secure and reliable machine learning in sensitive and safety-critical applications.

Deep learning models achieve state-of-the-art performance across domains but face scalability challenges in real-time or resource-constrained scenarios. To address this, we propose Correlation of Loss Differences (CLD), a simple and scalable metric for coreset selection that identifies the most impactful training samples by measuring their alignment with the loss trajectories of a held-out validation set. CLD is highly efficient, requiring only per-sample loss values computed at training checkpoints, and avoiding the costly gradient and curvature computations used in many existing subset selection methods. We develop a general theoretical framework that establishes convergence guarantees for CLD-based coresets, demonstrating that the convergence error is upper-bounded by the alignment of the selected samples and the representativeness of the validation set. On CIFAR-100 and ImageNet-1k, CLD-based coresets typically outperform or closely match state-of-the-art methods across subset sizes, and remain within 1% of more computationally expensive baselines even when not leading. CLD transfers effectively across architectures (ResNet, VGG, DenseNet), enabling proxy-to-target selection with <1% degradation. Moreover, CLD is stable when using only early checkpoints, incurring negligible accuracy loss. Finally, CLD exhibits inherent bias reduction via per-class validation alignment, obviating the need for additional stratified sampling. Together, these properties make CLD a principled, efficient, stable, and transferable tool for scalable dataset optimization.

Cardiovascular magnetic resonance imaging is emerging as a crucial tool to examine cardiac morphology and function. Essential to this endeavour are anatomical 3D surface and volumetric meshes derived from CMR images, which facilitate computational anatomy studies, biomarker discovery, and in-silico simulations. Traditional approaches typically follow complex multi-step pipelines, first segmenting images and then reconstructing meshes, making them time-consuming and prone to error propagation. In response, we introduce HybridVNet, a novel architecture for direct image-to-mesh extraction seamlessly integrating standard convolutional neural networks with graph convolutions, which we prove can efficiently handle surface and volumetric meshes by encoding them as graph structures. To further enhance accuracy, we propose a multi-view HybridVNet architecture which processes both long axis and short axis CMR, showing that it can increase the performance of cardiac MR mesh generation. Our model combines traditional convolutional networks with variational graph generative models, deep supervision and mesh-specific regularisation. Experiments on a comprehensive dataset from the UK Biobank confirm the potential of HybridVNet to significantly advance cardiac imaging and computational cardiology by efficiently generating high-fidelity meshes from CMR images. Multi-view HybridVNet outperforms the state-of-the-art, achieving improvements of up to sim27\% reduction in Mean Contour Distance (from 1.86 mm to 1.35 mm for the LV Myocardium), up to sim18\% improvement in Hausdorff distance (from 4.74 mm to 3.89mm, for the LV Endocardium), and up to sim8\% in Dice Coefficient (from 0.78 to 0.84, for the LV Myocardium), highlighting its superior accuracy.

Anomaly detection in 12-lead electrocardiograms (ECGs) is critical for identifying deviations associated with cardiovascular disease. This work presents a comparative analysis of three autoencoder-based architectures: convolutional autoencoder (CAE), variational autoencoder with bidirectional long short-term memory (VAE-BiLSTM), and VAE-BiLSTM with multi-head attention (VAE-BiLSTM-MHA), for unsupervised anomaly detection in ECGs. To the best of our knowledge, this study reports the first application of a VAE-BiLSTM-MHA architecture to ECG anomaly detection. All models are trained on normal ECG samples to reconstruct non-anomalous cardiac morphology and detect deviations indicative of disease. Using a unified preprocessing and evaluation pipeline on the public China Physiological Signal Challenge (CPSC) dataset, the attention-augmented VAE achieves the best performance, with an AUPRC of 0.81 and a recall of 0.85 on the held-out test set, outperforming the other architectures. To support clinical triage, this model is further integrated into an interactive dashboard that visualizes anomaly localization. In addition, a performance comparison with baseline models from the literature is provided.

Machine learning models, particularly deep neural networks, have demonstrated strong performance in classifying complex time series data. However, their black-box nature limits trust and adoption, especially in high-stakes domains such as healthcare. To address this challenge, we introduce UniCoMTE, a model-agnostic framework for generating counterfactual explanations for multivariate time series classifiers. The framework identifies temporal features that most heavily influence a model's prediction by modifying the input sample and assessing its impact on the model's prediction. UniCoMTE is compatible with a wide range of model architectures and operates directly on raw time series inputs. In this study, we evaluate UniCoMTE's explanations on a time series ECG classifier. We quantify explanation quality by comparing our explanations' comprehensibility to comprehensibility of established techniques (LIME and SHAP) and assessing their generalizability to similar samples. Furthermore, clinical utility is assessed through a questionnaire completed by medical experts who review counterfactual explanations presented alongside original ECG samples. Results show that our approach produces concise, stable, and human-aligned explanations that outperform existing methods in both clarity and applicability. By linking model predictions to meaningful signal patterns, the framework advances the interpretability of deep learning models for real-world time series applications.

ICD Coding aims to assign a wide range of medical codes to a medical text document, which is a popular and challenging task in the healthcare domain. To alleviate the problems of long-tail distribution and the lack of annotations of code-specific evidence, many previous works have proposed incorporating code knowledge to improve coding performance. However, existing methods often focus on a single type of knowledge and design specialized modules that are complex and incompatible with each other, thereby limiting their scalability and effectiveness. To address this issue, we propose GKI-ICD, a novel, general knowledge injection framework that integrates three key types of knowledge, namely ICD Description, ICD Synonym, and ICD Hierarchy, without specialized design of additional modules. The comprehensive utilization of the above knowledge, which exhibits both differences and complementarity, can effectively enhance the ICD coding performance. Extensive experiments on existing popular ICD coding benchmarks demonstrate the effectiveness of GKI-ICD, which achieves the state-of-the-art performance on most evaluation metrics. Code is available at https://github.com/xuzhang0112/GKI-ICD.

Idiopathic pulmonary fibrosis (IPF) is a progressive disease that irreversibly transforms lung tissue into rigid fibrotic structures, leading to debilitating symptoms such as shortness of breath and chronic fatigue. The heterogeneity and complexity of this disease, particularly regarding its severity and progression rate, have made predicting its future course a complex and challenging task. Besides, traditional diagnostic methods based on clinical evaluations and imaging have limitations in capturing the disease's complexity. Using the Kaggle Pulmonary Fibrosis Progression dataset, which includes computed tomography images, and clinical information, the model predicts changes in forced vital capacity (FVC), a key progression indicator. Our method uses a proposed context-aware sequential-parallel hybrid transformer model and clinical information enrichment for its prediction. The proposed method achieved a Laplace Log-Likelihood score of -6.508, outperforming prior methods and demonstrating superior predictive capabilities. These results highlight the potential of advanced deep learning techniques to provide more accurate and timely predictions, offering a transformative approach to the diagnosis and management of IPF, with implications for improved patient outcomes and therapeutic advancements.

ASR Error Detection (AED) models aim to post-process the output of Automatic Speech Recognition (ASR) systems, in order to detect transcription errors. Modern approaches usually use text-based input, comprised solely of the ASR transcription hypothesis, disregarding additional signals from the ASR model. Instead, we propose to utilize the ASR system's word-level confidence scores for improving AED performance. Specifically, we add an ASR Confidence Embedding (ACE) layer to the AED model's encoder, allowing us to jointly encode the confidence scores and the transcribed text into a contextualized representation. Our experiments show the benefits of ASR confidence scores for AED, their complementary effect over the textual signal, as well as the effectiveness and robustness of ACE for combining these signals. To foster further research, we publish a novel AED dataset consisting of ASR outputs on the LibriSpeech corpus with annotated transcription errors.

Sleep staging models often degrade when deployed on patients with unseen physiology or recording conditions. We propose a streaming, source-free test-time adaptation (TTA) recipe that combines entropy minimization (Tent) with Batch-Norm statistic refresh and two safety rails: an entropy gate to pause adaptation on uncertain windows and an EMA-based reset to reel back drift. On Sleep-EDF Expanded, using single-lead EEG (Fpz-Cz, 100 Hz, 30s epochs; R&K to AASM mapping), we show consistent gains over a frozen baseline at seconds-level latency and minimal memory, reporting per-stage metrics and Cohen's k. The method is model-agnostic, requires no source data or patient calibration, and is practical for on-device or bedside use.

The electrocardiogram (ECG) remains a fundamental tool in cardiac diagnostics, yet its interpretation traditionally reliant on the expertise of cardiologists. The emergence of deep learning has heralded a revolutionary era in medical data analysis, particularly in the domain of ECG diagnostics. However, inter-patient variability prohibit the generalibility of ECG-AI model trained on a population dataset, hence degrade the performance of ECG-AI on specific patient or patient group. Many studies have address this challenge using different deep learning technologies. This comprehensive review systematically synthesizes research from a wide range of studies to provide an in-depth examination of cutting-edge deep-learning techniques in personalized ECG diagnosis. The review outlines a rigorous methodology for the selection of pertinent scholarly articles and offers a comprehensive overview of deep learning approaches applied to personalized ECG diagnostics. Moreover, the challenges these methods encounter are investigated, along with future research directions, culminating in insights into how the integration of deep learning can transform personalized ECG diagnosis and enhance cardiac care. By emphasizing both the strengths and limitations of current methodologies, this review underscores the immense potential of deep learning to refine and redefine ECG analysis in clinical practice, paving the way for more accurate, efficient, and personalized cardiac diagnostics.

Age-related macular degeneration (AMD) and choroidal neovascularization (CNV)-related conditions are leading causes of vision loss worldwide, with optical coherence tomography (OCT) serving as a cornerstone for early detection and management. However, deploying state-of-the-art deep learning models like ConvNeXtV2-Large in clinical settings is hindered by their computational demands. Therefore, it is desirable to develop efficient models that maintain high diagnostic performance while enabling real-time deployment. In this study, a novel knowledge distillation framework, termed KD-OCT, is proposed to compress a high-performance ConvNeXtV2-Large teacher model, enhanced with advanced augmentations, stochastic weight averaging, and focal loss, into a lightweight EfficientNet-B2 student for classifying normal, drusen, and CNV cases. KD-OCT employs real-time distillation with a combined loss balancing soft teacher knowledge transfer and hard ground-truth supervision. The effectiveness of the proposed method is evaluated on the Noor Eye Hospital (NEH) dataset using patient-level cross-validation. Experimental results demonstrate that KD-OCT outperforms comparable multi-scale or feature-fusion OCT classifiers in efficiency- accuracy balance, achieving near-teacher performance with substantial reductions in model size and inference time. Despite the compression, the student model exceeds most existing frameworks, facilitating edge deployment for AMD screening. Code is available at https://github.com/erfan-nourbakhsh/KD- OCT.

Accurate estimation of brain infarction (i.e., irreversibly damaged tissue) is critical for guiding treatment decisions in acute ischemic stroke. Reliable infarct prediction informs key clinical interventions, including the need for patient transfer to comprehensive stroke centers, the potential benefit of additional reperfusion attempts during mechanical thrombectomy, decisions regarding secondary neuroprotective treatments, and ultimately, prognosis of clinical outcomes. This work introduces the Ischemic Stroke Lesion Segmentation (ISLES) 2024 challenge, which focuses on the prediction of final infarct volumes from pre-interventional acute stroke imaging and clinical data. ISLES24 provides a comprehensive, multimodal setting where participants can leverage all clinically and practically available data, including full acute CT imaging, sub-acute follow-up MRI, and structured clinical information, across a train set of 150 cases. On the hidden test set of 98 cases, the top-performing model, a multimodal nnU-Net-based architecture, achieved a Dice score of 0.285 (+/- 0.213) and an absolute volume difference of 21.2 (+/- 37.2) mL, underlining the significant challenges posed by this task and the need for further advances in multimodal learning. This work makes two primary contributions: first, we establish a standardized, clinically realistic benchmark for post-treatment infarct prediction, enabling systematic evaluation of multimodal algorithmic strategies on a longitudinal stroke dataset; second, we analyze current methodological limitations and outline key research directions to guide the development of next-generation infarct prediction models.

We introduce a novel contextual embedding model med-gte-hybrid that was derived from the gte-large sentence transformer to extract information from unstructured clinical narratives. Our model tuning strategy for med-gte-hybrid combines contrastive learning and a denoising autoencoder. To evaluate the performance of med-gte-hybrid, we investigate several clinical prediction tasks in large patient cohorts extracted from the MIMIC-IV dataset, including Chronic Kidney Disease (CKD) patient prognosis, estimated glomerular filtration rate (eGFR) prediction, and patient mortality prediction. Furthermore, we demonstrate that the med-gte-hybrid model improves patient stratification, clustering, and text retrieval, thus outperforms current state-of-the-art models on the Massive Text Embedding Benchmark (MTEB). While some of our evaluations focus on CKD, our hybrid tuning of sentence transformers could be transferred to other medical domains and has the potential to improve clinical decision-making and personalised treatment pathways in various healthcare applications.

Accurate, continuous out-of-hospital electrocardiogram (ECG) parameter measurement is vital for real-time cardiac health monitoring and telemedicine. On-device computation of single-lead ECG parameters enables timely assessment without reliance on centralized data processing, advancing personalized, ubiquitous cardiac care-yet comprehensive validation across heterogeneous real-world populations remains limited. This study validated the on-device algorithm FeatureDB (https://github.com/PKUDigitalHealth/FeatureDB) using two datasets: HeartVoice-ECG-lite (369 participants with single-lead ECGs annotated by two physicians) and PTB-XL/PTB-XL+ (21,354 patients with 12-lead ECGs and physicians' diagnostic annotations). FeatureDB computed PR, QT, and QTc intervals, with accuracy evaluated against physician annotations via mean absolute error (MAE), correlation analysis, and Bland-Altman analysis. Diagnostic performance for first-degree atrioventricular block (AVBI, PR-based) and long QT syndrome (LQT, QTc-based) was benchmarked against commercial 12-lead systems (12SL, Uni-G) and open-source algorithm Deli, using AUC, accuracy, sensitivity, and specificity. Results showed high concordance with expert annotations (Pearson correlations: 0.836-0.960), MAEs matching inter-observer variability, and minimal bias. AVBI AUC reached 0.787 (12SL: 0.859; Uni-G: 0.812; Deli: 0.501); LQT AUC was 0.684 (12SL: 0.716; Uni-G: 0.605; Deli: 0.569)-comparable to commercial tools and superior to open-source alternatives. FeatureDB delivers physician-level parameter accuracy and commercial-grade abnormality detection via single-lead devices, supporting scalable telemedicine, decentralized cardiac screening, and continuous monitoring in community and outpatient settings.

Multi-modal fusion approaches aim to integrate information from different data sources. Unlike natural datasets, such as in audio-visual applications, where samples consist of "paired" modalities, data in healthcare is often collected asynchronously. Hence, requiring the presence of all modalities for a given sample is not realistic for clinical tasks and significantly limits the size of the dataset during training. In this paper, we propose MedFuse, a conceptually simple yet promising LSTM-based fusion module that can accommodate uni-modal as well as multi-modal input. We evaluate the fusion method and introduce new benchmark results for in-hospital mortality prediction and phenotype classification, using clinical time-series data in the MIMIC-IV dataset and corresponding chest X-ray images in MIMIC-CXR. Compared to more complex multi-modal fusion strategies, MedFuse provides a performance improvement by a large margin on the fully paired test set. It also remains robust across the partially paired test set containing samples with missing chest X-ray images. We release our code for reproducibility and to enable the evaluation of competing models in the future.

Although deep models have greatly improved the accuracy and robustness of image segmentation, obtaining segmentation results with highly accurate boundaries and fine structures is still a challenging problem. In this paper, we propose a simple yet powerful Boundary-Aware Segmentation Network (BASNet), which comprises a predict-refine architecture and a hybrid loss, for highly accurate image segmentation. The predict-refine architecture consists of a densely supervised encoder-decoder network and a residual refinement module, which are respectively used to predict and refine a segmentation probability map. The hybrid loss is a combination of the binary cross entropy, structural similarity and intersection-over-union losses, which guide the network to learn three-level (ie, pixel-, patch- and map- level) hierarchy representations. We evaluate our BASNet on two reverse tasks including salient object segmentation, camouflaged object segmentation, showing that it achieves very competitive performance with sharp segmentation boundaries. Importantly, BASNet runs at over 70 fps on a single GPU which benefits many potential real applications. Based on BASNet, we further developed two (close to) commercial applications: AR COPY & PASTE, in which BASNet is integrated with augmented reality for "COPYING" and "PASTING" real-world objects, and OBJECT CUT, which is a web-based tool for automatic object background removal. Both applications have already drawn huge amount of attention and have important real-world impacts. The code and two applications will be publicly available at: https://github.com/NathanUA/BASNet.

Long short-term memory (LSTM) is a kind of recurrent neural networks (RNN) for sequence and temporal dependency data modeling and its effectiveness has been extensively established. In this work, we propose a hybrid quantum-classical model of LSTM, which we dub QLSTM. We demonstrate that the proposed model successfully learns several kinds of temporal data. In particular, we show that for certain testing cases, this quantum version of LSTM converges faster, or equivalently, reaches a better accuracy, than its classical counterpart. Due to the variational nature of our approach, the requirements on qubit counts and circuit depth are eased, and our work thus paves the way toward implementing machine learning algorithms for sequence modeling on noisy intermediate-scale quantum (NISQ) devices.

Electrocardiograms (ECGs) are inexpensive, widely used, and well-suited to deep learning. Recently, interest has grown in developing foundation models for ECGs - models that generalise across diverse downstream tasks. However, consistent evaluation has been lacking: prior work often uses narrow task selections and inconsistent datasets, hindering fair comparison. Here, we introduce BenchECG, a standardised benchmark comprising a comprehensive suite of publicly available ECG datasets and versatile tasks. We also propose xECG, an xLSTM-based recurrent model trained with SimDINOv2 self-supervised learning, which achieves the best BenchECG score compared to publicly available state-of-the-art models. In particular, xECG is the only publicly available model to perform strongly on all datasets and tasks. By standardising evaluation, BenchECG enables rigorous comparison and aims to accelerate progress in ECG representation learning. xECG achieves superior performance over earlier approaches, defining a new baseline for future ECG foundation models.

Transformers are highly parallel but are limited to computations in the TC^0 complexity class, excluding tasks such as entity tracking and code execution that provably require greater expressive power. Motivated by this limitation, we revisit non-linear Recurrent Neural Networks (RNNs) for language modeling and introduce Matrix-to-Matrix RNN (M^2RNN): an architecture with matrix-valued hidden states and expressive non-linear state transitions. We demonstrate that the language modeling performance of non-linear RNNs is limited by their state size. We also demonstrate how the state size expansion mechanism enables efficient use of tensor cores. Empirically, M^2RNN achieves perfect state tracking generalization at sequence lengths not seen during training. These benefits also translate to large-scale language modeling. In hybrid settings that interleave recurrent layers with attention, Hybrid M^2RNN outperforms equivalent Gated DeltaNet hybrids by 0.4-0.5 perplexity points on a 7B MoE model, while using 3times smaller state sizes for the recurrent layers. Notably, replacing even a single recurrent layer with M^2RNN in an existing hybrid architecture yields accuracy gains comparable to Hybrid M^2RNN with minimal impact on training throughput. Further, the Hybrid Gated DeltaNet models with a single M^2RNN layer also achieve superior long-context generalization, outperforming state-of-the-art hybrid linear attention architectures by up to 8 points on LongBench. Together, these results establish non-linear RNN layers as a compelling building block for efficient and scalable language models.

End-to-end (E2E) automatic speech recognition (ASR) systems have revolutionized the field by integrating all components into a single neural network, with attention-based encoder-decoder models achieving state-of-the-art performance. However, their autoregressive decoding process limits inference speed, making them unsuitable for real-time applications. In contrast, CTC-based models offer faster, non-autoregressive decoding but struggle to model linguistic dependencies effectively. Addressing this challenge, we propose a novel auxiliary loss framework called Language-Aware Intermediate Loss (LAIL) to enhance CTC-based ASR using the linguistic knowledge of large language models (LLMs). By attaching connector layers to intermediate encoder layers, LAIL maps outputs to the embedding space of an LLM and computes a causal language modeling loss during training. This approach enhances linguistic modeling while preserving the computational efficiency of CTC decoding. Using the Conformer architecture and various LLaMA models, we demonstrate significant improvements in Word Error Rate (WER) on the LibriSpeech, TEDLIUM2, and WSJ corpora, achieving state-of-the-art performance for CTC-based ASR with minimal computational overhead.

In this paper, we propose an efficient and accurate streaming speech recognition model based on the FastConformer architecture. We adapted the FastConformer architecture for streaming applications through: (1) constraining both the look-ahead and past contexts in the encoder, and (2) introducing an activation caching mechanism to enable the non-autoregressive encoder to operate autoregressively during inference. The proposed model is thoughtfully designed in a way to eliminate the accuracy disparity between the train and inference time which is common for many streaming models. Furthermore, our proposed encoder works with various decoder configurations including Connectionist Temporal Classification (CTC) and RNN-Transducer (RNNT) decoders. Additionally, we introduced a hybrid CTC/RNNT architecture which utilizes a shared encoder with both a CTC and RNNT decoder to boost the accuracy and save computation. We evaluate the proposed model on LibriSpeech dataset and a multi-domain large scale dataset and demonstrate that it can achieve better accuracy with lower latency and inference time compared to a conventional buffered streaming model baseline. We also showed that training a model with multiple latencies can achieve better accuracy than single latency models while it enables us to support multiple latencies with a single model. Our experiments also showed the hybrid architecture would not only speedup the convergence of the CTC decoder but also improves the accuracy of streaming models compared to single decoder models.

Accurate diagnostic coding of medical notes is crucial for enhancing patient care, medical research, and error-free billing in healthcare organizations. Manual coding is a time-consuming task for providers, and diagnostic codes often exhibit low sensitivity and specificity, whereas the free text in medical notes can be a more precise description of a patients status. Thus, accurate automated diagnostic coding of medical notes has become critical for a learning healthcare system. Recent developments in long-document transformer architectures have enabled attention-based deep-learning models to adjudicate medical notes. In addition, contrastive loss functions have been used to jointly pre-train large language and image models with noisy labels. To further improve the automated adjudication of medical notes, we developed an approach based on i) models for ICD-10 diagnostic code sequences using a large real-world data set, ii) large language models for medical notes, and iii) contrastive pre-training to build an integrated model of both ICD-10 diagnostic codes and corresponding medical text. We demonstrate that a contrastive approach for pre-training improves performance over prior state-of-the-art models for the MIMIC-III-50, MIMIC-III-rare50, and MIMIC-III-full diagnostic coding tasks.

In this paper, we introduce a novel Multi-Modal Contrastive Pre-training Framework that synergistically combines X-rays, electrocardiograms (ECGs), and radiology/cardiology reports. Our approach leverages transformers to encode these diverse modalities into a unified representation space, aiming to enhance diagnostic accuracy and facilitate comprehensive patient assessments. We utilize LoRA-Peft to significantly reduce trainable parameters in the LLM and incorporate recent linear attention dropping strategy in the Vision Transformer(ViT) for smoother attention. Furthermore, we provide novel multimodal attention explanations and retrieval for our model. To the best of our knowledge, we are the first to propose an integrated model that combines X-ray, ECG, and Radiology/Cardiology Report with this approach. By utilizing contrastive loss, MoRE effectively aligns modality-specific features into a coherent embedding, which supports various downstream tasks such as zero-shot classification and multimodal retrieval. Employing our proposed methodology, we achieve state-of-the-art (SOTA) on the Mimic-IV, CheXpert, Edema Severity, and PtbXl downstream datasets, surpassing existing multimodal approaches. Our proposed framework shows significant improvements in capturing intricate inter-modal relationships and its robustness in medical diagnosis that establishes a framework for future research in multimodal learning in the healthcare sector.

Hybrid models that combine the language modeling capabilities of Attention layers with the efficiency of Recurrent layers (e.g., State Space Models) have gained traction in practically supporting long contexts in Large Language Model serving. Yet, the unique properties of these models complicate the usage of complementary efficiency optimizations such as prefix caching that skip redundant computations across requests. Most notably, their use of in-place state updates for recurrent layers precludes rolling back cache entries for partial sequence overlaps, and instead mandates only exact-match cache hits; the effect is a deluge of (large) cache entries per sequence, most of which yield minimal reuse opportunities. We present Marconi, the first system that supports efficient prefix caching with Hybrid LLMs. Key to Marconi are its novel admission and eviction policies that more judiciously assess potential cache entries based not only on recency, but also on (1) forecasts of their reuse likelihood across a taxonomy of different hit scenarios, and (2) the compute savings that hits deliver relative to memory footprints. Across diverse workloads and Hybrid models, Marconi achieves up to 34.4times higher token hit rates (71.1% or 617 ms lower TTFT) compared to state-of-the-art prefix caching systems.

Electrocardiogram (ECG) plays a foundational role in modern cardiovascular care, enabling non-invasive diagnosis of arrhythmias, myocardial ischemia, and conduction disorders. While machine learning has achieved expert-level performance in ECG interpretation, the development of clinically deployable multimodal AI systems remains constrained, primarily due to the lack of publicly available datasets that simultaneously incorporate raw signals, diagnostic images, and interpretation text. Most existing ECG datasets provide only single-modality data or, at most, dual modalities, making it difficult to build models that can understand and integrate diverse ECG information in real-world settings. To address this gap, we introduce MEETI (MIMIC-IV-Ext ECG-Text-Image), the first large-scale ECG dataset that synchronizes raw waveform data, high-resolution plotted images, and detailed textual interpretations generated by large language models. In addition, MEETI includes beat-level quantitative ECG parameters extracted from each lead, offering structured parameters that support fine-grained analysis and model interpretability. Each MEETI record is aligned across four components: (1) the raw ECG waveform, (2) the corresponding plotted image, (3) extracted feature parameters, and (4) detailed interpretation text. This alignment is achieved using consistent, unique identifiers. This unified structure supports transformer-based multimodal learning and supports fine-grained, interpretable reasoning about cardiac health. By bridging the gap between traditional signal analysis, image-based interpretation, and language-driven understanding, MEETI established a robust foundation for the next generation of explainable, multimodal cardiovascular AI. It offers the research community a comprehensive benchmark for developing and evaluating ECG-based AI systems.

The gap between speech and text modalities is a major challenge in speech-to-text translation (ST). Different methods have been proposed to reduce this gap, but most of them require architectural changes in ST training. In this work, we propose to mitigate this issue at the pre-training stage, requiring no change in the ST model. First, we show that the connectionist temporal classification (CTC) loss can reduce the modality gap by design. We provide a quantitative comparison with the more common cross-entropy loss, showing that pre-training with CTC consistently achieves better final ST accuracy. Nevertheless, CTC is only a partial solution and thus, in our second contribution, we propose a novel pre-training method combining CTC and optimal transport to further reduce this gap. Our method pre-trains a Siamese-like model composed of two encoders, one for acoustic inputs and the other for textual inputs, such that they produce representations that are close to each other in the Wasserstein space. Extensive experiments on the standard CoVoST-2 and MuST-C datasets show that our pre-training method applied to the vanilla encoder-decoder Transformer achieves state-of-the-art performance under the no-external-data setting, and performs on par with recent strong multi-task learning systems trained with external data. Finally, our method can also be applied on top of these multi-task systems, leading to further improvements for these models. Code and pre-trained models are available at https://github.com/formiel/fairseq.

Cardiac biosignals, such as electrocardiograms (ECG) and photoplethysmograms (PPG), are of paramount importance for the diagnosis, prevention, and management of cardiovascular diseases, and have been extensively used in a variety of clinical tasks. Conventional deep learning approaches for analyzing these signals typically rely on homogeneous datasets and static bespoke models, limiting their robustness and generalizability across diverse clinical settings and acquisition protocols. In this study, we present a cardiac sensing foundation model (CSFM) that leverages advanced transformer architectures and a generative, masked pretraining strategy to learn unified representations from vast, heterogeneous health records. Our model is pretrained on an innovative multi-modal integration of data from multiple large-scale datasets (including MIMIC-III-WDB, MIMIC-IV-ECG, and CODE), comprising cardiac signals and the corresponding clinical or machine-generated text reports from approximately 1.7 million individuals. We demonstrate that the embeddings derived from our CSFM not only serve as effective feature extractors across diverse cardiac sensing scenarios, but also enable seamless transfer learning across varying input configurations and sensor modalities. Extensive evaluations across diagnostic tasks, demographic information recognition, vital sign measurement, clinical outcome prediction, and ECG question answering reveal that CSFM consistently outperforms traditional one-modal-one-task approaches. Notably, CSFM exhibits robust performance across multiple ECG lead configurations from standard 12-lead systems to single-lead setups, and in scenarios where only ECG, only PPG, or a combination thereof is available. These findings highlight the potential of CSFM as a versatile and scalable solution, for comprehensive cardiac monitoring.

Cerebrovascular disease often requires multiple imaging modalities for accurate diagnosis, treatment, and monitoring. Computed Tomography Angiography (CTA) and Time-of-Flight Magnetic Resonance Angiography (TOF-MRA) are two common non-invasive angiography techniques, each with distinct strengths in accessibility, safety, and diagnostic accuracy. While CTA is more widely used in acute stroke due to its faster acquisition times and higher diagnostic accuracy, TOF-MRA is preferred for its safety, as it avoids radiation exposure and contrast agent-related health risks. Despite the predominant role of CTA in clinical workflows, there is a scarcity of open-source CTA data, limiting the research and development of AI models for tasks such as large vessel occlusion detection and aneurysm segmentation. This study explores diffusion-based image-to-image translation models to generate synthetic CTA images from TOF-MRA input. We demonstrate the modality conversion from TOF-MRA to CTA and show that diffusion models outperform a traditional U-Net-based approach. Our work compares different state-of-the-art diffusion architectures and samplers, offering recommendations for optimal model performance in this cross-modality translation task.

Electrocardiogram (ECG) is a widely used tool for assessing cardiac function due to its low cost and accessibility. Emergent research shows that ECGs can help make predictions on key outcomes traditionally derived from more complex modalities such as echocardiograms (ECHO), enabling the use of ECGs as a more accessible method to predict broader measurements of cardiac function. ECHO, in particular, are of great importance because they require considerable hospital resources while playing a key role in clinical cardiac assessment. To aid this use case, we introduce EchoingECG, a probabilistic student-teacher model that leverages uncertainty-aware ECG embeddings and ECHO supervision to improve ECG-based cardiac function prediction. Our approach integrates Probabilistic Cross-Modal Embeddings (PCME++), a probabilistic contrastive framework, with ECHO-CLIP, a vision-language pre-trained model trained on ECHO-text pairs, to distill ECHO knowledge into ECG representations. Through experiments and external validation, we showed that EchoingECG outperforms state-of-the-art foundation ECG models in zero-shot, few-shot, and fine-tune settings for ECHO predictions based on ECG. We also highlighted that variance estimation (enabled through our method) enhanced our understanding of model performance by identifying underlying regions of uncertainty within ECGs. The code is available: https://github.com/mcintoshML/EchoingECG.

Computed tomography perfusion (CTP) at admission is routinely used to estimate the ischemic core and penumbra, while follow-up diffusion-weighted MRI (DWI) provides the definitive infarct outcome. However, single time-point segmentations fail to capture the biological heterogeneity and temporal evolution of stroke. We propose a bi-temporal analysis framework that characterizes ischemic tissue using statistical descriptors, radiomic texture features, and deep feature embeddings from two architectures (mJ-Net and nnU-Net). Bi-temporal refers to admission (T1) and post-treatment follow-up (T2). All features are extracted at T1 from CTP, with follow-up DWI aligned to ensure spatial correspondence. Manually delineated masks at T1 and T2 are intersected to construct six regions of interest (ROIs) encoding both initial tissue state and final outcome. Features were aggregated per region and analyzed in feature space. Evaluation on 18 patients with successful reperfusion demonstrated meaningful clustering of region-level representations. Regions classified as penumbra or healthy at T1 that ultimately recovered exhibited feature similarity to preserved brain tissue, whereas infarct-bound regions formed distinct groupings. Both baseline GLCM and deep embeddings showed a similar trend: penumbra regions exhibit features that are significantly different depending on final state, whereas this difference is not significant for core regions. Deep feature spaces, particularly mJ-Net, showed strong separation between salvageable and non-salvageable tissue, with a penumbra separation index that differed significantly from zero (Wilcoxon signed-rank test). These findings suggest that encoder-derived feature manifolds reflect underlying tissue phenotypes and state transitions, providing insight into imaging-based quantification of stroke evolution.

Photon-counting CT (PCCT) provides superior image quality with higher spatial resolution and lower noise compared to conventional energy-integrating CT (EICT), but its limited clinical availability restricts large-scale research and clinical deployment. To bridge this gap, we propose SUMI, a simulated degradation-to-enhancement method that learns to reverse realistic acquisition artifacts in low-quality EICT by leveraging high-quality PCCT as reference. Our central insight is to explicitly model realistic acquisition degradations, transforming PCCT into clinically plausible lower-quality counterparts and learning to invert this process. The simulated degradations were validated for clinical realism by board-certified radiologists, enabling faithful supervision without requiring paired acquisitions at scale. As outcomes of this technical contribution, we: (1) train a latent diffusion model on 1,046 PCCTs, using an autoencoder first pre-trained on both these PCCTs and 405,379 EICTs from 145 hospitals to extract general CT latent features that we release for reuse in other generative medical imaging tasks; (2) construct a large-scale dataset of over 17,316 publicly available EICTs enhanced to PCCT-like quality, with radiologist-validated voxel-wise annotations of airway trees, arteries, veins, lungs, and lobes; and (3) demonstrate substantial improvements: across external data, SUMI outperforms state-of-the-art image translation methods by 15% in SSIM and 20% in PSNR, improves radiologist-rated clinical utility in reader studies, and enhances downstream top-ranking lesion detection performance, increasing sensitivity by up to 15% and F1 score by up to 10%. Our results suggest that emerging imaging advances can be systematically distilled into routine EICT using limited high-quality scans as reference.

ECG foundation models are increasingly popular due to their adaptability across various tasks. However, their clinical applicability is often limited by performance gaps compared to task-specific models, even after pre-training on large ECG datasets and fine-tuning on target data. This limitation is likely due to the lack of an effective post-training strategy. In this paper, we propose a simple yet effective post-training approach to enhance ECG foundation models. We evaluate it on a publicly available Transformer-based foundation model. Experiments across multiple ECG tasks show that our method consistently outperforms baseline fine-tuning. On the PTB-XL benchmarks, it improves macro AUROC by 0.7%-8.9% and macro AUPRC by 23.3%-77.9%, also outperforming several recent state-of-the-art approaches, including task-specific and advanced architectures. Further analyses demonstrate improved training dynamics and data efficiency, with only 30% of the training data outperforming the baseline trained on the full dataset. Ablation studies highlight the importance of stochastic depth and preview linear probing. These findings underscore the potential of post-training strategies to improve ECG foundation models, and we hope this work will contribute to the continued development of foundation models in the ECG domain.

Automatic coding of International Classification of Diseases (ICD) is a multi-label text categorization task that involves extracting disease or procedure codes from clinical notes. Despite the application of state-of-the-art natural language processing (NLP) techniques, there are still challenges including limited availability of data due to privacy constraints and the high variability of clinical notes caused by different writing habits of medical professionals and various pathological features of patients. In this work, we investigate the semi-structured nature of clinical notes and propose an automatic algorithm to segment them into sections. To address the variability issues in existing ICD coding models with limited data, we introduce a contrastive pre-training approach on sections using a soft multi-label similarity metric based on tree edit distance. Additionally, we design a masked section training strategy to enable ICD coding models to locate sections related to ICD codes. Extensive experimental results demonstrate that our proposed training strategies effectively enhance the performance of existing ICD coding methods.

In this paper the task of emotion recognition from speech is considered. Proposed approach uses deep recurrent neural network trained on a sequence of acoustic features calculated over small speech intervals. At the same time special probabilistic-nature CTC loss function allows to consider long utterances containing both emotional and neutral parts. The effectiveness of such an approach is shown in two ways. Firstly, the comparison with recent advances in this field is carried out. Secondly, human performance on the same task is measured. Both criteria show the high quality of the proposed method.

Electrocardiograms (ECGs) are non-invasive diagnostic tools crucial for detecting cardiac arrhythmic diseases in clinical practice. While ECG Self-supervised Learning (eSSL) methods show promise in representation learning from unannotated ECG data, they often overlook the clinical knowledge that can be found in reports. This oversight and the requirement for annotated samples for downstream tasks limit eSSL's versatility. In this work, we address these issues with the Multimodal ECG Representation Learning (MERL}) framework. Through multimodal learning on ECG records and associated reports, MERL is capable of performing zero-shot ECG classification with text prompts, eliminating the need for training data in downstream tasks. At test time, we propose the Clinical Knowledge Enhanced Prompt Engineering (CKEPE) approach, which uses Large Language Models (LLMs) to exploit external expert-verified clinical knowledge databases, generating more descriptive prompts and reducing hallucinations in LLM-generated content to boost zero-shot classification. Based on MERL, we perform the first benchmark across six public ECG datasets, showing the superior performance of MERL compared against eSSL methods. Notably, MERL achieves an average AUC score of 75.2% in zero-shot classification (without training data), 3.2% higher than linear probed eSSL methods with 10\% annotated training data, averaged across all six datasets. Code and models are available at https://github.com/cheliu-computation/MERL

This study aims to develop and evaluate an ensemble machine learning-based framework for the automatic detection of Wide QRS Complex Tachycardia (WCT) from ECG signals, emphasizing diagnostic accuracy and interpretability using Explainable AI. The proposed system integrates ensemble learning techniques, i.e., an optimized Random Forest known as CardioForest, and models like XGBoost and LightGBM. The models were trained and tested on ECG data from the publicly available MIMIC-IV dataset. The testing was carried out with the assistance of accuracy, balanced accuracy, precision, recall, F1 score, ROC-AUC, and error rate (RMSE, MAE) measures. In addition, SHAP (SHapley Additive exPlanations) was used to ascertain model explainability and clinical relevance. The CardioForest model performed best on all metrics, achieving a test accuracy of 94.95%, a balanced accuracy of 88.31%, and high precision and recall metrics. SHAP analysis confirmed the model's ability to rank the most relevant ECG features, such as QRS duration, in accordance with clinical intuitions, thereby fostering trust and usability in clinical practice. The findings recognize CardioForest as an extremely dependable and interpretable WCT detection model. Being able to offer accurate predictions and transparency through explainability makes it a valuable tool to help cardiologists make timely and well-informed diagnoses, especially for high-stakes and emergency scenarios.

We propose a new end-to-end neural acoustic model for automatic speech recognition. The model is composed of multiple blocks with residual connections between them. Each block consists of one or more modules with 1D time-channel separable convolutional layers, batch normalization, and ReLU layers. It is trained with CTC loss. The proposed network achieves near state-of-the-art accuracy on LibriSpeech and Wall Street Journal, while having fewer parameters than all competing models. We also demonstrate that this model can be effectively fine-tuned on new datasets.

This paper introduces a hybrid encryption framework combining classical cryptography (EdDSA, ECDH), post-quantum cryptography (ML-DSA-6x5, ML-KEM-768), and Quantum Key Distribution (QKD) via Guardian to counter quantum computing threats. Our prototype implements this integration, using a key derivation function to generate secure symmetric and HMAC keys, and evaluates its performance across execution time and network metrics. The approach improves data protection by merging classical efficiency with PQC's quantum resilience and QKD's key security, offering a practical transition path for cryptographic systems. This research lays the foundation for future adoption of PQC in securing digital communication.

Recently, In-context Learning (ICL) has become a significant inference paradigm in Large Multimodal Models (LMMs), utilizing a few in-context demonstrations (ICDs) to prompt LMMs for new tasks. However, the synergistic effects in multimodal data increase the sensitivity of ICL performance to the configurations of ICDs, stimulating the need for a more stable and general mapping function. Mathematically, in Transformer-based models, ICDs act as ``shift vectors'' added to the hidden states of query tokens. Inspired by this, we introduce Mimic In-Context Learning (MimIC) to learn stable and generalizable shift effects from ICDs. Specifically, compared with some previous shift vector-based methods, MimIC more strictly approximates the shift effects by integrating lightweight learnable modules into LMMs with four key enhancements: 1) inserting shift vectors after attention layers, 2) assigning a shift vector to each attention head, 3) making shift magnitude query-dependent, and 4) employing a layer-wise alignment loss. Extensive experiments on two LMMs (Idefics-9b and Idefics2-8b-base) across three multimodal tasks (VQAv2, OK-VQA, Captioning) demonstrate that MimIC outperforms existing shift vector-based methods. The code is available at https://github.com/Kamichanw/MimIC.

We release the largest public ECG dataset of continuous raw signals for representation learning containing 11 thousand patients and 2 billion labelled beats. Our goal is to enable semi-supervised ECG models to be made as well as to discover unknown subtypes of arrhythmia and anomalous ECG signal events. To this end, we propose an unsupervised representation learning task, evaluated in a semi-supervised fashion. We provide a set of baselines for different feature extractors that can be built upon. Additionally, we perform qualitative evaluations on results from PCA embeddings, where we identify some clustering of known subtypes indicating the potential for representation learning in arrhythmia sub-type discovery.

The volatility and complex dynamics of cryptocurrency markets present unique challenges for accurate price forecasting. This research proposes a hybrid deep learning and machine learning model that integrates Long Short-Term Memory (LSTM) networks and Extreme Gradient Boosting (XGBoost) for cryptocurrency price prediction. The LSTM component captures temporal dependencies in historical price data, while XGBoost enhances prediction by modeling nonlinear relationships with auxiliary features such as sentiment scores and macroeconomic indicators. The model is evaluated on historical datasets of Bitcoin, Ethereum, Dogecoin, and Litecoin, incorporating both global and localized exchange data. Comparative analysis using Mean Absolute Percentage Error (MAPE) and Min-Max Normalized Root Mean Square Error (MinMax RMSE) demonstrates that the LSTM+XGBoost hybrid consistently outperforms standalone models and traditional forecasting methods. This study underscores the potential of hybrid architectures in financial forecasting and provides insights into model adaptability across different cryptocurrencies and market contexts.

Heart failure (HF) affects 11.8% of adults aged 65 and older, reducing quality of life and longevity. Preventing HF can reduce morbidity and mortality. We hypothesized that artificial intelligence (AI) applied to 24-hour single-lead electrocardiogram (ECG) data could predict the risk of HF within five years. To research this, the Technion-Leumit Holter ECG (TLHE) dataset, including 69,663 recordings from 47,729 patients, collected over 20 years was used. Our deep learning model, DeepHHF, trained on 24-hour ECG recordings, achieved an area under the receiver operating characteristic curve of 0.80 that outperformed a model using 30-second segments and a clinical score. High-risk individuals identified by DeepHHF had a two-fold chance of hospitalization or death incidents. Explainability analysis showed DeepHHF focused on arrhythmias and heart abnormalities, with key attention between 8 AM and 3 PM. This study highlights the feasibility of deep learning to model 24-hour continuous ECG data, capturing paroxysmal events and circadian variations essential for reliable risk prediction. Artificial intelligence applied to single-lead Holter ECG is non-invasive, inexpensive, and widely accessible, making it a promising tool for HF risk prediction.

Accurate sleep staging is essential for diagnosing OSA and hypopnea in stroke patients. Although PSG is reliable, it is costly, labor-intensive, and manually scored. While deep learning enables automated EEG-based sleep staging in healthy subjects, our analysis shows poor generalization to clinical populations with disrupted sleep. Using Grad-CAM interpretations, we systematically demonstrate this limitation. We introduce iSLEEPS, a newly clinically annotated ischemic stroke dataset (to be publicly released), and evaluate a SE-ResNet plus bidirectional LSTM model for single-channel EEG sleep staging. As expected, cross-domain performance between healthy and diseased subjects is poor. Attention visualizations, supported by clinical expert feedback, show the model focuses on physiologically uninformative EEG regions in patient data. Statistical and computational analyses further confirm significant sleep architecture differences between healthy and ischemic stroke cohorts, highlighting the need for subject-aware or disease-specific models with clinical validation before deployment. A summary of the paper and the code is available at https://himalayansaswatabose.github.io/iSLEEPS_Explainability.github.io/

CTC compressor can be an effective approach to integrate audio encoders to decoder-only models, which has gained growing interest for different speech applications. In this work, we propose a novel CTC compressor based joint speech and text training (CJST) framework for decoder-only ASR. CJST matches speech and text modalities from both directions by exploring a simple modality adaptor and several features of the CTC compressor, including sequence compression, on-the-fly forced peaky alignment and CTC class embeddings. Experimental results on the Librispeech and TED-LIUM2 corpora show that the proposed CJST achieves an effective text injection without the need of duration handling, leading to the best performance for both in-domain and cross-domain scenarios. We also provide a comprehensive study on CTC compressor, covering various compression modes, edge case handling and behavior under both clean and noisy data conditions, which reveals the most robust setting to use CTC compressor for decoder-only models.

Connectionist Temporal Classification (CTC) suffers from the latency problem when applied to streaming models. We argue that in CTC lattice, the alignments that can access more future context are preferred during training, thereby leading to higher symbol delay. In this work we propose the delay-penalized CTC which is augmented with latency penalty regularization. We devise a flexible and efficient implementation based on the differentiable Finite State Transducer (FST). Specifically, by attaching a binary attribute to CTC topology, we can locate the frames that firstly emit non-blank tokens on the resulting CTC lattice, and add the frame offsets to the log-probabilities. Experimental results demonstrate the effectiveness of our proposed delay-penalized CTC, which is able to balance the delay-accuracy trade-off. Furthermore, combining the delay-penalized transducer enables the CTC model to achieve better performance and lower latency. Our work is open-sourced and publicly available https://github.com/k2-fsa/k2.

With the increasing availability of wearable devices, photoplethysmography (PPG) has emerged as a promising non-invasive tool for monitoring human hemodynamics. We propose a deep learning framework to estimate vascular age (AI-vascular age) from PPG signals, incorporating a distribution-aware loss to address biases caused by imbalanced data. The model was developed using data from the UK Biobank (UKB), with 98,672 participants in the development cohort and 113,559 participants (144,683 data pairs) for clinical evaluation. After adjusting for key confounders, individuals with a vascular age gap (AI-vascular age minus calendar age) exceeding 9 years had a significantly higher risk of major adverse cardiovascular and cerebrovascular events (MACCE) (HR = 2.37, p < 0.005) and secondary outcomes, including diabetes (HR = 2.69, p < 0.005), hypertension (HR = 2.88, p < 0.005), coronary heart disease (HR = 2.20, p < 0.005), heart failure (HR = 2.15, p < 0.005), myocardial infarction (HR = 2.51, p < 0.005), stroke (HR = 2.55, p < 0.005), and all-cause mortality (HR = 2.51, p < 0.005). Conversely, participants with a vascular age gap below -9 years exhibited a significantly lower incidence of these outcomes. We further evaluated the longitudinal applicability of AI-vascular age using serial PPG data from the UKB, demonstrating its value in risk stratification by leveraging AI-vascular age at two distinct time points to predict future MACCE incidence. External validation was performed on a MIMIC-III-derived cohort (n = 2,343), where each one-year increase in vascular age gap was significantly associated with elevated in-hospital mortality risk (OR = 1.02, p < 0.005). In conclusion, our study establishes AI-vascular age as a novel, non-invasive digital biomarker for cardiovascular health assessment.

Dual-encoder retrievers depend on the principle that relevant documents should score higher than irrelevant ones for a given query. Yet the dominant Noise Contrastive Estimation (NCE) objective, which underpins Contrastive Loss, optimizes a softened ranking surrogate that we rigorously prove is fundamentally oblivious to score separation quality and unrelated to AUC. This mismatch leads to poor calibration and suboptimal performance in downstream tasks like retrieval-augmented generation (RAG). To address this fundamental limitation, we introduce the MW loss, a new training objective that maximizes the Mann-Whitney U statistic, which is mathematically equivalent to the Area under the ROC Curve (AUC). MW loss encourages each positive-negative pair to be correctly ranked by minimizing binary cross entropy over score differences. We provide theoretical guarantees that MW loss directly upper-bounds the AoC, better aligning optimization with retrieval goals. We further promote ROC curves and AUC as natural threshold free diagnostics for evaluating retriever calibration and ranking quality. Empirically, retrievers trained with MW loss consistently outperform contrastive counterparts in AUC and standard retrieval metrics. Our experiments show that MW loss is an empirically superior alternative to Contrastive Loss, yielding better-calibrated and more discriminative retrievers for high-stakes applications like RAG.

Physiological foundation models (FMs) have shown promise for biosignal representation learning, yet most remain confined to a single modality such as EEG, ECG, or PPG, largely because paired multimodal datasets are scarce. In this paper, we present PanLUNA, a compact 5.4M-parameter pan-modal FM that jointly processes EEG, ECG, and PPG within a single shared encoder. Extending LUNA's channel-unification module, PanLUNA treats multimodal channels as entries in a unified query set augmented with sensor-type embeddings, enabling efficient cross-modal early fusion while remaining inherently robust to missing modalities at inference time. Despite its small footprint, PanLUNA matches or exceeds models up to 57times larger: 81.21% balanced accuracy on TUAB abnormal EEG detection and state-of-the-art 0.7416 balanced accuracy on HMC multimodal sleep staging. Quantization-aware training with INT8 weights recovers geq96% of full-precision performance, and deployment on the GAP9 ultra-low-power RISC-V microcontroller for wearables achieves 325.6 ms latency and 18.8 mJ per 10-second, 12-lead ECG inference, and 1.206 s latency at 68.65 mJ for multimodal 5-channel sleep staging over 30-second epochs.

The soft Dice loss (SDL) has taken a pivotal role in numerous automated segmentation pipelines in the medical imaging community. Over the last years, some reasons behind its superior functioning have been uncovered and further optimizations have been explored. However, there is currently no implementation that supports its direct utilization in scenarios involving soft labels. Hence, a synergy between the use of SDL and research leveraging the use of soft labels, also in the context of model calibration, is still missing. In this work, we introduce Dice semimetric losses (DMLs), which (i) are by design identical to SDL in a standard setting with hard labels, but (ii) can be employed in settings with soft labels. Our experiments on the public QUBIQ, LiTS and KiTS benchmarks confirm the potential synergy of DMLs with soft labels (e.g.\ averaging, label smoothing, and knowledge distillation) over hard labels (e.g.\ majority voting and random selection). As a result, we obtain superior Dice scores and model calibration, which supports the wider adoption of DMLs in practice. The code is available at https://github.com/zifuwanggg/JDTLosses{https://github.com/zifuwanggg/JDTLosses}.

Recognizing overlapping speech from multiple speakers in conversational scenarios is one of the most challenging problem for automatic speech recognition (ASR). Serialized output training (SOT) is a classic method to address multi-talker ASR, with the idea of concatenating transcriptions from multiple speakers according to the emission times of their speech for training. However, SOT-style transcriptions, derived from concatenating multiple related utterances in a conversation, depend significantly on modeling long contexts. Therefore, compared to traditional methods that primarily emphasize encoder performance in attention-based encoder-decoder (AED) architectures, a novel approach utilizing large language models (LLMs) that leverages the capabilities of pre-trained decoders may be better suited for such complex and challenging scenarios. In this paper, we propose an LLM-based SOT approach for multi-talker ASR, leveraging pre-trained speech encoder and LLM, fine-tuning them on multi-talker dataset using appropriate strategies. Experimental results demonstrate that our approach surpasses traditional AED-based methods on the simulated dataset LibriMix and achieves state-of-the-art performance on the evaluation set of the real-world dataset AMI, outperforming the AED model trained with 1000 times more supervised data in previous works.

Electrocardiogram (ECG) serves as the primary non-invasive diagnostic tool for cardiac conditions monitoring, are crucial in assisting clinicians. Recent studies have concentrated on classifying cardiac conditions using ECG data but have overlooked ECG report generation, which is not only time-consuming but also requires clinical expertise. To automate ECG report generation and ensure its versatility, we propose the Multimodal ECG Instruction Tuning (MEIT) framework, the first attempt to tackle ECG report generation with LLMs and multimodal instructions. To facilitate future research, we establish a benchmark to evaluate MEIT with various LLMs backbones across two large-scale ECG datasets. Our approach uniquely aligns the representations of the ECG signal and the report, and we conduct extensive experiments to benchmark MEIT with nine open source LLMs, using more than 800,000 ECG reports. MEIT's results underscore the superior performance of instruction-tuned LLMs, showcasing their proficiency in quality report generation, zero-shot capabilities, and resilience to signal perturbation. These findings emphasize the efficacy of our MEIT framework and its potential for real-world clinical application.

With an estimated 160,000 deaths in 2018, lung cancer is the most common cause of cancer death in the United States. Lung cancer CT screening has been shown to reduce mortality by up to 40% and is now included in US screening guidelines. Reducing the high error rates in lung cancer screening is imperative because of the high clinical and financial costs caused by diagnosis mistakes. Despite the use of standards for radiological diagnosis, persistent inter-grader variability and incomplete characterization of comprehensive imaging findings remain as limitations of current methods. These limitations suggest opportunities for more sophisticated systems to improve performance and inter-reader consistency. In this report, we reproduce a state-of-the-art deep learning algorithm for lung cancer risk prediction. Our model predicts malignancy probability and risk bucket classification from lung CT studies. This allows for risk categorization of patients being screened and suggests the most appropriate surveillance and management. Combining our solution high accuracy, consistency and fully automated nature, our approach may enable highly efficient screening procedures and accelerate the adoption of lung cancer screening.

Brain stroke remains one of the principal causes of death and disability worldwide, yet most tabular-data prediction models still hover below the 95% accuracy threshold, limiting real-world utility. Addressing this gap, the present work develops and validates a completely data-driven and interpretable machine-learning framework designed to predict strokes using ten routinely gathered demographic, lifestyle, and clinical variables sourced from a public cohort of 4,981 records. We employ a detailed exploratory data analysis (EDA) to understand the dataset's structure and distribution, followed by rigorous data preprocessing, including handling missing values, outlier removal, and class imbalance correction using Synthetic Minority Over-sampling Technique (SMOTE). To streamline feature selection, point-biserial correlation and random-forest Gini importance were utilized, and ten varied algorithms-encompassing tree ensembles, boosting, kernel methods, and a multilayer neural network-were optimized using stratified five-fold cross-validation. Their predictions based on probabilities helped us build the proposed model, which included Random Forest, XGBoost, LightGBM, and a support-vector classifier, with logistic regression acting as a meta-learner. The proposed model achieved an accuracy rate of 97.2% and an F1-score of 97.15%, indicating a significant enhancement compared to the leading individual model, LightGBM, which had an accuracy of 91.4%. Our study's findings indicate that rigorous preprocessing, coupled with a diverse hybrid model, can convert low-cost tabular data into a nearly clinical-grade stroke-risk assessment tool.

Gastrointestinal malignancies constitute a leading cause of cancer-related mortality worldwide, with advanced-stage prognosis remaining particularly dismal. Originating as a groundbreaking technique for early gastric cancer treatment, Endoscopic Submucosal Dissection has evolved into a versatile intervention for diverse gastrointestinal lesions. While computer-assisted systems significantly enhance procedural precision and safety in ESD, their clinical adoption faces a critical bottleneck: reliable surgical phase recognition within complex endoscopic workflows. Current state-of-the-art approaches predominantly rely on multi-stage refinement architectures that iteratively optimize temporal predictions. In this paper, we present Clinical Prior Knowledge-Constrained Diffusion (CPKD), a novel generative framework that reimagines phase recognition through denoising diffusion principles while preserving the core iterative refinement philosophy. This architecture progressively reconstructs phase sequences starting from random noise and conditioned on visual-temporal features. To better capture three domain-specific characteristics, including positional priors, boundary ambiguity, and relation dependency, we design a conditional masking strategy. Furthermore, we incorporate clinical prior knowledge into the model training to improve its ability to correct phase logical errors. Comprehensive evaluations on ESD820, Cholec80, and external multi-center demonstrate that our proposed CPKD achieves superior or comparable performance to state-of-the-art approaches, validating the effectiveness of diffusion-based generative paradigms for surgical phase recognition.

Electrocardiograms (ECGs) play a vital role in monitoring cardiac health and diagnosing heart diseases. However, traditional deep learning approaches for ECG analysis rely heavily on large-scale manual annotations, which are both time-consuming and resource-intensive to obtain. To overcome this limitation, self-supervised learning (SSL) has emerged as a promising alternative, enabling the extraction of robust ECG representations that can be efficiently transferred to various downstream tasks. While previous studies have explored SSL for ECG pretraining and multi-modal ECG-language alignment, they often fail to capture the multi-scale nature of ECG signals. As a result, these methods struggle to learn generalized representations due to their inability to model the hierarchical structure of ECG data. To address this gap, we introduce MELP, a novel Multi-scale ECG-Language Pretraining (MELP) model that fully leverages hierarchical supervision from ECG-text pairs. MELP first pretrains a cardiology-specific language model to enhance its understanding of clinical text. It then applies three levels of cross-modal supervision-at the token, beat, and rhythm levels-to align ECG signals with textual reports, capturing structured information across different time scales. We evaluate MELP on three public ECG datasets across multiple tasks, including zero-shot ECG classification, linear probing, and transfer learning. Experimental results demonstrate that MELP outperforms existing SSL methods, underscoring its effectiveness and adaptability across diverse clinical applications. Our code is available at https://github.com/HKU-MedAI/MELP.

Collecting audio-text pairs is expensive; however, it is much easier to access text-only data. Unless using shallow fusion, end-to-end automatic speech recognition (ASR) models require architecture modifications or additional training schemes to use text-only data. Inspired by recent advances in decoder-only language models (LMs), such as GPT-3 and PaLM adopted for speech-processing tasks, we propose using a decoder-only architecture for ASR with simple text augmentation. To provide audio information, encoder features compressed by CTC prediction are used as prompts for the decoder, which can be regarded as refining CTC prediction using the decoder-only model. Because the decoder architecture is the same as an autoregressive LM, it is simple to enhance the model by leveraging external text data with LM training. An experimental comparison using LibriSpeech and Switchboard shows that our proposed models with text augmentation training reduced word error rates from ordinary CTC by 0.3% and 1.4% on LibriSpeech test-clean and testother set, respectively, and 2.9% and 5.0% on Switchboard and CallHome. The proposed model had advantage on computational efficiency compared with conventional encoder-decoder ASR models with a similar parameter setup, and outperformed them on the LibriSpeech 100h and Switchboard training scenarios.

Consistency Models (CM) (Song et al., 2023) accelerate score-based diffusion model sampling at the cost of sample quality but lack a natural way to trade-off quality for speed. To address this limitation, we propose Consistency Trajectory Model (CTM), a generalization encompassing CM and score-based models as special cases. CTM trains a single neural network that can -- in a single forward pass -- output scores (i.e., gradients of log-density) and enables unrestricted traversal between any initial and final time along the Probability Flow Ordinary Differential Equation (ODE) in a diffusion process. CTM enables the efficient combination of adversarial training and denoising score matching loss to enhance performance and achieves new state-of-the-art FIDs for single-step diffusion model sampling on CIFAR-10 (FID 1.73) and ImageNet at 64x64 resolution (FID 1.92). CTM also enables a new family of sampling schemes, both deterministic and stochastic, involving long jumps along the ODE solution trajectories. It consistently improves sample quality as computational budgets increase, avoiding the degradation seen in CM. Furthermore, unlike CM, CTM's access to the score function can streamline the adoption of established controllable/conditional generation methods from the diffusion community. This access also enables the computation of likelihood. The code is available at https://github.com/sony/ctm.

Accurate prediction of major adverse cardiovascular events recurrence risk in acute myocardial infarction patients based on postoperative cardiac MRI and associated clinical notes is crucial for precision treatment and personalized intervention. Existing methods primarily focus on risk stratification capability while overlooking the need for intermediate robust reasoning and model interpretability in clinical practice. Moreover, end-to-end risk prediction using LLM/VLM faces significant challenges due to data limitations and modeling complexity. To bridge this gap, we propose CardioCoT, a novel two-stage hierarchical reasoning-enhanced survival analysis framework designed to enhance both model interpretability and predictive performance. In the first stage, we employ an evidence-augmented self-refinement mechanism to guide LLM/VLMs in generating robust hierarchical reasoning trajectories based on associated radiological findings. In the second stage, we integrate the reasoning trajectories with imaging data for risk model training and prediction. CardioCoT demonstrates superior performance in MACE recurrence risk prediction while providing interpretable reasoning processes, offering valuable insights for clinical decision-making.

Coronary microvascular dysfunction (CMD), characterized by impaired regulation of blood flow in the coronary microcirculation, plays a key role in the pathogenesis of ischemic heart disease and is increasingly recognized as a contributor to adverse cardiovascular outcomes. Despite its clinical importance, CMD remains underdiagnosed due to the reliance on invasive procedures such as pressure wire-based measurements of the index of microcirculatory resistance (IMR) and coronary flow reserve (CFR), which are costly, time-consuming, and carry procedural risks. To date, no study has sought to quantify CMD indices using data-driven approaches while leveraging the rich information contained in coronary angiograms. To address these limitations, this study proposes a novel data-driven framework for inference of CMD indices based on coronary angiography. A physiologically validated multi-physics model was used to generate synthetic datasets for data-driven model training, consisting of CMD indices and computational angiograms with corresponding contrast intensity profiles (CIPs). Two neural network architectures were developed: a single-input-channel encoder-MLP model for IMR prediction and a dual-input-channel encoder-MLP model for CFR prediction, both incorporating epistemic uncertainty estimation to quantify prediction confidence. Results demonstrate that the data-driven models achieve high predictive accuracy when evaluated against physics-based synthetic datasets, and that the uncertainty estimates are positively correlated with prediction errors. Furthermore, the utility of CIPs as informative surrogates for coronary physiology is demonstrated, underscoring the potential of the proposed framework to enable accurate, real-time, image-based CMD assessment using routine angiography without the need for more invasive approaches.

Generating synthetic Computed Tomography (CT) images from Cone Beam Computed Tomography (CBCT) is desirable for improving the image quality of CBCT. Existing synthetic CT (sCT) generation methods using Convolutional Neural Networks (CNN) and Transformers often face difficulties in effectively capturing both global and local features and contrasts for high-quality sCT generation. In this work, we propose a Global-Local Feature and Contrast learning (GLFC) framework for sCT generation. First, a Mamba-Enhanced UNet (MEUNet) is introduced by integrating Mamba blocks into the skip connections of a high-resolution UNet for effective global and local feature learning. Second, we propose a Multiple Contrast Loss (MCL) that calculates synthetic loss at different intensity windows to improve quality for both soft tissues and bone regions. Experiments on the SynthRAD2023 dataset demonstrate that GLFC improved the SSIM of sCT from 77.91% to 91.50% compared with the original CBCT, and significantly outperformed several existing methods for sCT generation. The code is available at https://github.com/HiLab-git/GLFC

Medical coding translates clinical documentation into standardized codes for billing, research, and public health, but manual coding is time-consuming and error-prone. Existing automation efforts rely on small datasets that poorly represent real-world patient heterogeneity. We trained a language model on 5.8 million electronic health records from 1.8 million patients across nearly all specialties in Eastern Denmark (2006--2016) to predict ICD-10 codes from clinical notes, medications, and laboratory results. Evaluated on 270,000 held-out patients, the model achieved a micro F1 of 71.8% and a top-10 recall of 95.5%. Performance varied by specialty (F1: 53--91%), with higher scores in specialties with well-defined diagnostic criteria. Codes appearing predominantly as secondary diagnoses had markedly lower F1 scores. For three such codes (suicide-related behaviors, weight disorders, and hypertension), the model identified thousands of uncoded cases, of which 76-86% were confirmed valid upon manual review, suggesting systematic under-coding rather than model error. These findings suggest under-coding of secondary diagnoses in Eastern Denmark during this period, with potential implications for epidemiological research, public health surveillance, and understanding of multimorbidity. Similar time constraints and reimbursement structures in other healthcare systems suggest this may not be isolated to this dataset. The model can automate coding for approximately 50% of cases and provide accurate suggestions for most others, and may offer a practical solution to help capture missed secondary conditions.

Accurate diagnosis of heart arrhythmias requires the interpretation of electrocardiograms (ECG), which capture the electrical activity of the heart. Automating this process through machine learning is challenging due to the need for large annotated datasets, which are difficult and costly to collect. To address this issue, transfer learning is often employed, where models are pre-trained on large datasets and fine-tuned for specific ECG classification tasks with limited labeled data. Self-supervised learning has become a widely adopted pre-training method, enabling models to learn meaningful representations from unlabeled datasets. In this work, we explore the joint-embedding predictive architecture (JEPA) for self-supervised learning from ECG data. Unlike invariance-based methods, JEPA does not rely on hand-crafted data augmentations, and unlike generative methods, it predicts latent features rather than reconstructing input data. We create a large unsupervised pre-training dataset by combining ten public ECG databases, amounting to over one million records. We pre-train Vision Transformers using JEPA on this dataset and fine-tune them on various PTB-XL benchmarks. Our results show that JEPA outperforms existing invariance-based and generative approaches, achieving an AUC of 0.945 on the PTB-XL all statements task. JEPA consistently learns the highest quality representations, as demonstrated in linear evaluations, and proves advantageous for pre-training even in the absence of additional data.

Tokenization strategies shape how models process electronic health records, yet fair comparisons of their effectiveness remain limited. We present a systematic evaluation of tokenization approaches for clinical time series modeling using transformer-based architectures, revealing task-dependent and sometimes counterintuitive findings about temporal and value feature importance. Through controlled ablations across four clinical prediction tasks on MIMIC-IV, we demonstrate that explicit time encodings provide no consistent statistically significant benefit for the evaluated downstream tasks. Value features show task-dependent importance, affecting mortality prediction but not readmission, suggesting code sequences alone can carry sufficient predictive signal. We further show that frozen pretrained code encoders dramatically outperform their trainable counterparts while requiring dramatically fewer parameters. Larger clinical encoders provide consistent improvements across tasks, benefiting from frozen embeddings that eliminate computational overhead. Our controlled evaluation enables fairer tokenization comparisons and demonstrates that simpler, parameter-efficient approaches can, in many cases, achieve strong performance, though the optimal tokenization strategy remains task-dependent.

Spatially variant dynamic convolution provides a principled approach of integrating spatial adaptivity into deep neural networks. However, mainstream designs in medical segmentation commonly generate dynamic kernels through average pooling, which implicitly collapses high-frequency spatial details into a coarse, spatially-compressed representation, leading to over-smoothed predictions that degrade the fidelity of fine-grained clinical structures. To address this limitation, we propose a novel Structure-Guided Dynamic Convolution (SGDC) mechanism, which leverages an explicitly supervised structure-extraction branch to guide the generation of dynamic kernels and gating signals for structure-aware feature modulation. Specifically, the high-fidelity boundary information from this auxiliary branch is fused with semantic features to enable spatially-precise feature modulation. By replacing context aggregation with pixel-wise structural guidance, the proposed design effectively prevents the information loss introduced by average pooling. Experimental results show that SGDC achieves state-of-the-art performance on ISIC 2016, PH2, ISIC 2018, and CoNIC datasets, delivering superior boundary fidelity by reducing the Hausdorff Distance (HD95) by 2.05, and providing consistent IoU gains of 0.99\%-1.49\% over pooling-based baselines. Moreover, the mechanism exhibits strong potential for extension to other fine-grained, structure-sensitive vision tasks, such as small-object detection, offering a principled solution for preserving structural integrity in medical image analysis. To facilitate reproducibility and encourage further research, the implementation code for both our SGE and SGDC modules has been is publicly released at https://github.com/solstice0621/SGDC.

Automatic International Classification of Diseases (ICD) coding aims to assign multiple ICD codes to a medical note with average length of 3,000+ tokens. This task is challenging due to a high-dimensional space of multi-label assignment (tens of thousands of ICD codes) and the long-tail challenge: only a few codes (common diseases) are frequently assigned while most codes (rare diseases) are infrequently assigned. This study addresses the long-tail challenge by adapting a prompt-based fine-tuning technique with label semantics, which has been shown to be effective under few-shot setting. To further enhance the performance in medical domain, we propose a knowledge-enhanced longformer by injecting three domain-specific knowledge: hierarchy, synonym, and abbreviation with additional pretraining using contrastive learning. Experiments on MIMIC-III-full, a benchmark dataset of code assignment, show that our proposed method outperforms previous state-of-the-art method in 14.5% in marco F1 (from 10.3 to 11.8, P<0.001). To further test our model on few-shot setting, we created a new rare diseases coding dataset, MIMIC-III-rare50, on which our model improves marco F1 from 17.1 to 30.4 and micro F1 from 17.2 to 32.6 compared to previous method.

Convolutional Neural Networks (CNN) are known to exhibit poor generalization performance under distribution shifts. Their generalization have been studied extensively, and one line of work approaches the problem from a frequency-centric perspective. These studies highlight the fact that humans and CNNs might focus on different frequency components of an image. First, inspired by these observations, we propose a simple yet effective data augmentation method HybridAugment that reduces the reliance of CNNs on high-frequency components, and thus improves their robustness while keeping their clean accuracy high. Second, we propose HybridAugment++, which is a hierarchical augmentation method that attempts to unify various frequency-spectrum augmentations. HybridAugment++ builds on HybridAugment, and also reduces the reliance of CNNs on the amplitude component of images, and promotes phase information instead. This unification results in competitive to or better than state-of-the-art results on clean accuracy (CIFAR-10/100 and ImageNet), corruption benchmarks (ImageNet-C, CIFAR-10-C and CIFAR-100-C), adversarial robustness on CIFAR-10 and out-of-distribution detection on various datasets. HybridAugment and HybridAugment++ are implemented in a few lines of code, does not require extra data, ensemble models or additional networks.

Electrocardiogram (ECG) interpretation requires specialized expertise, often involving synthesizing insights from ECG signals with complex clinical queries posed in natural language. The scarcity of labeled ECG data coupled with the diverse nature of clinical inquiries presents a significant challenge for developing robust and adaptable ECG diagnostic systems. This work introduces a novel multimodal meta-learning method for few-shot ECG question answering, addressing the challenge of limited labeled data while leveraging the rich knowledge encoded within large language models (LLMs). Our LLM-agnostic approach integrates a pre-trained ECG encoder with a frozen LLM (e.g., LLaMA and Gemma) via a trainable fusion module, enabling the language model to reason about ECG data and generate clinically meaningful answers. Extensive experiments demonstrate superior generalization to unseen diagnostic tasks compared to supervised baselines, achieving notable performance even with limited ECG leads. For instance, in a 5-way 5-shot setting, our method using LLaMA-3.1-8B achieves accuracy of 84.6%, 77.3%, and 69.6% on single verify, choose and query question types, respectively. These results highlight the potential of our method to enhance clinical ECG interpretation by combining signal processing with the nuanced language understanding capabilities of LLMs, particularly in data-constrained scenarios.

Four-dimensional computed tomography (4D CT) reconstruction is crucial for capturing dynamic anatomical changes but faces inherent limitations from conventional phase-binning workflows. Current methods discretize temporal resolution into fixed phases with respiratory gating devices, introducing motion misalignment and restricting clinical practicality. In this paper, We propose X^2-Gaussian, a novel framework that enables continuous-time 4D-CT reconstruction by integrating dynamic radiative Gaussian splatting with self-supervised respiratory motion learning. Our approach models anatomical dynamics through a spatiotemporal encoder-decoder architecture that predicts time-varying Gaussian deformations, eliminating phase discretization. To remove dependency on external gating devices, we introduce a physiology-driven periodic consistency loss that learns patient-specific breathing cycles directly from projections via differentiable optimization. Extensive experiments demonstrate state-of-the-art performance, achieving a 9.93 dB PSNR gain over traditional methods and 2.25 dB improvement against prior Gaussian splatting techniques. By unifying continuous motion modeling with hardware-free period learning, X^2-Gaussian advances high-fidelity 4D CT reconstruction for dynamic clinical imaging. Project website at: https://x2-gaussian.github.io/.

Accurate medical classification requires a large number of multi-modal data, and in many cases, different feature types. Previous studies have shown promising results when using multi-modal data, outperforming single-modality models when classifying diseases such as Alzheimer's Disease (AD). However, those models are usually not flexible enough to handle missing modalities. Currently, the most common workaround is discarding samples with missing modalities which leads to considerable data under-utilization. Adding to the fact that labeled medical images are already scarce, the performance of data-driven methods like deep learning can be severely hampered. Therefore, a multi-modal method that can handle missing data in various clinical settings is highly desirable. In this paper, we present Multi-Modal Mixing Transformer (3MAT), a disease classification transformer that not only leverages multi-modal data but also handles missing data scenarios. In this work, we test 3MT for AD and Cognitively normal (CN) classification and mild cognitive impairment (MCI) conversion prediction to progressive MCI (pMCI) or stable MCI (sMCI) using clinical and neuroimaging data. The model uses a novel Cascaded Modality Transformer architecture with cross-attention to incorporate multi-modal information for more informed predictions. We propose a novel modality dropout mechanism to ensure an unprecedented level of modality independence and robustness to handle missing data scenarios. The result is a versatile network that enables the mixing of arbitrary numbers of modalities with different feature types and also ensures full data utilization missing data scenarios. The model is trained and evaluated on the ADNI dataset with the SOTRA performance and further evaluated with the AIBL dataset with missing data.

We participated in the SynthRAD2025 challenge (Tasks 1 and 2) with a unified pipeline for synthetic CT (sCT) generation from MRI and CBCT, implemented using the KonfAI framework. Our model is a 2.5D U-Net++ with a ResNet-34 encoder, trained jointly across anatomical regions and fine-tuned per region. The loss function combined pixel-wise L1 loss with IMPACT-Synth, a perceptual loss derived from SAM and TotalSegmentator to enhance structural fidelity. Training was performed using AdamW (initial learning rate = 0.001, halved every 25k steps) on patch-based, normalized, body-masked inputs (320x320 for MRI, 256x256 for CBCT), with random flipping as the only augmentation. No post-processing was applied. Final predictions leveraged test-time augmentation and five-fold ensembling. The best model was selected based on validation MAE. Two registration strategies were evaluated: (i) Elastix with mutual information, consistent with the challenge pipeline, and (ii) IMPACT, a feature-based similarity metric leveraging pretrained segmentation networks. On the local test sets, IMPACT-based registration achieved more accurate and anatomically consistent alignments than mutual-information-based registration, resulting in improved sCT synthesis with lower MAE and more realistic anatomical structures. On the public validation set, however, models trained with Elastix-aligned data achieved higher scores, reflecting a registration bias favoring alignment strategies consistent with the evaluation pipeline. This highlights how registration errors can propagate into supervised learning, influencing both training and evaluation, and potentially inflating performance metrics at the expense of anatomical fidelity. By promoting anatomically consistent alignment, IMPACT helps mitigate this bias and supports the development of more robust and generalizable sCT synthesis models.

Electrocardiography plays a central role in cardiovascular diagnostics, yet existing automated approaches often struggle to generalize across clinical tasks and offer limited support for open-ended reasoning. We present DiagECG, a novel framework that integrates time-series and language modeling by enabling large language models to process 12-lead ECG signals for clinical text generation tasks. Our approach discretizes continuous ECG embeddings into symbolic tokens using a lead-independent encoder and quantization module. These tokens are then used to extend the vocabulary of LLM, allowing the model to handle both ECG and natural language inputs in a unified manner. To bridge the modality gap, we pretrain the model on an autoregressive ECG forecasting task, enabling the LLM to model temporal dynamics using its native language modeling capabilities. Finally, we perform instruction tuning on both ECG question answering and diagnostic report generation. Without modifying the core model, DiagECG achieves strong performance across tasks while maintaining generalization to out-of-distribution settings. Extensive experiments demonstrate the effectiveness of each component and highlight the potential of integrating symbolic ECG representations into LLMs for medical reasoning.

Recent progress in large language models demonstrates that hybrid architectures--combining self-attention mechanisms with structured state space models like Mamba--can achieve a compelling balance between modeling quality and computational efficiency, particularly for long-context tasks. While these hybrid models show promising performance, systematic comparisons of hybridization strategies and analyses on the key factors behind their effectiveness have not been clearly shared to the community. In this work, we present a holistic evaluation of hybrid architectures based on inter-layer (sequential) or intra-layer (parallel) fusion. We evaluate these designs from a variety of perspectives: language modeling performance, long-context capabilities, scaling analysis, and training and inference efficiency. By investigating the core characteristics of their computational primitive, we identify the most critical elements for each hybridization strategy and further propose optimal design recipes for both hybrid models. Our comprehensive analysis provides practical guidance and valuable insights for developing hybrid language models, facilitating the optimization of architectural configurations.

While recent multimodal large language models (MLLMs) have advanced automated ECG interpretation, they still face two key limitations: (1) insufficient multimodal synergy between time series signals and visual ECG representations, and (2) limited explainability in linking diagnoses to granular waveform evidence. We introduce GEM, the first MLLM unifying ECG time series, 12-lead ECG images and text for grounded and clinician-aligned ECG interpretation. GEM enables feature-grounded analysis, evidence-driven reasoning, and a clinician-like diagnostic process through three core innovations: a dual-encoder framework extracting complementary time series and image features, cross-modal alignment for effective multimodal understanding, and knowledge-guided instruction generation for generating high-granularity grounding data (ECG-Grounding) linking diagnoses to measurable parameters (e.g., QRS/PR Intervals). Additionally, we propose the Grounded ECG Understanding task, a clinically motivated benchmark designed to comprehensively assess the MLLM's capability in grounded ECG understanding. Experimental results on both existing and our proposed benchmarks show GEM significantly improves predictive performance (CSN 7.4% uparrow), explainability (22.7% uparrow), and grounding (24.8% uparrow), making it more suitable for real-world clinical applications. GitHub repository: https://github.com/lanxiang1017/GEM.git

Accurate sequence-to-sequence (seq2seq) alignment is critical for applications like medical speech analysis and language learning tools relying on automatic speech recognition (ASR). State-of-the-art end-to-end (E2E) ASR systems, such as the Connectionist Temporal Classification (CTC) and transducer-based models, suffer from peaky behavior and alignment inaccuracies. In this paper, we propose a novel differentiable alignment framework based on one-dimensional optimal transport, enabling the model to learn a single alignment and perform ASR in an E2E manner. We introduce a pseudo-metric, called Sequence Optimal Transport Distance (SOTD), over the sequence space and discuss its theoretical properties. Based on the SOTD, we propose Optimal Temporal Transport Classification (OTTC) loss for ASR and contrast its behavior with CTC. Experimental results on the TIMIT, AMI, and LibriSpeech datasets show that our method considerably improves alignment performance compared to CTC and the more recently proposed Consistency-Regularized CTC, though with a trade-off in ASR performance. We believe this work opens new avenues for seq2seq alignment research, providing a solid foundation for further exploration and development within the community. Our code is publicly available at: https://github.com/idiap/OTTC

A ventilator simulation system can make mechanical ventilation easier and more effective. As a result, predicting a patient's ventilator pressure is essential when designing a simulation ventilator. We suggested a hybrid deep learning-based approach to forecast required ventilator pressure for patients. This system is made up of Bi-LSTM and Bi-GRU networks. The SELU activation function was used in our proposed model. MAE and MSE were used to examine the accuracy of the proposed model so that our proposed methodology can be applied to real-world problems. The model performed well against test data and created far too few losses. Major parts of our research were data collection, data analysis, data cleaning, building hybrid Bi-LSTM and Bi-GRU model, training the model, model evaluation, and result analysis. We compared the results of our research with some contemporary works, and our proposed model performed better than those models.

Lack of large expert annotated MR datasets makes training deep learning models difficult. Therefore, a cross-modality (MR-CT) deep learning segmentation approach that augments training data using pseudo MR images produced by transforming expert-segmented CT images was developed. Eighty-One T2-weighted MRI scans from 28 patients with non-small cell lung cancers were analyzed. Cross-modality prior encoding the transformation of CT to pseudo MR images resembling T2w MRI was learned as a generative adversarial deep learning model. This model augmented training data arising from 6 expert-segmented T2w MR patient scans with 377 pseudo MRI from non-small cell lung cancer CT patient scans with obtained from the Cancer Imaging Archive. A two-dimensional Unet implemented with batch normalization was trained to segment the tumors from T2w MRI. This method was benchmarked against (a) standard data augmentation and two state-of-the art cross-modality pseudo MR-based augmentation and (b) two segmentation networks. Segmentation accuracy was computed using Dice similarity coefficient (DSC), Hausdroff distance metrics, and volume ratio. The proposed approach produced the lowest statistical variability in the intensity distribution between pseudo and T2w MR images measured as Kullback-Leibler divergence of 0.069. This method produced the highest segmentation accuracy with a DSC of 0.75 and the lowest Hausdroff distance on the test dataset. This approach produced highly similar estimations of tumor growth as an expert (P = 0.37). A novel deep learning MR segmentation was developed that overcomes the limitation of learning robust models from small datasets by leveraging learned cross-modality priors to augment training. The results show the feasibility of the approach and the corresponding improvement over the state-of-the-art methods.

We propose self-speculative decoding for speech-aware LLMs by using the CTC encoder as a draft model to accelerate auto-regressive (AR) inference and improve ASR accuracy. Our three-step procedure works as follows: (1) if the frame entropies of the CTC output distributions are below a threshold, the greedy CTC hypothesis is accepted as final; (2) otherwise, the CTC hypothesis is verified in a single LLM forward pass using a relaxed acceptance criterion based on token likelihoods; (3) if verification fails, AR decoding resumes from the accepted CTC prefix. Experiments on nine corpora and five languages show that this approach can simultaneously accelerate decoding and reduce WER. On the HuggingFace Open ASR benchmark with a 1B parameter LLM and 440M parameter CTC encoder, we achieve a record 5.58% WER and improve the inverse real time factor by a factor of 4.4 with only a 12% relative WER increase over AR search. Code and model weights are publicly available under a permissive license.

Large Language Models (LLMs) have shown remarkable adaptability across domains beyond text, specifically electrocardiograms (ECGs). More specifically, there is a growing body of work exploring the task of generating text from a multi-channeled ECG and corresponding textual prompt. Current approaches typically involve pretraining an ECG-specific encoder with a self-supervised learning (SSL) objective and using the features output by the pretrained encoder to finetune a LLM for natural language generation (NLG). However, these methods are limited by 1) inefficiency from two-stage training and 2) interpretability challenges with encoder-generated features. To address these limitations, we introduce ECG-Byte, an adapted byte pair encoding (BPE) tokenizer pipeline for autoregressive language modeling of ECGs. This approach compresses and encodes ECG signals into tokens, enabling end-to-end LLM training by combining ECG and text tokens directly, while being much more interpretable since the ECG tokens can be directly mapped back to the original signal. Using ECG-Byte, we achieve competitive performance in NLG tasks in only half the time and ~48% of the data required by two-stage approaches.

Recently, end-to-end models have been widely used in automatic speech recognition (ASR) systems. Two of the most representative approaches are connectionist temporal classification (CTC) and attention-based encoder-decoder (AED) models. Autoregressive transformers, variants of AED, adopt an autoregressive mechanism for token generation and thus are relatively slow during inference. In this paper, we present a comprehensive study of a CTC Alignment-based Single-Step Non-Autoregressive Transformer (CASS-NAT) for end-to-end ASR. In CASS-NAT, word embeddings in the autoregressive transformer (AT) are substituted with token-level acoustic embeddings (TAE) that are extracted from encoder outputs with the acoustical boundary information offered by the CTC alignment. TAE can be obtained in parallel, resulting in a parallel generation of output tokens. During training, Viterbi-alignment is used for TAE generation, and multiple training strategies are further explored to improve the word error rate (WER) performance. During inference, an error-based alignment sampling method is investigated in depth to reduce the alignment mismatch in the training and testing processes. Experimental results show that the CASS-NAT has a WER that is close to AT on various ASR tasks, while providing a ~24x inference speedup. With and without self-supervised learning, we achieve new state-of-the-art results for non-autoregressive models on several datasets. We also analyze the behavior of the CASS-NAT decoder to explain why it can perform similarly to AT. We find that TAEs have similar functionality to word embeddings for grammatical structures, which might indicate the possibility of learning some semantic information from TAEs without a language model.

The emergence of Deep Neural Network (DNN) and machine learning-based applications paved the way for a new generation of hybrid hardware platforms. Hybrid platforms embed several cores and accelerators in a small package. However, in order to satisfy the Size, Weight and Power (SWaP) constraints, limited and shared resources are integrated. This paper presents an overview of the standards applicable to the certification of hybrid platforms and an early mapping of their objectives to said platforms. In particular, we consider how the classification of AMC20-152A for airborne electronic hardware applies to hybrid platforms. We also consider AMC20-193 for multi-core platforms, and how this standard fits different types of accelerators.

This study investigates the feasibility and performance of federated learning (FL) for multi-label ICD code classification using clinical notes from the MIMIC-IV dataset. Unlike previous approaches that rely on centralized training or fine-tuned large language models, we propose a lightweight and scalable pipeline combining frozen text embeddings with simple multilayer perceptron (MLP) classifiers. This design offers a privacy-preserving and deployment-efficient alternative for clinical NLP applications, particularly suited to distributed healthcare settings. Extensive experiments across both centralized and federated configurations were conducted, testing six publicly available embedding models from Massive Text Embedding Benchmark leaderboard and three MLP classifier architectures under two medical coding (ICD-9 and ICD-10). Additionally, ablation studies over ten random stratified splits assess performance stability. Results show that embedding quality substantially outweighs classifier complexity in determining predictive performance, and that federated learning can closely match centralized results in idealized conditions. While the models are orders of magnitude smaller than state-of-the-art architectures and achieved competitive micro and macro F1 scores, limitations remain including the lack of end-to-end training and the simplified FL assumptions. Nevertheless, this work demonstrates a viable way toward scalable, privacy-conscious medical coding systems and offers a step toward for future research into federated, domain-adaptive clinical AI.

Implanted devices providing real-time neural activity classification and control are increasingly used to treat neurological disorders, such as epilepsy and Parkinson's disease. Classification performance is critical to identifying brain states appropriate for the therapeutic action. However, advanced algorithms that have shown promise in offline studies, in particular deep learning (DL) methods, have not been deployed on resource-restrained neural implants. Here, we designed and optimized three embedded DL models of commonly adopted architectures and evaluated their inference performance in a case study of seizure detection. A deep neural network (DNN), a convolutional neural network (CNN), and a long short-term memory (LSTM) network were designed to classify ictal, preictal, and interictal phases from the CHB-MIT scalp EEG database. After iterative model compression and quantization, the algorithms were deployed on a general-purpose, off-the-shelf microcontroller. Inference sensitivity, false positive rate, execution time, memory size, and power consumption were quantified. For seizure event detection, the sensitivity and FPR (h-1) for the DNN, CNN, and LSTM models were 87.36%/0.169, 96.70%/0.102, and 97.61%/0.071, respectively. Predicting seizures for early warnings was also feasible. The implemented compression and quantization achieved a significant saving of power and memory with an accuracy degradation of less than 0.5%. Edge DL models achieved performance comparable to many prior implementations that had no time or computational resource limitations. Generic microcontrollers can provide the required memory and computational resources, while model designs can be migrated to ASICs for further optimization. The results suggest that edge DL inference is a feasible option for future neural implants to improve classification performance and therapeutic outcomes.