Daily Papers

Hotword customization is one of the concerned issues remained in ASR field - it is of value to enable users of ASR systems to customize names of entities, persons and other phrases to obtain better experience. The past few years have seen effective modeling strategies for ASR contextualization developed, but they still exhibit space for improvement about training stability and the invisible activation process. In this paper we propose Semantic-Augmented Contextual-Paraformer (SeACo-Paraformer) a novel NAR based ASR system with flexible and effective hotword customization ability. It possesses the advantages of AED-based model's accuracy, NAR model's efficiency, and explicit customization capacity of superior performance. Through extensive experiments with 50,000 hours of industrial big data, our proposed model outperforms strong baselines in customization. Besides, we explore an efficient way to filter large-scale incoming hotwords for further improvement. The industrial models compared, source codes and two hotword test sets are all open source.

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.

We present FireRedASR, a family of large-scale automatic speech recognition (ASR) models for Mandarin, designed to meet diverse requirements in superior performance and optimal efficiency across various applications. FireRedASR comprises two variants: FireRedASR-LLM: Designed to achieve state-of-the-art (SOTA) performance and to enable seamless end-to-end speech interaction. It adopts an Encoder-Adapter-LLM framework leveraging large language model (LLM) capabilities. On public Mandarin benchmarks, FireRedASR-LLM (8.3B parameters) achieves an average Character Error Rate (CER) of 3.05%, surpassing the latest SOTA of 3.33% with an 8.4% relative CER reduction (CERR). It demonstrates superior generalization capability over industrial-grade baselines, achieving 24%-40% CERR in multi-source Mandarin ASR scenarios such as video, live, and intelligent assistant. FireRedASR-AED: Designed to balance high performance and computational efficiency and to serve as an effective speech representation module in LLM-based speech models. It utilizes an Attention-based Encoder-Decoder (AED) architecture. On public Mandarin benchmarks, FireRedASR-AED (1.1B parameters) achieves an average CER of 3.18%, slightly worse than FireRedASR-LLM but still outperforming the latest SOTA model with over 12B parameters. It offers a more compact size, making it suitable for resource-constrained applications. Moreover, both models exhibit competitive results on Chinese dialects and English speech benchmarks and excel in singing lyrics recognition. To advance research in speech processing, we release our models and inference code at https://github.com/FireRedTeam/FireRedASR.

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.

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 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.

While electroencephalogram (EEG) has been a crucial tool for monitoring the brain and diagnosing neurological disorders (e.g., epilepsy), learning meaningful representations from raw EEG signals remains challenging due to limited annotations and high signal variability. Recently, EEG foundation models (FMs) have shown promising potential by adopting transformer architectures and self-supervised pre-training methods from large language models (e.g., masked prediction) to learn representations from diverse EEG data, followed by fine-tuning on specific EEG tasks. Nonetheless, these large models often incurred high computational costs during both training and inference, with only marginal performance improvements as model size increases. In this work, we proposed EEG representation learning framework building upon Generative Diffusion Model (EEGDM). Specifically, we developed structured state-space model for diffusion pretraining (SSMDP) to better capture the temporal dynamics of EEG signals and trained the architecture using a Denoising Diffusion Probabilistic Model. The resulting latent EEG representations were then used for downstream classification tasks via our proposed latent fusion transformer (LFT). To evaluate our method, we used the multi-event Temple University EEG Event Corpus and compared EEGDM with current state-of-the-art approaches, including EEG FMs. Empirical results showed that our method outperformed existing methods while being approximately 19x more lightweight. These findings suggested that EEGDM offered a promising alternative to current FMs. Our code is available at: https://github.com/jhpuah/EEGDM.

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.

The electrocardiogram (ECG) is a cost-effective, highly accessible and widely employed diagnostic tool. With the advent of Foundation Models (FMs), the field of AI-assisted ECG interpretation has begun to evolve, as they enable model reuse across different tasks by relying on embeddings. However, to responsibly employ FMs, it is crucial to rigorously assess to which extent the embeddings they produce are generalizable, particularly in error-sensitive domains such as healthcare. Although prior works have already addressed the problem of benchmarking ECG-expert FMs, they focus predominantly on the evaluation of downstream performance. To fill this gap, this study aims to find an in-depth, comprehensive benchmarking framework for FMs, with a specific focus on ECG-expert ones. To this aim, we introduce a benchmark methodology that complements performance-based evaluation with representation-level analysis, leveraging SHAP and UMAP techniques. Furthermore, we rely on the methodology for carrying out an extensive evaluation of several ECG-expert FMs pretrained via state-of-the-art techniques over different cross-continental datasets and data availability settings; this includes ones featuring data scarcity, a fairly common situation in real-world medical scenarios. Experimental results show that our benchmarking protocol provides a rich insight of ECG-expert FMs' embedded patterns, enabling a deeper understanding of their representational structure and generalizability.

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.

Databases of electronic health records (EHRs) are increasingly used to inform clinical decisions. Machine learning methods can find patterns in EHRs that are predictive of future adverse outcomes. However, statistical models may be built upon patterns of health-seeking behavior that vary across patient subpopulations, leading to poor predictive performance when training on one patient population and predicting on another. This note proposes two tests to better measure and understand model generalization. We use these tests to compare models derived from two data sources: (i) historical medical records, and (ii) electrocardiogram (EKG) waveforms. In a predictive task, we show that EKG-based models can be more stable than EHR-based models across different patient populations.

In the present research, we delve into the intricate realm of electroencephalogram (EEG) data analysis, focusing on sequence-to-sequence prediction of data across 32 EEG channels. The study harmoniously fuses the principles of applied chaos theory and dynamical systems theory to engender a novel feature set, enriching the representational capacity of our deep learning model. The endeavour's cornerstone is a transformer-based sequence-to-sequence architecture, calibrated meticulously to capture the non-linear and high-dimensional temporal dependencies inherent in EEG sequences. Through judicious architecture design, parameter initialisation strategies, and optimisation techniques, we have navigated the intricate balance between computational expediency and predictive performance. Our model stands as a vanguard in EEG data sequence prediction, demonstrating remarkable generalisability and robustness. The findings not only extend our understanding of EEG data dynamics but also unveil a potent analytical framework that can be adapted to diverse temporal sequence prediction tasks in neuroscience and beyond.

Artificial intelligence (AI) has demonstrated significant potential in ECG analysis and cardiovascular disease assessment. Recently, foundation models have played a remarkable role in advancing medical AI. The development of an ECG foundation model holds the promise of elevating AI-ECG research to new heights. However, building such a model faces several challenges, including insufficient database sample sizes and inadequate generalization across multiple domains. Additionally, there is a notable performance gap between single-lead and multi-lead ECG analyses. We introduced an ECG Foundation Model (ECGFounder), a general-purpose model that leverages real-world ECG annotations from cardiology experts to broaden the diagnostic capabilities of ECG analysis. ECGFounder was trained on over 10 million ECGs with 150 label categories from the Harvard-Emory ECG Database, enabling comprehensive cardiovascular disease diagnosis through ECG analysis. The model is designed to be both an effective out-of-the-box solution, and a to be fine-tunable for downstream tasks, maximizing usability. Importantly, we extended its application to lower rank ECGs, and arbitrary single-lead ECGs in particular. ECGFounder is applicable to supporting various downstream tasks in mobile monitoring scenarios. Experimental results demonstrate that ECGFounder achieves expert-level performance on internal validation sets, with AUROC exceeding 0.95 for eighty diagnoses. It also shows strong classification performance and generalization across various diagnoses on external validation sets. When fine-tuned, ECGFounder outperforms baseline models in demographic analysis, clinical event detection, and cross-modality cardiac rhythm diagnosis. The trained model and data will be publicly released upon publication through the bdsp.io. Our code is available at https://github.com/bdsp-core/ECGFounder

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 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 integration of power electronic converters (PECs) and distributed energy resources (DERs) in modern power systems has introduced dynamism and complexity. Accurate simulation becomes essential to comprehend the influence of converter domination on the power grid. This study addresses the fast-switching and stochastic behaviors exhibited by inverter-based resources in converter-dominated power systems, highlighting the necessity for precise analytical models. In the realm of modeling real-world systems, multiple methodologies exist. Notably, black-box and data-driven system identification techniques are employed to construct PEC models using experimental data, without relying on a priori knowledge of the internal system physics. This approach entails a systematic process of model class selection, parameter estimation, and model validation. While a range of linear and nonlinear model structures and estimation algorithms are at our disposal, it remains imperative to harness creativity and a profound understanding of the physical system to craft data-driven models that align seamlessly with their intended applications. These applications may encompass simulation, prediction, control, or fault detection. This report offers valuable insights into the collection of datasets from commercial off-the-shelf inverters, along with the presentation of intricate simulation models.

Background: AI-driven prediction algorithms have the potential to enhance emergency medicine by enabling rapid and accurate decision-making regarding patient status and potential deterioration. However, the integration of multimodal data, including raw waveform signals, remains underexplored in clinical decision support. Methods: We present a dataset and benchmarking protocol designed to advance multimodal decision support in emergency care. Our models utilize demographics, biometrics, vital signs, laboratory values, and electrocardiogram (ECG) waveforms as inputs to predict both discharge diagnoses and patient deterioration. Results: The diagnostic model achieves area under the receiver operating curve (AUROC) scores above 0.8 for 609 out of 1,428 conditions, covering both cardiac (e.g., myocardial infarction) and non-cardiac (e.g., renal disease, diabetes) diagnoses. The deterioration model attains AUROC scores above 0.8 for 14 out of 15 targets, accurately predicting critical events such as cardiac arrest, mechanical ventilation, ICU admission, and mortality. Conclusions: Our study highlights the positive impact of incorporating raw waveform data into decision support models, improving predictive performance. By introducing a unique, publicly available dataset and baseline models, we provide a foundation for measurable progress in AI-driven decision support for emergency care.

Data scarcity in the brain-computer interface field can be alleviated through the use of generative models, specifically diffusion models. While diffusion models have previously been successfully applied to electroencephalogram (EEG) data, existing models lack flexibility w.r.t.~sampling or require alternative representations of the EEG data. To overcome these limitations, we introduce a novel approach to conditional diffusion models that utilizes classifier-free guidance to directly generate subject-, session-, and class-specific EEG data. In addition to commonly used metrics, domain-specific metrics are employed to evaluate the specificity of the generated samples. The results indicate that the proposed model can generate EEG data that resembles real data for each subject, session, and class.

Electroencephalogram (EEG) signals play a crucial role in understanding brain activity and diagnosing neurological diseases. Because supervised EEG encoders are unable to learn robust EEG patterns and rely too heavily on expensive signal annotation, research has turned to general-purpose self-supervised EEG encoders, known as EEG-based models (EEG-FMs), to achieve robust and scalable EEG feature extraction. However, the readiness of early EEG-FMs for practical applications and the standards for long-term research progress remain unclear. Therefore, a systematic and comprehensive review of first-generation EEG-FMs is necessary to understand their current state-of-the-art and identify key directions for future EEG-FMs. To this end, this study reviews 14 early EEG-FMs and provides a critical comprehensive analysis of their methodologies, empirical findings, and unaddressed research gaps. This review focuses on the latest developments in EEG-based models (EEG-FMs), which have shown great potential for processing and analyzing EEG data. We discuss various EEG-FMs, including their architectures, pretraining strategies, pretraining and downstream datasets, and other details. This review also highlights challenges and future directions in the field, aiming to provide a comprehensive overview for researchers and practitioners interested in EEG analysis and related EEG-FM.

Understanding the irregular electrical activity of atrial fibrillation (AFib) has been a key challenge in electrocardiography. For serious cases of AFib, catheter ablations are performed to collect intracardiac electrograms (EGMs). EGMs offer intricately detailed and localized electrical activity of the heart and are an ideal modality for interpretable cardiac studies. Recent advancements in artificial intelligence (AI) has allowed some works to utilize deep learning frameworks to interpret EGMs during AFib. Additionally, language models (LMs) have shown exceptional performance in being able to generalize to unseen domains, especially in healthcare. In this study, we are the first to leverage pretrained LMs for finetuning of EGM interpolation and AFib classification via masked language modeling. We formulate the EGM as a textual sequence and present competitive performances on AFib classification compared against other representations. Lastly, we provide a comprehensive interpretability study to provide a multi-perspective intuition of the model's behavior, which could greatly benefit the clinical use.

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.

Prototype-based neural networks offer interpretable predictions by comparing inputs to learned, representative signal patterns anchored in training data. While such models have shown promise in the classification of physiological data, it remains unclear whether their prototypes capture an underlying structure that aligns with broader clinical phenotypes. We use a prototype-based deep learning model trained for multi-label ECG classification using the PTB-XL dataset. Then without modification we performed inference on the MIMIC-IV clinical database. We assess whether individual prototypes, trained solely for classification, are associated with hospital discharge diagnoses in the form of phecodes in this external population. Individual prototypes demonstrate significantly stronger and more specific associations with clinical outcomes compared to the classifier's class predictions, NLP-extracted concepts, or broader prototype classes across all phecode categories. Prototype classes with mixed significance patterns exhibit significantly greater intra-class distances (p < 0.0001), indicating the model learned to differentiate clinically meaningful variations within diagnostic categories. The prototypes achieve strong predictive performance across diverse conditions, with AUCs ranging from 0.89 for atrial fibrillation to 0.91 for heart failure, while also showing substantial signal for non-cardiac conditions such as sepsis and renal disease. These findings suggest that prototype-based models can support interpretable digital phenotyping from physiologic time-series data, providing transferable intermediate phenotypes that capture clinically meaningful physiologic signatures beyond their original training objectives.

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.

Electroencephalography (EEG) is a non-invasive technique to measure and record brain electrical activity, widely used in various BCI and healthcare applications. Early EEG decoding methods rely on supervised learning, limited by specific tasks and datasets, hindering model performance and generalizability. With the success of large language models, there is a growing body of studies focusing on EEG foundation models. However, these studies still leave challenges: Firstly, most of existing EEG foundation models employ full EEG modeling strategy. It models the spatial and temporal dependencies between all EEG patches together, but ignores that the spatial and temporal dependencies are heterogeneous due to the unique structural characteristics of EEG signals. Secondly, existing EEG foundation models have limited generalizability on a wide range of downstream BCI tasks due to varying formats of EEG data, making it challenging to adapt to. To address these challenges, we propose a novel foundation model called CBraMod. Specifically, we devise a criss-cross transformer as the backbone to thoroughly leverage the structural characteristics of EEG signals, which can model spatial and temporal dependencies separately through two parallel attention mechanisms. And we utilize an asymmetric conditional positional encoding scheme which can encode positional information of EEG patches and be easily adapted to the EEG with diverse formats. CBraMod is pre-trained on a very large corpus of EEG through patch-based masked EEG reconstruction. We evaluate CBraMod on up to 10 downstream BCI tasks (12 public datasets). CBraMod achieves the state-of-the-art performance across the wide range of tasks, proving its strong capability and generalizability. The source code is publicly available at https://github.com/wjq-learning/CBraMod.

An arrhythmia, also known as a dysrhythmia, refers to an irregular heartbeat. There are various types of arrhythmias that can originate from different areas of the heart, resulting in either a rapid, slow, or irregular heartbeat. An electrocardiogram (ECG) is a vital diagnostic tool used to detect heart irregularities and abnormalities, allowing experts to analyze the heart's electrical signals to identify intricate patterns and deviations from the norm. Over the past few decades, numerous studies have been conducted to develop automated methods for classifying heartbeats based on ECG data. In recent years, deep learning has demonstrated exceptional capabilities in tackling various medical challenges, particularly with transformers as a model architecture for sequence processing. By leveraging the transformers, we developed the ECGformer model for the classification of various arrhythmias present in electrocardiogram data. We assessed the suggested approach using the MIT-BIH and PTB datasets. ECG heartbeat arrhythmia classification results show that the proposed method is highly effective.

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.

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.

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.

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.

Accurate and efficient electroencephalography (EEG) analysis is essential for detecting seizures and artifacts in long-term monitoring, with applications spanning hospital diagnostics to wearable health devices. Robust EEG analytics have the potential to greatly improve patient care. However, traditional deep learning models, especially Transformer-based architectures, are hindered by their quadratic time and memory complexity, making them less suitable for resource-constrained environments. To address these challenges, we present FEMBA (Foundational EEG Mamba + Bidirectional Architecture), a novel self-supervised framework that establishes new efficiency benchmarks for EEG analysis through bidirectional state-space modeling. Unlike Transformer-based models, which incur quadratic time and memory complexity, FEMBA scales linearly with sequence length, enabling more scalable and efficient processing of extended EEG recordings. Trained on over 21,000 hours of unlabeled EEG and fine-tuned on three downstream tasks, FEMBA achieves competitive performance in comparison with transformer models, with significantly lower computational cost. Specifically, it reaches 81.82% balanced accuracy (0.8921 AUROC) on TUAB and 0.949 AUROC on TUAR, while a tiny 7.8M-parameter variant demonstrates viability for resource-constrained devices. These results pave the way for scalable, general-purpose EEG analytics in both clinical and highlight FEMBA as a promising candidate for wearable applications.

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/

Millions of clinical ECGs exist only as paper scans, making them unusable for modern automated diagnostics. We introduce a fully automated, modular framework that converts scanned or photographed ECGs into digital signals, suitable for both clinical and research applications. The framework is validated on 37,191 ECG images with 1,596 collected at Akershus University Hospital, where the algorithm obtains a mean signal-to-noise ratio of 19.65 dB on scanned papers with common artifacts. It is further evaluated on the Emory Paper Digitization ECG Dataset, comprising 35,595 images, including images with perspective distortion, wrinkles, and stains. The model improves on the state-of-the-art in all subcategories. The full software is released as open-source, promoting reproducibility and further development. We hope the software will contribute to unlocking retrospective ECG archives and democratize access to AI-driven diagnostics.

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.

A network-based approach is presented to investigate the cerebrovascular flow patterns during atrial fibrillation (AF) with respect to normal sinus rhythm (NSR). AF, the most common cardiac arrhythmia with faster and irregular beating, has been recently and independently associated with the increased risk of dementia. However, the underlying hemodynamic mechanisms relating the two pathologies remain mainly undetermined so far; thus the contribution of modeling and refined statistical tools is valuable. Pressure and flow rate temporal series in NSR and AF are here evaluated along representative cerebral sites (from carotid arteries to capillary brain circulation), exploiting reliable artificially built signals recently obtained from an in silico approach. The complex network analysis evidences, in a synthetic and original way, a dramatic signal variation towards the distal/capillary cerebral regions during AF, which has no counterpart in NSR conditions. At the large artery level, networks obtained from both AF and NSR hemodynamic signals exhibit elongated and chained features, which are typical of pseudo-periodic series. These aspects are almost completely lost towards the microcirculation during AF, where the networks are topologically more circular and present random-like characteristics. As a consequence, all the physiological phenomena at microcerebral level ruled by periodicity - such as regular perfusion, mean pressure per beat, and average nutrient supply at cellular level - can be strongly compromised, since the AF hemodynamic signals assume irregular behaviour and random-like features. Through a powerful approach which is complementary to the classical statistical tools, the present findings further strengthen the potential link between AF hemodynamic and cognitive decline.

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.

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.

Objective: To enable continuous, long-term neuro-monitoring on wearable devices by overcoming the computational bottlenecks of Transformer-based Electroencephalography (EEG) foundation models and the quantization challenges inherent to State-Space Models (SSMs). Methods: We present FEMBA, a bidirectional Mamba architecture pre-trained on over 21,000 hours of EEG. We introduce a novel Physiologically-Aware pre-training objective, consisting of a reconstruction with low-pass filtering, to prioritize neural oscillations over high-frequency artifacts. To address the activation outliers common in SSMs, we employ Quantization-Aware Training (QAT) to compress the model to 2-bit weights. The framework is deployed on a parallel ultra-low-power RISC-V microcontroller (GAP9) using a custom double-buffered memory streaming scheme. Results: The proposed low-pass pre-training improves downstream AUROC on TUAB from 0.863 to 0.893 and AUPR from 0.862 to 0.898 compared to the best contrastive baseline. QAT successfully compresses weights with negligible performance loss, whereas standard post-training quantization degrades accuracy by approximately 30\%. The embedded implementation achieves deterministic real-time inference (1.70~s per 5~s window) and reduces the memory footprint by 74\% (to approx2~MB), achieving competitive accuracy with up to 27times fewer FLOPs than Transformer benchmarks. Conclusion: FEMBA demonstrates that Mamba-based foundation models can be effectively quantized and deployed on extreme-edge hardware without sacrificing the representation quality required for robust clinical analysis. Significance: This work establishes the first full-stack framework for deploying large-scale EEG foundation models on ultra-low-power wearables, facilitating continuous, SSM based monitoring for epilepsy and sleep disorders.

Standard continuous-depth models, such as Neural Ordinary Differential Equations (NODEs), offer significant advantages in modeling physical systems by learning continuous vector fields rather than discrete temporal steps. However, when applied to complex dynamical systems, standard NODEs frequently struggle with highly nonlinear dynamics. This paper investigates the Frequency-domain Neural ODE (FNODE), an architecture that projects continuous temporal dynamics into the frequency domain using the Fast Fourier Transform (FFT). By operating in the frequency domain, the model provides better generalization to the dynamical system. The architecture is empirically evaluated against discrete models, specifically Gated Recurrent Units (GRUs) and Long Short-Term Memory (LSTMs), and other continuous-depth variants, including Augmented Neural ODE (ANODE), across four distinct dynamical systems: the Lotka-Volterra model, the forced Duffing oscillator, the Van der Pol oscillator, and the Lorenz system. To rigorously assess generalization and robustness, curriculum and ensemble learning are used to evaluate the model's convergence by estimating confidence intervals across different ensemble models. The empirical results demonstrate that the FNODE architecture achieves better generalization while exhibiting remarkable convergence stability.

Tracking biosignals is crucial for monitoring wellness and preempting the development of severe medical conditions. Today, wearable devices can conveniently record various biosignals, creating the opportunity to monitor health status without disruption to one's daily routine. Despite widespread use of wearable devices and existing digital biomarkers, the absence of curated data with annotated medical labels hinders the development of new biomarkers to measure common health conditions. In fact, medical datasets are usually small in comparison to other domains, which is an obstacle for developing neural network models for biosignals. To address this challenge, we have employed self-supervised learning using the unlabeled sensor data collected under informed consent from the large longitudinal Apple Heart and Movement Study (AHMS) to train foundation models for two common biosignals: photoplethysmography (PPG) and electrocardiogram (ECG) recorded on Apple Watch. We curated PPG and ECG datasets from AHMS that include data from ~141K participants spanning ~3 years. Our self-supervised learning framework includes participant level positive pair selection, stochastic augmentation module and a regularized contrastive loss optimized with momentum training, and generalizes well to both PPG and ECG modalities. We show that the pre-trained foundation models readily encode information regarding participants' demographics and health conditions. To the best of our knowledge, this is the first study that builds foundation models using large-scale PPG and ECG data collected via wearable consumer devices x2013 prior works have commonly used smaller-size datasets collected in clinical and experimental settings. We believe PPG and ECG foundation models can enhance future wearable devices by reducing the reliance on labeled data and hold the potential to help the users improve their health.

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.

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.

Neurophysiological recordings such as electroencephalography (EEG) offer accessible and minimally invasive means of estimating physiological activity for applications in healthcare, diagnostic screening, and even immersive entertainment. However, these recordings yield high-dimensional, noisy time-series data that typically require extensive pre-processing and handcrafted feature extraction to reveal meaningful information. Recently, there has been a surge of interest in applying representation learning techniques from large pre-trained (foundation) models to effectively decode and interpret biosignals. We discuss the challenges posed for incorporating such methods and introduce BioCodec, an alternative representation learning framework inspired by neural codecs to capture low-level signal characteristics in the form of discrete tokens. Pre-trained on thousands of EEG hours, BioCodec shows efficacy across multiple downstream tasks, ranging from clinical diagnostic tasks and sleep physiology to decoding speech and motor imagery, particularly in low-resource settings. Additionally, we provide a qualitative analysis of codebook usage and estimate the spatial coherence of codebook embeddings from EEG connectivity. Notably, we also document the suitability of our method to other biosignal data, i.e., electromyographic (EMG) signals. Overall, the proposed approach provides a versatile solution for biosignal tokenization that performs competitively with state-of-the-art models. The source code and model checkpoints are shared.

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.

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.

Large language models (LLMs) can make scientific software easier to use. However, a general model does not automatically know which measurements a particular sensor can support, which algorithms are implemented in the current software, or which conclusions are justified by a computed result. These distinctions are especially important for low-channel electroencephalography (EEG), where sparse spatial coverage and variable signal quality make plausible but unsupported interpretations easy to produce. We present NeuraDock Agent, an open-source architecture that separates a deterministic local EEG engine from a hardware-aware language layer. The numerical engine parses recordings, performs quality control, executes reviewed spectral workflows, and writes machine-readable artifacts. The LLM receives only a compact, allowlisted summary and a versioned context pack. The context describes the seven-channel hardware, reviewed workflows, result fields, implementation boundaries, scientific limits, and reference cases. Raw EEG and dense per-sample arrays remain local We evaluate the system at three levels. First, 12 recordings produced identical structured results over ten numerical repetitions, and a complete Rest/Task run produced identical result, report, and figure hashes over three repetitions. Second, request-capture and failure-injection experiments confirmed the tested data boundary and preservation of local artifacts under HTTP, malformed-output, and connection failures. Third, a boundary-awareness benchmark tested 36 ordinary and adversarial questions under four context ablations and two LLMs, yielding 288 outputs.These results support hardware- and implementation-aware grounding as a practical mechanism for calibrating what an EEG agent accepts, qualifies, or refuses; they do not establish clinical validity or a validated absolute cognitive-load index.

Electroencephalography (EEG) signals provide critical insights for applications in disease diagnosis and healthcare. However, the scarcity of labeled EEG data poses a significant challenge. Foundation models offer a promising solution by leveraging large-scale unlabeled data through pre-training, enabling strong performance across diverse tasks. While both temporal dynamics and inter-channel relationships are vital for understanding EEG signals, existing EEG foundation models primarily focus on the former, overlooking the latter. To address this limitation, we propose Graph-Enhanced EEG Foundation Model (GEFM), a novel foundation model for EEG that integrates both temporal and inter-channel information. Our architecture combines Graph Neural Networks (GNNs), which effectively capture relational structures, with a masked autoencoder to enable efficient pre-training. We evaluated our approach using three downstream tasks and experimented with various GNN architectures. The results demonstrate that our proposed model, particularly when employing the GCN architecture with optimized configurations, consistently outperformed baseline methods across all tasks. These findings suggest that our model serves as a robust foundation model for EEG analysis.

Foundation models have transformed AI by reducing reliance on task-specific data through large-scale pretraining. While successful in language and vision, their adoption in EEG has lagged due to the heterogeneity of public datasets, which are collected under varying protocols, devices, and electrode configurations. Existing EEG foundation models struggle to generalize across these variations, often restricting pretraining to a single setup, resulting in suboptimal performance, in particular under linear probing. We present REVE (Representation for EEG with Versatile Embeddings), a pretrained model explicitly designed to generalize across diverse EEG signals. REVE introduces a novel 4D positional encoding scheme that enables it to process signals of arbitrary length and electrode arrangement. Using a masked autoencoding objective, we pretrain REVE on over 60,000 hours of EEG data from 92 datasets spanning 25,000 subjects, representing the largest EEG pretraining effort to date. REVE achieves state-of-the-art results on 10 downstream EEG tasks, including motor imagery classification, seizure detection, sleep staging, cognitive load estimation, and emotion recognition. With little to no fine-tuning, it demonstrates strong generalization, and nuanced spatio-temporal modeling. We release code, pretrained weights, and tutorials to support standardized EEG research and accelerate progress in clinical neuroscience.

Electroencephalography (EEG) provides real-time insights into brain activity and supports diverse applications in neuroscience. While EEG foundation models (EFMs) have emerged to address the scalability issues of task-specific models, current approaches still yield clinically uninterpretable and weakly discriminative representations, inefficiently capture global dependencies, and neglect important local neural events. We present CodeBrain, a two-stage EFM designed to fill this gap. In the first stage, we introduce the TFDual-Tokenizer, which decouples heterogeneous temporal and frequency EEG signals into discrete tokens, quadratically expanding the representation space to enhance discriminative power and offering domain-specific interpretability by suggesting potential links to neural events and spectral rhythms. In the second stage, we propose the multi-scale EEGSSM architecture, which combines structured global convolution with sliding window attention to efficiently capture both sparse long-range and local dependencies, reflecting the brain's small-world topology. Pretrained on the largest public EEG corpus, CodeBrain achieves strong generalization across 8 downstream tasks and 10 datasets under distribution shifts, supported by comprehensive ablations, scaling-law analyses, and interpretability evaluations. Both code and pretraining weights will be released in the future version.

State space models (SSM) have recently been shown to be very effective as a deep learning layer as a promising alternative to sequence models such as RNNs, CNNs, or Transformers. The first version to show this potential was the S4 model, which is particularly effective on tasks involving long-range dependencies by using a prescribed state matrix called the HiPPO matrix. While this has an interpretable mathematical mechanism for modeling long dependencies, it introduces a custom representation and algorithm that can be difficult to implement. On the other hand, a recent variant of S4 called DSS showed that restricting the state matrix to be fully diagonal can still preserve the performance of the original model when using a specific initialization based on approximating S4's matrix. This work seeks to systematically understand how to parameterize and initialize such diagonal state space models. While it follows from classical results that almost all SSMs have an equivalent diagonal form, we show that the initialization is critical for performance. We explain why DSS works mathematically, by showing that the diagonal restriction of S4's matrix surprisingly recovers the same kernel in the limit of infinite state dimension. We also systematically describe various design choices in parameterizing and computing diagonal SSMs, and perform a controlled empirical study ablating the effects of these choices. Our final model S4D is a simple diagonal version of S4 whose kernel computation requires just 2 lines of code and performs comparably to S4 in almost all settings, with state-of-the-art results for image, audio, and medical time-series domains, and averaging 85\% on the Long Range Arena benchmark.

While Multimodal Large Language Models (MLLMs) show promising performance in automated electrocardiogram interpretation, it remains unclear whether they genuinely perform actual step-by-step reasoning or just rely on superficial visual cues. To investigate this, we introduce ECG-Reasoning-Benchmark, a novel multi-turn evaluation framework comprising over 6,400 samples to systematically assess step-by-step reasoning across 17 core ECG diagnoses. Our comprehensive evaluation of state-of-the-art models reveals a critical failure in executing multi-step logical deduction. Although models possess the medical knowledge to retrieve clinical criteria for a diagnosis, they exhibit near-zero success rates (6% Completion) in maintaining a complete reasoning chain, primarily failing to ground the corresponding ECG findings to the actual visual evidence in the ECG signal. These results demonstrate that current MLLMs bypass actual visual interpretation, exposing a critical flaw in existing training paradigms and underscoring the necessity for robust, reasoning-centric medical AI. The code and data are available at https://github.com/Jwoo5/ecg-reasoning-benchmark.

Reliable automatic seizure detection from long-term EEG remains a challenge, as current machine learning models often fail to generalize across patients or clinical settings. Manual EEG review remains the clinical standard, underscoring the need for robust models and standardized evaluation. To rigorously assess algorithm performance, we organized a challenge using a private dataset of continuous EEG recordings from 65 subjects (4,360 hours). Expert neurophysiologists annotated the data, providing ground truth for seizure events. Participants were required to detect seizure onset and duration, with evaluation based on event-based metrics, including sensitivity, precision, F1-score, and false positives per day. The SzCORE framework ensured standardized evaluation. The primary ranking criterion was the event-based F1-score, reflecting clinical relevance by balancing sensitivity and false positives. The challenge received 30 submissions from 19 teams, with 28 algorithms evaluated. Results revealed wide variability in performance, with a top F1-score of 43% (sensitivity 37%, precision 45%), highlighting the ongoing difficulty of seizure detection. The challenge also revealed a gap between reported performance and real-world evaluation, emphasizing the importance of rigorous benchmarking. Compared to previous challenges and commercial systems, the best-performing algorithm in this contest showed improved performance. Importantly, the challenge platform now supports continuous benchmarking, enabling reproducible research, integration of new datasets, and clinical evaluation of seizure detection algorithms using a standardized framework.

Heart disease, also known as cardiovascular disease, is a prevalent and critical medical condition characterized by the impairment of the heart and blood vessels, leading to various complications such as coronary artery disease, heart failure, and myocardial infarction. The timely and accurate detection of heart disease is of paramount importance in clinical practice. Early identification of individuals at risk enables proactive interventions, preventive measures, and personalized treatment strategies to mitigate the progression of the disease and reduce adverse outcomes. In recent years, the field of heart disease detection has witnessed notable advancements due to the integration of sophisticated technologies and computational approaches. These include machine learning algorithms, data mining techniques, and predictive modeling frameworks that leverage vast amounts of clinical and physiological data to improve diagnostic accuracy and risk stratification. In this work, we propose to detect heart disease from ECG images using cutting-edge technologies, namely vision transformer models. These models are Google-Vit, Microsoft-Beit, and Swin-Tiny. To the best of our knowledge, this is the initial endeavor concentrating on the detection of heart diseases through image-based ECG data by employing cuttingedge technologies namely, transformer models. To demonstrate the contribution of the proposed framework, the performance of vision transformer models are compared with state-of-the-art studies. Experiment results show that the proposed framework exhibits remarkable classification results.

Alarm fatigue in intensive care units (ICUs) is a well documented patient safety crisis. Clinical monitors generate 350 or more alarms per patient per day, out of which 72-99% are clinically irrelevant. Staff desensitization to non-actionable alarms increases the risk of missed true emergencies. This paper presents SigmaMedStat, a machine learning system that evaluates the trustworthiness of physiological alarm signals before clinical action is taken. Four approaches were evaluated on the PhysioNet/Computing in Cardiology Challenge 2015 dataset of 498 four-channel ICU alarm recordings. Primary contribution is a temporal modeling framework that splits each 60 second recording into six consecutive 10-second chunks, and this in turn generates Continuous Wavelet Transform (CWT) scalograms per chunk, encodes each chunk with a shared EfficientNet-B0 encoder, and passes the resulting feature sequence to a two-layer Long Short-Term Memory (LSTM) network. Five-fold stratified cross-validation yields a mean AUC of 0.822 +/- 0.016 (95% CI: [0.790,0.853]), compared to 0.641 for a static EfficientNet baseline trained on the full 60-second window. Ablation studies confirm that temporal chunking and multi-channel signal fusion both contribute independently to classification performance. Per-alarm type analysis reveals that Ventricular Flutter is the most accurately classified alarm type (AUC 0.820) while Asystole remains the hardest (AUC 0.722). Error analysis identifies 65 false negatives and 85 high-confidence misclassifications as the primary failure modes. All code and results are publicly available at https://github.com/Arun-K-Ram/sigmamedstat.

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 objective of personalized medicine is to tailor interventions to an individual patient's unique characteristics. A key technology for this purpose involves medical digital twins, computational models of human biology that can be personalized and dynamically updated to incorporate patient-specific data collected over time. Certain aspects of human biology, such as the immune system, are not easily captured with physics-based models, such as differential equations. Instead, they are often multi-scale, stochastic, and hybrid. This poses a challenge to existing model-based control and optimization approaches that cannot be readily applied to such models. Recent advances in automatic differentiation and neural-network control methods hold promise in addressing complex control problems. However, the application of these approaches to biomedical systems is still in its early stages. This work introduces dynamics-informed neural-network controllers as an alternative approach to control of medical digital twins. As a first use case for this method, the focus is on agent-based models, a versatile and increasingly common modeling platform in biomedicine. The effectiveness of the proposed neural-network control method is illustrated and benchmarked against other methods with two widely-used agent-based model types. The relevance of the method introduced here extends beyond medical digital twins to other complex dynamical systems.

Purpose: With advancements in Large Language Models (LLMs) for healthcare, the need arises for competitive open-source models to protect the public interest. This work contributes to the field of open medical LLMs by optimizing key stages of data preprocessing and training, while showing how to improve model safety (through DPO) and efficacy (through RAG). The evaluation methodology used, which includes four different types of tests, defines a new standard for the field. The resultant models, shown to be competitive with the best private alternatives, are released with a permisive license. Methods: Building on top of strong base models like Llama 3.1 and Qwen 2.5, Aloe Beta uses a custom dataset to enhance public data with synthetic Chain of Thought examples. The models undergo alignment with Direct Preference Optimization, emphasizing ethical and policy-aligned performance in the presence of jailbreaking attacks. Evaluation includes close-ended, open-ended, safety and human assessments, to maximize the reliability of results. Results: Recommendations are made across the entire pipeline, backed by the solid performance of the Aloe Family. These models deliver competitive performance across healthcare benchmarks and medical fields, and are often preferred by healthcare professionals. On bias and toxicity, the Aloe Beta models significantly improve safety, showing resilience to unseen jailbreaking attacks. For a responsible release, a detailed risk assessment specific to healthcare is attached to the Aloe Family models. Conclusion: The Aloe Beta models, and the recipe that leads to them, are a significant contribution to the open-source medical LLM field, offering top-of-the-line performance while maintaining high ethical requirements. This work sets a new standard for developing and reporting aligned LLMs in healthcare.

Electroencephalography (EEG) foundation models have recently emerged as a promising paradigm for brain-computer interfaces (BCIs), aiming to learn transferable neural representations from large-scale heterogeneous recordings. Despite rapid progresses, there lacks fair and comprehensive comparisons of existing EEG foundation models, due to inconsistent pre-training objectives, preprocessing choices, and downstream evaluation protocols. This paper fills this gap. We first review 50 representative models and organize their design choices into a unified taxonomic framework including data standardization, model architectures, and self-supervised pre-training strategies. We then evaluate 12 open-source foundation models and competitive specialist baselines across 13 EEG datasets spanning nine BCI paradigms. Emphasizing real-world deployments, we consider both cross-subject generalization under a leave-one-subject-out protocol and rapid calibration under a within-subject few-shot setting. We further compare full-parameter fine-tuning with linear probing to assess the transferability of pre-trained representations, and examine the relationship between model scale and downstream performance. Our results indicate that: 1) linear probing is frequently insufficient; 2) specialist models trained from scratch remain competitive across many tasks; and, 3) larger foundation models do not necessarily yield better generalization performance under current data regimes and training practices.

Time series foundation models (TSFMs) pretrained on data from multiple domains have shown strong performance on diverse modeling tasks. Various efforts have been made to develop foundation models specific to electroencephalography (EEG) data, which records brain electrical activity as time series. However, no comparative analysis of EEG-specific foundation models (EEGFMs) versus general TSFMs has been performed on EEG-specific tasks. We introduce a novel Spatial-Temporal Adapter with Multi-Head Pooling (STAMP), which leverages univariate embeddings produced by a general TSFM, implicitly models spatial-temporal characteristics of EEG data, and achieves performance comparable to state-of-the-art EEGFMs. A comprehensive analysis is performed on 8 benchmark datasets of clinical tasks using EEG for classification, along with ablation studies. Our proposed adapter is lightweight in trainable parameters and flexible in the inputs it can accommodate, supporting easy modeling of EEG data using TSFMs.

Conventional task-specific electrocardiogram (ECG) analysis models require large annotated datasets to train. Foundation models mitigate this burden by leveraging self-supervised pretraining; however, the scarcity of open-weight ECG foundation models hinders adoption and cross-study comparability. We present ECG-FM, an open foundation model for ECG analysis, and conduct a study using a dataset of 1.5 million ECGs. ECG-FM is a transformer-based model pretrained using a hybrid contrastive and generative self-supervised learning approach. Our downstream tasks include predicting reduced left ventricular ejection fraction (LVEF) and ECG interpretation labels, where we release a benchmark task on the MIMIC-IV-ECG dataset. We affirm that ECG-FM is robust, label-efficient, and functionally discriminative by showcasing data scaling experiments, performing a latent space analysis, and generating saliency maps. ECG-FM markedly outperforms task-specific models in the small-to-medium-scale data regime and demonstrates cross-dataset generalizability, achieving high AUROC on many clinically salient labels such as atrial fibrillation (0.996) and LVEF<=40% (0.929). We release our code, model weights, and benchmark task at https://github.com/bowang-lab/ECG-FM/.

We propose two novel purpose-built deep learning (DL) models for synthesis of the arterial blood pressure (ABP) waveform in a cuff-less manner, using a single-site photoplethysmography (PPG) signal. We utilize the public UCI dataset on cuff-less blood pressure (CLBP) estimation to train and evaluate our DL models. Firstly, we implement a transformer model that incorporates positional encoding, multi-head attention, layer normalization, and dropout techniques, and synthesizes the ABP waveform with a mean absolute error (MAE) of 14. Secondly, we implement a frequency-domain (FD) learning approach where we first obtain the discrete cosine transform (DCT) coefficients of the PPG and ABP signals corresponding to two cardiac cycles, and then learn a linear/non-linear (L/NL) regression between them. We learn that the FD L/NL regression model outperforms the transformer model by achieving an MAE of 11.87 and 8.01, for diastolic blood pressure (DBP) and systolic blood pressure (SBP), respectively. Our FD L/NL regression model also fulfills the AAMI criterion of utilizing data from more than 85 subjects, and achieves grade B by the BHS criterion.

We propose a theoretical framework--Holographic Reservoir Computing (HRC)--which hypothesizes that the thermodynamic noise and timing dynamics in voltage-stressed Bitcoin mining ASICs (BM1366) could potentially serve as a physical reservoir computing substrate. We present the CHIMERA (Conscious Hybrid Intelligence via Miner-Embedded Resonance Architecture) system architecture, which treats the SHA-256 hashing pipeline not as an entropy source, but as a deterministic diffusion operator whose timing characteristics under controlled voltage and frequency conditions may exhibit computationally useful dynamics. We report preliminary observations of non-Poissonian variability in inter-arrival time statistics during edge-of-stability operation, which we term the "Silicon Heartbeat" hypothesis. Theoretical analysis based on Hierarchical Number System (HNS) representations suggests that such architectures could achieve O(log n) energy scaling compared to traditional von Neumann O(2^n) dependencies. However, we emphasize that these are theoretical projections requiring experimental validation. We present the implemented measurement infrastructure, acknowledge current limitations, and outline the experimental program necessary to confirm or refute these hypotheses. This work contributes to the emerging field of thermodynamic computing by proposing a novel approach to repurposing obsolete cryptographic hardware for neuromorphic applications.

As the prevalence of Alzheimer's disease (AD) rises, improving mechanistic insight from non-invasive biomarkers is increasingly critical. Recent work suggests that circuit-level brain alterations manifest as changes in electroencephalography (EEG) spectral features detectable by machine learning. However, conventional deep learning approaches for EEG-based AD detection are computationally intensive and mechanistically opaque. Spiking neural networks (SNNs) offer a biologically plausible and energy-efficient alternative, yet their application to AD diagnosis remains largely unexplored. We propose a neuro-bridge framework that links data-driven learning with minimal, biophysically grounded simulations, enabling bidirectional interpretation between machine learning signatures and circuit-level mechanisms in AD. Using resting-state clinical EEG, we train an SNN classifier that achieves competitive performance (AUC = 0.839) and identifies the aperiodic 1/f slope as a key discriminative marker. The 1/f slope reflects excitation-inhibition balance. To interpret this mechanistically, we construct spiking network simulations in which inhibitory-to-excitatory synaptic ratios are systematically varied to emulate healthy, mild cognitive impairment, and AD-like states. Using both membrane potential-based and synaptic current-based EEG proxies, we reproduce empirical spectral slowing and altered alpha organization. Incorporating empirical functional connectivity priors into multi-subnetwork simulations further enhances spectral differentiation, demonstrating that large-scale network topology constrains EEG signatures more strongly than excitation-inhibition balance alone. Overall, this neuro-bridge approach connects SNN-based classification with interpretable circuit simulations, advancing mechanistic understanding of EEG biomarkers while enabling scalable, explainable AD detection.

Epilepsy is one of the most prevalent brain disorders that disrupts the lives of millions worldwide. For patients with drug-resistant seizures, there exist implantable devices capable of monitoring neural activity, promptly triggering neurostimulation to regulate seizures, or alerting patients of potential episodes. Next-generation seizure detection systems heavily rely on high-accuracy machine learning-based classifiers to detect the seizure onset. Here, we propose to enhance the seizure detection performance by learning informative embeddings of the EEG signal. We empirically demonstrate, for the first time, that converting raw EEG signals to appropriate embeddings can significantly boost the performance of seizure detection algorithms. Importantly, we show that embedding features, which converts the raw EEG into an alternative representation, is beneficial for various machine learning models such as Logistic Regression, Multi-Layer Perceptron, Support Vector Machines, and Gradient Boosted Trees. The experiments were conducted on the CHB-MIT scalp EEG dataset. With the proposed EEG feature embeddings, we achieve significant improvements in sensitivity, specificity, and AUC score across multiple models. By employing this approach alongside an SVM classifier, we were able to attain state-of-the-art classification performance with a sensitivity of 100% and specificity of 99%, setting a new benchmark in the field.

Spiking neural networks (SNNs) represent a promising approach to developing artificial neural networks that are both energy-efficient and biologically plausible. However, applying SNNs to sequential tasks, such as text classification and time-series forecasting, has been hindered by the challenge of creating an effective and hardware-friendly spike-form positional encoding (PE) strategy. Drawing inspiration from the central pattern generators (CPGs) in the human brain, which produce rhythmic patterned outputs without requiring rhythmic inputs, we propose a novel PE technique for SNNs, termed CPG-PE. We demonstrate that the commonly used sinusoidal PE is mathematically a specific solution to the membrane potential dynamics of a particular CPG. Moreover, extensive experiments across various domains, including time-series forecasting, natural language processing, and image classification, show that SNNs with CPG-PE outperform their conventional counterparts. Additionally, we perform analysis experiments to elucidate the mechanism through which SNNs encode positional information and to explore the function of CPGs in the human brain. This investigation may offer valuable insights into the fundamental principles of neural computation. Our code is available at https://github.com/microsoft/SeqSNN.

Electroencephalography (EEG) foundation models hold significant promise for universal Brain-Computer Interfaces (BCIs). However, existing approaches often rely on end-to-end fine-tuning and exhibit limited efficacy under frozen-probing protocols, lacking the intrinsic universality required for broad generalization. This limitation stems from adapting general-purpose sequence architectures that overlook the biophysical and dynamical principles of neural activity. To bridge this gap, we propose DeeperBrain, a neuro-grounded foundation model integrating domain-specific inductive biases into its model design and learning objectives. Architecturally, DeeperBrain incorporates a volume conduction-aware channel encoding to model spatial mixing via 3D geometry, and a neurodynamics-aware temporal encoding capturing slow adaptations using oscillatory and exponential bases. For pretraining, we introduce a dual-objective strategy combining Masked EEG Reconstruction (MER) for local fidelity and Neurodynamics Statistics Prediction (NSP). NSP enforces alignment with macroscopic brain states by predicting interpretable order parameters, including spectral power, functional connectivity, cross-frequency coupling, and dynamic complexity. Extensive experiments demonstrate that DeeperBrain achieves state-of-the-art or highly competitive performance under end-to-end fine-tuning. Crucially, it maintains superior efficacy under a rigorous frozen-probing protocol, verifying that embedding neuroscientific first principles endows learned representations with the intrinsic universality essential for universal BCI. The code will be publicly available.

In the rapidly evolving semiconductor industry, where research, design, verification, and manufacturing are intricately linked, the potential of Large Language Models to revolutionize hardware design and security verification is immense. The primary challenge, however, lies in the complexity of hardware specific issues that are not adequately addressed by the natural language or software code knowledge typically acquired during the pretraining stage. Additionally, the scarcity of datasets specific to the hardware domain poses a significant hurdle in developing a foundational model. Addressing these challenges, this paper introduces Hardware Phi 1.5B, an innovative large language model specifically tailored for the hardware domain of the semiconductor industry. We have developed a specialized, tiered dataset comprising small, medium, and large subsets and focused our efforts on pretraining using the medium dataset. This approach harnesses the compact yet efficient architecture of the Phi 1.5B model. The creation of this first pretrained, hardware domain specific large language model marks a significant advancement, offering improved performance in hardware design and verification tasks and illustrating a promising path forward for AI applications in the semiconductor sector.

We develop an algorithm which exceeds the performance of board certified cardiologists in detecting a wide range of heart arrhythmias from electrocardiograms recorded with a single-lead wearable monitor. We build a dataset with more than 500 times the number of unique patients than previously studied corpora. On this dataset, we train a 34-layer convolutional neural network which maps a sequence of ECG samples to a sequence of rhythm classes. Committees of board-certified cardiologists annotate a gold standard test set on which we compare the performance of our model to that of 6 other individual cardiologists. We exceed the average cardiologist performance in both recall (sensitivity) and precision (positive predictive value).

Electrocardiogram (ECG) is a widely used reliable, non-invasive approach for cardiovascular disease diagnosis. With the rapid growth of ECG examinations and the insufficiency of cardiologists, accurate and automatic diagnosis of ECG signals has become a hot research topic. Deep learning methods have demonstrated promising results in predictive healthcare tasks. In this paper, we developed a deep neural network for multi-label classification of cardiac arrhythmias in 12-lead ECG recordings. Experiments on a public 12-lead ECG dataset showed the effectiveness of our method. The proposed model achieved an average area under the receiver operating characteristic curve (AUC) of 0.970 and an average F1 score of 0.813. The deep model showed superior performance than 4 machine learning methods learned from extracted expert features. Besides, the deep models trained on single-lead ECGs produce lower performance than using all 12 leads simultaneously. The best-performing leads are lead I, aVR, and V5 among 12 leads. Finally, we employed the SHapley Additive exPlanations (SHAP) method to interpret the model's behavior at both patient level and population level. Our code is freely available at https://github.com/onlyzdd/ecg-diagnosis.

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 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.

Recent advancements in large language models (LLMs) have led to significant successes across various applications, where the most noticeable is to a series of emerging capabilities, particularly in the areas of In-Context Learning (ICL) and Chain-of-Thought (CoT). To better understand and control model performance, many studies have begun investigating the underlying causes of these phenomena and their impact on task outcomes. However, existing explanatory frameworks predominantly focus on isolating and explaining ICL and CoT independently, leading to an incomplete understanding of their combined influence on model performance. To address this gap, we propose the Electronic Circuit Model (ECM), which provides a foundation for developing scalable, learnable policies and improving the management of AI-generated content. Specifically, ECM conceptualizes model behavior as an electronic circuit: ICL is represented as semantic magnetic field to providing an additional voltage following Faraday's Law, while CoT is modeled as series resistors to constrain the model output performance following Ohm's Law. Experimental results demonstrate that the ECM effectively predicts and explains LLM performance across a variety of prompting strategies. Furthermore, we apply ECM to advanced reasoning strategy optimization on a series of tasks, such as the International Olympiad in Informatics (IOI) and the International Mathematical Olympiad (IMO), achieving competitive performance that surpasses nearly 80% of top human competitors.

Electroencephalography (EEG) enables non-invasive monitoring of brain activity across clinical and neurotechnology applications, yet building foundation models for EEG remains challenging due to differing electrode topologies and computational scalability, as Transformer architectures incur quadratic sequence complexity. As a joint solution, we propose LuMamba (Latent Unified Mamba), a self-supervised framework combining topology-invariant encodings with linear-complexity state-space modeling, using LUNA's learned-query cross-attention mechanism for channel unification~luna, and FEMBA's bidirectional Mamba blocks for efficient temporal modeling~femba. Within this architecture, we provide the first systematic investigation of the Latent-Euclidean Joint-Embedding Predictive Architecture (LeJEPA) for biosignal learning. Pre-trained on over 21,000 hours of unlabeled EEG from the TUEG corpus, LuMamba is evaluated on five downstream tasks spanning abnormality detection, artifact recognition, and mental condition classification across electrode configurations ranging from 16 to 26 channels. In the pre-training objective, masked reconstruction alone yields structured but less generalizable representations, while LeJEPA alone produces diffuse embeddings; combining both objectives achieves the most robust performance. With only 4.6M parameters, LuMamba attains 80.99\% balanced accuracy on TUAB and achieves state-of-art performance on Alzheimer's detection (0.97 AUPR), while requiring 377times fewer FLOPS than state-of-art models at equivalent sequence lengths and scaling to 12times longer sequences before reaching typical GPU memory limits. Code is available at https://github.com/pulp-bio/biofoundation

Electrocardiogram (ECG) interpretation is a cornerstone of cardiac diagnostics. This paper explores a practical approach to enhance ECG image interpretation using the multimodal LLaMA 3.2 model. We used a parameter-efficient fine-tuning strategy, Low-Rank Adaptation (LoRA), specifically designed to boost the model's ability to understand ECG images and achieve better outcomes across a wide range of cardiac conditions. Our method is tailored for ECG analysis and leverages ECGInstruct, a large-scale instruction dataset with 1 Million samples. This dataset is a rich collection of synthesized ECG images, generated from raw ECG data from trusted open-source repositories like MIMIC-IV ECG and PTB-XL. Each ECG image in ECGInstruct comes with expert-written questions and detailed answers, covering diverse ECG interpretation scenarios, including complex cardiac conditions like Myocardial Infarction and Conduction Disturbances. Our fine-tuning approach efficiently adapts the LLaMA 3.2 model (built upon LLaMA 3) by integrating low-rank adaptation techniques, focusing on efficiency by updating only a small set of parameters, specifically ignoring the `lm_head` and `embed_tokens` layers. This paper details the model setup, our efficient fine-tuning method, and implementation specifics. We provide a thorough evaluation through extensive experiments, demonstrating the effectiveness of our method across various ECG interpretation tasks. The results convincingly show that our parameter-efficient LoRA fine-tuning achieves excellent performance in ECG image interpretation, significantly outperforming baseline models and reaching accuracy comparable to or exceeding traditional CNN-based methods in identifying a wide range of cardiac abnormalities, including over 70 conditions from the PTB-XL dataset.

Accurate interpretation of electrocardiogram (ECG) remains challenging due to the scarcity of labeled data and the high cost of expert annotation. Self-supervised learning (SSL) offers a promising solution by enabling models to learn expressive representations from unlabeled signals. Existing ECG SSL methods typically rely on either contrastive learning or reconstructive learning. However, each approach in isolation provides limited supervisory signals and suffers from additional limitations, including non-physiological distortions introduced by naive augmentations and trivial correlations across multiple leads that models may exploit as shortcuts. In this work, we propose CoRe-ECG, a unified contrastive and reconstructive pretraining paradigm that establishes a synergistic interaction between global semantic modeling and local structural learning. CoRe-ECG aligns global representations during reconstruction, enabling instance-level discriminative signals to guide local waveform recovery. To further enhance pretraining, we introduce Frequency Dynamic Augmentation (FDA) to adaptively perturb ECG signals based on their frequency-domain importance, and Spatio-Temporal Dual Masking (STDM) to break linear dependencies across leads, increasing the difficulty of reconstructive tasks. Our method achieves state-of-the-art performance across multiple downstream ECG datasets. Ablation studies further demonstrate the necessity and complementarity of each component. This approach provides a robust and physiologically meaningful representation learning framework for ECG analysis.

Invasive brain-computer interfaces have garnered significant attention due to their high performance. The current intracranial stereoElectroEncephaloGraphy (sEEG) foundation models typically build univariate representations based on a single channel. Some of them further use Transformer to model the relationship among channels. However, due to the locality and specificity of brain computation, their performance on more difficult tasks, e.g., speech decoding, which demands intricate processing in specific brain regions, is yet to be fully investigated. We hypothesize that building multi-variate representations within certain brain regions can better capture the specific neural processing. To explore this hypothesis, we collect a well-annotated Chinese word-reading sEEG dataset, targeting language-related brain networks, over 12 subjects. Leveraging this benchmark dataset, we developed the Du-IN model that can extract contextual embeddings from specific brain regions through discrete codebook-guided mask modeling. Our model achieves SOTA performance on the downstream 61-word classification task, surpassing all baseline models. Model comparison and ablation analysis reveal that our design choices, including (i) multi-variate representation by fusing channels in vSMC and STG regions and (ii) self-supervision by discrete codebook-guided mask modeling, significantly contribute to these performances. Collectively, our approach, inspired by neuroscience findings, capitalizing on multi-variate neural representation from specific brain regions, is suitable for invasive brain modeling. It marks a promising neuro-inspired AI approach in BCI.

With the rapid deployment of SCADA systems, how to effectively analyze industrial signals and detect abnormal states is an urgent need for the industry. Due to the significant heterogeneity of these signals, which we summarize as the M5 problem, previous works only focus on small sub-problems and employ specialized models, failing to utilize the synergies between modalities and the powerful scaling law. However, we argue that the M5 signals can be modeled in a unified manner due to the intrinsic similarity. As a result, we propose FISHER, a Foundation model for multi-modal Industrial Signal compreHEnsive Representation. To support arbitrary sampling rates, FISHER considers the increment of sampling rate as the concatenation of sub-band information. Specifically, FISHER takes the STFT sub-band as the modeling unit and adopts a teacher student SSL framework for pre-training. We also develop the RMIS benchmark, which evaluates the representations of M5 industrial signals on multiple health management tasks. Compared with top SSL models, FISHER showcases versatile and outstanding capabilities with a general performance gain up to 5.03%, along with much more efficient scaling curves. We also investigate the scaling law on downstream tasks and derive potential avenues for future works. FISHER is now open-sourced on https://github.com/jianganbai/FISHER

In this work, we contribute towards the development of video-based epileptic seizure classification by introducing a novel framework (SETR-PKD), which could achieve privacy-preserved early detection of seizures in videos. Specifically, our framework has two significant components - (1) It is built upon optical flow features extracted from the video of a seizure, which encodes the seizure motion semiotics while preserving the privacy of the patient; (2) It utilizes a transformer based progressive knowledge distillation, where the knowledge is gradually distilled from networks trained on a longer portion of video samples to the ones which will operate on shorter portions. Thus, our proposed framework addresses the limitations of the current approaches which compromise the privacy of the patients by directly operating on the RGB video of a seizure as well as impede real-time detection of a seizure by utilizing the full video sample to make a prediction. Our SETR-PKD framework could detect tonic-clonic seizures (TCSs) in a privacy-preserving manner with an accuracy of 83.9% while they are only half-way into their progression. Our data and code is available at https://github.com/DevD1092/seizure-detection

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

Automated interpretation of electrocardiograms (ECG) has garnered significant attention with the advancements in machine learning methodologies. Despite the growing interest, most current studies focus solely on classification or regression tasks, which overlook a crucial aspect of clinical cardio-disease diagnosis: the diagnostic report generated by experienced human clinicians. In this paper, we introduce a novel approach to ECG interpretation, leveraging recent breakthroughs in Large Language Models (LLMs) and Vision-Transformer (ViT) models. Rather than treating ECG diagnosis as a classification or regression task, we propose an alternative method of automatically identifying the most similar clinical cases based on the input ECG data. Also, since interpreting ECG as images is more affordable and accessible, we process ECG as encoded images and adopt a vision-language learning paradigm to jointly learn vision-language alignment between encoded ECG images and ECG diagnosis reports. Encoding ECG into images can result in an efficient ECG retrieval system, which will be highly practical and useful in clinical applications. More importantly, our findings could serve as a crucial resource for providing diagnostic services in underdeveloped regions.

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.

We propose EEG-SimpleConv, a straightforward 1D convolutional neural network for Motor Imagery decoding in BCI. Our main motivation is to propose a simple and performing baseline to compare to, using only very standard ingredients from the literature. We evaluate its performance on four EEG Motor Imagery datasets, including simulated online setups, and compare it to recent Deep Learning and Machine Learning approaches. EEG-SimpleConv is at least as good or far more efficient than other approaches, showing strong knowledge-transfer capabilities across subjects, at the cost of a low inference time. We advocate that using off-the-shelf ingredients rather than coming with ad-hoc solutions can significantly help the adoption of Deep Learning approaches for BCI. We make the code of the models and the experiments accessible.

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.

Contrastive representation learning struggles on physiological signals when each subject contributes a distinct baseline pattern. If class differences overlap with subject differences,class-level objectives such as supervised contrastive learning tend to merge per-subject structure into a single per-class cluster,removing the individual variation that a model needs to generalize to unseen patients. We study this problem in the setting of Paroxysmal Atrial Fibrillation(PAF) detection from RR-interval(RRI) sequences and propose a patient-aware contrastive objective that forms positive pairs only from same-patient, same-class segments, preserving each patient's own sinus rhythm(SR) baseline while still pushing the two classes apart. Examining the learned embeddings directly, our objective achieves the most consistent per-patient SR structure (cohesion 0.850 vs. 0.800 for supervised contrastive loss (SupCon) and 0.772 for binary cross-entropy (BCE)). We also identify that BCE produces the cleanest global class separation yet the most disordered per-patient structure. This is precisely why a linear probe trained on its features breaks down on unseen patients. On the IRIDIA-AF dataset, the resulting representation reaches a patient-independent Area Under the Receiver Operating Characteristic Curve (AUROC) of 0.989 pm 0.003 with 2.6times lower seed variance than supervised contrastive baselines.These results highlight that per-subject geometric consistency, rather than global class separability, is key to robust cross-patient generalization.

We characterise the dynamics of neuronal activity, in terms of field theory, using neural units placed on a 2D-lattice modelling the cortical surface. The electrical activity of neuronal units was analysed with the aim of deriving a neural field model with a simple functional form that still able to predict or reproduce empirical findings. Each neural unit was modelled using a neural mass and the accompanying field theory was derived in the continuum limit. The field theory comprised coupled (real) Klein-Gordon fields, where predictions of the model fall within the range of experimental findings. These predictions included the frequency spectrum of electric activity measured from the cortex, which was derived using an equipartition of energy over eigenfunctions of the neural fields. Moreover, the neural field model was invariant, within a set of parameters, to the dynamical system used to model each neuronal mass. Specifically, topologically equivalent dynamical systems resulted in the same neural field model when connected in a lattice; indicating that the fields derived could be read as a canonical cortical field theory. We specifically investigated non-dispersive fields that provide a structure for the coding (or representation) of afferent information. Further elaboration of the ensuing neural field theory, including the effect of dispersive forces, could be of importance in the understanding of the cortical processing of information.

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.

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}.

Foundation models offer a promising paradigm for Electroencephalography (EEG) analysis, leveraging generalizable representations from vast unlabeled datasets. Yet, Transformer-based architectures face a critical bottleneck: global attention mechanisms couple the attention memory state to the signal duration, causing memory overflow during continuous monitoring. To address this, we introduce S-CEReBrO (Streaming CEReBrO), an evolution of the CEReBrO architecture designed for continuous monitoring. Our novel Windowed Alternating Attention mechanism factorizes attention computation into fixed-size spatiotemporal windows, guaranteeing constant KV cache memory as only the active window requires resident attention maps. Empirical scaling analysis confirms that windowed alternating attention can process signals 100X longer than full self-attention and 3X longer than low-rank linear attention. Compared to low-rank linear attention on long contexts, windowed alternating attention requires 55% of the memory while increasing inference throughput by 2.1X. Pre-trained on >25,000 hours of recordings from >12,000 subjects, S-CEReBrO achieves state-of-the-art performance on 7 of 11 downstream tasks, with up to 60% fewer parameters. This work represents a significant step toward the realization of efficient, generalizable, and continuous EEG monitoring. An accompanying code repository is available.

State-space models (SSMs) have recently emerged as a framework for learning long-range sequence tasks. An example is the structured state-space sequence (S4) layer, which uses the diagonal-plus-low-rank structure of the HiPPO initialization framework. However, the complicated structure of the S4 layer poses challenges; and, in an effort to address these challenges, models such as S4D and S5 have considered a purely diagonal structure. This choice simplifies the implementation, improves computational efficiency, and allows channel communication. However, diagonalizing the HiPPO framework is itself an ill-posed problem. In this paper, we propose a general solution for this and related ill-posed diagonalization problems in machine learning. We introduce a generic, backward-stable "perturb-then-diagonalize" (PTD) methodology, which is based on the pseudospectral theory of non-normal operators, and which may be interpreted as the approximate diagonalization of the non-normal matrices defining SSMs. Based on this, we introduce the S4-PTD and S5-PTD models. Through theoretical analysis of the transfer functions of different initialization schemes, we demonstrate that the S4-PTD/S5-PTD initialization strongly converges to the HiPPO framework, while the S4D/S5 initialization only achieves weak convergences. As a result, our new models show resilience to Fourier-mode noise-perturbed inputs, a crucial property not achieved by the S4D/S5 models. In addition to improved robustness, our S5-PTD model averages 87.6% accuracy on the Long-Range Arena benchmark, demonstrating that the PTD methodology helps to improve the accuracy of deep learning models.

Generating clinical reports that summarize abnormal patterns, diagnostic findings, and clinical interpretations from long-term EEG recordings remains labor-intensive. We curate a large-scale clinical EEG dataset with 9{,}922 reports paired with approximately 11{,}000 hours of EEG recordings from 9{,}048 patients. We therefore develop CELM, the first clinical EEG-to-Language foundation model capable of summarizing long-duration, variable-length EEG recordings and performing end-to-end clinical report generation at multiple scales, including recording description, background activity, epileptiform abnormalities, events/seizures, and impressions. Experimental results show that, with patient history supervision, our method achieves 70%-95% average relative improvements in standard generation metrics (e.g., ROUGE-1 and METEOR) from 0.2-0.3 to 0.4-0.6. In the zero-shot setting without patient history, CELM attains generation scores in the range of 0.43-0.52, compared to baselines of 0.17-0.26. CELM integrates pretrained EEG foundation models with language models to enable scalable multimodal learning. We release our model and benchmark construction pipeline at https://github.com/Jathurshan0330/CELM.

This study introduces a novel application of a Generative Pre-trained Transformer (GPT) model tailored for photoplethysmography (PPG) signals, serving as a foundation model for various downstream tasks. Adapting the standard GPT architecture to suit the continuous characteristics of PPG signals, our approach demonstrates promising results. Our models are pre-trained on our extensive dataset that contains more than 200 million 30s PPG samples. We explored different supervised fine-tuning techniques to adapt our model to downstream tasks, resulting in performance comparable to or surpassing current state-of-the-art (SOTA) methods in tasks like atrial fibrillation detection. A standout feature of our GPT model is its inherent capability to perform generative tasks such as signal denoising effectively, without the need for further fine-tuning. This success is attributed to the generative nature of the GPT framework.

Energy-Based Models (EBMs) have emerged as a powerful framework in the realm of generative modeling, offering a unique perspective that aligns closely with principles of statistical mechanics. This review aims to provide physicists with a comprehensive understanding of EBMs, delineating their connection to other generative models such as Generative Adversarial Networks (GANs), Variational Autoencoders (VAEs), and Normalizing Flows. We explore the sampling techniques crucial for EBMs, including Markov Chain Monte Carlo (MCMC) methods, and draw parallels between EBM concepts and statistical mechanics, highlighting the significance of energy functions and partition functions. Furthermore, we delve into state-of-the-art training methodologies for EBMs, covering recent advancements and their implications for enhanced model performance and efficiency. This review is designed to clarify the often complex interconnections between these models, which can be challenging due to the diverse communities working on the topic.

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.

Study Objectives: We investigate a Mamba-based deep learning approach for sleep staging on signals from ANNE One (Sibel Health, Evanston, IL), a non-intrusive dual-module wireless wearable system measuring chest electrocardiography (ECG), triaxial accelerometry, and chest temperature, and finger photoplethysmography and finger temperature. Methods: We obtained wearable sensor recordings from 357 adults undergoing concurrent polysomnography (PSG) at a tertiary care sleep lab. Each PSG recording was manually scored and these annotations served as ground truth labels for training and evaluation of our models. PSG and wearable sensor data were automatically aligned using their ECG channels with manual confirmation by visual inspection. We trained a Mamba-based recurrent neural network architecture on these recordings. Ensembling of model variants with similar architectures was performed. Results: After ensembling, the model attains a 3-class (wake, non rapid eye movement [NREM] sleep, rapid eye movement [REM] sleep) balanced accuracy of 84.02%, F1 score of 84.23%, Cohen's κ of 72.89%, and a Matthews correlation coefficient (MCC) score of 73.00%; a 4-class (wake, light NREM [N1/N2], deep NREM [N3], REM) balanced accuracy of 75.30%, F1 score of 74.10%, Cohen's κ of 61.51%, and MCC score of 61.95%; a 5-class (wake, N1, N2, N3, REM) balanced accuracy of 65.11%, F1 score of 66.15%, Cohen's κ of 53.23%, MCC score of 54.38%. Conclusions: Our Mamba-based deep learning model can successfully infer major sleep stages from the ANNE One, a wearable system without electroencephalography (EEG), and can be applied to data from adults attending a tertiary care sleep clinic.

Besides entity-centric knowledge, usually organized as Knowledge Graph (KG), events are also an essential kind of knowledge in the world, which trigger the spring up of event-centric knowledge representation form like Event KG (EKG). It plays an increasingly important role in many downstream applications, such as search, question-answering, recommendation, financial quantitative investments, and text generation. This paper provides a comprehensive survey of EKG from history, ontology, instance, and application views. Specifically, to characterize EKG thoroughly, we focus on its history, definition, schema induction, acquisition, related representative graphs/systems, and applications. The development processes and trends are studied therein. We further summarize prospective directions to facilitate future research on EKG.

Accurate classification of sleep stages from less obtrusive sensor measurements such as the electrocardiogram (ECG) or photoplethysmogram (PPG) could enable important applications in sleep medicine. Existing approaches to this problem have typically used deep learning models designed and trained to operate on one or more specific input signals. However, the datasets used to develop these models often do not contain the same sets of input signals. Some signals, particularly PPG, are much less prevalent than others, and this has previously been addressed with techniques such as transfer learning. Additionally, only training on one or more fixed modalities precludes cross-modal information transfer from other sources, which has proved valuable in other problem domains. To address this, we introduce wav2sleep, a unified model designed to operate on variable sets of input signals during training and inference. After jointly training on over 10,000 overnight recordings from six publicly available polysomnography datasets, including SHHS and MESA, wav2sleep outperforms existing sleep stage classification models across test-time input combinations including ECG, PPG, and respiratory signals.

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.

Physiological time series signals reflect complex, multi-scale dynamical processes of the human body. Existing modeling studies focus on static tasks such as classification, event forecasting, or short-horizon next step prediction, while long-horizon signal-level forecasting and predictive nature of physiological signals remain underexplored. We introduce NormWear-2, a world model that encodes both multivariate physiological signals and clinical intervention variables into a shared latent space and models their joint temporal evolution as a dynamical system. Our approach combines inference from prior pre-trained knowledge (intuition) with instant non-parametric latent state transition adaptation (insight), enabling coherent forecasting across multiple temporal scales, conditioned on heterogeneous clinical interventions. During the pretraining phase, we find that chaos-theoretic balancing of dynamical regime diversity yields more robust representations, with a smaller balanced corpus outperforming one twice its size and capturing bifurcation regimes. We evaluate the world model performance across diverse real-world physiological datasets spanning heterogeneous temporal resolutions and intervention regimes, covering daily life, point-of-care, and clinical settings, including fitness planning, hemodialysis, diabetes management, and surgical monitoring. These evaluation datasets comprise records from 8,026 subjects, spanning study durations from 3.2 hours for high-resolution signal data to 2.3 years for longitudinal clinical biomarker tracking. NormWear-2 achieves the best overall forecasting performance across time, frequency, and latent representation domains, with significant improvements over state-of-the-art time series foundation models, while maintaining competitive downstream representation quality, providing a step toward general-purpose world models for physiological signals.

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.

Electrocardiogram (ECG) is essential for the clinical diagnosis of arrhythmias and other heart diseases, but deep learning methods based on ECG often face limitations due to the need for high-quality annotations. Although previous ECG self-supervised learning (eSSL) methods have made significant progress in representation learning from unannotated ECG data, they typically treat ECG signals as ordinary time-series data, segmenting the signals using fixed-size and fixed-step time windows, which often ignore the form and rhythm characteristics and latent semantic relationships in ECG signals. In this work, we introduce a novel perspective on ECG signals, treating heartbeats as words and rhythms as sentences. Based on this perspective, we first designed the QRS-Tokenizer, which generates semantically meaningful ECG sentences from the raw ECG signals. Building on these, we then propose HeartLang, a novel self-supervised learning framework for ECG language processing, learning general representations at form and rhythm levels. Additionally, we construct the largest heartbeat-based ECG vocabulary to date, which will further advance the development of ECG language processing. We evaluated HeartLang across six public ECG datasets, where it demonstrated robust competitiveness against other eSSL methods. Our data and code are publicly available at https://github.com/PKUDigitalHealth/HeartLang.

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.

Current medical language models, adapted from large language models (LLMs), typically predict ICD code-based diagnosis from electronic health records (EHRs) because these labels are readily available. However, ICD codes do not capture the nuanced, context-rich reasoning clinicians use for diagnosis. Clinicians synthesize diverse patient data and reference clinical practice guidelines (CPGs) to make evidence-based decisions. This misalignment limits the clinical utility of existing models. We introduce GARMLE-G, a Generation-Augmented Retrieval framework that grounds medical language model outputs in authoritative CPGs. Unlike conventional Retrieval-Augmented Generation based approaches, GARMLE-G enables hallucination-free outputs by directly retrieving authoritative guideline content without relying on model-generated text. It (1) integrates LLM predictions with EHR data to create semantically rich queries, (2) retrieves relevant CPG knowledge snippets via embedding similarity, and (3) fuses guideline content with model output to generate clinically aligned recommendations. A prototype system for hypertension diagnosis was developed and evaluated on multiple metrics, demonstrating superior retrieval precision, semantic relevance, and clinical guideline adherence compared to RAG-based baselines, while maintaining a lightweight architecture suitable for localized healthcare deployment. This work provides a scalable, low-cost, and hallucination-free method for grounding medical language models in evidence-based clinical practice, with strong potential for broader clinical deployment.

Electroencephalography (EEG) is a cornerstone of brain-computer interfaces and clinical neuroscience, yet deep learning models are typically trained and evaluated under a single, unreported preprocessing pipeline. We formalize preprocessing choices as a counterfactual intervention space and show that EEG predictions are surprisingly unstable under this space: across six datasets spanning four paradigms, up to 42% of trial-level predictions flip when only the preprocessing changes, a variability that standard uncertainty methods do not explicitly quantify because they condition on a fixed preprocessing pipeline. We provide three tools to make this instability measurable, decomposable, and reducible. First, a Walsh-Hadamard decomposition of the 2^7 pipeline space reveals that sensitivity is near-additive in practice under the binary intervention design, enabling efficient step-by-step optimization. Second, we introduce Preprocessing Uncertainty (PU), a per-trial diagnostic that captures a dimension of instability complementary to model-based confidence. Third, we study Normalized Adaptive PGI (NA-PGI), a graph-structured regularizer that exploits the compositional structure of preprocessing interventions as one mitigation strategy with clear scope conditions.

Reinforcement learning (RL) tasks are typically framed as Markov Decision Processes (MDPs), assuming that decisions are made at fixed time intervals. However, many applications of great importance, including healthcare, do not satisfy this assumption, yet they are commonly modelled as MDPs after an artificial reshaping of the data. In addition, most healthcare (and similar) problems are offline by nature, allowing for only retrospective studies. To address both challenges, we begin by discussing the Semi-MDP (SMDP) framework, which formally handles actions of variable timings. We next present a formal way to apply SMDP modifications to nearly any given value-based offline RL method. We use this theory to introduce three SMDP-based offline RL algorithms, namely, SDQN, SDDQN, and SBCQ. We then experimentally demonstrate that only these SMDP-based algorithms learn the optimal policy in variable-time environments, whereas their MDP counterparts do not. Finally, we apply our new algorithms to a real-world offline dataset pertaining to warfarin dosing for stroke prevention and demonstrate similar results.

This study concentrates on evaluating the efficacy of Large Language Models (LLMs) in healthcare, with a specific focus on their application in personal anomalous health monitoring. Our research primarily investigates the capabilities of LLMs in interpreting and analyzing physiological data obtained from FDA-approved devices. We conducted an extensive analysis using anomalous physiological data gathered in a simulated low-air-pressure plateau environment. This allowed us to assess the precision and reliability of LLMs in understanding and evaluating users' health status with notable specificity. Our findings reveal that LLMs exhibit exceptional performance in determining medical indicators, including a Mean Absolute Error (MAE) of less than 1 beat per minute for heart rate and less than 1% for oxygen saturation (SpO2). Furthermore, the Mean Absolute Percentage Error (MAPE) for these evaluations remained below 1%, with the overall accuracy of health assessments surpassing 85%. In image analysis tasks, such as interpreting photoplethysmography (PPG) data, our specially adapted GPT models demonstrated remarkable proficiency, achieving less than 1 bpm error in cycle count and 7.28 MAE for heart rate estimation. This study highlights LLMs' dual role as health data analysis tools and pivotal elements in advanced AI health assistants, offering personalized health insights and recommendations within the future health assistant framework.

Conventional multi-lead electrocardiogram (ECG) systems capture cardiac signals from a fixed set of anatomical viewpoints defined by lead placement. However, certain cardiac conditions (e.g., Brugada syndrome) require additional, non-standard viewpoints to reveal diagnostically critical patterns that may be absent in standard leads. To systematically overcome this limitation, Nef-Net was recently introduced to reconstruct a continuous electrocardiac field, enabling virtual observation of ECG signals from arbitrary views (termed Electrocardio Panorama). Despite its promise, Nef-Net operates under idealized assumptions and faces in-the-wild challenges, such as long-duration ECG modeling, robustness to device-specific signal artifacts, and suboptimal lead placement calibration. This paper presents NEF-NET+, an enhanced framework for realistic panoramic ECG synthesis that supports arbitrary-length signal synthesis from any desired view, generalizes across ECG devices, and compensates for operator-induced deviations in electrode placement. These capabilities are enabled by a newly designed model architecture that performs direct view transformation, incorporating a workflow comprising offline pretraining, device calibration tuning steps as well as an on-the-fly calibration step for patient-specific adaptation. To rigorously evaluate panoramic ECG synthesis, we construct a new Electrocardio Panorama benchmark, called Panobench, comprising 5367 recordings with 48-view per subject, capturing the full spatial variability of cardiac electrical activity. Experimental results show that NEF-NET+ delivers substantial improvements over Nef-Net, yielding an increase of around 6 dB in PSNR in real-world setting. The code and Panobench will be released in a subsequent publication.

Objective: To transform heterogeneous clinical data from electronic health records into clinically meaningful constructed features using data driven method that rely, in part, on temporal relations among data. Materials and Methods: The clinically meaningful representations of medical concepts and patients are the key for health analytic applications. Most of existing approaches directly construct features mapped to raw data (e.g., ICD or CPT codes), or utilize some ontology mapping such as SNOMED codes. However, none of the existing approaches leverage EHR data directly for learning such concept representation. We propose a new way to represent heterogeneous medical concepts (e.g., diagnoses, medications and procedures) based on co-occurrence patterns in longitudinal electronic health records. The intuition behind the method is to map medical concepts that are co-occuring closely in time to similar concept vectors so that their distance will be small. We also derive a simple method to construct patient vectors from the related medical concept vectors. Results: For qualitative evaluation, we study similar medical concepts across diagnosis, medication and procedure. In quantitative evaluation, our proposed representation significantly improves the predictive modeling performance for onset of heart failure (HF), where classification methods (e.g. logistic regression, neural network, support vector machine and K-nearest neighbors) achieve up to 23% improvement in area under the ROC curve (AUC) using this proposed representation. Conclusion: We proposed an effective method for patient and medical concept representation learning. The resulting representation can map relevant concepts together and also improves predictive modeling performance.

Electrocardiography (ECG) is one of the most widely used tests for diagnosing cardiovascular disease. Yet several remote clinics still utilize paper ECG printouts for their analysis due to limited connectivity and computational capacity. As a result, vast numbers of physical ECGs obtained in remote areas still remain incapable of being accessed by contemporary artificial-intelligence (AI)-based decision support as they require high computational resources or strong high-speed internet connectivity. This causes several cases where conditions like acute coronary occlusion (ACS) is overlooked and reperfusion therapy delayed. Although prior work has tackled digitization and diagnosis separately, and utilized advanced AI models for them, there still remains a lack of a compute-light, on-device framework that reconstructs paper ECGs at high fidelity, while accurately supporting multiple clinically relevant endpoints. We address this need with an end-to-end lightweight on-device digitization-to-diagnosis pipeline that converts a smartphone photo or scan of a paper ECG into a calibrated 12-lead signal and screens for Myocardial Infarction (MI) pathologies, with SHapley Additive exPlanations (SHAP) to support interpretability. Trained and evaluated on 21,799 ECGs from the PTB-XL dataset and further validated on hospital-acquired ECG-Matrix dataset, the complete system runs in <30 s per ECG on CPU-only resources, achieving 95.51% accuracy (F1 = 0.9519) for MI detection on PTB-XL and 88.89% accuracy (F1 = 0.8862) for OMI detection on ECG-Matrix. This work showcases that legacy paper records can be reliably democratized in any part of the world, providing a scalable decision support when digital ECG export, connectivity, or high-end compute are unavailable

Price responsiveness is a major feature of end use customers (EUCs) that participate in demand response (DR) programs, and has been conventionally modeled with static demand functions, which take the electricity price as the input and the aggregate energy consumption as the output. This, however, neglects the inherent temporal correlation of the EUC behaviors, and may result in large errors when predicting the actual responses of EUCs in real-time pricing (RTP) programs. In this paper, we propose a dynamical DR model so as to capture the temporal behavior of the EUCs. The states in the proposed dynamical DR model can be explicitly chosen, in which case the model can be represented by a linear function or a multi-layer feedforward neural network, or implicitly chosen, in which case the model can be represented by a recurrent neural network or a long short-term memory unit network. In both cases, the dynamical DR model can be learned from historical price and energy consumption data. Numerical simulation illustrated how the states are chosen and also showed the proposed dynamical DR model significantly outperforms the static ones.

Sepsis remains one of the leading causes of mortality in intensive care units, where timely and accurate treatment decisions can significantly impact patient outcomes. In this work, we propose an interpretable decision support framework. Our system integrates four core components: (1) a clustering-based stratification module that categorizes patients into low, intermediate, and high-risk groups upon ICU admission, using clustering with statistical validation; (2) a synthetic data augmentation pipeline leveraging variational autoencoders (VAE) and diffusion models to enrich underrepresented trajectories such as fluid or vasopressor administration; (3) an offline reinforcement learning (RL) agent trained using Advantage Weighted Regression (AWR) with a lightweight attention encoder and supported by an ensemble models for conservative, safety-aware treatment recommendations; and (4) a rationale generation module powered by a multi-modal large language model (LLM), which produces natural-language justifications grounded in clinical context and retrieved expert knowledge. Evaluated on the MIMIC-III and eICU datasets, our approach achieves high treatment accuracy while providing clinicians with interpretable and robust policy recommendations.

As the capabilities of Large Language Models (LLMs) in healthcare and medicine continue to advance, there is a growing need for competitive open-source models that can safeguard public interest. With the increasing availability of highly competitive open base models, the impact of continued pre-training is increasingly uncertain. In this work, we explore the role of instruct tuning, model merging, alignment, red teaming and advanced inference schemes, as means to improve current open models. To that end, we introduce the Aloe family, a set of open medical LLMs highly competitive within its scale range. Aloe models are trained on the current best base models (Mistral, LLaMA 3), using a new custom dataset which combines public data sources improved with synthetic Chain of Thought (CoT). Aloe models undergo an alignment phase, becoming one of the first few policy-aligned open healthcare LLM using Direct Preference Optimization, setting a new standard for ethical performance in healthcare LLMs. Model evaluation expands to include various bias and toxicity datasets, a dedicated red teaming effort, and a much-needed risk assessment for healthcare LLMs. Finally, to explore the limits of current LLMs in inference, we study several advanced prompt engineering strategies to boost performance across benchmarks, yielding state-of-the-art results for open healthcare 7B LLMs, unprecedented at this scale.

In this work, we introduce LightCNN, a minimalist Convolutional Neural Network (CNN) architecture designed for Parkinson's disease (PD) classification using EEG data. LightCNN's strength lies in its simplicity, utilizing just a single convolutional layer. Embracing Leonardo da Vinci's principle that "simplicity is the ultimate sophistication," LightCNN demonstrates that complexity is not required to achieve outstanding results. We benchmarked LightCNN against several state-of-the-art deep learning models known for their effectiveness in EEG-based PD classification. Remarkably, LightCNN outperformed all these complex architectures, with a 2.3% improvement in recall, a 4.6% increase in precision, a 0.1% edge in AUC, a 4% boost in F1-score, and a 3.3% higher accuracy compared to the closest competitor. Furthermore, LightCNN identifies known pathological brain rhythms associated with PD and effectively captures clinically relevant neurophysiological changes in EEG. Its simplicity and interpretability make it ideal for deployment in resource-constrained environments, such as mobile or embedded systems for EEG analysis. In conclusion, LightCNN represents a significant step forward in efficient EEG-based PD classification, demonstrating that a well-designed, lightweight model can achieve superior performance over more complex architectures. This work underscores the potential for minimalist models to meet the needs of modern healthcare applications, particularly where resources are limited.

We develop a data-driven deep neural operator framework to approximate multiple output states for a diesel engine and generate real-time predictions with reasonable accuracy. As emission norms become more stringent, the need for fast and accurate models that enable analysis of system behavior have become an essential requirement for system development. The fast transient processes involved in the operation of a combustion engine make it difficult to develop accurate physics-based models for such systems. As an alternative to physics based models, we develop an operator-based regression model (DeepONet) to learn the relevant output states for a mean-value gas flow engine model using the engine operating conditions as input variables. We have adopted a mean-value model as a benchmark for comparison, simulated using Simulink. The developed approach necessitates using the initial conditions of the output states to predict the accurate sequence over the temporal domain. To this end, a sequence-to-sequence approach is embedded into the proposed framework. The accuracy of the model is evaluated by comparing the prediction output to ground truth generated from Simulink model. The maximum mathcal L_2 relative error observed was approximately 6.5%. The sensitivity of the DeepONet model is evaluated under simulated noise conditions and the model shows relatively low sensitivity to noise. The uncertainty in model prediction is further assessed by using a mean ensemble approach. The worst-case error at the (mu + 2sigma) boundary was found to be 12%. The proposed framework provides the ability to predict output states in real-time and enables data-driven learning of complex input-output operator mapping. As a result, this model can be applied during initial development stages, where accurate models may not be available.

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.

Epilepsy is a common disease of the nervous system. Timely prediction of seizures and intervention treatment can significantly reduce the accidental injury of patients and protect the life and health of patients. This paper presents a neuromorphic Spiking Convolutional Transformer, named Spiking Conformer, to detect and predict epileptic seizure segments from scalped long-term electroencephalogram (EEG) recordings. We report evaluation results from the Spiking Conformer model using the Boston Children's Hospital-MIT (CHB-MIT) EEG dataset. By leveraging spike-based addition operations, the Spiking Conformer significantly reduces the classification computational cost compared to the non-spiking model. Additionally, we introduce an approximate spiking neuron layer to further reduce spike-triggered neuron updates by nearly 38% without sacrificing accuracy. Using raw EEG data as input, the proposed Spiking Conformer achieved an average sensitivity rate of 94.9% and a specificity rate of 99.3% for the seizure detection task, and 96.8%, 89.5% for the seizure prediction task, and needs >10x fewer operations compared to the non-spiking equivalent model.

Nowadays, neural networks act as a synonym for artificial intelligence. Present neural network models, although remarkably powerful, are inefficient both in terms of data and energy. Several alternative forms of neural networks have been proposed to address some of these problems. Specifically, spiking neural networks are suitable for efficient hardware implementations. However, effective learning algorithms for spiking networks remain elusive, although it is suspected that effective plasticity mechanisms could alleviate the problem of data efficiency. Here, we present a new framework for spiking neural networks - Spark - built upon the idea of modular design, from simple components to entire models. The aim of this framework is to provide an efficient and streamlined pipeline for spiking neural networks. We showcase this framework by solving the sparse-reward cartpole problem with simple plasticity mechanisms. We hope that a framework compatible with traditional ML pipelines may accelerate research in the area, specifically for continuous and unbatched learning, akin to the one animals exhibit.

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.

We present a novel framework for leveraging synthetic ICU time-series data not only to train but also to rigorously and trustworthily evaluate predictive models, both at the population level and within fine-grained demographic subgroups. Building on prior diffusion and VAE-based generators (TimeDiff, HealthGen, TimeAutoDiff), we introduce Enhanced TimeAutoDiff, which augments the latent diffusion objective with distribution-alignment penalties. We extensively benchmark all models on MIMIC-III and eICU, on 24-hour mortality and binary length-of-stay tasks. Our results show that Enhanced TimeAutoDiff reduces the gap between real-on-synthetic and real-on-real evaluation (``TRTS gap'') by over 70\%, achieving Δ_{TRTS} leq 0.014 AUROC, while preserving training utility (Δ_{TSTR} approx 0.01). Crucially, for 32 intersectional subgroups, large synthetic cohorts cut subgroup-level AUROC estimation error by up to 50\% relative to small real test sets, and outperform them in 72--84\% of subgroups. This work provides a practical, privacy-preserving roadmap for trustworthy, granular model evaluation in critical care, enabling robust and reliable performance analysis across diverse patient populations without exposing sensitive EHR data, contributing to the overall trustworthiness of Medical AI.

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

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.

Electrocardiograms (ECGs), a medical monitoring technology recording cardiac activity, are widely used for diagnosing cardiac arrhythmia. The diagnosis is based on the analysis of the deformation of the signal shapes due to irregular heart rates associated with heart diseases. Due to the infeasibility of manual examination of large volumes of ECG data, this paper aims to propose an automated AI based system for ECG-based arrhythmia classification. To this front, a deep learning based solution has been proposed for ECG-based arrhythmia classification. Twelve lead electrocardiograms (ECG) of length 10 sec from 45, 152 individuals from Shaoxing People's Hospital (SPH) dataset from PhysioNet with four different types of arrhythmias were used. The sampling frequency utilized was 500 Hz. Median filtering was used to preprocess the ECG signals. For every 1 sec of ECG signal, the time-frequency (TF) scalogram was estimated and stacked row wise to obtain a single image from 12 channels, resulting in 10 stacked TF scalograms for each ECG signal. These stacked TF scalograms are fed to the pretrained convolutional neural network (CNN), 1D CNN, and 1D CNN-LSTM (Long short-term memory) models, for arrhythmia classification. The fine-tuned CNN models obtained the best test accuracy of about 98% followed by 95% test accuracy by basic CNN-LSTM in arrhythmia classification.