Daily Papers

Context. Low-mass bodies, such as comets, asteroids, planetesimals, and free-floating planets, are continuously injected into the intra-cluster environment after expulsion from their host planetary systems. These can be modeled as massless particles (MLPs, hereafter). The dynamics of large populations of MLPs, however, has yet received little attention in literature. Aims. We investigate the dynamical evolution of MLP populations in star clusters, and characterize their kinematics and ejection rates. Methods. We present NBODY6++GPU-MASSLESS, a modified version of the N-body simulation code NBODY6++GPU, that allows fast integration of star clusters that contain large numbers of massless particles (MLPs). NBODY6++GPU-MASSLESS contains routines specifically directed at the dynamical evolution of low-mass bodies, such as planets. Results. Unlike stars, MLPs do not participate in the mass segregation process. Instead, MLPs mostly follow the gravitational potential of the star cluster, which gradually decreases over time due to stellar ejections and stellar evolution. The dynamical evolution of MLPs is primarily affected by the evolution of the core of the star cluster. This is most apparent in the outer regions for clusters with higher initial densities. High escape rates of MLPs are observed before the core-collapse, after which escape rates remain stable. Denser star clusters undergo a more intense core collapse, but this does not impact the dynamical evolution of MLPs. The speeds of escaping stars are similar to those of escaping MLPs, when disregarding the high-velocity ejections of neutron stars during the first 50 Myr.

One of the main challenges in current research on segmentation in cardiac ultrasound is the lack of large and varied labeled datasets and the differences in annotation conventions between datasets. This makes it difficult to design robust segmentation models that generalize well to external datasets. This work utilizes diffusion models to create generative augmentations that can significantly improve diversity of the dataset and thus the generalisability of segmentation models without the need for more annotated data. The augmentations are applied in addition to regular augmentations. A visual test survey showed that experts cannot clearly distinguish between real and fully generated images. Using the proposed generative augmentations, segmentation robustness was increased when training on an internal dataset and testing on an external dataset with an improvement of over 20 millimeters in Hausdorff distance. Additionally, the limits of agreement for automatic ejection fraction estimation improved by up to 20% of absolute ejection fraction value on out of distribution cases. These improvements come exclusively from the increased variation of the training data using the generative augmentations, without modifying the underlying machine learning model. The augmentation tool is available as an open source Python library at https://github.com/GillesVanDeVyver/EchoGAINS.

We investigate whether large language models produce different medical triage recommendations for identical symptoms based solely on the language of the patient prompt. Using Gemini 3.5 Flash, we evaluate a neurological symptom profile (persistent headache, blurred vision, nausea) across six languages (English, Spanish, Chinese, Hindi, Japanese, Arabic) with 30 runs per condition (n=450 total API calls). We find that the model recommends emergency room visits at rates ranging from 0% (Japanese, Hindi) to 30% (English, Arabic), despite assigning nearly identical severity scores (7.7-8.0/10) across all languages. Adding a single sentence specifying the patient's US location increases ER recommendations by up to 76.7 percentage points for non-English prompts, while the reverse anchor (English prompt with a Tokyo location) reduces the ER rate from 30% to 6.7%. A back-translation control (Japanese to English) produces ER rates comparable to the English baseline, confirming that the disparity is not caused by translation quality but by implicit geographic inference from the input language. We release the complete dataset, experiment code, and results.

We develop and evaluate a data-driven approach for detecting unusual (anomalous) patient-management decisions using past patient cases stored in electronic health records (EHRs). Our hypothesis is that a patient-management decision that is unusual with respect to past patient care may be due to an error and that it is worthwhile to generate an alert if such a decision is encountered. We evaluate this hypothesis using data obtained from EHRs of 4486 post-cardiac surgical patients and a subset of 222 alerts generated from the data. We base the evaluation on the opinions of a panel of experts. The results of the study support our hypothesis that the outlier-based alerting can lead to promising true alert rates. We observed true alert rates that ranged from 25\% to 66\% for a variety of patient-management actions, with 66\% corresponding to the strongest outliers.

Focused transmit beamforming is the most commonly used acquisition scheme for echocardiograms, but suffers from relatively low frame rates, and in 3D, even lower volume rates. Fast imaging based on unfocused transmits has disadvantages such as motion decorrelation and limited harmonic imaging capabilities. This work introduces a patient-adaptive focused transmit scheme that has the ability to drastically reduce the number of transmits needed to produce a high-quality ultrasound image. The method relies on posterior sampling with a temporal diffusion model to perceive and reconstruct the anatomy based on partial observations, while subsequently taking an action to acquire the most informative transmits. This active perception modality outperforms random and equispaced subsampling on the 2D EchoNet-Dynamic dataset and a 3D Philips dataset, where we actively select focused elevation planes. Furthermore, we show it achieves better performance in terms of generalized contrast-to-noise ratio when compared to the same number of diverging waves transmits on three in-house echocardiograms. Additionally, we can estimate ejection fraction using only 2% of the total transmits and show that the method is robust to outlier patients. Finally, our method can be run in real-time on GPU accelerators from 2023. The code is publicly available at https://tue-bmd.github.io/ulsa/

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.

Word error rate (WER) is the dominant metric for automatic speech recognition, yet it cannot detect a systematic failure mode: models that produce fluent output in the wrong writing system. We define Script Fidelity Rate (SFR), the fraction of hypothesis characters in the target script block, computable without reference transcriptions, and report the first systematic measurement of script collapse across six languages spanning four writing systems (Pashto, Urdu, Hindi, Bengali, Malayalam, Somali) and nine ASR models on FLEURS test sets. Across 53 evaluated model-language pairs, 18 (34%; 95% Wilson CI: 23-47%) exhibit script collapse (SFR < 10%); MMS-1B and SeamlessM4T-v2 maintain SFR above 99% on every language evaluated, confirming that SFR correctly identifies high fidelity where it is present. We identify three distinct collapse patterns: Latin phonetic substitution (smaller Whisper on Indic languages), Arabic substitution for Somali's Latin-script orthography, and Devanagari substitution where larger Whisper models treat all Indic audio as Hindi, a failure present even in Whisper large-v3.