Daily Papers

Accurate segmentation of the coronary vessel lumen is a prerequisite for quantitative assessment of atherosclerotic plaque and perivascular adipose tissue in coronary computed tomography angiography (CCTA). Cardiologists rely on semi-automated methods for this task because manual vessel tracing and segmentation are labour-intensive. Although many automated methods have been proposed, their validation remains limited by the lack of large, high-quality publicly available datasets. We provide a new dataset of voxel-wise annotations of the vessel lumen and coronary segments, alongside centerlines, and mesh surfaces for 800 scans from the publicly available ImageCAS dataset. Using this dataset, we benchmark established lumen segmentation methods against inter-observer variability, stratifying performance by disease, image quality, coronary dominance, coronary segment, vessel diameter, and lumen attenuation. These labels allow segmentation accuracy to be described in anatomical and clinical context rather than reported as a single aggregate score. The dataset supports the development and validation of methods for lumen segmentation, plaque and perivascular quantification, and haemodynamic modelling.

In the domain of medical imaging, many supervised learning based methods for segmentation face several challenges such as high variability in annotations from multiple experts, paucity of labelled data and class imbalanced datasets. These issues may result in segmentations that lack the requisite precision for clinical analysis and can be misleadingly overconfident without associated uncertainty quantification. We propose the PULASki for biomedical image segmentation that accurately captures variability in expert annotations, even in small datasets. Our approach makes use of an improved loss function based on statistical distances in a conditional variational autoencoder structure (Probabilistic UNet), which improves learning of the conditional decoder compared to the standard cross-entropy particularly in class imbalanced problems. We analyse our method for two structurally different segmentation tasks (intracranial vessel and multiple sclerosis (MS) lesion) and compare our results to four well-established baselines in terms of quantitative metrics and qualitative output. Empirical results demonstrate the PULASKi method outperforms all baselines at the 5\% significance level. The generated segmentations are shown to be much more anatomically plausible than in the 2D case, particularly for the vessel task. Our method can also be applied to a wide range of multi-label segmentation tasks and and is useful for downstream tasks such as hemodynamic modelling (computational fluid dynamics and data assimilation), clinical decision making, and treatment planning.

Accurate and rapid estimation of hemodynamic metrics, such as pressure and wall shear stress (WSS), is important for assessing the severity of Coronary Artery Disease (CAD). Existing approaches, including invasive Fractional Flow Reserve (FFR) measurements and computationally expensive Computational Fluid Dynamics (CFD) simulations, face challenges in invasiveness, cost, and speed. We present a framework for fast, non-invasive coronary hemodynamics prediction. The model encodes 1D vessel centerlines together with inlet flow rate using a transformer-based encoder, and predicts continuous wall-based fields via an anisotropic Radial Basis Function (RBF) decoder aligned with vessel morphology. To support training and evaluation, we introduce two datasets with paired steady-state OpenFOAM simulations: (i) a synthetic benchmark of 4,200 single-vessel geometries with controlled anatomical variations, and (ii) a multi-vessel dataset derived from ImageCAS including 4,800 cases spanning both right and left coronary arteries, generated by randomly introducing stenoses and varying physiologically plausible flow rates. Across both datasets, our method achieves lower pressure and WSS errors than strong neural-operator baselines (GNOT, Transolver, and ONO) at a fraction of the computational cost of CFD. On the multi-vessel dataset, using 1,024 anisotropic RBF centers our model reduces the mean relative L2 error by 52% compared to the best neural-operator baseline, while at 128 centers it requires 13.8x fewer FLOPs than GNOT and still outperforms all baselines. The single-vessel dataset is publicly available at https://huggingface.co/datasets/angioinsight/single-vessel-flow.

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.

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.

The development of biophysical models for clinical applications is rapidly advancing in the research community, thanks to their predictive nature and their ability to assist the interpretation of clinical data. However, high-resolution and accurate multi-physics computational models are computationally expensive and their personalisation involves fine calibration of a large number of parameters, which may be space-dependent, challenging their clinical translation. In this work, we propose a new approach which relies on the combination of physics-informed neural networks (PINNs) with three-dimensional soft tissue nonlinear biomechanical models, capable of reconstructing displacement fields and estimating heterogeneous patient-specific biophysical properties. The proposed learning algorithm encodes information from a limited amount of displacement and, in some cases, strain data, that can be routinely acquired in the clinical setting, and combines it with the physics of the problem, represented by a mathematical model based on partial differential equations, to regularise the problem and improve its convergence properties. Several benchmarks are presented to show the accuracy and robustness of the proposed method and its great potential to enable the robust and effective identification of patient-specific, heterogeneous physical properties, s.a. tissue stiffness properties. In particular, we demonstrate the capability of the PINN to detect the presence, location and severity of scar tissue, which is beneficial to develop personalised simulation models for disease diagnosis, especially for cardiac applications.

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

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.

Heart diseases remain the leading cause of mortality worldwide, implying approximately 18 million deaths according to the WHO. In particular, heart failures (HF) press the healthcare industry to develop systems for their early, rapid, and effective prediction. This work presents an automatic system based on a novel framework which combines Modal Decomposition and Masked Autoencoders (MAE) to extend the application from heart disease classification to the more challenging and specific task of heart failure time prediction, not previously addressed to the best of authors' knowledge. This system comprises two stages. The first one transforms the data from a database of echocardiography video sequences into a large collection of annotated images compatible with the training phase of machine learning-based frameworks and deep learning-based ones. This stage includes the use of the Higher Order Dynamic Mode Decomposition (HODMD) algorithm for both data augmentation and feature extraction. The second stage builds and trains a Vision Transformer (ViT). MAEs based on a combined scheme of self-supervised (SSL) and supervised learning, so far barely explored in the literature about heart failure prediction, are adopted to effectively train the ViT from scratch, even with scarce databases. The designed neural network analyses in real-time images from echocardiography sequences to estimate the time of happening a heart failure. This approach demonstrates to improve prediction accuracy from scarce databases and to be superior to several established ViT and Convolutional Neural Network (CNN) architectures. The source code will be incorporated into the next version release of the ModelFLOWs-app software (https://github.com/modelflows/ModelFLOWs-app).

A digital twin is a virtual replica of a real-world physical phenomena that uses mathematical modeling to characterize and simulate its defining features. By constructing digital twins for disease processes, we can perform in-silico simulations that mimic patients' health conditions and counterfactual outcomes under hypothetical interventions in a virtual setting. This eliminates the need for invasive procedures or uncertain treatment decisions. In this paper, we propose a method to identify digital twin model parameters using only noninvasive patient health data. We approach the digital twin modeling as a composite inverse problem, and observe that its structure resembles pretraining and finetuning in self-supervised learning (SSL). Leveraging this, we introduce a physics-informed SSL algorithm that initially pretrains a neural network on the pretext task of solving the physical model equations. Subsequently, the model is trained to reconstruct low-dimensional health measurements from noninvasive modalities while being constrained by the physical equations learned in pretraining. We apply our method to identify digital twins of cardiac hemodynamics using noninvasive echocardiogram videos, and demonstrate its utility in unsupervised disease detection and in-silico clinical trials.

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.

Extracting patient-specific vascular trees from volumetric medical images is fundamental to computational angiography and non-invasive hemodynamic assessment. Conventional voxel segmentation models often sever delicate bifurcations, while heuristic Euclidean Minimum Spanning Trees introduce non-anatomical shortcuts. Moreover, linear Poiseuille flow neglects quadratic kinetic dissipation across arterial narrowings, underestimating ischemia. We formulate an end-to-end framework decoupling continuous geometric arborescence generation from non-linear hemodynamics. First, an autonomous 3D Ostium Landmark Localization Head with dual-sinus query channels and spherical-gated refinement eliminates centerline seeding dependency, achieving cohort mean localization error of 7.63 mm (7.43 mm LCA, 7.83 mm RCA; 71.4% <= 8.0 mm) from raw contrast context. Second, a Spatially-Grounded Deformable Step Flow Architecture queries continuous 3D feature pyramids via trilinear sampling, sequentially generating trajectories with anchor boundary enforcement (X(0) = P_start). Third, a Top-Down Recursive Arborescence State Machine detects bifurcation peaks via Tree-NMS and parameterizes predecessor parent pointers (p_k < k), guaranteeing single connected acyclic tree topology (beta_0 = 1, beta_1 = 0) with differentiable step termination. Fourth, an iterative Picard non-linear Kirchhoff solver with Young-Tsai / Gould quadratic dissipation enforces machine-precision mass conservation (residual 5.82e-11 mL/s). Across 14 development patients under standardized in-silico stenosis stress testing (Q_0 = 4.0 mL/s), linear Poiseuille flow misclassifies 75% diameter lesions as non-ischemic (FFR > 0.80) in 14/14 cases, whereas our non-linear solver captures functional ischemia (FFR = 0.5864, lesion disparity 32.89 mmHg, p = 6.10e-5) with 3.66x collateral shunting. Test set firewall isolation was maintained.

This paper explores the advancements and applications of large-scale models in the medical field, with a particular focus on Medical Large Models (MedLMs). These models, encompassing Large Language Models (LLMs), Vision Models, 3D Large Models, and Multimodal Models, are revolutionizing healthcare by enhancing disease prediction, diagnostic assistance, personalized treatment planning, and drug discovery. The integration of graph neural networks in medical knowledge graphs and drug discovery highlights the potential of Large Graph Models (LGMs) in understanding complex biomedical relationships. The study also emphasizes the transformative role of Vision-Language Models (VLMs) and 3D Large Models in medical image analysis, anatomical modeling, and prosthetic design. Despite the challenges, these technologies are setting new benchmarks in medical innovation, improving diagnostic accuracy, and paving the way for personalized healthcare solutions. This paper aims to provide a comprehensive overview of the current state and future directions of large models in medicine, underscoring their significance in advancing global health.

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.

We introduce EchoXFlow, a clinical echocardiography dataset for learning from ultrasound in its native acquisition geometry rather than from scan-converted Cartesian videos. Existing public datasets offer limited opportunities to study cross-modal relationships between cardiac anatomy, myocardial motion, and blood flow, as Doppler is typically absent or fused as RGB overlays, and acquisitions are released after lossy vendor display processing. EchoXFlow comprises 37125 recordings from 666 routine-care examinations, preserving the timing, geometry, and modality relationships needed for physically grounded echo learning. Each recording is retained as separable modality-specific streams: temporally resolved 1D, 2D, and 3D data alongside multiple Doppler modalities, paired with a synchronized ECG. Clinical annotations span guideline-based measurements to dense 2D myocardial contours and 3D left-ventricular endocardial meshes. With its associated open-source tooling, EchoXFlow enables cross-modal, acquisition-aware learning tasks that cannot be formulated from conventional scan-converted videos alone, and serves as a testbed for 4D vision and physically grounded multi-modal learning more broadly.

Flow matching has emerged as a compelling generative modeling approach that is widely used across domains. To generate data via a flow matching model, an ordinary differential equation (ODE) is numerically solved via forward integration of the modeled velocity field. To better capture the multi-modality that is inherent in typical velocity fields, hierarchical flow matching was recently introduced. It uses a hierarchy of ODEs that are numerically integrated when generating data. This hierarchy of ODEs captures the multi-modal velocity distribution just like vanilla flow matching is capable of modeling a multi-modal data distribution. While this hierarchy enables to model multi-modal velocity distributions, the complexity of the modeled distribution remains identical across levels of the hierarchy. In this paper, we study how to gradually adjust the complexity of the distributions across different levels of the hierarchy via mini-batch couplings. We show the benefits of mini-batch couplings in hierarchical rectified flow matching via compelling results on synthetic and imaging data. Code is available at https://riccizz.github.io/HRF_coupling.

Non-invasive continuous blood pressure (BP) monitoring using photoplethysmography (PPG) is a promising alternative to cuff-based measurements. However, existing PPG-based BP estimation studies predominantly rely on aggregated performance metrics (e.g., mean absolute error) computed over entire evaluation intervals, which can obscure model failures during rapid BP fluctuations and limit clinical relevance. In this work, we propose a fluctuation-aware evaluation framework for PPG-based BP estimation based on time-series change point detection. Instead of heuristic BP thresholding (e.g., ΔBP > 10mmHg), we identify BP change points by capturing abrupt distributional shifts in BP trajectories and evaluate estimation performance specifically during these fluctuation periods. Our analysis shows that several state-of-the-art models exhibit substantial performance degradation around BP change points, and that periodic test-time calibration is insufficient to handle such dynamic BP variations. To address this limitation, we introduce a targeted re-calibration framework triggered by detected BP change points, improving robustness without modifying model architectures. To the best of our knowledge, this is the first systematic evaluation of PPG-based BP estimation from a BP change point perspective, highlighting the importance of fluctuation-aware evaluation and calibration for real-world continuous BP monitoring.

Learning spatial-temporal correspondences in cardiac motion from images is important for understanding the underlying dynamics of cardiac anatomical structures. Many methods explicitly impose smoothness constraints such as the L_2 norm on the displacement vector field (DVF), while usually ignoring biomechanical feasibility in the transformation. Other geometric constraints either regularize specific regions of interest such as imposing incompressibility on the myocardium or introduce additional steps such as training a separate network-based regularizer on physically simulated datasets. In this work, we propose an explicit biomechanics-informed prior as regularization on the predicted DVF in modeling a more generic biomechanically plausible transformation within all cardiac structures without introducing additional training complexity. We validate our methods on two publicly available datasets in the context of 2D MRI data and perform extensive experiments to illustrate the effectiveness and robustness of our proposed methods compared to other competing regularization schemes. Our proposed methods better preserve biomechanical properties by visual assessment and show advantages in segmentation performance using quantitative evaluation metrics. The code is publicly available at https://github.com/Voldemort108X/bioinformed_reg.

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.

Medical applications of machine learning (ML) have experienced a surge in popularity in recent years. The intensive care unit (ICU) is a natural habitat for ML given the abundance of available data from electronic health records. Models have been proposed to address numerous ICU prediction tasks like the early detection of complications. While authors frequently report state-of-the-art performance, it is challenging to verify claims of superiority. Datasets and code are not always published, and cohort definitions, preprocessing pipelines, and training setups are difficult to reproduce. This work introduces Yet Another ICU Benchmark (YAIB), a modular framework that allows researchers to define reproducible and comparable clinical ML experiments; we offer an end-to-end solution from cohort definition to model evaluation. The framework natively supports most open-access ICU datasets (MIMIC III/IV, eICU, HiRID, AUMCdb) and is easily adaptable to future ICU datasets. Combined with a transparent preprocessing pipeline and extensible training code for multiple ML and deep learning models, YAIB enables unified model development. Our benchmark comes with five predefined established prediction tasks (mortality, acute kidney injury, sepsis, kidney function, and length of stay) developed in collaboration with clinicians. Adding further tasks is straightforward by design. Using YAIB, we demonstrate that the choice of dataset, cohort definition, and preprocessing have a major impact on the prediction performance - often more so than model class - indicating an urgent need for YAIB as a holistic benchmarking tool. We provide our work to the clinical ML community to accelerate method development and enable real-world clinical implementations. Software Repository: https://github.com/rvandewater/YAIB.

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.

Transformers have significantly advanced the modeling of Electronic Health Records (EHR), yet their deployment in real-world healthcare is limited by several key challenges. Firstly, the quadratic computational cost and insufficient context length of these models pose significant obstacles for hospitals in processing the extensive medical histories typical in EHR data. Additionally, existing models employ separate finetuning for each clinical task, complicating maintenance in healthcare environments. Moreover, these models focus exclusively on either clinical prediction or EHR forecasting, lacking the flexibility to perform well across both. To overcome these limitations, we introduce EHRMamba, a robust foundation model built on the Mamba architecture. EHRMamba can process sequences up to four times longer than previous models due to its linear computational cost. We also introduce a novel approach to Multitask Prompted Finetuning (MTF) for EHR data, which enables EHRMamba to simultaneously learn multiple clinical tasks in a single finetuning phase, significantly enhancing deployment and cross-task generalization. Furthermore, our model leverages the HL7 FHIR data standard to simplify integration into existing hospital systems. Alongside EHRMamba, we open-source Odyssey, a toolkit designed to support the development and deployment of EHR foundation models, with an emphasis on data standardization and interpretability. Our evaluations on the MIMIC-IV dataset demonstrate that EHRMamba advances state-of-the-art performance across 6 major clinical tasks and excels in EHR forecasting, marking a significant leap forward in the field.

Simulating fluid flow around arbitrary shapes is key to solving various engineering problems. However, simulating flow physics across complex geometries remains numerically challenging and computationally resource-intensive, particularly when using conventional PDE solvers. Machine learning methods offer attractive opportunities to create fast and adaptable PDE solvers. However, benchmark datasets to measure the performance of such methods are scarce, especially for flow physics across complex geometries. We introduce FlowBench, a dataset for neural simulators with over 10K samples, which is currently larger than any publicly available flow physics dataset. FlowBench contains flow simulation data across complex geometries (parametric vs. non-parametric), spanning a range of flow conditions (Reynolds number and Grashoff number), capturing a diverse array of flow phenomena (steady vs. transient; forced vs. free convection), and for both 2D and 3D. FlowBench contains over 10K data samples, with each sample the outcome of a fully resolved, direct numerical simulation using a well-validated simulator framework designed for modeling transport phenomena in complex geometries. For each sample, we include velocity, pressure, and temperature field data at 3 different resolutions and several summary statistics features of engineering relevance (such as coefficients of lift and drag, and Nusselt numbers). %Additionally, we include masks and signed distance fields for each shape. We envision that FlowBench will enable evaluating the interplay between complex geometry, coupled flow phenomena, and data sufficiency on the performance of current, and future, neural PDE solvers. We enumerate several evaluation metrics to help rank order the performance of neural PDE solvers. We benchmark the performance of several baseline methods including FNO, CNO, WNO, and DeepONet.

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

Recently, many mesh-based graph neural network (GNN) models have been proposed for modeling complex high-dimensional physical systems. Remarkable achievements have been made in significantly reducing the solving time compared to traditional numerical solvers. These methods are typically designed to i) reduce the computational cost in solving physical dynamics and/or ii) propose techniques to enhance the solution accuracy in fluid and rigid body dynamics. However, it remains under-explored whether they are effective in addressing the challenges of flexible body dynamics, where instantaneous collisions occur within a very short timeframe. In this paper, we present Hierarchical Contact Mesh Transformer (HCMT), which uses hierarchical mesh structures and can learn long-range dependencies (occurred by collisions) among spatially distant positions of a body -- two close positions in a higher-level mesh correspond to two distant positions in a lower-level mesh. HCMT enables long-range interactions, and the hierarchical mesh structure quickly propagates collision effects to faraway positions. To this end, it consists of a contact mesh Transformer and a hierarchical mesh Transformer (CMT and HMT, respectively). Lastly, we propose a flexible body dynamics dataset, consisting of trajectories that reflect experimental settings frequently used in the display industry for product designs. We also compare the performance of several baselines using well-known benchmark datasets. Our results show that HCMT provides significant performance improvements over existing methods. Our code is available at https://github.com/yuyudeep/hcmt.

Biosignals acquired from different locations on the body often provide temporally ordered views of the same underlying physiological process. However, most existing self supervised learning methods treat these signals as interchangeable views, overlooking the directional temporal dynamics that link them. A canonical example is the relationship between electrocardiography (ECG), which captures the electrical activation initiating each heartbeat, and photoplethysmography (PPG), which records the resulting peripheral pulse delayed by vascular dynamics. To capture this structured relationship, we introduce xMAE, a biosignal pretraining framework that leverages masked cross modal reconstruction across temporally ordered biosignals as a training time constraint to encourage physiologically meaningful timing structure in the learned representations. We show that pretraining with xMAE yields representations that outperform both unimodal and multimodal baselines on 15 of 19 downstream tasks, including cardiovascular outcome prediction, abnormal laboratory test detection, sleep staging, and demographic inference, while generalizing across devices, body locations, and acquisition settings. Further analysis suggests that the ECG PPG timing structure is reflected in the learned PPG representations. More broadly, xMAE demonstrates the effectiveness of incorporating temporal structure into multimodal pretraining when signals observe different stages of a shared underlying process. Code is available at https://github.com/hzhou3/xMAE.

We introduce VascX models, a comprehensive set of model ensembles for analyzing retinal vasculature from color fundus images (CFIs). Annotated CFIs were aggregated from public datasets for vessel, artery-vein, and disc segmentation; and fovea localization. Additional CFIs from the population-based Rotterdam Study were, with arteries and veins annotated by graders at pixel level. Our models achieved robust performance across devices from different vendors, varying levels of image quality levels, and diverse pathologies. Our models demonstrated superior segmentation performance compared to existing systems under a variety of conditions. Significant enhancements were observed in artery-vein and disc segmentation performance, particularly in segmentations of these structures on CFIs of intermediate quality, a common characteristic of large cohorts and clinical datasets. Our model outperformed human graders in segmenting vessels with greater precision. With VascX models we provide a robust, ready-to-use set of model ensembles and inference code aimed at simplifying the implementation and enhancing the quality of automated retinal vasculature analyses. The precise vessel parameters generated by the model can serve as starting points for the identification of disease patterns in and outside of the eye.

Accurate vessel segmentation in X-ray angiograms is crucial for numerous clinical applications. However, the scarcity of annotated data presents a significant challenge, which has driven the adoption of self-supervised learning (SSL) methods such as masked image modeling (MIM) to leverage large-scale unlabeled data for learning transferable representations. Unfortunately, conventional MIM often fails to capture vascular anatomy because of the severe class imbalance between vessel and background pixels, leading to weak vascular representations. To address this, we introduce Vascular anatomy-aware Masked Image Modeling (VasoMIM), a novel MIM framework tailored for X-ray angiograms that explicitly integrates anatomical knowledge into the pre-training process. Specifically, it comprises two complementary components: anatomy-guided masking strategy and anatomical consistency loss. The former preferentially masks vessel-containing patches to focus the model on reconstructing vessel-relevant regions. The latter enforces consistency in vascular semantics between the original and reconstructed images, thereby improving the discriminability of vascular representations. Empirically, VasoMIM achieves state-of-the-art performance across three datasets. These findings highlight its potential to facilitate X-ray angiogram analysis.

The human menstrual cycle is regulated by complex hormonal feedback mechanisms which are essential for reproductive health. Existing mathematical models either rely on simplified phenomenological assumptions or achieve physiological accuracy at the cost of high mathematical complexity and computational costs. This paper presents a novel mechanistic model which balances biological realism with mathematical simplicity. The proposed framework describes the dynamics of the four central cycle-driving hormones, namely follicle stimulating hormone, luteinizing hormone, estradiol, and progesterone, using a system of ordinary differential equations. Mechanistic detail is incorporated through representations of feedback mechanisms, follicular development, luteinization, vascularization of the corpus luteum, and aspects of hormone synthesis mechanisms. Despite its comparatively low complexity, the model reproduces characteristic trends of hormone activity and concentration dynamics reported in experimental data. Due to its computational efficiency and modularity, the model is well suited as a basis for extended in-silico experiments, including applications in pharmacology and personalized medicine. Our results demonstrate that targeted incorporation of biological mechanisms enables accurate yet tractable modeling of endocrine system dynamics.

We formulate a hierarchical rectified flow to model data distributions. It hierarchically couples multiple ordinary differential equations (ODEs) and defines a time-differentiable stochastic process that generates a data distribution from a known source distribution. Each ODE resembles the ODE that is solved in a classic rectified flow, but differs in its domain, i.e., location, velocity, acceleration, etc. Unlike the classic rectified flow formulation, which formulates a single ODE in the location domain and only captures the expected velocity field (sufficient to capture a multi-modal data distribution), the hierarchical rectified flow formulation models the multi-modal random velocity field, acceleration field, etc., in their entirety. This more faithful modeling of the random velocity field enables integration paths to intersect when the underlying ODE is solved during data generation. Intersecting paths in turn lead to integration trajectories that are more straight than those obtained in the classic rectified flow formulation, where integration paths cannot intersect. This leads to modeling of data distributions with fewer neural function evaluations. We empirically verify this on synthetic 1D and 2D data as well as MNIST, CIFAR-10, and ImageNet-32 data. Our code is available at: https://riccizz.github.io/HRF/.

Realistic surgical simulation plays a crucial role in training novice surgeons and in the development of autonomous agents. World models can scale such simulation environments to realistic and diverse procedures by predicting future patient states conditioned on current observations and surgical actions. However, current state-of-the-art approaches often fail to satisfy key criteria required for clinical applicability, including visual realism, physically grounded interactions, and the ability to simulate scenarios beyond the training distribution. Hence, we introduce SWoMo, a neuro-symbolic world model for cataract surgery simulation that decouples motion generation from visual realism. The symbolic component, consisting of a rule-based simulator and scene graph representations, models motion dynamics and tool-tissue interactions, while a diffusion model produces realistic visual appearance, including textures and tissue deformations. We propose an inverse pairing strategy that reconstructs real surgical videos in the simulator to obtain paired simulated and real videos, which are then used to train our video diffusion model for the reverse objective of sim-to-real translation. Our experiments show both qualitative and quantitative improvements over prior work. We demonstrate that our simulator further satisfies the key criteria, including generalisation to unseen interaction geometries, improvements in downstream phase detection, and unsupervised video style transfer. The code, data, and model weights are available at: https://ssharvienkumar.github.io/SWoMo/

Numerous biological and physical processes can be modeled as systems of interacting entities evolving continuously over time, e.g. the dynamics of communicating cells or physical particles. Learning the dynamics of such systems is essential for predicting the temporal evolution of populations across novel samples and unseen environments. Flow-based models allow for learning these dynamics at the population level - they model the evolution of the entire distribution of samples. However, current flow-based models are limited to a single initial population and a set of predefined conditions which describe different dynamics. We argue that multiple processes in natural sciences have to be represented as vector fields on the Wasserstein manifold of probability densities. That is, the change of the population at any moment in time depends on the population itself due to the interactions between samples. In particular, this is crucial for personalized medicine where the development of diseases and their respective treatment response depends on the microenvironment of cells specific to each patient. We propose Meta Flow Matching (MFM), a practical approach to integrating along these vector fields on the Wasserstein manifold by amortizing the flow model over the initial populations. Namely, we embed the population of samples using a Graph Neural Network (GNN) and use these embeddings to train a Flow Matching model. This gives MFM the ability to generalize over the initial distributions unlike previously proposed methods. We demonstrate the ability of MFM to improve prediction of individual treatment responses on a large scale multi-patient single-cell drug screen dataset.

In recent years, the machine learning research community has benefited tremendously from the availability of openly accessible benchmark datasets. Clinical data are usually not openly available due to their highly confidential nature. This has hampered the development of reproducible and generalisable machine learning applications in health care. Here we introduce the Health Gym - a growing collection of highly realistic synthetic medical datasets that can be freely accessed to prototype, evaluate, and compare machine learning algorithms, with a specific focus on reinforcement learning. The three synthetic datasets described in this paper present patient cohorts with acute hypotension and sepsis in the intensive care unit, and people with human immunodeficiency virus (HIV) receiving antiretroviral therapy in ambulatory care. The datasets were created using a novel generative adversarial network (GAN). The distributions of variables, and correlations between variables and trends over time in the synthetic datasets mirror those in the real datasets. Furthermore, the risk of sensitive information disclosure associated with the public distribution of the synthetic datasets is estimated to be very low.

Large language models (LLMs) have captured significant interest from both academia and industry due to their impressive performance across various textual tasks. However, the potential of LLMs to analyze physiological time-series data remains an emerging research field. Particularly, there is a notable gap in the utilization of LLMs for analyzing wearable biosignals to achieve cuffless blood pressure (BP) measurement, which is critical for the management of cardiovascular diseases. This paper presents the first work to explore the capacity of LLMs to perform cuffless BP estimation based on wearable biosignals. We extracted physiological features from electrocardiogram (ECG) and photoplethysmogram (PPG) signals and designed context-enhanced prompts by combining these features with BP domain knowledge and user information. Subsequently, we adapted LLMs to BP estimation tasks through fine-tuning. To evaluate the proposed approach, we conducted assessments of ten advanced LLMs using a comprehensive public dataset of wearable biosignals from 1,272 participants. The experimental results demonstrate that the optimally fine-tuned LLM significantly surpasses conventional task-specific baselines, achieving an estimation error of 0.00 pm 9.25 mmHg for systolic BP and 1.29 pm 6.37 mmHg for diastolic BP. Notably, the ablation studies highlight the benefits of our context enhancement strategy, leading to an 8.9% reduction in mean absolute error for systolic BP estimation. This paper pioneers the exploration of LLMs for cuffless BP measurement, providing a potential solution to enhance the accuracy of cuffless BP measurement.

X-ray angiography is the gold standard imaging modality for cardiovascular diseases. However, current deep learning approaches for X-ray angiogram analysis are severely constrained by the scarcity of annotated data. While large-scale self-supervised learning (SSL) has emerged as a promising solution, its potential in this domain remains largely unexplored, primarily due to the lack of effective SSL frameworks and large-scale datasets. To bridge this gap, we introduce a vascular anatomy-aware masked image modeling (VasoMIM) framework that explicitly integrates domain-specific anatomical knowledge. Specifically, VasoMIM comprises two key designs: an anatomy-guided masking strategy and an anatomical consistency loss. The former strategically masks vessel-containing patches to compel the model to learn robust vascular semantics, while the latter preserves structural consistency of vessels between original and reconstructed images, enhancing the discriminability of the learned representations. In conjunction with VasoMIM, we curate XA-170K, the largest X-ray angiogram pre-training dataset to date. We validate VasoMIM on four downstream tasks across six datasets, where it demonstrates superior transferability and achieves state-of-the-art performance compared to existing methods. These findings highlight the significant potential of VasoMIM as a foundation model for advancing a wide range of X-ray angiogram analysis tasks. VasoMIM and XA-170K will be available at https://github.com/Dxhuang-CASIA/XA-SSL.

The complexity and heterogeneity of data in many real-world applications pose significant challenges for traditional machine learning and signal processing techniques. For instance, in medicine, effective analysis of diverse physiological signals is crucial for patient monitoring and clinical decision-making and yet highly challenging. We introduce MedTsLLM, a general multimodal large language model (LLM) framework that effectively integrates time series data and rich contextual information in the form of text to analyze physiological signals, performing three tasks with clinical relevance: semantic segmentation, boundary detection, and anomaly detection in time series. These critical tasks enable deeper analysis of physiological signals and can provide actionable insights for clinicians. We utilize a reprogramming layer to align embeddings of time series patches with a pretrained LLM's embedding space and make effective use of raw time series, in conjunction with textual context. Given the multivariate nature of medical datasets, we develop methods to handle multiple covariates. We additionally tailor the text prompt to include patient-specific information. Our model outperforms state-of-the-art baselines, including deep learning models, other LLMs, and clinical methods across multiple medical domains, specifically electrocardiograms and respiratory waveforms. MedTsLLM presents a promising step towards harnessing the power of LLMs for medical time series analysis that can elevate data-driven tools for clinicians and improve patient outcomes.

Echocardiography is widely used for assessing cardiac function, where clinically meaningful parameters such as left-ventricular ejection fraction (EF) play a central role in diagnosis and management. Generative models capable of synthesising realistic echocardiogram videos with explicit control over such parameters are valuable for data augmentation, counterfactual analysis, and specialist training. However, existing approaches typically rely on computationally expensive multi-step sampling and aggressive temporal normalisation, limiting efficiency and applicability to heterogeneous real-world data. We introduce EchoLVFM, a one-step latent video flow-matching framework for controllable echocardiogram generation. Operating in the latent space, EchoLVFM synthesises temporally coherent videos in a single inference step, achieving a sim 50times improvement in sampling efficiency compared to multi-step flow baselines while maintaining visual fidelity. The model supports global conditioning on clinical variables, demonstrated through precise control of EF, and enables reconstruction and counterfactual generation from partially observed sequences. A masked conditioning strategy further removes fixed-length constraints, allowing shorter sequences to be retained rather than discarded. We evaluate EchoLVFM on the CAMUS dataset under challenging single-frame conditioning. Quantitative and qualitative results demonstrate competitive video quality, strong EF adherence, and 57.9% discrimination accuracy by expert clinicians which is close to chance. These findings indicate that efficient, one-step flow matching can enable practical, controllable echocardiogram video synthesis without sacrificing fidelity. Code available at: https://github.com/EngEmmanuel/EchoLVFM

Echocardiography records ultrasound videos of the heart, enabling clinicians to assess cardiac function. Recent advances in large-scale vision-language models (VLMs) have spurred interest in automating echocardiographic interpretation. However, most existing medical VLMs rely on single-frame (image) inputs, which can reduce diagnostic accuracy for conditions identifiable only through cardiac motion. In addition, echocardiographic videos are captured from multiple views, each varying in suitability for detecting specific conditions. Leveraging multiple views may therefore improve diagnostic performance. We developed a video-language model that processes full video sequences from five standard views, trained on 60,747 echocardiographic video-report pairs. We evaluated the gains in retrieval performance from video input and multi-view support, including the contributions of various pretrained models.

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.

Photoplethysmography (PPG) is a widely used non-invasive sensing modality for continuous cardiovascular and physiological monitoring across clinical, laboratory, and wearable settings. While existing PPG datasets support a broad range of downstream tasks, they typically provide supervision in the form of numerical measurements or task-specific labels, limiting their suitability for language-based physiological reasoning and multimodal foundation models. In this work, we introduce PulseLM, a large-scale PPG-text dataset designed to bridge raw PPG waveforms and natural language through a unified, closed-ended question answering (QA) formulation. PulseLM aggregates PPG recordings from fifteen publicly available sources and harmonizes heterogeneous annotations into twelve common physiologically QA tasks. The dataset comprises 1.31 million standardized 10-second PPG segments, associated with 3.15 million question-answer pairs. We further define reproducible preprocessing, supervision, and evaluation protocols and establish baseline benchmarks using multimodal PPG-aware large language models. PulseLM provides a standardized foundation for studying multimodal physiological reasoning, cross-dataset generalization, and scalable benchmarking of PPG-based language models. The data and code can be found publicly available at: https://github.com/manhph2211/PulseLM.

Electrocardiography (ECG), photoplethysmography (PPG), and phonocardiography (PCG) provide complementary views of the same cardiac cycle, yet existing cardiac foundation models are trained for a single sensing modality, leaving the shared physiology across sensors unexploited. We introduce CardioState-JEPA, a cardiac foundation model to learn a single shared representation jointly across ECG, PPG, and PCG, built on a physiology-aware joint-embedding predictive architecture. The model maps heterogeneous waveforms into a common token space, processes them with a single shared Transformer encoder, and learns by predicting masked latent cardiac states, placing the pretraining target on shared physiology rather than sensor-specific waveform appearance. To handle the temporal offsets between electrical, mechanical, and hemodynamic events, cross-modal prediction uses a learned delay aligner that matches signals at the corresponding cardiac time. Because synchronized multi-sensor recordings are scarce, CardioState-JEPA first learns within-modality structure from abundant unimodal data and then uses paired data to align modalities in latent cardiac time. Evaluated as a frozen encoder across 25 downstream tasks spanning ECG, PPG, and PCG, our encoder improves average PPG classification by 8.2 AUROC points, PCG murmur detection by 18.8 AUROC points, and ECG classification by 15.5 AUROC points over the best self-supervised signal baseline and matches or exceeds cardiac models trained with privileged clinical text or supervised labels on several ECG benchmarks. These results establish that heterogeneous cardiac signals can mutually supervise a single foundation model of cardiac physiology.

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.

Modern techniques for physical simulations rely on numerical schemes and mesh-refinement methods to address trade-offs between precision and complexity, but these handcrafted solutions are tedious and require high computational power. Data-driven methods based on large-scale machine learning promise high adaptivity by integrating long-range dependencies more directly and efficiently. In this work, we focus on fluid dynamics and address the shortcomings of a large part of the literature, which are based on fixed support for computations and predictions in the form of regular or irregular grids. We propose a novel setup to perform predictions in a continuous spatial and temporal domain while being trained on sparse observations. We formulate the task as a double observation problem and propose a solution with two interlinked dynamical systems defined on, respectively, the sparse positions and the continuous domain, which allows to forecast and interpolate a solution from the initial condition. Our practical implementation involves recurrent GNNs and a spatio-temporal attention observer capable of interpolating the solution at arbitrary locations. Our model not only generalizes to new initial conditions (as standard auto-regressive models do) but also performs evaluation at arbitrary space and time locations. We evaluate on three standard datasets in fluid dynamics and compare to strong baselines, which are outperformed both in classical settings and in the extended new task requiring continuous predictions.

Human health can be critically affected by cardiovascular diseases, such as hypertension, arrhythmias, and stroke. Heart rate and blood pressure are important biometric information for the monitoring of cardiovascular system and early diagnosis of cardiovascular diseases. Existing methods for estimating the heart rate are based on electrocardiography and photoplethyomography, which require contacting the sensor to the skin surface. Moreover, catheter and cuff-based methods for measuring blood pressure cause inconvenience and have limited applicability. Therefore, in this thesis, we propose a vision-based method for estimating the heart rate and blood pressure. This thesis proposes a 2-stage deep learning framework consisting of a dual remote photoplethysmography network (DRP-Net) and bounded blood pressure network (BBP-Net). In the first stage, DRP-Net infers remote photoplethysmography (rPPG) signals for the acral and facial regions, and these phase-shifted rPPG signals are utilized to estimate the heart rate. In the second stage, BBP-Net integrates temporal features and analyzes phase discrepancy between the acral and facial rPPG signals to estimate SBP and DBP values. To improve the accuracy of estimating the heart rate, we employed a data augmentation method based on a frame interpolation model. Moreover, we designed BBP-Net to infer blood pressure within a predefined range by incorporating a scaled sigmoid function. Our method resulted in estimating the heart rate with the mean absolute error (MAE) of 1.78 BPM, reducing the MAE by 34.31 % compared to the recent method, on the MMSE-HR dataset. The MAE for estimating the systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 10.19 mmHg and 7.09 mmHg. On the V4V dataset, the MAE for the heart rate, SBP, and DBP were 3.83 BPM, 13.64 mmHg, and 9.4 mmHg, respectively.

Providing effective treatment and making informed clinical decisions are essential goals of modern medicine and clinical care. We are interested in simulating disease dynamics for clinical decision-making, leveraging recent advances in large generative models. To this end, we introduce the Medical World Model (MeWM), the first world model in medicine that visually predicts future disease states based on clinical decisions. MeWM comprises (i) vision-language models to serve as policy models, and (ii) tumor generative models as dynamics models. The policy model generates action plans, such as clinical treatments, while the dynamics model simulates tumor progression or regression under given treatment conditions. Building on this, we propose the inverse dynamics model that applies survival analysis to the simulated post-treatment tumor, enabling the evaluation of treatment efficacy and the selection of the optimal clinical action plan. As a result, the proposed MeWM simulates disease dynamics by synthesizing post-treatment tumors, with state-of-the-art specificity in Turing tests evaluated by radiologists. Simultaneously, its inverse dynamics model outperforms medical-specialized GPTs in optimizing individualized treatment protocols across all metrics. Notably, MeWM improves clinical decision-making for interventional physicians, boosting F1-score in selecting the optimal TACE protocol by 13%, paving the way for future integration of medical world models as the second readers.

Accurate and efficient simulations of physical phenomena governed by partial differential equations (PDEs) are important for scientific and engineering progress. While traditional numerical solvers are powerful, they are often computationally expensive. Recently, data-driven methods have emerged as alternatives, but they frequently suffer from error accumulation and limited physical consistency, especially in multiphysics and complex geometries. To address these challenges, we propose PEGNet, a Physics-Embedded Graph Network that incorporates PDE-guided message passing to redesign the graph neural network architecture. By embedding key PDE dynamics like convection, viscosity, and diffusion into distinct message functions, the model naturally integrates physical constraints into its forward propagation, producing more stable and physically consistent solutions. Additionally, a hierarchical architecture is employed to capture multi-scale features, and physical regularization is integrated into the loss function to further enforce adherence to governing physics. We evaluated PEGNet on benchmarks, including custom datasets for respiratory airflow and drug delivery, showing significant improvements in long-term prediction accuracy and physical consistency over existing methods. Our code is available at https://github.com/Yanghuoshan/PEGNet.

Medical image analysis is a fundamental component. As deep learning progresses, the focus has shifted from single-task applications, such as classification and segmentation, to more complex multimodal tasks, including medical visual question answering and report generation. Traditional shallow and task-specific models are increasingly limited in addressing the complexity and scalability required in clinical practice. The emergence of large language models (LLMs) has driven the development of medical Large Vision-Language Models (LVLMs), offering a unified solution for diverse vision-language tasks. In this study, we investigate various architectural designs for medical LVLMs based on the widely adopted LLaVA framework, which follows an encoder-connector-LLM paradigm. We construct two distinct models targeting 2D and 3D modalities, respectively. These models are designed to support both general-purpose medical tasks and domain-specific fine-tuning, thereby serving as effective foundation models. To facilitate reproducibility and further research, we develop a modular and extensible codebase, MedM-VL, and release two LVLM variants: MedM-VL-2D for 2D medical image analysis and MedM-VL-CT-Chest for 3D CT-based applications. The code and models are available at: https://github.com/MSIIP/MedM-VL

Cell tracking is a subject of active research gathering great interest in medicine and biology. Positron emission tomography (PET) is well suited for tracking radio-labeled cells in vivo due to its exceptional sensitivity and whole-body capability. For validation, ground-truth data are desirable that realistically mimic the flow of cells in a clinical situation. This study develops a workflow (CeFloPS) for simulating moving radio-labeled cells in a human phantom. From the XCAT phantom, the blood vessels are reduced to nodal networks along which cells can move and distribute to organs and tissues. The movement is directed by the blood flow, which is calculated in each node using the Hagen-Pooiseuille equation and Kirchhoff's laws assuming laminar flow. Organs are voxelized and movement of cells from artery entry to vein exit is generated via a biased 3D random walk. The probabilities of cells moving or remaining in tissues are derived from rate constants of tracer kinetic-based compartment modeling. PET listmode data is generated using the Monte-Carlo simulation framework GATE based on the definition of a large-body PET scanner with cell paths as moving radioactive sources and the XCAT phantom providing attenuation data. From the flow simulation of 100,000 cells, 100 sample cells were further processed by GATE and listmode data was reconstructed into images for comparison. As demonstrated by comparisons of simulated and reconstructed cell distributions, CeFloPS is capable of simulating cell behavior in whole-body PET. It achieves this simulation in a way that is anatomically and physiologically reasonable, thereby providing valuable data for the development and validation of cell tracking algorithms.

We propose PROSE-FD, a zero-shot multimodal PDE foundational model for simultaneous prediction of heterogeneous two-dimensional physical systems related to distinct fluid dynamics settings. These systems include shallow water equations and the Navier-Stokes equations with incompressible and compressible flow, regular and complex geometries, and different buoyancy settings. This work presents a new transformer-based multi-operator learning approach that fuses symbolic information to perform operator-based data prediction, i.e. non-autoregressive. By incorporating multiple modalities in the inputs, the PDE foundation model builds in a pathway for including mathematical descriptions of the physical behavior. We pre-train our foundation model on 6 parametric families of equations collected from 13 datasets, including over 60K trajectories. Our model outperforms popular operator learning, computer vision, and multi-physics models, in benchmark forward prediction tasks. We test our architecture choices with ablation studies.

Medication reconciliation at clinical handoffs is a high-stakes, error-prone process. Large language models are increasingly proposed to assist with this task using FHIR-structured patient records, but a fundamental and largely unstudied variable is how the FHIR data is serialised before being passed to the model. We present the first systematic comparison of four FHIR serialisation strategies (Raw JSON, Markdown Table, Clinical Narrative, and Chronological Timeline) across five open-weight models (Phi-3.5-mini, Mistral-7B, BioMistral-7B, Llama-3.1-8B, Llama-3.3-70B) on a controlled benchmark of 200 synthetic patients, totalling 4,000 inference runs. We find that serialisation strategy has a large, statistically significant effect on performance for models up to 8B parameters: Clinical Narrative outperforms Raw JSON by up to 19 F1 points for Mistral-7B (r = 0.617, p < 10^{-10}). This advantage reverses at 70B, where Raw JSON achieves the best mean F1 of 0.9956. In all 20 model and strategy combinations, mean precision exceeds mean recall: omission is the dominant failure mode, with models more often missing an active medication than fabricating one, which changes how clinical safety auditing priorities should be set. Smaller models plateau at roughly 7-10 concurrent active medications, leaving polypharmacy patients, the patients most at risk from reconciliation errors, systematically underserved. BioMistral-7B, a domain-pretrained model without instruction tuning, produces zero usable output in all conditions, showing that domain pretraining alone is not sufficient for structured extraction. These results offer practical, evidence-based format recommendations for clinical LLM deployment: Clinical Narrative for models up to 8B, Raw JSON for 70B and above. The complete pipeline is reproducible on open-source tools running on an AWS g6e.xlarge instance (NVIDIA L40S, 48 GB VRAM).

We consider the problem of modeling high-speed flows using machine learning methods. While most prior studies focus on low-speed fluid flows in which uniform time-stepping is practical, flows approaching and exceeding the speed of sound exhibit sudden changes such as shock waves. In such cases, it is essential to use adaptive time-stepping methods to allow a temporal resolution sufficient to resolve these phenomena while simultaneously balancing computational costs. Here, we propose a two-phase machine learning method, known as ShockCast, to model high-speed flows with adaptive time-stepping. In the first phase, we propose to employ a machine learning model to predict the timestep size. In the second phase, the predicted timestep is used as an input along with the current fluid fields to advance the system state by the predicted timestep. We explore several physically-motivated components for timestep prediction and introduce timestep conditioning strategies inspired by neural ODE and Mixture of Experts. As ShockCast is the first framework for learning high-speed flows, we evaluate our methods by generating two supersonic flow datasets, available at https://huggingface.co/datasets/divelab. Our code is publicly available as part of the AIRS library (https://github.com/divelab/AIRS).

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

Automated construction of surface geometries of cardiac structures from volumetric medical images is important for a number of clinical applications. While deep-learning-based approaches have demonstrated promising reconstruction precision, these approaches have mostly focused on voxel-wise segmentation followed by surface reconstruction and post-processing techniques. However, such approaches suffer from a number of limitations including disconnected regions or incorrect surface topology due to erroneous segmentation and stair-case artifacts due to limited segmentation resolution. We propose a novel deep-learning-based approach that directly predicts whole heart surface meshes from volumetric CT and MR image data. Our approach leverages a graph convolutional neural network to predict deformation on mesh vertices from a pre-defined mesh template to reconstruct multiple anatomical structures in a 3D image volume. Our method demonstrated promising performance of generating whole heart reconstructions with as good or better accuracy than prior deep-learning-based methods on both CT and MR data. Furthermore, by deforming a template mesh, our method can generate whole heart geometries with better anatomical consistency and produce high-resolution geometries from lower resolution input image data. Our method was also able to produce temporally consistent surface mesh predictions for heart motion from CT or MR cine sequences, and therefore can potentially be applied for efficiently constructing 4D whole heart dynamics. Our code and pre-trained networks are available at https://github.com/fkong7/MeshDeformNet

Predicting how a patient's vital signs respond to an intervention is a central question in intensive care. World models can do so by learning dynamics as a function of prior actions. However, such models tend to be brittle outside of training data. Clinicians choose drug dosages based on the patient's state, so the association a model learns between dose and outcome runs opposite to the drug's effect, generalizing poorly to out-of-distribution (OOD) dosing practices. Yet, pharmacological information provides the directional effects of different drugs, which are invariant to OOD shifts. To resolve the OOD sensitivity of current ICU world models, we introduce PHYSIO WORLD, which isolates an intervention's effect by evaluating a forward pass twice: once under recorded doses, and once with those doses set to zero. The difference is projected onto pharmacologically admissible effect directions stated by 70 rules over 28 drugs, leaving the magnitude to be learned from data. Across five distribution-shift parameters over cohorts from three intensive-care databases, and against forecasters, counterfactual models, and invariance objectives, PHYSIO WORLD attains the lowest OOD RMSE in every setting, improving on the strongest external baseline by 8-12%, while matching the in-distribution error of its backbone. Reversing the pharmacological directions degrades accuracy below the backbone, and data-mined directions recover almost no gain, indicating the improvement derives from the content of the pharmacological knowledge. The construction may extend to other settings where the sign of an effect is known in advance and its magnitude is confounded by treatment assignment.

Numerical simulation of non-linear partial differential equations plays a crucial role in modeling physical science and engineering phenomena, such as weather, climate, and aerodynamics. Recent Machine Learning (ML) models trained on low-resolution spatio-temporal signals have shown new promises in capturing important dynamics in high-resolution signals, under the condition that the models can effectively recover the missing details. However, this study shows that significant information is often lost in the low-resolution down-sampled features. To address such issues, we propose a new approach, namely Temporal Stencil Modeling (TSM), which combines the strengths of advanced time-series sequence modeling (with the HiPPO features) and state-of-the-art neural PDE solvers (with learnable stencil modeling). TSM aims to recover the lost information from the PDE trajectories and can be regarded as a temporal generalization of classic finite volume methods such as WENO. Our experimental results show that TSM achieves the new state-of-the-art simulation accuracy for 2-D incompressible Navier-Stokes turbulent flows: it significantly outperforms the previously reported best results by 19.9% in terms of the highly-correlated duration time and reduces the inference latency into 80%. We also show a strong generalization ability of the proposed method to various out-of-distribution turbulent flow settings. Our code is available at "https://github.com/Edward-Sun/TSM-PDE".

Segmenting 3D blood vessels is a critical yet challenging task in medical image analysis. This is due to significant imaging modality-specific variations in artifacts, vascular patterns and scales, signal-to-noise ratios, and background tissues. These variations, along with domain gaps arising from varying imaging protocols, limit the generalization of existing supervised learning-based methods, requiring tedious voxel-level annotations for each dataset separately. While foundation models promise to alleviate this limitation, they typically fail to generalize to the task of blood vessel segmentation, posing a unique, complex problem. In this work, we present vesselFM, a foundation model designed specifically for the broad task of 3D blood vessel segmentation. Unlike previous models, vesselFM can effortlessly generalize to unseen domains. To achieve zero-shot generalization, we train vesselFM on three heterogeneous data sources: a large, curated annotated dataset, data generated by a domain randomization scheme, and data sampled from a flow matching-based generative model. Extensive evaluations show that vesselFM outperforms state-of-the-art medical image segmentation foundation models across four (pre-)clinically relevant imaging modalities in zero-, one-, and few-shot scenarios, therefore providing a universal solution for 3D blood vessel segmentation.

We present Shap-MeD, a text-to-3D object generative model specialized in the biomedical domain. The objective of this study is to develop an assistant that facilitates the 3D modeling of medical objects, thereby reducing development time. 3D modeling in medicine has various applications, including surgical procedure simulation and planning, the design of personalized prosthetic implants, medical education, the creation of anatomical models, and the development of research prototypes. To achieve this, we leverage Shap-e, an open-source text-to-3D generative model developed by OpenAI, and fine-tune it using a dataset of biomedical objects. Our model achieved a mean squared error (MSE) of 0.089 in latent generation on the evaluation set, compared to Shap-e's MSE of 0.147. Additionally, we conducted a qualitative evaluation, comparing our model with others in the generation of biomedical objects. Our results indicate that Shap-MeD demonstrates higher structural accuracy in biomedical object generation.

Physical systems commonly exhibit spatially varying complexity, presenting a significant challenge for neural PDE solvers. While Graph Neural Networks can handle the irregular meshes required for complex geometries and boundary conditions, they still apply uniform computational effort across all nodes regardless of the underlying physics complexity. This leads to inefficient resource allocation where computationally simple regions receive the same treatment as complex phenomena. We address this challenge by introducing Adaptive Mesh Quantization: spatially adaptive quantization across mesh node, edge, and cluster features, dynamically adjusting the bit-width used by a quantized model. We propose an adaptive bit-width allocation strategy driven by a lightweight auxiliary model that identifies high-loss regions in the input mesh. This enables dynamic resource distribution in the main model, where regions of higher difficulty are allocated increased bit-width, optimizing computational resource utilization. We demonstrate our framework's effectiveness by integrating it with two state-of-the-art models, MP-PDE and GraphViT, to evaluate performance across multiple tasks: 2D Darcy flow, large-scale unsteady fluid dynamics in 2D, steady-state Navier-Stokes simulations in 3D, and a 2D hyper-elasticity problem. Our framework demonstrates consistent Pareto improvements over uniformly quantized baselines, yielding up to 50% improvements in performance at the same cost.

Modeling medical vessel-like anatomy is challenging due to its intricate topology and sensitivity to dataset shifts. Consequently, task-specific models often suffer from topological inconsistencies, including artificial disconnections and spurious merges. Motivated by the promise of multimodal large language models (MLLMs) for zero-shot generalization, we propose TubeMLLM, a unified foundation model that couples structured understanding with controllable generation for medical vessel-like anatomy. By integrating topological priors through explicit natural language prompting and aligning them with visual representations in a shared-attention architecture, TubeMLLM significantly enhances topology-aware perception. Furthermore, we construct TubeMData, a pionner multimodal benchmark comprising comprehensive topology-centric tasks, and introduce an adaptive loss weighting strategy to emphasize topology-critical regions during training. Extensive experiments on fifteen diverse datasets demonstrate our superiority. Quantitatively, TubeMLLM achieves state-of-the-art out-of-distribution performance, substantially reducing global topological discrepancies on color fundus photography (decreasing the β_{0} number error from 37.42 to 8.58 compared to baselines). Notably, TubeMLLM exhibits exceptional zero-shot cross-modality transferring ability on unseen X-ray angiography, achieving a Dice score of 67.50% while significantly reducing the β_{0} error to 1.21. TubeMLLM also maintains robustness against degradations such as blur, noise, and low resolution. Furthermore, in topology-aware understanding tasks, the model achieves 97.38% accuracy in evaluating mask topological quality, significantly outperforming standard vision-language baselines.

We introduce (U)NFV, a modular neural network architecture that generalizes classical finite volume (FV) methods for solving hyperbolic conservation laws. Hyperbolic partial differential equations (PDEs) are challenging to solve, particularly conservation laws whose physically relevant solutions contain shocks and discontinuities. FV methods are widely used for their mathematical properties: convergence to entropy solutions, flow conservation, or total variation diminishing, but often lack accuracy and flexibility in complex settings. Neural Finite Volume addresses these limitations by learning update rules over extended spatial and temporal stencils while preserving conservation structure. It supports both supervised training on solution data (NFV) and unsupervised training via weak-form residual loss (UNFV). Applied to first-order conservation laws, (U)NFV achieves up to 10x lower error than Godunov's method, outperforms ENO/WENO, and rivals discontinuous Galerkin solvers with far less complexity. On traffic modeling problems, both from PDEs and from experimental highway data, (U)NFV captures nonlinear wave dynamics with significantly higher fidelity and scalability than traditional FV approaches.

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.

We propose a novel neural deformable model (NDM) targeting at the reconstruction and modeling of 3D bi-ventricular shape of the heart from 2D sparse cardiac magnetic resonance (CMR) imaging data. We model the bi-ventricular shape using blended deformable superquadrics, which are parameterized by a set of geometric parameter functions and are capable of deforming globally and locally. While global geometric parameter functions and deformations capture gross shape features from visual data, local deformations, parameterized as neural diffeomorphic point flows, can be learned to recover the detailed heart shape.Different from iterative optimization methods used in conventional deformable model formulations, NDMs can be trained to learn such geometric parameter functions, global and local deformations from a shape distribution manifold. Our NDM can learn to densify a sparse cardiac point cloud with arbitrary scales and generate high-quality triangular meshes automatically. It also enables the implicit learning of dense correspondences among different heart shape instances for accurate cardiac shape registration. Furthermore, the parameters of NDM are intuitive, and can be used by a physician without sophisticated post-processing. Experimental results on a large CMR dataset demonstrate the improved performance of NDM over conventional methods.

Sepsis management in the ICU requires sequential treatment decisions under rapidly evolving patient physiology. Although large language models (LLMs) encode broad clinical knowledge and can reason over guidelines, they are not inherently grounded in action-conditioned patient dynamics. We introduce SepsisAgent, a world model-augmented LLM agent for sepsis treatment recommendation. SepsisAgent uses a learned Clinical World Model to simulate patient responses under candidate fluid--vasopressor interventions, and follows a propose--simulate--refine workflow before committing to a prescription. We first show that world-model access alone yields inconsistent LLM decision performance, motivating agent-specific training. We then train SepsisAgent through a three-stage curriculum: patient-dynamics supervised fine-tuning, propose--simulate--refine behavior cloning, and world-model-based agentic reinforcement learning. On MIMIC-IV sepsis trajectories, SepsisAgent outperforms all traditional RL and LLM-based baselines in off-policy value while achieving the best safety profile under guideline adherence and unsafe-action metrics. Further analysis shows that repeated interaction with the Clinical World Model enables the agent to learn regularities in patient evolution, which remain useful even when simulator access is removed.

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

Currently, evaluating vision-language models (VLMs) in medical imaging tasks oversimplifies clinical reality by relying on pre-selected 2D images that demand significant manual labor to curate. This setup misses the core challenge of realworld diagnostics: a true clinical agent must actively navigate full 3D volumes across multiple sequences or modalities to gather evidence and ultimately support a final decision. To address this, we propose MEDOPENCLAW, an auditable runtime designed to let VLMs operate dynamically within standard medical tools or viewers (e.g., 3D Slicer). On top of this runtime, we introduce MEDFLOWBENCH, a full-study medical imaging benchmark covering multi-sequence brain MRI and lung CT/PET. It systematically evaluates medical agentic capabilities across viewer-only, tool-use, and open-method tracks. Initial results reveal a critical insight: while state-of-the-art LLMs/VLMs (e.g., Gemini 3.1 Pro and GPT-5.4) can successfully navigate the viewer to solve basic study-level tasks, their performance paradoxically degrades when given access to professional support tools due to a lack of precise spatial grounding. By bridging the gap between static-image perception and interactive clinical workflows, MEDOPENCLAW and MEDFLOWBENCH establish a reproducible foundation for developing auditable, full-study medical imaging agents.

We present a novel paradigm for modeling certain types of dynamic simulation in real-time with the aid of neural networks. In order to significantly reduce the requirements on data (especially time-dependent data), as well as decrease generalization error, our approach utilizes a data-driven neural network only to capture quasistatic information (instead of dynamic or time-dependent information). Subsequently, we augment our quasistatic neural network (QNN) inference with a (real-time) dynamic simulation layer. Our key insight is that the dynamic modes lost when using a QNN approximation can be captured with a quite simple (and decoupled) zero-restlength spring model, which can be integrated analytically (as opposed to numerically) and thus has no time-step stability restrictions. Additionally, we demonstrate that the spring constitutive parameters can be robustly learned from a surprisingly small amount of dynamic simulation data. Although we illustrate the efficacy of our approach by considering soft-tissue dynamics on animated human bodies, the paradigm is extensible to many different simulation frameworks.

PURPOSE: Subarachnoid hemorrhage (SAH) entails high morbidity and mortality rates. Convolutional neural networks (CNN), a form of deep learning, are capable of generating highly accurate predictions from imaging data. Our objective was to predict mortality in SAH patients by processing the initial CT scan on a CNN based algorithm. METHODS: Retrospective multicentric study of a consecutive cohort of patients with SAH between 2011-2022. Demographic, clinical and radiological variables were analyzed. Pre-processed baseline CT scan images were used as the input for training a CNN using AUCMEDI Framework. Our model's architecture leverages the DenseNet-121 structure, employing transfer learning principles. The output variable was mortality in the first three months. Performance of the model was evaluated by statistical parameters conventionally used in studies involving artificial intelligence methods. RESULTS: Images from 219 patients were processed, 175 for training and validation of the CNN and 44 for its evaluation. 52%(115/219) of patients were female, and the median age was 58(SD=13.06) years. 18.5%(39/219) were idiopathic SAH. Mortality rate was 28.5%(63/219). The model showed good accuracy at predicting mortality in SAH patients exclusively using the images of the initial CT scan (Accuracy=74%, F1=75% and AUC=82%). CONCLUSION: Modern image processing techniques based on AI and CNN make possible to predict mortality in SAH patients with high accuracy using CT scan images as the only input. These models might be optimized by including more data and patients resulting in better training, development and performance on tasks which are beyond the skills of conventional clinical knowledge.

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.

Echocardiography is a vital non-invasive modality for cardiac assessment, with left ventricular ejection fraction (LVEF) serving as a key indicator of heart function. Existing LVEF estimation methods depend on large-scale annotated video datasets, which are costly and limit adaptability across various clinical settings. Recent vision-language models for echocardiography, such as EchoCLIP, apply image-to-text pretraining but fail to capture crucial temporal dynamics and localized cardiac structures essential for accurate diagnosis. To address these challenges, we propose CardiacCLIP, a video-based framework that enhances LVEF prediction through attention-based frame aggregation and multi-resolution input scaling. Specifically, we introduce MFL (Multi Frame Learning), a novel attention-based mechanism for selectively fusing informative frames, and EchoZoom, a multi-scale feature extraction strategy that refines spatial representations of cardiac structures. As a novel adaptation of CLIP models for few-shot echocardiogram video analysis, our approach significantly improves diagnostic accuracy, reducing MAE by 2.07 on the EchoNet-Dynamic dataset under 1-shot setting. The code is available at https://github.com/xmed-lab/CardiacCLIP.

Medical calculators are fundamental to quantitative, evidence-based clinical practice. However, their real-world use is an adaptive, multi-stage process, requiring proactive EHR data acquisition, scenario-dependent calculator selection, and multi-step computation, whereas current benchmarks focus only on static single-step calculations with explicit instructions. To address these limitations, we introduce MedMCP-Calc, the first benchmark for evaluating LLMs in realistic medical calculator scenarios through Model Context Protocol (MCP) integration. MedMCP-Calc comprises 118 scenario tasks across 4 clinical domains, featuring fuzzy task descriptions mimicking natural queries, structured EHR database interaction, external reference retrieval, and process-level evaluation. Our evaluation of 23 leading models reveals critical limitations: even top performers like Claude Opus 4.5 exhibit substantial gaps, including difficulty selecting appropriate calculators for end-to-end workflows given fuzzy queries, poor performance in iterative SQL-based database interactions, and marked reluctance to leverage external tools for numerical computation. Performance also varies considerably across clinical domains. Building on these findings, we develop CalcMate, a fine-tuned model incorporating scenario planning and tool augmentation, achieving state-of-the-art performance among open-source models. Benchmark and Codes are available in https://github.com/SPIRAL-MED/MedMCP-Calc.

In this work, we introduce an efficient generation procedure to produce synthetic multi-modal datasets of fluid simulations. The procedure can reproduce the dynamics of fluid flows and allows for exploring and learning various properties of their complex behavior, from distinct perspectives and modalities. We employ our framework to generate a set of thoughtfully designed training datasets, which attempt to span specific fluid simulation scenarios in a meaningful way. The properties of our contributions are demonstrated by evaluating recently published algorithms for the neural fluid simulation and fluid inverse rendering tasks using our benchmark datasets. Our contribution aims to fulfill the community's need for standardized training data, fostering more reproducibile and robust research.

Complete orthogonal predictive coordinates do not by themselves bind a latent direction to a named intervention. We present a mathematical and synthetic audit motivated by vascular device-vessel suitcordance. Capacity-matched least-squares predictors were exactly equivalent under complete fixed output transforms, whereas an anchor-only observer recovered interpretations only within the span of known perturbation signatures. Six three-dimensional configurations across 64 seeds gave a maximum paired prediction discrepancy of 6.7e-15 but a median untransported edit error of 1.513. Coordinate transport removed that error. Noisy and weak anchors constrained calibration stability, and changing the representation basis required recalibration or verified transport. Across 256 additional fits in dimensions 3-24, prediction equivalence persisted within 4.0e-15. We then evaluated nine deliberate runnable fault classes across 64 seeds. All 576 faulty executions completed, but each violated at least one reconstruction, prediction, delivered-edit or scope contract; all 320 valid control records passed. Repeating a faulty implementation gave exact self-agreement despite error against the separately computed simulator expectation. For one omitted-direction defect, probe coverage followed its analytic law, and rank-aware abstention protected unsupported interpretations. Scalar-noise experiments exposed both missed weak faults and excessive rejection under narrow relative tolerances. These controls provide an executable separation of prediction, semantic support and scientific acceptance. They are synthetic numerical audits, not clinical validation, neural JEPA-Anything replication, agent learning or patient treatment-effect estimation.

The digitization of healthcare has generated vast, longitudinal, and multimodal patient records over a lifetime, yet fully exploiting these data to represent and predict patient state trajectories remains a critical challenge. Current AI models often struggle to capture the complex, irregular temporal dynamics and inherent stochasticity of real-world multimodal patient data. Existing AI approaches for modeling longitudinal patient records are predominantly discriminative, limited to a few modalities, constrained by closed categorical vocabularies, treating time as a monotonic inductive bias, or they are limited in forecasting future patient states. We introduce NOAH, a time-aware, task-agnostic, generative transformer model representing and forecasting the full multimodal patient journey. NOAH features a novel bidirectional time integration and a variational latent space to capture the continuous evolution of patient states and the stochasticity of clinical trajectories. Built from over 559 million clinical events from 431,000 hospital visits of 299,000 patients across the MIMIC dataset family, NOAH natively processes medical images, time-series and numeric signals, categorical events, as well as structured and unstructured clinical records. NOAH is the first truly holistic generative model in its field, enabling autoregressive forecasting with optional time control, zero-shot classification, and counterfactual intervention simulation. It generates highly informative and predictive patient state representations that demonstrate strong performance in probing for clinical outcomes, 15 ICD chapters, and 29 comorbidities, as well as in time-to-event prediction. Seamlessly handling diverse modalities and complex temporal dynamics, NOAH provides a versatile, task-agnostic, scalable foundation for intelligent predictive systems in personalized clinical care and digital medicine.

Latent diffusion models (LDMs) have recently achieved strong performance in 3D medical image synthesis. However, modalities like cine cardiac MRI (CMR), representing a temporally synchronized 3D volume across the cardiac cycle, add an additional dimension that most generative approaches do not model directly. Instead, they factorize space and time or enforce temporal consistency through auxiliary mechanisms such as anatomical masks. Such strategies introduce structural biases that may limit global context integration and lead to subtle spatiotemporal discontinuities or physiologically inconsistent cardiac dynamics. We investigate whether a unified 4D generative model can learn continuous cardiac dynamics without architectural factorization. We propose CardioDiT, a fully 4D latent diffusion framework for short-axis cine CMR synthesis based on diffusion transformers. A spatiotemporal VQ-VAE encodes 2D+t slices into compact latents, which a diffusion transformer then models jointly as complete 3D+t volumes, coupling space and time throughout the generative process. We evaluate CardioDiT on public CMR datasets and a larger private cohort, comparing it to baselines with progressively stronger spatiotemporal coupling. Results show improved inter-slice consistency, temporally coherent motion, and realistic cardiac function distributions, suggesting that explicit 4D modeling with a diffusion transformer provides a principled foundation for spatiotemporal cardiac image synthesis. Code and models trained on public data are available at https://github.com/Cardio-AI/cardiodit.

Intravital microscopy is an essential tool that reveals behaviours of live cells under conditions close to natural physiological states. So far, although various approaches for imaging cells in vivo have been proposed, most require the use of labelling and also provide only qualitative imaging information. Holographic imaging approach based on measuring the refractive index distributions of cells, however, circumvent these problems and offer quantitative and label-free imaging capability. Here, we demonstrate in vivo two- and three-dimensional holographic imaging of circulating blood cells in intact microcapillaries of live mice. The measured refractive index distributions of blood cells provide morphological and biochemical properties including three-dimensional cell shape, haemoglobin concentration, and haemoglobin contents at the individual cell level. With the present method, alterations in blood flow dynamics in live healthy and sepsis-model mouse were also investigated.

Estimating the shape and motion state of the myocardium is essential in diagnosing cardiovascular diseases.However, cine magnetic resonance (CMR) imaging is dominated by 2D slices, whose large slice spacing challenges inter-slice shape reconstruction and motion acquisition.To address this problem, we propose a 4D reconstruction method that decouples motion and shape, which can predict the inter-/intra- shape and motion estimation from a given sparse point cloud sequence obtained from limited slices. Our framework comprises a neural motion model and an end-diastolic (ED) shape model. The implicit ED shape model can learn a continuous boundary and encourage the motion model to predict without the supervision of ground truth deformation, and the motion model enables canonical input of the shape model by deforming any point from any phase to the ED phase. Additionally, the constructed ED-space enables pre-training of the shape model, thereby guiding the motion model and addressing the issue of data scarcity. We propose the first 4D myocardial dataset as we know and verify our method on the proposed, public, and cross-modal datasets, showing superior reconstruction performance and enabling various clinical applications.

Introduction: Blood vessels can be non-invasively visualized from a digital fundus image (DFI). Several studies have shown an association between cardiovascular risk and vascular features obtained from DFI. Recent advances in computer vision and image segmentation enable automatising DFI blood vessel segmentation. There is a need for a resource that can automatically compute digital vasculature biomarkers (VBM) from these segmented DFI. Methods: In this paper, we introduce a Python Vasculature BioMarker toolbox, denoted PVBM. A total of 11 VBMs were implemented. In particular, we introduce new algorithmic methods to estimate tortuosity and branching angles. Using PVBM, and as a proof of usability, we analyze geometric vascular differences between glaucomatous patients and healthy controls. Results: We built a fully automated vasculature biomarker toolbox based on DFI segmentations and provided a proof of usability to characterize the vascular changes in glaucoma. For arterioles and venules, all biomarkers were significant and lower in glaucoma patients compared to healthy controls except for tortuosity, venular singularity length and venular branching angles. Conclusion: We have automated the computation of 11 VBMs from retinal blood vessel segmentation. The PVBM toolbox is made open source under a GNU GPL 3 license and is available on physiozoo.com (following publication).

Current foundation model for photoplethysmography (PPG) signals is challenged by the intrinsic redundancy and noise of the signal. Standard masked modeling often yields trivial solutions while contrastive methods lack morphological precision. To address these limitations, we propose a Statistical-prior Informed Generative Masking Architecture (SIGMA-PPG), a generative foundation model featuring a Prior-Guided Adversarial Masking mechanism, where a reinforcement learning-driven teacher leverages statistical priors to create challenging learning paths that prevent overfitting to noise. We also incorporate a semantic consistency constraint via vector quantization to ensure that physiologically identical waveforms (even those altered by recording artifacts or minor perturbations) map to shared indices. This enhances codebook semantic density and eliminates redundant feature structures. Pre-trained on over 120,000 hours of data, SIGMA-PPG achieves superior average performance compared to five state-of-the-art baselines across 12 diverse downstream tasks. The code is available at https://github.com/ZonghengGuo/SigmaPPG.

Foundation models have demonstrated remarkable potential in medical domain. However, their application to complex cardiovascular diagnostics remains underexplored. In this paper, we present Cardiac-CLIP, a multi-modal foundation model designed for 3D cardiac CT images. Cardiac-CLIP is developed through a two-stage pre-training strategy. The first stage employs a 3D masked autoencoder (MAE) to perform self-supervised representation learning from large-scale unlabeled volumetric data, enabling the visual encoder to capture rich anatomical and contextual features. In the second stage, contrastive learning is introduced to align visual and textual representations, facilitating cross-modal understanding. To support the pre-training, we collect 16641 real clinical CT scans, supplemented by 114k publicly available data. Meanwhile, we standardize free-text radiology reports into unified templates and construct the pathology vectors according to diagnostic attributes, based on which the soft-label matrix is generated to supervise the contrastive learning process. On the other hand, to comprehensively evaluate the effectiveness of Cardiac-CLIP, we collect 6,722 real-clinical data from 12 independent institutions, along with the open-source data to construct the evaluation dataset. Specifically, Cardiac-CLIP is comprehensively evaluated across multiple tasks, including cardiovascular abnormality classification, information retrieval and clinical analysis. Experimental results demonstrate that Cardiac-CLIP achieves state-of-the-art performance across various downstream tasks in both internal and external data. Particularly, Cardiac-CLIP exhibits great effectiveness in supporting complex clinical tasks such as the prospective prediction of acute coronary syndrome, which is notoriously difficult in real-world scenarios.

Left ventricular hypertrophy (LVH) results from chronic remodeling caused by a broad range of systemic and cardiovascular disease including hypertension, aortic stenosis, hypertrophic cardiomyopathy, and cardiac amyloidosis. Early detection and characterization of LVH can significantly impact patient care but is limited by under-recognition of hypertrophy, measurement error and variability, and difficulty differentiating etiologies of LVH. To overcome this challenge, we present EchoNet-LVH - a deep learning workflow that automatically quantifies ventricular hypertrophy with precision equal to human experts and predicts etiology of LVH. Trained on 28,201 echocardiogram videos, our model accurately measures intraventricular wall thickness (mean absolute error [MAE] 1.4mm, 95% CI 1.2-1.5mm), left ventricular diameter (MAE 2.4mm, 95% CI 2.2-2.6mm), and posterior wall thickness (MAE 1.2mm, 95% CI 1.1-1.3mm) and classifies cardiac amyloidosis (area under the curve of 0.83) and hypertrophic cardiomyopathy (AUC 0.98) from other etiologies of LVH. In external datasets from independent domestic and international healthcare systems, EchoNet-LVH accurately quantified ventricular parameters (R2 of 0.96 and 0.90 respectively) and detected cardiac amyloidosis (AUC 0.79) and hypertrophic cardiomyopathy (AUC 0.89) on the domestic external validation site. Leveraging measurements across multiple heart beats, our model can more accurately identify subtle changes in LV geometry and its causal etiologies. Compared to human experts, EchoNet-LVH is fully automated, allowing for reproducible, precise measurements, and lays the foundation for precision diagnosis of cardiac hypertrophy. As a resource to promote further innovation, we also make publicly available a large dataset of 23,212 annotated echocardiogram videos.

Identifying disease phenotypes from electronic health records (EHRs) is critical for numerous secondary uses. Manually encoding physician knowledge into rules is particularly challenging for rare diseases due to inadequate EHR coding, necessitating review of clinical notes. Large language models (LLMs) offer promise in text understanding but may not efficiently handle real-world clinical documentation. We propose a zero-shot LLM-based method enriched by retrieval-augmented generation and MapReduce, which pre-identifies disease-related text snippets to be used in parallel as queries for the LLM to establish diagnosis. We show that this method as applied to pulmonary hypertension (PH), a rare disease characterized by elevated arterial pressures in the lungs, significantly outperforms physician logic rules (F_1 score of 0.62 vs. 0.75). This method has the potential to enhance rare disease cohort identification, expanding the scope of robust clinical research and care gap identification.

Progress in remote PhotoPlethysmoGraphy (rPPG) is limited by the critical issues of existing publicly available datasets: small size, privacy concerns with facial videos, and lack of diversity in conditions. The paper introduces a novel comprehensive large-scale multi-view video dataset for rPPG and health biomarkers estimation. Our dataset comprises 3600 synchronized video recordings from 600 subjects, captured under varied conditions (resting and post-exercise) using multiple consumer-grade cameras at different angles. To enable multimodal analysis of physiological states, each recording is paired with a 100 Hz PPG signal and extended health metrics, such as electrocardiogram, arterial blood pressure, biomarkers, temperature, oxygen saturation, respiratory rate, and stress level. Using this data, we train an efficient rPPG model and compare its quality with existing approaches in cross-dataset scenarios. The public release of our dataset and model should significantly speed up the progress in the development of AI medical assistants.

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.

Advances in medical imaging technologies have enabled the collection of longitudinal images, which involve repeated scanning of the same patients over time, to monitor disease progression. However, predictive modeling of such data remains challenging due to high dimensionality, irregular sampling, and data sparsity. To address these issues, we propose ImageFlowNet, a novel model designed to forecast disease trajectories from initial images while preserving spatial details. ImageFlowNet first learns multiscale joint representation spaces across patients and time points, then optimizes deterministic or stochastic flow fields within these spaces using a position-parameterized neural ODE/SDE framework. The model leverages a UNet architecture to create robust multiscale representations and mitigates data scarcity by combining knowledge from all patients. We provide theoretical insights that support our formulation of ODEs, and motivate our regularizations involving high-level visual features, latent space organization, and trajectory smoothness. We validate ImageFlowNet on three longitudinal medical image datasets depicting progression in geographic atrophy, multiple sclerosis, and glioblastoma, demonstrating its ability to effectively forecast disease progression and outperform existing methods. Our contributions include the development of ImageFlowNet, its theoretical underpinnings, and empirical validation on real-world datasets. The official implementation is available at https://github.com/KrishnaswamyLab/ImageFlowNet.

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.

Multimodal cardiovascular magnetic resonance (CMR) imaging provides comprehensive and non-invasive insights into cardiovascular disease (CVD) diagnosis and underlying mechanisms. Despite decades of advancements, its widespread clinical adoption remains constrained by prolonged scan times and heterogeneity across medical environments. This underscores the urgent need for a generalist reconstruction foundation model for ultra-fast CMR imaging, one capable of adapting across diverse imaging scenarios and serving as the essential substrate for all downstream analyses. To enable this goal, we curate MMCMR-427K, the largest and most comprehensive multimodal CMR k-space database to date, comprising 427,465 multi-coil k-space data paired with structured metadata across 13 international centers, 12 CMR modalities, 15 scanners, and 17 CVD categories in populations across three continents. Building on this unprecedented resource, we introduce CardioMM, a generalist reconstruction foundation model capable of dynamically adapting to heterogeneous fast CMR imaging scenarios. CardioMM unifies semantic contextual understanding with physics-informed data consistency to deliver robust reconstructions across varied scanners, protocols, and patient presentations. Comprehensive evaluations demonstrate that CardioMM achieves state-of-the-art performance in the internal centers and exhibits strong zero-shot generalization to unseen external settings. Even at imaging acceleration up to 24x, CardioMM reliably preserves key cardiac phenotypes, quantitative myocardial biomarkers, and diagnostic image quality, enabling a substantial increase in CMR examination throughput without compromising clinical integrity. Together, our open-access MMCMR-427K database and CardioMM framework establish a scalable pathway toward high-throughput, high-quality, and clinically accessible cardiovascular imaging.

Human organs constantly undergo anatomical changes due to a complex mix of short-term (e.g., heartbeat) and long-term (e.g., aging) factors. Evidently, prior knowledge of these factors will be beneficial when modeling their future state, i.e., via image generation. However, most of the medical image generation tasks only rely on the input from a single image, thus ignoring the sequential dependency even when longitudinal data is available. Sequence-aware deep generative models, where model input is a sequence of ordered and timestamped images, are still underexplored in the medical imaging domain that is featured by several unique challenges: 1) Sequences with various lengths; 2) Missing data or frame, and 3) High dimensionality. To this end, we propose a sequence-aware diffusion model (SADM) for the generation of longitudinal medical images. Recently, diffusion models have shown promising results in high-fidelity image generation. Our method extends this new technique by introducing a sequence-aware transformer as the conditional module in a diffusion model. The novel design enables learning longitudinal dependency even with missing data during training and allows autoregressive generation of a sequence of images during inference. Our extensive experiments on 3D longitudinal medical images demonstrate the effectiveness of SADM compared with baselines and alternative methods. The code is available at https://github.com/ubc-tea/SADM-Longitudinal-Medical-Image-Generation.

A unified foundation model for medical time series -- pretrained on open access and ethics board-approved medical corpora -- offers the potential to reduce annotation burdens, minimize model customization, and enable robust transfer across clinical institutions, modalities, and tasks, particularly in data-scarce or privacy-constrained environments. However, existing generalist time series foundation models struggle to handle medical time series data due to their inherent challenges, including irregular intervals, heterogeneous sampling rates, and frequent missing values. To address these challenges, we introduce MIRA, a unified foundation model specifically designed for medical time series forecasting. MIRA incorporates a Continuous-Time Rotary Positional Encoding that enables fine-grained modeling of variable time intervals, a frequency-specific mixture-of-experts layer that routes computation across latent frequency regimes to further promote temporal specialization, and a Continuous Dynamics Extrapolation Block based on Neural ODE that models the continuous trajectory of latent states, enabling accurate forecasting at arbitrary target timestamps. Pretrained on a large-scale and diverse medical corpus comprising over 454 billion time points collect from publicly available datasets, MIRA achieves reductions in forecasting errors by an average of 10% and 7% in out-of-distribution and in-distribution scenarios, respectively, when compared to other zero-shot and fine-tuned baselines. We also introduce a comprehensive benchmark spanning multiple downstream clinical tasks, establishing a foundation for future research in medical time series modeling.

Survival analysis, or time-to-event modelling, is a classical statistical problem that has garnered a lot of interest for its practical use in epidemiology, demographics or actuarial sciences. Recent advances on the subject from the point of view of machine learning have been concerned with precise per-individual predictions instead of population studies, driven by the rise of individualized medicine. We introduce here a conditional normalizing flow based estimate of the time-to-event density as a way to model highly flexible and individualized conditional survival distributions. We use a novel hierarchical formulation of normalizing flows to enable efficient fitting of flexible conditional distributions without overfitting and show how the normalizing flow formulation can be efficiently adapted to the censored setting. We experimentally validate the proposed approach on a synthetic dataset as well as four open medical datasets and an example of a common financial problem.

Cardiac magnetic resonance (CMR) is a key investigation in clinical cardiovascular medicine and has been used extensively in population research. However, extracting clinically important measurements such as ejection fraction for diagnosing cardiovascular diseases remains time-consuming and subjective. We developed CineMA, a foundation AI model automating these tasks with limited labels. CineMA is a self-supervised autoencoder model trained on 74,916 cine CMR studies to reconstruct images from masked inputs. After fine-tuning, it was evaluated across eight datasets on 23 tasks from four categories: ventricle and myocardium segmentation, left and right ventricle ejection fraction calculation, disease detection and classification, and landmark localisation. CineMA is the first foundation model for cine CMR to match or outperform convolutional neural networks (CNNs). CineMA demonstrated greater label efficiency than CNNs, achieving comparable or better performance with fewer annotations. This reduces the burden of clinician labelling and supports replacing task-specific training with fine-tuning foundation models in future cardiac imaging applications. Models and code for pre-training and fine-tuning are available at https://github.com/mathpluscode/CineMA, democratising access to high-performance models that otherwise require substantial computational resources, promoting reproducibility and accelerating clinical translation.

Cardiac magnetic resonance (CMR) is a cornerstone for diagnosing cardiovascular disease. However, it remains underutilized due to complex, time-consuming interpretation across multi-sequences, phases, quantitative measures that heavily reliant on specialized expertise. Here, we present BAAI Cardiac Agent, a multimodal intelligent system designed for end-to-end CMR interpretation. The agent integrates specialized cardiac expert models to perform automated segmentation of cardiac structures, functional quantification, tissue characterization and disease diagnosis, and generates structured clinical reports within a unified workflow. Evaluated on CMR datasets from two hospitals (2413 patients) spanning 7-types of major cardiovascular diseases, the agent achieved an area under the receiver-operating-characteristic curve exceeding 0.93 internally and 0.81 externally. In the task of estimating left ventricular function indices, the results generated by this system for core parameters such as ejection fraction, stroke volume, and left ventricular mass are highly consistent with clinical reports, with Pearson correlation coefficients all exceeding 0.90. The agent outperformed state-of-the-art models in segmentation and diagnostic tasks, and generated clinical reports showing high concordance with expert radiologists (six readers across three experience levels). By dynamically orchestrating expert models for coordinated multimodal analysis, this agent framework enables accurate, efficient CMR interpretation and highlights its potentials for complex clinical imaging workflows. Code is available at https://github.com/plantain-herb/Cardiac-Agent.

Data-driven modeling of fluid dynamics has advanced rapidly with neural PDE solvers, yet a fair and strong benchmark remains fragmented due to the absence of unified PDE datasets and standardized evaluation protocols. Although architectural innovations are abundant, fair assessment is further impeded by the lack of clear disentanglement between spatial, temporal and loss modules. In this paper, we introduce FD-Bench, the first fair, modular, comprehensive and reproducible benchmark for data-driven fluid simulation. FD-Bench systematically evaluates 85 baseline models across 10 representative flow scenarios under a unified experimental setup. It provides four key contributions: (1) a modular design enabling fair comparisons across spatial, temporal, and loss function modules; (2) the first systematic framework for direct comparison with traditional numerical solvers; (3) fine-grained generalization analysis across resolutions, initial conditions, and temporal windows; and (4) a user-friendly, extensible codebase to support future research. Through rigorous empirical studies, FD-Bench establishes the most comprehensive leaderboard to date, resolving long-standing issues in reproducibility and comparability, and laying a foundation for robust evaluation of future data-driven fluid models. The code is open-sourced at https://anonymous.4open.science/r/FD-Bench-15BC.

Foundation Models (FMs) trained on Electronic Health Records (EHRs) have achieved state-of-the-art results on numerous clinical prediction tasks. However, most existing EHR FMs have context windows of <1k tokens. This prevents them from modeling full patient EHRs which can exceed 10k's of events. Recent advancements in subquadratic long-context architectures (e.g., Mamba) offer a promising solution. However, their application to EHR data has not been well-studied. We address this gap by presenting the first systematic evaluation of the effect of context length on modeling EHR data. We find that longer context models improve predictive performance -- our Mamba-based model surpasses the prior state-of-the-art on 9/14 tasks on the EHRSHOT prediction benchmark. For clinical applications, however, model performance alone is insufficient -- robustness to the unique properties of EHR is crucial. Thus, we also evaluate models across three previously underexplored properties of EHR data: (1) the prevalence of "copy-forwarded" diagnoses which creates artificial repetition of tokens within EHR sequences; (2) the irregular time intervals between EHR events which can lead to a wide range of timespans within a context window; and (3) the natural increase in disease complexity over time which makes later tokens in the EHR harder to predict than earlier ones. Stratifying our EHRSHOT results, we find that higher levels of each property correlate negatively with model performance, but that longer context models are more robust to more extreme levels of these properties. Our work highlights the potential for using long-context architectures to model EHR data, and offers a case study for identifying new challenges in modeling sequential data motivated by domains outside of natural language. We release our models and code at: https://github.com/som-shahlab/long_context_clues

Pulmonary Hypertension (PH) is a severe disease characterized by an elevated pulmonary artery pressure. The gold standard for PH diagnosis is measurement of mean Pulmonary Artery Pressure (mPAP) during an invasive Right Heart Catheterization. In this paper, we investigate noninvasive approach to PH detection utilizing Magnetic Resonance Imaging, Computer Models and Machine Learning. We show using the ablation study, that physics-informed feature engineering based on models of blood circulation increases the performance of Gradient Boosting Decision Trees-based algorithms for classification of PH and regression of values of mPAP. We compare results of regression (with thresholding of estimated mPAP) and classification and demonstrate that metrics achieved in both experiments are comparable. The predicted mPAP values are more informative to the physicians than the probability of PH returned by classification models. They provide the intuitive explanation of the outcome of the machine learning model (clinicians are accustomed to the mPAP metric, contrary to the PH probability).

In this study, we develop a novel methodology for annotating the brain vasculature using dynamic 4D-CTA head scans. By using multiple time points from dynamic CTA acquisitions, we subtract bone and soft tissue to enhance the visualization of arteries and veins, reducing the effort required to obtain manual annotations of brain vessels. We then train deep learning models on our ground truth annotations by using the same segmentation for multiple phases from the dynamic 4D-CTA collection, effectively enlarging our dataset by 4 to 5 times and inducing robustness to contrast phases. In total, our dataset comprises 110 training images from 25 patients and 165 test images from 14 patients. In comparison with two similarly-sized datasets for CTA-based brain vessel segmentation, a nnUNet model trained on our dataset can achieve significantly better segmentations across all vascular regions, with an average mDC of 0.846 for arteries and 0.957 for veins in the TopBrain dataset. Furthermore, metrics such as average directed Hausdorff distance (adHD) and topology sensitivity (tSens) reflected similar trends: using our dataset resulted in low error margins (adHD of 0.304 mm for arteries and 0.078 for veins) and high sensitivity (tSens of 0.877 for arteries and 0.974 for veins), indicating excellent accuracy in capturing vessel morphology. Our code and model weights are available online at https://github.com/alceballosa/robust-vessel-segmentation

Large language models (LLMs) trained with next-word-prediction have achieved success as clinical foundation models. Representations from these language backbones yield strong linear probe performance across biomedical tasks, suggesting that patient semantics emerge from next-token prediction at scale. However, this paradigm treats patients as a document to be summarized rather than a dynamical system to be simulated; a patient's trajectory emerges from their state evolving under interventions and time, requiring models that simulate dynamics rather than predict tokens. To address this, we introduce SMB-Structure, a world model for structured EHR that grounds a joint-embedding prediction architecture (JEPA) with next-token prediction (SFT). SFT grounds our model to reconstruct future patient states in token space, while JEPA predicts those futures in latent space from the initial patient representation alone, forcing trajectory dynamics to be encoded before the next state is observed. We validate across two large-scale cohorts: Memorial Sloan Kettering (23,319 oncology patients; 323,000+ patient-years) and INSPECT (19,402 pulmonary embolism patients). Using a linear probe evaluated at multiple points along the disease trajectory, we demonstrate that our training paradigm learns embeddings that capture disease dynamics not recoverable by autoregressive baselines, enabling SMB-Structure to achieve competitive performance on complex tasks characterized by high patient heterogeneity. Model weights are available at https://huggingface.co/standardmodelbio/SMB-v1-1.7B-Structure.

Cardiac Magnetic Resonance (CMR) imaging is a critical tool for diagnosing and managing cardiovascular disease, yet its utility is often limited by the sparse acquisition of 2D short-axis slices, resulting in incomplete volumetric information. Accurate 3D reconstruction from these sparse slices is essential for comprehensive cardiac assessment, but existing methods face challenges, including reliance on predefined interpolation schemes (e.g., linear or spherical), computational inefficiency, and dependence on additional semantic inputs such as segmentation labels or motion data. To address these limitations, we propose a novel Cardiac Latent Interpolation Diffusion (CaLID) framework that introduces three key innovations. First, we present a data-driven interpolation scheme based on diffusion models, which can capture complex, non-linear relationships between sparse slices and improves reconstruction accuracy. Second, we design a computationally efficient method that operates in the latent space and speeds up 3D whole-heart upsampling time by a factor of 24, reducing computational overhead compared to previous methods. Third, with only sparse 2D CMR images as input, our method achieves SOTA performance against baseline methods, eliminating the need for auxiliary input such as morphological guidance, thus simplifying workflows. We further extend our method to 2D+T data, enabling the effective modeling of spatiotemporal dynamics and ensuring temporal coherence. Extensive volumetric evaluations and downstream segmentation tasks demonstrate that CaLID achieves superior reconstruction quality and efficiency. By addressing the fundamental limitations of existing approaches, our framework advances the state of the art for spatio and spatiotemporal whole-heart reconstruction, offering a robust and clinically practical solution for cardiovascular imaging.

Clinical decision-making in oncology requires predicting dynamic disease evolution, a task current static AI predictors cannot perform. While world models (WMs) offer a paradigm for generative prediction, existing medical applications remain limited. Existing methods often rely on stochastic diffusion models, focusing on visual reconstruction rather than causal, physiological transitions. Furthermore, in medical domain, models like MeWM typically ignore patient-specific temporal and clinical contexts and lack a feedback mechanism to link predictions to treatment decisions. To address these gaps, we introduce CLARITY, a medical world model that forecasts disease evolution directly within a structured latent space. It explicitly integrates time intervals (temporal context) and patient-specific data (clinical context) to model treatment-conditioned progression as a smooth, interpretable trajectory, and thus generate physiologically faithful, individualized treatment plans. Finally, CLARITY introduces a novel prediction-to-decision framework, translating latent rollouts into transparent, actionable recommendations. CLARITY demonstrates state-of-the-art performance in treatment planning. On the MU-Glioma-Post dataset, our approach outperforms recent MeWM by 12\%, and significantly surpasses all other medical-specific large language models.

Dynamic MRI is a technique of acquiring a series of images continuously to follow the physiological changes over time. However, such fast imaging results in low resolution images. In this work, abdominal deformation model computed from dynamic low resolution images have been applied to high resolution image, acquired previously, to generate dynamic high resolution MRI. Dynamic low resolution images were simulated into different breathing phases (inhale and exhale). Then, the image registration between breathing time points was performed using the B-spline SyN deformable model and using cross-correlation as a similarity metric. The deformation model between different breathing phases were estimated from highly undersampled data. This deformation model was then applied to the high resolution images to obtain high resolution images of different breathing phases. The results indicated that the deformation model could be computed from relatively very low resolution images.

This paper presents a new open-source high-fidelity dataset for Machine Learning (ML) containing 355 geometric variants of the Windsor body, to help the development and testing of ML surrogate models for external automotive aerodynamics. Each Computational Fluid Dynamics (CFD) simulation was run with a GPU-native high-fidelity Wall-Modeled Large-Eddy Simulations (WMLES) using a Cartesian immersed-boundary method using more than 280M cells to ensure the greatest possible accuracy. The dataset contains geometry variants that exhibits a wide range of flow characteristics that are representative of those observed on road-cars. The dataset itself contains the 3D time-averaged volume & boundary data as well as the geometry and force & moment coefficients. This paper discusses the validation of the underlying CFD methods as well as contents and structure of the dataset. To the authors knowledge, this represents the first, large-scale high-fidelity CFD dataset for the Windsor body with a permissive open-source license (CC-BY-SA).

Traditional diagnosis of aortic valve disease relies on echocardiography, but its cost and required expertise limit its use in large-scale early screening. Photoplethysmography (PPG) has emerged as a promising screening modality due to its widespread availability in wearable devices and its ability to reflect underlying hemodynamic dynamics. However, the extreme scarcity of gold-standard labeled PPG data severely constrains the effectiveness of data-driven approaches. To address this challenge, we propose and validate a new paradigm, Physiology-Guided Self-Supervised Learning (PG-SSL), aimed at unlocking the value of large-scale unlabeled PPG data for efficient screening of Aortic Stenosis (AS) and Aortic Regurgitation (AR). Using over 170,000 unlabeled PPG samples from the UK Biobank, we formalize clinical knowledge into a set of PPG morphological phenotypes and construct a pulse pattern recognition proxy task for self-supervised pre-training. A dual-branch, gated-fusion architecture is then employed for efficient fine-tuning on a small labeled subset. The proposed PG-SSL framework achieves AUCs of 0.765 and 0.776 for AS and AR screening, respectively, significantly outperforming supervised baselines trained on limited labeled data. Multivariable analysis further validates the model output as an independent digital biomarker with sustained prognostic value after adjustment for standard clinical risk factors. This study demonstrates that PG-SSL provides an effective, domain knowledge-driven solution to label scarcity in medical artificial intelligence and shows strong potential for enabling low-cost, large-scale early screening of aortic valve disease.

Developing robust artificial intelligence models for 4D (3D + time) medical imaging is constrained by limited annotated data, inter-device domain shifts, and privacy restrictions. To address this, we propose a 4D controllable generative framework for anatomically consistent data augmentation. A semi-supervised variational autoencoder learns a compact latent representation of anatomical volumes while jointly predicting aligned segmentation masks in a unified framework. Anatomical structure is then disentangled from temporal dynamics through a cascaded latent diffusion model (LDM). A static LDM generates subject-specific anatomy conditioned on clinical priors (diagnosis and volumes measures) and a subsequent motion LDM estimates residual latent motions, ensuring strict temporal coherence across the 4D sequence. The proposed approach was evaluated on cine cardiac MRI as a representative 4D imaging application. Experiments across multiple datasets demonstrate high controllability of static anatomy (Pearson r > 0.8) and strong temporal coherence (FVD = 288.08). In cross-vendor generalization experiments, augmenting training sets with synthetic 4D sequences significantly improves downstream segmentation performance. Using nnU-Net, the proposed augmentation strategy improves the average Dice score by 1.4% and reduces the Hausdorff Distance by 3.0mm compared to training on real data alone, for the left ventricle, Dice improves by 2.8% with a 5.4mm reduction in boundary error. Overall, this framework provides a scalable and controllable solution for 4D medical image synthesis, supporting the development of more robust models with limited annotations and cross-vendor variability. Code available on https://github.com/cyiheng/4DCardiacMRISynthesis.

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

Listening to heart and lung sounds - auscultation - is one of the first and most fundamental steps in a clinical examination. Despite being fast and non-invasive, it demands years of experience to interpret subtle audio cues. Recent deep learning methods have made progress in automating cardiopulmonary sound analysis, yet most are restricted to simple classification and offer little clinical interpretability or decision support. We present StethoLM, the first audio-language model specialized for cardiopulmonary auscultation, capable of performing instruction-driven clinical tasks across the full spectrum of auscultation analysis. StethoLM integrates audio encoding with a medical language model backbone and is trained on StethoBench, a comprehensive benchmark comprising 77,027 instruction-response pairs synthesized from 16,125 labeled cardiopulmonary recordings spanning seven clinical task categories: binary classification, detection, reporting, reasoning, differential diagnosis, comparison, and location-based analysis. Through multi-stage training that combines supervised fine-tuning and direct preference optimization, StethoLM achieves substantial gains in performance and robustness on out-of-distribution data. Our work establishes a foundation for instruction-following AI systems in clinical auscultation.

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.

The scaling laws and extraordinary performance of large foundation models motivate the development and utilization of such models in biomedicine. However, despite early promising results on some biomedical benchmarks, there are still major challenges that need to be addressed before these models can be used in real-world clinics. Frontier general-domain models such as GPT-4V still have significant performance gaps in multimodal biomedical applications. More importantly, less-acknowledged pragmatic issues, including accessibility, model cost, and tedious manual evaluation make it hard for clinicians to use state-of-the-art large models directly on private patient data. Here, we explore training open-source small multimodal models (SMMs) to bridge competency gaps for unmet clinical needs in radiology. To maximize data efficiency, we adopt a modular approach by incorporating state-of-the-art pre-trained models for image and text modalities, and focusing on training a lightweight adapter to ground each modality to the text embedding space, as exemplified by LLaVA-Med. For training, we assemble a large dataset of over 697 thousand radiology image-text pairs. For evaluation, we propose CheXprompt, a GPT-4-based metric for factuality evaluation, and demonstrate its parity with expert evaluation. For best practice, we conduct a systematic ablation study on various choices in data engineering and multimodal training. The resulting LlaVA-Rad (7B) model attains state-of-the-art results on standard radiology tasks such as report generation and cross-modal retrieval, even outperforming much larger models such as GPT-4V and Med-PaLM M (84B). The inference of LlaVA-Rad is fast and can be performed on a single V100 GPU in private settings, offering a promising state-of-the-art tool for real-world clinical applications.

Automated clinical diagnosis remains a core challenge in medical AI, which usually requires models to integrate multi-modal data and reason across complex, case-specific contexts. Although recent methods have advanced medical report generation (MRG) and visual question answering (VQA) with medical vision-language models (VLMs), these methods, however, predominantly operate under a sample-isolated inference paradigm, as such processing cases independently without access to longitudinal electronic health records (EHRs) or structurally related patient examples. This paradigm limits reasoning to image-derived information alone, which ignores external complementary medical evidence for potentially more accurate diagnosis. To overcome this limitation, we propose HyperWalker, a Deep Diagnosis framework that reformulates clinical reasoning via dynamic hypergraphs and test-time training. First, we construct a dynamic hypergraph, termed iBrochure, to model the structural heterogeneity of EHR data and implicit high-order associations among multimodal clinical information. Within this hypergraph, a reinforcement learning agent, Walker, navigates to and identifies optimal diagnostic paths. To ensure comprehensive coverage of diverse clinical characteristics in test samples, we incorporate a linger mechanism, a multi-hop orthogonal retrieval strategy that iteratively selects clinically complementary neighborhood cases reflecting distinct clinical attributes. Experiments on MRG with MIMIC and medical VQA on EHRXQA demonstrate that HyperWalker achieves state-of-the-art performance. Code is available at: https://github.com/Bean-Young/HyperWalker

Large language models (LLMs) represent a transformative class of AI tools capable of revolutionizing various aspects of healthcare by generating human-like responses across diverse contexts and adapting to novel tasks following human instructions. Their potential application spans a broad range of medical tasks, such as clinical documentation, matching patients to clinical trials, and answering medical questions. In this primer paper, we propose an actionable guideline to help healthcare professionals more efficiently utilize LLMs in their work, along with a set of best practices. This approach consists of several main phases, including formulating the task, choosing LLMs, prompt engineering, fine-tuning, and deployment. We start with the discussion of critical considerations in identifying healthcare tasks that align with the core capabilities of LLMs and selecting models based on the selected task and data, performance requirements, and model interface. We then review the strategies, such as prompt engineering and fine-tuning, to adapt standard LLMs to specialized medical tasks. Deployment considerations, including regulatory compliance, ethical guidelines, and continuous monitoring for fairness and bias, are also discussed. By providing a structured step-by-step methodology, this tutorial aims to equip healthcare professionals with the tools necessary to effectively integrate LLMs into clinical practice, ensuring that these powerful technologies are applied in a safe, reliable, and impactful manner.

While multimodal large language models (MLLMs) excel in medical applications, most of them favor static images or short-term signals. In the critical field of dynamic electrocardiograms (ECG), models struggle with complex temporal reasoning and diagnostic report generation due to a lack of high-quality datasets and benchmarks. To address this, we introduce (i) Holtercare-23K, a large-scale multimodal dynamic ECG dataset comprising 22,980 QA pairs derived from 788 clinical Holter records and featuring a novel signal-video-text tri-modal alignment. Based on this dataset, we present (ii) Holtercare-Bench, a multimodal benchmark that evaluates models on temporal localization, clinical diagnosis, and global summarization. Zero-shot evaluations of leading MLLMs reveal a significant performance gap in processing ultra-long pathological sequences. However, fine-tuning representative models yields substantial improvements. This work illuminates the limitations of current MLLMs in electrophysiology and provides a foundational benchmark for long-term medical MLLMs. Our project is available at https://github.com/ZJU4HealthCare/Holtercare-Bench.

Introduction: Mechanical thrombectomy can cause vessel deformation and procedure-related injury. Benchtop models are widely used for device testing, but time-resolved, full-field 3D vessel-motion measurements remain limited. Methods: We developed a nine-camera, low-cost multi-view workflow for benchtop thrombectomy in silicone middle cerebral artery phantoms (2160p, 20 fps). Multi-view videos were calibrated, segmented, and reconstructed with 4D Gaussian Splatting. Reconstructed point clouds were converted to fixed-connectivity edge graphs for region-of-interest (ROI) displacement tracking and a relative surface-based stress proxy. Stress-proxy values were derived from edge stretch using a Neo-Hookean mapping and reported as comparative surface metrics. A synthetic Blender pipeline with known deformation provided geometric and temporal validation. Results: In synthetic bulk translation, the stress proxy remained near zero for most edges (median approx 0 MPa; 90th percentile 0.028 MPa), with sparse outliers. In synthetic pulling (1-5 mm), reconstruction showed close geometric and temporal agreement with ground truth, with symmetric Chamfer distance of 1.714-1.815 mm and precision of 0.964-0.972 at τ= 1 mm. In preliminary benchtop comparative trials (one trial per condition), cervical aspiration catheter placement showed higher max-median ROI displacement and stress-proxy values than internal carotid artery terminus placement. Conclusion: The proposed protocol provides standardized, time-resolved surface kinematics and comparative relative displacement and stress proxy measurements for thrombectomy benchtop studies. The framework supports condition-to-condition comparisons and methods validation, while remaining distinct from absolute wall-stress estimation. Implementation code and example data are available at https://ethanuser.github.io/vessel4D

In recent years, Physics-Informed Neural Networks (PINNs) have emerged as a powerful and robust framework for solving nonlinear differential equations across a wide range of scientific and engineering disciplines, including biology, geophysics, astrophysics and fluid dynamics. In the PINN framework, the governing partial differential equations, along with initial and boundary conditions, are encoded directly into the loss function, enabling the network to learn solutions that are consistent with the underlying physics. In this work, we employ the PINN framework to solve the dimensionless Navier-Stokes equations for three two-dimensional incompressible, steady, laminar flow problems without using any labeled data. The boundary and initial conditions are enforced in a hard manner, ensuring they are satisfied exactly rather than penalized during training. We validate the PINN predicted velocity profiles, drag coefficients and pressure profiles against the conventional computational fluid dynamics (CFD) simulations for moderate to high values of Reynolds number (Re). It is observed that the PINN predictions show good agreement with the CFD results at lower Re. We also extend our analysis to a transient condition and find that our method is equally capable of simulating complex time-dependent flow dynamics. To quantitatively assess the accuracy, we compute the L_2 normalized error, which lies in the range O(10^{-4}) - O(10^{-1}) for our chosen case studies.

As large language models (LLMs) advance in conversational and reasoning capabilities, their practical application in healthcare has become a critical research focus. However, there is a notable gap between the performance of medical LLMs on static benchmarks such as USMLE and their utility in real-world clinical decision-making. This discrepancy arises because traditional exams fail to capture the dynamic, interactive nature of medical consultations. To address this challenge, we introduce a novel dynamic verification framework that moves beyond static answer verifier, establishing a large-scale, high-fidelity interactive reinforcement learning system. Our framework comprises two key components: a Patient Simulator that creates realistic clinical environments using de-identified medical records, and a Clinical Rubrics Generator that dynamically produces multi-dimensional evaluation metrics. Building on this foundation, we develop Baichuan-M2, a 32B-parameter medical augmented reasoning model trained through a multi-stage reinforcement learning strategy with an improved Group Relative Policy Optimization (GRPO) algorithm. Evaluated on HealthBench, Baichuan-M2 outperforms all other open-source models and most advanced closed-source counterparts, achieving a score above 32 on the challenging HealthBench Hard benchmark-previously exceeded only by GPT-5. Our work demonstrates that robust dynamic verifier system is essential for aligning LLM capabilities with practical clinical applications, establishing a new Pareto front in the performance-parameter trade-off for medical AI deployment.

Implicit Neural Spatial Representation (INSR) has emerged as an effective representation of spatially-dependent vector fields. This work explores solving time-dependent PDEs with INSR. Classical PDE solvers introduce both temporal and spatial discretizations. Common spatial discretizations include meshes and meshless point clouds, where each degree-of-freedom corresponds to a location in space. While these explicit spatial correspondences are intuitive to model and understand, these representations are not necessarily optimal for accuracy, memory usage, or adaptivity. Keeping the classical temporal discretization unchanged (e.g., explicit/implicit Euler), we explore INSR as an alternative spatial discretization, where spatial information is implicitly stored in the neural network weights. The network weights then evolve over time via time integration. Our approach does not require any training data generated by existing solvers because our approach is the solver itself. We validate our approach on various PDEs with examples involving large elastic deformations, turbulent fluids, and multi-scale phenomena. While slower to compute than traditional representations, our approach exhibits higher accuracy and lower memory consumption. Whereas classical solvers can dynamically adapt their spatial representation only by resorting to complex remeshing algorithms, our INSR approach is intrinsically adaptive. By tapping into the rich literature of classic time integrators, e.g., operator-splitting schemes, our method enables challenging simulations in contact mechanics and turbulent flows where previous neural-physics approaches struggle. Videos and codes are available on the project page: http://www.cs.columbia.edu/cg/INSR-PDE/

Accurate emulation of multi-scale physical systems governed by PDEs demands models that remain stable over long autoregressive rollouts while preserving fine-scale structures. Deterministic emulators produce overly-smoothed predictions, while generative approaches better capture details but are costly. Latent-space generative models have emerged as a compromise but with the additional cost of separately pre-trained autoencoders. We propose Wavelet Flow Matching (WFM), a novel generative emulator that overcomes current trade-offs between cost and skill by performing optimal-transport directly in the multi-scale wavelet space. Rather than learning a latent compression, WFM leverages the hierarchical structure of a U-Net to jointly predict transport velocities of a prescribed wavelet representation. On three challenging systems of chaotic fluid dynamics, WFM achieves superior long-horizon stability, accuracy and spectral coherence compared to state-of-the-art models. Our results clearly position the wavelet space as an effective training-free representation for generative emulation of complex physical dynamics.

Echocardiography (ECHO) is essential for cardiac assessments, but its video quality and interpretation heavily relies on manual expertise, leading to inconsistent results from clinical and portable devices. ECHO video generation offers a solution by improving automated monitoring through synthetic data and generating high-quality videos from routine health data. However, existing models often face high computational costs, slow inference, and rely on complex conditional prompts that require experts' annotations. To address these challenges, we propose ECHOPULSE, an ECG-conditioned ECHO video generation model. ECHOPULSE introduces two key advancements: (1) it accelerates ECHO video generation by leveraging VQ-VAE tokenization and masked visual token modeling for fast decoding, and (2) it conditions on readily accessible ECG signals, which are highly coherent with ECHO videos, bypassing complex conditional prompts. To the best of our knowledge, this is the first work to use time-series prompts like ECG signals for ECHO video generation. ECHOPULSE not only enables controllable synthetic ECHO data generation but also provides updated cardiac function information for disease monitoring and prediction beyond ECG alone. Evaluations on three public and private datasets demonstrate state-of-the-art performance in ECHO video generation across both qualitative and quantitative measures. Additionally, ECHOPULSE can be easily generalized to other modality generation tasks, such as cardiac MRI, fMRI, and 3D CT generation. Demo can seen from https://github.com/levyisthebest/ECHOPulse_Prelease.

The ability to resolve complex physical phenomena with high fidelity and at low computational cost is central to addressing key challenges in modern engineering. A prime example lies in hypersonic flows, where the precise prediction of the full flowfield topology, in particular with respect to shock wave location and intensity, is critical. Yet supersonic and hypersonic flows continue to be a stumbling block for traditional reduced-order models and neural emulators that struggle to capture steep gradients in flow states with physical consistency in applications of industrial relevance. To that end, we introduce a fully GPU based workflow that integrates accelerated data generation with the training of neural emulators augmented by uncertainty quantification and physics-aware refinement. Our workflow is enabled by a differentiable high-fidelity solver (JAX-Fluids) which we employ for rapid dataset creation and residual-based improvement of the neural emulator to enhance physical consistency. Building on this framework, we first present a suite of model architectures and analyze their scaling behavior to expose their strengths and shortcomings. We then show that residual-based refinement enables training on cases where only mesh and input parameters are available, substantially reducing residuals and improving physical consistency. Together, differentiable simulation and residual-based refinement yield physics emulators that remain reliable beyond their training distribution, a key requirement for deploying surrogates in real-world engineering design loops.

The purpose of this study is to present and compare three denoising diffusion probabilistic models (DDPMs) that generate 3D T_1-weighted MRI human brain images. Three DDPMs were trained using 80,675 image volumes from 42,406 subjects spanning 38 publicly available brain MRI datasets. These images had approximately 1 mm isotropic resolution and were manually inspected by three human experts to exclude those with poor quality, field-of-view issues, and excessive pathology. The images were minimally preprocessed to preserve the visual variability of the data. Furthermore, to enable the DDPMs to produce images with natural orientation variations and inhomogeneity, the images were neither registered to a common coordinate system nor bias field corrected. Evaluations included segmentation, Frechet Inception Distance (FID), and qualitative inspection. Regarding results, all three DDPMs generated coherent MR brain volumes. The velocity and flow prediction models achieved lower FIDs than the sample prediction model. However, all three models had higher FIDs compared to real images across multiple cohorts. In a permutation experiment, the generated brain regional volume distributions differed statistically from real data. However, the velocity and flow prediction models had fewer statistically different volume distributions in the thalamus and putamen. In conclusion this work presents and releases the first 3D non-latent diffusion model for brain data without skullstripping or registration. Despite the negative results in statistical testing, the presented DDPMs are capable of generating high-resolution 3D T_1-weighted brain images. All model weights and corresponding inference code are publicly available at https://github.com/piksl-research/medforj .

Spatial graphs provide a lightweight and elegant representation of curvilinear anatomical structures such as blood vessels, lung airways, and neuronal networks. Accurately modeling these graphs is crucial in clinical and (bio-)medical research. However, the high spatial resolution of large networks drastically increases their complexity, resulting in significant computational challenges. In this work, we aim to tackle these challenges by proposing VesselTok, a framework that approaches spatially dense graphs from a parametric shape perspective to learn latent representations (tokens). VesselTok leverages centerline points with a pseudo radius to effectively encode tubular geometry. Specifically, we learn a novel latent representation conditioned on centerline points to encode neural implicit representations of vessel-like, tubular structures. We demonstrate VesselTok's performance across diverse anatomies, including lung airways, lung vessels, and brain vessels, highlighting its ability to robustly encode complex topologies. To prove the effectiveness of VesselTok's learnt latent representations, we show that they (i) generalize to unseen anatomies, (ii) support generative modeling of plausible anatomical graphs, and (iii) transfer effectively to downstream inverse problems, such as link prediction.

To overcome the limitations of manual administrative coding in geriatric Cardiovascular Risk Management, this study introduces an automated classification framework leveraging unstructured Electronic Health Records (EHRs). Using a dataset of 3,482 patients, we benchmarked three distinct modeling paradigms on longitudinal Dutch clinical narratives: classical machine learning baselines, specialized deep learning architectures optimized for large-context sequences, and general-purpose generative Large Language Models (LLMs) in a zero-shot setting. Additionally, we evaluated a late fusion strategy to integrate unstructured text with structured medication embeddings and anthropometric data. Our analysis reveals that the custom Transformer architecture outperforms both traditional methods and generative llms, achieving the highest F1-scores and Matthews Correlation Coefficients. These findings underscore the critical role of specialized hierarchical attention mechanisms in capturing long-range dependencies within medical texts, presenting a robust, automated alternative to manual workflows for clinical risk stratification.

A mesh motion model based on deep operator networks is presented. The model is trained on and evaluated against a biharmonic mesh motion model on a fluid-structure interaction benchmark problem and further evaluated in a setting where biharmonic mesh motion fails. The performance of the proposed mesh motion model is comparable to the biharmonic mesh motion on the test problems.