Shuang Qian

Lei Li, Hannah Smith, Yilin Lyu et al.

Cardiac digital twins (CDTs) offer personalized in-silico cardiac representations for the inference of multi-scale properties tied to cardiac mechanisms. The creation of CDTs requires precise information about the electrode position on the torso, especially for the personalized electrocardiogram (ECG) calibration. However, current studies commonly rely on additional acquisition of torso imaging and manual/semi-automatic methods for ECG electrode localization. In this study, we propose a novel and efficient topology-informed model to fully automatically extract personalized ECG standard electrode locations from 2D clinically standard cardiac MRIs. Specifically, we obtain the sparse torso contours from the cardiac MRIs and then localize the standard electrodes of 12-lead ECG from the contours. Cardiac MRIs aim at imaging of the heart instead of the torso, leading to incomplete torso geometry within the imaging. To tackle the missing topology, we incorporate the electrodes as a subset of the keypoints, which can be explicitly aligned with the 3D torso topology. The experimental results demonstrate that the proposed model outperforms the time-consuming conventional model projection-based method in terms of accuracy (Euclidean distance: $1.24 \pm 0.293$ cm vs. $1.48 \pm 0.362$ cm) and efficiency ($2$~s vs. $30$-$35$~min). We further demonstrate the effectiveness of using the detected electrodes for in-silico ECG simulation, highlighting their potential for creating accurate and efficient CDT models. The code is available at https://github.com/lileitech/12lead_ECG_electrode_localizer.

Bei Zhou, Cesare Corrado, Shuang Qian et al.

Accurate maps of atrial electrical activation are essential for personalised treatment of arrhythmias, yet biophysically detailed simulations remain computationally intensive for real-time clinical use or population-scale analyses. Here we introduce a geometry-independent operator-learning framework that predicts local activation time (LAT) fields across diverse left atrial anatomies with near-instantaneous inference. We generated a dataset of 308,700 simulations using a GPU-accelerated electrophysiology solver, systematically varying multiple pacing sites and physiologically varied conduction properties across 147 patient-specific geometries derived from two independent clinical cohorts. All anatomical and functional data are expressed in a Universal Atrium Coordinate system, providing a consistent representation that decouples electrophysiological patterns from mesh topology. Within this coordinate space, we designed a neural operator with a vision-transformer backbone to learn the mapping from structural and electrophysiological inputs to LAT fields. With a mean prediction error of 5.1 ms over a 455 ms maximum simulation time, the model outperforms established operator-learning approaches and performs inference in 0.12 ms per sample. Our framework establishes a general strategy for learning domain-invariant biophysical mappings across variable anatomical domains and enables integration of computational electrophysiology into real-time and large-scale clinical workflows.

Devran Ugurlu, Shuang Qian, Elliot Fairweather et al.

A cardiac digital twin is a virtual replica of a patient's heart for screening, diagnosis, prognosis, risk assessment, and treatment planning of cardiovascular diseases. This requires an anatomically accurate patient-specific 3D structural representation of the heart, suitable for electro-mechanical simulations or study of disease mechanisms. However, generation of cardiac digital twins at scale is demanding and there are no public repositories of models across demographic groups. We describe an automatic open-source pipeline for creating patient-specific left and right ventricular meshes from cardiovascular magnetic resonance images, its application to a large cohort of ~55000 participants from UK Biobank, and the construction of the most comprehensive cohort of adult heart models to date, comprising 1423 representative meshes across sex (male, female), body mass index (range: 16 - 42 kg/m$^2$) and age (range: 49 - 80 years). Our code is available at https://github.com/cdttk/biv-volumetric-meshing/tree/plos2025 , and pre-trained networks, representative volumetric meshes with fibers and UVCs will be made available soon.

Changyuan Tian, Zhicong Lu, Shuang Qian et al.

To improve Multi-step Mathematical Reasoning (MsMR) of Large Language Models (LLMs), it is crucial to obtain scalable supervision from the corpus by automatically critiquing mistakes in the reasoning process of MsMR and rendering a final verdict of the problem-solution. Most existing methods rely on crafting high-quality supervised fine-tuning demonstrations for critiquing capability enhancement and pay little attention to delving into the underlying reason for the poor critiquing performance of LLMs. In this paper, we orthogonally quantify and investigate the potential reason -- imbalanced evaluation preference, and conduct a statistical preference analysis. Motivated by the analysis of the reason, a novel perplexity-aware reinforcement learning algorithm is proposed to rectify the evaluation preference, elevating the critiquing capability. Specifically, to probe into LLMs' critiquing characteristics, a One-to-many Problem-Solution (OPS) benchmark is meticulously constructed to quantify the behavior difference of LLMs when evaluating the problem solutions generated by itself and others. Then, to investigate the behavior difference in depth, we conduct a statistical preference analysis oriented on perplexity and find an intriguing phenomenon -- ``LLMs incline to judge solutions with lower perplexity as correct'', which is dubbed as \textit{imbalanced evaluation preference}. To rectify this preference, we regard perplexity as the baton in the algorithm of Group Relative Policy Optimization, supporting the LLMs to explore trajectories that judge lower perplexity as wrong and higher perplexity as correct. Extensive experimental results on our built OPS and existing available critic benchmarks demonstrate the validity of our method.