Mengling Feng

Kai He, Rui Mao, Qika Lin et al.

The utilization of large language models (LLMs) in the Healthcare domain has generated both excitement and concern due to their ability to effectively respond to freetext queries with certain professional knowledge. This survey outlines the capabilities of the currently developed LLMs for Healthcare and explicates their development process, with the aim of providing an overview of the development roadmap from traditional Pretrained Language Models (PLMs) to LLMs. Specifically, we first explore the potential of LLMs to enhance the efficiency and effectiveness of various Healthcare applications highlighting both the strengths and limitations. Secondly, we conduct a comparison between the previous PLMs and the latest LLMs, as well as comparing various LLMs with each other. Then we summarize related Healthcare training data, training methods, optimization strategies, and usage. Finally, the unique concerns associated with deploying LLMs in Healthcare settings are investigated, particularly regarding fairness, accountability, transparency and ethics. Our survey provide a comprehensive investigation from perspectives of both computer science and Healthcare specialty. Besides the discussion about Healthcare concerns, we supports the computer science community by compiling a collection of open source resources, such as accessible datasets, the latest methodologies, code implementations, and evaluation benchmarks in the Github. Summarily, we contend that a significant paradigm shift is underway, transitioning from PLMs to LLMs. This shift encompasses a move from discriminative AI approaches to generative AI approaches, as well as a shift from model-centered methodologies to data-centered methodologies. Also, we determine that the biggest obstacle of using LLMs in Healthcare are fairness, accountability, transparency and ethics.

Yucheng Ruan, Xiang Lan, Jingying Ma et al.

Tabular data, a prevalent data type across various domains, presents unique challenges due to its heterogeneous nature and complex structural relationships. Achieving high predictive performance and robustness in tabular data analysis holds significant promise for numerous applications. Influenced by recent advancements in natural language processing, particularly transformer architectures, new methods for tabular data modeling have emerged. Early techniques concentrated on pre-training transformers from scratch, often encountering scalability issues. Subsequently, methods leveraging pre-trained language models like BERT have been developed, which require less data and yield enhanced performance. The recent advent of large language models, such as GPT and LLaMA, has further revolutionized the field, facilitating more advanced and diverse applications with minimal fine-tuning. Despite the growing interest, a comprehensive survey of language modeling techniques for tabular data remains absent. This paper fills this gap by providing a systematic review of the development of language modeling for tabular data, encompassing: (1) a categorization of different tabular data structures and data types; (2) a review of key datasets used in model training and tasks used for evaluation; (3) a summary of modeling techniques including widely-adopted data processing methods, popular architectures, and training objectives; (4) the evolution from adapting traditional Pre-training/Pre-trained language models to the utilization of large language models; (5) an identification of persistent challenges and potential future research directions in language modeling for tabular data analysis. GitHub page associated with this survey is available at: https://github.com/lanxiang1017/Language-Modeling-on-Tabular-Data-Survey.git.

Yanrui Du, Sendong Zhao, Yibo Gao et al.

Large language models (LLMs) equipped with chain-of-thought (CoT) achieve strong performance and offer a window into LLM behavior. However, recent evidence suggests that improvements in CoT capabilities often come with redundant reasoning processes, motivating a key question: Can LLMs acquire a fast-thinking mode analogous to human System 1 reasoning? To explore this, our study presents a self-sampling framework based on activation steering for efficient CoT learning. Our method can induce style-aligned and variable-length reasoning traces from target LLMs themselves without any teacher guidance, thereby alleviating a central bottleneck of SFT-based methods-the scarcity of high-quality supervision data. Using filtered data by gold answers, we perform SFT for efficient CoT learning with (i) a human-like dual-cognitive system, and (ii) a progressive compression curriculum. Furthermore, we explore a self-evolution regime in which SFT is driven solely by prediction-consistent data of variable-length variants, eliminating the need for gold answers. Extensive experiments on math benchmarks, together with cross-domain generalization tests in medicine, show that our method yields stable improvements for both general and R1-style LLMs. Our data and model checkpoints can be found at https://github.com/DYR1/S3-CoT.

Jingying Ma, Qika Lin, Ziyu Jia et al.

Sleep staging is critical to assess sleep quality and diagnose disorders. Despite advancements in artificial intelligence enabling automated sleep staging, significant challenges remain: (1) Simultaneously extracting prominent temporal and spatial sleep features from multi-channel raw signals, including characteristic sleep waveforms and salient spatial brain networks. (2) Capturing the spatial-temporal coupling patterns essential for accurate sleep staging. To address these challenges, we propose a novel framework named ST-USleepNet, comprising a spatial-temporal graph construction module (ST) and a U-shaped sleep network (USleepNet). The ST module converts raw signals into a spatial-temporal graph based on signal similarity, temporal, and spatial relationships to model spatial-temporal coupling patterns. The USleepNet employs a U-shaped structure for both the temporal and spatial streams, mirroring its original use in image segmentation to isolate significant targets. Applied to raw sleep signals and graph data from the ST module, USleepNet effectively segments these inputs, simultaneously extracting prominent temporal and spatial sleep features. Testing on three datasets demonstrates that ST-USleepNet outperforms existing baselines, and model visualizations confirm its efficacy in extracting prominent sleep features and temporal-spatial coupling patterns across various sleep stages. The code is available at https://github.com/Majy-Yuji/ST-USleepNet.

Qika Lin, Yifan Zhu, Xin Mei et al.

The rapid development of artificial intelligence has constantly reshaped the field of intelligent healthcare and medicine. As a vital technology, multimodal learning has increasingly garnered interest due to data complementarity, comprehensive modeling form, and great application potential. Currently, numerous researchers are dedicating their attention to this field, conducting extensive studies and constructing abundant intelligent systems. Naturally, an open question arises that has multimodal learning delivered universal intelligence in healthcare? To answer the question, we adopt three unique viewpoints for a holistic analysis. Firstly, we conduct a comprehensive survey of the current progress of medical multimodal learning from the perspectives of datasets, task-oriented methods, and universal foundation models. Based on them, we further discuss the proposed question from five issues to explore the real impacts of advanced techniques in healthcare, from data and technologies to performance and ethics. The answer is that current technologies have NOT achieved universal intelligence and there remains a significant journey to undertake. Finally, in light of the above reviews and discussions, we point out ten potential directions for exploration towards the goal of universal intelligence in healthcare.

Yanrui Du, Yibo Gao, Sendong Zhao et al.

R1-style LLMs have attracted growing attention for their capacity for self-reflection, yet the internal mechanisms underlying such behavior remain unclear. To bridge this gap, we anchor on the onset of reflection behavior and trace its layer-wise activation trajectory. Using the logit lens to read out token-level semantics, we uncover a structured progression: (i) Latent-control layers, where an approximate linear direction encodes the semantics of thinking budget; (ii) Semantic-pivot layers, where discourse-level cues, including turning-point and summarization cues, surface and dominate the probability mass; and (iii) Behavior-overt layers, where the likelihood of reflection-behavior tokens begins to rise until they become highly likely to be sampled. Moreover, our targeted interventions uncover a causal chain across these stages: prompt-level semantics modulate the projection of activations along latent-control directions, thereby inducing competition between turning-point and summarization cues in semantic-pivot layers, which in turn regulates the sampling likelihood of reflection-behavior tokens in behavior-overt layers. Collectively, our findings suggest a human-like meta-cognitive process-progressing from latent monitoring, to discourse-level regulation, and to finally overt self-reflection. Our analysis code can be found at https://github.com/DYR1/S3-CoT.

Xiang Lan, Hanshu Yan, Shenda Hong et al.

Not all positive pairs are beneficial to time series contrastive learning. In this paper, we study two types of bad positive pairs that can impair the quality of time series representation learned through contrastive learning: the noisy positive pair and the faulty positive pair. We observe that, with the presence of noisy positive pairs, the model tends to simply learn the pattern of noise (Noisy Alignment). Meanwhile, when faulty positive pairs arise, the model wastes considerable amount of effort aligning non-representative patterns (Faulty Alignment). To address this problem, we propose a Dynamic Bad Pair Mining (DBPM) algorithm, which reliably identifies and suppresses bad positive pairs in time series contrastive learning. Specifically, DBPM utilizes a memory module to dynamically track the training behavior of each positive pair along training process. This allows us to identify potential bad positive pairs at each epoch based on their historical training behaviors. The identified bad pairs are subsequently down-weighted through a transformation module, thereby mitigating their negative impact on the representation learning process. DBPM is a simple algorithm designed as a lightweight plug-in without learnable parameters to enhance the performance of existing state-of-the-art methods. Through extensive experiments conducted on four large-scale, real-world time series datasets, we demonstrate DBPM's efficacy in mitigating the adverse effects of bad positive pairs.

Yucheng Ruan, Xiang Lan, Daniel J. Tan et al.

Medical tabular data, abundant in Electronic Health Records (EHRs), is a valuable resource for diverse medical tasks such as risk prediction. While deep learning approaches, particularly transformer-based models, have shown remarkable performance in tabular data prediction, there are still problems remaining for existing work to be effectively adapted into medical domain, such as ignoring unstructured free-texts and underutilizing the textual information in structured data. To address these issues, we propose PTransformer, a \underline{P}rompt-based multimodal \underline{Transformer} architecture designed specifically for medical tabular data. This framework consists of two critical components: a tabular cell embedding generator and a tabular transformer. The former efficiently encodes diverse modalities from both structured and unstructured tabular data into a harmonized language semantic space with the help of pre-trained sentence encoder and medical prompts. The latter integrates cell representations to generate patient embeddings for various medical tasks. In comprehensive experiments on two real-world datasets for three medical tasks, PTransformer demonstrated the improvements with 10.9%/11.0% on RMSE/MAE, 0.5%/2.2% on RMSE/MAE, and 1.6%/0.8% on BACC/AUROC compared to state-of-the-art (SOTA) baselines in predictability.

Jiangeng Chang, Yucheng Ruan, Cui Shaoze et al.

We suggested a unified system with core components of data augmentation, ImageNet-pretrained ResNet-50, cost-sensitive loss, deep ensemble learning, and uncertainty estimation to quickly and consistently detect COVID-19 using acoustic evidence. To increase the model's capacity to identify a minority class, data augmentation and cost-sensitive loss are incorporated (infected samples). In the COVID-19 detection challenge, ImageNet-pretrained ResNet-50 has been found to be effective. The unified framework also integrates deep ensemble learning and uncertainty estimation to integrate predictions from various base classifiers for generalisation and reliability. We ran a series of tests using the DiCOVA2021 challenge dataset to assess the efficacy of our proposed method, and the results show that our method has an AUC-ROC of 85.43 percent, making it a promising method for COVID-19 detection. The unified framework also demonstrates that audio may be used to quickly diagnose different respiratory disorders.

Young Seok Jeon, Hongfei Yang, Mengling Feng

The encoder-decoder model is a commonly used Deep Neural Network (DNN) model for medical image segmentation. Conventional encoder-decoder models make pixel-wise predictions focusing heavily on local patterns around the pixel. This makes it challenging to give segmentation that preserves the object's shape and topology, which often requires an understanding of the global context of the object. In this work, we propose a Fourier Coefficient Segmentation Network~(FCSN) -- a novel DNN-based model that segments an object by learning the complex Fourier coefficients of the object's masks. The Fourier coefficients are calculated by integrating over the whole contour. Therefore, for our model to make a precise estimation of the coefficients, the model is motivated to incorporate the global context of the object, leading to a more accurate segmentation of the object's shape. This global context awareness also makes our model robust to unseen local perturbations during inference, such as additive noise or motion blur that are prevalent in medical images. When FCSN is compared with other state-of-the-art models (UNet+, DeepLabV3+, UNETR) on 3 medical image segmentation tasks (ISIC\_2018, RIM\_CUP, RIM\_DISC), FCSN attains significantly lower Hausdorff scores of 19.14 (6\%), 17.42 (6\%), and 9.16 (14\%) on the 3 tasks, respectively. Moreover, FCSN is lightweight by discarding the decoder module, which incurs significant computational overhead. FCSN only requires 22.2M parameters, 82M and 10M fewer parameters than UNETR and DeepLabV3+. FCSN attains inference and training speeds of 1.6ms/img and 6.3ms/img, that is 8$\times$ and 3$\times$ faster than UNet and UNETR.

Ling Huang, Su Ruan, Yucheng Xing et al.

The comprehensive integration of machine learning healthcare models within clinical practice remains suboptimal, notwithstanding the proliferation of high-performing solutions reported in the literature. A predominant factor hindering widespread adoption pertains to an insufficiency of evidence affirming the reliability of the aforementioned models. Recently, uncertainty quantification methods have been proposed as a potential solution to quantify the reliability of machine learning models and thus increase the interpretability and acceptability of the result. In this review, we offer a comprehensive overview of prevailing methods proposed to quantify uncertainty inherent in machine learning models developed for various medical image tasks. Contrary to earlier reviews that exclusively focused on probabilistic methods, this review also explores non-probabilistic approaches, thereby furnishing a more holistic survey of research pertaining to uncertainty quantification for machine learning models. Analysis of medical images with the summary and discussion on medical applications and the corresponding uncertainty evaluation protocols are presented, which focus on the specific challenges of uncertainty in medical image analysis. We also highlight some potential future research work at the end. Generally, this review aims to allow researchers from both clinical and technical backgrounds to gain a quick and yet in-depth understanding of the research in uncertainty quantification for medical image analysis machine learning models.

Xiang Lan, Feng Wu, Kai He et al.

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

Huiting Huang, Tieliang Gong, Kai He et al.

Multimodal sentiment analysis has received significant attention across diverse research domains. Despite advancements in algorithm design, existing approaches suffer from two critical limitations: insufficient learning of noise-contaminated unimodal data, leading to corrupted cross-modal interactions, and inadequate fusion of multimodal representations, resulting in discarding discriminative unimodal information while retaining multimodal redundant information. To address these challenges, this paper proposes a Double Information Bottleneck (DIB) strategy to obtain a powerful, unified compact multimodal representation. Implemented within the framework of low-rank Renyi's entropy functional, DIB offers enhanced robustness against diverse noise sources and computational tractability for high-dimensional data, as compared to the conventional Shannon entropy-based methods. The DIB comprises two key modules: 1) learning a sufficient and compressed representation of individual unimodal data by maximizing the task-relevant information and discarding the superfluous information, and 2) ensuring the discriminative ability of multimodal representation through a novel attention bottleneck fusion mechanism. Consequently, DIB yields a multimodal representation that effectively filters out noisy information from unimodal data while capturing inter-modal complementarity. Extensive experiments on CMU-MOSI, CMU-MOSEI, CH-SIMS, and MVSA-Single validate the effectiveness of our method. The model achieves 47.4% accuracy under the Acc-7 metric on CMU-MOSI and 81.63% F1-score on CH-SIMS, outperforming the second-best baseline by 1.19%. Under noise, it shows only 0.36% and 0.29% performance degradation on CMU-MOSI and CMU-MOSEI respectively.

Daniel J. Tan, Qianyi Xu, Kay Choong See et al.

In healthcare, multi-organ system diseases pose unique and significant challenges as they impact multiple physiological systems concurrently, demanding complex and coordinated treatment strategies. Despite recent advancements in the AI based clinical decision support systems, these solutions only focus on individual organ systems, failing to account for complex interdependencies between them. This narrow focus greatly hinders their effectiveness in recommending holistic and clinically actionable treatments in the real world setting. To address this critical gap, we propose a novel Hierarchical Multi-Agent Reinforcement Learning (HMARL) framework. Our architecture deploys specialized and dedicated agents for each organ system and facilitates inter-agent communication to enable synergistic decision-making across organ systems. Furthermore, we introduce a dual-layer state representation technique that contextualizes patient conditions at both global and organ-specific levels, improving the accuracy and relevance of treatment decisions. We evaluate our HMARL solution on the task of sepsis management, a common and critical multi-organ disease, using both qualitative and quantitative metrics. Our method learns effective, clinically aligned treatment policies that considerably improve patient survival. We believe this framework represents a significant advancement in clinical decision support systems, introducing the first RL solution explicitly designed for multi-organ treatment recommendations. Our solution moves beyond prevailing simplified, single-organ models that fall short in addressing the complexity of multi-organ diseases.

Zhihui Chen, Mengling Feng

Medical image editing has emerged as a pivotal technology with broad applications in data augmentation, model interpretability, medical education, and treatment simulation. However, the lack of large-scale, high-quality, and openly accessible datasets tailored for medical contexts with strict anatomical and clinical constraints has significantly hindered progress in this domain. To bridge this gap, we introduce Med-Banana-50K, a comprehensive dataset of over 50k medically curated image edits spanning chest X-ray, brain MRI, and fundus photography across 23 diseases. Each sample supports bidirectional lesion editing (addition and removal) and is constructed using Gemini-2.5-Flash-Image based on real clinical images. A key differentiator of our dataset is the medically grounded quality control protocol: we employ an LLM-as-Judge evaluation framework with criteria such as instruction compliance, structural plausibility, image realism, and fidelity preservation, alongside iterative refinement over up to five rounds. Additionally, Med-Banana-50K includes around 37,000 failed editing attempts with full evaluation logs to support preference learning and alignment research. By offering a large-scale, medically rigorous, and fully documented resource, Med-Banana-50K establishes a critical foundation for developing and evaluating reliable medical image editing systems. Our dataset and code are publicly available. [https://github.com/richardChenzhihui/med-banana-50k].

Jiaxing Xu, Jingying Ma, Xin Lin et al.

Brain network analysis provides an interpretable framework for characterizing brain organization and has been widely used for neurological disorder identification. Recent advances in self-supervised learning have motivated the development of brain network foundation models. However, existing approaches are often limited by atlas dependency, insufficient exploitation of multiple network views, and weak incorporation of anatomical priors. In this work, we propose MV-BrainFM, a multi-view brain network foundation model designed to learn generalizable and scalable representations from brain networks constructed with arbitrary atlases. MV-BrainFM explicitly incorporates anatomical distance information into Transformer-based modeling to guide inter-regional interactions, and introduces an unsupervised cross-view consistency learning strategy to align representations from multiple atlases of the same subject in a shared latent space. By jointly enforcing within-view robustness and cross-view alignment during pretraining, the model effectively captures complementary information across heterogeneous network views while remaining atlas-aware. In addition, MV-BrainFM adopts a unified multi-view pretraining paradigm that enables simultaneous learning from multiple datasets and atlases, significantly improving computational efficiency compared to conventional sequential training strategies. The proposed framework also demonstrates strong scalability, consistently benefiting from increasing data diversity while maintaining stable performance across unseen atlas configurations. Extensive experiments on more than 20K subjects from 17 fMRI datasets show that MV-BrainFM consistently outperforms 14 existing brain network foundation models and task-specific baselines under both single-atlas and multi-atlas settings.

Young Seok Jeon, Hongfei Yang, Huazhu Fu et al.

3D models surpass 2D models in CT/MRI segmentation by effectively capturing inter-slice relationships. However, the added depth dimension substantially increases memory consumption. While patch-based training alleviates memory constraints, it significantly slows down the inference speed due to the sliding window (SW) approach. We propose No-More-Sliding-Window (NMSW), a novel end-to-end trainable framework that enhances the efficiency of generic 3D segmentation backbone during an inference step by eliminating the need for SW. NMSW employs a differentiable Top-k module to selectively sample only the most relevant patches, thereby minimizing redundant computations. When patch-level predictions are insufficient, the framework intelligently leverages coarse global predictions to refine results. Evaluated across 3 tasks using 3 segmentation backbones, NMSW achieves competitive accuracy compared to SW inference while significantly reducing computational complexity by 91% (88.0 to 8.00 TMACs). Moreover, it delivers a 9.1x faster inference on the H100 GPU (99.0 to 8.3 sec) and a 11.1x faster inference on the Xeon Gold CPU (2110 to 189 sec). NMSW is model-agnostic, further boosting efficiency when integrated with any existing efficient segmentation backbones. The code is avaialble: https://github.com/Youngseok0001/open_nmsw.

Jingying Ma, Feng Wu, Yucheng Xing et al.

Electroencephalography (EEG) foundation models (EFMs) have achieved strong performance under full fine-tuning but exhibit poor generalization when subject-level supervision is limited, a common constraint in real-world clinical settings. We show that this failure stems not merely from limited supervision, but from a structural mismatch between noisy, limited supervision and the highly plastic parameter space of EFMs. To address this challenge, we propose SCOPE, a Structured COnfidence-aware Prototype-guided adaptation framework for EFM fine-tuning. SCOPE follows a two-stage pipeline. In the first stage, we construct reliable external supervision by learning geometry-regularized task priors, constructing balanced class-level prototypes over the resulting embeddings, and producing confidence-aware pseudo-labels from their agreement to filter unreliable signals on unlabeled data. In the second stage, we introduce ProAdapter, which adapts frozen EEG foundation models via a lightweight adapter conditioned on the structured prototypes. Experiments across three EEG tasks and five foundation model backbones demonstrate that SCOPE consistently achieves strong performance and efficiency under label-limited cross-subject settings.

Qianyi Xu, Gousia Habib, Feng Wu et al.

Reinforcement Learning (RL) offers a powerful framework for optimizing dynamic treatment regimes (DTRs). However, clinical RL is fundamentally bottlenecked by reward engineering: the challenge of defining signals that safely and effectively guide policy learning in complex, sparse offline environments. Existing approaches often rely on manual heuristics that fail to generalize across diverse pathologies. To address this, we propose an automated pipeline leveraging Large Language Models (LLMs) for offline reward design and verification. We formulate the reward function using potential functions consisted of three core components: survival, confidence, and competence. We further introduce quantitative metrics to rigorously evaluate and select the optimal reward structure prior to deployment. By integrating LLM-driven domain knowledge, our framework automates the design of reward functions for specific diseases while significantly enhancing the performance of the resulting policies.

Jiaxing Xu, Kai He, Yue Tang et al.

Neurological conditions, such as Alzheimer's Disease, are challenging to diagnose, particularly in the early stages where symptoms closely resemble healthy controls. Existing brain network analysis methods primarily focus on graph-based models that rely solely on imaging data, which may overlook important non-imaging factors and limit the model's predictive power and interpretability. In this paper, we present BrainPrompt, an innovative framework that enhances Graph Neural Networks (GNNs) by integrating Large Language Models (LLMs) with knowledge-driven prompts, enabling more effective capture of complex, non-imaging information and external knowledge for neurological disease identification. BrainPrompt integrates three types of knowledge-driven prompts: (1) ROI-level prompts to encode the identity and function of each brain region, (2) subject-level prompts that incorporate demographic information, and (3) disease-level prompts to capture the temporal progression of disease. By leveraging these multi-level prompts, BrainPrompt effectively harnesses knowledge-enhanced multi-modal information from LLMs, enhancing the model's capability to predict neurological disease stages and meanwhile offers more interpretable results. We evaluate BrainPrompt on two resting-state functional Magnetic Resonance Imaging (fMRI) datasets from neurological disorders, showing its superiority over state-of-the-art methods. Additionally, a biomarker study demonstrates the framework's ability to extract valuable and interpretable information aligned with domain knowledge in neuroscience. The code is available at https://github.com/AngusMonroe/BrainPrompt

Yucheng Xing, Pei Liu, Jingying Ma et al.

Multiple instance learning (MIL) is the dominant framework for whole-slide image analysis in computational pathology, typically combining a frozen patch encoder, a projection layer, and a slide-level aggregator. While encoders and aggregators have been extensively studied, the projection layer remains a largely morphology-only bottleneck. This limits endpoints such as biomarker status and survival, which are governed by a molecular state that is not fully captured by H&E morphology. We introduce Molecularly Informed Staining Transform (MIST), a plug-in replacement for the MIL projection layer that uses paired spatial transcriptomics only during training to construct virtual molecular stains. MIST clusters gene expression profiles into cross-modal prototypes, anchors them in the frozen foundation model feature space, and uses them to reorganize H&E patch features along molecularly guided axes. It requires no transcriptomics at inference and can be inserted before standard MIL aggregators. We evaluate MIST across 23 downstream tasks and 8 MIL aggregators. MIST improves 240 of 256 configurations over the standard projection layer, with an average gain of +3.5%, observed consistently across endpoint types: +5.2% on survival prediction, +3.3% on tissue subtyping, and +2.6% on biomarker prediction. Ablations confirm that gene-derived prototypes are the primary source of the gains, while spatial, biological, and pathological analyses show that cross-modal prototype affinities capture spatially coherent molecular programs from H&E alone.

Daniel J. Tan, Kay Choong See, Mengling Feng

Designing reward functions remains a central challenge in reinforcement learning (RL) for healthcare, where outcomes are sparse, delayed, and difficult to specify. While structured data capture physiological states, they often fail to reflect the overall quality of a patient's clinical trajectory, including recovery dynamics, treatment burden, and stability. Clinical narratives, in contrast, summarize longitudinal reasoning and implicitly encode evaluations of treatment effectiveness. We propose Clinical Narrative-informed Preference Rewards (CN-PR), a framework for learning reward functions directly from discharge summaries by treating them as scalable supervision for trajectory-level preferences. Using a large language model, we derive trajectory quality scores (TQS) and construct pairwise preferences over patient trajectories, enabling reward learning via a structured preference-based objective. To account for variability in narrative informativeness, we incorporate a confidence signal that weights supervision based on its relevance to the decision-making task. The learned reward aligns strongly with trajectory quality (Spearman rho = 0.63) and enables policies that are consistently associated with improved recovery-related outcomes, including increased organ support-free days and faster shock resolution, while maintaining comparable performance on mortality. These effects persist under external validation. Our results demonstrate that narrative-derived supervision provides a scalable and expressive alternative to handcrafted or outcome-based reward design for dynamic treatment regimes.

Yucheng Ruan, Ling Huang, Qika Lin et al.

Automated mental health prediction using textual data has shown promising results with deep learning and large language models. However, deploying these models in high-stakes real-world settings remains challenging, as existing approaches largely rely on semantic representations and often produce overconfident predictions under ambiguous, noisy, or shifted data. Moreover, most methods lack reliable uncertainty estimation, undermining trust in risk-sensitive mental health applications. To address these limitations, we formulate the task as a multi-view learning problem that integrates semantic information from encoder-only models with higher-level reasoning information from decoder-only models, where reasoning-aware representations and uncertainty modeling are obtained in a trustworthy manner. To ensure reliable fusion, we adopt an evidential learning framework based on Subjective Logic to explicitly model uncertainty and introduce an evidential fusion strategy that balances complementary views while discounting unreliable evidence. Benchmarking on three real-world datasets, Dreaddit, SDCNL, and DepSeverity, reports accuracies of 0.835, 0.731, and 0.751, respectively, demonstrating its potential for reliable mental health prediction. Additional experiments on robustness to noise and case studies for interpretability confirm that our proposed framework not only improves predictive performance but also provides trustworthy uncertainty estimates and human-understandable reasoning signals, making it suitable for risk-sensitive applications in mental health assessment.

Zhihui Chen, Kai He, Qingyuan Lei et al.

Text-guided image editors can now manipulate authentic medical scans with high fidelity, enabling lesion implantation/removal that threatens clinical trust and safety. Existing defenses are inadequate for healthcare. Medical detectors are largely black-box, while MLLM-based explainers are typically post-hoc, lack medical expertise, and may hallucinate evidence on ambiguous cases. We present MedForge, a data-and-method solution for pre-hoc, evidence-grounded medical forgery detection. We introduce MedForge-90K, a large-scale benchmark of realistic lesion edits across 19 pathologies with expert-guided reasoning supervision via doctor inspection guidelines and gold edit locations. Building on it, MedForge-Reasoner performs localize-then-analyze reasoning, predicting suspicious regions before producing a verdict, and is further aligned with Forgery-aware GSPO to strengthen grounding and reduce hallucinations. Experiments demonstrate state-of-the-art detection accuracy and trustworthy, expert-aligned explanations.

Yihao Liu, Xu Cao, Tingting Chen et al.

Healthcare systems worldwide face persistent challenges in efficiency, accessibility, and personalization. Powered by modern AI technologies such as multimodal large language models and world models, Embodied AI (EmAI) represents a transformative frontier, offering enhanced autonomy and the ability to interact with the physical world to address these challenges. As an interdisciplinary and rapidly evolving research domain, "EmAI in healthcare" spans diverse fields such as algorithms, robotics, and biomedicine. This complexity underscores the importance of timely reviews and analyses to track advancements, address challenges, and foster cross-disciplinary collaboration. In this paper, we provide a comprehensive overview of the "brain" of EmAI for healthcare, wherein we introduce foundational AI algorithms for perception, actuation, planning, and memory, and focus on presenting the healthcare applications spanning clinical interventions, daily care & companionship, infrastructure support, and biomedical research. Despite its promise, the development of EmAI for healthcare is hindered by critical challenges such as safety concerns, gaps between simulation platforms and real-world applications, the absence of standardized benchmarks, and uneven progress across interdisciplinary domains. We discuss the technical barriers and explore ethical considerations, offering a forward-looking perspective on the future of EmAI in healthcare. A hierarchical framework of intelligent levels for EmAI systems is also introduced to guide further development. By providing systematic insights, this work aims to inspire innovation and practical applications, paving the way for a new era of intelligent, patient-centered healthcare.

Qika Lin, Tianzhe Zhao, Kai He et al.

Due to the presence of the natural gap between Knowledge Graph (KG) structures and the natural language, the effective integration of holistic structural information of KGs with Large Language Models (LLMs) has emerged as a significant question. To this end, we propose a two-stage framework to learn and apply quantized codes for each entity, aiming for the seamless integration of KGs with LLMs. Firstly, a self-supervised quantized representation (SSQR) method is proposed to compress both KG structural and semantic knowledge into discrete codes (\ie, tokens) that align the format of language sentences. We further design KG instruction-following data by viewing these learned codes as features to directly input to LLMs, thereby achieving seamless integration. The experiment results demonstrate that SSQR outperforms existing unsupervised quantized methods, producing more distinguishable codes. Further, the fine-tuned LLaMA2 and LLaMA3.1 also have superior performance on KG link prediction and triple classification tasks, utilizing only 16 tokens per entity instead of thousands in conventional prompting methods.

Jihai Zhang, Xiang Lan, Xiaoye Qu et al.

Self-Supervised Contrastive Learning has proven effective in deriving high-quality representations from unlabeled data. However, a major challenge that hinders both unimodal and multimodal contrastive learning is feature suppression, a phenomenon where the trained model captures only a limited portion of the information from the input data while overlooking other potentially valuable content. This issue often leads to indistinguishable representations for visually similar but semantically different inputs, adversely affecting downstream task performance, particularly those requiring rigorous semantic comprehension. To address this challenge, we propose a novel model-agnostic Multistage Contrastive Learning (MCL) framework. Unlike standard contrastive learning which inherently captures one single biased feature distribution, MCL progressively learns previously unlearned features through feature-aware negative sampling at each stage, where the negative samples of an anchor are exclusively selected from the cluster it was assigned to in preceding stages. Meanwhile, MCL preserves the previously well-learned features by cross-stage representation integration, integrating features across all stages to form final representations. Our comprehensive evaluation demonstrates MCL's effectiveness and superiority across both unimodal and multimodal contrastive learning, spanning a range of model architectures from ResNet to Vision Transformers (ViT). Remarkably, in tasks where the original CLIP model has shown limitations, MCL dramatically enhances performance, with improvements up to threefold on specific attributes in the recently proposed MMVP benchmark.

Ling Huang, Yucheng Xing, Qika Lin et al.

Multimodal survival analysis aims to combine heterogeneous data sources (e.g., clinical, imaging, text, genomics) to improve the prediction quality of survival outcomes. However, this task is particularly challenging due to high heterogeneity and noise across data sources, which vary in structure, distribution, and context. Additionally, the ground truth is often censored (uncertain) due to incomplete follow-up data. In this paper, we propose a novel evidential multimodal survival fusion model, EsurvFusion, designed to combine multimodal data at the decision level through an evidence-based decision fusion layer that jointly addresses both data and model uncertainty while incorporating modality-level reliability. Specifically, EsurvFusion first models unimodal data with newly introduced Gaussian random fuzzy numbers, producing unimodal survival predictions along with corresponding aleatoric and epistemic uncertainties. It then estimates modality-level reliability through a reliability discounting layer to correct the misleading impact of noisy data modalities. Finally, a multimodal evidence-based fusion layer is introduced to combine the discounted predictions to form a unified, interpretable multimodal survival analysis model, revealing each modality's influence based on the learned reliability coefficients. This is the first work that studies multimodal survival analysis with both uncertainty and reliability. Extensive experiments on four multimodal survival datasets demonstrate the effectiveness of our model in handling high heterogeneity data, establishing new state-of-the-art on several benchmarks.

Qika Lin, Zhen Peng, Kaize Shi et al.

Recent years have witnessed rapid advances in graph representation learning, with the continuous embedding approach emerging as the dominant paradigm. However, such methods encounter issues regarding parameter efficiency, interpretability, and robustness. Thus, Quantized Graph Representation (QGR) learning has recently gained increasing interest, which represents the graph structure with discrete codes instead of conventional continuous embeddings. Given its analogous representation form to natural language, QGR also possesses the capability to seamlessly integrate graph structures with large language models (LLMs). As this emerging paradigm is still in its infancy yet holds significant promise, we undertake this thorough survey to promote its rapid future prosperity. We first present the background of the general quantization methods and their merits. Moreover, we provide an in-depth demonstration of current QGR studies from the perspectives of quantized strategies, training objectives, distinctive designs, knowledge graph quantization, and applications. We further explore the strategies for code dependence learning and integration with LLMs. At last, we give discussions and conclude future directions, aiming to provide a comprehensive picture of QGR and inspire future research.

Ling Huang, Yucheng Xing, Swapnil Mishra et al.

Time-to-event analysis provides insights into clinical prognosis and treatment recommendations. However, this task is more challenging than standard regression problems due to the presence of censored observations. Additionally, the lack of confidence assessment, model robustness, and prediction calibration raises concerns about the reliability of predictions. To address these challenges, we propose an evidential regression model specifically designed for time-to-event prediction. The proposed model quantifies both epistemic and aleatory uncertainties using Gaussian Random Fuzzy Numbers and belief functions, providing clinicians with uncertainty-aware survival time predictions. The model is trained by minimizing a generalized negative log-likelihood function accounting for data censoring. Experimental evaluations using simulated datasets with different data distributions and censoring conditions, as well as real-world datasets across diverse clinical applications, demonstrate that our model delivers both accurate and reliable performance, outperforming state-of-the-art methods. These results highlight the potential of our approach for enhancing clinical decision-making in survival analysis.

Yanrui Du, Fenglei Fan, Sendong Zhao et al.

Instruction Fine-Tuning (IFT) has been widely adopted as an effective post-training strategy to enhance various abilities of Large Language Models (LLMs). However, prior studies have shown that IFT can significantly compromise LLMs' safety, particularly their ability to refuse malicious instructions, raising significant concerns. Recent research into the internal mechanisms of LLMs has identified the refusal direction (r-direction) in the hidden states, which plays a pivotal role in governing refusal behavior. Building on this insight, our study reveals that the r-direction tends to drift during training, which we identify as one of the causes of the associated safety risks. To mitigate such drift, our proposed ProCon method introduces a projection-constrained loss term that regularizes the projection magnitude of each training sample's hidden state onto the r-direction. Our initial analysis shows that applying an appropriate constraint can effectively mitigate the refusal direction drift and associated safety risks, but remains limited by overall performance barriers. To overcome this barrier, informed by our observation of early-stage sharp drift and a data-driven perspective, we introduce a warm-up strategy that emphasizes early-stage strong constraints and broaden the data distribution to strengthen constraint signals, leading to an enhanced ProCon method. Experimental results under various datasets, scenarios, and LLMs demonstrate that our method can significantly mitigate safety risks posed by IFT while preserving task performance gains. Even compared with strong baselines, our method consistently delivers superior overall performance. Crucially, our analysis indicates that ProCon can contribute to stabilizing the r-direction during training, while such an interpretability-driven exploration of LLMs' internal mechanisms lays a solid foundation for future safety research.

Qika Lin, Yifan Zhu, Bin Pu et al.

Medical foundation models (FMs) have shown tremendous promise amid the rapid advancements in artificial intelligence (AI) technologies. However, current medical FMs typically generate answers in a black-box manner, lacking transparent reasoning processes and locally grounded interpretability, which hinders their practical clinical deployments. To this end, we introduce DeepMedix-R1, a holistic medical FM for chest X-ray (CXR) interpretation. It leverages a sequential training pipeline: initially fine-tuned on curated CXR instruction data to equip with fundamental CXR interpretation capabilities, then exposed to high-quality synthetic reasoning samples to enable cold-start reasoning, and finally refined via online reinforcement learning to enhance both grounded reasoning quality and generation performance. Thus, the model produces both an answer and reasoning steps tied to the image's local regions for each query. Quantitative evaluation demonstrates substantial improvements in report generation (e.g., 14.54% and 31.32% over LLaVA-Rad and MedGemma) and visual question answering (e.g., 57.75% and 23.06% over MedGemma and CheXagent) tasks. To facilitate robust assessment, we propose Report Arena, a benchmarking framework using advanced language models to evaluate answer quality, further highlighting the superiority of DeepMedix-R1. Expert review of generated reasoning steps reveals greater interpretability and clinical plausibility compared to the established Qwen2.5-VL-7B model (0.7416 vs. 0.2584 overall preference). Collectively, our work advances medical FM development toward holistic, transparent, and clinically actionable modeling for CXR interpretation.

Daniel Jason Tan, Jiayang Chen, Dilruk Perera et al.

ICU enteral feeding remains sub-optimal due to limited personalization and uncertainty about appropriate calorie, protein, and fluid targets, particularly under rapidly changing metabolic demands and heterogeneous patient responses. This study introduces DeepEN, a reinforcement learning (RL)-based framework that personalizes enteral nutrition (EN) dosing for critically ill patients using electronic health record data. DeepEN was trained on over 11,000 ICU patients from the MIMIC-IV database to generate 4-hourly, patient-specific targets for caloric, protein, and fluid intake. The model's state space integrates demographics, comorbidities, vital signs, laboratory results, and prior interventions relevant to nutritional management, while its reward function balances short-term physiological and nutrition-related goals with long-term survival. A dueling double deep Q-network with Conservative Q-Learning regularization is used to ensure safe and reliable policy learning from retrospective data. DeepEN achieved a 3.7 $\pm$ 0.17 percentage-point absolute reduction in estimated mortality compared with the clinician policy (18.8% vs 22.5%) and higher expected returns compared with guideline-based dosing (11.89 vs 8.11), with improvements in key nutritional biomarkers. U-shaped associations between deviations from clinician dosing and mortality suggest that the learned policy aligns with high-value clinician actions while diverging from suboptimal ones. These findings demonstrate the feasibility of conservative offline RL for individualized EN therapy and suggest that data-driven personalization may improve outcomes beyond guideline- or heuristic-based approaches.

Yucheng Xing, Ling Huang, Jingying Ma et al.

Pathology whole-slide images (WSIs) are widely used for cancer survival analysis because of their comprehensive histopathological information at both cellular and tissue levels, enabling quantitative, large-scale, and prognostically rich tumor feature analysis. However, most existing methods in WSI survival analysis struggle with limited interpretability and often overlook predictive uncertainty in heterogeneous slide images. In this paper, we propose DPsurv, a dual-prototype whole-slide image evidential fusion network that outputs uncertainty-aware survival intervals, while enabling interpretation of predictions through patch prototype assignment maps, component prototypes, and component-wise relative risk aggregation. Experiments on five publicly available datasets achieve the highest mean concordance index and the lowest mean integrated Brier score, validating the effectiveness and reliability of DPsurv. The interpretation of prediction results provides transparency at the feature, reasoning, and decision levels, thereby enhancing the trustworthiness and interpretability of DPsurv.

Dilruk Perera, Gousia Habib, Qianyi Xu et al.

Reinforcement learning (RL) marks a fundamental shift in how artificial intelligence is applied in healthcare. Instead of merely predicting outcomes, RL actively decides interventions with long term goals. Unlike traditional models that operate on fixed associations, RL systems learn through trial, feedback, and long-term reward optimization, introducing transformative possibilities and new risks. From an information fusion lens, healthcare RL typically integrates multi-source signals such as vitals, labs clinical notes, imaging and device telemetry using temporal and decision-level mechanisms. These systems can operate within centralized, federated, or edge architectures to meet real-time clinical constraints, and naturally span data, features and decision fusion levels. This survey explore RL's rise in healthcare as more than a set of tools, rather a shift toward agentive intelligence in clinical environments. We first structure the landscape of RL techniques including model-based and model-free methods, offline and batch-constrained approaches, and emerging strategies for reward specification and uncertainty calibration through the lens of healthcare constraints. We then comprehensively analyze RL applications spanning critical care, chronic disease, mental health, diagnostics, and robotic assistance, identifying their trends, gaps, and translational bottlenecks. In contrast to prior reviews, we critically analyze RL's ethical, deployment, and reward design challenges, and synthesize lessons for safe, human-aligned policy learning. This paper serves as both a a technical roadmap and a critical reflection of RL's emerging transformative role in healthcare AI not as prediction machinery, but as agentive clinical intelligence.

Yucheng Ruan, Xiang Lan, Daniel J. Tan et al.

Background Predicting mortality and resource utilization from electronic health records (EHRs) is challenging yet crucial for optimizing patient outcomes and managing costs in intensive care unit (ICU). Existing approaches predominantly focus on structured EHRs, often ignoring the valuable clinical insights in free-text notes. Additionally, the potential of textual information within structured data is not fully leveraged. This study aimed to introduce and assess a deep learning framework using natural language processing techniques that integrates multimodal EHRs to predict mortality and resource utilization in critical care settings. Methods Utilizing two real-world EHR datasets, we developed and evaluated our model on three clinical tasks with leading existing methods. We also performed an ablation study on three key components in our framework: medical prompts, free-texts, and pre-trained sentence encoder. Furthermore, we assessed the model's robustness against the corruption in structured EHRs. Results Our experiments on two real-world datasets across three clinical tasks showed that our proposed model improved performance metrics by 1.6\%/0.8\% on BACC/AUROC for mortality prediction, 0.5%/2.2% on RMSE/MAE for LOS prediction, 10.9%/11.0% on RMSE/MAE for surgical duration estimation compared to the best existing methods. It consistently demonstrated superior performance compared to other baselines across three tasks at different corruption rates. Conclusions The proposed framework is an effective and accurate deep learning approach for predicting mortality and resource utilization in critical care. The study also highlights the success of using prompt learning with a transformer encoder in analyzing multimodal EHRs. Importantly, the model showed strong resilience to data corruption within structured data, especially at high corruption levels.

Deyun Zhang, Xiang Lan, Shijia Geng et al.

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

Qika Lin, Fangzhi Xu, Hao Lu et al.

Knowledge Graph (KG) reasoning has received significant attention in the fields of artificial intelligence and knowledge engineering, owing to its ability to autonomously deduce new knowledge and consequently enhance the availability and precision of downstream applications. However, current methods predominantly concentrate on a single form of neural or symbolic reasoning, failing to effectively integrate the inherent strengths of both approaches. Furthermore, the current prevalent methods primarily focus on addressing a single reasoning scenario, presenting limitations in meeting the diverse demands of real-world reasoning tasks. Unifying the neural and symbolic methods, as well as diverse reasoning scenarios in one model is challenging as there is a natural representation gap between symbolic rules and neural networks, and diverse scenarios exhibit distinct knowledge structures and specific reasoning objectives. To address these issues, we propose a unified neurosymbolic reasoning framework, namely Tunsr, for KG reasoning. Tunsr first introduces a consistent structure of reasoning graph that starts from the query entity and constantly expands subsequent nodes by iteratively searching posterior neighbors. Based on it, a forward logic message-passing mechanism is proposed to update both the propositional representations and attentions, as well as first-order logic (FOL) representations and attentions of each node. In this way, Tunsr conducts the transformation of merging multiple rules by merging possible relations at each step. Finally, the FARI algorithm is proposed to induce FOL rules by constantly performing attention calculations over the reasoning graph. Extensive experimental results on 19 datasets of four reasoning scenarios (transductive, inductive, interpolation, and extrapolation) demonstrate the effectiveness of Tunsr.

Jingying Ma, Feng Wu, Qika Lin et al.

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

Jingying Ma, Jinwei Wang, Lanlan Lu et al.

Background: Chronic kidney disease (CKD), a progressive disease with high morbidity and mortality, has become a significant global public health problem. Most existing models are static and fail to capture temporal trends in disease progression, limiting their ability to inform timely interventions. We address this gap by developing a dynamic model that leverages common longitudinal clinical indicators from real-world Electronic Health Records (EHRs) for real-time kidney failure prediction. Findings: A retrospective cohort of 4,587 patients from Yinzhou, China, was used for model development (2,752 patients for training, 917 patients for validation) and internal validation (918 patients), while external validation was conducted on a prospective PKUFH cohort (934 patients). The model demonstrated competitive performance across datasets, with an AUROC of 0.9311 (95%CI, 0.8873-0.9749) in the internal validation cohort and 0.8141 (95%CI, 0.7728-0.8554) in the external validation cohort, alongside progressively improving dynamic predictions, good calibration, and clinically consistent interpretability. KFDeep has been deployed on an open-access website and in primary care settings. Interpretation: The KFDeep model enables dynamic prediction of kidney failure without increasing clinical examination costs. It has been integrated into existing hospital systems, providing physicians with a continuously updated decision-support tool in routine care.

Xianghu Yue, Yiming Chen, Xueyi Zhang et al.

Multi-modal class-incremental learning (MMCIL) seeks to leverage multi-modal data, such as audio-visual and image-text pairs, thereby enabling models to learn continuously across a sequence of tasks while mitigating forgetting. While existing studies primarily focus on the integration and utilization of multi-modal information for MMCIL, a critical challenge remains: the issue of missing modalities during incremental learning phases. This oversight can exacerbate severe forgetting and significantly impair model performance. To bridge this gap, we propose PAL, a novel exemplar-free framework tailored to MMCIL under missing-modality scenarios. Concretely, we devise modality-specific prompts to compensate for missing information, facilitating the model to maintain a holistic representation of the data. On this foundation, we reformulate the MMCIL problem into a Recursive Least-Squares task, delivering an analytical linear solution. Building upon these, PAL not only alleviates the inherent under-fitting limitation in analytic learning but also preserves the holistic representation of missing-modality data, achieving superior performance with less forgetting across various multi-modal incremental scenarios. Extensive experiments demonstrate that PAL significantly outperforms competitive methods across various datasets, including UPMC-Food101 and N24News, showcasing its robustness towards modality absence and its anti-forgetting ability to maintain high incremental accuracy.

Ling Huang, Yucheng Xing, Thierry Denoeux et al.

We introduce an evidential model for time-to-event prediction with censored data. In this model, uncertainty on event time is quantified by Gaussian random fuzzy numbers, a newly introduced family of random fuzzy subsets of the real line with associated belief functions, generalizing both Gaussian random variables and Gaussian possibility distributions. Our approach makes minimal assumptions about the underlying time-to-event distribution. The model is fit by minimizing a generalized negative log-likelihood function that accounts for both normal and censored data. Comparative experiments on two real-world datasets demonstrate the very good performance of our model as compared to the state-of-the-art.

Young Seok Jeon, Hongfei Yang, Huazhu Fu et al.

Imposing key anatomical features, such as the number of organs, their shapes and relative positions, is crucial for building a robust multi-organ segmentation model. Current attempts to incorporate anatomical features include broadening the effective receptive field (ERF) size with data-intensive modules, or introducing anatomical constraints that scales poorly to multi-organ segmentation. We introduce a novel architecture called the Anatomy-Informed Cascaded Segmentation Network (AIC-Net). AIC-Net incorporates a learnable input termed "Anatomical Prior", which can be adapted to patient-specific anatomy using a differentiable spatial deformation. The deformed prior later guides decoder layers towards more anatomy-informed predictions. We repeat this process at a local patch level to enhance the representation of intricate objects, resulting in a cascaded network structure. AIC-Net is a general method that enhances any existing segmentation models to be more anatomy-aware. We have validated the performance of AIC-Net, with various backbones, on two multi-organ segmentation tasks: abdominal organs and vertebrae. For each respective task, our benchmarks demonstrate improved dice score and Hausdorff distance.

Meng Ge, Yizhou Peng, Yidi Jiang et al.

This paper summarizes our team's efforts in both tracks of the ICMC-ASR Challenge for in-car multi-channel automatic speech recognition. Our submitted systems for ICMC-ASR Challenge include the multi-channel front-end enhancement and diarization, training data augmentation, speech recognition modeling with multi-channel branches. Tested on the offical Eval1 and Eval2 set, our best system achieves a relative 34.3% improvement in CER and 56.5% improvement in cpCER, compared to the offical baseline system.

Xiang Lan, Dianwen Ng, Shenda Hong et al.

Learning information-rich and generalizable representations effectively from unlabeled multivariate cardiac signals to identify abnormal heart rhythms (cardiac arrhythmias) is valuable in real-world clinical settings but often challenging due to its complex temporal dynamics. Cardiac arrhythmias can vary significantly in temporal patterns even for the same patient ($i.e.$, intra subject difference). Meanwhile, the same type of cardiac arrhythmia can show different temporal patterns among different patients due to different cardiac structures ($i.e.$, inter subject difference). In this paper, we address the challenges by proposing an Intra-inter Subject self-supervised Learning (ISL) model that is customized for multivariate cardiac signals. Our proposed ISL model integrates medical knowledge into self-supervision to effectively learn from intra-inter subject differences. In intra subject self-supervision, ISL model first extracts heartbeat-level features from each subject using a channel-wise attentional CNN-RNN encoder. Then a stationarity test module is employed to capture the temporal dependencies between heartbeats. In inter subject self-supervision, we design a set of data augmentations according to the clinical characteristics of cardiac signals and perform contrastive learning among subjects to learn distinctive representations for various types of patients. Extensive experiments on three real-world datasets were conducted. In a semi-supervised transfer learning scenario, our pre-trained ISL model leads about 10% improvement over supervised training when only 1% labeled data is available, suggesting strong generalizability and robustness of the model.

Feng Xie, Han Yuan, Yilin Ning et al.

Objective: Temporal electronic health records (EHRs) can be a wealth of information for secondary uses, such as clinical events prediction or chronic disease management. However, challenges exist for temporal data representation. We therefore sought to identify these challenges and evaluate novel methodologies for addressing them through a systematic examination of deep learning solutions. Methods: We searched five databases (PubMed, EMBASE, the Institute of Electrical and Electronics Engineers [IEEE] Xplore Digital Library, the Association for Computing Machinery [ACM] digital library, and Web of Science) complemented with hand-searching in several prestigious computer science conference proceedings. We sought articles that reported deep learning methodologies on temporal data representation in structured EHR data from January 1, 2010, to August 30, 2020. We summarized and analyzed the selected articles from three perspectives: nature of time series, methodology, and model implementation. Results: We included 98 articles related to temporal data representation using deep learning. Four major challenges were identified, including data irregularity, data heterogeneity, data sparsity, and model opacity. We then studied how deep learning techniques were applied to address these challenges. Finally, we discuss some open challenges arising from deep learning. Conclusion: Temporal EHR data present several major challenges for clinical prediction modeling and data utilization. To some extent, current deep learning solutions can address these challenges. Future studies can consider designing comprehensive and integrated solutions. Moreover, researchers should incorporate additional clinical domain knowledge into study designs and enhance the interpretability of the model to facilitate its implementation in clinical practice.

Jiangeng Chang, Shaoze Cui, Mengling Feng

In this paper, we propose a deep residual network-based method, namely the DiCOVA-Net, to identify COVID-19 infected patients based on the acoustic recording of their coughs. Since there are far more healthy people than infected patients, this classification problem faces the challenge of imbalanced data. To improve the model's ability to recognize minority class (the infected patients), we introduce data augmentation and cost-sensitive methods into our model. Besides, considering the particularity of this task, we deploy some fine-tuning techniques to adjust the pre-training ResNet50. Furthermore, to improve the model's generalizability, we use ensemble learning to integrate prediction results from multiple base classifiers generated using different random seeds. To evaluate the proposed DiCOVA-Net's performance, we conducted experiments with the DiCOVA challenge dataset. The results show that our method has achieved 85.43\% in AUC, among the top of all competing teams.

Hao Du, Melissa Min-Szu Yao, Liangyu Chen et al.

The morphology and distribution of microcalcifications in a cluster are the most important characteristics for radiologists to diagnose breast cancer. However, it is time-consuming and difficult for radiologists to identify these characteristics, and there also lacks of effective solutions for automatic characterization. In this study, we proposed a multi-task deep graph convolutional network (GCN) method for the automatic characterization of morphology and distribution of microcalcifications in mammograms. Our proposed method transforms morphology and distribution characterization into node and graph classification problem and learns the representations concurrently. Through extensive experiments, we demonstrate significant improvements with the proposed multi-task GCN comparing to the baselines. Moreover, the achieved improvements can be related to and enhance clinical understandings. We explore, for the first time, the application of GCNs in microcalcification characterization that suggests the potential of graph learning for more robust understanding of medical images.

Zhaowei Zhu, Xiang Lan, Tingting Zhao et al.

Cardiovascular disease is a major threat to health and one of the primary causes of death globally. The 12-lead ECG is a cheap and commonly accessible tool to identify cardiac abnormalities. Early and accurate diagnosis will allow early treatment and intervention to prevent severe complications of cardiovascular disease. In the PhysioNet/Computing in Cardiology Challenge 2020, our objective is to develop an algorithm that automatically identifies 27 ECG abnormalities from 12-lead ECG recordings.

Hao Du, Jiashi Feng, Mengling Feng

In clinical practice, human radiologists actually review medical images with high resolution monitors and zoom into region of interests (ROIs) for a close-up examination. Inspired by this observation, we propose a hierarchical graph neural network to detect abnormal lesions from medical images by automatically zooming into ROIs. We focus on mammogram analysis for breast cancer diagnosis for this study. Our proposed network consist of two graph attention networks performing two tasks: (1) node classification to predict whether to zoom into next level; (2) graph classification to classify whether a mammogram is normal/benign or malignant. The model is trained and evaluated on INbreast dataset and we obtain comparable AUC with state-of-the-art methods.