Intraoperative monitoring and prediction of vital signs are critical for ensuring patient safety and improving surgical outcomes. Despite recent advances in deep learning models for medical time-series forecasting, several challenges persist, including the lack of standardized benchmarks, incomplete data, and limited cross-center validation. To address these challenges, we introduce VitalBench, a novel benchmark specifically designed for intraoperative vital sign prediction. VitalBench includes data from over 4,000 surgeries across two independent medical centers, offering three evaluation tracks: complete data, incomplete data, and cross-center generalization. This framework reflects the real-world complexities of clinical practice, minimizing reliance on extensive preprocessing and incorporating masked loss techniques for robust and unbiased model evaluation. By providing a standardized and unified platform for model development and comparison, VitalBench enables researchers to focus on architectural innovation while ensuring consistency in data handling. This work lays the foundation for advancing predictive models for intraoperative vital sign forecasting, ensuring that these models are not only accurate but also robust and adaptable across diverse clinical environments. Our code and data are available at https://github.com/XiudingCai/VitalBench.
Automated anesthesia promises to enable more precise and personalized anesthetic administration and free anesthesiologists from repetitive tasks, allowing them to focus on the most critical aspects of a patient's surgical care. Current research has typically focused on creating simulated environments from which agents can learn. These approaches have demonstrated good experimental results, but are still far from clinical application. In this paper, Policy Constraint Q-Learning (PCQL), a data-driven reinforcement learning algorithm for solving the problem of learning anesthesia strategies on real clinical datasets, is proposed. Conservative Q-Learning was first introduced to alleviate the problem of Q function overestimation in an offline context. A policy constraint term is added to agent training to keep the policy distribution of the agent and the anesthesiologist consistent to ensure safer decisions made by the agent in anesthesia scenarios. The effectiveness of PCQL was validated by extensive experiments on a real clinical anesthesia dataset. Experimental results show that PCQL is predicted to achieve higher gains than the baseline approach while maintaining good agreement with the reference dose given by the anesthesiologist, using less total dose, and being more responsive to the patient's vital signs. In addition, the confidence intervals of the agent were investigated, which were able to cover most of the clinical decisions of the anesthesiologist. Finally, an interpretable method, SHAP, was used to analyze the contributing components of the model predictions to increase the transparency of the model.
DONNs leverage light propagation for efficient analog AI and signal processing. Advances in nanophotonic fabrication and metasurface-based wavefront engineering have opened new pathways to realize high-capacity DONNs across various spectral regimes. Training such DONN systems to determine the metasurface structures remains challenging. Heuristic methods are fast but oversimplify metasurfaces modulation, often resulting in physically unrealizable designs and significant performance degradation. Simulation-in-the-loop optimizes implementable metasurfaces via adjoint methods, but is computationally prohibitive and unscalable. To address these limitations, we propose SP2RINT, a spatially decoupled, progressive training framework that formulates DONN training as a PDE-constrained learning problem. Metasurface responses are first relaxed into freely trainable transfer matrices with a banded structure. We then progressively enforce physical constraints by alternating between transfer matrix training and adjoint-based inverse design, avoiding per-iteration PDE solves while ensuring final physical realizability. To further reduce runtime, we introduce a physics-inspired, spatially decoupled inverse design strategy based on the natural locality of field interactions. This approach partitions the metasurface into independently solvable patches, enabling scalable and parallel inverse design with system-level calibration. Evaluated across diverse DONN training tasks, SP2RINT achieves digital-comparable accuracy while being 1825 times faster than simulation-in-the-loop approaches. By bridging the gap between abstract DONN models and implementable photonic hardware, SP2RINT enables scalable, high-performance training of physically realizable meta-optical neural systems. Our code is available at https://github.com/ScopeX-ASU/SP2RINT