Xiaofeng Yang

Yifei Zhang, Jiashuo Zhang, Mojtaba Safari et al.

Low-dose chest computed tomography (LDCT) inherently captures both pulmonary and cardiac structures, offering a unique opportunity for joint assessment of lung and cardiovascular health. However, most existing approaches treat these domains as independent tasks, overlooking their physiological interplay and shared imaging biomarkers. We propose an Explainable Cross-Disease Reasoning Framework that enables interpretable cardiopulmonary risk assessment from a single LDCT scan. The framework introduces an agentic reasoning process that emulates clinical diagnostic thinking-first perceiving pulmonary findings, then reasoning through established medical knowledge, and finally deriving a cardiovascular judgment with explanatory rationale. It integrates three synergistic components: a pulmonary perception module that summarizes lung abnormalities, a knowledge-guided reasoning module that infers their cardiovascular implications, and a cardiac representation module that encodes structural biomarkers. Their outputs are fused to produce a holistic cardiovascular risk prediction that is both accurate and physiologically grounded. Experiments on the NLST cohort demonstrate that the proposed framework achieves state-of-the-art performance for CVD screening and mortality prediction, outperforming single-disease and purely image-based baselines. Beyond quantitative gains, the framework provides human-verifiable reasoning that aligns with cardiological understanding, revealing coherent links between pulmonary abnormalities and cardiac stress mechanisms. Overall, this work establishes a unified and explainable paradigm for cardiovascular analysis from LDCT, bridging the gap between image-based prediction and mechanism-based medical interpretation.

Huaqin Zhao, Jiaxi Li, Yi Pan et al.

Fine-tuning large language models (LLMs) poses significant memory challenges, as the back-propagation process demands extensive resources, especially with growing model sizes. Recent work, MeZO, addresses this issue using a zeroth-order (ZO) optimization method, which reduces memory consumption by matching the usage to the inference phase. However, MeZO experiences slow convergence due to varying curvatures across model parameters. To overcome this limitation, we introduce HELENE, a novel scalable and memory-efficient optimizer that integrates annealed A-GNB gradients with a diagonal Hessian estimation and layer-wise clipping, serving as a second-order pre-conditioner. This combination allows for faster and more stable convergence. Our theoretical analysis demonstrates that HELENE improves convergence rates, particularly for models with heterogeneous layer dimensions, by reducing the dependency on the total parameter space dimension. Instead, the method scales with the largest layer dimension, making it highly suitable for modern LLM architectures. Experimental results on RoBERTa-large and OPT-1.3B across multiple tasks show that HELENE achieves up to a 20x speedup compared to MeZO, with average accuracy improvements of 1.5%. Furthermore, HELENE remains compatible with both full parameter tuning and parameter-efficient fine-tuning (PEFT), outperforming several state-of-the-art optimizers. The codes will be released after reviewing.