Mathias Unberath

Dominik Schneider, Lalithkumar Seenivasan, Sampath Rapuri et al.

Purpose: Curating large-scale datasets of operating room (OR) workflow, encompassing rare, safety-critical, or atypical events, remains operationally and ethically challenging. This data bottleneck complicates the development of ambient intelligence for detecting, understanding, and mitigating rare or safety-critical events in the OR. Methods: This work presents an OR video diffusion framework that enables controlled synthesis of rare and safety-critical events. The framework integrates a geometric abstraction module, a conditioning module, and a fine-tuned diffusion model to first transform OR scenes into abstract geometric representations, then condition the synthesis process, and finally generate realistic OR event videos. Using this framework, we also curate a synthetic dataset to train and validate AI models for detecting near-misses of sterile-field violations. Results: In synthesizing routine OR events, our method outperforms off-the-shelf video diffusion baselines, achieving lower FVD/LPIPS and higher SSIM/PSNR in both in- and out-of-domain datasets. Through qualitative results, we illustrate its ability for controlled video synthesis of counterfactual events. An AI model trained and validated on the generated synthetic data achieved a RECALL of 70.13% in detecting near safety-critical events. Finally, we conduct an ablation study to quantify performance gains from key design choices. Conclusion: Our solution enables controlled synthesis of routine and rare OR events from abstract geometric representations. Beyond demonstrating its capability to generate rare and safety-critical scenarios, we show its potential to support the development of ambient intelligence models.

Yiqing Shen, Chenxiao Fan, Chenjia Li et al.

The goal of text-to-video retrieval is to search large databases for relevant videos based on text queries. Existing methods have progressed to handling explicit queries where the visual content of interest is described explicitly; however, they fail with implicit queries where identifying videos relevant to the query requires reasoning. We introduce reasoning text-to-video retrieval, a paradigm that extends traditional retrieval to process implicit queries through reasoning while providing object-level grounding masks that identify which entities satisfy the query conditions. Instead of relying on vision-language models directly, we propose representing video content as digital twins, i.e., structured scene representations that decompose salient objects through specialist vision models. This approach is beneficial because it enables large language models to reason directly over long-horizon video content without visual token compression. Specifically, our two-stage framework first performs compositional alignment between decomposed sub-queries and digital twin representations for candidate identification, then applies large language model-based reasoning with just-in-time refinement that invokes additional specialist models to address information gaps. We construct a benchmark of 447 manually created implicit queries with 135 videos (ReasonT2VBench-135) and another more challenging version of 1000 videos (ReasonT2VBench-1000). Our method achieves 81.2% R@1 on ReasonT2VBench-135, outperforming the strongest baseline by greater than 50 percentage points, and maintains 81.7% R@1 on the extended configuration while establishing state-of-the-art results in three conventional benchmarks (MSR-VTT, MSVD, and VATEX).

Blanca Inigo, Yiqing Shen, Benjamin D. Killeen et al.

Vertebral compression fractures (VCFs) are a common and potentially serious consequence of osteoporosis. Yet, they often remain undiagnosed. Opportunistic screening, which involves automated analysis of medical imaging data acquired primarily for other purposes, is a cost-effective method to identify undiagnosed VCFs. In high-stakes scenarios like opportunistic medical diagnosis, model interpretability is a key factor for the adoption of AI recommendations. Rule-based methods are inherently explainable and closely align with clinical guidelines, but they are not immediately applicable to high-dimensional data such as CT scans. To address this gap, we introduce a neurosymbolic approach for VCF detection in CT volumes. The proposed model combines deep learning (DL) for vertebral segmentation with a shape-based algorithm (SBA) that analyzes vertebral height distributions in salient anatomical regions. This allows for the definition of a rule set over the height distributions to detect VCFs. Evaluation of VerSe19 dataset shows that our method achieves an accuracy of 96% and a sensitivity of 91% in VCF detection. In comparison, a black box model, DenseNet, achieved an accuracy of 95% and sensitivity of 91% in the same dataset. Our results demonstrate that our intrinsically explainable approach can match or surpass the performance of black box deep neural networks while providing additional insights into why a prediction was made. This transparency can enhance clinician's trust thus, supporting more informed decision-making in VCF diagnosis and treatment planning.

Hao Ding, Yuqian Zhang, Wenzheng Cheng et al.

Surgical phase recognition (SPR) is an integral component of surgical data science, enabling high-level surgical analysis. End-to-end trained neural networks that predict surgical phase directly from videos have shown excellent performance on benchmarks. However, these models struggle with robustness due to non-causal associations in the training set. Our goal is to improve model robustness to variations in the surgical videos by leveraging the digital twin (DT) paradigm -- an intermediary layer to separate high-level analysis (SPR) from low-level processing. As a proof of concept, we present a DT representation-based framework for SPR from videos. The framework employs vision foundation models with reliable low-level scene understanding to craft DT representation. We embed the DT representation in place of raw video inputs in the state-of-the-art SPR model. The framework is trained on the Cholec80 dataset and evaluated on out-of-distribution (OOD) and corrupted test samples. Contrary to the vulnerability of the baseline model, our framework demonstrates strong robustness on both OOD and corrupted samples, with a video-level accuracy of 80.3 on a highly corrupted Cholec80 test set, 67.9 on the challenging CRCD dataset, and 99.8 on an internal robotic surgery dataset, outperforming the baseline by 3.9, 16.8, and 90.9 respectively. We also find that using DT representation as an augmentation to the raw input can significantly improve model robustness. Our findings lend support to the thesis that DT representations are effective in enhancing model robustness. Future work will seek to improve the feature informativeness and incorporate interpretability for a more comprehensive framework.