David A. Clifton

Hang Yuan, Shing Chan, Andrew P. Creagh et al.

Advances in deep learning for human activity recognition have been relatively limited due to the lack of large labelled datasets. In this study, we leverage self-supervised learning techniques on the UK-Biobank activity tracker dataset--the largest of its kind to date--containing more than 700,000 person-days of unlabelled wearable sensor data. Our resulting activity recognition model consistently outperformed strong baselines across seven benchmark datasets, with an F1 relative improvement of 2.5%-100% (median 18.4%), the largest improvements occurring in the smaller datasets. In contrast to previous studies, our results generalise across external datasets, devices, and environments. Our open-source model will help researchers and developers to build customisable and generalisable activity classifiers with high performance.

Peng Jin, Jinfa Huang, Fenglin Liu et al. · oxford

Most video-and-language representation learning approaches employ contrastive learning, e.g., CLIP, to project the video and text features into a common latent space according to the semantic similarities of text-video pairs. However, such learned shared latent spaces are not often optimal, and the modality gap between visual and textual representation can not be fully eliminated. In this paper, we propose Expectation-Maximization Contrastive Learning (EMCL) to learn compact video-and-language representations. Specifically, we use the Expectation-Maximization algorithm to find a compact set of bases for the latent space, where the features could be concisely represented as the linear combinations of these bases. Such feature decomposition of video-and-language representations reduces the rank of the latent space, resulting in increased representing power for the semantics. Extensive experiments on three benchmark text-video retrieval datasets prove that our EMCL can learn more discriminative video-and-language representations than previous methods, and significantly outperform previous state-of-the-art methods across all metrics. More encouragingly, the proposed method can be applied to boost the performance of existing approaches either as a jointly training layer or an out-of-the-box inference module with no extra training, making it easy to be incorporated into any existing methods.

Omid Rohanian, Mohammadmahdi Nouriborji, Samaneh Kouchaki et al.

Language models pre-trained on biomedical corpora, such as BioBERT, have recently shown promising results on downstream biomedical tasks. Many existing pre-trained models, on the other hand, are resource-intensive and computationally heavy owing to factors such as embedding size, hidden dimension, and number of layers. The natural language processing (NLP) community has developed numerous strategies to compress these models utilising techniques such as pruning, quantisation, and knowledge distillation, resulting in models that are considerably faster, smaller, and subsequently easier to use in practice. By the same token, in this paper we introduce six lightweight models, namely, BioDistilBERT, BioTinyBERT, BioMobileBERT, DistilBioBERT, TinyBioBERT, and CompactBioBERT which are obtained either by knowledge distillation from a biomedical teacher or continual learning on the Pubmed dataset via the Masked Language Modelling (MLM) objective. We evaluate all of our models on three biomedical tasks and compare them with BioBERT-v1.1 to create efficient lightweight models that perform on par with their larger counterparts. All the models will be publicly available on our Huggingface profile at https://huggingface.co/nlpie and the codes used to run the experiments will be available at https://github.com/nlpie-research/Compact-Biomedical-Transformers.

Chenyu You, Weicheng Dai, Yifei Min et al. · oxford

For medical image segmentation, contrastive learning is the dominant practice to improve the quality of visual representations by contrasting semantically similar and dissimilar pairs of samples. This is enabled by the observation that without accessing ground truth labels, negative examples with truly dissimilar anatomical features, if sampled, can significantly improve the performance. In reality, however, these samples may come from similar anatomical regions and the models may struggle to distinguish the minority tail-class samples, making the tail classes more prone to misclassification, both of which typically lead to model collapse. In this paper, we propose ARCO, a semi-supervised contrastive learning (CL) framework with stratified group theory for medical image segmentation. In particular, we first propose building ARCO through the concept of variance-reduced estimation and show that certain variance-reduction techniques are particularly beneficial in pixel/voxel-level segmentation tasks with extremely limited labels. Furthermore, we theoretically prove these sampling techniques are universal in variance reduction. Finally, we experimentally validate our approaches on eight benchmarks, i.e., five 2D/3D medical and three semantic segmentation datasets, with different label settings, and our methods consistently outperform state-of-the-art semi-supervised methods. Additionally, we augment the CL frameworks with these sampling techniques and demonstrate significant gains over previous methods. We believe our work is an important step towards semi-supervised medical image segmentation by quantifying the limitation of current self-supervision objectives for accomplishing such challenging safety-critical tasks.

Vinod Kumar Chauhan, Jiandong Zhou, Ping Lu et al. · oxford

Hypernetworks, or hypernets for short, are neural networks that generate weights for another neural network, known as the target network. They have emerged as a powerful deep learning technique that allows for greater flexibility, adaptability, dynamism, faster training, information sharing, and model compression. Hypernets have shown promising results in a variety of deep learning problems, including continual learning, causal inference, transfer learning, weight pruning, uncertainty quantification, zero-shot learning, natural language processing, and reinforcement learning. Despite their success across different problem settings, there is currently no comprehensive review available to inform researchers about the latest developments and to assist in utilizing hypernets. To fill this gap, we review the progress in hypernets. We present an illustrative example of training deep neural networks using hypernets and propose categorizing hypernets based on five design criteria: inputs, outputs, variability of inputs and outputs, and the architecture of hypernets. We also review applications of hypernets across different deep learning problem settings, followed by a discussion of general scenarios where hypernets can be effectively employed. Finally, we discuss the challenges and future directions that remain underexplored in the field of hypernets. We believe that hypernetworks have the potential to revolutionize the field of deep learning. They offer a new way to design and train neural networks, and they have the potential to improve the performance of deep learning models on a variety of tasks. Through this review, we aim to inspire further advancements in deep learning through hypernetworks.

Omid Rohanian, Mohammadmahdi Nouriborji, Hannah Jauncey et al.

Specialised pre-trained language models are becoming more frequent in NLP since they can potentially outperform models trained on generic texts. BioBERT and BioClinicalBERT are two examples of such models that have shown promise in medical NLP tasks. Many of these models are overparametrised and resource-intensive, but thanks to techniques like Knowledge Distillation (KD), it is possible to create smaller versions that perform almost as well as their larger counterparts. In this work, we specifically focus on development of compact language models for processing clinical texts (i.e. progress notes, discharge summaries etc). We developed a number of efficient lightweight clinical transformers using knowledge distillation and continual learning, with the number of parameters ranging from 15 million to 65 million. These models performed comparably to larger models such as BioBERT and ClinicalBioBERT and significantly outperformed other compact models trained on general or biomedical data. Our extensive evaluation was done across several standard datasets and covered a wide range of clinical text-mining tasks, including Natural Language Inference, Relation Extraction, Named Entity Recognition, and Sequence Classification. To our knowledge, this is the first comprehensive study specifically focused on creating efficient and compact transformers for clinical NLP tasks. The models and code used in this study can be found on our Huggingface profile at https://huggingface.co/nlpie and Github page at https://github.com/nlpie-research/Lightweight-Clinical-Transformers, respectively, promoting reproducibility of our results.

Chenyu You, Weicheng Dai, Fenglin Liu et al. · oxford

Recent studies on contrastive learning have achieved remarkable performance solely by leveraging few labels in the context of medical image segmentation. Existing methods mainly focus on instance discrimination and invariant mapping. However, they face three common pitfalls: (1) tailness: medical image data usually follows an implicit long-tail class distribution. Blindly leveraging all pixels in training hence can lead to the data imbalance issues, and cause deteriorated performance; (2) consistency: it remains unclear whether a segmentation model has learned meaningful and yet consistent anatomical features due to the intra-class variations between different anatomical features; and (3) diversity: the intra-slice correlations within the entire dataset have received significantly less attention. This motivates us to seek a principled approach for strategically making use of the dataset itself to discover similar yet distinct samples from different anatomical views. In this paper, we introduce a novel semi-supervised 2D medical image segmentation framework termed Mine yOur owN Anatomy (MONA), and make three contributions. First, prior work argues that every pixel equally matters to the model training; we observe empirically that this alone is unlikely to define meaningful anatomical features, mainly due to lacking the supervision signal. We show two simple solutions towards learning invariances - through the use of stronger data augmentations and nearest neighbors. Second, we construct a set of objectives that encourage the model to be capable of decomposing medical images into a collection of anatomical features in an unsupervised manner. Lastly, we both empirically and theoretically, demonstrate the efficacy of our MONA on three benchmark datasets with different labeled settings, achieving new state-of-the-art under different labeled semi-supervised settings.

Hongjian Zhou, Fenglin Liu, Boyang Gu et al.

Large language models (LLMs), such as ChatGPT, have received substantial attention due to their capabilities for understanding and generating human language. While there has been a burgeoning trend in research focusing on the employment of LLMs in supporting different medical tasks (e.g., enhancing clinical diagnostics and providing medical education), a review of these efforts, particularly their development, practical applications, and outcomes in medicine, remains scarce. Therefore, this review aims to provide a detailed overview of the development and deployment of LLMs in medicine, including the challenges and opportunities they face. In terms of development, we provide a detailed introduction to the principles of existing medical LLMs, including their basic model structures, number of parameters, and sources and scales of data used for model development. It serves as a guide for practitioners in developing medical LLMs tailored to their specific needs. In terms of deployment, we offer a comparison of the performance of different LLMs across various medical tasks, and further compare them with state-of-the-art lightweight models, aiming to provide an understanding of the advantages and limitations of LLMs in medicine. Overall, in this review, we address the following questions: 1) What are the practices for developing medical LLMs 2) How to measure the medical task performance of LLMs in a medical setting? 3) How have medical LLMs been employed in real-world practice? 4) What challenges arise from the use of medical LLMs? and 5) How to more effectively develop and deploy medical LLMs? By answering these questions, this review aims to provide insights into the opportunities for LLMs in medicine and serve as a practical resource. We also maintain a regularly updated list of practical guides on medical LLMs at https://github.com/AI-in-Health/MedLLMsPracticalGuide

Mohammadmahdi Nouriborji, Omid Rohanian, Samaneh Kouchaki et al.

Pre-trained Language Models (LMs) have become an integral part of Natural Language Processing (NLP) in recent years, due to their superior performance in downstream applications. In spite of this resounding success, the usability of LMs is constrained by computational and time complexity, along with their increasing size; an issue that has been referred to as `overparameterisation'. Different strategies have been proposed in the literature to alleviate these problems, with the aim to create effective compact models that nearly match the performance of their bloated counterparts with negligible performance losses. One of the most popular techniques in this area of research is model distillation. Another potent but underutilised technique is cross-layer parameter sharing. In this work, we combine these two strategies and present MiniALBERT, a technique for converting the knowledge of fully parameterised LMs (such as BERT) into a compact recursive student. In addition, we investigate the application of bottleneck adapters for layer-wise adaptation of our recursive student, and also explore the efficacy of adapter tuning for fine-tuning of compact models. We test our proposed models on a number of general and biomedical NLP tasks to demonstrate their viability and compare them with the state-of-the-art and other existing compact models. All the codes used in the experiments are available at https://github.com/nlpie-research/MiniALBERT. Our pre-trained compact models can be accessed from https://huggingface.co/nlpie.

Peng Xu, Xiatian Zhu, David A. Clifton

Transformer is a promising neural network learner, and has achieved great success in various machine learning tasks. Thanks to the recent prevalence of multimodal applications and big data, Transformer-based multimodal learning has become a hot topic in AI research. This paper presents a comprehensive survey of Transformer techniques oriented at multimodal data. The main contents of this survey include: (1) a background of multimodal learning, Transformer ecosystem, and the multimodal big data era, (2) a theoretical review of Vanilla Transformer, Vision Transformer, and multimodal Transformers, from a geometrically topological perspective, (3) a review of multimodal Transformer applications, via two important paradigms, i.e., for multimodal pretraining and for specific multimodal tasks, (4) a summary of the common challenges and designs shared by the multimodal Transformer models and applications, and (5) a discussion of open problems and potential research directions for the community.

Bang Yang, Fenglin Liu, Yuexian Zou et al. · oxford

Natural Language Generation (NLG) accepts input data in the form of images, videos, or text and generates corresponding natural language text as output. Existing NLG methods mainly adopt a supervised approach and rely heavily on coupled data-to-text pairs. However, for many targeted scenarios and for non-English languages, sufficient quantities of labeled data are often not available. To relax the dependency on labeled data of downstream tasks, we propose an intuitive and effective zero-shot learning framework, ZeroNLG, which can deal with multiple NLG tasks, including image-to-text (image captioning), video-to-text (video captioning), and text-to-text (neural machine translation), across English, Chinese, German, and French within a unified framework. ZeroNLG does not require any labeled downstream pairs for training. During training, ZeroNLG (i) projects different domains (across modalities and languages) to corresponding coordinates in a shared common latent space; (ii) bridges different domains by aligning their corresponding coordinates in this space; and (iii) builds an unsupervised multilingual auto-encoder to learn to generate text by reconstructing the input text given its coordinate in shared latent space. Consequently, during inference, based on the data-to-text pipeline, ZeroNLG can generate target sentences across different languages given the coordinate of input data in the common space. Within this unified framework, given visual (imaging or video) data as input, ZeroNLG can perform zero-shot visual captioning; given textual sentences as input, ZeroNLG can perform zero-shot machine translation. We present the results of extensive experiments on twelve NLG tasks, showing that, without using any labeled downstream pairs for training, ZeroNLG generates high-quality and believable outputs and significantly outperforms existing zero-shot methods.

Fenglin Liu, Bang Yang, Chenyu You et al. · oxford

Language models (LMs), including large language models (such as ChatGPT), have the potential to assist clinicians in generating various clinical notes. However, LMs are prone to produce ``hallucinations'', i.e., generated content that is not aligned with facts and knowledge. In this paper, we propose the Re$^3$Writer method with retrieval-augmented generation and knowledge-grounded reasoning to enable LMs to generate faithful clinical texts. We demonstrate the effectiveness of our method in generating patient discharge instructions. It requires the LMs not to only understand the patients' long clinical documents, i.e., the health records during hospitalization, but also to generate critical instructional information provided both to carers and to the patient at the time of discharge. The proposed Re$^3$Writer imitates the working patterns of physicians to first \textbf{re}trieve related working experience from historical instructions written by physicians, then \textbf{re}ason related medical knowledge. Finally, it \textbf{re}fines the retrieved working experience and reasoned medical knowledge to extract useful information, which is used to generate the discharge instructions for previously-unseen patients. Our experiments show that, using our method, the performance of five representative LMs can be substantially boosted across all metrics. Meanwhile, we show results from human evaluations to measure the effectiveness in terms of fluency, faithfulness, and comprehensiveness.

Vinod Kumar Chauhan, Soheila Molaei, Marzia Hoque Tania et al. · oxford

Observational studies have recently received significant attention from the machine learning community due to the increasingly available non-experimental observational data and the limitations of the experimental studies, such as considerable cost, impracticality, small and less representative sample sizes, etc. In observational studies, de-confounding is a fundamental problem of individualised treatment effects (ITE) estimation. This paper proposes disentangled representations with adversarial training to selectively balance the confounders in the binary treatment setting for the ITE estimation. The adversarial training of treatment policy selectively encourages treatment-agnostic balanced representations for the confounders and helps to estimate the ITE in the observational studies via counterfactual inference. Empirical results on synthetic and real-world datasets, with varying degrees of confounding, prove that our proposed approach improves the state-of-the-art methods in achieving lower error in the ITE estimation.

Rushuang Zhou, Lei Lu, Zijun Liu et al.

Electrocardiography (ECG) is a non-invasive tool for predicting cardiovascular diseases (CVDs). Current ECG-based diagnosis systems show promising performance owing to the rapid development of deep learning techniques. However, the label scarcity problem, the co-occurrence of multiple CVDs and the poor performance on unseen datasets greatly hinder the widespread application of deep learning-based models. Addressing them in a unified framework remains a significant challenge. To this end, we propose a multi-label semi-supervised model (ECGMatch) to recognize multiple CVDs simultaneously with limited supervision. In the ECGMatch, an ECGAugment module is developed for weak and strong ECG data augmentation, which generates diverse samples for model training. Subsequently, a hyperparameter-efficient framework with neighbor agreement modeling and knowledge distillation is designed for pseudo-label generation and refinement, which mitigates the label scarcity problem. Finally, a label correlation alignment module is proposed to capture the co-occurrence information of different CVDs within labeled samples and propagate this information to unlabeled samples. Extensive experiments on four datasets and three protocols demonstrate the effectiveness and stability of the proposed model, especially on unseen datasets. As such, this model can pave the way for diagnostic systems that achieve robust performance on multi-label CVDs prediction with limited supervision.

Vinod Kumar Chauhan, Anshul Thakur, Odhran O'Donoghue et al.

In electronic health records (EHRs), irregular time-series (ITS) occur naturally due to patient health dynamics, reflected by irregular hospital visits, diseases/conditions and the necessity to measure different vitals signs at each visit etc. ITS present challenges in training machine learning algorithms which mostly are built on assumption of coherent fixed dimensional feature space. In this paper, we propose a novel COntinuous patient state PERceiver model, called COPER, to cope with ITS in EHRs. COPER uses Perceiver model and the concept of neural ordinary differential equations (ODEs) to learn the continuous time dynamics of patient state, i.e., continuity of input space and continuity of output space. The neural ODEs help COPER to generate regular time-series to feed to Perceiver model which has the capability to handle multi-modality large-scale inputs. To evaluate the performance of the proposed model, we use in-hospital mortality prediction task on MIMIC-III dataset and carefully design experiments to study irregularity. The results are compared with the baselines which prove the efficacy of the proposed model.

Xinshao Wang, Yang Hua, Elyor Kodirov et al.

There is a family of label modification approaches including self and non-self label correction (LC), and output regularisation. They are widely used for training robust deep neural networks (DNNs), but have not been mathematically and thoroughly analysed together. We study them and discover three key issues: (1) We are more interested in adopting Self LC as it leverages its own knowledge and requires no auxiliary models. However, it is unclear how to adaptively trust a learner as the training proceeds. (2) Some methods penalise while the others reward low-entropy (i.e., high-confidence) predictions, prompting us to ask which one is better. (3) Using the standard training setting, a learned model becomes less confident when severe noise exists. Self LC using high-entropy knowledge would generate high-entropy targets. To resolve the issue (1), inspired by a well-accepted finding, i.e., deep neural networks learn meaningful patterns before fitting noise, we propose a novel end-to-end method named ProSelfLC, which is designed according to the learning time and prediction entropy. Concretely, for any data point, we progressively and adaptively trust its predicted probability distribution versus its annotated one if a network has been trained for a relatively long time and the prediction is of low entropy. For the issue (2), the effectiveness of ProSelfLC defends entropy minimisation. By ProSelfLC, we empirically prove that it is more effective to redefine a semantic low-entropy state and optimise the learner toward it. To address the issue (3), we decrease the entropy of self knowledge using a low temperature before exploiting it to correct labels, so that the revised labels redefine low-entropy target probability distributions. We demonstrate the effectiveness of ProSelfLC through extensive experiments in both clean and noisy settings, and on both image and protein datasets.

Taha Ceritli, Andrew P. Creagh, David A. Clifton

A particular challenge for disease progression modeling is the heterogeneity of a disease and its manifestations in the patients. Existing approaches often assume the presence of a single disease progression characteristics which is unlikely for neurodegenerative disorders such as Parkinson's disease. In this paper, we propose a hierarchical time-series model that can discover multiple disease progression dynamics. The proposed model is an extension of an input-output hidden Markov model that takes into account the clinical assessments of patients' health status and prescribed medications. We illustrate the benefits of our model using a synthetically generated dataset and a real-world longitudinal dataset for Parkinson's disease.

Taha Ceritli, Ghadeer O. Ghosheh, Vinod Kumar Chauhan et al.

Electronic Health Records (EHRs) contain sensitive patient information, which presents privacy concerns when sharing such data. Synthetic data generation is a promising solution to mitigate these risks, often relying on deep generative models such as Generative Adversarial Networks (GANs). However, recent studies have shown that diffusion models offer several advantages over GANs, such as generation of more realistic synthetic data and stable training in generating data modalities, including image, text, and sound. In this work, we investigate the potential of diffusion models for generating realistic mixed-type tabular EHRs, comparing TabDDPM model with existing methods on four datasets in terms of data quality, utility, privacy, and augmentation. Our experiments demonstrate that TabDDPM outperforms the state-of-the-art models across all evaluation metrics, except for privacy, which confirms the trade-off between privacy and utility.

Joaquín Polonuer, Lucas Vittor, Iñaki Arango et al.

Retrieving evidence for language model queries from knowledge graphs requires balancing broad search across the graph with multi-hop traversal to follow relational links. Similarity-based retrievers provide coverage but remain shallow, whereas traversal-based methods rely on selecting seed nodes to start exploration, which can fail when queries span multiple entities and relations. We introduce ARK: Adaptive Retriever of Knowledge, an agentic KG retriever that gives a language model control over this breadth-depth tradeoff using a two-operation toolset: global lexical search over node descriptors and one-hop neighborhood exploration that composes into multi-hop traversal. ARK alternates between breadth-oriented discovery and depth-oriented expansion without depending on a fragile seed selection, a pre-set hop depth, or requiring retrieval training. ARK adapts tool use to queries, using global search for language-heavy queries and neighborhood exploration for relation-heavy queries. On STaRK, ARK reaches 59.1% average Hit@1 and 67.4 average MRR, improving average Hit@1 by up to 31.4% and average MRR by up to 28.0% over retrieval-based and agentic training-free methods. Finally, we distill ARK's tool-use trajectories from a large teacher into an 8B model via label-free imitation, improving Hit@1 by +7.0, +26.6, and +13.5 absolute points over the base 8B model on AMAZON, MAG, and PRIME datasets, respectively, while retaining up to 98.5% of the teacher's Hit@1 rate.

Jenny Yang, Rasheed El-Bouri, Odhran O'Donoghue et al.

With the rapid growth of memory and computing power, datasets are becoming increasingly complex and imbalanced. This is especially severe in the context of clinical data, where there may be one rare event for many cases in the majority class. We introduce an imbalanced classification framework, based on reinforcement learning, for training extremely imbalanced data sets, and extend it for use in multi-class settings. We combine dueling and double deep Q-learning architectures, and formulate a custom reward function and episode-training procedure, specifically with the added capability of handling multi-class imbalanced training. Using real-world clinical case studies, we demonstrate that our proposed framework outperforms current state-of-the-art imbalanced learning methods, achieving more fair and balanced classification, while also significantly improving the prediction of minority classes.

Shreyank N Gowda, David A. Clifton

The Segment Anything Model (SAM) has achieved remarkable successes in the realm of natural image segmentation, but its deployment in the medical imaging sphere has encountered challenges. Specifically, the model struggles with medical images that feature low contrast, faint boundaries, intricate morphologies, and small-sized objects. To address these challenges and enhance SAM's performance in the medical domain, we introduce a comprehensive modification. Firstly, we incorporate a frozen Convolutional Neural Network (CNN) branch as an image encoder, which synergizes with SAM's original Vision Transformer (ViT) encoder through a novel variational attention fusion module. This integration bolsters the model's capability to capture local spatial information, which is often paramount in medical imagery. Moreover, to further optimize SAM for medical imaging, we introduce feature and position adapters within the ViT branch, refining the encoder's representations. We see that compared to current prompting strategies to fine-tune SAM for ultrasound medical segmentation, the use of text descriptions that serve as text prompts for SAM helps significantly improve the performance. Leveraging ChatGPT's natural language understanding capabilities, we generate prompts that offer contextual information and guidance to SAM, enabling it to better understand the nuances of ultrasound medical images and improve its segmentation accuracy. Our method, in its entirety, represents a significant stride towards making universal image segmentation models more adaptable and efficient in the medical domain.

Shreyank N Gowda, Boyan Gao, David A. Clifton

Utilizing large pre-trained models for specific tasks has yielded impressive results. However, fully fine-tuning these increasingly large models is becoming prohibitively resource-intensive. This has led to a focus on more parameter-efficient transfer learning, primarily within the same modality. But this approach has limitations, particularly in video understanding where suitable pre-trained models are less common. Addressing this, our study introduces a novel cross-modality transfer learning approach from images to videos, which we call parameter-efficient image-to-video transfer learning. We present the Facial-Emotion Adapter (FE-Adapter), designed for efficient fine-tuning in video tasks. This adapter allows pre-trained image models, which traditionally lack temporal processing capabilities, to analyze dynamic video content efficiently. Notably, it uses about 15 times fewer parameters than previous methods, while improving accuracy. Our experiments in video emotion recognition demonstrate that the FE-Adapter can match or even surpass existing fine-tuning and video emotion models in both performance and efficiency. This breakthrough highlights the potential for cross-modality approaches in enhancing the capabilities of AI models, particularly in fields like video emotion analysis where the demand for efficiency and accuracy is constantly rising.

Xingrun Xing, Boyan Gao, Zheng Zhang et al.

Recent advancements in large language models (LLMs) with billions of parameters have improved performance in various applications, but their inference processes demand significant energy and computational resources. In contrast, the human brain, with approximately 86 billion neurons, is much more energy-efficient than LLMs with similar parameters. Inspired by this, we redesign 7$\sim$70 billion parameter LLMs using bio-plausible spiking mechanisms, emulating the efficient behavior of the human brain. We propose the first spiking large language model, SpikeLLM. Coupled with the proposed model, two essential approaches are proposed to improve spike training efficiency: Generalized Integrate-and-Fire (GIF) neurons to compress spike length from $T$ to $\frac{T}{L} \log_2 L$ bits, and an Optimal Brain Spiking framework to divide outlier channels and allocate different $T$ for GIF neurons, which further compresses spike length to approximate $log_2T$ bits. The necessity of spike-driven LLM is proved by comparison with quantized LLMs with similar operations. In the OmniQuant pipeline, SpikeLLM reduces 11.01% WikiText2 perplexity and improves 2.55% accuracy of common scene reasoning on a LLAMA-7B W4A4 model. In the GPTQ pipeline, SpikeLLM achieves direct additive in linear layers, significantly exceeding PB-LLMs.

Jinge Wu, Hongjian Zhou, Mingde Zeng et al.

Building a deep research agent today is an exercise in glue code: the same backbone evaluated on the same benchmark can report different accuracies in different papers because harness and tool registry all differ, and integrating a new foundation model into a comparable evaluation surface costs weeks of model-specific engineering. We call this the per-paper engineering tax and release BioMedArena, an open-source toolkit that not only alleviates it but also provides an arena for fair comparison of different foundation models when evaluating them as deep-research agents. BioMedArena decouples six layers of biomedical agent evaluation -- benchmark loading, tool exposure, tool selection, execution mode, context management, and scoring -- and exposes 147 biomedical benchmarks and 75 biomedical tools across 9 functional families. Adding a new model, benchmark, or tool reduces to registering a few-line provider adapter. We further provide 6 agent harnesses with 6 context-management strategies, which provide 12 backbones with competitive research capabilities and significantly improved performance, achieving state-of-the-art (SOTA) results on 8 representative biomedical benchmarks, with an average lift of +15.03 percentage points over prior SOTA. The toolkit, configurations, and per-task traces are available at https://github.com/AI-in-Health/BioMedArena

Omid Rohanian, Mohammadmahdi Nouriborji, David A. Clifton

Large Language Models (LLMs), particularly those similar to ChatGPT, have significantly influenced the field of Natural Language Processing (NLP). While these models excel in general language tasks, their performance in domain-specific downstream tasks such as biomedical and clinical Named Entity Recognition (NER), Relation Extraction (RE), and Medical Natural Language Inference (NLI) is still evolving. In this context, our study investigates the potential of instruction tuning for biomedical language processing, applying this technique to two general LLMs of substantial scale. We present a comprehensive, instruction-based model trained on a dataset that consists of approximately $200,000$ instruction-focused samples. This dataset represents a carefully curated compilation of existing data, meticulously adapted and reformatted to align with the specific requirements of our instruction-based tasks. This initiative represents an important step in utilising such models to achieve results on par with specialised encoder-only models like BioBERT and BioClinicalBERT for various classical biomedical NLP tasks. Our work includes an analysis of the dataset's composition and its impact on model performance, providing insights into the intricacies of instruction tuning. By sharing our codes, models, and the distinctively assembled instruction-based dataset, we seek to encourage ongoing research and development in this area.

Shreyank N Gowda, David A. Clifton

Contemporary medical contrastive learning faces challenges from inconsistent semantics and sample pair morphology, leading to dispersed and converging semantic shifts. The variability in text reports, due to multiple authors, complicates semantic consistency. To tackle these issues, we propose a two-step approach. Initially, text reports are converted into a standardized triplet format, laying the groundwork for our novel concept of ``observations'' and ``verdicts''. This approach refines the {Entity, Position, Exist} triplet into binary questions, guiding towards a clear ``verdict''. We also innovate in visual pre-training with a Meijering-based masking, focusing on features representative of medical images' local context. By integrating this with our text conversion method, our model advances cross-modal representation in a multimodal contrastive learning framework, setting new benchmarks in medical image analysis.

Fenglin Liu, Zheng Li, Hongjian Zhou et al.

The adoption of large language models (LLMs) to assist clinicians has attracted remarkable attention. Existing works mainly adopt the close-ended question-answering (QA) task with answer options for evaluation. However, many clinical decisions involve answering open-ended questions without pre-set options. To better understand LLMs in the clinic, we construct a benchmark ClinicBench. We first collect eleven existing datasets covering diverse clinical language generation, understanding, and reasoning tasks. Furthermore, we construct six novel datasets and clinical tasks that are complex but common in real-world practice, e.g., open-ended decision-making, long document processing, and emerging drug analysis. We conduct an extensive evaluation of twenty-two LLMs under both zero-shot and few-shot settings. Finally, we invite medical experts to evaluate the clinical usefulness of LLMs. The benchmark data is available at https://github.com/AI-in-Health/ClinicBench.

Anshul Thakur, Soheila Molaei, Pafue Christy Nganjimi et al.

Dataset condensation (DC) learns a compact synthetic dataset that enables models to match the performance of full-data training, prioritising utility over distributional fidelity. While typically explored for computational efficiency, DC also holds promise for healthcare data democratisation, especially when paired with differential privacy, allowing synthetic data to serve as a safe alternative to real records. However, existing DC methods rely on differentiable neural networks, limiting their compatibility with widely used clinical models such as decision trees and Cox regression. We address this gap using a differentially private, zero-order optimisation framework that extends DC to non-differentiable models using only function evaluations. Empirical results across six datasets, including both classification and survival tasks, show that the proposed method produces condensed datasets that preserve model utility while providing effective differential privacy guarantees - enabling model-agnostic data sharing for clinical prediction tasks without exposing sensitive patient information.

Omid Rohanian, Mohammadmahdi Nouriborji, Olena Seminog et al.

This paper introduces the Pandemic PACT Advanced Categorisation Engine (PPACE) along with its associated dataset. PPACE is a fine-tuned model developed to automatically classify research abstracts from funded biomedical projects according to WHO-aligned research priorities. This task is crucial for monitoring research trends and identifying gaps in global health preparedness and response. Our approach builds on human-annotated projects, which are allocated one or more categories from a predefined list. A large language model is then used to generate `rationales' explaining the reasoning behind these annotations. This augmented data, comprising expert annotations and rationales, is subsequently used to fine-tune a smaller, more efficient model. Developed as part of the Pandemic PACT project, which aims to track and analyse research funding and clinical evidence for a wide range of diseases with outbreak potential, PPACE supports informed decision-making by research funders, policymakers, and independent researchers. We introduce and release both the trained model and the instruction-based dataset used for its training. Our evaluation shows that PPACE significantly outperforms its baselines. The release of PPACE and its associated dataset offers valuable resources for researchers in multilabel biomedical document classification and supports advancements in aligning biomedical research with key global health priorities.

Edward Phillips, Fredrik K. Gustafsson, Sean Wu et al.

Selective prediction systems can mitigate harms resulting from language model hallucinations by abstaining from answering in high-risk cases. Uncertainty quantification techniques are often employed to identify such cases, but are rarely evaluated in the context of the wider selective prediction policy and its ability to operate at low target error rates. We identify a model-dependent failure mode of entropy-based uncertainty methods that leads to unreliable abstention behaviour, and address it by combining entropy scores with a correctness probe signal. We find that across three QA benchmarks (TriviaQA, BioASQ, MedicalQA) and four model families, the combined score generally improves both the risk--coverage trade-off and calibration performance relative to entropy-only baselines. Our results highlight the importance of deployment-facing evaluation of uncertainty methods, using metrics that directly reflect whether a system can be trusted to operate at a stated risk level.

Fredrik K. Gustafsson, Xiao Gu, Mattia Carletti et al.

Recent biosignal foundation models (FMs) have demonstrated promising performance across diverse clinical prediction tasks, yet systematic evaluation on long-duration multimodal data remains limited. We introduce SignalMC-MED, a benchmark for evaluating biosignal FMs on synchronized single-lead electrocardiogram (ECG) and photoplethysmogram (PPG) data. Derived from the MC-MED dataset, SignalMC-MED comprises 22,256 visits with 10-minute overlapping ECG and PPG signals, and includes 20 clinically relevant tasks spanning prediction of demographics, emergency department disposition, laboratory value regression, and detection of prior ICD-10 diagnoses. Using this benchmark, we perform a systematic evaluation of representative time-series and biosignal FMs across ECG-only, PPG-only, and ECG + PPG settings. We find that domain-specific biosignal FMs consistently outperform general time-series models, and that multimodal ECG + PPG fusion yields robust improvements over unimodal inputs. Moreover, using the full 10-minute signal consistently outperforms shorter segments, and larger model variants do not reliably outperform smaller ones. Hand-crafted ECG domain features provide a strong baseline and offer complementary value when combined with learned FM representations. Together, these results establish SignalMC-MED as a standardized benchmark and provide practical guidance for evaluating and deploying biosignal FMs.

Wei Tang, Jinpei Han, Kangning Cui et al.

Electrocardiogram (ECG) foundation models pretrained on typical diagnostic 10-second ECG segments, have demonstrated strong transferability across a range of clinical applications. However, many real-world applications produce recordings that are typically longer, and are varied in duration during inference time. These 10-second models have no built-in way to combine information across time. Extending them to longer horizons introduces two challenges: structural incompatibilities arising from input-length disparities, and semantic challenges that limit meaningful temporal aggregation. We propose a parameter-efficient framework that extends pretrained ECG foundation models to longer and variable-length ECGs without retraining the backbone. Guided by a frozen pretrained 10-second model, we introduce a lightweight plug-in module that extends the model in two complementary ways: (i) structurally compatible long-sequence processing and (ii) semantically informed temporal modeling. Experiments on multiple long-horizon ECG tasks, datasets, and foundation model backbones demonstrate that our method enables robust long-horizon extension from pretrained snapshot models, consistently outperforming sliding-window and pooling-based baselines with strong parameter efficiency.

Li Wang, Boyan Gao, Yanran Li et al.

Despite the groundbreaking success of diffusion models in generating high-fidelity images, their latent space remains relatively under-explored, even though it holds significant promise for enabling versatile and interpretable image editing capabilities. The complicated denoising trajectory and high dimensionality of the latent space make it extremely challenging to interpret. Existing methods mainly explore the feature space of U-Net in Diffusion Models (DMs) instead of the latent space itself. In contrast, we directly investigate the latent space via Singular Value Decomposition (SVD) and discover three useful properties that can be used to control generation results without the requirements of data collection and maintain identity fidelity generated images. Based on these properties, we propose a novel image editing framework that is capable of learning arbitrary attributes from one pair of latent codes destined by text prompts in Stable Diffusion Models. To validate our approach, extensive experiments are conducted to demonstrate its effectiveness and flexibility in image editing. We will release our codes soon to foster further research and applications in this area.

Fenglin Liu, Jinge Wu, Hongjian Zhou et al. · oxford

The application of Large Language Models (LLMs) to various clinical applications has attracted growing research attention. However, real-world clinical decision-making differs significantly from the standardized, exam-style scenarios commonly used in current efforts. In this paper, we present the RiskAgent system to perform a broad range of medical risk predictions, covering over 387 risk scenarios across diverse complex diseases, e.g., cardiovascular disease and cancer. RiskAgent is designed to collaborate with hundreds of clinical decision tools, i.e., risk calculators and scoring systems that are supported by evidence-based medicine. To evaluate our method, we have built the first benchmark MedRisk specialized for risk prediction, including 12,352 questions spanning 154 diseases, 86 symptoms, 50 specialties, and 24 organ systems. The results show that our RiskAgent, with 8 billion model parameters, achieves 76.33% accuracy, outperforming the most recent commercial LLMs, o1, o3-mini, and GPT-4.5, and doubling the 38.39% accuracy of GPT-4o. On rare diseases, e.g., Idiopathic Pulmonary Fibrosis (IPF), RiskAgent outperforms o1 and GPT-4.5 by 27.27% and 45.46% accuracy, respectively. Finally, we further conduct a generalization evaluation on an external evidence-based diagnosis benchmark and show that our RiskAgent achieves the best results. These encouraging results demonstrate the great potential of our solution for diverse diagnosis domains. To improve the adaptability of our model in different scenarios, we have built and open-sourced a family of models ranging from 1 billion to 70 billion parameters. Our code, data, and models are all available at https://github.com/AI-in-Health/RiskAgent.

Boyan Gao, Bo Zhao, Shreyank N Gowda et al.

Dataset condensation aims to synthesize datasets with a few representative samples that can effectively represent the original datasets. This enables efficient training and produces models with performance close to those trained on the original sets. Most existing dataset condensation methods conduct dataset learning under the bilevel (inner- and outer-loop) based optimization. However, the preceding methods perform with limited dataset generalization due to the notoriously complicated loss landscape and expensive time-space complexity of the inner-loop unrolling of bilevel optimization. These issues deteriorate when the datasets are learned via matching the trajectories of networks trained on the real and synthetic datasets with a long horizon inner-loop. To address these issues, we introduce Sharpness-Aware Trajectory Matching (SATM), which enhances the generalization capability of learned synthetic datasets by optimising the sharpness of the loss landscape and objective simultaneously. Moreover, our approach is coupled with an efficient hypergradient approximation that is mathematically well-supported and straightforward to implement along with controllable computational overhead. Empirical evaluations of SATM demonstrate its effectiveness across various applications, including in-domain benchmarks and out-of-domain settings. Moreover, its easy-to-implement properties afford flexibility, allowing it to integrate with other advanced sharpness-aware minimizers. Our code will be released.

Rushuang Zhou, Lei Clifton, Zijun Liu et al.

The label scarcity problem is the main challenge that hinders the wide application of deep learning systems in automatic cardiovascular diseases (CVDs) detection using electrocardiography (ECG). Tuning pre-trained models alleviates this problem by transferring knowledge learned from large datasets to downstream small datasets. However, bottlenecks in computational efficiency and detection performance limit its clinical applications. It is difficult to improve the detection performance without significantly sacrificing the computational efficiency during model training. Here, we propose a computation-efficient semi-supervised learning paradigm (CE-SSL) for robust and computation-efficient CVDs detection using ECG. It enables a robust adaptation of pre-trained models on downstream datasets with limited supervision and high computational efficiency. First, a random-deactivation technique is developed to achieve robust and fast low-rank adaptation of pre-trained weights. Subsequently, we propose a one-shot rank allocation module to determine the optimal ranks for the update matrices of the pre-trained weights. Finally, a lightweight semi-supervised learning pipeline is introduced to enhance model performance by leveraging labeled and unlabeled data with high computational efficiency. Extensive experiments on four downstream datasets demonstrate that CE-SSL not only outperforms the state-of-the-art methods in multi-label CVDs detection but also consumes fewer GPU footprints, training time, and parameter storage space. As such, this paradigm provides an effective solution for achieving high computational efficiency and robust detection performance in the clinical applications of pre-trained models under limited supervision. Code and Supplementary Materials are available at https://github.com/KAZABANA/CE-SSL

Xinshao Wang, Yang Hua, Elyor Kodirov et al.

To train robust deep neural networks (DNNs), we systematically study several target modification approaches, which include output regularisation, self and non-self label correction (LC). Two key issues are discovered: (1) Self LC is the most appealing as it exploits its own knowledge and requires no extra models. However, how to automatically decide the trust degree of a learner as training goes is not well answered in the literature? (2) Some methods penalise while the others reward low-entropy predictions, prompting us to ask which one is better? To resolve the first issue, taking two well-accepted propositions--deep neural networks learn meaningful patterns before fitting noise [3] and minimum entropy regularisation principle [10]--we propose a novel end-to-end method named ProSelfLC, which is designed according to learning time and entropy. Specifically, given a data point, we progressively increase trust in its predicted label distribution versus its annotated one if a model has been trained for enough time and the prediction is of low entropy (high confidence). For the second issue, according to ProSelfLC, we empirically prove that it is better to redefine a meaningful low-entropy status and optimise the learner toward it. This serves as a defence of entropy minimisation. We demonstrate the effectiveness of ProSelfLC through extensive experiments in both clean and noisy settings. The source code is available at https://github.com/XinshaoAmosWang/ProSelfLC-CVPR2021. Keywords: entropy minimisation, maximum entropy, confidence penalty, self knowledge distillation, label correction, label noise, semi-supervised learning, output regularisation

Edward Phillips, Sean Wu, Boyan Gao et al.

Large language models present challenges for principled uncertainty quantification, in part due to their complexity and the diversity of their outputs. Semantic dispersion, or the variance in the meaning of sampled answers, has been proposed as a useful proxy for model uncertainty, but the associated computational cost prohibits its use in latency-critical applications. We show that sampled semantic distributions can be distilled into lightweight student models which estimate a prompt-conditioned uncertainty before the language model generates an answer token. The student model predicts a semantic distribution over possible answers; the entropy of this distribution provides an effective uncertainty signal for hallucination prediction, and the probability density allows candidate answers to be evaluated for reliability. On TriviaQA, our student models match or outperform finite-sample semantic dispersion for hallucination prediction and provide a strong signal for out-of-domain answer detection. We term this technique Semantic Self-Distillation (SSD), which we suggest provides a general framework for distilling predictive uncertainty in complex output spaces beyond language.

Zhangdaihong Liu, Chang Liu, Fenglin Liu et al.

Cardiovascular disease remains the leading cause of global mortality, yet scalable cardiac monitoring is hindered by the gap between diagnostic-rich ECG and ubiquitous wearable PPG. Bridging this gap requires representations that are compact, transferable across modalities and devices, and deployable without task-specific retraining. Here we introduce biosignal fingerprints: compact latent representations of cardiovascular state derived from a cross-modal foundation model, the Multi-modal Masked Autoencoder (M2AE), trained on over 3.4 million paired ECG and PPG signals. M2AE integrates modality-specific encoders with a shared bottleneck and dual decoders, jointly optimized using reconstruction and cross-modal contrastive objectives, yielding generalizable fingerprints that retain intra- and inter-modality features. Like a biometric fingerprint, these representations uniquely encode an individual's cardiovascular state in a modality-agnostic, privacy-preserving form reusable across clinical tasks without exposing raw waveform data or requiring model retraining. Across 7 downstream tasks, spanning cross-modal reconstruction, cardiovascular disease classification, hypertension detection, mortality prediction, and demographic inference, biosignal fingerprints achieve competitive or superior performance compared to leading domain-specialist foundation models in frozen settings, including an AUROC of 0.974 for five-class CVD classification and 0.877 for hypertension detection, with a maximum improvement of 27.7% in AUROC across 5 classification tasks. Critically, strong performance is maintained with only a single modality, enabling deployment in resource-constrained, single-sensor environments typical of real-world wearable monitoring, with direct implications for continuous cardiovascular monitoring across clinical and consumer health settings.

Yining Hua, Fenglin Liu, Kailai Yang et al.

Objectieve:This review aims to deliver a comprehensive analysis of Large Language Models (LLMs) utilization in mental health care, evaluating their effectiveness, identifying challenges, and exploring their potential for future application. Materials and Methods: A systematic search was performed across multiple databases including PubMed, Web of Science, Google Scholar, arXiv, medRxiv, and PsyArXiv in November 2023. The review includes all types of original research, regardless of peer-review status, published or disseminated between October 1, 2019, and December 2, 2023. Studies were included without language restrictions if they employed LLMs developed after T5 and directly investigated research questions within mental health care settings. Results: Out of an initial 313 articles, 34 were selected based on their relevance to LLMs applications in mental health care and the rigor of their reported outcomes. The review identified various LLMs applications in mental health care, including diagnostics, therapy, and enhancing patient engagement. Key challenges highlighted were related to data availability and reliability, the nuanced handling of mental states, and effective evaluation methods. While LLMs showed promise in improving accuracy and accessibility, significant gaps in clinical applicability and ethical considerations were noted. Conclusion: LLMs hold substantial promise for enhancing mental health care. For their full potential to be realized, emphasis must be placed on developing robust datasets, development and evaluation frameworks, ethical guidelines, and interdisciplinary collaborations to address current limitations.

Lucas Vittor, Ayush Noori, Iñaki Arango et al.

Biomedical knowledge graphs (KGs) are widely used in the life sciences, yet many are derived from unstructured documents and therefore lack schema-level constrains, whereas graphs assembled from structured resources are difficult to harmonize into a unified representation. We present OptimusKG, a multimodal biomedical labeled property graph (LPG) built from structured and semi-structured resources to preserve factual, type-specific metadata across molecular, anatomical, clinical, and environmental domains. OptimusKG contains 190,531 nodes across 10 entity types, 21,813,816 edges across 26 relation types, and 67,249,863 property instances encoding 110,276,843 values across 150 distinct property keys, derived from 18 ontologies and controlled vocabularies. The graph enforces a top-level schema for nodes and edges and retains granular, type-specific properties, cross-references, and provenance across molecular, anatomical, clinical, and environmental domains. We assessed the validity of OptimusKG by evaluating whether graph relationships are supported by evidence from the scientific literature using a multimodal agent, PaperQA3. PaperQA3 identified supporting evidence for 70.0% of sampled edges, whereas 83.4% of sampled false edges received no supporting evidence. Edges without literature support were concentrated in associations derived from experimental and functional genomics resources, suggesting that OptimusKG captures biomedical knowledge that may precede synthesis in the scientific literature. OptimusKG is distributed as Apache Parquet files, providing a standardized resource for graph-based machine learning, knowledge-grounded retrieval with large language models, and biomedical discovery use cases such as hypothesis generation.

Fredrik K. Gustafsson, Constance Boissin, Johan Vallon-Christersson et al.

Pathology foundation models (PFMs) have recently emerged as powerful pretrained encoders for computational pathology, enabling transfer learning across a wide range of downstream tasks. However, systematic comparisons of these models for clinically meaningful prediction problems remain limited, especially in the context of survival prediction under external validation. In this study, we benchmark widely used and recently proposed PFMs for breast cancer survival prediction from whole-slide histopathology images. Using a standardized pipeline based on patch-level feature extraction and a unified survival modeling framework, we evaluate model representations across three independent clinical cohorts comprising more than 5,400 patients with long-term follow-up. Models are trained on one cohort and evaluated on two independent external cohorts, enabling a rigorous assessment of cross-dataset generalization. Overall, H-optimus-1 achieves the strongest survival prediction performance. More broadly, we observe consistent generational improvements across model families, with second-generation PFMs outperforming their first-generation counterparts. However, absolute performance differences between many recent PFMs remain modest, suggesting diminishing returns from further scaling of pretraining data or model size alone. Notably, the compact distilled model H0-mini slightly outperforms its larger teacher model H-optimus-0, despite using fewer than 8% of the parameters and enabling significantly faster feature extraction. Together, these results provide the first large-scale, externally validated benchmark of PFMs for breast cancer survival prediction, and offer practical guidance for efficient deployment of PFMs in clinical workflows.

Sean Wu, Fredrik K. Gustafsson, Edward Phillips et al.

Large language models (LLMs) often produce confident but incorrect answers in settings where abstention would be safer. Standard evaluation protocols, however, require a response and do not account for how confidence should guide decisions under different risk preferences. To address this gap, we introduce the Behavioral Alignment Score (BAS), a decision-theoretic metric for evaluating how well LLM confidence supports abstention-aware decision making. BAS is derived from an explicit answer-or-abstain utility model and aggregates realized utility across a continuum of risk thresholds, yielding a measure of decision-level reliability that depends on both the magnitude and ordering of confidence. We show theoretically that truthful confidence estimates uniquely maximize expected BAS utility, linking calibration to decision-optimal behavior. BAS is related to proper scoring rules such as log loss, but differs structurally: log loss penalizes underconfidence and overconfidence symmetrically, whereas BAS imposes an asymmetric penalty that strongly prioritizes avoiding overconfident errors. Using BAS alongside widely used metrics such as ECE and AURC, we then construct a benchmark of self-reported confidence reliability across multiple LLMs and tasks. Our results reveal substantial variation in decision-useful confidence, and while larger and more accurate models tend to achieve higher BAS, even frontier models remain prone to severe overconfidence. Importantly, models with similar ECE or AURC can exhibit very different BAS due to highly overconfident errors, highlighting limitations of standard metrics. We further show that simple interventions, such as top-$k$ confidence elicitation and post-hoc calibration, can meaningfully improve confidence reliability. Overall, our work provides both a principled metric and a comprehensive benchmark for evaluating LLM confidence reliability.

Vinod Kumar Chauhan, Lei Clifton, Achille Salaün et al. · oxford

While machine learning algorithms hold promise for personalised medicine, their clinical adoption remains limited, partly due to biases that can compromise the reliability of predictions. In this paper, we focus on sample selection bias (SSB), a specific type of bias where the study population is less representative of the target population, leading to biased and potentially harmful decisions. Despite being well-known in the literature, SSB remains scarcely studied in machine learning for healthcare. Moreover, the existing machine learning techniques try to correct the bias mostly by balancing distributions between the study and the target populations, which may result in a loss of predictive performance. To address these problems, our study illustrates the potential risks associated with SSB by examining SSB's impact on the performance of machine learning algorithms. Most importantly, we propose a new research direction for addressing SSB, based on the target population identification rather than the bias correction. Specifically, we propose two independent networks(T-Net) and a multitasking network (MT-Net) for addressing SSB, where one network/task identifies the target subpopulation which is representative of the study population and the second makes predictions for the identified subpopulation. Our empirical results with synthetic and semi-synthetic datasets highlight that SSB can lead to a large drop in the performance of an algorithm for the target population as compared with the study population, as well as a substantial difference in the performance for the target subpopulations that are representative of the selected and the non-selected patients from the study population. Furthermore, our proposed techniques demonstrate robustness across various settings, including different dataset sizes, event rates, and selection rates, outperforming the existing bias correction techniques.

Sihao Liu, Yibo Yang, Xiaojie Li et al.

Online continual learning (OCL) seeks to learn new tasks from data streams that appear only once, while retaining knowledge of previously learned tasks. Most existing methods rely on replay, focusing on enhancing memory retention through regularization or distillation. However, they often overlook the adaptability of the model, limiting the ability to learn generalizable and discriminative features incrementally from online training data. To address this, we introduce a plug-and-play module, S6MOD, which can be integrated into most existing methods and directly improve adaptability. Specifically, S6MOD introduces an extra branch after the backbone, where a mixture of discretization selectively adjusts parameters in a selective state space model, enriching selective scan patterns such that the model can adaptively select the most sensitive discretization method for current dynamics. We further design a class-conditional routing algorithm for dynamic, uncertainty-based adjustment and implement a contrastive discretization loss to optimize it. Extensive experiments combining our module with various models demonstrate that S6MOD significantly enhances model adaptability, leading to substantial performance gains and achieving the state-of-the-art results.

Peng Xu, Shengwu Xiong, Jiajun Zhang et al.

This paper reviews the MARS2 2025 Challenge on Multimodal Reasoning. We aim to bring together different approaches in multimodal machine learning and LLMs via a large benchmark. We hope it better allows researchers to follow the state-of-the-art in this very dynamic area. Meanwhile, a growing number of testbeds have boosted the evolution of general-purpose large language models. Thus, this year's MARS2 focuses on real-world and specialized scenarios to broaden the multimodal reasoning applications of MLLMs. Our organizing team released two tailored datasets Lens and AdsQA as test sets, which support general reasoning in 12 daily scenarios and domain-specific reasoning in advertisement videos, respectively. We evaluated 40+ baselines that include both generalist MLLMs and task-specific models, and opened up three competition tracks, i.e., Visual Grounding in Real-world Scenarios (VG-RS), Visual Question Answering with Spatial Awareness (VQA-SA), and Visual Reasoning in Creative Advertisement Videos (VR-Ads). Finally, 76 teams from the renowned academic and industrial institutions have registered and 40+ valid submissions (out of 1200+) have been included in our ranking lists. Our datasets, code sets (40+ baselines and 15+ participants' methods), and rankings are publicly available on the MARS2 workshop website and our GitHub organization page https://github.com/mars2workshop/, where our updates and announcements of upcoming events will be continuously provided.

Ayush Noori, Joaquín Polonuer, Katharina Meyer et al.

Neurological diseases are the leading global cause of disability, yet most lack disease-modifying treatments. We present PROTON, a heterogeneous graph transformer that generates testable hypotheses across molecular, organoid, and clinical systems. To evaluate PROTON, we apply it to Parkinson's disease (PD), bipolar disorder (BD), and Alzheimer's disease (AD). In PD, PROTON linked genetic risk loci to genes essential for dopaminergic neuron survival and predicted pesticides toxic to patient-derived neurons, including the insecticide endosulfan, which ranked within the top 1.29% of predictions. In silico screens performed by PROTON reproduced six genome-wide $α$-synuclein experiments, including a split-ubiquitin yeast two-hybrid system (normalized enrichment score [NES] = 2.30, FDR-adjusted $p < 1 \times 10^{-4}$), an ascorbate peroxidase proximity labeling assay (NES = 2.16, FDR $< 1 \times 10^{-4}$), and a high-depth targeted exome sequencing study in 496 synucleinopathy patients (NES = 2.13, FDR $< 1 \times 10^{-4}$). In BD, PROTON predicted calcitriol as a candidate drug that reversed proteomic alterations observed in cortical organoids derived from BD patients. In AD, we evaluated PROTON predictions in health records from $n = 610,524$ patients at Mass General Brigham, confirming that five PROTON-predicted drugs were associated with reduced seven-year dementia risk (minimum hazard ratio = 0.63, 95% CI: 0.53-0.75, $p < 1 \times 10^{-7}$). PROTON generated neurological hypotheses that were evaluated across molecular, organoid, and clinical systems, defining a path for AI-driven discovery in neurological disease.

Pafue Christy Nganjimi, Andrew Soltan, Danielle Belgrave et al.

Dataset condensation (DC) enables the creation of compact, privacy-preserving synthetic datasets that can match the utility of real patient records, supporting democratised access to highly regulated clinical data for developing downstream clinical models. State-of-the-art DC methods supervise synthetic data by aligning the training dynamics of models trained on real and those trained on synthetic data, typically using full stochastic gradient descent (SGD) trajectories as alignment targets; however, these trajectories are often noisy, high-curvature, and storage-intensive, leading to unstable gradients, slow convergence, and substantial memory overhead. We address these limitations by replacing full SGD trajectories with smooth, low-loss parametric surrogates, specifically quadratic Bézier curves that connect the initial and final model states from real training trajectories. These mode-connected paths provide noise-free, low-curvature supervision signals that stabilise gradients, accelerate convergence, and eliminate the need for dense trajectory storage. We theoretically justify Bézier-mode connections as effective surrogates for SGD paths and empirically show that the proposed method outperforms state-of-the-art condensation approaches across five clinical datasets, yielding condensed datasets that enable clinically effective model development.

Ayush Noori, Adam Rodman, Alan Karthikesalingam et al.

Modern computer systems often rely on syslog, a simple, universal protocol that records every critical event across heterogeneous infrastructure. However, healthcare's rapidly growing clinical AI stack has no equivalent. As hospitals rush to pilot large language models and other AI-based clinical decision support tools, we still lack a standard way to record how, when, by whom, and for whom these AI models are used. Without that transparency and visibility, it is challenging to measure real-world performance and outcomes, detect adverse events, or correct bias or dataset drift. In the spirit of syslog, we introduce MedLog, a protocol for event-level logging of clinical AI. Any time an AI model is invoked to interact with a human, interface with another algorithm, or act independently, a MedLog record is created. This record consists of nine core fields: header, model, user, target, inputs, artifacts, outputs, outcomes, and feedback, providing a structured and consistent record of model activity. To encourage early adoption, especially in low-resource settings, and minimize the data footprint, MedLog supports risk-based sampling, lifecycle-aware retention policies, and write-behind caching; detailed traces for complex, agentic, or multi-stage workflows can also be captured under MedLog. MedLog can catalyze the development of new databases and software to store and analyze MedLog records. Realizing this vision would enable continuous surveillance, auditing, and iterative improvement of medical AI, laying the foundation for a new form of digital epidemiology.

Xiao Gu, Wei Tang, Jinpei Han et al. · oxford

Cardiac biosignals, such as electrocardiograms (ECG) and photoplethysmograms (PPG), are of paramount importance for the diagnosis, prevention, and management of cardiovascular diseases, and have been extensively used in a variety of clinical tasks. Conventional deep learning approaches for analyzing these signals typically rely on homogeneous datasets and static bespoke models, limiting their robustness and generalizability across diverse clinical settings and acquisition protocols. In this study, we present a cardiac sensing foundation model (CSFM) that leverages advanced transformer architectures and a generative, masked pretraining strategy to learn unified representations from vast, heterogeneous health records. Our model is pretrained on an innovative multi-modal integration of data from multiple large-scale datasets (including MIMIC-III-WDB, MIMIC-IV-ECG, and CODE), comprising cardiac signals and the corresponding clinical or machine-generated text reports from approximately 1.7 million individuals. We demonstrate that the embeddings derived from our CSFM not only serve as effective feature extractors across diverse cardiac sensing scenarios, but also enable seamless transfer learning across varying input configurations and sensor modalities. Extensive evaluations across diagnostic tasks, demographic information recognition, vital sign measurement, clinical outcome prediction, and ECG question answering reveal that CSFM consistently outperforms traditional one-modal-one-task approaches. Notably, CSFM exhibits robust performance across multiple ECG lead configurations from standard 12-lead systems to single-lead setups, and in scenarios where only ECG, only PPG, or a combination thereof is available. These findings highlight the potential of CSFM as a versatile and scalable solution, for comprehensive cardiac monitoring.