Zhenxing Xu

Adrienne Kline, Hanyin Wang, Yikuan Li et al.

As machine learning and artificial intelligence are more frequently being leveraged to tackle problems in the health sector, there has been increased interest in utilizing them in clinical decision-support. This has historically been the case in single modal data such as electronic health record data. Attempts to improve prediction and resemble the multimodal nature of clinical expert decision-making this has been met in the computational field of machine learning by a fusion of disparate data. This review was conducted to summarize this field and identify topics ripe for future research. We conducted this review in accordance with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) extension for Scoping Reviews to characterize multi-modal data fusion in health. We used a combination of content analysis and literature searches to establish search strings and databases of PubMed, Google Scholar, and IEEEXplore from 2011 to 2021. A final set of 125 articles were included in the analysis. The most common health areas utilizing multi-modal methods were neurology and oncology. However, there exist a wide breadth of current applications. The most common form of information fusion was early fusion. Notably, there was an improvement in predictive performance performing heterogeneous data fusion. Lacking from the papers were clear clinical deployment strategies and pursuit of FDA-approved tools. These findings provide a map of the current literature on multimodal data fusion as applied to health diagnosis/prognosis problems. Multi-modal machine learning, while more robust in its estimations over unimodal methods, has drawbacks in its scalability and the time-consuming nature of information concatenation.

Zhenxing Xu, Zeyuan Ma, Weidong Bao et al.

We propose ECO, a versatile learning paradigm that enables efficient offline self-play for Neural Combinatorial Optimization (NCO). ECO addresses key limitations in the field through: 1) Paradigm Shift: Moving beyond inefficient online paradigms, we introduce a two-phase offline paradigm consisting of supervised warm-up and iterative Direct Preference Optimization (DPO); 2) Architecture Shift: We deliberately design a Mamba-based architecture to further enhance the efficiency in the offline paradigm; and 3) Progressive Bootstrapping: To stabilize training, we employ a heuristic-based bootstrapping mechanism that ensures continuous policy improvement during training. Comparison results on TSP and CVRP highlight that ECO performs competitively with up-to-date baselines, with significant advantage on the efficiency side in terms of memory utilization and training throughput. We provide further in-depth analysis on the efficiency, throughput and memory usage of ECO. Ablation studies show rationale behind our designs.

Zhenxing Xu, Yizhe Zhang, Weidong Bao et al.

Dynamically configuring algorithm hyperparameters is a fundamental challenge in computational intelligence. While learning-based methods offer automation, they suffer from prohibitive sample complexity and poor generalization. We introduce AutoEP, a novel framework that bypasses training entirely by leveraging Large Language Models (LLMs) as zero-shot reasoning engines for algorithm control. AutoEP's core innovation lies in a tight synergy between two components: (1) an online Exploratory Landscape Analysis (ELA) module that provides real-time, quantitative feedback on the search dynamics, and (2) a multi-LLM reasoning chain that interprets this feedback to generate adaptive hyperparameter strategies. This approach grounds high-level reasoning in empirical data, mitigating hallucination. Evaluated on three distinct metaheuristics across diverse combinatorial optimization benchmarks, AutoEP consistently outperforms state-of-the-art tuners, including neural evolution and other LLM-based methods. Notably, our framework enables open-source models like Qwen3-30B to match the performance of GPT-4, demonstrating a powerful and accessible new paradigm for automated hyperparameter design. Our code is available at https://anonymous.4open.science/r/AutoEP-3E11

Zhenxing Xu, Jingyuan Chou, Xi Sheryl Zhang et al.

Acute Kidney Injury (AKI) is a common clinical syndrome characterized by the rapid loss of kidney excretory function, which aggravates the clinical severity of other diseases in a large number of hospitalized patients. Accurate early prediction of AKI can enable in-time interventions and treatments. However, AKI is highly heterogeneous, thus identification of AKI sub-phenotypes can lead to an improved understanding of the disease pathophysiology and development of more targeted clinical interventions. This study used a memory network-based deep learning approach to discover AKI sub-phenotypes using structured and unstructured electronic health record (EHR) data of patients before AKI diagnosis. We leveraged a real world critical care EHR corpus including 37,486 ICU stays. Our approach identified three distinct sub-phenotypes: sub-phenotype I is with an average age of 63.03$ \pm 17.25 $ years, and is characterized by mild loss of kidney excretory function (Serum Creatinine (SCr) $1.55\pm 0.34$ mg/dL, estimated Glomerular Filtration Rate Test (eGFR) $107.65\pm 54.98$ mL/min/1.73$m^2$). These patients are more likely to develop stage I AKI. Sub-phenotype II is with average age 66.81$ \pm 10.43 $ years, and was characterized by severe loss of kidney excretory function (SCr $1.96\pm 0.49$ mg/dL, eGFR $82.19\pm 55.92$ mL/min/1.73$m^2$). These patients are more likely to develop stage III AKI. Sub-phenotype III is with average age 65.07$ \pm 11.32 $ years, and was characterized moderate loss of kidney excretory function and thus more likely to develop stage II AKI (SCr $1.69\pm 0.32$ mg/dL, eGFR $93.97\pm 56.53$ mL/min/1.73$m^2$). Both SCr and eGFR are significantly different across the three sub-phenotypes with statistical testing plus postdoc analysis, and the conclusion still holds after age adjustment.

Prakash Adekkanattu, Guoqian Jiang, Yuan Luo et al.

While natural language processing (NLP) of unstructured clinical narratives holds the potential for patient care and clinical research, portability of NLP approaches across multiple sites remains a major challenge. This study investigated the portability of an NLP system developed initially at the Department of Veterans Affairs (VA) to extract 27 key cardiac concepts from free-text or semi-structured echocardiograms from three academic medical centers: Weill Cornell Medicine, Mayo Clinic and Northwestern Medicine. While the NLP system showed high precision and recall measurements for four target concepts (aortic valve regurgitation, left atrium size at end systole, mitral valve regurgitation, tricuspid valve regurgitation) across all sites, we found moderate or poor results for the remaining concepts and the NLP system performance varied between individual sites.