Polar Code Based Federated Learning: Convergence Analysis and Resource Allocation

Federated learning (FL) enables collaborative model training across distributed devices without sharing raw data; however, it faces significant communication bottlenecks and channel impairments in practice. Conventional network layer treatments either idealize the channel as error free or apply equal error protection (EEP) to transmitted model updates, failing to account for the inherently unequal importance of quantization bits within a single local model. To address this limitation, we propose a cross layer polar code based FL scheme that leverages the unequal error protection (UEP) property of polar codes under finite block lengths. Specifically, the proposed design selectively protects more significant quantization bits, thereby mitigating the detrimental effects of channel noise. We further provide a rigorous convergence analysis of the proposed scheme, deriving an upper bound on the convergence gap, which we then jointly optimize over the number of quantization bits and the polar code block length across all training iterations. Experimental results demonstrate that both constant and variable block length configurations of our polar code based scheme consistently achieve substantial performance gains over uncoded and LDPC-based EEP benchmarks, with the advantage becoming increasingly pronounced as the channel quality deteriorating. These findings confirm the efficacy of our cross-layer design in enhancing FL robustness and efficiency under realistic channel conditions.

Evaluating Multi-Turn Multimodal Diagnostic Reasoning on Challenging Real-World Clinical Cases

Clinical diagnostic evaluation should not only assess whether models can provide correct diagnoses, but also reflect the realities of clinical practice, including progressive disclosure of multimodal information, dynamic updating of diagnostic hypotheses, and continuous refinement of clinical reasoning. However, existing evaluations of multimodal large language models (MLLMs) typically rely on single-turn or isolated tasks, making it difficult to fully capture the complexity of real-world clinical diagnosis. To bridge this gap, we developed ClinMM-Bench, the largest multi-turn multimodal clinical diagnostic evaluation benchmark to date. ClinMM-Bench contains 1,089 challenging real-world clinical cases and 3,760 medical images across eight specialties. We systematically evaluated 15 representative MLLMs using a two-level evaluation framework that assessed both diagnostic accuracy and diagnostic reasoning quality. Results showed that proprietary models achieved the highest overall diagnostic accuracy, but the proportion of completely correct diagnoses remained limited across all models. In terms of diagnostic reasoning quality, current models can identify plausible diagnostic directions but still have considerable limitations in generating reliable diagnostic reasoning. Error analysis further identified five representative failure modes: information synthesis failure, knowledge mapping error, perception error, premature closure, and visual hallucination.

SIMAX: A Scalable and Interpretable Framework for Multi-Fidelity and Annotated Clinician-Patient Dialogue Simulation

Background. The widespread deployment of ambient digital scribes is driving large-scale capture of clinician-patient dialogues. Human coding of clinical communication data remains costly, inconsistent, and difficult to scale, motivating AI-driven communication coding systems. However, evaluating these systems requires real-world dialogues and human-coded labels, both hard to obtain at scale. Methods. We developed SIMAX (Scalable and Interpretable Framework for Multi-Fidelity and Annotated Clinician-Patient Dialogue Simulation), a framework for generating controlled clinical dialogue data with reference behavioral annotations. SIMAX generates clinician-patient dialogues from predefined clinical scenarios, personas and voice conditions, and target communication behaviors. Behaviors are controlled using two codebooks: the Global Codebook for overall communication quality and the WISER Codebook for specific countable behaviors. We evaluated SIMAX using automated and human quality assessments and an example communication coding system. Results. SIMAX generated 3,388 simulated dialogues across three specialties, multiple visit stages, persona characteristics, and accent conditions. Automated assessment showed mean UTMOS and WV-MOS scores of 3.03 and 2.61, WER and CER of 0.07 and 0.05, and CLAP cosine similarity of 0.41, suggesting reasonable speech naturalness, high transcription fidelity, and positive text-audio correspondence. Human evaluation showed a median MOS of 4.67 and a median clinical realism score of 3.00. Downstream evaluation suggests that SIMAX can assess how a communication coding system responds to behavioral targets and reveal insufficient sensitivity in some dimensions. Conclusions. SIMAX generates controlled and reproducible simulated clinician-patient dialogues, providing a data foundation for developing, validating, and refining communication coding systems.

Foundation VAEs for 3D CT Reconstruction, Augmentation, and Generation

Variational autoencoders (VAEs) compress high resolution CT volumes into compact latents while preserving clinically relevant structure. However, training CT-specific VAEs from scratch or heavily fine-tuning them incurs substantial computational and engineering cost, and often degrades under heterogeneous scanners, protocols, and diseases. This paper makes a progressive stride toward training-free medical VAEs by leveraging a critical observation: a single Foundation VAE, pretrained at scale on natural images and videos, can serve as a unified interface for CT Reconstruction, Augmentation, and Generation. With both encoder and decoder frozen, the Foundation VAE reconstructs CT volumes with preserved anatomy while suppressing acquisition noise; training segmentation models on these reconstructions improves surface accuracy by 3.9% NSD on average for pancreatic tumor and lung tumor. Within the same Foundation VAE latent space, a conditional latent diffusion model achieves 3.9% lower average FVD with 36.2% higher CT CLIP score, and improves multi-disease generation faithfulness across 18 types by 2.76% AUC. These results demonstrate Foundation VAEs as a practical interface for scalable CT representation reuse and faithful CT generation. Our code and demo are available at https://github.com/qic999/Foundation-VAE.

EpiCastBench: Datasets and Benchmarks for Multivariate Epidemic Forecasting

The increasing adoption of data-driven decision-making in public health has established epidemic forecasting as a critical area of research. Recent advances in multivariate forecasting models better capture complex temporal dependencies than conventional univariate approaches, which model individual series independently. Despite this potential, the development of robust epidemic forecasting methods is constrained by the lack of high-quality benchmarks comprising diverse multivariate datasets across infectious diseases and geographical regions. To address this gap, we present EpiCastBench, a large-scale benchmarking framework featuring 40 curated (correlated) multivariate epidemic datasets. These publicly available datasets span a wide range of infectious diseases and exhibit diverse characteristics in terms of temporal granularity, series length, and sparsity. We analyze these datasets to identify their global features and structural patterns. To ensure reproducibility and fair comparison, we establish standardized evaluation settings, including a unified forecasting horizon, consistent preprocessing pipelines, diverse performance metrics, and statistical significance testing. By leveraging this framework, we conduct a comprehensive evaluation of 15 multivariate forecasting models spanning statistical baselines to state-of-the-art deep learning and foundation models. All datasets and code are publicly available on Kaggle (https://www.kaggle.com/datasets/aimltsf/epicastbench) and GitHub (https://github.com/aimltsf/EpiCastBench).

A Versatile AI Agent for Rare Disease Diagnosis and Risk Gene Prioritization

Accurate and timely diagnosis is essential for effective treatment, particularly in the context of rare diseases. However, current diagnostic workflows often lead to prolonged assessment times and low accuracy. To address these limitations, we introduce Hygieia, a multi-modal AI agent system designed to support precision disease diagnosis by integrating diverse data sources, including phenotypic features, genetic profiles, and clinical records. Hygieia features a router-based and knowledge-enhanced framework that mitigates hallucination and tailors diagnostic strategies to different disease categories. Notably, it prioritizes risk-related genomic factors for rare diseases and provides confidence scores to assist clinical decision-making. We conducted a comprehensive evaluation demonstrating that Hygieia achieves state-of-the-art performance across multiple diagnostic benchmarks. In collaboration with clinical experts from Yale School of Medicine and Duke-NUS Medical School, we further validated its practical utility by showing (1) Hygieia's superior diagnostic performance compared to physicians with an improvement from 12%-60% and (2) its effectiveness in assisting clinicians with medical records for handling real-world cases. Our findings indicate that Hygieia not only enhances diagnostic accuracy and interpretability but also significantly reduces clinician workload, highlighting its potential as a valuable tool in clinical decision support systems.

Resolving the bias-precision paradox with stochastic causal representation learning for personalized medicine

Estimating individualized treatment effects from longitudinal observational data is central to data-driven medicine, yet existing methods face a fundamental limitation: reducing confounding bias often suppresses clinically informative heterogeneity, degrading patient-specific predictions. Here, we identify this tension as a bias-precision paradox in causal representation learning and introduce sampling-based maximum mean discrepancy (sMMD), a stochastic alignment strategy that replaces global adversarial balancing with subset-level matching. We instantiate this approach in a framework for counterfactual outcome prediction with attribution-grounded interpretability. Across two large-scale ICU cohorts (n = 27,783), our framework improves accuracy under distribution shift, reducing error by up to 11.5% and substantially increasing recall in high-risk tasks. Mechanistic analyses show that sMMD selectively preserves clinically decisive variables. In human-AI evaluation, our method outperforms clinicians-in-training and large language models, and improves clinician accuracy by 14.7% while reducing decision time, enabling interpretable, real-time clinical decision support.

Improving Spatial Allocation for Energy System Coupling with Graph Neural Networks

In energy system analysis, coupling models with mismatched spatial resolutions is a significant challenge. A common solution is assigning weights to high-resolution geographic units for aggregation, but traditional models are limited by using only a single geospatial attribute. This paper presents an innovative method employing a self-supervised Heterogeneous Graph Neural Network to address this issue. This method models high-resolution geographic units as graph nodes, integrating various geographical features to generate physically meaningful weights for each grid point. These weights enhance the conventional Voronoi-based allocation method, allowing it to go beyond simply geographic proximity by incorporating essential geographic information.In addition, the self-supervised learning paradigm overcomes the lack of accurate ground-truth data. Experimental results demonstrate that applying weights generated by this method to cluster-based Voronoi Diagrams significantly enhances scalability, accuracy, and physical plausibility, while increasing precision compared to traditional methods.

Communication-Efficient Federated Risk Difference Estimation for Time-to-Event Clinical Outcomes

Privacy-preserving model co-training in medical research is often hindered by server-dependent architectures incompatible with protected hospital data systems and by the predominant focus on relative effect measures (hazard ratios) which lack clinical interpretability for absolute survival risk assessment. We propose FedRD, a communication-efficient framework for federated risk difference estimation in distributed survival data. Unlike typical federated learning frameworks (e.g., FedAvg) that require persistent server connections and extensive iterative communication, FedRD is server-independent with minimal communication: one round of summary statistics exchange for the stratified model and three rounds for the unstratified model. Crucially, FedRD provides valid confidence intervals and hypothesis testing--capabilities absent in FedAvg-based frameworks. We provide theoretical guarantees by establishing the asymptotic properties of FedRD and prove that FedRD (unstratified) is asymptotically equivalent to pooled individual-level analysis. Simulation studies and real-world clinical applications across different countries demonstrate that FedRD outperforms local and federated baselines in both estimation accuracy and prediction performance, providing an architecturally feasible solution for absolute risk assessment in privacy-restricted, multi-site clinical studies.

Toward Global Large Language Models in Medicine

Despite continuous advances in medical technology, the global distribution of health care resources remains uneven. The development of large language models (LLMs) has transformed the landscape of medicine and holds promise for improving health care quality and expanding access to medical information globally. However, existing LLMs are primarily trained on high-resource languages, limiting their applicability in global medical scenarios. To address this gap, we constructed GlobMed, a large multilingual medical dataset, containing over 500,000 entries spanning 12 languages, including four low-resource languages. Building on this, we established GlobMed-Bench, which systematically assesses 56 state-of-the-art proprietary and open-weight LLMs across multiple multilingual medical tasks, revealing significant performance disparities across languages, particularly for low-resource languages. Additionally, we introduced GlobMed-LLMs, a suite of multilingual medical LLMs trained on GlobMed, with parameters ranging from 1.7B to 8B. GlobMed-LLMs achieved an average performance improvement of over 40% relative to baseline models, with a more than threefold increase in performance on low-resource languages. Together, these resources provide an important foundation for advancing the equitable development and application of LLMs globally, enabling broader language communities to benefit from technological advances.