LSTrans: Efficient Knowledge Transfer for Lightweight and Automated ECG Classification

Deploying deep learning models for automated electrocardiogram classification on resource-constrained wearable devices remains challenging due to high computational costs. To address this, we propose LSTrans, a lightweight hybrid model designed for efficient and sensitive ECG analysis. LSTrans introduces a specialized 1D convolutional backbone with an interleaved layer architecture to capture both macroscopic rhythmic trends and microscopic morphological variations. This backbone is cascaded with a Transformer encoder to model long-range temporal dependencies, incorporating Low-Rank Adaptation across critical layers to compress the model and reduce the trainable parameter space. We further employ homogeneous and heterogeneous knowledge distillation to transfer diagnostic expertise from high-capacity teacher models to the student. Experimental results on multiple benchmark datasets demonstrate that LSTrans achieves a competitive balance between diagnostic sensitivity and resource efficiency, substantially reducing peak memory footprints and training latency during downstream adaptation. The source code is available for review at https://github.com/zyee00128/LSTrans4BIBM.

Separating Expert Retention from Autonomous Source Inference in Raw-ECG-Replay-Free Continual ECG Deployment

In multi-source ECG deployment, models may need to incorporate new data sources when earlier raw ECGs cannot be retained or replayed. Freezing a pretrained backbone and assigning each source an isolated classifier prevents parameter interference, but deployment still requires selecting an expert when source metadata are unavailable. We study this distinction through \ours{}, an incremental expert bank built on frozen 1024-dimensional ECGFounder features. Each arriving domain adds a balanced-softmax linear expert, while a lightweight router is fitted only on retained training features and domain labels from sources observed so far. A validation-calibrated margin rule fuses the two most likely experts instead of committing to a single routed expert. On CPSC, PTB-XL, Georgia, and Chapman-Shaoxing, source-aware expert selection reaches $0.7915\pm0.0036$ Macro-F1 and a matched offline independent-head reference reaches $0.7885\pm0.0009$, supporting strong source-aware expert retention. Without source IDs, an MLP router reaches $0.7756\pm0.0027$ and top-2 margin fusion reaches $0.7782\pm0.0022$. The top-2 gain over hard MLP routing is small ($+0.0026$), with a 95\% confidence interval from paired bootstrap that includes zero. Across three domain orders, the top-2-to-oracle gap remains $0.0111$--$0.0133$, identifying autonomous source inference as the main remaining bottleneck. No raw ECGs are replayed, but frozen training features are retained for router updates; the method is therefore not memory-free.

Aligned but Fragile: Enhancing LLM Safety Robustness via Zeroth-Order Optimization

Safety alignment for large language models (LLMs) aims to reduce harmful or unsafe behavior while preserving general utility. However, recent findings reveal that alignment effects can be fragile: lightweight post-alignment manipulations, such as parameter noise, activation noise, or quantization, can easily weaken the intended safety behavior. Prior efforts to improve robustness have primarily focused on data curation, modified alignment objectives, and safety-critical parameter identification, leaving the role of the optimizer itself largely unexplored. In this paper, we are the first to study the robustness of safety alignment from the perspective of the base optimizer. This optimizer-centric view naturally points to zeroth-order optimization, which provides a robustness-oriented signal by evaluating safety alignment under perturbations. Based on this insight, we propose a hybrid framework that first performs standard first-order safety alignment and then applies zeroth-order refinement to improve robustness. Both theoretically and empirically, we show that only a few zeroth-order refinement steps can enhance robustness while preserving safety alignment. We further improve the efficiency of zeroth-order refinement by exploiting its inherent perturbation-based evaluations to estimate layer-wise robustness sensitivity, enabling the refinement process to concentrate updates on robustness-critical layers with modest training overhead.

Frequency-Enhanced Diffusion Models: Curriculum-Guided Semantic Alignment for Zero-Shot Skeleton Action Recognition

Human action recognition is pivotal in computer vision, with applications ranging from surveillance to human-robot interaction. Despite the effectiveness of supervised skeleton-based methods, their reliance on exhaustive annotation limits generalization to novel actions. Zero-Shot Skeleton Action Recognition (ZSAR) emerges as a promising paradigm, yet it faces challenges due to the spectral bias of diffusion models, which oversmooth high-frequency dynamics. Here, we propose Frequency-Aware Diffusion for Skeleton-Text Matching (FDSM), integrating a Semantic-Guided Spectral Residual Module, a Timestep-Adaptive Spectral Loss, and Curriculum-based Semantic Abstraction to address these challenges. Our approach effectively recovers fine-grained motion details, achieving state-of-the-art performance on NTU RGB+D, PKU-MMD, and Kinetics-skeleton datasets. Code has been made available at https://github.com/yuzhi535/FDSM. Project homepage: https://yuzhi535.github.io/FDSM.github.io/

Holter-to-Sleep: AI-Enabled Repurposing of Single-Lead ECG for Sleep Phenotyping

Sleep disturbances are tightly linked to cardiovascular risk, yet polysomnography (PSG)-the clinical reference standard-remains resource-intensive and poorly suited for multi-night, home-based, and large-scale screening. Single-lead electrocardiography (ECG), already ubiquitous in Holter and patch-based devices, enables comfortable long-term acquisition and encodes sleep-relevant physiology through autonomic modulation and cardiorespiratory coupling. Here, we present a proof-of-concept Holter-to-Sleep framework that, using single-lead ECG as the sole input, jointly supports overnight sleep phenotyping and Holter-grade cardiac phenotyping within the same recording, and further provides an explicit analytic pathway for scalable cardio-sleep association studies. The framework is developed and validated on a pooled multi-center PSG sample of 10,439 studies spanning four public cohorts, with independent external evaluation to assess cross-cohort generalizability, and additional real-world feasibility assessment using overnight patch-ECG recordings via objective-subjective consistency analysis. This integrated design enables robust extraction of clinically meaningful overnight sleep phenotypes under heterogeneous populations and acquisition conditions, and facilitates systematic linkage between ECG-derived sleep metrics and arrhythmia-related Holter phenotypes. Collectively, the Holter-to-Sleep paradigm offers a practical foundation for low-burden, home-deployable, and scalable cardio-sleep monitoring and research beyond traditional PSG-centric workflows.

Aortic Valve Disease Detection from PPG via Physiology-Informed Self-Supervised Learning

Traditional diagnosis of aortic valve disease relies on echocardiography, but its cost and required expertise limit its use in large-scale early screening. Photoplethysmography (PPG) has emerged as a promising screening modality due to its widespread availability in wearable devices and its ability to reflect underlying hemodynamic dynamics. However, the extreme scarcity of gold-standard labeled PPG data severely constrains the effectiveness of data-driven approaches. To address this challenge, we propose and validate a new paradigm, Physiology-Guided Self-Supervised Learning (PG-SSL), aimed at unlocking the value of large-scale unlabeled PPG data for efficient screening of Aortic Stenosis (AS) and Aortic Regurgitation (AR). Using over 170,000 unlabeled PPG samples from the UK Biobank, we formalize clinical knowledge into a set of PPG morphological phenotypes and construct a pulse pattern recognition proxy task for self-supervised pre-training. A dual-branch, gated-fusion architecture is then employed for efficient fine-tuning on a small labeled subset. The proposed PG-SSL framework achieves AUCs of 0.765 and 0.776 for AS and AR screening, respectively, significantly outperforming supervised baselines trained on limited labeled data. Multivariable analysis further validates the model output as an independent digital biomarker with sustained prognostic value after adjustment for standard clinical risk factors. This study demonstrates that PG-SSL provides an effective, domain knowledge-driven solution to label scarcity in medical artificial intelligence and shows strong potential for enabling low-cost, large-scale early screening of aortic valve disease.

Case Prompting to Mitigate Large Language Model Bias for ICU Mortality Prediction

Accurate mortality risk prediction for intensive care unit (ICU) patients is essential for clinical decision-making. Although large language models (LLMs) show promise in predicting outcomes from structured medical data, their predictions may exhibit demographic biases related to sex, age, and race, limiting their trustworthy use in clinical practice. Existing debiasing methods often reduce predictive performance, making it difficult to jointly optimize fairness and accuracy. In this study, we systematically examine bias in LLM-based ICU mortality prediction and propose a training-free, clinically adaptive prompting framework to simultaneously improve fairness and performance. We first develop a multi-dimensional bias assessment scheme for comprehensive model diagnosis. Building on this analysis, we introduce CAse Prompting (CAP), a novel prompting framework that integrates conventional debiasing prompts with case-based reasoning. CAP guides the model to learn from similar historical misprediction cases and their correct outcomes, enabling correction of biased reasoning patterns. Experiments on the MIMIC-IV dataset show that CAP substantially improves both predictive accuracy and fairness. CAP increases AUROC from 0.806 to 0.873 and AUPRC from 0.497 to 0.694, while reducing sex- and race-related disparities by over 90%. Feature reliance analysis further indicates highly consistent attention patterns across demographic groups, with similarity scores exceeding 0.98. These results demonstrate that LLMs exhibit measurable bias in ICU mortality prediction, and that a carefully designed prompting framework can effectively co-optimize fairness and performance without retraining, offering a transferable paradigm for equitable clinical decision support.

Artificial Intelligence-Enabled Spirometry for Early Detection of Right Heart Failure

Right heart failure (RHF) is a disease characterized by abnormalities in the structure or function of the right ventricle (RV), which is associated with high morbidity and mortality. Lung disease often causes increased right ventricular load, leading to RHF. Therefore, it is very important to screen out patients with cor pulmonale who develop RHF from people with underlying lung diseases. In this work, we propose a self-supervised representation learning method to early detecting RHF from patients with cor pulmonale, which uses spirogram time series to predict patients with RHF at an early stage. The proposed model is divided into two stages. The first stage is the self-supervised representation learning-based spirogram embedding (SLSE) network training process, where the encoder of the Variational autoencoder (VAE-encoder) learns a robust low-dimensional representation of the spirogram time series from the data-augmented unlabeled data. Second, this low-dimensional representation is fused with demographic information and fed into a CatBoost classifier for the downstream RHF prediction task. Trained and tested on a carefully selected subset of 26,617 individuals from the UK Biobank, our model achieved an AUROC of 0.7501 in detecting RHF, demonstrating strong population-level distinction ability. We further evaluated the model on high-risk clinical subgroups, achieving AUROC values of 0.8194 on a test set of 74 patients with chronic kidney disease (CKD) and 0.8413 on a set of 64 patients with valvular heart disease (VHD). These results highlight the model's potential utility in predicting RHF among clinically elevated-risk populations. In conclusion, this study presents a self-supervised representation learning approach combining spirogram time series and demographic data, demonstrating promising potential for early RHF detection in clinical practice.

Copy-Paste to Mitigate Large Language Model Hallucinations

While Retrieval-Augmented Generation (RAG) enables large language models (LLMs) to generate contextually grounded responses, contextual faithfulness remains challenging as LLMs may not consistently trust provided context, leading to hallucinations that undermine reliability. We observe an inverse correlation between response copying degree and context-unfaithful hallucinations on RAGTruth, suggesting that higher copying degrees reduce hallucinations by fostering genuine contextual belief. We propose CopyPasteLLM, obtained through two-stage high-copying response preference training. We design three prompting methods to enhance copying degree, demonstrating that high-copying responses achieve superior contextual faithfulness and hallucination control. These approaches enable a fully automated pipeline that transforms generated responses into high-copying preference data for training CopyPasteLLM. On FaithEval, ConFiQA and PubMedQA, CopyPasteLLM achieves best performance in both counterfactual and original contexts, remarkably with 12.2% to 24.5% accuracy improvements on FaithEval over the best baseline, while requiring only 365 training samples -- 1/50th of baseline data. To elucidate CopyPasteLLM's effectiveness, we propose the Context-Parameter Copying Capturing algorithm. Interestingly, this reveals that CopyPasteLLM recalibrates reliance on internal parametric knowledge rather than external knowledge during generation. All codes are available at https://github.com/longyongchao/CopyPasteLLM

Towards Better Cephalometric Landmark Detection with Diffusion Data Generation

Cephalometric landmark detection is essential for orthodontic diagnostics and treatment planning. Nevertheless, the scarcity of samples in data collection and the extensive effort required for manual annotation have significantly impeded the availability of diverse datasets. This limitation has restricted the effectiveness of deep learning-based detection methods, particularly those based on large-scale vision models. To address these challenges, we have developed an innovative data generation method capable of producing diverse cephalometric X-ray images along with corresponding annotations without human intervention. To achieve this, our approach initiates by constructing new cephalometric landmark annotations using anatomical priors. Then, we employ a diffusion-based generator to create realistic X-ray images that correspond closely with these annotations. To achieve precise control in producing samples with different attributes, we introduce a novel prompt cephalometric X-ray image dataset. This dataset includes real cephalometric X-ray images and detailed medical text prompts describing the images. By leveraging these detailed prompts, our method improves the generation process to control different styles and attributes. Facilitated by the large, diverse generated data, we introduce large-scale vision detection models into the cephalometric landmark detection task to improve accuracy. Experimental results demonstrate that training with the generated data substantially enhances the performance. Compared to methods without using the generated data, our approach improves the Success Detection Rate (SDR) by 6.5%, attaining a notable 82.2%. All code and data are available at: https://um-lab.github.io/cepha-generation