Learning Task-Aware Sampling with Shared Saliency through Density-Equalizing Mappings

In image and surface-based learning tasks, convolutional features are typically extracted using receptive fields that are sampled uniformly across the entire domain. However, informative structures are rarely distributed uniformly in practice and are often concentrated in localized regions. Such phenomena are particularly common in medical imaging, where pathological changes are spatially confined. Consequently, uniform convolution allocates equal computational effort to both informative and uninformative regions, resulting in inefficient feature extraction and suboptimal utilization of model capacity. To address this issue, we propose a framework for task-adaptive sampling that dynamically redistributes computational attention according to the spatial importance of the data. Specifically, we introduce the Density-Equalizing Convolutional Neural Network (DECNN), which employs density-equalizing mappings to guide convolution through a learned density function. The density function encodes the relative importance of different regions and induces a transformation that enlarges informative areas while compressing less relevant ones. As a result, convolutional receptive fields are redistributed non-uniformly over the domain, enabling denser sampling in task-relevant regions. By coupling this importance-driven transformation with convolution, DECNN performs adaptive feature extraction that focuses computational resources on informative structures. This leads to more efficient use of model capacity, yielding a lightweight yet expressive architecture while simultaneously producing an interpretable saliency map. Experiments on image classification and craniofacial surface analysis demonstrate that DECNN achieves competitive or superior performance with fewer parameters, accurately identifies task-relevant regions, and remains robust under complex geometric variations.

Curation of a Cardiology Interface Terminology for Highlighting Electronic Health Records using Machine Learning

Electronic health record (EHR) notes are dense medical documents containing large amounts of information, often filled with complex medical jargon. Highlighting all details in EHRs helps reduce the likelihood of missing crucial information by drawing attention to key content. This study proposes the design of a Cardiology Interface Terminology (CIT) to accurately highlight all details in EHR notes of cardiology patients. We introduce an innovative Machine Learning (ML) technique for the design of CIT. The ML technique requires training data. Manual preparation of such training data is time-consuming and expensive. The process of the CIT design includes three phases. In the first two phases, we innovatively derive a training data CIT to be used by the third phase, ML technique. We start by designing an initial CIT, composed of several components: the cardiology-related sub-hierarchies of SNOMED, other SNOMED concepts mined from EHRs of build set, and necessary components of terms e.g., medical abbreviations and medications. Utilizing an iterative process, fine-grained phrases containing initial CIT concepts are extracted from build set as CIT concept candidates. The candidate concepts are semi-automatically reviewed before being added to CIT, yielding the training data CIT, TCIT. In the third phase, a ML model is trained with TCIT to identify candidates fitting to be concepts in the CIT. This model is used to extract further concepts from build set, yielding the final CIT. The final CIT is then used to highlight the test set and evaluate the extent to which it captures details in an unseen EHR dataset. For this purpose, four evaluation metrics, coverage, breadth, completeness, and conciseness are used. The highlighted test set has a coverage of 74.21%, with a breadth of 1.68. For 20 random notes in test set, the average completeness is 98.2% and average conciseness is 84.2%.

Uncertainty Reasoning with Large Language Models for Explainable Disease Diagnosis

Clinical decision-making requires reasoning over incomplete, imprecise, and linguistically expressed patient narratives. While large language models (LLMs) excel at extracting latent information from natural language, they lack the verifiability and interpretability essential for trustworthy medical AI. We propose a neuro-symbolic reasoning framework that aligns LLMs with formal logic to enable explainable and formally verifiable medical diagnosis. Patient descriptions and clinical guidelines are embedded into a neural knowledge base, where LLMs extract structured medical entities, temporal relations, and fuzzy symptom patterns, which are decoded into a symbolic knowledge base expressed in fuzzy logic and declarative rules. We perform two-stage reasoning: (1) inductive symbolic generalization to capture diagnostic patterns from encoded narratives, and (2) inference verification via a logic programming engine to derive and validate diagnoses consistent with clinical standards. Each symptom is treated as a fuzzy predicate with probabilistic weights, and inference paths are auditable, adjustable, and compatible with physician feedback. Unlike purely statistical methods, our system supports iterative refinement: misalignment between LLM-generated diagnoses and ground truth can be traced, explained, and corrected through formal rules. By combining logic-based transparency, LLM adaptability, and probabilistic robustness, the framework enables human-aligned healthcare inference with strong generalization and verifiable, step-by-step reasoning chains. We validate our framework on public benchmarks, demonstrating effective reconciliation of symbolic reasoning and LLMs with real-world clinical narratives. Results show performance comparable to state-of-the-art LLMs, while additionally providing interpretable reasoning paths and formally verifiable diagnostic conclusions.

Embedding-Based Federated Learning with Runtime Governance for Iron Deficiency Prediction

Recent reviews find that the vast majority of published healthcare federated learning (FL) studies never reach real-world deployment. We developed an embedding-based FL pipeline for iron deficiency prediction from routine full blood count (FBC) data and deployed it across real institutional environments at Amsterdam University Medical Centre (AUMC) and NHS Blood and Transplant (NHSBT), two clinical environments that differ markedly in iron deficiency prevalence, ferritin distribution, and subject populations. A frozen domain-specific haematology foundation model, DeepCBC, performs site-local representation extraction, restricting federated training to a compact downstream classifier and substantially reducing recurrent communication relative to full-encoder federation. The two clinical datasets are structurally not independent and identically distributed (non-IID), with heterogeneity arising from distinct population differences rather than sampling artefacts. Runtime governance is enforced by FLA$^3$, a healthcare-oriented FL platform providing study-scoped execution, policy-based authorisation, and signed audit logging. Standard sample-size-weighted aggregation (FedAvg) reduced the area under the receiver operating characteristic curve (ROC-AUC) at both sites relative to local-only training, as the global update was biased towards the larger AUMC distribution. FedMAP, a personalised aggregation method, raised ROC-AUC from 0.9470 to 0.9594 at AUMC and from 0.8558 to 0.8671 at NHSBT relative to local-only training, achieving the highest macro ROC-AUC of 0.9133 and the best macro balanced accuracy overall. These results support personalised aggregation in clinical federations where client sample size and task relevance diverge substantially.

Frequency Adapter with SAM for Generalized Medical Image Segmentation

Medical image segmentation is a critical task in computer-aided diagnosis and treatment planning. However, deep learning models often struggle to generalize across datasets due to domain shifts arising from variations in imaging protocols, scanner types, and patient populations. Traditional domain generalization (DG) methods utilize causal feature learning, adversarial consistency, and style augmentation to improve segmentation robustness. While effective, these approaches rely on explicit feature alignment, adversarial objectives, or handcrafted augmentations, which may not fully exploit the capabilities of foundation models. Recently, the Segment Anything Model (SAM) has demonstrated strong generalization capabilities in segmentation tasks. SAM-based DG methods attempt to improve medical image segmentation. However, these approaches primarily operate in the spatial domain and overlook frequency-based discrepancies that significantly affect model robustness. In this work, we propose Frequency-based Domain Generalization with SAM (FSAM), a novel framework that integrates Low-Rank Adaptation (LoRA) for efficient fine-tuning and a frequency adapter to incorporate frequency-domain representations for single-source domain generalization. FSAM enhances SAM's segmentation robustness by extracting domain-invariant high-frequency features, mitigating frequency-related domain shifts. Experimental results on fundus and prostate datasets demonstrate that FSAM outperforms existing traditional DG and SAM-based DG approaches in domain generalization. Codes and pre-trained models will be made available on GitHub.

WavesFM: Hierarchical Representation Learning for Longitudinal Wearable Sensor Waveforms

Wearable sensors enable the continuous acquisition of high-resolution physiological waveforms, such as photoplethysmography and accelerometry, under free-living conditions. However, inferring health-related phenotypes from these signals presents significant challenges due to high sampling frequencies, multimodal dependencies, and extreme sequence lengths (e.g., weeks of recordings), compounded by a scarcity of ground-truth labels. To address these challenges, existing self-supervised learning (SSL) methodologies typically follow two paradigms: (1) learning rich morphological representations from short waveform segments while collapsing longitudinal dynamics through simple aggregation, or (2) modeling behavioral patterns from coarse, hand-crafted features (e.g. heart rate, step counts) spanning longer horizons but foregoing subtle, predictive signatures in raw waveforms. To bridge this gap, we propose WavesFM, a foundation model utilizing a two-stage SSL framework for longitudinal physiological data. Specifically, we decompose the learning problem into two stages: first, a segment-level encoder is pretrained to extract local embeddings from short waveforms; subsequently, a temporal encoder is trained to model the sequence of these embeddings across a multi-day horizon. This hierarchical approach overcomes the computational complexity of high-resolution, long-sequence data, allowing the overall model to capture both local signal semantics and the complex circadian and inter-day variations governing physiological dynamics. Pretrained on over 6.8M hours (N=324k individuals) of recordings for the first stage and 5.3M hours (N=10k) for the second stage, WavesFM demonstrates superior performance across 58 diverse tasks spanning demographics, lifestyle, health conditions, and medications.

CuraView: A Multi-Agent Framework for Medical Hallucination Detection with GraphRAG-Enhanced Knowledge Verification

Discharge summaries require extracting critical information from lengthy electronic health records (EHRs), a process that is labor-intensive when performed manually. Large language models (LLMs) can improve generation efficiency; however, they are prone to producing faithfulness hallucinations, statements that contradict source records, posing direct risks to patient safety. To address this, we present CuraView, a multi-agent framework for sentence-level detection and evidence-grounded explanation of faithfulness hallucinations in discharge summaries. CuraView constructs a GraphRAG-based knowledge graph from patient-level EHRs and implements a closed-loop generation-detection pipeline with sentence-level evidence retrieval and classification spanning four evidence grades from strong support to direct contradiction (E1-E4), yielding structured and interpretable evidence chains. We evaluate CuraView on a subset of 250 patients from the Discharge-Me benchmark, with 50 patients held out for testing. Our fine-tuned Qwen3-14B detection model achieves an F1 of 0.831 on the safety-critical E4 metric (90.9% recall, 76.5% precision) and an F1 of 0.823 on E3+E4, representing a 50.0% relative improvement over the base model and outperforming RAGTruth-style and QAGS-style baselines. These results demonstrate that evidence-chain-based graph retrieval verification substantially improves the factual reliability of clinical documentation, while simultaneously producing reusable annotated datasets for downstream model training and distillation.

OphMAE: Bridging Volumetric and Planar Imaging with a Foundation Model for Adaptive Ophthalmological Diagnosis

The advent of foundation models has heralded a new era in medical artificial intelligence (AI), enabling the extraction of generalizable representations from large-scale unlabeled datasets. However, current ophthalmic AI paradigms are predominantly constrained to single-modality inference, thereby creating a dissonance with clinical practice where diagnosis relies on the synthesis of complementary imaging modalities. Furthermore, the deployment of high-performance AI in resource-limited settings is frequently impeded by the unavailability of advanced three-dimensional imaging hardware. Here, we present the Ophthalmic multimodal Masked Autoencoder (OphMAE), a multi-imaging foundation model engineered to synergize the volumetric depth of 3D Optical Coherence Tomography (OCT) with the planar context of 2D en face OCT. By implementing a novel cross-modal fusion architecture and a unique adaptive inference mechanism, OphMAE was pre-trained on a massive dataset with of 183,875 paired OCT images derived from 32,765 patients. In a rigorous benchmark encompassing 17 diverse diagnostic tasks with 48,340 paired OCT images from 8,191 patients, the model demonstrated state-of-the-art performance, achieving an Area Under the Curve (AUC) of 96.9% for Age-related Macular Degeneration (AMD) and 97.2% for Diabetic Macular Edema (DME), consistently surpassing existing single-modal and multimodal foundation models. Crucially, OphMAE exhibits robust engineering adaptability: it maintains high diagnostic accuracy, such as 93.7\% AUC for AMD, even when restricted to single-modality 2D inputs, and demonstrates exceptional data efficiency by retaining 95.7% AUC with as few as 500 labeled samples. This work establishes a scalable and adaptable framework for ophthalmic AI, ensuring robust performance across different tasks.

Beyond Semantic Similarity: A Component-Wise Evaluation Framework for Medical Question Answering Systems with Health Equity Implications

The use of Large Language Models (LLMs) to support patients in addressing medical questions is becoming increasingly prevalent. However, most of the measures currently used to evaluate the performance of these models in this context only measure how closely a model's answers match semantically, and therefore do not provide a true indication of the model's medical accuracy or of the health equity risks associated with it. To address these shortcomings, we present a new evaluation framework for medical question answering called VB-Score (Verification-Based Score) that provides a separate evaluation of the four components of entity recognition, semantic similarity, factual consistency, and structured information completeness for medical question-answering models. We perform rigorous reviews of the performance of three well-known and widely used LLMs on 48 public health-related topics taken from high-quality, authoritative information sources. Based on our analyses, we discover a major discrepancy between the models' semantic and entity accuracy. Our assessments of the performance of all three models show that each of them has almost uniformly severe performance failures when evaluated against our criteria. Our findings indicate alarming performance disparities across various public health topics, with most of the models exhibiting 13.8% lower performance (compared to an overall average) for all the public health topics that relate to chronic conditions that occur in older and minority populations, which indicates the existence of what's known as condition-based algorithmic discrimination. Our findings also demonstrate that prompt engineering alone does not compensate for basic architectural limitations on how these models perform in extracting medical entities and raise the question of whether semantic evaluation alone is a sufficient measure of medical AI safety.

The Structured Output Benchmark: A Multi-Source Benchmark for Evaluating Structured Output Quality in Large Language Models

Large Language Models are increasingly being deployed to extract structured data from unstructured and semi-structured sources: parsing invoices, medical records, and converting PDF documents to database entries. Yet existing benchmarks for structured output generation either focus on schema compliance alone, or evaluate value correctness within a single source domain. We introduce SOB (The Structured Output Benchmark), a multi-source benchmark spanning three source modalities: native text, images, and audio conversations. All models receive a text-normalized representation of their context regardless of source modality; this deliberate design isolates structured-output capability from raw vision or speech-processing quality, ensuring a fair, source-agnostic comparison. Our benchmark comprises 5,000 text evaluation records derived from multi-hop QA drawn from a 25,091-record full corpus, 209 image records from OCR-processed PDFs across seven document types including multi-column layouts, dense tables, scanned historical documents, small-print text, and mathematical typesetting, and 115 audio records from the AMI corpus. Each record pairs a natural-language question with a JSON schema that the model must follow and a ground-truth answer verified against the source context. We evaluate 21 frontier and open-weight models across three source domains and seven metrics. Our results reveal a consistent pattern: models achieve near-perfect schema compliance, yet the best Value Accuracy, measured by exact leaf-value match, reaches only 83.0% on text, 67.2% on images, and 23.7% on audio, where longer context makes extraction substantially harder. We release the dataset, evaluation pipeline, and all related code.