Daily Papers

While dense biomedical embeddings achieve strong performance, their black-box nature limits their utility in clinical decision-making. Recent question-based interpretable embeddings represent text as binary answers to natural-language questions, but these approaches often rely on heuristic or surface-level contrastive signals and overlook specialized domain knowledge. We propose QIME, an ontology-grounded framework for constructing interpretable medical text embeddings in which each dimension corresponds to a clinically meaningful yes/no question. By conditioning on cluster-specific medical concept signatures, QIME generates semantically atomic questions that capture fine-grained distinctions in biomedical text. Furthermore, QIME supports a training-free embedding construction strategy that eliminates per-question classifier training while further improving performance. Experiments across biomedical semantic similarity, clustering, and retrieval benchmarks show that QIME consistently outperforms prior interpretable embedding methods and substantially narrows the gap to strong black-box biomedical encoders, while providing concise and clinically informative explanations.

Building generalizable AI models is one of the primary challenges in the healthcare domain. While radiologists rely on generalizable descriptive rules of abnormality, Neural Network (NN) models suffer even with a slight shift in input distribution (e.g., scanner type). Fine-tuning a model to transfer knowledge from one domain to another requires a significant amount of labeled data in the target domain. In this paper, we develop an interpretable model that can be efficiently fine-tuned to an unseen target domain with minimal computational cost. We assume the interpretable component of NN to be approximately domain-invariant. However, interpretable models typically underperform compared to their Blackbox (BB) variants. We start with a BB in the source domain and distill it into a mixture of shallow interpretable models using human-understandable concepts. As each interpretable model covers a subset of data, a mixture of interpretable models achieves comparable performance as BB. Further, we use the pseudo-labeling technique from semi-supervised learning (SSL) to learn the concept classifier in the target domain, followed by fine-tuning the interpretable models in the target domain. We evaluate our model using a real-life large-scale chest-X-ray (CXR) classification dataset. The code is available at: https://github.com/batmanlab/MICCAI-2023-Route-interpret-repeat-CXRs.

Deep neural networks (DNNs) have been shown to outperform traditional machine learning algorithms in a broad variety of application domains due to their effectiveness in modeling complex problems and handling high-dimensional datasets. Many real-life datasets, however, are of increasingly high dimensionality, where a large number of features may be irrelevant for both supervised and unsupervised learning tasks. The inclusion of such features would not only introduce unwanted noise but also increase computational complexity. Furthermore, due to high non-linearity and dependency among a large number of features, DNN models tend to be unavoidably opaque and perceived as black-box methods because of their not well-understood internal functioning. Their algorithmic complexity is often simply beyond the capacities of humans to understand the interplay among myriads of hyperparameters. A well-interpretable model can identify statistically significant features and explain the way they affect the model's outcome. In this paper, we propose an efficient method to improve the interpretability of black-box models for classification tasks in the case of high-dimensional datasets. First, we train a black-box model on a high-dimensional dataset to learn the embeddings on which the classification is performed. To decompose the inner working principles of the black-box model and to identify top-k important features, we employ different probing and perturbing techniques. We then approximate the behavior of the black-box model by means of an interpretable surrogate model on the top-k feature space. Finally, we derive decision rules and local explanations from the surrogate model to explain individual decisions. Our approach outperforms state-of-the-art methods like TabNet and XGboost when tested on different datasets with varying dimensionality between 50 and 20,000 w.r.t metrics and explainability.

Neurophysiological recordings such as electroencephalography (EEG) offer accessible and minimally invasive means of estimating physiological activity for applications in healthcare, diagnostic screening, and even immersive entertainment. However, these recordings yield high-dimensional, noisy time-series data that typically require extensive pre-processing and handcrafted feature extraction to reveal meaningful information. Recently, there has been a surge of interest in applying representation learning techniques from large pre-trained (foundation) models to effectively decode and interpret biosignals. We discuss the challenges posed for incorporating such methods and introduce BioCodec, an alternative representation learning framework inspired by neural codecs to capture low-level signal characteristics in the form of discrete tokens. Pre-trained on thousands of EEG hours, BioCodec shows efficacy across multiple downstream tasks, ranging from clinical diagnostic tasks and sleep physiology to decoding speech and motor imagery, particularly in low-resource settings. Additionally, we provide a qualitative analysis of codebook usage and estimate the spatial coherence of codebook embeddings from EEG connectivity. Notably, we also document the suitability of our method to other biosignal data, i.e., electromyographic (EMG) signals. Overall, the proposed approach provides a versatile solution for biosignal tokenization that performs competitively with state-of-the-art models. The source code and model checkpoints are shared.

We focus on the problem of black-box adversarial attacks, where the aim is to generate adversarial examples for deep learning models solely based on information limited to output label~(hard label) to a queried data input. We propose a simple and efficient Bayesian Optimization~(BO) based approach for developing black-box adversarial attacks. Issues with BO's performance in high dimensions are avoided by searching for adversarial examples in a structured low-dimensional subspace. We demonstrate the efficacy of our proposed attack method by evaluating both ell_infty and ell_2 norm constrained untargeted and targeted hard label black-box attacks on three standard datasets - MNIST, CIFAR-10 and ImageNet. Our proposed approach consistently achieves 2x to 10x higher attack success rate while requiring 10x to 20x fewer queries compared to the current state-of-the-art black-box adversarial attacks.

Categorical variables often appear in datasets for classification and regression tasks, and they need to be encoded into numerical values before training. Since many encoders have been developed and can significantly impact performance, choosing the appropriate encoder for a task becomes a time-consuming yet important practical issue. This study broadly classifies machine learning models into three categories: 1) ATI models that implicitly perform affine transformations on inputs, such as multi-layer perceptron neural network; 2) Tree-based models that are based on decision trees, such as random forest; and 3) the rest, such as kNN. Theoretically, we prove that the one-hot encoder is the best choice for ATI models in the sense that it can mimic any other encoders by learning suitable weights from the data. We also explain why the target encoder and its variants are the most suitable encoders for tree-based models. This study conducted comprehensive computational experiments to evaluate 14 encoders, including one-hot and target encoders, along with eight common machine-learning models on 28 datasets. The computational results agree with our theoretical analysis. The findings in this study shed light on how to select the suitable encoder for data scientists in fields such as fraud detection, disease diagnosis, etc.

Deep Neural Networks have created a paradigm shift in our ability to comprehend raw data in various important fields ranging from computer vision and natural language processing to intelligence warfare and healthcare. While DNNs are increasingly deployed either in a white-box setting where the model internal is publicly known, or a black-box setting where only the model outputs are known, a practical concern is protecting the models against Intellectual Property (IP) infringement. We propose BlackMarks, the first end-to-end multi-bit watermarking framework that is applicable in the black-box scenario. BlackMarks takes the pre-trained unmarked model and the owner's binary signature as inputs and outputs the corresponding marked model with a set of watermark keys. To do so, BlackMarks first designs a model-dependent encoding scheme that maps all possible classes in the task to bit '0' and bit '1' by clustering the output activations into two groups. Given the owner's watermark signature (a binary string), a set of key image and label pairs are designed using targeted adversarial attacks. The watermark (WM) is then embedded in the prediction behavior of the target DNN by fine-tuning the model with generated WM key set. To extract the WM, the remote model is queried by the WM key images and the owner's signature is decoded from the corresponding predictions according to the designed encoding scheme. We perform a comprehensive evaluation of BlackMarks's performance on MNIST, CIFAR10, ImageNet datasets and corroborate its effectiveness and robustness. BlackMarks preserves the functionality of the original DNN and incurs negligible WM embedding runtime overhead as low as 2.054%.

Generative models hold promise for revolutionizing medical education, robot-assisted surgery, and data augmentation for medical AI development. Diffusion models can now generate realistic images from text prompts, while recent advancements have demonstrated their ability to create diverse, high-quality videos. However, these models often struggle with generating accurate representations of medical procedures and detailed anatomical structures. This paper introduces Bora, the first spatio-temporal diffusion probabilistic model designed for text-guided biomedical video generation. Bora leverages Transformer architecture and is pre-trained on general-purpose video generation tasks. It is fine-tuned through model alignment and instruction tuning using a newly established medical video corpus, which includes paired text-video data from various biomedical fields. To the best of our knowledge, this is the first attempt to establish such a comprehensive annotated biomedical video dataset. Bora is capable of generating high-quality video data across four distinct biomedical domains, adhering to medical expert standards and demonstrating consistency and diversity. This generalist video generative model holds significant potential for enhancing medical consultation and decision-making, particularly in resource-limited settings. Additionally, Bora could pave the way for immersive medical training and procedure planning. Extensive experiments on distinct medical modalities such as endoscopy, ultrasound, MRI, and cell tracking validate the effectiveness of our model in understanding biomedical instructions and its superior performance across subjects compared to state-of-the-art generation models.

This paper studies the black-box optimization task which aims to find the maxima of a black-box function using a static set of its observed input-output pairs. This is often achieved via learning and optimizing a surrogate function with that offline data. Alternatively, it can also be framed as an inverse modeling task that maps a desired performance to potential input candidates that achieve it. Both approaches are constrained by the limited amount of offline data. To mitigate this limitation, we introduce a new perspective that casts offline optimization as a distributional translation task. This is formulated as learning a probabilistic bridge transforming an implicit distribution of low-value inputs (i.e., offline data) into another distribution of high-value inputs (i.e., solution candidates). Such probabilistic bridge can be learned using low- and high-value inputs sampled from synthetic functions that resemble the target function. These synthetic functions are constructed as the mean posterior of multiple Gaussian processes fitted with different parameterizations on the offline data, alleviating the data bottleneck. The proposed approach is evaluated on an extensive benchmark comprising most recent methods, demonstrating significant improvement and establishing a new state-of-the-art performance. Our code is publicly available at https://github.com/cuong-dm/ROOT.

Deep learning models have shown their potential for several applications. However, most of the models are opaque and difficult to trust due to their complex reasoning - commonly known as the black-box problem. Some fields, such as medicine, require a high degree of transparency to accept and adopt such technologies. Consequently, creating explainable/interpretable models or applying post-hoc methods on classifiers to build trust in deep learning models are required. Moreover, deep learning methods can be used for segmentation tasks, which typically require hard-to-obtain, time-consuming manually-annotated segmentation labels for training. This paper introduces three inherently-explainable classifiers to tackle both of these problems as one. The localisation heatmaps provided by the networks -- representing the models' focus areas and being used in classification decision-making -- can be directly interpreted, without requiring any post-hoc methods to derive information for model explanation. The models are trained by using the input image and only the classification labels as ground-truth in a supervised fashion - without using any information about the location of the region of interest (i.e. the segmentation labels), making the segmentation training of the models weakly-supervised through classification labels. The final segmentation is obtained by thresholding these heatmaps. The models were employed for the task of multi-class brain tumour classification using two different datasets, resulting in the best F1-score of 0.93 for the supervised classification task while securing a median Dice score of 0.67pm0.08 for the weakly-supervised segmentation task. Furthermore, the obtained accuracy on a subset of tumour-only images outperformed the state-of-the-art glioma tumour grading binary classifiers with the best model achieving 98.7\% accuracy.

Current volumetric biomedical foundation models struggle to generalize as public 3D datasets are small and do not cover the broad diversity of medical procedures, conditions, anatomical regions, and imaging protocols. We address this by creating a representation learning method that instead anticipates strong domain shifts at training time itself. We first propose a data engine that synthesizes highly variable training samples that would enable generalization to new biomedical contexts. To then train a single 3D network for any voxel-level task, we develop a contrastive learning method that pretrains the network to be stable against nuisance imaging variation simulated by the data engine, a key inductive bias for generalization. This network's features can be used as robust representations of input images for downstream tasks and its weights provide a strong, dataset-agnostic initialization for finetuning on new datasets. As a result, we set new standards across both multimodality registration and few-shot segmentation, a first for any 3D biomedical vision model, all without (pre-)training on any existing dataset of real images.

With the rapid growth of artificial intelligence (AI) in healthcare, there has been a significant increase in the generation and storage of sensitive medical data. This abundance of data, in turn, has propelled the advancement of medical AI technologies. However, concerns about unauthorized data exploitation, such as training commercial AI models, often deter researchers from making their invaluable datasets publicly available. In response to the need to protect this hard-to-collect data while still encouraging medical institutions to share it, one promising solution is to introduce imperceptible noise into the data. This method aims to safeguard the data against unauthorized training by inducing degradation in model generalization. Although existing methods have shown commendable data protection capabilities in general domains, they tend to fall short when applied to biomedical data, mainly due to their failure to account for the sparse nature of medical images. To address this problem, we propose the Sparsity-Aware Local Masking (SALM) method, a novel approach that selectively perturbs significant pixel regions rather than the entire image as previous strategies have done. This simple-yet-effective approach significantly reduces the perturbation search space by concentrating on local regions, thereby improving both the efficiency and effectiveness of data protection for biomedical datasets characterized by sparse features. Besides, we have demonstrated that SALM maintains the essential characteristics of the data, ensuring its clinical utility remains uncompromised. Our extensive experiments across various datasets and model architectures demonstrate that SALM effectively prevents unauthorized training of deep-learning models and outperforms previous state-of-the-art data protection methods.

Many deployed learned models are black boxes: given input, returns output. Internal information about the model, such as the architecture, optimisation procedure, or training data, is not disclosed explicitly as it might contain proprietary information or make the system more vulnerable. This work shows that such attributes of neural networks can be exposed from a sequence of queries. This has multiple implications. On the one hand, our work exposes the vulnerability of black-box neural networks to different types of attacks -- we show that the revealed internal information helps generate more effective adversarial examples against the black box model. On the other hand, this technique can be used for better protection of private content from automatic recognition models using adversarial examples. Our paper suggests that it is actually hard to draw a line between white box and black box models.

Masked autoencoders (MAEs) are increasingly applied to electronic health records (EHR) for learning general-purpose representations that support diverse clinical tasks. However, existing approaches typically rely on uniform random masking, implicitly assuming all features are equally predictable. In reality, laboratory tests exhibit substantial heterogeneity in volatility: some biomarkers (e.g., sodium) remain stable, while others (e.g., lactate) fluctuate considerably and are more difficult to model. Clinically, volatile biomarkers often signal acute pathophysiology and require more sophisticated modeling to capture their complex temporal patterns. We propose a volatility-aware pretraining strategy, Coefficient of Variation Masking (CV-Masking), that adaptively adjusts masking probabilities according to the intrinsic variability of each feature. Combined with a value-only masking objective aligned with clinical workflows, CV-Masking yields systematic improvements over random and variance-based strategies. Experiments on a large panel of laboratory tests show that CV-Masking enhances reconstruction, improves downstream predictive performance, and accelerates convergence, producing more robust and clinically meaningful EHR representations.

Deep implicit functions have been found to be an effective tool for efficiently encoding all manner of natural signals. Their attractiveness stems from their ability to compactly represent signals with little to no off-line training data. Instead, they leverage the implicit bias of deep networks to decouple hidden redundancies within the signal. In this paper, we explore the hypothesis that additional compression can be achieved by leveraging the redundancies that exist between layers. We propose to use a novel run-time decoder-only hypernetwork - that uses no offline training data - to better model this cross-layer parameter redundancy. Previous applications of hyper-networks with deep implicit functions have applied feed-forward encoder/decoder frameworks that rely on large offline datasets that do not generalize beyond the signals they were trained on. We instead present a strategy for the initialization of run-time deep implicit functions for single-instance signals through a Decoder-Only randomly projected Hypernetwork (D'OH). By directly changing the dimension of a latent code to approximate a target implicit neural architecture, we provide a natural way to vary the memory footprint of neural representations without the costly need for neural architecture search on a space of alternative low-rate structures.

Medical image classification is a critical problem for healthcare, with the potential to alleviate the workload of doctors and facilitate diagnoses of patients. However, two challenges arise when deploying deep learning models to real-world healthcare applications. First, neural models tend to learn spurious correlations instead of desired features, which could fall short when generalizing to new domains (e.g., patients with different ages). Second, these black-box models lack interpretability. When making diagnostic predictions, it is important to understand why a model makes a decision for trustworthy and safety considerations. In this paper, to address these two limitations, we propose a new paradigm to build robust and interpretable medical image classifiers with natural language concepts. Specifically, we first query clinical concepts from GPT-4, then transform latent image features into explicit concepts with a vision-language model. We systematically evaluate our method on eight medical image classification datasets to verify its effectiveness. On challenging datasets with strong confounding factors, our method can mitigate spurious correlations thus substantially outperform standard visual encoders and other baselines. Finally, we show how classification with a small number of concepts brings a level of interpretability for understanding model decisions through case studies in real medical data.

Faced with distribution shift between training and test set, we wish to detect and quantify the shift, and to correct our classifiers without test set labels. Motivated by medical diagnosis, where diseases (targets) cause symptoms (observations), we focus on label shift, where the label marginal p(y) changes but the conditional p(x| y) does not. We propose Black Box Shift Estimation (BBSE) to estimate the test distribution p(y). BBSE exploits arbitrary black box predictors to reduce dimensionality prior to shift correction. While better predictors give tighter estimates, BBSE works even when predictors are biased, inaccurate, or uncalibrated, so long as their confusion matrices are invertible. We prove BBSE's consistency, bound its error, and introduce a statistical test that uses BBSE to detect shift. We also leverage BBSE to correct classifiers. Experiments demonstrate accurate estimates and improved prediction, even on high-dimensional datasets of natural images.

Offline optimization has recently emerged as an increasingly popular approach to mitigate the prohibitively expensive cost of online experimentation. The key idea is to learn a surrogate of the black-box function that underlines the target experiment using a static (offline) dataset of its previous input-output queries. Such an approach is, however, fraught with an out-of-distribution issue where the learned surrogate becomes inaccurate outside the offline data regimes. To mitigate this, existing offline optimizers have proposed numerous conditioning techniques to prevent the learned surrogate from being too erratic. Nonetheless, such conditioning strategies are often specific to particular surrogate or search models, which might not generalize to a different model choice. This motivates us to develop a model-agnostic approach instead, which incorporates a notion of model sharpness into the training loss of the surrogate as a regularizer. Our approach is supported by a new theoretical analysis demonstrating that reducing surrogate sharpness on the offline dataset provably reduces its generalized sharpness on unseen data. Our analysis extends existing theories from bounding generalized prediction loss (on unseen data) with loss sharpness to bounding the worst-case generalized surrogate sharpness with its empirical estimate on training data, providing a new perspective on sharpness regularization. Our extensive experimentation on a diverse range of optimization tasks also shows that reducing surrogate sharpness often leads to significant improvement, marking (up to) a noticeable 9.6% performance boost. Our code is publicly available at https://github.com/cuong-dm/IGNITE

Recently, methods for skeleton-based human activity recognition have been shown to be vulnerable to adversarial attacks. However, these attack methods require either the full knowledge of the victim (i.e. white-box attacks), access to training data (i.e. transfer-based attacks) or frequent model queries (i.e. black-box attacks). All their requirements are highly restrictive, raising the question of how detrimental the vulnerability is. In this paper, we show that the vulnerability indeed exists. To this end, we consider a new attack task: the attacker has no access to the victim model or the training data or labels, where we coin the term hard no-box attack. Specifically, we first learn a motion manifold where we define an adversarial loss to compute a new gradient for the attack, named skeleton-motion-informed (SMI) gradient. Our gradient contains information of the motion dynamics, which is different from existing gradient-based attack methods that compute the loss gradient assuming each dimension in the data is independent. The SMI gradient can augment many gradient-based attack methods, leading to a new family of no-box attack methods. Extensive evaluation and comparison show that our method imposes a real threat to existing classifiers. They also show that the SMI gradient improves the transferability and imperceptibility of adversarial samples in both no-box and transfer-based black-box settings.

Implicit Neural Representations (INRs) and Neural Fields are a novel paradigm for signal representation, from images and audio to 3D scenes and videos. The fundamental idea is to represent a signal as a continuous and differentiable neural network. This idea offers unprecedented benefits such as continuous resolution and memory efficiency, enabling new compression techniques. However, representing data as neural networks poses new challenges. For instance, given a 2D image as a neural network, how can we further compress such a neural image?. In this work, we present a novel analysis on compressing neural fields, with the focus on images. We also introduce Adaptive Neural Images (ANI), an efficient neural representation that enables adaptation to different inference or transmission requirements. Our proposed method allows to reduce the bits-per-pixel (bpp) of the neural image by 4x, without losing sensitive details or harming fidelity. We achieve this thanks to our successful implementation of 4-bit neural representations. Our work offers a new framework for developing compressed neural fields.

Large language models (LLMs) have demonstrated remarkable prediction performance for a growing array of tasks. However, their rapid proliferation and increasing opaqueness have created a growing need for interpretability. Here, we ask whether we can automatically obtain natural language explanations for black box text modules. A "text module" is any function that maps text to a scalar continuous value, such as a submodule within an LLM or a fitted model of a brain region. "Black box" indicates that we only have access to the module's inputs/outputs. We introduce Summarize and Score (SASC), a method that takes in a text module and returns a natural language explanation of the module's selectivity along with a score for how reliable the explanation is. We study SASC in 3 contexts. First, we evaluate SASC on synthetic modules and find that it often recovers ground truth explanations. Second, we use SASC to explain modules found within a pre-trained BERT model, enabling inspection of the model's internals. Finally, we show that SASC can generate explanations for the response of individual fMRI voxels to language stimuli, with potential applications to fine-grained brain mapping. All code for using SASC and reproducing results is made available on Github.

Recent works have shown that deep neural networks are vulnerable to adversarial examples that find samples close to the original image but can make the model misclassify. Even with access only to the model's output, an attacker can employ black-box attacks to generate such adversarial examples. In this work, we propose a simple and lightweight defense against black-box attacks by adding random noise to hidden features at intermediate layers of the model at inference time. Our theoretical analysis confirms that this method effectively enhances the model's resilience against both score-based and decision-based black-box attacks. Importantly, our defense does not necessitate adversarial training and has minimal impact on accuracy, rendering it applicable to any pre-trained model. Our analysis also reveals the significance of selectively adding noise to different parts of the model based on the gradient of the adversarial objective function, which can be varied during the attack. We demonstrate the robustness of our defense against multiple black-box attacks through extensive empirical experiments involving diverse models with various architectures.

We propose a new uncertainty estimator for gradient-free optimisation of black-box simulators using deep generative surrogate models. Optimisation of these simulators is especially challenging for stochastic simulators and higher dimensions. To address these issues, we utilise a deep generative surrogate approach to model the black box response for the entire parameter space. We then leverage this knowledge to estimate the proposed uncertainty based on the Wasserstein distance - the Wasserstein uncertainty. This approach is employed in a posterior agnostic gradient-free optimisation algorithm that minimises regret over the entire parameter space. A series of tests were conducted to demonstrate that our method is more robust to the shape of both the black box function and the stochastic response of the black box than state-of-the-art methods, such as efficient global optimisation with a deep Gaussian process surrogate.

Information retrieval (IR) is essential in biomedical knowledge acquisition and clinical decision support. While recent progress has shown that language model encoders perform better semantic retrieval, training such models requires abundant query-article annotations that are difficult to obtain in biomedicine. As a result, most biomedical IR systems only conduct lexical matching. In response, we introduce BioCPT, a first-of-its-kind Contrastively Pre-trained Transformer model for zero-shot biomedical IR. To train BioCPT, we collected an unprecedented scale of 255 million user click logs from PubMed. With such data, we use contrastive learning to train a pair of closely-integrated retriever and re-ranker. Experimental results show that BioCPT sets new state-of-the-art performance on five biomedical IR tasks, outperforming various baselines including much larger models such as GPT-3-sized cpt-text-XL. In addition, BioCPT also generates better biomedical article and sentence representations for semantic evaluations. As such, BioCPT can be readily applied to various real-world biomedical IR tasks. BioCPT API and code are publicly available at https://github.com/ncbi/BioCPT.

Annotating medical data for training AI models is often costly and limited due to the shortage of specialists with relevant clinical expertise. This challenge is further compounded by privacy and ethical concerns associated with sensitive patient information. As a result, well-trained medical segmentation models on private datasets constitute valuable intellectual property requiring robust protection mechanisms. Existing model protection techniques primarily focus on classification and generative tasks, while segmentation models-crucial to medical image analysis-remain largely underexplored. In this paper, we propose a novel, stealthy, and harmless method, StealthMark, for verifying the ownership of medical segmentation models under black-box conditions. Our approach subtly modulates model uncertainty without altering the final segmentation outputs, thereby preserving the model's performance. To enable ownership verification, we incorporate model-agnostic explanation methods, e.g. LIME, to extract feature attributions from the model outputs. Under specific triggering conditions, these explanations reveal a distinct and verifiable watermark. We further design the watermark as a QR code to facilitate robust and recognizable ownership claims. We conducted extensive experiments across four medical imaging datasets and five mainstream segmentation models. The results demonstrate the effectiveness, stealthiness, and harmlessness of our method on the original model's segmentation performance. For example, when applied to the SAM model, StealthMark consistently achieved ASR above 95% across various datasets while maintaining less than a 1% drop in Dice and AUC scores, significantly outperforming backdoor-based watermarking methods and highlighting its strong potential for practical deployment. Our implementation code is made available at: https://github.com/Qinkaiyu/StealthMark.

Large Language Models (LLMs) have shown remarkable adaptability across domains beyond text, specifically electrocardiograms (ECGs). More specifically, there is a growing body of work exploring the task of generating text from a multi-channeled ECG and corresponding textual prompt. Current approaches typically involve pretraining an ECG-specific encoder with a self-supervised learning (SSL) objective and using the features output by the pretrained encoder to finetune a LLM for natural language generation (NLG). However, these methods are limited by 1) inefficiency from two-stage training and 2) interpretability challenges with encoder-generated features. To address these limitations, we introduce ECG-Byte, an adapted byte pair encoding (BPE) tokenizer pipeline for autoregressive language modeling of ECGs. This approach compresses and encodes ECG signals into tokens, enabling end-to-end LLM training by combining ECG and text tokens directly, while being much more interpretable since the ECG tokens can be directly mapped back to the original signal. Using ECG-Byte, we achieve competitive performance in NLG tasks in only half the time and ~48% of the data required by two-stage approaches.

Domain-specific text embeddings are critical for clinical natural language processing, yet systematic comparisons across model architectures remain limited. This study evaluates ten transformer-based embedding models adapted for cardiology through Low-Rank Adaptation (LoRA) fine-tuning on 106,535 cardiology text pairs derived from authoritative medical textbooks. Results demonstrate that encoder-only architectures, particularly BioLinkBERT, achieve superior domain-specific performance (separation score: 0.510) compared to larger decoder-based models, while requiring significantly fewer computational resources. The findings challenge the assumption that larger language models necessarily produce better domain-specific embeddings and provide practical guidance for clinical NLP system development. All models, training code, and evaluation datasets are publicly available to support reproducible research in medical informatics.

In this paper, we present UNet++, a new, more powerful architecture for medical image segmentation. Our architecture is essentially a deeply-supervised encoder-decoder network where the encoder and decoder sub-networks are connected through a series of nested, dense skip pathways. The re-designed skip pathways aim at reducing the semantic gap between the feature maps of the encoder and decoder sub-networks. We argue that the optimizer would deal with an easier learning task when the feature maps from the decoder and encoder networks are semantically similar. We have evaluated UNet++ in comparison with U-Net and wide U-Net architectures across multiple medical image segmentation tasks: nodule segmentation in the low-dose CT scans of chest, nuclei segmentation in the microscopy images, liver segmentation in abdominal CT scans, and polyp segmentation in colonoscopy videos. Our experiments demonstrate that UNet++ with deep supervision achieves an average IoU gain of 3.9 and 3.4 points over U-Net and wide U-Net, respectively.

The purported "black box" nature of neural networks is a barrier to adoption in applications where interpretability is essential. Here we present DeepLIFT (Deep Learning Important FeaTures), a method for decomposing the output prediction of a neural network on a specific input by backpropagating the contributions of all neurons in the network to every feature of the input. DeepLIFT compares the activation of each neuron to its 'reference activation' and assigns contribution scores according to the difference. By optionally giving separate consideration to positive and negative contributions, DeepLIFT can also reveal dependencies which are missed by other approaches. Scores can be computed efficiently in a single backward pass. We apply DeepLIFT to models trained on MNIST and simulated genomic data, and show significant advantages over gradient-based methods. Video tutorial: http://goo.gl/qKb7pL, ICML slides: bit.ly/deeplifticmlslides, ICML talk: https://vimeo.com/238275076, code: http://goo.gl/RM8jvH.

Medicine is inherently multimodal, with rich data modalities spanning text, imaging, genomics, and more. Generalist biomedical artificial intelligence (AI) systems that flexibly encode, integrate, and interpret this data at scale can potentially enable impactful applications ranging from scientific discovery to care delivery. To enable the development of these models, we first curate MultiMedBench, a new multimodal biomedical benchmark. MultiMedBench encompasses 14 diverse tasks such as medical question answering, mammography and dermatology image interpretation, radiology report generation and summarization, and genomic variant calling. We then introduce Med-PaLM Multimodal (Med-PaLM M), our proof of concept for a generalist biomedical AI system. Med-PaLM M is a large multimodal generative model that flexibly encodes and interprets biomedical data including clinical language, imaging, and genomics with the same set of model weights. Med-PaLM M reaches performance competitive with or exceeding the state of the art on all MultiMedBench tasks, often surpassing specialist models by a wide margin. We also report examples of zero-shot generalization to novel medical concepts and tasks, positive transfer learning across tasks, and emergent zero-shot medical reasoning. To further probe the capabilities and limitations of Med-PaLM M, we conduct a radiologist evaluation of model-generated (and human) chest X-ray reports and observe encouraging performance across model scales. In a side-by-side ranking on 246 retrospective chest X-rays, clinicians express a pairwise preference for Med-PaLM M reports over those produced by radiologists in up to 40.50% of cases, suggesting potential clinical utility. While considerable work is needed to validate these models in real-world use cases, our results represent a milestone towards the development of generalist biomedical AI systems.

Recent research in medical image analysis with deep learning almost exclusively focuses on grid- or voxel-based data representations. We challenge this common choice by introducing MedFuncta, a modality-agnostic continuous data representation based on neural fields. We demonstrate how to scale neural fields from single instances to large datasets by exploiting redundancy in medical signals and by applying an efficient meta-learning approach with a context reduction scheme. We further address the spectral bias in commonly used SIREN activations, by introducing an omega_0-schedule, improving reconstruction quality and convergence speed. We validate our proposed approach on a large variety of medical signals of different dimensions and modalities (1D: ECG; 2D: Chest X-ray, Retinal OCT, Fundus Camera, Dermatoscope, Colon Histopathology, Cell Microscopy; 3D: Brain MRI, Lung CT) and successfully demonstrate that we can solve relevant downstream tasks on these representations. We additionally release a large-scale dataset of > 550k annotated neural fields to promote research in this direction.

Identifying low-dimensional latent structures within high-dimensional data has long been a central topic in the machine learning community, driven by the need for data compression, storage, transmission, and deeper data understanding. Traditional methods, such as principal component analysis (PCA) and autoencoders (AE), operate in an unsupervised manner, ignoring label information even when it is available. In this work, we introduce a unified method capable of learning latent spaces in both unsupervised and supervised settings. We formulate the problem as a nonlinear multiple-response regression within an index model context. By applying the generalized Stein's lemma, the latent space can be estimated without knowing the nonlinear link functions. Our method can be viewed as a nonlinear generalization of PCA. Moreover, unlike AE and other neural network methods that operate as "black boxes", our approach not only offers better interpretability but also reduces computational complexity while providing strong theoretical guarantees. Comprehensive numerical experiments and real data analyses demonstrate the superior performance of our method.

Electrocardiography (ECG) offers critical cardiovascular insights, such as identifying arrhythmias and myocardial ischemia, but enabling automated systems to answer complex clinical questions directly from ECG signals (ECG-QA) remains a significant challenge. Current approaches often lack robust multimodal reasoning capabilities or rely on generic architectures ill-suited for the nuances of physiological signals. We introduce Q-Heart, a novel multimodal framework designed to bridge this gap. Q-Heart leverages a powerful, adapted ECG encoder and integrates its representations with textual information via a specialized ECG-aware transformer-based mapping layer. Furthermore, Q-Heart leverages dynamic prompting and retrieval of relevant historical clinical reports to guide tuning the language model toward knowledge-aware ECG reasoning. Extensive evaluations on the benchmark ECG-QA dataset show Q-Heart achieves state-of-the-art performance, outperforming existing methods by a 4% improvement in exact match accuracy. Our work demonstrates the effectiveness of combining domain-specific architectural adaptations with knowledge-augmented LLM instruction tuning for complex physiological ECG analysis, paving the way for more capable and potentially interpretable clinical patient care systems.

Prototype-based neural networks offer interpretable predictions by comparing inputs to learned, representative signal patterns anchored in training data. While such models have shown promise in the classification of physiological data, it remains unclear whether their prototypes capture an underlying structure that aligns with broader clinical phenotypes. We use a prototype-based deep learning model trained for multi-label ECG classification using the PTB-XL dataset. Then without modification we performed inference on the MIMIC-IV clinical database. We assess whether individual prototypes, trained solely for classification, are associated with hospital discharge diagnoses in the form of phecodes in this external population. Individual prototypes demonstrate significantly stronger and more specific associations with clinical outcomes compared to the classifier's class predictions, NLP-extracted concepts, or broader prototype classes across all phecode categories. Prototype classes with mixed significance patterns exhibit significantly greater intra-class distances (p < 0.0001), indicating the model learned to differentiate clinically meaningful variations within diagnostic categories. The prototypes achieve strong predictive performance across diverse conditions, with AUCs ranging from 0.89 for atrial fibrillation to 0.91 for heart failure, while also showing substantial signal for non-cardiac conditions such as sepsis and renal disease. These findings suggest that prototype-based models can support interpretable digital phenotyping from physiologic time-series data, providing transferable intermediate phenotypes that capture clinically meaningful physiologic signatures beyond their original training objectives.

Machine Learning as a Service (MLaaS) is often provided as a pay-per-query, black-box system to clients. Such a black-box approach not only hinders open replication, validation, and interpretation of model results, but also makes it harder for white-hat researchers to identify vulnerabilities in the MLaaS systems. Model extraction is a promising technique to address these challenges by reverse-engineering black-box models. Since training data is typically unavailable for MLaaS models, this paper focuses on the realistic version of it: data-free model extraction. We propose a data-free model extraction approach, CaBaGe, to achieve higher model extraction accuracy with a small number of queries. Our innovations include (1) a novel experience replay for focusing on difficult training samples; (2) an ensemble of generators for steadily producing diverse synthetic data; and (3) a selective filtering process for querying the victim model with harder, more balanced samples. In addition, we create a more realistic setting, for the first time, where the attacker has no knowledge of the number of classes in the victim training data, and create a solution to learn the number of classes on the fly. Our evaluation shows that CaBaGe outperforms existing techniques on seven datasets -- MNIST, FMNIST, SVHN, CIFAR-10, CIFAR-100, ImageNet-subset, and Tiny ImageNet -- with an accuracy improvement of the extracted models by up to 43.13%. Furthermore, the number of queries required to extract a clone model matching the final accuracy of prior work is reduced by up to 75.7%.

Offline model-based optimization aims to maximize a black-box objective function with a static dataset of designs and their scores. In this paper, we focus on biological sequence design to maximize some sequence score. A recent approach employs bidirectional learning, combining a forward mapping for exploitation and a backward mapping for constraint, and it relies on the neural tangent kernel (NTK) of an infinitely wide network to build a proxy model. Though effective, the NTK cannot learn features because of its parametrization, and its use prevents the incorporation of powerful pre-trained Language Models (LMs) that can capture the rich biophysical information in millions of biological sequences. We adopt an alternative proxy model, adding a linear head to a pre-trained LM, and propose a linearization scheme. This yields a closed-form loss and also takes into account the biophysical information in the pre-trained LM. In addition, the forward mapping and the backward mapping play different roles and thus deserve different weights during sequence optimization. To achieve this, we train an auxiliary model and leverage its weak supervision signal via a bi-level optimization framework to effectively learn how to balance the two mappings. Further, by extending the framework, we develop the first learning rate adaptation module Adaptive-eta, which is compatible with all gradient-based algorithms for offline model-based optimization. Experimental results on DNA/protein sequence design tasks verify the effectiveness of our algorithm. Our code is available~https://anonymous.4open.science/r/BIB-ICLR2023-Submission/README.md{here.}

Multimodal models trained on large natural image-text pair datasets have exhibited astounding abilities in generating high-quality images. Medical imaging data is fundamentally different to natural images, and the language used to succinctly capture relevant details in medical data uses a different, narrow but semantically rich, domain-specific vocabulary. Not surprisingly, multi-modal models trained on natural image-text pairs do not tend to generalize well to the medical domain. Developing generative imaging models faithfully representing medical concepts while providing compositional diversity could mitigate the existing paucity of high-quality, annotated medical imaging datasets. In this work, we develop a strategy to overcome the large natural-medical distributional shift by adapting a pre-trained latent diffusion model on a corpus of publicly available chest x-rays (CXR) and their corresponding radiology (text) reports. We investigate the model's ability to generate high-fidelity, diverse synthetic CXR conditioned on text prompts. We assess the model outputs quantitatively using image quality metrics, and evaluate image quality and text-image alignment by human domain experts. We present evidence that the resulting model (RoentGen) is able to create visually convincing, diverse synthetic CXR images, and that the output can be controlled to a new extent by using free-form text prompts including radiology-specific language. Fine-tuning this model on a fixed training set and using it as a data augmentation method, we measure a 5% improvement of a classifier trained jointly on synthetic and real images, and a 3% improvement when trained on a larger but purely synthetic training set. Finally, we observe that this fine-tuning distills in-domain knowledge in the text-encoder and can improve its representation capabilities of certain diseases like pneumothorax by 25%.

Deep learning classifiers face significant challenges when dealing with heterogeneous multi-modal and multi-organ biomedical datasets. The low-level feature distinguishability limited to imaging-modality hinders the classifiers' ability to learn high-level semantic relationships, resulting in sub-optimal performance. To address this issue, image augmentation strategies are employed as regularization techniques. While additive noise input during network training is a well-established augmentation as regularization method, modern pipelines often favor more robust techniques such as dropout and weight decay. This preference stems from the observation that combining these established techniques with noise input can adversely affect model performance. In this study, we propose a novel pretraining pipeline that learns to generate conditional noise mask specifically tailored to improve performance on multi-modal and multi-organ datasets. As a reinforcement learning algorithm, our approach employs a dual-component system comprising a very light-weight policy network that learns to sample conditional noise using a differentiable beta distribution as well as a classifier network. The policy network is trained using the reinforce algorithm to generate image-specific noise masks that regularize the classifier during pretraining. A key aspect is that the policy network's role is limited to obtaining an intermediate (or heated) model before fine-tuning. During inference, the policy network is omitted, allowing direct comparison between the baseline and noise-regularized models. We conducted experiments and related analyses on RadImageNet datasets. Results demonstrate that fine-tuning the intermediate models consistently outperforms conventional training algorithms on both classification and generalization to unseen concept tasks.

In clinical practice, electrocardiography (ECG) remains the gold standard for cardiac monitoring, providing crucial insights for diagnosing a wide range of cardiovascular diseases (CVDs). However, its reliance on specialized equipment and trained personnel limits feasibility for continuous routine monitoring. Photoplethysmography (PPG) offers accessible, continuous monitoring but lacks definitive electrophysiological information, preventing conclusive diagnosis. Generative models present a promising approach to translate PPG into clinically valuable ECG signals, yet current methods face substantial challenges, including the misalignment of physiological semantics in generative models and the complexity of modeling in high-dimensional signals. To this end, we propose PPGFlowECG, a two-stage framework that aligns PPG and ECG in a shared latent space via the CardioAlign Encoder and employs latent rectified flow to generate ECGs with high fidelity and interpretability. To the best of our knowledge, this is the first study to experiment on MCMED, a newly released clinical-grade dataset comprising over 10 million paired PPG-ECG samples from more than 118,000 emergency department visits with expert-labeled cardiovascular disease annotations. Results demonstrate the effectiveness of our method for PPG-to-ECG translation and cardiovascular disease detection. Moreover, cardiologist-led evaluations confirm that the synthesized ECGs achieve high fidelity and improve diagnostic reliability, underscoring our method's potential for real-world cardiovascular screening.

The increasing depth of parametric domain knowledge in large language models (LLMs) is fueling their rapid deployment in real-world applications. Understanding model vulnerabilities in high-stakes and knowledge-intensive tasks is essential for quantifying the trustworthiness of model predictions and regulating their use. The recent discovery of named entities as adversarial examples (i.e. adversarial entities) in natural language processing tasks raises questions about their potential impact on the knowledge robustness of pre-trained and finetuned LLMs in high-stakes and specialized domains. We examined the use of type-consistent entity substitution as a template for collecting adversarial entities for billion-parameter LLMs with biomedical knowledge. To this end, we developed an embedding-space attack based on powerscaled distance-weighted sampling to assess the robustness of their biomedical knowledge with a low query budget and controllable coverage. Our method has favorable query efficiency and scaling over alternative approaches based on random sampling and blackbox gradient-guided search, which we demonstrated for adversarial distractor generation in biomedical question answering. Subsequent failure mode analysis uncovered two regimes of adversarial entities on the attack surface with distinct characteristics and we showed that entity substitution attacks can manipulate token-wise Shapley value explanations, which become deceptive in this setting. Our approach complements standard evaluations for high-capacity models and the results highlight the brittleness of domain knowledge in LLMs.

Medical images are acquired at high resolutions with large fields of view in order to capture fine-grained features necessary for clinical decision-making. Consequently, training deep learning models on medical images can incur large computational costs. In this work, we address the challenge of downsizing medical images in order to improve downstream computational efficiency while preserving clinically-relevant features. We introduce MedVAE, a family of six large-scale 2D and 3D autoencoders capable of encoding medical images as downsized latent representations and decoding latent representations back to high-resolution images. We train MedVAE autoencoders using a novel two-stage training approach with 1,052,730 medical images. Across diverse tasks obtained from 20 medical image datasets, we demonstrate that (1) utilizing MedVAE latent representations in place of high-resolution images when training downstream models can lead to efficiency benefits (up to 70x improvement in throughput) while simultaneously preserving clinically-relevant features and (2) MedVAE can decode latent representations back to high-resolution images with high fidelity. Our work demonstrates that large-scale, generalizable autoencoders can help address critical efficiency challenges in the medical domain. Our code is available at https://github.com/StanfordMIMI/MedVAE.

Artificial intelligence is revealing what medicine never intended to encode. Deep vision models, trained on chest X-rays, can now detect not only disease but also invisible traces of social inequality. In this study, we show that state-of-the-art architectures (DenseNet121, SwinV2-B, MedMamba) can predict a patient's health insurance type, a strong proxy for socioeconomic status, from normal chest X-rays with significant accuracy (AUC around 0.70 on MIMIC-CXR-JPG, 0.68 on CheXpert). The signal was unlikely contributed by demographic features by our machine learning study combining age, race, and sex labels to predict health insurance types; it also remains detectable when the model is trained exclusively on a single racial group. Patch-based occlusion reveals that the signal is diffuse rather than localized, embedded in the upper and mid-thoracic regions. This suggests that deep networks may be internalizing subtle traces of clinical environments, equipment differences, or care pathways; learning socioeconomic segregation itself. These findings challenge the assumption that medical images are neutral biological data. By uncovering how models perceive and exploit these hidden social signatures, this work reframes fairness in medical AI: the goal is no longer only to balance datasets or adjust thresholds, but to interrogate and disentangle the social fingerprints embedded in clinical data itself.

Existing methods, such as concept bottleneck models (CBMs), have been successful in providing concept-based interpretations for black-box deep learning models. They typically work by predicting concepts given the input and then predicting the final class label given the predicted concepts. However, (1) they often fail to capture the high-order, nonlinear interaction between concepts, e.g., correcting a predicted concept (e.g., "yellow breast") does not help correct highly correlated concepts (e.g., "yellow belly"), leading to suboptimal final accuracy; (2) they cannot naturally quantify the complex conditional dependencies between different concepts and class labels (e.g., for an image with the class label "Kentucky Warbler" and a concept "black bill", what is the probability that the model correctly predicts another concept "black crown"), therefore failing to provide deeper insight into how a black-box model works. In response to these limitations, we propose Energy-based Concept Bottleneck Models (ECBMs). Our ECBMs use a set of neural networks to define the joint energy of candidate (input, concept, class) tuples. With such a unified interface, prediction, concept correction, and conditional dependency quantification are then represented as conditional probabilities, which are generated by composing different energy functions. Our ECBMs address both limitations of existing CBMs, providing higher accuracy and richer concept interpretations. Empirical results show that our approach outperforms the state-of-the-art on real-world datasets.

The application of machine learning to medical ultrasound videos of the heart, i.e., echocardiography, has recently gained traction with the availability of large public datasets. Traditional supervised tasks, such as ejection fraction regression, are now making way for approaches focusing more on the latent structure of data distributions, as well as generative methods. We propose a model trained exclusively by knowledge distillation, either on real or synthetical data, involving retrieving masks suggested by a teacher model. We achieve state-of-the-art (SOTA) values on the task of identifying end-diastolic and end-systolic frames. By training the model only on synthetic data, it reaches segmentation capabilities close to the performance when trained on real data with a significantly reduced number of weights. A comparison with the 5 main existing methods shows that our method outperforms the others in most cases. We also present a new evaluation method that does not require human annotation and instead relies on a large auxiliary model. We show that this method produces scores consistent with those obtained from human annotations. Relying on the integrated knowledge from a vast amount of records, this method overcomes certain inherent limitations of human annotator labeling. Code: https://github.com/GregoirePetit/EchoDFKD

Gaining insight into how deep convolutional neural network models perform image classification and how to explain their outputs have been a concern to computer vision researchers and decision makers. These deep models are often referred to as black box due to low comprehension of their internal workings. As an effort to developing explainable deep learning models, several methods have been proposed such as finding gradients of class output with respect to input image (sensitivity maps), class activation map (CAM), and Gradient based Class Activation Maps (Grad-CAM). These methods under perform when localizing multiple occurrences of the same class and do not work for all CNNs. In addition, Grad-CAM does not capture the entire object in completeness when used on single object images, this affect performance on recognition tasks. With the intention to create an enhanced visual explanation in terms of visual sharpness, object localization and explaining multiple occurrences of objects in a single image, we present Smooth Grad-CAM++ Simple demo: http://35.238.22.135:5000/, a technique that combines methods from two other recent techniques---SMOOTHGRAD and Grad-CAM++. Our Smooth Grad-CAM++ technique provides the capability of either visualizing a layer, subset of feature maps, or subset of neurons within a feature map at each instance at the inference level (model prediction process). After experimenting with few images, Smooth Grad-CAM++ produced more visually sharp maps with better localization of objects in the given input images when compared with other methods.

Segmenting biomarkers in medical images is crucial for various biotech applications. Despite advances, Transformer and CNN based methods often struggle with variations in staining and morphology, limiting feature extraction. In medical image segmentation, where datasets often have limited sample availability, recent state-of-the-art (SOTA) methods achieve higher accuracy by leveraging pre-trained encoders, whereas end-to-end methods tend to underperform. This is due to challenges in effectively transferring rich multiscale features from encoders to decoders, as well as limitations in decoder efficiency. To address these issues, we propose an architecture that captures multi-scale local and global contextual information and a novel decoder design, which effectively integrates features from the encoder, emphasizes important channels and regions, and reconstructs spatial dimensions to enhance segmentation accuracy. Our method, compatible with various encoders, outperforms SOTA methods, as demonstrated by experiments on four datasets and ablation studies. Specifically, our method achieves absolute performance gains of 2.76% on MoNuSeg, 3.12% on DSB, 2.87% on Electron Microscopy, and 4.03% on TNBC datasets compared to existing SOTA methods. Code: https://github.com/saadwazir/MCADS-Decoder

Tokenization strategies shape how models process electronic health records, yet fair comparisons of their effectiveness remain limited. We present a systematic evaluation of tokenization approaches for clinical time series modeling using transformer-based architectures, revealing task-dependent and sometimes counterintuitive findings about temporal and value feature importance. Through controlled ablations across four clinical prediction tasks on MIMIC-IV, we demonstrate that explicit time encodings provide no consistent statistically significant benefit for the evaluated downstream tasks. Value features show task-dependent importance, affecting mortality prediction but not readmission, suggesting code sequences alone can carry sufficient predictive signal. We further show that frozen pretrained code encoders dramatically outperform their trainable counterparts while requiring dramatically fewer parameters. Larger clinical encoders provide consistent improvements across tasks, benefiting from frozen embeddings that eliminate computational overhead. Our controlled evaluation enables fairer tokenization comparisons and demonstrates that simpler, parameter-efficient approaches can, in many cases, achieve strong performance, though the optimal tokenization strategy remains task-dependent.

Anomaly detection in medical images is an important yet challenging task due to the diversity of possible anomalies and the practical impossibility of collecting comprehensively annotated data sets. In this work, we tackle unsupervised medical anomaly detection proposing a modernized autoencoder-based framework, the Q-Former Autoencoder, that leverages state-of-the-art pretrained vision foundation models, such as DINO, DINOv2 and Masked Autoencoder. Instead of training encoders from scratch, we directly utilize frozen vision foundation models as feature extractors, enabling rich, multi-stage, high-level representations without domain-specific fine-tuning. We propose the usage of the Q-Former architecture as the bottleneck, which enables the control of the length of the reconstruction sequence, while efficiently aggregating multiscale features. Additionally, we incorporate a perceptual loss computed using features from a pretrained Masked Autoencoder, guiding the reconstruction towards semantically meaningful structures. Our framework is evaluated on four diverse medical anomaly detection benchmarks, achieving state-of-the-art results on BraTS2021, RESC, and RSNA. Our results highlight the potential of vision foundation model encoders, pretrained on natural images, to generalize effectively to medical image analysis tasks without further fine-tuning. We release the code and models at https://github.com/emirhanbayar/QFAE.

Despite extensive progress on image generation, common deep generative model architectures are not easily applied to lossless compression. For example, VAEs suffer from a compression cost overhead due to their latent variables. This overhead can only be partially eliminated with elaborate schemes such as bits-back coding, often resulting in poor single-sample compression rates. To overcome such problems, we establish a new class of tractable lossless compression models that permit efficient encoding and decoding: Probabilistic Circuits (PCs). These are a class of neural networks involving |p| computational units that support efficient marginalization over arbitrary subsets of the D feature dimensions, enabling efficient arithmetic coding. We derive efficient encoding and decoding schemes that both have time complexity O (log(D) cdot |p|), where a naive scheme would have linear costs in D and |p|, making the approach highly scalable. Empirically, our PC-based (de)compression algorithm runs 5-40 times faster than neural compression algorithms that achieve similar bitrates. By scaling up the traditional PC structure learning pipeline, we achieve state-of-the-art results on image datasets such as MNIST. Furthermore, PCs can be naturally integrated with existing neural compression algorithms to improve the performance of these base models on natural image datasets. Our results highlight the potential impact that non-standard learning architectures may have on neural data compression.

Black-Box Knowledge Distillation (B2KD) is a formulated problem for cloud-to-edge model compression with invisible data and models hosted on the server. B2KD faces challenges such as limited Internet exchange and edge-cloud disparity of data distributions. In this paper, we formalize a two-step workflow consisting of deprivatization and distillation, and theoretically provide a new optimization direction from logits to cell boundary different from direct logits alignment. With its guidance, we propose a new method Mapping-Emulation KD (MEKD) that distills a black-box cumbersome model into a lightweight one. Our method does not differentiate between treating soft or hard responses, and consists of: 1) deprivatization: emulating the inverse mapping of the teacher function with a generator, and 2) distillation: aligning low-dimensional logits of the teacher and student models by reducing the distance of high-dimensional image points. For different teacher-student pairs, our method yields inspiring distillation performance on various benchmarks, and outperforms the previous state-of-the-art approaches.

Chest X-rays (CXRs) are commonly utilized as a low-dose modality for lung screening. Nonetheless, the efficacy of CXRs is somewhat impeded, given that approximately 75% of the lung area overlaps with bone, which in turn hampers the detection and diagnosis of diseases. As a remedial measure, bone suppression techniques have been introduced. The current dual-energy subtraction imaging technique in the clinic requires costly equipment and subjects being exposed to high radiation. To circumvent these issues, deep learning-based image generation algorithms have been proposed. However, existing methods fall short in terms of producing high-quality images and capturing texture details, particularly with pulmonary vessels. To address these issues, this paper proposes a new bone suppression framework, termed BS-Diff, that comprises a conditional diffusion model equipped with a U-Net architecture and a simple enhancement module to incorporate an autoencoder. Our proposed network cannot only generate soft tissue images with a high bone suppression rate but also possesses the capability to capture fine image details. Additionally, we compiled the largest dataset since 2010, including data from 120 patients with high-definition, high-resolution paired CXRs and soft tissue images collected by our affiliated hospital. Extensive experiments, comparative analyses, ablation studies, and clinical evaluations indicate that the proposed BS-Diff outperforms several bone-suppression models across multiple metrics. Our code can be accessed at https://github.com/Benny0323/BS-Diff.

Pre-trained language models like ChatGPT have significantly improved code generation. As these models scale up, there is an increasing need for the output to handle more intricate tasks. Moreover, in bioinformatics, generating functional programs poses additional notable challenges due to the amount of domain knowledge, the need for complicated data operations, and intricate functional dependencies between the operations. Here, we present BioCoder, a benchmark developed to evaluate existing pre-trained models in generating bioinformatics code. In relation to function-code generation, BioCoder covers potential package dependencies, class declarations, and global variables. It incorporates 1026 functions and 1243 methods in Python and Java from GitHub and 253 examples from the Rosalind Project. BioCoder incorporates a fuzz-testing framework for evaluation, and we have applied it to evaluate many models including InCoder, CodeGen, CodeGen2, SantaCoder, StarCoder, StarCoder+, InstructCodeT5+, and ChatGPT. Our detailed analysis of these models emphasizes the importance of domain knowledge, pragmatic code generation, and contextual understanding. Our dataset, benchmark, Docker images, and scripts required for testing are all available at https://github.com/gersteinlab/biocoder.

Recent advancements in mixed-modal generative models have enabled flexible integration of information across image-text content. These models have opened new avenues for developing unified biomedical assistants capable of analyzing biomedical images, answering complex questions about them, and predicting the impact of medical procedures on a patient's health. However, existing resources face challenges such as limited data availability, narrow domain coverage, and restricted sources (e.g., medical papers). To address these gaps, we present MedMax, the first large-scale multimodal biomedical instruction-tuning dataset for mixed-modal foundation models. With 1.47 million instances, MedMax encompasses a diverse range of tasks, including multimodal content generation (interleaved image-text data), biomedical image captioning and generation, visual chatting, and report understanding. These tasks span diverse medical domains such as radiology and histopathology. Subsequently, we fine-tune a mixed-modal foundation model on the MedMax dataset, achieving significant performance improvements: a 26% gain over the Chameleon model and an 18.3% improvement over GPT-4o across 12 downstream biomedical visual question-answering tasks. Additionally, we introduce a unified evaluation suite for biomedical tasks, providing a robust framework to guide the development of next-generation mixed-modal biomedical AI assistants.

We participated in the SynthRAD2025 challenge (Tasks 1 and 2) with a unified pipeline for synthetic CT (sCT) generation from MRI and CBCT, implemented using the KonfAI framework. Our model is a 2.5D U-Net++ with a ResNet-34 encoder, trained jointly across anatomical regions and fine-tuned per region. The loss function combined pixel-wise L1 loss with IMPACT-Synth, a perceptual loss derived from SAM and TotalSegmentator to enhance structural fidelity. Training was performed using AdamW (initial learning rate = 0.001, halved every 25k steps) on patch-based, normalized, body-masked inputs (320x320 for MRI, 256x256 for CBCT), with random flipping as the only augmentation. No post-processing was applied. Final predictions leveraged test-time augmentation and five-fold ensembling. The best model was selected based on validation MAE. Two registration strategies were evaluated: (i) Elastix with mutual information, consistent with the challenge pipeline, and (ii) IMPACT, a feature-based similarity metric leveraging pretrained segmentation networks. On the local test sets, IMPACT-based registration achieved more accurate and anatomically consistent alignments than mutual-information-based registration, resulting in improved sCT synthesis with lower MAE and more realistic anatomical structures. On the public validation set, however, models trained with Elastix-aligned data achieved higher scores, reflecting a registration bias favoring alignment strategies consistent with the evaluation pipeline. This highlights how registration errors can propagate into supervised learning, influencing both training and evaluation, and potentially inflating performance metrics at the expense of anatomical fidelity. By promoting anatomically consistent alignment, IMPACT helps mitigate this bias and supports the development of more robust and generalizable sCT synthesis models.

Safety alignment is critical for the ethical deployment of large language models (LLMs), guiding them to avoid generating harmful or unethical content. Current alignment techniques, such as supervised fine-tuning and reinforcement learning from human feedback, remain fragile and can be bypassed by carefully crafted adversarial prompts. Unfortunately, such attacks rely on trial and error, lack generalizability across models, and are constrained by scalability and reliability. This paper presents NeuroStrike, a novel and generalizable attack framework that exploits a fundamental vulnerability introduced by alignment techniques: the reliance on sparse, specialized safety neurons responsible for detecting and suppressing harmful inputs. We apply NeuroStrike to both white-box and black-box settings: In the white-box setting, NeuroStrike identifies safety neurons through feedforward activation analysis and prunes them during inference to disable safety mechanisms. In the black-box setting, we propose the first LLM profiling attack, which leverages safety neuron transferability by training adversarial prompt generators on open-weight surrogate models and then deploying them against black-box and proprietary targets. We evaluate NeuroStrike on over 20 open-weight LLMs from major LLM developers. By removing less than 0.6% of neurons in targeted layers, NeuroStrike achieves an average attack success rate (ASR) of 76.9% using only vanilla malicious prompts. Moreover, Neurostrike generalizes to four multimodal LLMs with 100% ASR on unsafe image inputs. Safety neurons transfer effectively across architectures, raising ASR to 78.5% on 11 fine-tuned models and 77.7% on five distilled models. The black-box LLM profiling attack achieves an average ASR of 63.7% across five black-box models, including the Google Gemini family.

Multimodal magnetic resonance imaging (MRI) constitutes the first line of investigation for clinicians in the care of brain tumors, providing crucial insights for surgery planning, treatment monitoring, and biomarker identification. Pre-training on large datasets have been shown to help models learn transferable representations and adapt with minimal labeled data. This behavior is especially valuable in medical imaging, where annotations are often scarce. However, applying this paradigm to multimodal medical data introduces a challenge: most existing approaches assume that all imaging modalities are available during both pre-training and fine-tuning. In practice, missing modalities often occur due to acquisition issues, specialist unavailability, or specific experimental designs on small in-house datasets. Consequently, a common approach involves training a separate model for each desired modality combination, making the process both resource-intensive and impractical for clinical use. Therefore, we introduce BM-MAE, a masked image modeling pre-training strategy tailored for multimodal MRI data. The same pre-trained model seamlessly adapts to any combination of available modalities, extracting rich representations that capture both intra- and inter-modal information. This allows fine-tuning on any subset of modalities without requiring architectural changes, while still benefiting from a model pre-trained on the full set of modalities. Extensive experiments show that the proposed pre-training strategy outperforms or remains competitive with baselines that require separate pre-training for each modality subset, while substantially surpassing training from scratch on several downstream tasks. Additionally, it can quickly and efficiently reconstruct missing modalities, highlighting its practical value. Code and trained models are available at: https://github.com/Lucas-rbnt/BM-MAE

Encoder-based transformer models are central to biomedical and clinical Natural Language Processing (NLP), as their bidirectional self-attention makes them well-suited for efficiently extracting structured information from unstructured text through discriminative tasks. However, encoders have seen slower development compared to decoder models, leading to limited domain adaptation in biomedical and clinical settings. We introduce BioClinical ModernBERT, a domain-adapted encoder that builds on the recent ModernBERT release, incorporating long-context processing and substantial improvements in speed and performance for biomedical and clinical NLP. BioClinical ModernBERT is developed through continued pretraining on the largest biomedical and clinical corpus to date, with over 53.5 billion tokens, and addresses a key limitation of prior clinical encoders by leveraging 20 datasets from diverse institutions, domains, and geographic regions, rather than relying on data from a single source. It outperforms existing biomedical and clinical encoders on four downstream tasks spanning a broad range of use cases. We release both base (150M parameters) and large (396M parameters) versions of BioClinical ModernBERT, along with training checkpoints to support further research.

Large language models (LLMs) have shown increasing power on various natural language processing (NLP) tasks. However, tuning these models for downstream tasks usually needs exorbitant costs or is unavailable due to commercial considerations. Recently, black-box tuning has been proposed to address this problem by optimizing task-specific prompts without accessing the gradients and hidden representations. However, most existing works have yet fully exploited the potential of gradient-free optimization under the scenario of few-shot learning. In this paper, we describe BBT-RGB, a suite of straightforward and complementary techniques for enhancing the efficiency and performance of black-box optimization. Specifically, our method includes three plug-and-play components: (1) Two-stage derivative-free optimization strategy that facilitates fast convergence and mitigates overfitting; (2) Automatic verbalizer construction with its novel usage under few-shot settings; (3) Better prompt initialization policy based on instruction search and auto-selected demonstration. Extensive experiments across various tasks on natural language understanding and inference demonstrate the effectiveness of our method. Our codes are publicly available at https://github.com/QiushiSun/BBT-RGB.

From a simple text prompt, generative-AI image models can create stunningly realistic and creative images bounded, it seems, by only our imagination. These models have achieved this remarkable feat thanks, in part, to the ingestion of billions of images collected from nearly every corner of the internet. Many creators have understandably expressed concern over how their intellectual property has been ingested without their permission or a mechanism to opt out of training. As a result, questions of fair use and copyright infringement have quickly emerged. We describe a method that allows us to determine if a model was trained on a specific image or set of images. This method is computationally efficient and assumes no explicit knowledge of the model architecture or weights (so-called black-box membership inference). We anticipate that this method will be crucial for auditing existing models and, looking ahead, ensuring the fairer development and deployment of generative AI models.

Anatomical segmentation is a fundamental task in medical image computing, generally tackled with fully convolutional neural networks which produce dense segmentation masks. These models are often trained with loss functions such as cross-entropy or Dice, which assume pixels to be independent of each other, thus ignoring topological errors and anatomical inconsistencies. We address this limitation by moving from pixel-level to graph representations, which allow to naturally incorporate anatomical constraints by construction. To this end, we introduce HybridGNet, an encoder-decoder neural architecture that leverages standard convolutions for image feature encoding and graph convolutional neural networks (GCNNs) to decode plausible representations of anatomical structures. We also propose a novel image-to-graph skip connection layer which allows localized features to flow from standard convolutional blocks to GCNN blocks, and show that it improves segmentation accuracy. The proposed architecture is extensively evaluated in a variety of domain shift and image occlusion scenarios, and audited considering different types of demographic domain shift. Our comprehensive experimental setup compares HybridGNet with other landmark and pixel-based models for anatomical segmentation in chest x-ray images, and shows that it produces anatomically plausible results in challenging scenarios where other models tend to fail.

The lack of adversarial robustness has been recognized as an important issue for state-of-the-art machine learning (ML) models, e.g., deep neural networks (DNNs). Thereby, robustifying ML models against adversarial attacks is now a major focus of research. However, nearly all existing defense methods, particularly for robust training, made the white-box assumption that the defender has the access to the details of an ML model (or its surrogate alternatives if available), e.g., its architectures and parameters. Beyond existing works, in this paper we aim to address the problem of black-box defense: How to robustify a black-box model using just input queries and output feedback? Such a problem arises in practical scenarios, where the owner of the predictive model is reluctant to share model information in order to preserve privacy. To this end, we propose a general notion of defensive operation that can be applied to black-box models, and design it through the lens of denoised smoothing (DS), a first-order (FO) certified defense technique. To allow the design of merely using model queries, we further integrate DS with the zeroth-order (gradient-free) optimization. However, a direct implementation of zeroth-order (ZO) optimization suffers a high variance of gradient estimates, and thus leads to ineffective defense. To tackle this problem, we next propose to prepend an autoencoder (AE) to a given (black-box) model so that DS can be trained using variance-reduced ZO optimization. We term the eventual defense as ZO-AE-DS. In practice, we empirically show that ZO-AE- DS can achieve improved accuracy, certified robustness, and query complexity over existing baselines. And the effectiveness of our approach is justified under both image classification and image reconstruction tasks. Codes are available at https://github.com/damon-demon/Black-Box-Defense.

Recent progress in vision-language modeling for 3D medical imaging has been fueled by large-scale computed tomography (CT) corpora with paired free-text reports, stronger architectures, and powerful pretrained models. This has enabled applications such as automated report generation and text-conditioned 3D image synthesis. Yet, current approaches struggle with high-resolution, long-sequence volumes: contrastive pretraining often yields vision encoders that are misaligned with clinical language, and slice-wise tokenization blurs fine anatomy, reducing diagnostic performance on downstream tasks. We introduce BTB3D (Better Tokens for Better 3D), a causal convolutional encoder-decoder that unifies 2D and 3D training and inference while producing compact, frequency-aware volumetric tokens. A three-stage training curriculum enables (i) local reconstruction, (ii) overlapping-window tiling, and (iii) long-context decoder refinement, during which the model learns from short slice excerpts yet generalizes to scans exceeding 300 slices without additional memory overhead. BTB3D sets a new state-of-the-art on two key tasks: it improves BLEU scores and increases clinical F1 by 40% over CT2Rep, CT-CHAT, and Merlin for report generation; and it reduces FID by 75% and halves FVD compared to GenerateCT and MedSyn for text-to-CT synthesis, producing anatomically consistent 512*512*241 volumes. These results confirm that precise three-dimensional tokenization, rather than larger language backbones alone, is essential for scalable vision-language modeling in 3D medical imaging. The codebase is available at: https://github.com/ibrahimethemhamamci/BTB3D

De novo drug design requires simultaneously generating novel molecules outside of training data and predicting their target properties, making it a hard task for generative models. To address this, we propose Joint Transformer that combines a Transformer decoder, Transformer encoder, and a predictor in a joint generative model with shared weights. We formulate a probabilistic black-box optimization algorithm that employs Joint Transformer to generate novel molecules with improved target properties and outperforms other SMILES-based optimization methods in de novo drug design.

Advances in deep learning have significantly enhanced medical image analysis, yet the availability of large-scale medical datasets remains constrained by patient privacy concerns. We present EchoFlow, a novel framework designed to generate high-quality, privacy-preserving synthetic echocardiogram images and videos. EchoFlow comprises four key components: an adversarial variational autoencoder for defining an efficient latent representation of cardiac ultrasound images, a latent image flow matching model for generating accurate latent echocardiogram images, a latent re-identification model to ensure privacy by filtering images anatomically, and a latent video flow matching model for animating latent images into realistic echocardiogram videos conditioned on ejection fraction. We rigorously evaluate our synthetic datasets on the clinically relevant task of ejection fraction regression and demonstrate, for the first time, that downstream models trained exclusively on EchoFlow-generated synthetic datasets achieve performance parity with models trained on real datasets. We release our models and synthetic datasets, enabling broader, privacy-compliant research in medical ultrasound imaging at https://huggingface.co/spaces/HReynaud/EchoFlow.

Despite the outstanding performance of deep learning models in clinical prediction tasks, explainability remains a significant challenge. Inspired by transformer architectures, we introduce the Temporal-Feature Cross Attention Mechanism (TFCAM), a novel deep learning framework designed to capture dynamic interactions among clinical features across time, enhancing both predictive accuracy and interpretability. In an experiment with 1,422 patients with Chronic Kidney Disease, predicting progression to End-Stage Renal Disease, TFCAM outperformed LSTM and RETAIN baselines, achieving an AUROC of 0.95 and an F1-score of 0.69. Beyond performance gains, TFCAM provides multi-level explainability by identifying critical temporal periods, ranking feature importance, and quantifying how features influence each other across time before affecting predictions. Our approach addresses the "black box" limitations of deep learning in healthcare, offering clinicians transparent insights into disease progression mechanisms while maintaining state-of-the-art predictive performance.

Medical coding is the task of assigning medical codes to clinical free-text documentation. Healthcare professionals manually assign such codes to track patient diagnoses and treatments. Automated medical coding can considerably alleviate this administrative burden. In this paper, we reproduce, compare, and analyze state-of-the-art automated medical coding machine learning models. We show that several models underperform due to weak configurations, poorly sampled train-test splits, and insufficient evaluation. In previous work, the macro F1 score has been calculated sub-optimally, and our correction doubles it. We contribute a revised model comparison using stratified sampling and identical experimental setups, including hyperparameters and decision boundary tuning. We analyze prediction errors to validate and falsify assumptions of previous works. The analysis confirms that all models struggle with rare codes, while long documents only have a negligible impact. Finally, we present the first comprehensive results on the newly released MIMIC-IV dataset using the reproduced models. We release our code, model parameters, and new MIMIC-III and MIMIC-IV training and evaluation pipelines to accommodate fair future comparisons.

We study neural image compression based on the Sparse Visual Representation (SVR), where images are embedded into a discrete latent space spanned by learned visual codebooks. By sharing codebooks with the decoder, the encoder transfers integer codeword indices that are efficient and cross-platform robust, and the decoder retrieves the embedded latent feature using the indices for reconstruction. Previous SVR-based compression lacks effective mechanism for rate-distortion tradeoffs, where one can only pursue either high reconstruction quality or low transmission bitrate. We propose a Masked Adaptive Codebook learning (M-AdaCode) method that applies masks to the latent feature subspace to balance bitrate and reconstruction quality. A set of semantic-class-dependent basis codebooks are learned, which are weighted combined to generate a rich latent feature for high-quality reconstruction. The combining weights are adaptively derived from each input image, providing fidelity information with additional transmission costs. By masking out unimportant weights in the encoder and recovering them in the decoder, we can trade off reconstruction quality for transmission bits, and the masking rate controls the balance between bitrate and distortion. Experiments over the standard JPEG-AI dataset demonstrate the effectiveness of our M-AdaCode approach.

Electroencephalography (EEG) enables non-invasive monitoring of brain activity across clinical and neurotechnology applications, yet building foundation models for EEG remains challenging due to differing electrode topologies and computational scalability, as Transformer architectures incur quadratic sequence complexity. As a joint solution, we propose LuMamba (Latent Unified Mamba), a self-supervised framework combining topology-invariant encodings with linear-complexity state-space modeling, using LUNA's learned-query cross-attention mechanism for channel unification~luna, and FEMBA's bidirectional Mamba blocks for efficient temporal modeling~femba. Within this architecture, we provide the first systematic investigation of the Latent-Euclidean Joint-Embedding Predictive Architecture (LeJEPA) for biosignal learning. Pre-trained on over 21,000 hours of unlabeled EEG from the TUEG corpus, LuMamba is evaluated on five downstream tasks spanning abnormality detection, artifact recognition, and mental condition classification across electrode configurations ranging from 16 to 26 channels. In the pre-training objective, masked reconstruction alone yields structured but less generalizable representations, while LeJEPA alone produces diffuse embeddings; combining both objectives achieves the most robust performance. With only 4.6M parameters, LuMamba attains 80.99\% balanced accuracy on TUAB and achieves state-of-art performance on Alzheimer's detection (0.97 AUPR), while requiring 377times fewer FLOPS than state-of-art models at equivalent sequence lengths and scaling to 12times longer sequences before reaching typical GPU memory limits. Code is available at https://github.com/pulp-bio/biofoundation

With the surge of large-scale pre-trained models (PTMs), fine-tuning these models to numerous downstream tasks becomes a crucial problem. Consequently, parameter efficient transfer learning (PETL) of large models has grasped huge attention. While recent PETL methods showcase impressive performance, they rely on optimistic assumptions: 1) the entire parameter set of a PTM is available, and 2) a sufficiently large memory capacity for the fine-tuning is equipped. However, in most real-world applications, PTMs are served as a black-box API or proprietary software without explicit parameter accessibility. Besides, it is hard to meet a large memory requirement for modern PTMs. In this work, we propose black-box visual prompting (BlackVIP), which efficiently adapts the PTMs without knowledge about model architectures and parameters. BlackVIP has two components; 1) Coordinator and 2) simultaneous perturbation stochastic approximation with gradient correction (SPSA-GC). The Coordinator designs input-dependent image-shaped visual prompts, which improves few-shot adaptation and robustness on distribution/location shift. SPSA-GC efficiently estimates the gradient of a target model to update Coordinator. Extensive experiments on 16 datasets demonstrate that BlackVIP enables robust adaptation to diverse domains without accessing PTMs' parameters, with minimal memory requirements. Code: https://github.com/changdaeoh/BlackVIP

Quantized neural networks employ reduced precision representations for both weights and activations. This quantization process significantly reduces the memory requirements and computational complexity of the network. Binary Neural Networks (BNNs) are the extreme quantization case, representing values with just one bit. Since the sign function is typically used to map real values to binary values, smooth approximations are introduced to mimic the gradients during error backpropagation. Thus, the mismatch between the forward and backward models corrupts the direction of the gradient, causing training inconsistency problems and performance degradation. In contrast to current BNN approaches, we propose to employ a binary periodic (BiPer) function during binarization. Specifically, we use a square wave for the forward pass to obtain the binary values and employ the trigonometric sine function with the same period of the square wave as a differentiable surrogate during the backward pass. We demonstrate that this approach can control the quantization error by using the frequency of the periodic function and improves network performance. Extensive experiments validate the effectiveness of BiPer in benchmark datasets and network architectures, with improvements of up to 1% and 0.69% with respect to state-of-the-art methods in the classification task over CIFAR-10 and ImageNet, respectively. Our code is publicly available at https://github.com/edmav4/BiPer.

Lung diseases represent a significant global health challenge, with Chest X-Ray (CXR) being a key diagnostic tool due to their accessibility and affordability. Nonetheless, the detection of pulmonary lesions is often hindered by overlapping bone structures in CXR images, leading to potential misdiagnoses. To address this issue, we developed an end-to-end framework called BS-LDM, designed to effectively suppress bone in high-resolution CXR images. This framework is based on conditional latent diffusion models and incorporates a multi-level hybrid loss-constrained vector-quantized generative adversarial network which is crafted for perceptual compression, ensuring the preservation of details. To further enhance the framework's performance, we introduce offset noise and a temporal adaptive thresholding strategy. These additions help minimize discrepancies in generating low-frequency information, thereby improving the clarity of the generated soft tissue images. Additionally, we have compiled a high-quality bone suppression dataset named SZCH-X-Rays. This dataset includes 818 pairs of high-resolution CXR and dual-energy subtraction soft tissue images collected from a partner hospital. Moreover, we processed 241 data pairs from the JSRT dataset into negative images, which are more commonly used in clinical practice. Our comprehensive experimental and clinical evaluations reveal that BS-LDM excels in bone suppression, underscoring its significant clinical value.

Developing effective biomedical retrieval models is important for excelling at knowledge-intensive biomedical tasks but still challenging due to the deficiency of sufficient publicly annotated biomedical data and computational resources. We present BMRetriever, a series of dense retrievers for enhancing biomedical retrieval via unsupervised pre-training on large biomedical corpora, followed by instruction fine-tuning on a combination of labeled datasets and synthetic pairs. Experiments on 5 biomedical tasks across 11 datasets verify BMRetriever's efficacy on various biomedical applications. BMRetriever also exhibits strong parameter efficiency, with the 410M variant outperforming baselines up to 11.7 times larger, and the 2B variant matching the performance of models with over 5B parameters. The training data and model checkpoints are released at https://huggingface.co/BMRetriever to ensure transparency, reproducibility, and application to new domains.

Existing tasks fall short in evaluating reasoning ability of Large Language Models (LLMs) in an interactive, unknown environment. This deficiency leads to the isolated assessment of deductive, inductive, and abductive reasoning, neglecting the integrated reasoning process that is indispensable for humans discovery of real world. We introduce a novel evaluation paradigm, black-box interaction, to tackle this challenge. A black-box is defined by a hidden function that maps a specific set of inputs to outputs. LLMs are required to unravel the hidden function behind the black-box by interacting with it in given exploration turns, and reasoning over observed input-output pairs. Leveraging this idea, we build the Oracle benchmark which comprises 6 types of black-box task and 96 black-boxes. 19 modern LLMs are benchmarked. o3 ranks first in 5 of the 6 tasks, achieving over 70\% accuracy on most easy black-boxes. But it still struggles with some hard black-box tasks, where its average performance drops below 40\%. Further analysis indicates a universal difficulty among LLMs: They lack the high-level planning capability to develop efficient and adaptive exploration strategies for hypothesis refinement.

Deep neural networks are widely used for classification. These deep models often suffer from a lack of interpretability -- they are particularly difficult to understand because of their non-linear nature. As a result, neural networks are often treated as "black box" models, and in the past, have been trained purely to optimize the accuracy of predictions. In this work, we create a novel network architecture for deep learning that naturally explains its own reasoning for each prediction. This architecture contains an autoencoder and a special prototype layer, where each unit of that layer stores a weight vector that resembles an encoded training input. The encoder of the autoencoder allows us to do comparisons within the latent space, while the decoder allows us to visualize the learned prototypes. The training objective has four terms: an accuracy term, a term that encourages every prototype to be similar to at least one encoded input, a term that encourages every encoded input to be close to at least one prototype, and a term that encourages faithful reconstruction by the autoencoder. The distances computed in the prototype layer are used as part of the classification process. Since the prototypes are learned during training, the learned network naturally comes with explanations for each prediction, and the explanations are loyal to what the network actually computes.

Purpose: Hard-to-interpret Black-box Machine Learning (ML) were often used for early Alzheimer's Disease (AD) detection. Methods: To interpret eXtreme Gradient Boosting (XGBoost), Random Forest (RF), and Support Vector Machine (SVM) black-box models a workflow based on Shapley values was developed. All models were trained on the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset and evaluated for an independent ADNI test set, as well as the external Australian Imaging and Lifestyle flagship study of Ageing (AIBL), and Open Access Series of Imaging Studies (OASIS) datasets. Shapley values were compared to intuitively interpretable Decision Trees (DTs), and Logistic Regression (LR), as well as natural and permutation feature importances. To avoid the reduction of the explanation validity caused by correlated features, forward selection and aspect consolidation were implemented. Results: Some black-box models outperformed DTs and LR. The forward-selected features correspond to brain areas previously associated with AD. Shapley values identified biologically plausible associations with moderate to strong correlations with feature importances. The most important RF features to predict AD conversion were the volume of the amygdalae, and a cognitive test score. Good cognitive test performances and large brain volumes decreased the AD risk. The models trained using cognitive test scores significantly outperformed brain volumetric models (p<0.05). Cognitive Normal (CN) vs. AD models were successfully transferred to external datasets. Conclusion: In comparison to previous work, improved performances for ADNI and AIBL were achieved for CN vs. Mild Cognitive Impairment (MCI) classification using brain volumes. The Shapley values and the feature importances showed moderate to strong correlations.

Prostate cancer, a growing global health concern, necessitates precise diagnostic tools, with Magnetic Resonance Imaging (MRI) offering high-resolution soft tissue imaging that significantly enhances diagnostic accuracy. Recent advancements in explainable AI and representation learning have significantly improved prostate cancer diagnosis by enabling automated and precise lesion classification. However, existing explainable AI methods, particularly those based on frameworks like generative adversarial networks (GANs), are predominantly developed for natural image generation, and their application to medical imaging often leads to suboptimal performance due to the unique characteristics and complexity of medical image. To address these challenges, our paper introduces three key contributions. First, we propose ProjectedEx, a generative framework that provides interpretable, multi-attribute explanations, effectively linking medical image features to classifier decisions. Second, we enhance the encoder module by incorporating feature pyramids, which enables multiscale feedback to refine the latent space and improves the quality of generated explanations. Additionally, we conduct comprehensive experiments on both the generator and classifier, demonstrating the clinical relevance and effectiveness of ProjectedEx in enhancing interpretability and supporting the adoption of AI in medical settings. Code will be released at https://github.com/Richardqiyi/ProjectedEx

Accurate interpretation of Electrocardiogram (ECG) signals is pivotal for diagnosing cardiovascular diseases. Integrating ECG signals with their accompanying textual reports holds immense potential to enhance clinical diagnostics through the combination of physiological data and qualitative insights. However, this integration faces significant challenges due to inherent modality disparities and the scarcity of labeled data for robust cross-modal learning. To address these obstacles, we propose C-MELT, a novel framework that pre-trains ECG and text data using a contrastive masked auto-encoder architecture. C-MELT uniquely combines the strengths of generative with enhanced discriminative capabilities to achieve robust cross-modal representations. This is accomplished through masked modality modeling, specialized loss functions, and an improved negative sampling strategy tailored for cross-modal alignment. Extensive experiments on five public datasets across diverse downstream tasks demonstrate that C-MELT significantly outperforms existing methods, achieving 15% and 2% increases in linear probing and zero-shot performance over state-of-the-art models, respectively. These results highlight the effectiveness of C-MELT, underscoring its potential to advance automated clinical diagnostics through multi-modal representations.

Cardiovascular disease remains the leading cause of global mortality, with progress hindered by human interpretation of complex cardiac tests. Current AI vision-language models are limited to single-modality inputs and are non-interactive. We present MARCUS (Multimodal Autonomous Reasoning and Chat for Ultrasound and Signals), an agentic vision-language system for end-to-end interpretation of electrocardiograms (ECGs), echocardiograms, and cardiac magnetic resonance imaging (CMR) independently and as multimodal input. MARCUS employs a hierarchical agentic architecture comprising modality-specific vision-language expert models, each integrating domain-trained visual encoders with multi-stage language model optimization, coordinated by a multimodal orchestrator. Trained on 13.5 million images (0.25M ECGs, 1.3M echocardiogram images, 12M CMR images) and our novel expert-curated dataset spanning 1.6 million questions, MARCUS achieves state-of-the-art performance surpassing frontier models (GPT-5 Thinking, Gemini 2.5 Pro Deep Think). Across internal (Stanford) and external (UCSF) test cohorts, MARCUS achieves accuracies of 87-91% for ECG, 67-86% for echocardiography, and 85-88% for CMR, outperforming frontier models by 34-45% (P<0.001). On multimodal cases, MARCUS achieved 70% accuracy, nearly triple that of frontier models (22-28%), with 1.7-3.0x higher free-text quality scores. Our agentic architecture also confers resistance to mirage reasoning, whereby vision-language models derive reasoning from unintended textual signals or hallucinated visual content. MARCUS demonstrates that domain-specific visual encoders with an agentic orchestrator enable multimodal cardiac interpretation. We release our models, code, and benchmark open-source.

Modern image-to-text systems typically adopt the encoder-decoder framework, which comprises two main components: an image encoder, responsible for extracting image features, and a transformer-based decoder, used for generating captions. Taking inspiration from the analysis of neural networks' robustness against adversarial perturbations, we propose a novel gray-box algorithm for creating adversarial examples in image-to-text models. Unlike image classification tasks that have a finite set of class labels, finding visually similar adversarial examples in an image-to-text task poses greater challenges because the captioning system allows for a virtually infinite space of possible captions. In this paper, we present a gray-box adversarial attack on image-to-text, both untargeted and targeted. We formulate the process of discovering adversarial perturbations as an optimization problem that uses only the image-encoder component, meaning the proposed attack is language-model agnostic. Through experiments conducted on the ViT-GPT2 model, which is the most-used image-to-text model in Hugging Face, and the Flickr30k dataset, we demonstrate that our proposed attack successfully generates visually similar adversarial examples, both with untargeted and targeted captions. Notably, our attack operates in a gray-box manner, requiring no knowledge about the decoder module. We also show that our attacks fool the popular open-source platform Hugging Face.

Electroencephalography (EEG) captures neural activity across multiple temporal and spectral scales, yielding signals that are rich but complex for representation learning. Recently, EEG foundation models trained to predict masked signal-tokens have shown promise for learning generalizable representations. However, their performance is hindered by their signal tokenization modules. Existing neural tokenizers fail to preserve high-frequency dynamics, limiting their ability to reconstruct EEG signals with high fidelity. We introduce NeuroRVQ, a scalable Large Brainwave Model (LBM) centered on a codebook-based tokenizer. Our tokenizer integrates: (i) multi-scale feature extraction modules that capture the full frequency neural spectrum; (ii) hierarchical residual vector quantization (RVQ) codebooks for high-resolution encoding; and, (iii) an EEG signal phase- and amplitude-aware loss function for efficient training. This design enables efficient EEG compression while supporting accurate reconstruction across all frequency bands, leading to robust generative masked modeling. Our empirical results demonstrate that NeuroRVQ achieves lower reconstruction error and outperforms existing LBMs on a variety of downstream tasks. More broadly, NeuroRVQ tokenizer establishes a strong prior for codebook-based general-purpose brainwave models, enabling advances in neural decoding, generative modeling and multimodal biosignal integration.

The ability of deep neural networks (DNNs) come from extracting and interpreting features from the data provided. By exploiting intermediate features in DNNs instead of relying on hard labels, we craft adversarial perturbation that generalize more effectively, boosting black-box transferability. These features ubiquitously come from supervised learning in previous work. Inspired by the exceptional synergy between self-supervised learning and the Transformer architecture, this paper explores whether exploiting self-supervised Vision Transformer (ViT) representations can improve adversarial transferability. We present dSVA -- a generative dual self-supervised ViT features attack, that exploits both global structural features from contrastive learning (CL) and local textural features from masked image modeling (MIM), the self-supervised learning paradigm duo for ViTs. We design a novel generative training framework that incorporates a generator to create black-box adversarial examples, and strategies to train the generator by exploiting joint features and the attention mechanism of self-supervised ViTs. Our findings show that CL and MIM enable ViTs to attend to distinct feature tendencies, which, when exploited in tandem, boast great adversarial generalizability. By disrupting dual deep features distilled by self-supervised ViTs, we are rewarded with remarkable black-box transferability to models of various architectures that outperform state-of-the-arts. Code available at https://github.com/spencerwooo/dSVA.

In recent years, there is strong emphasis on mining medical data using machine learning techniques. A common problem is to obtain a noiseless set of textual documents, with a relevant content for the research question, and developing a Question Answering (QA) model for a specific medical field. The purpose of this paper is to present a new methodology for building a medical dataset and obtain a QA model for analysis of symptoms and impact on daily life for a specific disease domain. The ``Mental Health'' forum was used, a forum dedicated to people suffering from schizophrenia and different mental disorders. Relevant posts of active users, who regularly participate, were extrapolated providing a new method of obtaining low-bias content and without privacy issues. Furthermore, it is shown how to pre-process the dataset to convert it into a QA dataset. The Bidirectional Encoder Representations from Transformers (BERT), DistilBERT, RoBERTa, and BioBERT models were fine-tuned and evaluated via F1-Score, Exact Match, Precision and Recall. Accurate empirical experiments demonstrated the effectiveness of the proposed method for obtaining an accurate dataset for QA model implementation. By fine-tuning the BioBERT QA model, we achieved an F1 score of 0.885, showing a considerable improvement and outperforming the state-of-the-art model for mental disorders domain.

Ensuring the quality and integrity of medical images is crucial for maintaining diagnostic accuracy in deep learning-based Computer-Aided Diagnosis and Computer-Aided Detection (CAD) systems. Covariate shifts are subtle variations in the data distribution caused by different imaging devices or settings and can severely degrade model performance, similar to the effects of adversarial attacks. Therefore, it is vital to have a lightweight and fast method to assess the quality of these images prior to using CAD models. AdverX-Ray addresses this need by serving as an image-quality assessment layer, designed to detect covariate shifts effectively. This Adversarial Variational Autoencoder prioritizes the discriminator's role, using the suboptimal outputs of the generator as negative samples to fine-tune the discriminator's ability to identify high-frequency artifacts. Images generated by adversarial networks often exhibit severe high-frequency artifacts, guiding the discriminator to focus excessively on these components. This makes the discriminator ideal for this approach. Trained on patches from X-ray images of specific machine models, AdverX-Ray can evaluate whether a scan matches the training distribution, or if a scan from the same machine is captured under different settings. Extensive comparisons with various OOD detection methods show that AdverX-Ray significantly outperforms existing techniques, achieving a 96.2% average AUROC using only 64 random patches from an X-ray. Its lightweight and fast architecture makes it suitable for real-time applications, enhancing the reliability of medical imaging systems. The code and pretrained models are publicly available.

Prompting interfaces allow users to quickly adjust the output of generative models in both vision and language. However, small changes and design choices in the prompt can lead to significant differences in the output. In this work, we develop a black-box framework for generating adversarial prompts for unstructured image and text generation. These prompts, which can be standalone or prepended to benign prompts, induce specific behaviors into the generative process, such as generating images of a particular object or generating high perplexity text.

Language-supervised pre-training has proven to be a valuable method for extracting semantically meaningful features from images, serving as a foundational element in multimodal systems within the computer vision and medical imaging domains. However, resulting features are limited by the information contained within the text. This is particularly problematic in medical imaging, where radiologists' written findings focus on specific observations; a challenge compounded by the scarcity of paired imaging-text data due to concerns over leakage of personal health information. In this work, we fundamentally challenge the prevailing reliance on language supervision for learning general purpose biomedical imaging encoders. We introduce RAD-DINO, a biomedical image encoder pre-trained solely on unimodal biomedical imaging data that obtains similar or greater performance than state-of-the-art biomedical language supervised models on a diverse range of benchmarks. Specifically, the quality of learned representations is evaluated on standard imaging tasks (classification and semantic segmentation), and a vision-language alignment task (text report generation from images). To further demonstrate the drawback of language supervision, we show that features from RAD-DINO correlate with other medical records (e.g., sex or age) better than language-supervised models, which are generally not mentioned in radiology reports. Finally, we conduct a series of ablations determining the factors in RAD-DINO's performance; notably, we observe that RAD-DINO's downstream performance scales well with the quantity and diversity of training data, demonstrating that image-only supervision is a scalable approach for training a foundational biomedical image encoder.

Interpreting electrocardiograms (ECGs) and generating comprehensive reports remain challenging tasks in cardiology, often requiring specialized expertise and significant time investment. To address these critical issues, we propose ECG-ReGen, a retrieval-based approach for ECG-to-text report generation and question answering. Our method leverages a self-supervised learning for the ECG encoder, enabling efficient similarity searches and report retrieval. By combining pre-training with dynamic retrieval and Large Language Model (LLM)-based refinement, ECG-ReGen effectively analyzes ECG data and answers related queries, with the potential of improving patient care. Experiments conducted on the PTB-XL and MIMIC-IV-ECG datasets demonstrate superior performance in both in-domain and cross-domain scenarios for report generation. Furthermore, our approach exhibits competitive performance on ECG-QA dataset compared to fully supervised methods when utilizing off-the-shelf LLMs for zero-shot question answering. This approach, effectively combining self-supervised encoder and LLMs, offers a scalable and efficient solution for accurate ECG interpretation, holding significant potential to enhance clinical decision-making.

Note: This paper describes an older version of DeepLIFT. See https://arxiv.org/abs/1704.02685 for the newer version. Original abstract follows: The purported "black box" nature of neural networks is a barrier to adoption in applications where interpretability is essential. Here we present DeepLIFT (Learning Important FeaTures), an efficient and effective method for computing importance scores in a neural network. DeepLIFT compares the activation of each neuron to its 'reference activation' and assigns contribution scores according to the difference. We apply DeepLIFT to models trained on natural images and genomic data, and show significant advantages over gradient-based methods.

We introduce an algorithm where the individual bits representing the weights of a neural network are learned. This method allows training weights with integer values on arbitrary bit-depths and naturally uncovers sparse networks, without additional constraints or regularization techniques. We show better results than the standard training technique with fully connected networks and similar performance as compared to standard training for convolutional and residual networks. By training bits in a selective manner we found that the biggest contribution to achieving high accuracy is given by the first three most significant bits, while the rest provide an intrinsic regularization. As a consequence more than 90\% of a network can be used to store arbitrary codes without affecting its accuracy. These codes may be random noise, binary files or even the weights of previously trained networks.

In recent years, the incidence of vision-threatening eye diseases has risen dramatically, necessitating scalable and accurate screening solutions. This paper presents a comprehensive study on deep learning architectures for the automated diagnosis of ocular conditions. To mitigate the "black-box" limitations of standard convolutional neural networks (CNNs), we implement a pipeline that combines deep feature extraction with interpretable image processing modules. Specifically, we focus on high-fidelity retinal vessel segmentation as an auxiliary task to guide the classification process. By grounding the model's predictions in clinically relevant morphological features, we aim to bridge the gap between algorithmic output and expert medical validation, thereby reducing false positives and improving deployment viability in clinical settings.

Semantic text embedding is essential to many tasks in Natural Language Processing (NLP). While black-box models are capable of generating high-quality embeddings, their lack of interpretability limits their use in tasks that demand transparency. Recent approaches have improved interpretability by leveraging domain-expert-crafted or LLM-generated questions, but these methods rely heavily on expert input or well-prompt design, which restricts their generalizability and ability to generate discriminative questions across a wide range of tasks. To address these challenges, we introduce CQG-MBQA (Contrastive Question Generation - Multi-task Binary Question Answering), a general framework for producing interpretable semantic text embeddings across diverse tasks. Our framework systematically generates highly discriminative, low cognitive load yes/no questions through the CQG method and answers them efficiently with the MBQA model, resulting in interpretable embeddings in a cost-effective manner. We validate the effectiveness and interpretability of CQG-MBQA through extensive experiments and ablation studies, demonstrating that it delivers embedding quality comparable to many advanced black-box models while maintaining inherently interpretability. Additionally, CQG-MBQA outperforms other interpretable text embedding methods across various downstream tasks.

Medical image segmentation plays a vital role in clinical decision-making, enabling precise localization of lesions and guiding interventions. Despite significant advances in segmentation accuracy, the black-box nature of most deep models has raised growing concerns about their trustworthiness in high-stakes medical scenarios. Current explanation techniques have primarily focused on classification tasks, leaving the segmentation domain relatively underexplored. We introduced an explanation model for segmentation task which employs the causal inference framework and backpropagates the average treatment effect (ATE) into a quantification metric to determine the influence of input regions, as well as network components, on target segmentation areas. Through comparison with recent segmentation explainability techniques on two representative medical imaging datasets, we demonstrated that our approach provides more faithful explanations than existing approaches. Furthermore, we carried out a systematic causal analysis of multiple foundational segmentation models using our method, which reveals significant heterogeneity in perceptual strategies across different models, and even between different inputs for the same model. Suggesting the potential of our method to provide notable insights for optimizing segmentation models. Our code can be found at https://github.com/lcmmai/PdCR.

Obtaining large pre-trained models that can be fine-tuned to new tasks with limited annotated samples has remained an open challenge for medical imaging data. While pre-trained deep networks on ImageNet and vision-language foundation models trained on web-scale data are prevailing approaches, their effectiveness on medical tasks is limited due to the significant domain shift between natural and medical images. To bridge this gap, we introduce LVM-Med, the first family of deep networks trained on large-scale medical datasets. We have collected approximately 1.3 million medical images from 55 publicly available datasets, covering a large number of organs and modalities such as CT, MRI, X-ray, and Ultrasound. We benchmark several state-of-the-art self-supervised algorithms on this dataset and propose a novel self-supervised contrastive learning algorithm using a graph-matching formulation. The proposed approach makes three contributions: (i) it integrates prior pair-wise image similarity metrics based on local and global information; (ii) it captures the structural constraints of feature embeddings through a loss function constructed via a combinatorial graph-matching objective; and (iii) it can be trained efficiently end-to-end using modern gradient-estimation techniques for black-box solvers. We thoroughly evaluate the proposed LVM-Med on 15 downstream medical tasks ranging from segmentation and classification to object detection, and both for the in and out-of-distribution settings. LVM-Med empirically outperforms a number of state-of-the-art supervised, self-supervised, and foundation models. For challenging tasks such as Brain Tumor Classification or Diabetic Retinopathy Grading, LVM-Med improves previous vision-language models trained on 1 billion masks by 6-7% while using only a ResNet-50.

Biomedical text embeddings have primarily been developed using research literature from PubMed, yet clinical cardiology practice relies heavily on procedural knowledge and specialized terminology found in comprehensive textbooks rather than research abstracts. This research practice gap limits the effectiveness of existing embedding models for clinical applications incardiology. This study trained CardioEmbed, a domain-specialized embedding model based on Qwen3-Embedding-8B, using contrastive learning on a curated corpus of seven comprehensive cardiology textbooks totaling approximately 150,000 sentences after deduplication. The model employs InfoNCE loss with in-batch negatives and achieves 99.60% retrieval accuracy on cardiac-specific semantic retrieval tasks, a +15.94 percentage point improvement over MedTE, the current state-of-the-art medical embedding model. On MTEB medical benchmarks, the model obtained BIOSSES 0.77 Spearman and SciFact 0.61 NDCG@10, indicating competitive performance on related biomedical domains. Domain-specialized training on comprehensive clinical textbooks yields near-perfect cardiology retrieval (99.60% Acc@1), improving over MedTE by +15.94 percentage points.

In the field of chest X-ray (CXR) diagnosis, existing works often focus solely on determining where a radiologist looks, typically through tasks such as detection, segmentation, or classification. However, these approaches are often designed as black-box models, lacking interpretability. In this paper, we introduce Interpretable Artificial Intelligence (I-AI) a novel and unified controllable interpretable pipeline for decoding the intense focus of radiologists in CXR diagnosis. Our I-AI addresses three key questions: where a radiologist looks, how long they focus on specific areas, and what findings they diagnose. By capturing the intensity of the radiologist's gaze, we provide a unified solution that offers insights into the cognitive process underlying radiological interpretation. Unlike current methods that rely on black-box machine learning models, which can be prone to extracting erroneous information from the entire input image during the diagnosis process, we tackle this issue by effectively masking out irrelevant information. Our proposed I-AI leverages a vision-language model, allowing for precise control over the interpretation process while ensuring the exclusion of irrelevant features. To train our I-AI model, we utilize an eye gaze dataset to extract anatomical gaze information and generate ground truth heatmaps. Through extensive experimentation, we demonstrate the efficacy of our method. We showcase that the attention heatmaps, designed to mimic radiologists' focus, encode sufficient and relevant information, enabling accurate classification tasks using only a portion of CXR. The code, checkpoints, and data are at https://github.com/UARK-AICV/IAI

Tracking biosignals is crucial for monitoring wellness and preempting the development of severe medical conditions. Today, wearable devices can conveniently record various biosignals, creating the opportunity to monitor health status without disruption to one's daily routine. Despite widespread use of wearable devices and existing digital biomarkers, the absence of curated data with annotated medical labels hinders the development of new biomarkers to measure common health conditions. In fact, medical datasets are usually small in comparison to other domains, which is an obstacle for developing neural network models for biosignals. To address this challenge, we have employed self-supervised learning using the unlabeled sensor data collected under informed consent from the large longitudinal Apple Heart and Movement Study (AHMS) to train foundation models for two common biosignals: photoplethysmography (PPG) and electrocardiogram (ECG) recorded on Apple Watch. We curated PPG and ECG datasets from AHMS that include data from ~141K participants spanning ~3 years. Our self-supervised learning framework includes participant level positive pair selection, stochastic augmentation module and a regularized contrastive loss optimized with momentum training, and generalizes well to both PPG and ECG modalities. We show that the pre-trained foundation models readily encode information regarding participants' demographics and health conditions. To the best of our knowledge, this is the first study that builds foundation models using large-scale PPG and ECG data collected via wearable consumer devices x2013 prior works have commonly used smaller-size datasets collected in clinical and experimental settings. We believe PPG and ECG foundation models can enhance future wearable devices by reducing the reliance on labeled data and hold the potential to help the users improve their health.

Medical coding is essential for standardizing clinical data and communication but is often time-consuming and prone to errors. Traditional Natural Language Processing (NLP) methods struggle with automating coding due to the large label space, lengthy text inputs, and the absence of supporting evidence annotations that justify code selection. Recent advancements in Generative Artificial Intelligence (AI) offer promising solutions to these challenges. In this work, we introduce MedCodER, a Generative AI framework for automatic medical coding that leverages extraction, retrieval, and re-ranking techniques as core components. MedCodER achieves a micro-F1 score of 0.60 on International Classification of Diseases (ICD) code prediction, significantly outperforming state-of-the-art methods. Additionally, we present a new dataset containing medical records annotated with disease diagnoses, ICD codes, and supporting evidence texts (https://doi.org/10.5281/zenodo.13308316). Ablation tests confirm that MedCodER's performance depends on the integration of each of its aforementioned components, as performance declines when these components are evaluated in isolation.

Deep learning-based medical image classification techniques are rapidly advancing in medical image analysis, making it crucial to develop accurate and trustworthy models that can be efficiently deployed across diverse clinical scenarios. Concept Bottleneck Models (CBMs), which first predict a set of explainable concepts from images and then perform classification based on these concepts, are increasingly being adopted for explainable medical image classification. However, the inherent explainability of CBMs introduces new challenges when deploying trained models to new environments. Variations in imaging protocols and staining methods may induce concept-level shifts, such as alterations in color distribution and scale. Furthermore, since CBM training requires explicit concept annotations, fine-tuning models solely with image-level labels could compromise concept prediction accuracy and faithfulness - a critical limitation given the high cost of acquiring expert-annotated concept labels in medical domains. To address these challenges, we propose a training-free confusion concept identification strategy. By leveraging minimal new data (e.g., 4 images per class) with only image-level labels, our approach enhances out-of-domain performance without sacrificing source domain accuracy through two key operations: masking misactivated confounding concepts and amplifying under-activated discriminative concepts. The efficacy of our method is validated on both skin and white blood cell images. Our code is available at: https://github.com/riverback/TF-TTI-XMed.

The scarcity of high-quality data remains a primary bottleneck in adapting multimodal generative models for medical image editing. Existing medical image editing datasets often suffer from limited diversity, neglect of medical image understanding and inability to balance quality with scalability. To address these gaps, we propose MieDB-100k, a large-scale, high-quality and diverse dataset for text-guided medical image editing. It categorizes editing tasks into perspectives of Perception, Modification and Transformation, considering both understanding and generation abilities. We construct MieDB-100k via a data curation pipeline leveraging both modality-specific expert models and rule-based data synthetic methods, followed by rigorous manual inspection to ensure clinical fidelity. Extensive experiments demonstrate that model trained with MieDB-100k consistently outperform both open-source and proprietary models while exhibiting strong generalization ability. We anticipate that this dataset will serve as a cornerstone for future advancements in specialized medical image editing.

Heart disease remains a significant threat to human health. As a non-invasive diagnostic tool, the electrocardiogram (ECG) is one of the most widely used methods for cardiac screening. However, the scarcity of high-quality ECG data, driven by privacy concerns and limited medical resources, creates a pressing need for effective ECG signal generation. Existing approaches for generating ECG signals typically rely on small training datasets, lack comprehensive evaluation frameworks, and overlook potential applications beyond data augmentation. To address these challenges, we propose DiffuSETS, a novel framework capable of generating ECG signals with high semantic alignment and fidelity. DiffuSETS accepts various modalities of clinical text reports and patient-specific information as inputs, enabling the creation of clinically meaningful ECG signals. Additionally, to address the lack of standardized evaluation in ECG generation, we introduce a comprehensive benchmarking methodology to assess the effectiveness of generative models in this domain. Our model achieve excellent results in tests, proving its superiority in the task of ECG generation. Furthermore, we showcase its potential to mitigate data scarcity while exploring novel applications in cardiology education and medical knowledge discovery, highlighting the broader impact of our work.

Convolutional Neural Networks (CNNs) and Transformers have been the most popular architectures for biomedical image segmentation, but both of them have limited ability to handle long-range dependencies because of inherent locality or computational complexity. To address this challenge, we introduce U-Mamba, a general-purpose network for biomedical image segmentation. Inspired by the State Space Sequence Models (SSMs), a new family of deep sequence models known for their strong capability in handling long sequences, we design a hybrid CNN-SSM block that integrates the local feature extraction power of convolutional layers with the abilities of SSMs for capturing the long-range dependency. Moreover, U-Mamba enjoys a self-configuring mechanism, allowing it to automatically adapt to various datasets without manual intervention. We conduct extensive experiments on four diverse tasks, including the 3D abdominal organ segmentation in CT and MR images, instrument segmentation in endoscopy images, and cell segmentation in microscopy images. The results reveal that U-Mamba outperforms state-of-the-art CNN-based and Transformer-based segmentation networks across all tasks. This opens new avenues for efficient long-range dependency modeling in biomedical image analysis. The code, models, and data are publicly available at https://wanglab.ai/u-mamba.html.

We introduce Neural Organ Transplantation (NOT), a modular adaptation framework that enables trained transformer layers to function as reusable transferable checkpoints for domain adaptation. Unlike conventional fine-tuning approaches that tightly couple trained parameters to specific model instances and training data, NOT extracts contiguous layer subsets ("donor organs") from pre-trained models, trains them independently on domain-specific data, and saves them as standalone checkpoint files that can be transplanted into compatible recipient models without access to the original training data. Through experiments on three decoder-only transformer architectures spanning 124M to 20B parameters (GPT-2, TinyLlama, and GPT-OSS), we demonstrate that donor transplantation substantially outperforms existing adaptation methods, achieving an order-of-magnitude improvement in perplexity over LoRA while training significantly faster. The method exhibits position dependence, with early insertion positions yielding optimal results. Cross-domain transfer at billion-parameter scale reveals unexpected regularization benefits. These findings demonstrate that transformer middle layers can support efficient modular transfer for decoder-only architectures, enabling privacy-preserving expertise sharing through checkpoint distribution. We note that this approach is currently limited to decoder-only models; preliminary experiments on encoder-based architectures show reduced effectiveness.

Deep learning models are susceptible to adversarial samples in white and black-box environments. Although previous studies have shown high attack success rates, coupling DNN models with interpretation models could offer a sense of security when a human expert is involved, who can identify whether a given sample is benign or malicious. However, in white-box environments, interpretable deep learning systems (IDLSes) have been shown to be vulnerable to malicious manipulations. In black-box settings, as access to the components of IDLSes is limited, it becomes more challenging for the adversary to fool the system. In this work, we propose a Query-efficient Score-based black-box attack against IDLSes, QuScore, which requires no knowledge of the target model and its coupled interpretation model. QuScore is based on transfer-based and score-based methods by employing an effective microbial genetic algorithm. Our method is designed to reduce the number of queries necessary to carry out successful attacks, resulting in a more efficient process. By continuously refining the adversarial samples created based on feedback scores from the IDLS, our approach effectively navigates the search space to identify perturbations that can fool the system. We evaluate the attack's effectiveness on four CNN models (Inception, ResNet, VGG, DenseNet) and two interpretation models (CAM, Grad), using both ImageNet and CIFAR datasets. Our results show that the proposed approach is query-efficient with a high attack success rate that can reach between 95% and 100% and transferability with an average success rate of 69% in the ImageNet and CIFAR datasets. Our attack method generates adversarial examples with attribution maps that resemble benign samples. We have also demonstrated that our attack is resilient against various preprocessing defense techniques and can easily be transferred to different DNN models.

We release the largest public ECG dataset of continuous raw signals for representation learning containing 11 thousand patients and 2 billion labelled beats. Our goal is to enable semi-supervised ECG models to be made as well as to discover unknown subtypes of arrhythmia and anomalous ECG signal events. To this end, we propose an unsupervised representation learning task, evaluated in a semi-supervised fashion. We provide a set of baselines for different feature extractors that can be built upon. Additionally, we perform qualitative evaluations on results from PCA embeddings, where we identify some clustering of known subtypes indicating the potential for representation learning in arrhythmia sub-type discovery.

Recent breakthroughs in large language models (LLMs) offer unprecedented natural language understanding and generation capabilities. However, existing surveys on LLMs in biomedicine often focus on specific applications or model architectures, lacking a comprehensive analysis that integrates the latest advancements across various biomedical domains. This review, based on an analysis of 484 publications sourced from databases including PubMed, Web of Science, and arXiv, provides an in-depth examination of the current landscape, applications, challenges, and prospects of LLMs in biomedicine, distinguishing itself by focusing on the practical implications of these models in real-world biomedical contexts. Firstly, we explore the capabilities of LLMs in zero-shot learning across a broad spectrum of biomedical tasks, including diagnostic assistance, drug discovery, and personalized medicine, among others, with insights drawn from 137 key studies. Then, we discuss adaptation strategies of LLMs, including fine-tuning methods for both uni-modal and multi-modal LLMs to enhance their performance in specialized biomedical contexts where zero-shot fails to achieve, such as medical question answering and efficient processing of biomedical literature. Finally, we discuss the challenges that LLMs face in the biomedicine domain including data privacy concerns, limited model interpretability, issues with dataset quality, and ethics due to the sensitive nature of biomedical data, the need for highly reliable model outputs, and the ethical implications of deploying AI in healthcare. To address these challenges, we also identify future research directions of LLM in biomedicine including federated learning methods to preserve data privacy and integrating explainable AI methodologies to enhance the transparency of LLMs.

Current foundation model for photoplethysmography (PPG) signals is challenged by the intrinsic redundancy and noise of the signal. Standard masked modeling often yields trivial solutions while contrastive methods lack morphological precision. To address these limitations, we propose a Statistical-prior Informed Generative Masking Architecture (SIGMA-PPG), a generative foundation model featuring a Prior-Guided Adversarial Masking mechanism, where a reinforcement learning-driven teacher leverages statistical priors to create challenging learning paths that prevent overfitting to noise. We also incorporate a semantic consistency constraint via vector quantization to ensure that physiologically identical waveforms (even those altered by recording artifacts or minor perturbations) map to shared indices. This enhances codebook semantic density and eliminates redundant feature structures. Pre-trained on over 120,000 hours of data, SIGMA-PPG achieves superior average performance compared to five state-of-the-art baselines across 12 diverse downstream tasks. The code is available at https://github.com/ZonghengGuo/SigmaPPG.

The ability to interpret and intervene model decisions is important for the adoption of computer-aided diagnosis methods in clinical workflows. Recent concept-based methods link the model predictions with interpretable concepts and modify their activation scores to interact with the model. However, these concepts are at the image level, which hinders the model from pinpointing the exact patches the concepts are activated. Alternatively, prototype-based methods learn representations from training image patches and compare these with test image patches, using the similarity scores for final class prediction. However, interpreting the underlying concepts of these patches can be challenging and often necessitates post-hoc guesswork. To address this issue, this paper introduces the novel Concept-based Similarity Reasoning network (CSR), which offers (i) patch-level prototype with intrinsic concept interpretation, and (ii) spatial interactivity. First, the proposed CSR provides localized explanation by grounding prototypes of each concept on image regions. Second, our model introduces novel spatial-level interaction, allowing doctors to engage directly with specific image areas, making it an intuitive and transparent tool for medical imaging. CSR improves upon prior state-of-the-art interpretable methods by up to 4.5\% across three biomedical datasets. Our code is released at https://github.com/tadeephuy/InteractCSR.

Biomedical text mining is becoming increasingly important as the number of biomedical documents rapidly grows. With the progress in natural language processing (NLP), extracting valuable information from biomedical literature has gained popularity among researchers, and deep learning has boosted the development of effective biomedical text mining models. However, directly applying the advancements in NLP to biomedical text mining often yields unsatisfactory results due to a word distribution shift from general domain corpora to biomedical corpora. In this article, we investigate how the recently introduced pre-trained language model BERT can be adapted for biomedical corpora. We introduce BioBERT (Bidirectional Encoder Representations from Transformers for Biomedical Text Mining), which is a domain-specific language representation model pre-trained on large-scale biomedical corpora. With almost the same architecture across tasks, BioBERT largely outperforms BERT and previous state-of-the-art models in a variety of biomedical text mining tasks when pre-trained on biomedical corpora. While BERT obtains performance comparable to that of previous state-of-the-art models, BioBERT significantly outperforms them on the following three representative biomedical text mining tasks: biomedical named entity recognition (0.62% F1 score improvement), biomedical relation extraction (2.80% F1 score improvement) and biomedical question answering (12.24% MRR improvement). Our analysis results show that pre-training BERT on biomedical corpora helps it to understand complex biomedical texts. We make the pre-trained weights of BioBERT freely available at https://github.com/naver/biobert-pretrained, and the source code for fine-tuning BioBERT available at https://github.com/dmis-lab/biobert.

Single-cell technologies generate high-dimensional point clouds of cells, enabling detailed characterization of complex patient states and treatment responses. Yet each patient is represented by an irregular point cloud rather than a simple vector, making it difficult to directly quantify and compare biological differences between individuals. Nonlinear methods such as kernels and neural networks achieve predictive accuracy but act as black boxes, offering little biological interpretability. To address these limitations, we adapt the Linear Optimal Transport (LOT) framework to this setting, embedding irregular point clouds into a fixed-dimensional Euclidean space while preserving distributional structure. This embedding provides a principled linear representation that preserves optimal transport geometry while enabling downstream analysis. It also forms a registration between any two patients, enabling direct comparison of their cellular distributions. Within this space, LOT enables: (i) accurate and interpretable classification of COVID-19 patient states, where classifier weights map back to specific markers and spatial regions driving predictions; and (ii) synthetic data generation for patient-derived organoids, exploiting the linearity of the LOT embedding. LOT barycenters yield averaged cellular profiles representing combined conditions or samples, supporting drug interaction testing. Together, these results establish LOT as a unified framework that bridges predictive performance, interpretability, and generative modeling. By transforming heterogeneous point clouds into structured embeddings directly traceable to the original data, LOT opens new opportunities for understanding immune variation and treatment effects in high-dimensional biological systems.

We introduce MrBERT, a family of 150M-300M parameter encoders built on the ModernBERT architecture and pre-trained on 35 languages and code. Through targeted adaptation, this model family achieves state-of-the-art results on Catalan- and Spanish-specific tasks, while establishing robust performance across specialized biomedical and legal domains. To bridge the gap between research and production, we incorporate Matryoshka Representation Learning (MRL), enabling flexible vector sizing that significantly reduces inference and storage costs. Ultimately, the MrBERT family demonstrates that modern encoder architectures can be optimized for both localized linguistic excellence and efficient, high-stakes domain specialization. We open source the complete model family on Huggingface.

Using language models (LMs) pre-trained in a self-supervised setting on large corpora and then fine-tuning for a downstream task has helped to deal with the problem of limited label data for supervised learning tasks such as Named Entity Recognition (NER). Recent research in biomedical language processing has offered a number of biomedical LMs pre-trained using different methods and techniques that advance results on many BioNLP tasks, including NER. However, there is still a lack of a comprehensive comparison of pre-training approaches that would work more optimally in the biomedical domain. This paper aims to investigate different pre-training methods, such as pre-training the biomedical LM from scratch and pre-training it in a continued fashion. We compare existing methods with our proposed pre-training method of initializing weights for new tokens by distilling existing weights from the BERT model inside the context where the tokens were found. The method helps to speed up the pre-training stage and improve performance on NER. In addition, we compare how masking rate, corruption strategy, and masking strategies impact the performance of the biomedical LM. Finally, using the insights from our experiments, we introduce a new biomedical LM (BIOptimus), which is pre-trained using Curriculum Learning (CL) and contextualized weight distillation method. Our model sets new states of the art on several biomedical Named Entity Recognition (NER) tasks. We release our code and all pre-trained models

Vision-and-language models (VLMs) have been increasingly explored in the medical domain, particularly following the success of CLIP in general domain. However, unlike the relatively straightforward pairing of 2D images and text, curating large-scale paired data in the medical field for volumetric modalities such as CT scans remains a challenging and time-intensive process. This difficulty often limits the performance on downstream tasks. To address these challenges, we propose a novel vision-language pre-training (VLP) framework, termed as VELVET-Med, specifically designed for limited volumetric data such as 3D CT and associated radiology reports. Instead of relying on large-scale data collection, our method focuses on the development of effective pre-training objectives and model architectures. The key contributions are: 1) We incorporate uni-modal self-supervised learning into VLP framework, which are often underexplored in the existing literature. 2) We propose a novel language encoder, termed as TriBERT, for learning multi-level textual semantics. 3) We devise the hierarchical contrastive learning to capture multi-level vision-language correspondence. Using only 38,875 scan-report pairs, our approach seeks to uncover rich spatial and semantic relationships embedded in volumetric medical images and corresponding clinical narratives, thereby enhancing the generalization ability of the learned encoders. The resulting encoders exhibit strong transferability, achieving state-of-the-art performance across a wide range of downstream tasks, including 3D segmentation, cross-modal retrieval, visual question answering, and report generation.

DNA foundation models have become transformative tools in bioinformatics and healthcare applications. Trained on vast genomic datasets, these models can be used to generate sequence embeddings, dense vector representations that capture complex genomic information. These embeddings are increasingly being shared via Embeddings-as-a-Service (EaaS) frameworks to facilitate downstream tasks, while supposedly protecting the privacy of the underlying raw sequences. However, as this practice becomes more prevalent, the security of these representations is being called into question. This study evaluates the resilience of DNA foundation models to model inversion attacks, whereby adversaries attempt to reconstruct sensitive training data from model outputs. In our study, the model's output for reconstructing the DNA sequence is a zero-shot embedding, which is then fed to a decoder. We evaluated the privacy of three DNA foundation models: DNABERT-2, Evo 2, and Nucleotide Transformer v2 (NTv2). Our results show that per-token embeddings allow near-perfect sequence reconstruction across all models. For mean-pooled embeddings, reconstruction quality degrades as sequence length increases, though it remains substantially above random baselines. Evo 2 and NTv2 prove to be most vulnerable, especially for shorter sequences with reconstruction similarities > 90%, while DNABERT-2's BPE tokenization provides the greatest resilience. We found that the correlation between embedding similarity and sequence similarity was a key predictor of reconstruction success. Our findings emphasize the urgent need for privacy-aware design in genomic foundation models prior to their widespread deployment in EaaS settings. Training code, model weights and evaluation pipeline are released on: https://github.com/not-a-feature/DNA-Embedding-Inversion.

Text autoencoders are often used for unsupervised conditional text generation by applying mappings in the latent space to change attributes to the desired values. Recently, Mai et al. (2020) proposed Emb2Emb, a method to learn these mappings in the embedding space of an autoencoder. However, their method is restricted to autoencoders with a single-vector embedding, which limits how much information can be retained. We address this issue by extending their method to Bag-of-Vectors Autoencoders (BoV-AEs), which encode the text into a variable-size bag of vectors that grows with the size of the text, as in attention-based models. This allows to encode and reconstruct much longer texts than standard autoencoders. Analogous to conventional autoencoders, we propose regularization techniques that facilitate learning meaningful operations in the latent space. Finally, we adapt Emb2Emb for a training scheme that learns to map an input bag to an output bag, including a novel loss function and neural architecture. Our empirical evaluations on unsupervised sentiment transfer show that our method performs substantially better than a standard autoencoder.

Motivated by the strong performance of CLIP-based models in natural image-text domains, recent efforts have adapted these architectures to medical tasks, particularly in radiology, where large paired datasets of images and reports, such as chest X-rays, are available. While these models have shown encouraging results in terms of accuracy and discriminative performance, their fairness and robustness in the different clinical tasks remain largely underexplored. In this study, we extensively evaluate six widely used CLIP-based models on chest X-ray classification using three publicly available datasets: MIMIC-CXR, NIH-CXR14, and NEATX. We assess the models fairness across six conditions and patient subgroups based on age, sex, and race. Additionally, we assess the robustness to shortcut learning by evaluating performance on pneumothorax cases with and without chest drains. Our results indicate performance gaps between patients of different ages, but more equitable results for the other attributes. Moreover, all models exhibit lower performance on images without chest drains, suggesting reliance on spurious correlations. We further complement the performance analysis with a study of the embeddings generated by the models. While the sensitive attributes could be classified from the embeddings, we do not see such patterns using PCA, showing the limitations of these visualisation techniques when assessing models. Our code is available at https://github.com/TheoSourget/clip_cxr_fairness

Biomedical datasets are often constrained by stringent privacy requirements and frequently suffer from severe class imbalance. These two aspects hinder the development of accurate machine learning models. While generative AI offers a promising solution, producing synthetic images of sufficient quality for training robust classifiers remains challenging. This work addresses the classification of individual white blood cells, a critical task in diagnosing hematological malignancies such as acute myeloid leukemia (AML). We introduce CytoDiff, a stable diffusion model fine-tuned with LoRA weights and guided by few-shot samples that generates high-fidelity synthetic white blood cell images. Our approach demonstrates substantial improvements in classifier performance when training data is limited. Using a small, highly imbalanced real dataset, the addition of 5,000 synthetic images per class improved ResNet classifier accuracy from 27\% to 78\% (+51\%). Similarly, CLIP-based classification accuracy increased from 62\% to 77\% (+15\%). These results establish synthetic image generation as a valuable tool for biomedical machine learning, enhancing data coverage and facilitating secure data sharing while preserving patient privacy. Paper code is publicly available at https://github.com/JanCarreras24/CytoDiff.

We present DeepCABAC, a novel context-adaptive binary arithmetic coder for compressing deep neural networks. It quantizes each weight parameter by minimizing a weighted rate-distortion function, which implicitly takes the impact of quantization on to the accuracy of the network into account. Subsequently, it compresses the quantized values into a bitstream representation with minimal redundancies. We show that DeepCABAC is able to reach very high compression ratios across a wide set of different network architectures and datasets. For instance, we are able to compress by x63.6 the VGG16 ImageNet model with no loss of accuracy, thus being able to represent the entire network with merely 8.7MB.

Self-Supervised Learning (SSL) presents an exciting opportunity to unlock the potential of vast, untapped clinical datasets, for various downstream applications that suffer from the scarcity of labeled data. While SSL has revolutionized fields like natural language processing and computer vision, its adoption in 3D medical image computing has been limited by three key pitfalls: Small pre-training dataset sizes, architectures inadequate for 3D medical image analysis, and insufficient evaluation practices. In this paper, we address these issues by i) leveraging a large-scale dataset of 39k 3D brain MRI volumes and ii) using a Residual Encoder U-Net architecture within the state-of-the-art nnU-Net framework. iii) A robust development framework, incorporating 5 development and 8 testing brain MRI segmentation datasets, allowed performance-driven design decisions to optimize the simple concept of Masked Auto Encoders (MAEs) for 3D CNNs. The resulting model not only surpasses previous SSL methods but also outperforms the strong nnU-Net baseline by an average of approximately 3 Dice points setting a new state-of-the-art. Our code and models are made available here.

Concept Bottleneck Models (CBM) are inherently interpretable models that factor model decisions into human-readable concepts. They allow people to easily understand why a model is failing, a critical feature for high-stakes applications. CBMs require manually specified concepts and often under-perform their black box counterparts, preventing their broad adoption. We address these shortcomings and are first to show how to construct high-performance CBMs without manual specification of similar accuracy to black box models. Our approach, Language Guided Bottlenecks (LaBo), leverages a language model, GPT-3, to define a large space of possible bottlenecks. Given a problem domain, LaBo uses GPT-3 to produce factual sentences about categories to form candidate concepts. LaBo efficiently searches possible bottlenecks through a novel submodular utility that promotes the selection of discriminative and diverse information. Ultimately, GPT-3's sentential concepts can be aligned to images using CLIP, to form a bottleneck layer. Experiments demonstrate that LaBo is a highly effective prior for concepts important to visual recognition. In the evaluation with 11 diverse datasets, LaBo bottlenecks excel at few-shot classification: they are 11.7% more accurate than black box linear probes at 1 shot and comparable with more data. Overall, LaBo demonstrates that inherently interpretable models can be widely applied at similar, or better, performance than black box approaches.

Image-to-fMRI encoding is important for both neuroscience research and practical applications. However, such "Brain-Encoders" have been typically trained per-subject and per fMRI-dataset, thus restricted to very limited training data. In this paper we propose a Universal Brain-Encoder, which can be trained jointly on data from many different subjects/datasets/machines. What makes this possible is our new voxel-centric Encoder architecture, which learns a unique "voxel-embedding" per brain-voxel. Our Encoder trains to predict the response of each brain-voxel on every image, by directly computing the cross-attention between the brain-voxel embedding and multi-level deep image features. This voxel-centric architecture allows the functional role of each brain-voxel to naturally emerge from the voxel-image cross-attention. We show the power of this approach to (i) combine data from multiple different subjects (a "Crowd of Brains") to improve each individual brain-encoding, (ii) quick & effective Transfer-Learning across subjects, datasets, and machines (e.g., 3-Tesla, 7-Tesla), with few training examples, and (iii) use the learned voxel-embeddings as a powerful tool to explore brain functionality (e.g., what is encoded where in the brain).

Recent advancements in vision-language models (VLMs), such as CLIP, have demonstrated substantial success in self-supervised representation learning for vision tasks. However, effectively adapting VLMs to downstream applications remains challenging, as their accuracy often depends on time-intensive and expertise-demanding prompt engineering, while full model fine-tuning is costly. This is particularly true for biomedical images, which, unlike natural images, typically suffer from limited annotated datasets, unintuitive image contrasts, and nuanced visual features. Recent prompt learning techniques, such as Context Optimization (CoOp) intend to tackle these issues, but still fall short in generalizability. Meanwhile, explorations in prompt learning for biomedical image analysis are still highly limited. In this work, we propose BiomedCoOp, a novel prompt learning framework that enables efficient adaptation of BiomedCLIP for accurate and highly generalizable few-shot biomedical image classification. Our approach achieves effective prompt context learning by leveraging semantic consistency with average prompt ensembles from Large Language Models (LLMs) and knowledge distillation with a statistics-based prompt selection strategy. We conducted comprehensive validation of our proposed framework on 11 medical datasets across 9 modalities and 10 organs against existing state-of-the-art methods, demonstrating significant improvements in both accuracy and generalizability. The code is publicly available at https://github.com/HealthX-Lab/BiomedCoOp.