Daily Papers

Electrocardiography plays a central role in cardiovascular diagnostics, yet existing automated approaches often struggle to generalize across clinical tasks and offer limited support for open-ended reasoning. We present DiagECG, a novel framework that integrates time-series and language modeling by enabling large language models to process 12-lead ECG signals for clinical text generation tasks. Our approach discretizes continuous ECG embeddings into symbolic tokens using a lead-independent encoder and quantization module. These tokens are then used to extend the vocabulary of LLM, allowing the model to handle both ECG and natural language inputs in a unified manner. To bridge the modality gap, we pretrain the model on an autoregressive ECG forecasting task, enabling the LLM to model temporal dynamics using its native language modeling capabilities. Finally, we perform instruction tuning on both ECG question answering and diagnostic report generation. Without modifying the core model, DiagECG achieves strong performance across tasks while maintaining generalization to out-of-distribution settings. Extensive experiments demonstrate the effectiveness of each component and highlight the potential of integrating symbolic ECG representations into LLMs for medical reasoning.

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.

Electrocardiograms (ECGs) are non-invasive diagnostic tools crucial for detecting cardiac arrhythmic diseases in clinical practice. While ECG Self-supervised Learning (eSSL) methods show promise in representation learning from unannotated ECG data, they often overlook the clinical knowledge that can be found in reports. This oversight and the requirement for annotated samples for downstream tasks limit eSSL's versatility. In this work, we address these issues with the Multimodal ECG Representation Learning (MERL}) framework. Through multimodal learning on ECG records and associated reports, MERL is capable of performing zero-shot ECG classification with text prompts, eliminating the need for training data in downstream tasks. At test time, we propose the Clinical Knowledge Enhanced Prompt Engineering (CKEPE) approach, which uses Large Language Models (LLMs) to exploit external expert-verified clinical knowledge databases, generating more descriptive prompts and reducing hallucinations in LLM-generated content to boost zero-shot classification. Based on MERL, we perform the first benchmark across six public ECG datasets, showing the superior performance of MERL compared against eSSL methods. Notably, MERL achieves an average AUC score of 75.2% in zero-shot classification (without training data), 3.2% higher than linear probed eSSL methods with 10\% annotated training data, averaged across all six datasets. Code and models are available at https://github.com/cheliu-computation/MERL

The electrocardiogram (ECG) is a cost-effective, highly accessible and widely employed diagnostic tool. With the advent of Foundation Models (FMs), the field of AI-assisted ECG interpretation has begun to evolve, as they enable model reuse across different tasks by relying on embeddings. However, to responsibly employ FMs, it is crucial to rigorously assess to which extent the embeddings they produce are generalizable, particularly in error-sensitive domains such as healthcare. Although prior works have already addressed the problem of benchmarking ECG-expert FMs, they focus predominantly on the evaluation of downstream performance. To fill this gap, this study aims to find an in-depth, comprehensive benchmarking framework for FMs, with a specific focus on ECG-expert ones. To this aim, we introduce a benchmark methodology that complements performance-based evaluation with representation-level analysis, leveraging SHAP and UMAP techniques. Furthermore, we rely on the methodology for carrying out an extensive evaluation of several ECG-expert FMs pretrained via state-of-the-art techniques over different cross-continental datasets and data availability settings; this includes ones featuring data scarcity, a fairly common situation in real-world medical scenarios. Experimental results show that our benchmarking protocol provides a rich insight of ECG-expert FMs' embedded patterns, enabling a deeper understanding of their representational structure and generalizability.

Electrocardiogram (ECG) is essential for the clinical diagnosis of arrhythmias and other heart diseases, but deep learning methods based on ECG often face limitations due to the need for high-quality annotations. Although previous ECG self-supervised learning (eSSL) methods have made significant progress in representation learning from unannotated ECG data, they typically treat ECG signals as ordinary time-series data, segmenting the signals using fixed-size and fixed-step time windows, which often ignore the form and rhythm characteristics and latent semantic relationships in ECG signals. In this work, we introduce a novel perspective on ECG signals, treating heartbeats as words and rhythms as sentences. Based on this perspective, we first designed the QRS-Tokenizer, which generates semantically meaningful ECG sentences from the raw ECG signals. Building on these, we then propose HeartLang, a novel self-supervised learning framework for ECG language processing, learning general representations at form and rhythm levels. Additionally, we construct the largest heartbeat-based ECG vocabulary to date, which will further advance the development of ECG language processing. We evaluated HeartLang across six public ECG datasets, where it demonstrated robust competitiveness against other eSSL methods. Our data and code are publicly available at https://github.com/PKUDigitalHealth/HeartLang.

Electrocardiograms (ECGs) play a vital role in monitoring cardiac health and diagnosing heart diseases. However, traditional deep learning approaches for ECG analysis rely heavily on large-scale manual annotations, which are both time-consuming and resource-intensive to obtain. To overcome this limitation, self-supervised learning (SSL) has emerged as a promising alternative, enabling the extraction of robust ECG representations that can be efficiently transferred to various downstream tasks. While previous studies have explored SSL for ECG pretraining and multi-modal ECG-language alignment, they often fail to capture the multi-scale nature of ECG signals. As a result, these methods struggle to learn generalized representations due to their inability to model the hierarchical structure of ECG data. To address this gap, we introduce MELP, a novel Multi-scale ECG-Language Pretraining (MELP) model that fully leverages hierarchical supervision from ECG-text pairs. MELP first pretrains a cardiology-specific language model to enhance its understanding of clinical text. It then applies three levels of cross-modal supervision-at the token, beat, and rhythm levels-to align ECG signals with textual reports, capturing structured information across different time scales. We evaluate MELP on three public ECG datasets across multiple tasks, including zero-shot ECG classification, linear probing, and transfer learning. Experimental results demonstrate that MELP outperforms existing SSL methods, underscoring its effectiveness and adaptability across diverse clinical applications. Our code is available at https://github.com/HKU-MedAI/MELP.

Automated interpretation of electrocardiograms (ECG) has garnered significant attention with the advancements in machine learning methodologies. Despite the growing interest, most current studies focus solely on classification or regression tasks, which overlook a crucial aspect of clinical cardio-disease diagnosis: the diagnostic report generated by experienced human clinicians. In this paper, we introduce a novel approach to ECG interpretation, leveraging recent breakthroughs in Large Language Models (LLMs) and Vision-Transformer (ViT) models. Rather than treating ECG diagnosis as a classification or regression task, we propose an alternative method of automatically identifying the most similar clinical cases based on the input ECG data. Also, since interpreting ECG as images is more affordable and accessible, we process ECG as encoded images and adopt a vision-language learning paradigm to jointly learn vision-language alignment between encoded ECG images and ECG diagnosis reports. Encoding ECG into images can result in an efficient ECG retrieval system, which will be highly practical and useful in clinical applications. More importantly, our findings could serve as a crucial resource for providing diagnostic services in underdeveloped regions.

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.

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.

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.

Electrocardiograms (ECGs) are among the most widely used diagnostic tools for cardiovascular diseases, and a large amount of ECG data worldwide appears only in image form. However, most existing automated ECG analysis methods rely on access to raw signal recordings, limiting their applicability in real-world and resource-constrained settings. In this paper, we present ECG-Scan, a self-supervised framework for learning clinically generalized representations from ECG images through dual physiological-aware alignments: 1) Our approach optimizes image representation learning using multimodal contrastive alignment between image and gold-standard signal-text modalities. 2) We further integrate domain knowledge via soft-lead constraints, regularizing the reconstruction process and improving signal lead inter-consistency. Extensive benchmarking across multiple datasets and downstream tasks demonstrates that our image-based model achieves superior performance compared to existing image baselines and notably narrows the gap between ECG image and signal analysis. These results highlight the potential of self-supervised image modeling to unlock large-scale legacy ECG data and broaden access to automated cardiovascular diagnostics.

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.

While recent multimodal large language models (MLLMs) have advanced automated ECG interpretation, they still face two key limitations: (1) insufficient multimodal synergy between time series signals and visual ECG representations, and (2) limited explainability in linking diagnoses to granular waveform evidence. We introduce GEM, the first MLLM unifying ECG time series, 12-lead ECG images and text for grounded and clinician-aligned ECG interpretation. GEM enables feature-grounded analysis, evidence-driven reasoning, and a clinician-like diagnostic process through three core innovations: a dual-encoder framework extracting complementary time series and image features, cross-modal alignment for effective multimodal understanding, and knowledge-guided instruction generation for generating high-granularity grounding data (ECG-Grounding) linking diagnoses to measurable parameters (e.g., QRS/PR Intervals). Additionally, we propose the Grounded ECG Understanding task, a clinically motivated benchmark designed to comprehensively assess the MLLM's capability in grounded ECG understanding. Experimental results on both existing and our proposed benchmarks show GEM significantly improves predictive performance (CSN 7.4% uparrow), explainability (22.7% uparrow), and grounding (24.8% uparrow), making it more suitable for real-world clinical applications. GitHub repository: https://github.com/lanxiang1017/GEM.git

Understanding the irregular electrical activity of atrial fibrillation (AFib) has been a key challenge in electrocardiography. For serious cases of AFib, catheter ablations are performed to collect intracardiac electrograms (EGMs). EGMs offer intricately detailed and localized electrical activity of the heart and are an ideal modality for interpretable cardiac studies. Recent advancements in artificial intelligence (AI) has allowed some works to utilize deep learning frameworks to interpret EGMs during AFib. Additionally, language models (LMs) have shown exceptional performance in being able to generalize to unseen domains, especially in healthcare. In this study, we are the first to leverage pretrained LMs for finetuning of EGM interpolation and AFib classification via masked language modeling. We formulate the EGM as a textual sequence and present competitive performances on AFib classification compared against other representations. Lastly, we provide a comprehensive interpretability study to provide a multi-perspective intuition of the model's behavior, which could greatly benefit the clinical use.

Electrocardiogram (ECG) serves as the primary non-invasive diagnostic tool for cardiac conditions monitoring, are crucial in assisting clinicians. Recent studies have concentrated on classifying cardiac conditions using ECG data but have overlooked ECG report generation, which is not only time-consuming but also requires clinical expertise. To automate ECG report generation and ensure its versatility, we propose the Multimodal ECG Instruction Tuning (MEIT) framework, the first attempt to tackle ECG report generation with LLMs and multimodal instructions. To facilitate future research, we establish a benchmark to evaluate MEIT with various LLMs backbones across two large-scale ECG datasets. Our approach uniquely aligns the representations of the ECG signal and the report, and we conduct extensive experiments to benchmark MEIT with nine open source LLMs, using more than 800,000 ECG reports. MEIT's results underscore the superior performance of instruction-tuned LLMs, showcasing their proficiency in quality report generation, zero-shot capabilities, and resilience to signal perturbation. These findings emphasize the efficacy of our MEIT framework and its potential for real-world clinical application.

Electrocardiograms (ECGs) are inexpensive, widely used, and well-suited to deep learning. Recently, interest has grown in developing foundation models for ECGs - models that generalise across diverse downstream tasks. However, consistent evaluation has been lacking: prior work often uses narrow task selections and inconsistent datasets, hindering fair comparison. Here, we introduce BenchECG, a standardised benchmark comprising a comprehensive suite of publicly available ECG datasets and versatile tasks. We also propose xECG, an xLSTM-based recurrent model trained with SimDINOv2 self-supervised learning, which achieves the best BenchECG score compared to publicly available state-of-the-art models. In particular, xECG is the only publicly available model to perform strongly on all datasets and tasks. By standardising evaluation, BenchECG enables rigorous comparison and aims to accelerate progress in ECG representation learning. xECG achieves superior performance over earlier approaches, defining a new baseline for future ECG foundation models.

Electrocardiogram (ECG) interpretation requires specialized expertise, often involving synthesizing insights from ECG signals with complex clinical queries posed in natural language. The scarcity of labeled ECG data coupled with the diverse nature of clinical inquiries presents a significant challenge for developing robust and adaptable ECG diagnostic systems. This work introduces a novel multimodal meta-learning method for few-shot ECG question answering, addressing the challenge of limited labeled data while leveraging the rich knowledge encoded within large language models (LLMs). Our LLM-agnostic approach integrates a pre-trained ECG encoder with a frozen LLM (e.g., LLaMA and Gemma) via a trainable fusion module, enabling the language model to reason about ECG data and generate clinically meaningful answers. Extensive experiments demonstrate superior generalization to unseen diagnostic tasks compared to supervised baselines, achieving notable performance even with limited ECG leads. For instance, in a 5-way 5-shot setting, our method using LLaMA-3.1-8B achieves accuracy of 84.6%, 77.3%, and 69.6% on single verify, choose and query question types, respectively. These results highlight the potential of our method to enhance clinical ECG interpretation by combining signal processing with the nuanced language understanding capabilities of LLMs, particularly in data-constrained scenarios.

Electrocardiograms (ECG) are widely employed as a diagnostic tool for monitoring electrical signals originating from a heart. Recent machine learning research efforts have focused on the application of screening various diseases using ECG signals. However, adapting to the application of screening disease is challenging in that labeled ECG data are limited. Achieving general representation through self-supervised learning (SSL) is a well-known approach to overcome the scarcity of labeled data; however, a naive application of SSL to ECG data, without considering the spatial-temporal relationships inherent in ECG signals, may yield suboptimal results. In this paper, we introduce ST-MEM (Spatio-Temporal Masked Electrocardiogram Modeling), designed to learn spatio-temporal features by reconstructing masked 12-lead ECG data. ST-MEM outperforms other SSL baseline methods in various experimental settings for arrhythmia classification tasks. Moreover, we demonstrate that ST-MEM is adaptable to various lead combinations. Through quantitative and qualitative analysis, we show a spatio-temporal relationship within ECG data. Our code is available at https://github.com/bakqui/ST-MEM.

Electrocardiography (ECG) serves as an indispensable diagnostic tool in clinical practice, yet existing multimodal large language models (MLLMs) remain unreliable for ECG interpretation, often producing plausible but clinically incorrect analyses. To address this, we propose ECG-R1, the first reasoning MLLM designed for reliable ECG interpretation via three innovations. First, we construct the interpretation corpus using Protocol-Guided Instruction Data Generation, grounding interpretation in measurable ECG features and monograph-defined quantitative thresholds and diagnostic logic. Second, we present a modality-decoupled architecture with Interleaved Modality Dropout to improve robustness and cross-modal consistency when either the ECG signal or ECG image is missing. Third, we present Reinforcement Learning with ECG Diagnostic Evidence Rewards to strengthen evidence-grounded ECG interpretation. Additionally, we systematically evaluate the ECG interpretation capabilities of proprietary, open-source, and medical MLLMs, and provide the first quantitative evidence that severe hallucinations are widespread, suggesting that the public should not directly trust these outputs without independent verification. Code and data are publicly available at https://github.com/PKUDigitalHealth/ECG-R1{here}, and an online platform can be accessed at http://ai.heartvoice.com.cn/ECG-R1/{here}.

Progress in the task of symbolic music generation may be lagging behind other tasks like audio and text generation, in part because of the scarcity of symbolic training data. In this paper, we leverage the greater scale of audio music data by applying pre-trained MIR models (for transcription, beat tracking, structure analysis, etc.) to extract symbolic events and encode them into token sequences. To the best of our knowledge, this work is the first to demonstrate the feasibility of training symbolic generation models solely from auto-transcribed audio data. Furthermore, to enhance the controllability of the trained model, we introduce SymPAC (Symbolic Music Language Model with Prompting And Constrained Generation), which is distinguished by using (a) prompt bars in encoding and (b) a technique called Constrained Generation via Finite State Machines (FSMs) during inference time. We show the flexibility and controllability of this approach, which may be critical in making music AI useful to creators and users.

This study introduces OpenECG, a large-scale benchmark of 1.2 million 12-lead ECG recordings from nine centers, to evaluate ECG foundation models (ECG-FMs) trained on public datasets. We investigate three self-supervised learning methods (SimCLR, BYOL, MAE) with ResNet-50 and Vision Transformer architectures, assessing model generalization through leave-one-dataset-out experiments and data scaling analysis. Results show that pre-training on diverse datasets significantly improves generalization, with BYOL and MAE outperforming SimCLR, highlighting the efficacy of feature-consistency and generative learning over contrastive approaches. Data scaling experiments reveal that performance saturates at 60-70% of total data for BYOL and MAE, while SimCLR requires more data. These findings demonstrate that publicly available ECG data can match or surpass proprietary datasets in training robust ECG-FMs, paving the way for scalable, clinically meaningful AI-driven ECG analysis.

Electrocardiogram (ECG) interpretation is a cornerstone of cardiac diagnostics. This paper explores a practical approach to enhance ECG image interpretation using the multimodal LLaMA 3.2 model. We used a parameter-efficient fine-tuning strategy, Low-Rank Adaptation (LoRA), specifically designed to boost the model's ability to understand ECG images and achieve better outcomes across a wide range of cardiac conditions. Our method is tailored for ECG analysis and leverages ECGInstruct, a large-scale instruction dataset with 1 Million samples. This dataset is a rich collection of synthesized ECG images, generated from raw ECG data from trusted open-source repositories like MIMIC-IV ECG and PTB-XL. Each ECG image in ECGInstruct comes with expert-written questions and detailed answers, covering diverse ECG interpretation scenarios, including complex cardiac conditions like Myocardial Infarction and Conduction Disturbances. Our fine-tuning approach efficiently adapts the LLaMA 3.2 model (built upon LLaMA 3) by integrating low-rank adaptation techniques, focusing on efficiency by updating only a small set of parameters, specifically ignoring the `lm_head` and `embed_tokens` layers. This paper details the model setup, our efficient fine-tuning method, and implementation specifics. We provide a thorough evaluation through extensive experiments, demonstrating the effectiveness of our method across various ECG interpretation tasks. The results convincingly show that our parameter-efficient LoRA fine-tuning achieves excellent performance in ECG image interpretation, significantly outperforming baseline models and reaching accuracy comparable to or exceeding traditional CNN-based methods in identifying a wide range of cardiac abnormalities, including over 70 conditions from the PTB-XL dataset.

Accurate diagnosis of heart arrhythmias requires the interpretation of electrocardiograms (ECG), which capture the electrical activity of the heart. Automating this process through machine learning is challenging due to the need for large annotated datasets, which are difficult and costly to collect. To address this issue, transfer learning is often employed, where models are pre-trained on large datasets and fine-tuned for specific ECG classification tasks with limited labeled data. Self-supervised learning has become a widely adopted pre-training method, enabling models to learn meaningful representations from unlabeled datasets. In this work, we explore the joint-embedding predictive architecture (JEPA) for self-supervised learning from ECG data. Unlike invariance-based methods, JEPA does not rely on hand-crafted data augmentations, and unlike generative methods, it predicts latent features rather than reconstructing input data. We create a large unsupervised pre-training dataset by combining ten public ECG databases, amounting to over one million records. We pre-train Vision Transformers using JEPA on this dataset and fine-tune them on various PTB-XL benchmarks. Our results show that JEPA outperforms existing invariance-based and generative approaches, achieving an AUC of 0.945 on the PTB-XL all statements task. JEPA consistently learns the highest quality representations, as demonstrated in linear evaluations, and proves advantageous for pre-training even in the absence of additional data.

Recent advancements in Large Language Models (LLMs) have drawn increasing attention since the learned embeddings pretrained on large-scale datasets have shown powerful ability in various downstream applications. However, whether the learned knowledge by LLMs can be transferred to clinical cardiology remains unknown. In this work, we aim to bridge this gap by transferring the knowledge of LLMs to clinical Electrocardiography (ECG). We propose an approach for cardiovascular disease diagnosis and automatic ECG diagnosis report generation. We also introduce an additional loss function by Optimal Transport (OT) to align the distribution between ECG and language embedding. The learned embeddings are evaluated on two downstream tasks: (1) automatic ECG diagnosis report generation, and (2) zero-shot cardiovascular disease detection. Our approach is able to generate high-quality cardiac diagnosis reports and also achieves competitive zero-shot classification performance even compared with supervised baselines, which proves the feasibility of transferring knowledge from LLMs to the cardiac domain.

The electrocardiogram (ECG) is an essential non-invasive diagnostic tool for assessing cardiac conditions. Existing automatic interpretation methods suffer from limited generalizability, focusing on a narrow range of cardiac conditions, and typically depend on raw physiological signals, which may not be readily available in resource-limited settings where only printed or digital ECG images are accessible. Recent advancements in multimodal large language models (MLLMs) present promising opportunities for addressing these challenges. However, the application of MLLMs to ECG image interpretation remains challenging due to the lack of instruction tuning datasets and well-established ECG image benchmarks for quantitative evaluation. To address these challenges, we introduce ECGInstruct, a comprehensive ECG image instruction tuning dataset of over one million samples, covering a wide range of ECG-related tasks from diverse data sources. Using ECGInstruct, we develop PULSE, an MLLM tailored for ECG image comprehension. In addition, we curate ECGBench, a new evaluation benchmark covering four key ECG image interpretation tasks across nine different datasets. Our experiments show that PULSE sets a new state-of-the-art, outperforming general MLLMs with an average accuracy improvement of 15% to 30%. This work highlights the potential of PULSE to enhance ECG interpretation in clinical practice.

While Multimodal Large Language Models (MLLMs) show promising performance in automated electrocardiogram interpretation, it remains unclear whether they genuinely perform actual step-by-step reasoning or just rely on superficial visual cues. To investigate this, we introduce ECG-Reasoning-Benchmark, a novel multi-turn evaluation framework comprising over 6,400 samples to systematically assess step-by-step reasoning across 17 core ECG diagnoses. Our comprehensive evaluation of state-of-the-art models reveals a critical failure in executing multi-step logical deduction. Although models possess the medical knowledge to retrieve clinical criteria for a diagnosis, they exhibit near-zero success rates (6% Completion) in maintaining a complete reasoning chain, primarily failing to ground the corresponding ECG findings to the actual visual evidence in the ECG signal. These results demonstrate that current MLLMs bypass actual visual interpretation, exposing a critical flaw in existing training paradigms and underscoring the necessity for robust, reasoning-centric medical AI. The code and data are available at https://github.com/Jwoo5/ecg-reasoning-benchmark.

Besides entity-centric knowledge, usually organized as Knowledge Graph (KG), events are also an essential kind of knowledge in the world, which trigger the spring up of event-centric knowledge representation form like Event KG (EKG). It plays an increasingly important role in many downstream applications, such as search, question-answering, recommendation, financial quantitative investments, and text generation. This paper provides a comprehensive survey of EKG from history, ontology, instance, and application views. Specifically, to characterize EKG thoroughly, we focus on its history, definition, schema induction, acquisition, related representative graphs/systems, and applications. The development processes and trends are studied therein. We further summarize prospective directions to facilitate future research on EKG.

The electrocardiogram (ECG) is a dependable instrument for assessing the function of the cardiovascular system. There has recently been much emphasis on precisely classifying ECGs. While ECG situations have numerous similarities, little attention has been paid to categorizing ECGs using graph neural networks. In this study, we offer three distinct techniques for classifying heartbeats using deep graph neural networks to classify the ECG signals accurately. We suggest using different methods to extract topological features from the ECG signal and then using a branch of the graph neural network named graph isomorphism network for classifying the ECGs. On the PTB Diagnostics data set, we tested the three proposed techniques. According to the findings, the three proposed techniques are capable of making arrhythmia classification predictions with the accuracy of 99.38, 98.76, and 91.93 percent, respectively.

Millions of clinical ECGs exist only as paper scans, making them unusable for modern automated diagnostics. We introduce a fully automated, modular framework that converts scanned or photographed ECGs into digital signals, suitable for both clinical and research applications. The framework is validated on 37,191 ECG images with 1,596 collected at Akershus University Hospital, where the algorithm obtains a mean signal-to-noise ratio of 19.65 dB on scanned papers with common artifacts. It is further evaluated on the Emory Paper Digitization ECG Dataset, comprising 35,595 images, including images with perspective distortion, wrinkles, and stains. The model improves on the state-of-the-art in all subcategories. The full software is released as open-source, promoting reproducibility and further development. We hope the software will contribute to unlocking retrospective ECG archives and democratize access to AI-driven diagnostics.

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.

Deep learning-based electrocardiogram (ECG) classification has shown impressive performance but clinical adoption has been slowed by the lack of transparent and faithful explanations. Post hoc methods such as saliency maps may fail to reflect a model's true decision process. Prototype-based reasoning offers a more transparent alternative by grounding decisions in similarity to learned representations of real ECG segments, enabling faithful, case-based explanations. We introduce ProtoECGNet, a prototype-based deep learning model for interpretable, multi-label ECG classification. ProtoECGNet employs a structured, multi-branch architecture that reflects clinical interpretation workflows: it integrates a 1D CNN with global prototypes for rhythm classification, a 2D CNN with time-localized prototypes for morphology-based reasoning, and a 2D CNN with global prototypes for diffuse abnormalities. Each branch is trained with a prototype loss designed for multi-label learning, combining clustering, separation, diversity, and a novel contrastive loss that encourages appropriate separation between prototypes of unrelated classes while allowing clustering for frequently co-occurring diagnoses. We evaluate ProtoECGNet on all 71 diagnostic labels from the PTB-XL dataset, demonstrating competitive performance relative to state-of-the-art black-box models while providing structured, case-based explanations. To assess prototype quality, we conduct a structured clinician review of the final model's projected prototypes, finding that they are rated as representative and clear. ProtoECGNet shows that prototype learning can be effectively scaled to complex, multi-label time-series classification, offering a practical path toward transparent and trustworthy deep learning models for clinical decision support.

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 develop an algorithm which exceeds the performance of board certified cardiologists in detecting a wide range of heart arrhythmias from electrocardiograms recorded with a single-lead wearable monitor. We build a dataset with more than 500 times the number of unique patients than previously studied corpora. On this dataset, we train a 34-layer convolutional neural network which maps a sequence of ECG samples to a sequence of rhythm classes. Committees of board-certified cardiologists annotate a gold standard test set on which we compare the performance of our model to that of 6 other individual cardiologists. We exceed the average cardiologist performance in both recall (sensitivity) and precision (positive predictive value).

The electrocardiogram (ECG) remains a fundamental tool in cardiac diagnostics, yet its interpretation traditionally reliant on the expertise of cardiologists. The emergence of deep learning has heralded a revolutionary era in medical data analysis, particularly in the domain of ECG diagnostics. However, inter-patient variability prohibit the generalibility of ECG-AI model trained on a population dataset, hence degrade the performance of ECG-AI on specific patient or patient group. Many studies have address this challenge using different deep learning technologies. This comprehensive review systematically synthesizes research from a wide range of studies to provide an in-depth examination of cutting-edge deep-learning techniques in personalized ECG diagnosis. The review outlines a rigorous methodology for the selection of pertinent scholarly articles and offers a comprehensive overview of deep learning approaches applied to personalized ECG diagnostics. Moreover, the challenges these methods encounter are investigated, along with future research directions, culminating in insights into how the integration of deep learning can transform personalized ECG diagnosis and enhance cardiac care. By emphasizing both the strengths and limitations of current methodologies, this review underscores the immense potential of deep learning to refine and redefine ECG analysis in clinical practice, paving the way for more accurate, efficient, and personalized cardiac diagnostics.

Conventional task-specific electrocardiogram (ECG) analysis models require large annotated datasets to train. Foundation models mitigate this burden by leveraging self-supervised pretraining; however, the scarcity of open-weight ECG foundation models hinders adoption and cross-study comparability. We present ECG-FM, an open foundation model for ECG analysis, and conduct a study using a dataset of 1.5 million ECGs. ECG-FM is a transformer-based model pretrained using a hybrid contrastive and generative self-supervised learning approach. Our downstream tasks include predicting reduced left ventricular ejection fraction (LVEF) and ECG interpretation labels, where we release a benchmark task on the MIMIC-IV-ECG dataset. We affirm that ECG-FM is robust, label-efficient, and functionally discriminative by showcasing data scaling experiments, performing a latent space analysis, and generating saliency maps. ECG-FM markedly outperforms task-specific models in the small-to-medium-scale data regime and demonstrates cross-dataset generalizability, achieving high AUROC on many clinically salient labels such as atrial fibrillation (0.996) and LVEF<=40% (0.929). We release our code, model weights, and benchmark task at https://github.com/bowang-lab/ECG-FM/.

We present ECG-Expert-QA, a comprehensive multimodal dataset for evaluating diagnostic capabilities in electrocardiogram (ECG) interpretation. It combines real-world clinical ECG data with systematically generated synthetic cases, covering 12 essential diagnostic tasks and totaling 47,211 expert-validated QA pairs. These encompass diverse clinical scenarios, from basic rhythm recognition to complex diagnoses involving rare conditions and temporal changes. A key innovation is the support for multi-turn dialogues, enabling the development of conversational medical AI systems that emulate clinician-patient or interprofessional interactions. This allows for more realistic assessment of AI models' clinical reasoning, diagnostic accuracy, and knowledge integration. Constructed through a knowledge-guided framework with strict quality control, ECG-Expert-QA ensures linguistic and clinical consistency, making it a high-quality resource for advancing AI-assisted ECG interpretation. It challenges models with tasks like identifying subtle ischemic changes and interpreting complex arrhythmias in context-rich scenarios. To promote research transparency and collaboration, the dataset, accompanying code, and prompts are publicly released at https://github.com/Zaozzz/ECG-Expert-QA

Question answering (QA) in the field of healthcare has received much attention due to significant advancements in natural language processing. However, existing healthcare QA datasets primarily focus on medical images, clinical notes, or structured electronic health record tables. This leaves the vast potential of combining electrocardiogram (ECG) data with these systems largely untapped. To address this gap, we present ECG-QA, the first QA dataset specifically designed for ECG analysis. The dataset comprises a total of 70 question templates that cover a wide range of clinically relevant ECG topics, each validated by an ECG expert to ensure their clinical utility. As a result, our dataset includes diverse ECG interpretation questions, including those that require a comparative analysis of two different ECGs. In addition, we have conducted numerous experiments to provide valuable insights for future research directions. We believe that ECG-QA will serve as a valuable resource for the development of intelligent QA systems capable of assisting clinicians in ECG interpretations. Dataset URL: https://github.com/Jwoo5/ecg-qa

Electrocardiogram (ECG) plays a foundational role in modern cardiovascular care, enabling non-invasive diagnosis of arrhythmias, myocardial ischemia, and conduction disorders. While machine learning has achieved expert-level performance in ECG interpretation, the development of clinically deployable multimodal AI systems remains constrained, primarily due to the lack of publicly available datasets that simultaneously incorporate raw signals, diagnostic images, and interpretation text. Most existing ECG datasets provide only single-modality data or, at most, dual modalities, making it difficult to build models that can understand and integrate diverse ECG information in real-world settings. To address this gap, we introduce MEETI (MIMIC-IV-Ext ECG-Text-Image), the first large-scale ECG dataset that synchronizes raw waveform data, high-resolution plotted images, and detailed textual interpretations generated by large language models. In addition, MEETI includes beat-level quantitative ECG parameters extracted from each lead, offering structured parameters that support fine-grained analysis and model interpretability. Each MEETI record is aligned across four components: (1) the raw ECG waveform, (2) the corresponding plotted image, (3) extracted feature parameters, and (4) detailed interpretation text. This alignment is achieved using consistent, unique identifiers. This unified structure supports transformer-based multimodal learning and supports fine-grained, interpretable reasoning about cardiac health. By bridging the gap between traditional signal analysis, image-based interpretation, and language-driven understanding, MEETI established a robust foundation for the next generation of explainable, multimodal cardiovascular AI. It offers the research community a comprehensive benchmark for developing and evaluating ECG-based AI systems.

Electrocardiogram (ECG) is a widely used tool for assessing cardiac function due to its low cost and accessibility. Emergent research shows that ECGs can help make predictions on key outcomes traditionally derived from more complex modalities such as echocardiograms (ECHO), enabling the use of ECGs as a more accessible method to predict broader measurements of cardiac function. ECHO, in particular, are of great importance because they require considerable hospital resources while playing a key role in clinical cardiac assessment. To aid this use case, we introduce EchoingECG, a probabilistic student-teacher model that leverages uncertainty-aware ECG embeddings and ECHO supervision to improve ECG-based cardiac function prediction. Our approach integrates Probabilistic Cross-Modal Embeddings (PCME++), a probabilistic contrastive framework, with ECHO-CLIP, a vision-language pre-trained model trained on ECHO-text pairs, to distill ECHO knowledge into ECG representations. Through experiments and external validation, we showed that EchoingECG outperforms state-of-the-art foundation ECG models in zero-shot, few-shot, and fine-tune settings for ECHO predictions based on ECG. We also highlighted that variance estimation (enabled through our method) enhanced our understanding of model performance by identifying underlying regions of uncertainty within ECGs. The code is available: https://github.com/mcintoshML/EchoingECG.

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.

Twelve-lead electrocardiograms (ECGs) are the clinical gold standard for cardiac diagnosis, providing comprehensive spatial coverage of the heart necessary to detect conditions such as myocardial infarction (MI). However, their lack of portability limits continuous and large-scale use. Three-lead ECG systems are widely used in wearable devices due to their simplicity and mobility, but they often fail to capture pathologies in unmeasured regions. To address this, we propose WearECG, a Variational Autoencoder (VAE) method that reconstructs twelve-lead ECGs from three leads: II, V1, and V5. Our model includes architectural improvements to better capture temporal and spatial dependencies in ECG signals. We evaluate generation quality using MSE, MAE, and Frechet Inception Distance (FID), and assess clinical validity via a Turing test with expert cardiologists. To further validate diagnostic utility, we fine-tune ECGFounder, a large-scale pretrained ECG model, on a multi-label classification task involving over 40 cardiac conditions, including six different myocardial infarction locations, using both real and generated signals. Experiments on the MIMIC dataset show that our method produces physiologically realistic and diagnostically informative signals, with robust performance in downstream tasks. This work demonstrates the potential of generative modeling for ECG reconstruction and its implications for scalable, low-cost cardiac screening.

Despite the tremendous success, existing machine learning models still fall short of human-like systematic generalization -- learning compositional rules from limited data and applying them to unseen combinations in various domains. We propose Neural-Symbolic Recursive Machine (NSR) to tackle this deficiency. The core representation of NSR is a Grounded Symbol System (GSS) with combinatorial syntax and semantics, which entirely emerges from training data. Akin to the neuroscience studies suggesting separate brain systems for perceptual, syntactic, and semantic processing, NSR implements analogous separate modules of neural perception, syntactic parsing, and semantic reasoning, which are jointly learned by a deduction-abduction algorithm. We prove that NSR is expressive enough to model various sequence-to-sequence tasks. Superior systematic generalization is achieved via the inductive biases of equivariance and recursiveness embedded in NSR. In experiments, NSR achieves state-of-the-art performance in three benchmarks from different domains: SCAN for semantic parsing, PCFG for string manipulation, and HINT for arithmetic reasoning. Specifically, NSR achieves 100% generalization accuracy on SCAN and PCFG and outperforms state-of-the-art models on HINT by about 23%. Our NSR demonstrates stronger generalization than pure neural networks due to its symbolic representation and inductive biases. NSR also demonstrates better transferability than existing neural-symbolic approaches due to less domain-specific knowledge required.

Understanding the interaction of neural and cardiac systems during cognitive activity is critical to advancing physiological computing. Although EEG has been the gold standard for assessing mental workload, its limited portability restricts its real-world use. Widely available ECG through wearable devices proposes a pragmatic alternative. This research investigates whether ECG signals can reliably reflect cognitive load and serve as proxies for EEG-based indicators. In this work, we present multimodal data acquired from two different paradigms involving working-memory and passive-listening tasks. For each modality, we extracted ECG time-domain HRV metrics and Catch22 descriptors against EEG spectral and Catch22 features, respectively. We propose a cross-modal XGBoost framework to project the ECG features onto EEG-representative cognitive spaces, thereby allowing workload inferences using only ECG. Our results show that ECG-derived projections expressively capture variation in cognitive states and provide good support for accurate classification. Our findings underpin ECG as an interpretable, real-time, wearable solution for everyday cognitive monitoring.

LLMs have emerged as powerful tools for interpreting multimodal data. In medicine, they hold particular promise for synthesizing large volumes of clinical information into actionable insights and digital health applications. Yet, a major limitation remains their inability to handle time series. To overcome this gap, we present OpenTSLM, a family of Time Series Language Models (TSLMs) created by integrating time series as a native modality to pretrained LLMs, enabling reasoning over multiple time series of any length. We investigate two architectures for OpenTSLM. The first, OpenTSLM-SoftPrompt, models time series implicitly by concatenating learnable time series tokens with text tokens via soft prompting. Although parameter-efficient, we hypothesize that explicit time series modeling scales better and outperforms implicit approaches. We thus introduce OpenTSLM-Flamingo, which integrates time series with text via cross-attention. We benchmark both variants against baselines that treat time series as text tokens or plots, across a suite of text-time-series Chain-of-Thought (CoT) reasoning tasks. We introduce three datasets: HAR-CoT, Sleep-CoT, and ECG-QA-CoT. Across all, OpenTSLM models outperform baselines, reaching 69.9 F1 in sleep staging and 65.4 in HAR, compared to 9.05 and 52.2 for finetuned text-only models. Notably, even 1B-parameter OpenTSLM models surpass GPT-4o (15.47 and 2.95). OpenTSLM-Flamingo matches OpenTSLM-SoftPrompt in performance and outperforms on longer sequences, while maintaining stable memory requirements. By contrast, SoftPrompt grows exponentially in memory with sequence length, requiring around 110 GB compared to 40 GB VRAM when training on ECG-QA with LLaMA-3B. Expert reviews by clinicians find strong reasoning capabilities exhibited by OpenTSLMs on ECG-QA. To facilitate further research, we provide all code, datasets, and models open-source.

The first ACM/IEEE TinyML Design Contest (TDC) held at the 41st International Conference on Computer-Aided Design (ICCAD) in 2022 is a challenging, multi-month, research and development competition. TDC'22 focuses on real-world medical problems that require the innovation and implementation of artificial intelligence/machine learning (AI/ML) algorithms on implantable devices. The challenge problem of TDC'22 is to develop a novel AI/ML-based real-time detection algorithm for life-threatening ventricular arrhythmia over low-power microcontrollers utilized in Implantable Cardioverter-Defibrillators (ICDs). The dataset contains more than 38,000 5-second intracardiac electrograms (IEGMs) segments over 8 different types of rhythm from 90 subjects. The dedicated hardware platform is NUCLEO-L432KC manufactured by STMicroelectronics. TDC'22, which is open to multi-person teams world-wide, attracted more than 150 teams from over 50 organizations. This paper first presents the medical problem, dataset, and evaluation procedure in detail. It further demonstrates and discusses the designs developed by the leading teams as well as representative results. This paper concludes with the direction of improvement for the future TinyML design for health monitoring applications.

Accurate detection of cardiac abnormalities from electrocardiogram recordings is regarded as essential for clinical diagnostics and decision support. Traditional deep learning models such as residual networks and transformer architectures have been applied successfully to this task, but their performance has been limited when long sequential signals are processed. Recently, state space models have been introduced as an efficient alternative. In this study, a hybrid framework named One Dimensional Convolutional Neural Network Electrocardiogram Mamba is introduced, in which convolutional feature extraction is combined with Mamba, a selective state space model designed for effective sequence modeling. The model is built upon Vision Mamba, a bidirectional variant through which the representation of temporal dependencies in electrocardiogram data is enhanced. Comprehensive experiments on the PhysioNet Computing in Cardiology Challenges of 2020 and 2021 were conducted, and superior performance compared with existing methods was achieved. Specifically, the proposed model achieved substantially higher AUPRC and AUROC scores than those reported by the best previously published algorithms on twelve lead electrocardiograms. These results demonstrate the potential of Mamba-based architectures to advance reliable ECG classification. This capability supports early diagnosis and personalized treatment, while enhancing accessibility in telemedicine and resource-constrained healthcare systems.

Machine learning models, particularly deep neural networks, have demonstrated strong performance in classifying complex time series data. However, their black-box nature limits trust and adoption, especially in high-stakes domains such as healthcare. To address this challenge, we introduce UniCoMTE, a model-agnostic framework for generating counterfactual explanations for multivariate time series classifiers. The framework identifies temporal features that most heavily influence a model's prediction by modifying the input sample and assessing its impact on the model's prediction. UniCoMTE is compatible with a wide range of model architectures and operates directly on raw time series inputs. In this study, we evaluate UniCoMTE's explanations on a time series ECG classifier. We quantify explanation quality by comparing our explanations' comprehensibility to comprehensibility of established techniques (LIME and SHAP) and assessing their generalizability to similar samples. Furthermore, clinical utility is assessed through a questionnaire completed by medical experts who review counterfactual explanations presented alongside original ECG samples. Results show that our approach produces concise, stable, and human-aligned explanations that outperform existing methods in both clarity and applicability. By linking model predictions to meaningful signal patterns, the framework advances the interpretability of deep learning models for real-world time series applications.

ECG foundation models are increasingly popular due to their adaptability across various tasks. However, their clinical applicability is often limited by performance gaps compared to task-specific models, even after pre-training on large ECG datasets and fine-tuning on target data. This limitation is likely due to the lack of an effective post-training strategy. In this paper, we propose a simple yet effective post-training approach to enhance ECG foundation models. We evaluate it on a publicly available Transformer-based foundation model. Experiments across multiple ECG tasks show that our method consistently outperforms baseline fine-tuning. On the PTB-XL benchmarks, it improves macro AUROC by 0.7%-8.9% and macro AUPRC by 23.3%-77.9%, also outperforming several recent state-of-the-art approaches, including task-specific and advanced architectures. Further analyses demonstrate improved training dynamics and data efficiency, with only 30% of the training data outperforming the baseline trained on the full dataset. Ablation studies highlight the importance of stochastic depth and preview linear probing. These findings underscore the potential of post-training strategies to improve ECG foundation models, and we hope this work will contribute to the continued development of foundation models in the ECG domain.

An arrhythmia, also known as a dysrhythmia, refers to an irregular heartbeat. There are various types of arrhythmias that can originate from different areas of the heart, resulting in either a rapid, slow, or irregular heartbeat. An electrocardiogram (ECG) is a vital diagnostic tool used to detect heart irregularities and abnormalities, allowing experts to analyze the heart's electrical signals to identify intricate patterns and deviations from the norm. Over the past few decades, numerous studies have been conducted to develop automated methods for classifying heartbeats based on ECG data. In recent years, deep learning has demonstrated exceptional capabilities in tackling various medical challenges, particularly with transformers as a model architecture for sequence processing. By leveraging the transformers, we developed the ECGformer model for the classification of various arrhythmias present in electrocardiogram data. We assessed the suggested approach using the MIT-BIH and PTB datasets. ECG heartbeat arrhythmia classification results show that the proposed method is highly effective.

Electrocardiogram (ECG) delineation, the segmentation of meaningful waveform features, is critical for clinical diagnosis. Despite recent advances using deep learning, progress has been limited by the scarcity of publicly available annotated datasets. Semi-supervised learning presents a promising solution by leveraging abundant unlabeled ECG data. In this study, we present SemiSegECG, the first systematic benchmark for semi-supervised semantic segmentation (SemiSeg) in ECG delineation. We curated and unified multiple public datasets, including previously underused sources, to support robust and diverse evaluation. We adopted five representative SemiSeg algorithms from computer vision, implemented them on two different architectures: the convolutional network and the transformer, and evaluated them in two different settings: in-domain and cross-domain. Additionally, we propose ECG-specific training configurations and augmentation strategies and introduce a standardized evaluation framework. Our results show that the transformer outperforms the convolutional network in semi-supervised ECG delineation. We anticipate that SemiSegECG will serve as a foundation for advancing semi-supervised ECG delineation methods and will facilitate further research in this domain.

Synthetic electrocardiogram generation serves medical AI applications requiring privacy-preserving data sharing and training dataset augmentation. Current diffusion-based methods achieve high generation quality but require hundreds of neural network evaluations during sampling, creating computational bottlenecks for clinical deployment. We propose FlowECG, a flow matching approach that adapts the SSSD-ECG architecture by replacing the iterative diffusion process with continuous flow dynamics. Flow matching learns direct transport paths from noise to data distributions through ordinary differential equation solving. We evaluate our method on the PTB-XL dataset using Dynamic Time Warping, Wasserstein distance, Maximum Mean Discrepancy, and spectral similarity metrics. FlowECG matches SSSD-ECG performance at 200 neural function evaluations, outperforming the baseline on three metrics. The key finding shows that FlowECG maintains generation quality with substantially fewer sampling steps, achieving comparable results with 10-25 evaluations compared to 200 for diffusion methods. This efficiency improvement reduces computational requirements by an order of magnitude while preserving physiologically realistic 12-lead ECG characteristics. The approach enables practical deployment in resource-limited clinical settings where real-time generation or large-scale synthetic data creation is needed.

Neural networks adapt very well to distributed and continuous representations, but struggle to generalize from small amounts of data. Symbolic systems commonly achieve data efficient generalization by exploiting modularity to benefit from local and discrete features of a representation. These features allow symbolic programs to be improved one module at a time and to experience combinatorial growth in the values they can successfully process. However, it is difficult to design a component that can be used to form symbolic abstractions and which is adequately overparametrized to learn arbitrary high-dimensional transformations. I present Graph-based Symbolically Synthesized Neural Networks (G-SSNNs), a class of neural modules that operate on representations modified with synthesized symbolic programs to include a fixed set of local and discrete features. I demonstrate that the choice of injected features within a G-SSNN module modulates the data efficiency and generalization of baseline neural models, creating predictable patterns of both heightened and curtailed generalization. By training G-SSNNs, we also derive information about desirable semantics of symbolic programs without manual engineering. This information is compact and amenable to abstraction, but can also be flexibly recontextualized for other high-dimensional settings. In future work, I will investigate data efficient generalization and the transferability of learned symbolic representations in more complex G-SSNN designs based on more complex classes of symbolic programs. Experimental code and data are available at https://github.com/shlomenu/symbolically_synthesized_networks .

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.

Several adaptations of Transformers models have been developed in various domains since its breakthrough in Natural Language Processing (NLP). This trend has spread into the field of Music Information Retrieval (MIR), including studies processing music data. However, the practice of leveraging NLP tools for symbolic music data is not novel in MIR. Music has been frequently compared to language, as they share several similarities, including sequential representations of text and music. These analogies are also reflected through similar tasks in MIR and NLP. This survey reviews NLP methods applied to symbolic music generation and information retrieval studies following two axes. We first propose an overview of representations of symbolic music adapted from natural language sequential representations. Such representations are designed by considering the specificities of symbolic music. These representations are then processed by models. Such models, possibly originally developed for text and adapted for symbolic music, are trained on various tasks. We describe these models, in particular deep learning models, through different prisms, highlighting music-specialized mechanisms. We finally present a discussion surrounding the effective use of NLP tools for symbolic music data. This includes technical issues regarding NLP methods and fundamental differences between text and music, which may open several doors for further research into more effectively adapting NLP tools to symbolic MIR.

Neural networks have a reputation for being better at solving statistical or approximate problems than at performing calculations or working with symbolic data. In this paper, we show that they can be surprisingly good at more elaborated tasks in mathematics, such as symbolic integration and solving differential equations. We propose a syntax for representing mathematical problems, and methods for generating large datasets that can be used to train sequence-to-sequence models. We achieve results that outperform commercial Computer Algebra Systems such as Matlab or Mathematica.

Electrocardiography (ECG) signal generation has been heavily explored using generative adversarial networks (GAN) because the implementation of 12-lead ECGs is not always feasible. The GAN models have achieved remarkable results in reproducing ECG signals but are only designed for multiple lead inputs and the features the GAN model preserves have not been identified-limiting the generated signals use in cardiovascular disease (CVD)-predictive models. This paper presents ECGNet which is a procedure that generates a complete set of 12-lead ECG signals from any single lead input using a GAN framework with a bidirectional long short-term memory (LSTM) generator and a convolutional neural network (CNN) discriminator. Cross and auto-correlation analysis performed on the generated signals identifies features conserved during the signal generation-i.e., features that can characterize the unique-nature of each signal and thus likely indicators of CVD. Finally, by using ECG signals annotated with the CVD-indicative features detailed by the correlation analysis as inputs for a CVD-onset-predictive CNN model, we overcome challenges preventing the prediction of multiple-CVD targets. Our models are experimented on 15s 12-lead ECG dataset recorded using MyoVista's wavECG. Functional outcome data for each patient is recorded and used in the CVD-predictive model. Our best GAN model achieves state-of-the-art accuracy with Frechet Distance (FD) scores of 4.73, 4.89, 5.18, 4.77, 4.71, and 5.55 on the V1-V6 pre-cordial leads respectively and shows strength in preserving the P-Q segments and R-peaks in the generated signals. To the best of our knowledge, ECGNet is the first to predict all of the remaining eleven leads from the input of any single lead.

This study aims to develop and evaluate an ensemble machine learning-based framework for the automatic detection of Wide QRS Complex Tachycardia (WCT) from ECG signals, emphasizing diagnostic accuracy and interpretability using Explainable AI. The proposed system integrates ensemble learning techniques, i.e., an optimized Random Forest known as CardioForest, and models like XGBoost and LightGBM. The models were trained and tested on ECG data from the publicly available MIMIC-IV dataset. The testing was carried out with the assistance of accuracy, balanced accuracy, precision, recall, F1 score, ROC-AUC, and error rate (RMSE, MAE) measures. In addition, SHAP (SHapley Additive exPlanations) was used to ascertain model explainability and clinical relevance. The CardioForest model performed best on all metrics, achieving a test accuracy of 94.95%, a balanced accuracy of 88.31%, and high precision and recall metrics. SHAP analysis confirmed the model's ability to rank the most relevant ECG features, such as QRS duration, in accordance with clinical intuitions, thereby fostering trust and usability in clinical practice. The findings recognize CardioForest as an extremely dependable and interpretable WCT detection model. Being able to offer accurate predictions and transparency through explainability makes it a valuable tool to help cardiologists make timely and well-informed diagnoses, especially for high-stakes and emergency scenarios.

Objective: To determine if a realistic, but computationally efficient model of the electrocardiogram can be used to pre-train a deep neural network (DNN) with a wide range of morphologies and abnormalities specific to a given condition - T-wave Alternans (TWA) as a result of Post-Traumatic Stress Disorder, or PTSD - and significantly boost performance on a small database of rare individuals. Approach: Using a previously validated artificial ECG model, we generated 180,000 artificial ECGs with or without significant TWA, with varying heart rate, breathing rate, TWA amplitude, and ECG morphology. A DNN, trained on over 70,000 patients to classify 25 different rhythms, was modified the output layer to a binary class (TWA or no-TWA, or equivalently, PTSD or no-PTSD), and transfer learning was performed on the artificial ECG. In a final transfer learning step, the DNN was trained and cross-validated on ECG from 12 PTSD and 24 controls for all combinations of using the three databases. Main results: The best performing approach (AUROC = 0.77, Accuracy = 0.72, F1-score = 0.64) was found by performing both transfer learning steps, using the pre-trained arrhythmia DNN, the artificial data and the real PTSD-related ECG data. Removing the artificial data from training led to the largest drop in performance. Removing the arrhythmia data from training provided a modest, but significant, drop in performance. The final model showed no significant drop in performance on the artificial data, indicating no overfitting. Significance: In healthcare, it is common to only have a small collection of high-quality data and labels, or a larger database with much lower quality (and less relevant) labels. The paradigm presented here, involving model-based performance boosting, provides a solution through transfer learning on a large realistic artificial database, and a partially relevant real database.

Diagrams matter. Unfortunately, the deep learning community has no standard method for diagramming architectures. The current combination of linear algebra notation and ad-hoc diagrams fails to offer the necessary precision to understand architectures in all their detail. However, this detail is critical for faithful implementation, mathematical analysis, further innovation, and ethical assurances. I present neural circuit diagrams, a graphical language tailored to the needs of communicating deep learning architectures. Neural circuit diagrams naturally keep track of the changing arrangement of data, precisely show how operations are broadcast over axes, and display the critical parallel behavior of linear operations. A lingering issue with existing diagramming methods is the inability to simultaneously express the detail of axes and the free arrangement of data, which neural circuit diagrams solve. Their compositional structure is analogous to code, creating a close correspondence between diagrams and implementation. In this work, I introduce neural circuit diagrams for an audience of machine learning researchers. After introducing neural circuit diagrams, I cover a host of architectures to show their utility and breed familiarity. This includes the transformer architecture, convolution (and its difficult-to-explain extensions), residual networks, the U-Net, and the vision transformer. I include a Jupyter notebook that provides evidence for the close correspondence between diagrams and code. Finally, I examine backpropagation using neural circuit diagrams. I show their utility in providing mathematical insight and analyzing algorithms' time and space complexities.

Cardiac biosignals, such as electrocardiograms (ECG) and photoplethysmograms (PPG), are of paramount importance for the diagnosis, prevention, and management of cardiovascular diseases, and have been extensively used in a variety of clinical tasks. Conventional deep learning approaches for analyzing these signals typically rely on homogeneous datasets and static bespoke models, limiting their robustness and generalizability across diverse clinical settings and acquisition protocols. In this study, we present a cardiac sensing foundation model (CSFM) that leverages advanced transformer architectures and a generative, masked pretraining strategy to learn unified representations from vast, heterogeneous health records. Our model is pretrained on an innovative multi-modal integration of data from multiple large-scale datasets (including MIMIC-III-WDB, MIMIC-IV-ECG, and CODE), comprising cardiac signals and the corresponding clinical or machine-generated text reports from approximately 1.7 million individuals. We demonstrate that the embeddings derived from our CSFM not only serve as effective feature extractors across diverse cardiac sensing scenarios, but also enable seamless transfer learning across varying input configurations and sensor modalities. Extensive evaluations across diagnostic tasks, demographic information recognition, vital sign measurement, clinical outcome prediction, and ECG question answering reveal that CSFM consistently outperforms traditional one-modal-one-task approaches. Notably, CSFM exhibits robust performance across multiple ECG lead configurations from standard 12-lead systems to single-lead setups, and in scenarios where only ECG, only PPG, or a combination thereof is available. These findings highlight the potential of CSFM as a versatile and scalable solution, for comprehensive cardiac monitoring.

Anomaly detection in 12-lead electrocardiograms (ECGs) is critical for identifying deviations associated with cardiovascular disease. This work presents a comparative analysis of three autoencoder-based architectures: convolutional autoencoder (CAE), variational autoencoder with bidirectional long short-term memory (VAE-BiLSTM), and VAE-BiLSTM with multi-head attention (VAE-BiLSTM-MHA), for unsupervised anomaly detection in ECGs. To the best of our knowledge, this study reports the first application of a VAE-BiLSTM-MHA architecture to ECG anomaly detection. All models are trained on normal ECG samples to reconstruct non-anomalous cardiac morphology and detect deviations indicative of disease. Using a unified preprocessing and evaluation pipeline on the public China Physiological Signal Challenge (CPSC) dataset, the attention-augmented VAE achieves the best performance, with an AUPRC of 0.81 and a recall of 0.85 on the held-out test set, outperforming the other architectures. To support clinical triage, this model is further integrated into an interactive dashboard that visualizes anomaly localization. In addition, a performance comparison with baseline models from the literature is provided.

Self-supervised learning excels at learning representations from large amounts of data. At the same time, generative models offer the complementary property of learning information about the underlying data generation process. In this study, we aim at establishing a principled connection between these two paradigms and highlight the benefits of their complementarity. In particular, we perform an analysis of self-supervised learning objectives, elucidating the underlying probabilistic graphical models and presenting a standardized methodology for their derivation from first principles. The analysis suggests a natural means of integrating self-supervised learning with likelihood-based generative models. We instantiate this concept within the realm of cluster-based self-supervised learning and energy models, introducing a lower bound proven to reliably penalize the most important failure modes and unlocking full unification. Our theoretical findings are substantiated through experiments on synthetic and real-world data, including SVHN, CIFAR10, and CIFAR100, demonstrating that our objective function allows to jointly train a backbone network in a discriminative and generative fashion, consequently outperforming existing self-supervised learning strategies in terms of clustering, generation and out-of-distribution detection performance by a wide margin. We also demonstrate that the solution can be integrated into a neuro-symbolic framework to tackle a simple yet non-trivial instantiation of the symbol grounding problem. The code is publicly available at https://github.com/emsansone/GEDI.

Time series play a fundamental role in many domains, capturing a plethora of information about the underlying data-generating processes. When a process generates multiple synchronized signals we are faced with multidimensional time series. In this context a fundamental problem is that of motif mining, where we seek patterns repeating twice with minor variations, spanning some of the dimensions. State of the art exact solutions for this problem run in time quadratic in the length of the input time series. We provide a scalable method to find the top-k motifs in multidimensional time series with probabilistic guarantees on the quality of the results. Our algorithm runs in time subquadratic in the length of the input, and returns the exact solution with probability at least 1-δ, where δ is a user-defined parameter. The algorithm is designed to be adaptive to the input distribution, self-tuning its parameters while respecting user-defined limits on the memory to use. Our theoretical analysis is complemented by an extensive experimental evaluation, showing that our algorithm is orders of magnitude faster than the state of the art.

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

The rapid evolution of artificial intelligence (AI), together with the increased availability of social media and news for epidemiological surveillance, are marking a pivotal moment in epidemiology and public health research. Leveraging the power of generative AI, we use an ensemble approach which incorporates multiple Large Language Models (LLMs) to extract valuable actionable epidemiological information from the World Health Organization (WHO) Disease Outbreak News (DONs). DONs is a collection of regular reports on global outbreaks curated by the WHO and the adopted decision-making processes to respond to them. The extracted information is made available in a daily-updated dataset and a knowledge graph, referred to as eKG, derived to provide a nuanced representation of the public health domain knowledge. We provide an overview of this new dataset and describe the structure of eKG, along with the services and tools used to access and utilize the data that we are building on top. These innovative data resources open altogether new opportunities for epidemiological research, and the analysis and surveillance of disease outbreaks.

This report overviews our ongoing work in enriching chain-of-thoughts datasets requiring arithmetical reasoning with the integration of non-parametric components, such as a calculator. We conduct an analysis of prominent relevant datasets such as GSM8K, Ape210K, AQuA-RAT, and MathQA and propose a machine-processable HTML-like format specifically tailored for working with semi-structured chains. By converting the datasets into this unified format, we enable the effective integration of large language models and symbolic systems, empowering them to tackle arithmetical reasoning tasks more efficiently.

The success of large language models (LLMs) for time series has been demonstrated in previous work. Utilizing a symbolic time series representation, one can efficiently bridge the gap between LLMs and time series. However, the remaining challenge is to exploit the semantic information hidden in time series by using symbols or existing tokens of LLMs, while aligning the embedding space of LLMs according to the hidden information of time series. The symbolic time series approximation (STSA) method called adaptive Brownian bridge-based symbolic aggregation (ABBA) shows outstanding efficacy in preserving salient time series features by modeling time series patterns in terms of amplitude and period while using existing tokens of LLMs. In this paper, we introduce a method, called LLM-ABBA, that integrates ABBA into large language models for various downstream time series tasks. By symbolizing time series, LLM-ABBA compares favorably to the recent state-of-the-art (SOTA) in UCR and three medical time series classification tasks. Meanwhile, a fixed-polygonal chain trick in ABBA is introduced to avoid obvious drifting during forecasting tasks by significantly mitigating the effects of cumulative error arising from misused symbols during the transition from symbols to numerical values. In time series regression tasks, LLM-ABBA achieves the new SOTA on Time Series Extrinsic Regression (TSER) benchmarks. LLM-ABBA also shows competitive forecasting capability compared to recent SOTA time series forecasting results. We believe this framework can also seamlessly extend to other time series tasks. Our simulation code is publicly available at: https://github.com/inEXASCALE/llm-abba

Photoplethysmogram (PPG) and electrocardiogram (ECG) are commonly recorded in intesive care unit (ICU) and operating room (OR). However, the high incidence of poor, incomplete, and inconsistent signal quality, can lead to false alarms or diagnostic inaccuracies. The methods explored so far suffer from limited generalizability, reliance on extensive labeled data, and poor cross-task transferability. To overcome these challenges, we introduce QualityFM, a novel multimodal foundation model for these physiological signals, designed to acquire a general-purpose understanding of signal quality. Our model is pre-trained on an large-scale dataset comprising over 21 million 30-second waveforms and 179,757 hours of data. Our approach involves a dual-track architecture that processes paired physiological signals of differing quality, leveraging a self-distillation strategy where an encoder for high-quality signals is used to guide the training of an encoder for low-quality signals. To efficiently handle long sequential signals and capture essential local quasi-periodic patterns, we integrate a windowed sparse attention mechanism within our Transformer-based model. Furthermore, a composite loss function, which combines direct distillation loss on encoder outputs with indirect reconstruction loss based on power and phase spectra, ensures the preservation of frequency-domain characteristics of the signals. We pre-train three models with varying parameter counts (9.6 M to 319 M) and demonstrate their efficacy and practical value through transfer learning on three distinct clinical tasks: false alarm of ventricular tachycardia detection, the identification of atrial fibrillation and the estimation of arterial blood pressure (ABP) from PPG and ECG signals.

Neurosymbolic (NeSy) frameworks combine neural representations and learning with symbolic representations and reasoning. Combining the reasoning capacities, explainability, and interpretability of symbolic processing with the flexibility and power of neural computing allows us to solve complex problems with more reliability while being data-efficient. However, this recently growing topic poses a challenge to developers with its learning curve, lack of user-friendly tools, libraries, and unifying frameworks. In this paper, we characterize the technical facets of existing NeSy frameworks, such as the symbolic representation language, integration with neural models, and the underlying algorithms. A majority of the NeSy research focuses on algorithms instead of providing generic frameworks for declarative problem specification to leverage problem solving. To highlight the key aspects of Neurosymbolic modeling, we showcase three generic NeSy frameworks - DeepProbLog, Scallop, and DomiKnowS. We identify the challenges within each facet that lay the foundation for identifying the expressivity of each framework in solving a variety of problems. Building on this foundation, we aim to spark transformative action and encourage the community to rethink this problem in novel ways.

This paper does not introduce a novel method. Instead, it offers a fairer and more comprehensive comparison of KAN and MLP models across various tasks, including machine learning, computer vision, audio processing, natural language processing, and symbolic formula representation. Specifically, we control the number of parameters and FLOPs to compare the performance of KAN and MLP. Our main observation is that, except for symbolic formula representation tasks, MLP generally outperforms KAN. We also conduct ablation studies on KAN and find that its advantage in symbolic formula representation mainly stems from its B-spline activation function. When B-spline is applied to MLP, performance in symbolic formula representation significantly improves, surpassing or matching that of KAN. However, in other tasks where MLP already excels over KAN, B-spline does not substantially enhance MLP's performance. Furthermore, we find that KAN's forgetting issue is more severe than that of MLP in a standard class-incremental continual learning setting, which differs from the findings reported in the KAN paper. We hope these results provide insights for future research on KAN and other MLP alternatives. Project link: https://github.com/yu-rp/KANbeFair

The neural Hawkes process (Mei & Eisner, 2017) is a generative model of irregularly spaced sequences of discrete events. To handle complex domains with many event types, Mei et al. (2020a) further consider a setting in which each event in the sequence updates a deductive database of facts (via domain-specific pattern-matching rules); future events are then conditioned on the database contents. They show how to convert such a symbolic system into a neuro-symbolic continuous-time generative model, in which each database fact and the possible event has a time-varying embedding that is derived from its symbolic provenance. In this paper, we modify both models, replacing their recurrent LSTM-based architectures with flatter attention-based architectures (Vaswani et al., 2017), which are simpler and more parallelizable. This does not appear to hurt our accuracy, which is comparable to or better than that of the original models as well as (where applicable) previous attention-based methods (Zuo et al., 2020; Zhang et al., 2020a).

The growing popularity of wearable sensors has generated large quantities of temporal physiological and activity data. Ability to analyze this data offers new opportunities for real-time health monitoring and forecasting. However, temporal physiological data presents many analytic challenges: the data is noisy, contains many missing values, and each series has a different length. Most methods proposed for time series analysis and classification do not handle datasets with these characteristics nor do they offer interpretability and explainability, a critical requirement in the health domain. We propose an unsupervised method for learning representations of time series based on common patterns identified within them. The patterns are, interpretable, variable in length, and extracted using Byte Pair Encoding compression technique. In this way the method can capture both long-term and short-term dependencies present in the data. We show that this method applies to both univariate and multivariate time series and beats state-of-the-art approaches on a real world dataset collected from wearable sensors.

Modeling multivariate time series is a well-established problem with a wide range of applications from healthcare to financial markets. Traditional State Space Models (SSMs) are classical approaches for univariate time series modeling due to their simplicity and expressive power to represent linear dependencies. They, however, have fundamentally limited expressive power to capture non-linear dependencies, are slow in practice, and fail to model the inter-variate information flow. Despite recent attempts to improve the expressive power of SSMs by using deep structured SSMs, the existing methods are either limited to univariate time series, fail to model complex patterns (e.g., seasonal patterns), fail to dynamically model the dependencies of variate and time dimensions, and/or are input-independent. We present Chimera that uses two input-dependent 2-D SSM heads with different discretization processes to learn long-term progression and seasonal patterns. To improve the efficiency of complex 2D recurrence, we present a fast training using a new 2-dimensional parallel selective scan. We further present and discuss 2-dimensional Mamba and Mamba-2 as the spacial cases of our 2D SSM. Our experimental evaluation shows the superior performance of Chimera on extensive and diverse benchmarks, including ECG and speech time series classification, long-term and short-term time series forecasting, and time series anomaly detection.

Harnessing the statistical power of neural networks to perform language understanding and symbolic reasoning is difficult, when it requires executing efficient discrete operations against a large knowledge-base. In this work, we introduce a Neural Symbolic Machine, which contains (a) a neural "programmer", i.e., a sequence-to-sequence model that maps language utterances to programs and utilizes a key-variable memory to handle compositionality (b) a symbolic "computer", i.e., a Lisp interpreter that performs program execution, and helps find good programs by pruning the search space. We apply REINFORCE to directly optimize the task reward of this structured prediction problem. To train with weak supervision and improve the stability of REINFORCE, we augment it with an iterative maximum-likelihood training process. NSM outperforms the state-of-the-art on the WebQuestionsSP dataset when trained from question-answer pairs only, without requiring any feature engineering or domain-specific knowledge.

Symbolic equations are at the core of scientific discovery. The task of discovering the underlying equation from a set of input-output pairs is called symbolic regression. Traditionally, symbolic regression methods use hand-designed strategies that do not improve with experience. In this paper, we introduce the first symbolic regression method that leverages large scale pre-training. We procedurally generate an unbounded set of equations, and simultaneously pre-train a Transformer to predict the symbolic equation from a corresponding set of input-output-pairs. At test time, we query the model on a new set of points and use its output to guide the search for the equation. We show empirically that this approach can re-discover a set of well-known physical equations, and that it improves over time with more data and compute.

Contrastive representation learning is crucial in medical time series analysis as it alleviates dependency on labor-intensive, domain-specific, and scarce expert annotations. However, existing contrastive learning methods primarily focus on one single data level, which fails to fully exploit the intricate nature of medical time series. To address this issue, we present COMET, an innovative hierarchical framework that leverages data consistencies at all inherent levels in medical time series. Our meticulously designed model systematically captures data consistency from four potential levels: observation, sample, trial, and patient levels. By developing contrastive loss at multiple levels, we can learn effective representations that preserve comprehensive data consistency, maximizing information utilization in a self-supervised manner. We conduct experiments in the challenging patient-independent setting. We compare COMET against six baselines using three diverse datasets, which include ECG signals for myocardial infarction and EEG signals for Alzheimer's and Parkinson's diseases. The results demonstrate that COMET consistently outperforms all baselines, particularly in setup with 10% and 1% labeled data fractions across all datasets. These results underscore the significant impact of our framework in advancing contrastive representation learning techniques for medical time series. The source code is available at https://github.com/DL4mHealth/COMET.

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.

Artificial intelligence (AI) has demonstrated significant potential in ECG analysis and cardiovascular disease assessment. Recently, foundation models have played a remarkable role in advancing medical AI. The development of an ECG foundation model holds the promise of elevating AI-ECG research to new heights. However, building such a model faces several challenges, including insufficient database sample sizes and inadequate generalization across multiple domains. Additionally, there is a notable performance gap between single-lead and multi-lead ECG analyses. We introduced an ECG Foundation Model (ECGFounder), a general-purpose model that leverages real-world ECG annotations from cardiology experts to broaden the diagnostic capabilities of ECG analysis. ECGFounder was trained on over 10 million ECGs with 150 label categories from the Harvard-Emory ECG Database, enabling comprehensive cardiovascular disease diagnosis through ECG analysis. The model is designed to be both an effective out-of-the-box solution, and a to be fine-tunable for downstream tasks, maximizing usability. Importantly, we extended its application to lower rank ECGs, and arbitrary single-lead ECGs in particular. ECGFounder is applicable to supporting various downstream tasks in mobile monitoring scenarios. Experimental results demonstrate that ECGFounder achieves expert-level performance on internal validation sets, with AUROC exceeding 0.95 for eighty diagnoses. It also shows strong classification performance and generalization across various diagnoses on external validation sets. When fine-tuned, ECGFounder outperforms baseline models in demographic analysis, clinical event detection, and cross-modality cardiac rhythm diagnosis. The trained model and data will be publicly released upon publication through the bdsp.io. Our code is available at https://github.com/bdsp-core/ECGFounder

In this paper, we present MusPy, an open source Python library for symbolic music generation. MusPy provides easy-to-use tools for essential components in a music generation system, including dataset management, data I/O, data preprocessing and model evaluation. In order to showcase its potential, we present statistical analysis of the eleven datasets currently supported by MusPy. Moreover, we conduct a cross-dataset generalizability experiment by training an autoregressive model on each dataset and measuring held-out likelihood on the others---a process which is made easier by MusPy's dataset management system. The results provide a map of domain overlap between various commonly used datasets and show that some datasets contain more representative cross-genre samples than others. Along with the dataset analysis, these results might serve as a guide for choosing datasets in future research. Source code and documentation are available at https://github.com/salu133445/muspy .

Large language models (LLMs) have captured significant interest from both academia and industry due to their impressive performance across various textual tasks. However, the potential of LLMs to analyze physiological time-series data remains an emerging research field. Particularly, there is a notable gap in the utilization of LLMs for analyzing wearable biosignals to achieve cuffless blood pressure (BP) measurement, which is critical for the management of cardiovascular diseases. This paper presents the first work to explore the capacity of LLMs to perform cuffless BP estimation based on wearable biosignals. We extracted physiological features from electrocardiogram (ECG) and photoplethysmogram (PPG) signals and designed context-enhanced prompts by combining these features with BP domain knowledge and user information. Subsequently, we adapted LLMs to BP estimation tasks through fine-tuning. To evaluate the proposed approach, we conducted assessments of ten advanced LLMs using a comprehensive public dataset of wearable biosignals from 1,272 participants. The experimental results demonstrate that the optimally fine-tuned LLM significantly surpasses conventional task-specific baselines, achieving an estimation error of 0.00 pm 9.25 mmHg for systolic BP and 1.29 pm 6.37 mmHg for diastolic BP. Notably, the ablation studies highlight the benefits of our context enhancement strategy, leading to an 8.9% reduction in mean absolute error for systolic BP estimation. This paper pioneers the exploration of LLMs for cuffless BP measurement, providing a potential solution to enhance the accuracy of cuffless BP measurement.

Contrastive learning methods, such as CLIP, leverage naturally paired data-for example, images and their corresponding text captions-to learn general representations that transfer efficiently to downstream tasks. While such approaches are generally applied to two modalities, domains such as robotics, healthcare, and video need to support many types of data at once. We show that the pairwise application of CLIP fails to capture joint information between modalities, thereby limiting the quality of the learned representations. To address this issue, we present Symile, a simple contrastive learning approach that captures higher-order information between any number of modalities. Symile provides a flexible, architecture-agnostic objective for learning modality-specific representations. To develop Symile's objective, we derive a lower bound on total correlation, and show that Symile representations for any set of modalities form a sufficient statistic for predicting the remaining modalities. Symile outperforms pairwise CLIP, even with modalities missing in the data, on cross-modal classification and retrieval across several experiments including on an original multilingual dataset of 33M image, text and audio samples and a clinical dataset of chest X-rays, electrocardiograms, and laboratory measurements. All datasets and code used in this work are publicly available at https://github.com/rajesh-lab/symile.

Neuro-symbolic learning was proposed to address challenges with training neural networks for complex reasoning tasks with the added benefits of interpretability, reliability, and efficiency. Neuro-symbolic learning methods traditionally train neural models in conjunction with symbolic programs, but they face significant challenges that limit them to simplistic problems. On the other hand, purely-neural foundation models now reach state-of-the-art performance through prompting rather than training, but they are often unreliable and lack interpretability. Supplementing foundation models with symbolic programs, which we call neuro-symbolic prompting, provides a way to use these models for complex reasoning tasks. Doing so raises the question: What role does specialized model training as part of neuro-symbolic learning have in the age of foundation models? To explore this question, we highlight three pitfalls of traditional neuro-symbolic learning with respect to the compute, data, and programs leading to generalization problems. This position paper argues that foundation models enable generalizable neuro-symbolic solutions, offering a path towards achieving the original goals of neuro-symbolic learning without the downsides of training from scratch.

Symbolic regression (SR) aims to discover closed-form mathematical expressions that accurately describe data, offering interpretability and analytical insight beyond standard black-box models. Existing SR methods often rely on population-based search or autoregressive modeling, which struggle with scalability and symbolic consistency. We introduce LIES (Logarithm, Identity, Exponential, Sine), a fixed neural network architecture with interpretable primitive activations that are optimized to model symbolic expressions. We develop a framework to extract compact formulae from LIES networks by training with an appropriate oversampling strategy and a tailored loss function to promote sparsity and to prevent gradient instability. After training, it applies additional pruning strategies to further simplify the learned expressions into compact formulae. Our experiments on SR benchmarks show that the LIES framework consistently produces sparse and accurate symbolic formulae outperforming all baselines. We also demonstrate the importance of each design component through ablation studies.

Symbolic regression (SR) is a powerful technique for discovering the underlying mathematical expressions from observed data. Inspired by the success of deep learning, recent efforts have focused on two categories for SR methods. One is using a neural network or genetic programming to search the expression tree directly. Although this has shown promising results, the large search space poses difficulties in learning constant factors and processing high-dimensional problems. Another approach is leveraging a transformer-based model training on synthetic data and offers advantages in inference speed. However, this method is limited to fixed small numbers of dimensions and may encounter inference problems when given data is out-of-distribution compared to the synthetic data. In this work, we propose DySymNet, a novel neural-guided Dynamic Symbolic Network for SR. Instead of searching for expressions within a large search space, we explore DySymNet with various structures and optimize them to identify expressions that better-fitting the data. With a topology structure like neural networks, DySymNet not only tackles the challenge of high-dimensional problems but also proves effective in optimizing constants. Based on extensive numerical experiments using low-dimensional public standard benchmarks and the well-known SRBench with more variables, our method achieves state-of-the-art performance in terms of fitting accuracy and robustness to noise.

We propose a fully spectral, neuro\-symbolic reasoning architecture that leverages Graph Signal Processing (GSP) as the primary computational backbone for integrating symbolic logic and neural inference. Unlike conventional reasoning models that treat spectral graph methods as peripheral components, our approach formulates the entire reasoning pipeline in the graph spectral domain. Logical entities and relationships are encoded as graph signals, processed via learnable spectral filters that control multi-scale information propagation, and mapped into symbolic predicates for rule-based inference. We present a complete mathematical framework for spectral reasoning, including graph Fourier transforms, band-selective attention, and spectral rule grounding. Experiments on benchmark reasoning datasets (ProofWriter, EntailmentBank, bAbI, CLUTRR, and ARC-Challenge) demonstrate improvements in logical consistency, interpretability, and computational efficiency over state\-of\-the\-art neuro\-symbolic models. Our results suggest that GSP provides a mathematically grounded and computationally efficient substrate for robust and interpretable reasoning systems.

Chagas disease screening via ECGs is limited by scarce and noisy labels in existing datasets. We propose a biomarker-based pretraining approach, where an ECG feature extractor is first trained to predict percentile-binned blood biomarkers from the MIMIC-IV-ECG dataset. The pretrained model is then fine-tuned on Brazilian datasets for Chagas detection. Our 5-model ensemble, developed by the Ahus AIM team, achieved a challenge score of 0.269 on the hidden test set, ranking 5th in Detection of Chagas Disease from the ECG: The George B. Moody PhysioNet Challenge 2025. Source code and the model are shared on GitHub: github.com/Ahus-AIM/physionet-challenge-2025

The rise of large language models (LLMs) has shifted time series analysis from narrow analytics to general-purpose reasoning. Yet, existing benchmarks cover only a small set of health time series modalities and tasks, failing to reflect the diverse domains and extensive temporal dependencies inherent in real-world physiological modeling. To bridge these gaps, we introduce HEARTS (Health Reasoning over Time Series), a unified benchmark for evaluating hierarchical reasoning capabilities of LLMs over general health time series. HEARTS integrates 16 real-world datasets across 12 health domains and 20 signal modalities, and defines a comprehensive taxonomy of 110 tasks grouped into four core capabilities: Perception, Inference, Generation, and Deduction. Evaluating 14 state-of-the-art LLMs on more than 20K test samples reveals intriguing findings. First, LLMs substantially underperform specialized models, and their performance is only weakly related to general reasoning scores. Moreover, LLMs often rely on simple heuristics and struggle with multi-step temporal reasoning. Finally, performance declines with increasing temporal complexity, with similar failure modes within model families, indicating that scaling alone is insufficient. By making these gaps measurable, HEARTS provides a standardized testbed and living benchmark for developing next-generation LLM agents capable of reasoning over diverse health signals.

Databases of electronic health records (EHRs) are increasingly used to inform clinical decisions. Machine learning methods can find patterns in EHRs that are predictive of future adverse outcomes. However, statistical models may be built upon patterns of health-seeking behavior that vary across patient subpopulations, leading to poor predictive performance when training on one patient population and predicting on another. This note proposes two tests to better measure and understand model generalization. We use these tests to compare models derived from two data sources: (i) historical medical records, and (ii) electrocardiogram (EKG) waveforms. In a predictive task, we show that EKG-based models can be more stable than EHR-based models across different patient populations.

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.

In symbolic regression, the goal is to find an analytical expression that accurately fits experimental data with the minimal use of mathematical symbols such as operators, variables, and constants. However, the combinatorial space of possible expressions can make it challenging for traditional evolutionary algorithms to find the correct expression in a reasonable amount of time. To address this issue, Neural Symbolic Regression (NSR) algorithms have been developed that can quickly identify patterns in the data and generate analytical expressions. However, these methods, in their current form, lack the capability to incorporate user-defined prior knowledge, which is often required in natural sciences and engineering fields. To overcome this limitation, we propose a novel neural symbolic regression method, named Neural Symbolic Regression with Hypothesis (NSRwH) that enables the explicit incorporation of assumptions about the expected structure of the ground-truth expression into the prediction process. Our experiments demonstrate that the proposed conditioned deep learning model outperforms its unconditioned counterparts in terms of accuracy while also providing control over the predicted expression structure.

In this paper, we explore the application of Large Language Models (LLMs) to the pre-training of music. While the prevalent use of MIDI in music modeling is well-established, our findings suggest that LLMs are inherently more compatible with ABC Notation, which aligns more closely with their design and strengths, thereby enhancing the model's performance in musical composition. To address the challenges associated with misaligned measures from different tracks during generation, we propose the development of a Synchronized Multi-Track ABC Notation (SMT-ABC Notation), which aims to preserve coherence across multiple musical tracks. Our contributions include a series of models capable of handling up to 8192 tokens, covering 90\% of the symbolic music data in our training set. Furthermore, we explore the implications of the Symbolic Music Scaling Law (SMS Law) on model performance. The results indicate a promising direction for future research in music generation, offering extensive resources for community-led research through our open-source contributions.

When used with deep learning, the symbolic music modality is often coupled with language model architectures. To do so, the music needs to be tokenized, i.e. converted into a sequence of discrete tokens. This can be achieved by different approaches, as music can be composed of simultaneous tracks, of simultaneous notes with several attributes. Until now, the proposed tokenizations rely on small vocabularies of tokens describing the note attributes and time events, resulting in fairly long token sequences, and a sub-optimal use of the embedding space of language models. Recent research has put efforts on reducing the overall sequence length by merging embeddings or combining tokens. In this paper, we show that Byte Pair Encoding, a compression technique widely used for natural language, significantly decreases the sequence length while increasing the vocabulary size. By doing so, we leverage the embedding capabilities of such models with more expressive tokens, resulting in both better results and faster inference in generation and classification tasks. The source code is shared on Github, along with a companion website. Finally, BPE is directly implemented in MidiTok, allowing the reader to easily benefit from this method.

Objective: To transform heterogeneous clinical data from electronic health records into clinically meaningful constructed features using data driven method that rely, in part, on temporal relations among data. Materials and Methods: The clinically meaningful representations of medical concepts and patients are the key for health analytic applications. Most of existing approaches directly construct features mapped to raw data (e.g., ICD or CPT codes), or utilize some ontology mapping such as SNOMED codes. However, none of the existing approaches leverage EHR data directly for learning such concept representation. We propose a new way to represent heterogeneous medical concepts (e.g., diagnoses, medications and procedures) based on co-occurrence patterns in longitudinal electronic health records. The intuition behind the method is to map medical concepts that are co-occuring closely in time to similar concept vectors so that their distance will be small. We also derive a simple method to construct patient vectors from the related medical concept vectors. Results: For qualitative evaluation, we study similar medical concepts across diagnosis, medication and procedure. In quantitative evaluation, our proposed representation significantly improves the predictive modeling performance for onset of heart failure (HF), where classification methods (e.g. logistic regression, neural network, support vector machine and K-nearest neighbors) achieve up to 23% improvement in area under the ROC curve (AUC) using this proposed representation. Conclusion: We proposed an effective method for patient and medical concept representation learning. The resulting representation can map relevant concepts together and also improves predictive modeling performance.

Engineering design operates through hierarchical abstraction from system specifications to component implementations, requiring visual understanding coupled with mathematical reasoning at each level. While Multi-modal Large Language Models (MLLMs) excel at natural image tasks, their ability to extract mathematical models from technical diagrams remains unexplored. We present CircuitSense, a comprehensive benchmark evaluating circuit understanding across this hierarchy through 8,006+ problems spanning component-level schematics to system-level block diagrams. Our benchmark uniquely examines the complete engineering workflow: Perception, Analysis, and Design, with a particular emphasis on the critical but underexplored capability of deriving symbolic equations from visual inputs. We introduce a hierarchical synthetic generation pipeline consisting of a grid-based schematic generator and a block diagram generator with auto-derived symbolic equation labels. Comprehensive evaluation of six state-of-the-art MLLMs, including both closed-source and open-source models, reveals fundamental limitations in visual-to-mathematical reasoning. Closed-source models achieve over 85\% accuracy on perception tasks involving component recognition and topology identification, yet their performance on symbolic derivation and analytical reasoning falls below 19\%, exposing a critical gap between visual parsing and symbolic reasoning. Models with stronger symbolic reasoning capabilities consistently achieve higher design task accuracy, confirming the fundamental role of mathematical understanding in circuit synthesis and establishing symbolic reasoning as the key metric for engineering competence.

Dynamical systems (DS) theory is fundamental for many areas of science and engineering. It can provide deep insights into the behavior of systems evolving in time, as typically described by differential or recursive equations. A common approach to facilitate mathematical tractability and interpretability of DS models involves decomposing nonlinear DS into multiple linear DS separated by switching manifolds, i.e. piecewise linear (PWL) systems. PWL models are popular in engineering and a frequent choice in mathematics for analyzing the topological properties of DS. However, hand-crafting such models is tedious and only possible for very low-dimensional scenarios, while inferring them from data usually gives rise to unnecessarily complex representations with very many linear subregions. Here we introduce Almost-Linear Recurrent Neural Networks (AL-RNNs) which automatically and robustly produce most parsimonious PWL representations of DS from time series data, using as few PWL nonlinearities as possible. AL-RNNs can be efficiently trained with any SOTA algorithm for dynamical systems reconstruction (DSR), and naturally give rise to a symbolic encoding of the underlying DS that provably preserves important topological properties. We show that for the Lorenz and R\"ossler systems, AL-RNNs discover, in a purely data-driven way, the known topologically minimal PWL representations of the corresponding chaotic attractors. We further illustrate on two challenging empirical datasets that interpretable symbolic encodings of the dynamics can be achieved, tremendously facilitating mathematical and computational analysis of the underlying systems.

Echocardiography (ECHO) is essential for cardiac assessments, but its video quality and interpretation heavily relies on manual expertise, leading to inconsistent results from clinical and portable devices. ECHO video generation offers a solution by improving automated monitoring through synthetic data and generating high-quality videos from routine health data. However, existing models often face high computational costs, slow inference, and rely on complex conditional prompts that require experts' annotations. To address these challenges, we propose ECHOPULSE, an ECG-conditioned ECHO video generation model. ECHOPULSE introduces two key advancements: (1) it accelerates ECHO video generation by leveraging VQ-VAE tokenization and masked visual token modeling for fast decoding, and (2) it conditions on readily accessible ECG signals, which are highly coherent with ECHO videos, bypassing complex conditional prompts. To the best of our knowledge, this is the first work to use time-series prompts like ECG signals for ECHO video generation. ECHOPULSE not only enables controllable synthetic ECHO data generation but also provides updated cardiac function information for disease monitoring and prediction beyond ECG alone. Evaluations on three public and private datasets demonstrate state-of-the-art performance in ECHO video generation across both qualitative and quantitative measures. Additionally, ECHOPULSE can be easily generalized to other modality generation tasks, such as cardiac MRI, fMRI, and 3D CT generation. Demo can seen from https://github.com/levyisthebest/ECHOPulse_Prelease.

The trade-off between expressiveness and interpretability remains a core challenge when building human-centric predictive models for classification and decision-making. While symbolic rules offer interpretability, they often lack expressiveness, whereas neural networks excel in performance but are known for being black boxes. In this paper, we show a combination of Large Language Models (LLMs) and symbolic programs can bridge this gap. In the proposed LLM-based Symbolic Programs (LSPs), the pretrained LLM with natural language prompts provides a massive set of interpretable modules that can transform raw input into natural language concepts. Symbolic programs then integrate these modules into an interpretable decision rule. To train LSPs, we develop a divide-and-conquer approach to incrementally build the program from scratch, where the learning process of each step is guided by LLMs. To evaluate the effectiveness of LSPs in extracting interpretable and accurate knowledge from data, we introduce IL-Bench, a collection of diverse tasks, including both synthetic and real-world scenarios across different modalities. Empirical results demonstrate LSP's superior performance compared to traditional neurosymbolic programs and vanilla automatic prompt tuning methods. Moreover, as the knowledge learned by LSP is a combination of natural language descriptions and symbolic rules, it is easily transferable to humans (interpretable), and other LLMs, and generalizes well to out-of-distribution samples.

Electrocardiograms (ECGs), a medical monitoring technology recording cardiac activity, are widely used for diagnosing cardiac arrhythmia. The diagnosis is based on the analysis of the deformation of the signal shapes due to irregular heart rates associated with heart diseases. Due to the infeasibility of manual examination of large volumes of ECG data, this paper aims to propose an automated AI based system for ECG-based arrhythmia classification. To this front, a deep learning based solution has been proposed for ECG-based arrhythmia classification. Twelve lead electrocardiograms (ECG) of length 10 sec from 45, 152 individuals from Shaoxing People's Hospital (SPH) dataset from PhysioNet with four different types of arrhythmias were used. The sampling frequency utilized was 500 Hz. Median filtering was used to preprocess the ECG signals. For every 1 sec of ECG signal, the time-frequency (TF) scalogram was estimated and stacked row wise to obtain a single image from 12 channels, resulting in 10 stacked TF scalograms for each ECG signal. These stacked TF scalograms are fed to the pretrained convolutional neural network (CNN), 1D CNN, and 1D CNN-LSTM (Long short-term memory) models, for arrhythmia classification. The fine-tuned CNN models obtained the best test accuracy of about 98% followed by 95% test accuracy by basic CNN-LSTM in arrhythmia classification.

We present a new large-scale emotion-labeled symbolic music dataset consisting of 12k MIDI songs. To create this dataset, we first trained emotion classification models on the GoEmotions dataset, achieving state-of-the-art results with a model half the size of the baseline. We then applied these models to lyrics from two large-scale MIDI datasets. Our dataset covers a wide range of fine-grained emotions, providing a valuable resource to explore the connection between music and emotions and, especially, to develop models that can generate music based on specific emotions. Our code for inference, trained models, and datasets are available online.

These handouts are designed for people who is just starting involved with the topic artificial neural networks. We show how it works a single artificial neuron (McCulloch & Pitt model), mathematically and graphically. We do explain the delta rule, a learning algorithm to find the neuron weights. We also present some examples in MATLAB/Octave. There are examples for classification task for lineal and non-lineal problems. At the end, we present an artificial neural network, a feed-forward neural network along its learning algorithm backpropagation. ----- Estos apuntes est\'an dise\~nados para personas que por primera vez se introducen en el tema de las redes neuronales artificiales. Se muestra el funcionamiento b\'asico de una neurona, matem\'aticamente y gr\'aficamente. Se explica la Regla Delta, algoritmo deaprendizaje para encontrar los pesos de una neurona. Tambi\'en se muestran ejemplos en MATLAB/Octave. Hay ejemplos para problemas de clasificaci\'on, para problemas lineales y no-lineales. En la parte final se muestra la arquitectura de red neuronal artificial conocida como backpropagation.

We present a novel approach to symbolic regression using vision-capable large language models (LLMs) and the ideas behind Google DeepMind's Funsearch. The LLM is given a plot of a univariate function and tasked with proposing an ansatz for that function. The free parameters of the ansatz are fitted using standard numerical optimisers, and a collection of such ansätze make up the population of a genetic algorithm. Unlike other symbolic regression techniques, our method does not require the specification of a set of functions to be used in regression, but with appropriate prompt engineering, we can arbitrarily condition the generative step. By using Kolmogorov Arnold Networks (KANs), we demonstrate that ``univariate is all you need'' for symbolic regression, and extend this method to multivariate functions by learning the univariate function on each edge of a trained KAN. The combined expression is then simplified by further processing with a language model.

Epilepsy is one of the most prevalent brain disorders that disrupts the lives of millions worldwide. For patients with drug-resistant seizures, there exist implantable devices capable of monitoring neural activity, promptly triggering neurostimulation to regulate seizures, or alerting patients of potential episodes. Next-generation seizure detection systems heavily rely on high-accuracy machine learning-based classifiers to detect the seizure onset. Here, we propose to enhance the seizure detection performance by learning informative embeddings of the EEG signal. We empirically demonstrate, for the first time, that converting raw EEG signals to appropriate embeddings can significantly boost the performance of seizure detection algorithms. Importantly, we show that embedding features, which converts the raw EEG into an alternative representation, is beneficial for various machine learning models such as Logistic Regression, Multi-Layer Perceptron, Support Vector Machines, and Gradient Boosted Trees. The experiments were conducted on the CHB-MIT scalp EEG dataset. With the proposed EEG feature embeddings, we achieve significant improvements in sensitivity, specificity, and AUC score across multiple models. By employing this approach alongside an SVM classifier, we were able to attain state-of-the-art classification performance with a sensitivity of 100% and specificity of 99%, setting a new benchmark in the field.

We introduce Explanatory Learning (EL), a framework to let machines use existing knowledge buried in symbolic sequences -- e.g. explanations written in hieroglyphic -- by autonomously learning to interpret them. In EL, the burden of interpreting symbols is not left to humans or rigid human-coded compilers, as done in Program Synthesis. Rather, EL calls for a learned interpreter, built upon a limited collection of symbolic sequences paired with observations of several phenomena. This interpreter can be used to make predictions on a novel phenomenon given its explanation, and even to find that explanation using only a handful of observations, like human scientists do. We formulate the EL problem as a simple binary classification task, so that common end-to-end approaches aligned with the dominant empiricist view of machine learning could, in principle, solve it. To these models, we oppose Critical Rationalist Networks (CRNs), which instead embrace a rationalist view on the acquisition of knowledge. CRNs express several desired properties by construction, they are truly explainable, can adjust their processing at test-time for harder inferences, and can offer strong confidence guarantees on their predictions. As a final contribution, we introduce Odeen, a basic EL environment that simulates a small flatland-style universe full of phenomena to explain. Using Odeen as a testbed, we show how CRNs outperform empiricist end-to-end approaches of similar size and architecture (Transformers) in discovering explanations for novel phenomena.