Daily Papers

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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

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) 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.

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.

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/.

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.

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.

The label scarcity problem is the main challenge that hinders the wide application of deep learning systems in automatic cardiovascular diseases (CVDs) detection using electrocardiography (ECG). Tuning pre-trained models alleviates this problem by transferring knowledge learned from large datasets to downstream small datasets. However, bottlenecks in computational efficiency and detection performance limit its clinical applications. It is difficult to improve the detection performance without significantly sacrificing the computational efficiency during model training. Here, we propose a computation-efficient semi-supervised learning paradigm (CE-SSL) for robust and computation-efficient CVDs detection using ECG. It enables a robust adaptation of pre-trained models on downstream datasets with limited supervision and high computational efficiency. First, a random-deactivation technique is developed to achieve robust and fast low-rank adaptation of pre-trained weights. Subsequently, we propose a one-shot rank allocation module to determine the optimal ranks for the update matrices of the pre-trained weights. Finally, a lightweight semi-supervised learning pipeline is introduced to enhance model performance by leveraging labeled and unlabeled data with high computational efficiency. Extensive experiments on four downstream datasets demonstrate that CE-SSL not only outperforms the state-of-the-art methods in multi-label CVDs detection but also consumes fewer GPU footprints, training time, and parameter storage space. As such, this paradigm provides an effective solution for achieving high computational efficiency and robust detection performance in the clinical applications of pre-trained models under limited supervision. Code and Supplementary Materials are available at https://github.com/KAZABANA/CE-SSL

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.

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.

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.

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.

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.

Pre-training (PT) followed by fine-tuning (FT) is an effective method for training neural networks, and has led to significant performance improvements in many domains. PT can incorporate various design choices such as task and data reweighting strategies, augmentation policies, and noise models, all of which can significantly impact the quality of representations learned. The hyperparameters introduced by these strategies therefore must be tuned appropriately. However, setting the values of these hyperparameters is challenging. Most existing methods either struggle to scale to high dimensions, are too slow and memory-intensive, or cannot be directly applied to the two-stage PT and FT learning process. In this work, we propose an efficient, gradient-based algorithm to meta-learn PT hyperparameters. We formalize the PT hyperparameter optimization problem and propose a novel method to obtain PT hyperparameter gradients by combining implicit differentiation and backpropagation through unrolled optimization. We demonstrate that our method improves predictive performance on two real-world domains. First, we optimize high-dimensional task weighting hyperparameters for multitask pre-training on protein-protein interaction graphs and improve AUROC by up to 3.9%. Second, we optimize a data augmentation neural network for self-supervised PT with SimCLR on electrocardiography data and improve AUROC by up to 1.9%.

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.

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.

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.

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.

Self-supervised learning has emerged as a highly effective approach in the fields of natural language processing and computer vision. It is also applicable to brain signals such as electroencephalography (EEG) data, given the abundance of available unlabeled data that exist in a wide spectrum of real-world medical applications ranging from seizure detection to wave analysis. The existing works leveraging self-supervised learning on EEG modeling mainly focus on pretraining upon each individual dataset corresponding to a single downstream task, which cannot leverage the power of abundant data, and they may derive sub-optimal solutions with a lack of generalization. Moreover, these methods rely on end-to-end model learning which is not easy for humans to understand. In this paper, we present a novel EEG foundation model, namely EEGFormer, pretrained on large-scale compound EEG data. The pretrained model cannot only learn universal representations on EEG signals with adaptable performance on various downstream tasks but also provide interpretable outcomes of the useful patterns within the data. To validate the effectiveness of our model, we extensively evaluate it on various downstream tasks and assess the performance under different transfer settings. Furthermore, we demonstrate how the learned model exhibits transferable anomaly detection performance and provides valuable interpretability of the acquired patterns via self-supervised learning.

Pre-trained text encoders have drawn sustaining attention in natural language processing (NLP) and shown their capability in obtaining promising results in different tasks. Recent studies illustrated that external self-supervised signals (or knowledge extracted by unsupervised learning, such as n-grams) are beneficial to provide useful semantic evidence for understanding languages such as Chinese, so as to improve the performance on various downstream tasks accordingly. To further enhance the encoders, in this paper, we propose to pre-train n-gram-enhanced encoders with a large volume of data and advanced techniques for training. Moreover, we try to extend the encoder to different languages as well as different domains, where it is confirmed that the same architecture is applicable to these varying circumstances and new state-of-the-art performance is observed from a long list of NLP tasks across languages and domains.

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.

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.

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.

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.

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.

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

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

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.

In this paper, we introduce a novel Multi-Modal Contrastive Pre-training Framework that synergistically combines X-rays, electrocardiograms (ECGs), and radiology/cardiology reports. Our approach leverages transformers to encode these diverse modalities into a unified representation space, aiming to enhance diagnostic accuracy and facilitate comprehensive patient assessments. We utilize LoRA-Peft to significantly reduce trainable parameters in the LLM and incorporate recent linear attention dropping strategy in the Vision Transformer(ViT) for smoother attention. Furthermore, we provide novel multimodal attention explanations and retrieval for our model. To the best of our knowledge, we are the first to propose an integrated model that combines X-ray, ECG, and Radiology/Cardiology Report with this approach. By utilizing contrastive loss, MoRE effectively aligns modality-specific features into a coherent embedding, which supports various downstream tasks such as zero-shot classification and multimodal retrieval. Employing our proposed methodology, we achieve state-of-the-art (SOTA) on the Mimic-IV, CheXpert, Edema Severity, and PtbXl downstream datasets, surpassing existing multimodal approaches. Our proposed framework shows significant improvements in capturing intricate inter-modal relationships and its robustness in medical diagnosis that establishes a framework for future research in multimodal learning in the healthcare sector.

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

Foundation models have transformed AI by reducing reliance on task-specific data through large-scale pretraining. While successful in language and vision, their adoption in EEG has lagged due to the heterogeneity of public datasets, which are collected under varying protocols, devices, and electrode configurations. Existing EEG foundation models struggle to generalize across these variations, often restricting pretraining to a single setup, resulting in suboptimal performance, in particular under linear probing. We present REVE (Representation for EEG with Versatile Embeddings), a pretrained model explicitly designed to generalize across diverse EEG signals. REVE introduces a novel 4D positional encoding scheme that enables it to process signals of arbitrary length and electrode arrangement. Using a masked autoencoding objective, we pretrain REVE on over 60,000 hours of EEG data from 92 datasets spanning 25,000 subjects, representing the largest EEG pretraining effort to date. REVE achieves state-of-the-art results on 10 downstream EEG tasks, including motor imagery classification, seizure detection, sleep staging, cognitive load estimation, and emotion recognition. With little to no fine-tuning, it demonstrates strong generalization, and nuanced spatio-temporal modeling. We release code, pretrained weights, and tutorials to support standardized EEG research and accelerate progress in clinical neuroscience.

This paper studies a novel pre-training technique with unpaired speech data, Speech2C, for encoder-decoder based automatic speech recognition (ASR). Within a multi-task learning framework, we introduce two pre-training tasks for the encoder-decoder network using acoustic units, i.e., pseudo codes, derived from an offline clustering model. One is to predict the pseudo codes via masked language modeling in encoder output, like HuBERT model, while the other lets the decoder learn to reconstruct pseudo codes autoregressively instead of generating textual scripts. In this way, the decoder learns to reconstruct original speech information with codes before learning to generate correct text. Comprehensive experiments on the LibriSpeech corpus show that the proposed Speech2C can relatively reduce the word error rate (WER) by 19.2% over the method without decoder pre-training, and also outperforms significantly the state-of-the-art wav2vec 2.0 and HuBERT on fine-tuning subsets of 10h and 100h. We release our code and model at https://github.com/microsoft/SpeechT5/tree/main/Speech2C.

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.

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

Transducer and Attention based Encoder-Decoder (AED) are two widely used frameworks for speech-to-text tasks. They are designed for different purposes and each has its own benefits and drawbacks for speech-to-text tasks. In order to leverage strengths of both modeling methods, we propose a solution by combining Transducer and Attention based Encoder-Decoder (TAED) for speech-to-text tasks. The new method leverages AED's strength in non-monotonic sequence to sequence learning while retaining Transducer's streaming property. In the proposed framework, Transducer and AED share the same speech encoder. The predictor in Transducer is replaced by the decoder in the AED model, and the outputs of the decoder are conditioned on the speech inputs instead of outputs from an unconditioned language model. The proposed solution ensures that the model is optimized by covering all possible read/write scenarios and creates a matched environment for streaming applications. We evaluate the proposed approach on the MuST-C dataset and the findings demonstrate that TAED performs significantly better than Transducer for offline automatic speech recognition (ASR) and speech-to-text translation (ST) tasks. In the streaming case, TAED outperforms Transducer in the ASR task and one ST direction while comparable results are achieved in another translation direction.

Accurate diagnostic coding of medical notes is crucial for enhancing patient care, medical research, and error-free billing in healthcare organizations. Manual coding is a time-consuming task for providers, and diagnostic codes often exhibit low sensitivity and specificity, whereas the free text in medical notes can be a more precise description of a patients status. Thus, accurate automated diagnostic coding of medical notes has become critical for a learning healthcare system. Recent developments in long-document transformer architectures have enabled attention-based deep-learning models to adjudicate medical notes. In addition, contrastive loss functions have been used to jointly pre-train large language and image models with noisy labels. To further improve the automated adjudication of medical notes, we developed an approach based on i) models for ICD-10 diagnostic code sequences using a large real-world data set, ii) large language models for medical notes, and iii) contrastive pre-training to build an integrated model of both ICD-10 diagnostic codes and corresponding medical text. We demonstrate that a contrastive approach for pre-training improves performance over prior state-of-the-art models for the MIMIC-III-50, MIMIC-III-rare50, and MIMIC-III-full diagnostic coding tasks.

We introduce a self-supervised speech pre-training method called TERA, which stands for Transformer Encoder Representations from Alteration. Recent approaches often learn by using a single auxiliary task like contrastive prediction, autoregressive prediction, or masked reconstruction. Unlike previous methods, we use alteration along three orthogonal axes to pre-train Transformer Encoders on a large amount of unlabeled speech. The model learns through the reconstruction of acoustic frames from their altered counterpart, where we use a stochastic policy to alter along various dimensions: time, frequency, and magnitude. TERA can be used for speech representations extraction or fine-tuning with downstream models. We evaluate TERA on several downstream tasks, including phoneme classification, keyword spotting, speaker recognition, and speech recognition. We present a large-scale comparison of various self-supervised models. TERA achieves strong performance in the comparison by improving upon surface features and outperforming previous models. In our experiments, we study the effect of applying different alteration techniques, pre-training on more data, and pre-training on various features. We analyze different model sizes and find that smaller models are strong representation learners than larger models, while larger models are more effective for downstream fine-tuning than smaller models. Furthermore, we show the proposed method is transferable to downstream datasets not used in pre-training.

Pre-trained encoders are widely employed in dense prediction tasks for their capability to effectively extract visual features from images. The decoder subsequently processes these features to generate pixel-level predictions. However, due to structural differences and variations in input data, only encoders benefit from pre-learned representations from vision benchmarks such as image classification and self-supervised learning, while decoders are typically trained from scratch. In this paper, we introduce timesNet, which facilitates a "pre-trained encoder times pre-trained decoder" collaboration through three innovative designs. timesNet enables the direct utilization of pre-trained models within the decoder, integrating pre-learned representations into the decoding process to enhance performance in dense prediction tasks. By simply coupling the pre-trained encoder and pre-trained decoder, timesNet distinguishes itself as a highly promising approach. Remarkably, it achieves this without relying on decoding-specific structures or task-specific algorithms. Despite its streamlined design, timesNet outperforms advanced methods in tasks such as monocular depth estimation and semantic segmentation, achieving state-of-the-art performance particularly in monocular depth estimation. and semantic segmentation, achieving state-of-the-art results, especially in monocular depth estimation. embedding algorithms. Despite its streamlined design, timesNet outperforms advanced methods in tasks such as monocular depth estimation and semantic segmentation, achieving state-of-the-art performance particularly in monocular depth estimation.

We explore unsupervised pre-training for speech recognition by learning representations of raw audio. wav2vec is trained on large amounts of unlabeled audio data and the resulting representations are then used to improve acoustic model training. We pre-train a simple multi-layer convolutional neural network optimized via a noise contrastive binary classification task. Our experiments on WSJ reduce WER of a strong character-based log-mel filterbank baseline by up to 36% when only a few hours of transcribed data is available. Our approach achieves 2.43% WER on the nov92 test set. This outperforms Deep Speech 2, the best reported character-based system in the literature while using two orders of magnitude less labeled training data.

We study speech intent classification and slot filling (SICSF) by proposing to use an encoder pretrained on speech recognition (ASR) to initialize an end-to-end (E2E) Conformer-Transformer model, which achieves the new state-of-the-art results on the SLURP dataset, with 90.14% intent accuracy and 82.27% SLURP-F1. We compare our model with encoders pretrained on self-supervised learning (SSL), and show that ASR pretraining is much more effective than SSL for SICSF. To explore parameter efficiency, we freeze the encoder and add Adapter modules, and show that parameter efficiency is only achievable with an ASR-pretrained encoder, while the SSL encoder needs full finetuning to achieve comparable results. In addition, we provide an in-depth comparison on end-to-end models versus cascading models (ASR+NLU), and show that E2E models are better than cascaded models unless an oracle ASR model is provided. Last but not least, our model is the first E2E model that achieves the same performance as cascading models with oracle ASR. Code, checkpoints and configs are available.

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.

Deep networks for electroencephalogram (EEG) decoding are often only trained to solve one specific task, such as pathology or age decoding. A more general task-agnostic approach is to train deep networks to match a (clinical) EEG recording to its corresponding textual medical report and vice versa. This approach was pioneered in the computer vision domain matching images and their text captions and subsequently allowed to do successful zero-shot decoding using textual class prompts. In this work, we follow this approach and develop a contrastive learning framework, EEG-CLIP, that aligns the EEG time series and the descriptions of the corresponding clinical text in a shared embedding space. We investigated its potential for versatile EEG decoding, evaluating performance in a range of few-shot and zero-shot settings. Overall, we show that EEG-CLIP manages to non-trivially align text and EEG representations. Our work presents a promising approach to learn general EEG representations, which could enable easier analyses of diverse decoding questions through zero-shot decoding or training task-specific models from fewer training examples. The code for reproducing our results is available at https://github.com/tidiane-camaret/EEGClip

Electroencephalography (EEG) signals, known for convenient non-invasive acquisition but low signal-to-noise ratio, have recently gained substantial attention due to the potential to decode natural images. This paper presents a self-supervised framework to demonstrate the feasibility of learning image representations from EEG signals, particularly for object recognition. The framework utilizes image and EEG encoders to extract features from paired image stimuli and EEG responses. Contrastive learning aligns these two modalities by constraining their similarity. With the framework, we attain significantly above-chance results on a comprehensive EEG-image dataset, achieving a top-1 accuracy of 15.6% and a top-5 accuracy of 42.8% in challenging 200-way zero-shot tasks. Moreover, we perform extensive experiments to explore the biological plausibility by resolving the temporal, spatial, spectral, and semantic aspects of EEG signals. Besides, we introduce attention modules to capture spatial correlations, providing implicit evidence of the brain activity perceived from EEG data. These findings yield valuable insights for neural decoding and brain-computer interfaces in real-world scenarios. The code will be released on https://github.com/eeyhsong/NICE-EEG.

Electrocardiography (ECG) signals are often degraded by noise, which complicates diagnosis in clinical and wearable settings. This study proposes a diffusion-based framework for ECG noise quantification via reconstruction-based anomaly detection, addressing annotation inconsistencies and the limited generalizability of conventional methods. We introduce a distributional evaluation using the Wasserstein-1 distance (W_1), comparing the reconstruction error distributions between clean and noisy ECGs to mitigate inconsistent annotations. Our final model achieved robust noise quantification using only three reverse diffusion steps. The model recorded a macro-average W_1 score of 1.308 across the benchmarks, outperforming the next-best method by over 48%. External validations demonstrated strong generalizability, supporting the exclusion of low-quality segments to enhance diagnostic accuracy and enable timely clinical responses to signal degradation. The proposed method enhances clinical decision-making, diagnostic accuracy, and real-time ECG monitoring capabilities, supporting future advancements in clinical and wearable ECG applications.

Large-scale pre-trained models (PTMs) such as BERT and GPT have recently achieved great success in Natural Language Processing and Computer Vision domains. However, the development of PTMs on healthcare time-series data is lagging behind.This underscores the limitations of the existing transformer-based architectures, particularly their scalability to handle large-scale time series and ability to capture long-term temporal dependencies. In this study, we present Timely Generative Pre-trained Transformer (TimelyGPT). TimelyGPT employs an extrapolatable position (xPos) embedding to encode trend and periodic patterns into time-series representations. It also integrates recurrent attention and temporal convolution modules to effectively capture global-local temporal dependencies. We evaluated TimelyGPT on two large-scale healthcare time series datasets corresponding to continuous biosignals and irregularly-sampled time series, respectively. Our experiments show that during pre-training, TimelyGPT excels in learning time-series representations from continuously monitored biosignals and irregularly-sampled time series data commonly observed in longitudinal electronic health records (EHRs). In forecasting continuous biosignals, TimelyGPT achieves accurate extrapolation up to 6,000 timesteps of body temperature during the sleep stage transition, given a short look-up window (i.e., prompt) containing only 2,000 timesteps. For irregularly-sampled time series, TimelyGPT with a proposed time-specific inference demonstrates high top recall scores in predicting future diagnoses using early diagnostic records, effectively handling irregular intervals between clinical records. Together, we envision TimelyGPT to be useful in a broad spectrum of health domains, including long-term patient health state forecasting and patient risk trajectory prediction.

This study assesses deep learning models for audio classification in a clinical setting with the constraint of small datasets reflecting real-world prospective data collection. We analyze CNNs, including DenseNet and ConvNeXt, alongside transformer models like ViT, SWIN, and AST, and compare them against pre-trained audio models such as YAMNet and VGGish. Our method highlights the benefits of pre-training on large datasets before fine-tuning on specific clinical data. We prospectively collected two first-of-their-kind patient audio datasets from stroke patients. We investigated various preprocessing techniques, finding that RGB and grayscale spectrogram transformations affect model performance differently based on the priors they learn from pre-training. Our findings indicate CNNs can match or exceed transformer models in small dataset contexts, with DenseNet-Contrastive and AST models showing notable performance. This study highlights the significance of incremental marginal gains through model selection, pre-training, and preprocessing in sound classification; this offers valuable insights for clinical diagnostics that rely on audio classification.

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

Masked token prediction has emerged as a powerful pre-training objective across language, vision, and speech, offering the potential to unify these diverse modalities through a single pre-training task. However, its application for general audio understanding remains underexplored, with BEATs being the only notable example. BEATs has seen limited modifications due to the absence of open-source pre-training code. Furthermore, BEATs was trained only on AudioSet, restricting its broader downstream applicability. To address these gaps, we present OpenBEATs, an open-source framework that extends BEATs via multi-domain audio pre-training. We conduct comprehensive evaluations across six types of tasks, twenty five datasets, and three audio domains, including audio reasoning tasks such as audio question answering, entailment, and captioning. OpenBEATs achieves state-of-the-art performance on six bioacoustics datasets, two environmental sound datasets and five reasoning datasets, performing better than models exceeding a billion parameters at one-fourth their parameter size. These results demonstrate the effectiveness of multi-domain datasets and masked token prediction task to learn general-purpose audio representations. To promote further research and reproducibility, we release all pre-training and evaluation code, pretrained and fine-tuned checkpoints, and training logs at https://shikhar-s.github.io/OpenBEATs

In recent years, self-supervised pre-training methods have gained significant traction in learning high-level information from raw speech. Among these methods, HuBERT has demonstrated SOTA performance in automatic speech recognition (ASR). However, HuBERT's performance lags behind data2vec due to disparities in pre-training strategies. In this paper, we propose (i) a Swap method to address pre-training and inference mismatch observed in HuBERT and (ii) incorporates Multicluster masked prediction loss for more effective utilization of the models capacity. The resulting method is, MS-HuBERT, an end-to-end self-supervised pre-training method for learning robust speech representations. It beats vanilla HuBERT on the ASR Librispeech benchmark on average by a 5% margin when evaluated on different finetuning splits. Additionally, we demonstrate that the learned embeddings obtained during pre-training encode essential information for improving performance of content based tasks such as ASR.

Heart disease, also known as cardiovascular disease, is a prevalent and critical medical condition characterized by the impairment of the heart and blood vessels, leading to various complications such as coronary artery disease, heart failure, and myocardial infarction. The timely and accurate detection of heart disease is of paramount importance in clinical practice. Early identification of individuals at risk enables proactive interventions, preventive measures, and personalized treatment strategies to mitigate the progression of the disease and reduce adverse outcomes. In recent years, the field of heart disease detection has witnessed notable advancements due to the integration of sophisticated technologies and computational approaches. These include machine learning algorithms, data mining techniques, and predictive modeling frameworks that leverage vast amounts of clinical and physiological data to improve diagnostic accuracy and risk stratification. In this work, we propose to detect heart disease from ECG images using cutting-edge technologies, namely vision transformer models. These models are Google-Vit, Microsoft-Beit, and Swin-Tiny. To the best of our knowledge, this is the initial endeavor concentrating on the detection of heart diseases through image-based ECG data by employing cuttingedge technologies namely, transformer models. To demonstrate the contribution of the proposed framework, the performance of vision transformer models are compared with state-of-the-art studies. Experiment results show that the proposed framework exhibits remarkable classification results.

Generating images from brain waves is gaining increasing attention due to its potential to advance brain-computer interface (BCI) systems by understanding how brain signals encode visual cues. Most of the literature has focused on fMRI-to-Image tasks as fMRI is characterized by high spatial resolution. However, fMRI is an expensive neuroimaging modality and does not allow for real-time BCI. On the other hand, electroencephalography (EEG) is a low-cost, non-invasive, and portable neuroimaging technique, making it an attractive option for future real-time applications. Nevertheless, EEG presents inherent challenges due to its low spatial resolution and susceptibility to noise and artifacts, which makes generating images from EEG more difficult. In this paper, we address these problems with a streamlined framework based on the ControlNet adapter for conditioning a latent diffusion model (LDM) through EEG signals. We conduct experiments and ablation studies on popular benchmarks to demonstrate that the proposed method beats other state-of-the-art models. Unlike these methods, which often require extensive preprocessing, pretraining, different losses, and captioning models, our approach is efficient and straightforward, requiring only minimal preprocessing and a few components. Code will be available after publication.

Cardiac magnetic resonance (CMR) is a key investigation in clinical cardiovascular medicine and has been used extensively in population research. However, extracting clinically important measurements such as ejection fraction for diagnosing cardiovascular diseases remains time-consuming and subjective. We developed CineMA, a foundation AI model automating these tasks with limited labels. CineMA is a self-supervised autoencoder model trained on 74,916 cine CMR studies to reconstruct images from masked inputs. After fine-tuning, it was evaluated across eight datasets on 23 tasks from four categories: ventricle and myocardium segmentation, left and right ventricle ejection fraction calculation, disease detection and classification, and landmark localisation. CineMA is the first foundation model for cine CMR to match or outperform convolutional neural networks (CNNs). CineMA demonstrated greater label efficiency than CNNs, achieving comparable or better performance with fewer annotations. This reduces the burden of clinician labelling and supports replacing task-specific training with fine-tuning foundation models in future cardiac imaging applications. Models and code for pre-training and fine-tuning are available at https://github.com/mathpluscode/CineMA, democratising access to high-performance models that otherwise require substantial computational resources, promoting reproducibility and accelerating clinical translation.

Accurate and contrast-free Major Adverse Cardiac Events (MACE) prediction from Cine MRI sequences remains a critical challenge. Existing methods typically necessitate supervised learning based on human-refined masks in the ventricular myocardium, which become impractical without contrast agents. We introduce a self-supervised framework, namely Codebook-based Temporal-Spatial Learning (CTSL), that learns dynamic, spatiotemporal representations from raw Cine data without requiring segmentation masks. CTSL decouples temporal and spatial features through a multi-view distillation strategy, where the teacher model processes multiple Cine views, and the student model learns from reduced-dimensional Cine-SA sequences. By leveraging codebook-based feature representations and dynamic lesion self-detection through motion cues, CTSL captures intricate temporal dependencies and motion patterns. High-confidence MACE risk predictions are achieved through our model, providing a rapid, non-invasive solution for cardiac risk assessment that outperforms traditional contrast-dependent methods, thereby enabling timely and accessible heart disease diagnosis in clinical settings.

Recently, the success of pre-training in text domain has been fully extended to vision, audio, and cross-modal scenarios. The proposed pre-training models of different modalities are showing a rising trend of homogeneity in their model structures, which brings the opportunity to implement different pre-training models within a uniform framework. In this paper, we present TencentPretrain, a toolkit supporting pre-training models of different modalities. The core feature of TencentPretrain is the modular design. The toolkit uniformly divides pre-training models into 5 components: embedding, encoder, target embedding, decoder, and target. As almost all of common modules are provided in each component, users can choose the desired modules from different components to build a complete pre-training model. The modular design enables users to efficiently reproduce existing pre-training models or build brand-new one. We test the toolkit on text, vision, and audio benchmarks and show that it can match the performance of the original implementations.

ELECTRA pre-trains language models by detecting tokens in a sequence that have been replaced by an auxiliary model. Although ELECTRA offers a significant boost in efficiency, its potential is constrained by the training cost brought by the auxiliary model. Notably, this model, which is jointly trained with the main model, only serves to assist the training of the main model and is discarded post-training. This results in a substantial amount of training cost being expended in vain. To mitigate this issue, we propose Fast-ELECTRA, which leverages an existing language model as the auxiliary model. To construct a learning curriculum for the main model, we smooth its output distribution via temperature scaling following a descending schedule. Our approach rivals the performance of state-of-the-art ELECTRA-style pre-training methods, while significantly eliminating the computation and memory cost brought by the joint training of the auxiliary model. Our method also reduces the sensitivity to hyper-parameters and enhances the pre-training stability.

Existing works, including ELMO and BERT, have revealed the importance of pre-training for NLP tasks. While there does not exist a single pre-training model that works best in all cases, it is of necessity to develop a framework that is able to deploy various pre-training models efficiently. For this purpose, we propose an assemble-on-demand pre-training toolkit, namely Universal Encoder Representations (UER). UER is loosely coupled, and encapsulated with rich modules. By assembling modules on demand, users can either reproduce a state-of-the-art pre-training model or develop a pre-training model that remains unexplored. With UER, we have built a model zoo, which contains pre-trained models based on different corpora, encoders, and targets (objectives). With proper pre-trained models, we could achieve new state-of-the-art results on a range of downstream datasets.

Recently proposed self-supervised learning approaches have been successful for pre-training speech representation models. The utility of these learned representations has been observed empirically, but not much has been studied about the type or extent of information encoded in the pre-trained representations themselves. Developing such insights can help understand the capabilities and limits of these models and enable the research community to more efficiently develop their usage for downstream applications. In this work, we begin to fill this gap by examining one recent and successful pre-trained model (wav2vec 2.0), via its intermediate representation vectors, using a suite of analysis tools. We use the metrics of canonical correlation, mutual information, and performance on simple downstream tasks with non-parametric probes, in order to (i) query for acoustic and linguistic information content, (ii) characterize the evolution of information across model layers, and (iii) understand how fine-tuning the model for automatic speech recognition (ASR) affects these observations. Our findings motivate modifying the fine-tuning protocol for ASR, which produces improved word error rates in a low-resource setting.

Vision Transformer (ViT) has become one of the most popular neural architectures due to its great scalability, computational efficiency, and compelling performance in many vision tasks. However, ViT has shown inferior performance to Convolutional Neural Network (CNN) on medical tasks due to its data-hungry nature and the lack of annotated medical data. In this paper, we pre-train ViTs on 266,340 chest X-rays using Masked Autoencoders (MAE) which reconstruct missing pixels from a small part of each image. For comparison, CNNs are also pre-trained on the same 266,340 X-rays using advanced self-supervised methods (e.g., MoCo v2). The results show that our pre-trained ViT performs comparably (sometimes better) to the state-of-the-art CNN (DenseNet-121) for multi-label thorax disease classification. This performance is attributed to the strong recipes extracted from our empirical studies for pre-training and fine-tuning ViT. The pre-training recipe signifies that medical reconstruction requires a much smaller proportion of an image (10% vs. 25%) and a more moderate random resized crop range (0.5~1.0 vs. 0.2~1.0) compared with natural imaging. Furthermore, we remark that in-domain transfer learning is preferred whenever possible. The fine-tuning recipe discloses that layer-wise LR decay, RandAug magnitude, and DropPath rate are significant factors to consider. We hope that this study can direct future research on the application of Transformers to a larger variety of medical imaging tasks.

This paper introduces WeatherFormer, a transformer encoder-based model designed to learn robust weather features from minimal observations. It addresses the challenge of modeling complex weather dynamics from small datasets, a bottleneck for many prediction tasks in agriculture, epidemiology, and climate science. WeatherFormer was pretrained on a large pretraining dataset comprised of 39 years of satellite measurements across the Americas. With a novel pretraining task and fine-tuning, WeatherFormer achieves state-of-the-art performance in county-level soybean yield prediction and influenza forecasting. Technical innovations include a unique spatiotemporal encoding that captures geographical, annual, and seasonal variations, adapting the transformer architecture to continuous weather data, and a pretraining strategy to learn representations that are robust to missing weather features. This paper for the first time demonstrates the effectiveness of pretraining large transformer encoder models for weather-dependent applications across multiple domains.

Self-supervised learning usually uses a large amount of unlabeled data to pre-train an encoder which can be used as a general-purpose feature extractor, such that downstream users only need to perform fine-tuning operations to enjoy the benefit of "large model". Despite this promising prospect, the security of pre-trained encoder has not been thoroughly investigated yet, especially when the pre-trained encoder is publicly available for commercial use. In this paper, we propose AdvEncoder, the first framework for generating downstream-agnostic universal adversarial examples based on the pre-trained encoder. AdvEncoder aims to construct a universal adversarial perturbation or patch for a set of natural images that can fool all the downstream tasks inheriting the victim pre-trained encoder. Unlike traditional adversarial example works, the pre-trained encoder only outputs feature vectors rather than classification labels. Therefore, we first exploit the high frequency component information of the image to guide the generation of adversarial examples. Then we design a generative attack framework to construct adversarial perturbations/patches by learning the distribution of the attack surrogate dataset to improve their attack success rates and transferability. Our results show that an attacker can successfully attack downstream tasks without knowing either the pre-training dataset or the downstream dataset. We also tailor four defenses for pre-trained encoders, the results of which further prove the attack ability of AdvEncoder.

This paper proposes a generative pretraining foundation model for high-quality speech restoration tasks. By directly operating on complex-valued short-time Fourier transform coefficients, our model does not rely on any vocoders for time-domain signal reconstruction. As a result, our model simplifies the synthesis process and removes the quality upper-bound introduced by any mel-spectrogram vocoder compared to prior work SpeechFlow. The proposed method is evaluated on multiple speech restoration tasks, including speech denoising, bandwidth extension, codec artifact removal, and target speaker extraction. In all scenarios, finetuning our pretrained model results in superior performance over strong baselines. Notably, in the target speaker extraction task, our model outperforms existing systems, including those leveraging SSL-pretrained encoders like WavLM. The code and the pretrained checkpoints are publicly available in the NVIDIA NeMo framework.

Pre-trained encoder-decoder transformer architectures have become increasingly popular recently with the advent of T5 models. T5 has also become more favorable over other architectures like BERT due to the amount of data that it is pre-trained on, increased scale of model parameter sizes and easy applicability to a diverse set of tasks due to the generative nature of the model. While being able to generalize to a wide variety of tasks, it is not clear that encoder-decoder architectures are the most efficient for fine-tuning tasks that don't require auto-regressive decoding. In this work, we study fine-tuning pre-trained encoder-decoder models for tasks such as classification, multi-label classification, and structured prediction. We propose EncT5, a framework for these problems, and illustrate instantiations for these tasks. Our experiment results show that EncT5 has advantages over T5 such as efficiency and usability out performs BERT when evaluated on publicly available pre-trained checkpoints.

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

Self-supervised pre-training bears potential to generate expressive representations without human annotation. Most pre-training in Earth observation (EO) are based on ImageNet or medium-size, labeled remote sensing (RS) datasets. We share an unlabeled RS dataset SSL4EO-S12 (Self-Supervised Learning for Earth Observation - Sentinel-1/2) to assemble a large-scale, global, multimodal, and multi-seasonal corpus of satellite imagery from the ESA Sentinel-1 \& -2 satellite missions. For EO applications we demonstrate SSL4EO-S12 to succeed in self-supervised pre-training for a set of methods: MoCo-v2, DINO, MAE, and data2vec. Resulting models yield downstream performance close to, or surpassing accuracy measures of supervised learning. In addition, pre-training on SSL4EO-S12 excels compared to existing datasets. We make openly available the dataset, related source code, and pre-trained models at https://github.com/zhu-xlab/SSL4EO-S12.

We present a novel masked image modeling (MIM) approach, context autoencoder (CAE), for self-supervised representation pretraining. We pretrain an encoder by making predictions in the encoded representation space. The pretraining tasks include two tasks: masked representation prediction - predict the representations for the masked patches, and masked patch reconstruction - reconstruct the masked patches. The network is an encoder-regressor-decoder architecture: the encoder takes the visible patches as input; the regressor predicts the representations of the masked patches, which are expected to be aligned with the representations computed from the encoder, using the representations of visible patches and the positions of visible and masked patches; the decoder reconstructs the masked patches from the predicted encoded representations. The CAE design encourages the separation of learning the encoder (representation) from completing the pertaining tasks: masked representation prediction and masked patch reconstruction tasks, and making predictions in the encoded representation space empirically shows the benefit to representation learning. We demonstrate the effectiveness of our CAE through superior transfer performance in downstream tasks: semantic segmentation, object detection and instance segmentation, and classification. The code will be available at https://github.com/Atten4Vis/CAE.

With the recent success of artificial intelligence in neuroscience, a number of deep learning (DL) models were proposed for classification, anomaly detection, and pattern recognition tasks in electroencephalography (EEG). EEG is a multi-channel time-series that provides information about the individual brain activity for diagnostics, neuro-rehabilitation, and other applications (including emotions recognition). Two main issues challenge the existing DL-based modeling methods for EEG: the high variability between subjects and the low signal-to-noise ratio making it difficult to ensure a good quality in the EEG data. In this paper, we propose two variational autoencoder models, namely vEEGNet-ver3 and hvEEGNet, to target the problem of high-fidelity EEG reconstruction. We properly designed their architectures using the blocks of the well-known EEGNet as the encoder, and proposed a loss function based on dynamic time warping. We tested the models on the public Dataset 2a - BCI Competition IV, where EEG was collected from 9 subjects and 22 channels. hvEEGNet was found to reconstruct the EEG data with very high-fidelity, outperforming most previous solutions (including our vEEGNet-ver3 ). Furthermore, this was consistent across all subjects. Interestingly, hvEEGNet made it possible to discover that this popular dataset includes a number of corrupted EEG recordings that might have influenced previous literature results. We also investigated the training behaviour of our models and related it with the quality and the size of the input EEG dataset, aiming at opening a new research debate on this relationship. In the future, hvEEGNet could be used as anomaly (e.g., artefact) detector in large EEG datasets to support the domain experts, but also the latent representations it provides could be used in other classification problems and EEG data generation.

We introduce a state-of-the-art real-time, high-fidelity, audio codec leveraging neural networks. It consists in a streaming encoder-decoder architecture with quantized latent space trained in an end-to-end fashion. We simplify and speed-up the training by using a single multiscale spectrogram adversary that efficiently reduces artifacts and produce high-quality samples. We introduce a novel loss balancer mechanism to stabilize training: the weight of a loss now defines the fraction of the overall gradient it should represent, thus decoupling the choice of this hyper-parameter from the typical scale of the loss. Finally, we study how lightweight Transformer models can be used to further compress the obtained representation by up to 40%, while staying faster than real time. We provide a detailed description of the key design choices of the proposed model including: training objective, architectural changes and a study of various perceptual loss functions. We present an extensive subjective evaluation (MUSHRA tests) together with an ablation study for a range of bandwidths and audio domains, including speech, noisy-reverberant speech, and music. Our approach is superior to the baselines methods across all evaluated settings, considering both 24 kHz monophonic and 48 kHz stereophonic audio. Code and models are available at github.com/facebookresearch/encodec.

Automatically classifying electronic health records (EHRs) into diagnostic codes has been challenging to the NLP community. State-of-the-art methods treated this problem as a multilabel classification problem and proposed various architectures to model this problem. However, these systems did not leverage the superb performance of pretrained language models, which achieved superb performance on natural language understanding tasks. Prior work has shown that pretrained language models underperformed on this task with the regular finetuning scheme. Therefore, this paper aims at analyzing the causes of the underperformance and developing a framework for automatic ICD coding with pretrained language models. We spotted three main issues through the experiments: 1) large label space, 2) long input sequences, and 3) domain mismatch between pretraining and fine-tuning. We propose PLMICD, a framework that tackles the challenges with various strategies. The experimental results show that our proposed framework can overcome the challenges and achieves state-of-the-art performance in terms of multiple metrics on the benchmark MIMIC data. The source code is available at https://github.com/MiuLab/PLM-ICD

Electroencephalogram (EEG) signals play a crucial role in understanding brain activity and diagnosing neurological diseases. Because supervised EEG encoders are unable to learn robust EEG patterns and rely too heavily on expensive signal annotation, research has turned to general-purpose self-supervised EEG encoders, known as EEG-based models (EEG-FMs), to achieve robust and scalable EEG feature extraction. However, the readiness of early EEG-FMs for practical applications and the standards for long-term research progress remain unclear. Therefore, a systematic and comprehensive review of first-generation EEG-FMs is necessary to understand their current state-of-the-art and identify key directions for future EEG-FMs. To this end, this study reviews 14 early EEG-FMs and provides a critical comprehensive analysis of their methodologies, empirical findings, and unaddressed research gaps. This review focuses on the latest developments in EEG-based models (EEG-FMs), which have shown great potential for processing and analyzing EEG data. We discuss various EEG-FMs, including their architectures, pretraining strategies, pretraining and downstream datasets, and other details. This review also highlights challenges and future directions in the field, aiming to provide a comprehensive overview for researchers and practitioners interested in EEG analysis and related EEG-FM.

We propose two novel purpose-built deep learning (DL) models for synthesis of the arterial blood pressure (ABP) waveform in a cuff-less manner, using a single-site photoplethysmography (PPG) signal. We utilize the public UCI dataset on cuff-less blood pressure (CLBP) estimation to train and evaluate our DL models. Firstly, we implement a transformer model that incorporates positional encoding, multi-head attention, layer normalization, and dropout techniques, and synthesizes the ABP waveform with a mean absolute error (MAE) of 14. Secondly, we implement a frequency-domain (FD) learning approach where we first obtain the discrete cosine transform (DCT) coefficients of the PPG and ABP signals corresponding to two cardiac cycles, and then learn a linear/non-linear (L/NL) regression between them. We learn that the FD L/NL regression model outperforms the transformer model by achieving an MAE of 11.87 and 8.01, for diastolic blood pressure (DBP) and systolic blood pressure (SBP), respectively. Our FD L/NL regression model also fulfills the AAMI criterion of utilizing data from more than 85 subjects, and achieves grade B by the BHS criterion.

To handle the scarcity and heterogeneity of electroencephalography (EEG) data for Brain-Computer Interface (BCI) tasks, and to harness the power of large publicly available data sets, we propose Neuro-GPT, a foundation model consisting of an EEG encoder and a GPT model. The foundation model is pre-trained on a large-scale data set using a self-supervised task that learns how to reconstruct masked EEG segments. We then fine-tune the model on a Motor Imagery Classification task to validate its performance in a low-data regime (9 subjects). Our experiments demonstrate that applying a foundation model can significantly improve classification performance compared to a model trained from scratch, which provides evidence for the generalizability of the foundation model and its ability to address challenges of data scarcity and heterogeneity in EEG. The code is publicly available at github.com/wenhui0206/NeuroGPT.

Cross-lingual and multi-lingual training of Automatic Speech Recognition (ASR) has been extensively investigated in the supervised setting. This assumes the existence of a parallel corpus of speech and orthographic transcriptions. Recently, contrastive predictive coding (CPC) algorithms have been proposed to pretrain ASR systems with unlabelled data. In this work, we investigate whether unsupervised pretraining transfers well across languages. We show that a slight modification of the CPC pretraining extracts features that transfer well to other languages, being on par or even outperforming supervised pretraining. This shows the potential of unsupervised methods for languages with few linguistic resources.

In this paper, we propose a novel pretraining-based encoder-decoder framework, which can generate the output sequence based on the input sequence in a two-stage manner. For the encoder of our model, we encode the input sequence into context representations using BERT. For the decoder, there are two stages in our model, in the first stage, we use a Transformer-based decoder to generate a draft output sequence. In the second stage, we mask each word of the draft sequence and feed it to BERT, then by combining the input sequence and the draft representation generated by BERT, we use a Transformer-based decoder to predict the refined word for each masked position. To the best of our knowledge, our approach is the first method which applies the BERT into text generation tasks. As the first step in this direction, we evaluate our proposed method on the text summarization task. Experimental results show that our model achieves new state-of-the-art on both CNN/Daily Mail and New York Times datasets.

While Self-Supervised Learning has helped reap the benefit of the scale from the available unlabeled data, the learning paradigms are continuously being bettered. We present a new pre-training strategy named ccc-wav2vec 2.0, which uses clustering and an augmentation-based cross-contrastive loss as its self-supervised objective. Through the clustering module, we scale down the influence of those negative examples that are highly similar to the positive. The Cross-Contrastive loss is computed between the encoder output of the original sample and the quantizer output of its augmentation and vice-versa, bringing robustness to the pre-training strategy. ccc-wav2vec 2.0 achieves up to 15.6% and 12.7% relative WER improvement over the baseline wav2vec 2.0 on the test-clean and test-other sets, respectively, of LibriSpeech, without the use of any language model. The proposed method also achieves up to 14.9% relative WER improvement over the baseline wav2vec 2.0 when fine-tuned on Switchboard data. We make all our codes publicly available on GitHub.

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

Audio codec models are widely used in audio communication as a crucial technique for compressing audio into discrete representations. Nowadays, audio codec models are increasingly utilized in generation fields as intermediate representations. For instance, AudioLM is an audio generation model that uses the discrete representation of SoundStream as a training target, while VALL-E employs the Encodec model as an intermediate feature to aid TTS tasks. Despite their usefulness, two challenges persist: (1) training these audio codec models can be difficult due to the lack of publicly available training processes and the need for large-scale data and GPUs; (2) achieving good reconstruction performance requires many codebooks, which increases the burden on generation models. In this study, we propose a group-residual vector quantization (GRVQ) technique and use it to develop a novel High Fidelity Audio Codec model, HiFi-Codec, which only requires 4 codebooks. We train all the models using publicly available TTS data such as LibriTTS, VCTK, AISHELL, and more, with a total duration of over 1000 hours, using 8 GPUs. Our experimental results show that HiFi-Codec outperforms Encodec in terms of reconstruction performance despite requiring only 4 codebooks. To facilitate research in audio codec and generation, we introduce AcademiCodec, the first open-source audio codec toolkit that offers training codes and pre-trained models for Encodec, SoundStream, and HiFi-Codec. Code and pre-trained model can be found on: https://github.com/yangdongchao/AcademiCodec{https://github.com/yangdongchao/AcademiCodec}

While electroencephalogram (EEG) has been a crucial tool for monitoring the brain and diagnosing neurological disorders (e.g., epilepsy), learning meaningful representations from raw EEG signals remains challenging due to limited annotations and high signal variability. Recently, EEG foundation models (FMs) have shown promising potential by adopting transformer architectures and self-supervised pre-training methods from large language models (e.g., masked prediction) to learn representations from diverse EEG data, followed by fine-tuning on specific EEG tasks. Nonetheless, these large models often incurred high computational costs during both training and inference, with only marginal performance improvements as model size increases. In this work, we proposed EEG representation learning framework building upon Generative Diffusion Model (EEGDM). Specifically, we developed structured state-space model for diffusion pretraining (SSMDP) to better capture the temporal dynamics of EEG signals and trained the architecture using a Denoising Diffusion Probabilistic Model. The resulting latent EEG representations were then used for downstream classification tasks via our proposed latent fusion transformer (LFT). To evaluate our method, we used the multi-event Temple University EEG Event Corpus and compared EEGDM with current state-of-the-art approaches, including EEG FMs. Empirical results showed that our method outperformed existing methods while being approximately 19x more lightweight. These findings suggested that EEGDM offered a promising alternative to current FMs. Our code is available at: https://github.com/jhpuah/EEGDM.

Cardiovascular diseases (CVDs) remain the leading cause of mortality globally, and echocardiography is critical for diagnosis of both common and congenital cardiac conditions. However, echocardiographic data for certain pathologies are scarce, hindering the development of robust automated diagnosis models. In this work, we propose Echo-Path, a novel generative framework to produce echocardiogram videos conditioned on specific cardiac pathologies. Echo-Path can synthesize realistic ultrasound video sequences that exhibit targeted abnormalities, focusing here on atrial septal defect (ASD) and pulmonary arterial hypertension (PAH). Our approach introduces a pathology-conditioning mechanism into a state-of-the-art echo video generator, allowing the model to learn and control disease-specific structural and motion patterns in the heart. Quantitative evaluation demonstrates that the synthetic videos achieve low distribution distances, indicating high visual fidelity. Clinically, the generated echoes exhibit plausible pathology markers. Furthermore, classifiers trained on our synthetic data generalize well to real data and, when used to augment real training sets, it improves downstream diagnosis of ASD and PAH by 7\% and 8\% respectively. Code, weights and dataset are available here https://github.com/Marshall-mk/EchoPathv1

The residual vector quantization (RVQ) technique plays a central role in recent advances in neural audio codecs. These models effectively synthesize high-fidelity audio from a limited number of codes due to the hierarchical structure among quantization levels. In this paper, we propose an encoding algorithm to further enhance the synthesis quality of RVQ-based neural codecs at test-time. Firstly, we point out the suboptimal nature of quantized vectors generated by conventional methods. We demonstrate that quantization error can be mitigated by selecting a different set of codes. Subsequently, we present our encoding algorithm, designed to identify a set of discrete codes that achieve a lower quantization error. We then apply the proposed method to pre-trained models and evaluate its efficacy using diverse metrics. Our experimental findings validate that our method not only reduces quantization errors, but also improves synthesis quality.

Electromyogenic (EMG) noise is a major contamination source in EEG data that can impede accurate analysis of brain-specific neural activity. Recent literature on EMG artifact removal has moved beyond traditional linear algorithms in favor of machine learning-based systems. However, existing deep learning-based filtration methods often have large compute footprints and prohibitively long training times. In this study, we present a new machine learning-based system for filtering EMG interference from EEG data using an autoencoder-targeted adversarial transformer (AT-AT). By leveraging the lightweight expressivity of an autoencoder to determine optimal time-series transformer application sites, our AT-AT architecture achieves a >90% model size reduction compared to published artifact removal models. The addition of adversarial training ensures that filtered signals adhere to the fundamental characteristics of EEG data. We trained AT-AT using published neural data from 67 subjects and found that the system was able to achieve comparable test performance to larger models; AT-AT posted a mean reconstructive correlation coefficient above 0.95 at an initial signal-to-noise ratio (SNR) of 2 dB and 0.70 at -7 dB SNR. Further research generalizing these results to broader sample sizes beyond these isolated test cases will be crucial; while outside the scope of this study, we also include results from a real-world deployment of AT-AT in the Appendix.

We investigate the use of randomly generated data for the sake of pre-training a model. We justify this approach theoretically from the perspective of algorithmic complexity, building on recent research that shows that sequence models can be trained to approximate Solomonoff induction. We derive similar, but complementary theoretical results. We show empirically that synthetically generated data can be used to pre-train a model before the data is seen. We replicate earlier results that models trained this way show zero-shot in-context learning across a variety of datasets, and that this performance improves with scale. We extend earlier results to real-world data, and show that finetuning a model after pre-training offers faster convergence and better generalization.

International Classification of Disease (ICD) coding procedure which refers to tagging medical notes with diagnosis codes has been shown to be effective and crucial to the billing system in medical sector. Currently, ICD codes are assigned to a clinical note manually which is likely to cause many errors. Moreover, training skilled coders also requires time and human resources. Therefore, automating the ICD code determination process is an important task. With the advancement of artificial intelligence theory and computational hardware, machine learning approach has emerged as a suitable solution to automate this process. In this project, we apply a transformer-based architecture to capture the interdependence among the tokens of a document and then use a code-wise attention mechanism to learn code-specific representations of the entire document. Finally, they are fed to separate dense layers for corresponding code prediction. Furthermore, to handle the imbalance in the code frequency of clinical datasets, we employ a label distribution aware margin (LDAM) loss function. The experimental results on the MIMIC-III dataset show that our proposed model outperforms other baselines by a significant margin. In particular, our best setting achieves a micro-AUC score of 0.923 compared to 0.868 of bidirectional recurrent neural networks. We also show that by using the code-wise attention mechanism, the model can provide more insights about its prediction, and thus it can support clinicians to make reliable decisions. Our code is available online (https://github.com/biplob1ly/TransICD)

This paper presents FunCodec, a fundamental neural speech codec toolkit, which is an extension of the open-source speech processing toolkit FunASR. FunCodec provides reproducible training recipes and inference scripts for the latest neural speech codec models, such as SoundStream and Encodec. Thanks to the unified design with FunASR, FunCodec can be easily integrated into downstream tasks, such as speech recognition. Along with FunCodec, pre-trained models are also provided, which can be used for academic or generalized purposes. Based on the toolkit, we further propose the frequency-domain codec models, FreqCodec, which can achieve comparable speech quality with much lower computation and parameter complexity. Experimental results show that, under the same compression ratio, FunCodec can achieve better reconstruction quality compared with other toolkits and released models. We also demonstrate that the pre-trained models are suitable for downstream tasks, including automatic speech recognition and personalized text-to-speech synthesis. This toolkit is publicly available at https://github.com/alibaba-damo-academy/FunCodec.

Vocoders reconstruct speech waveforms from acoustic features and play a pivotal role in modern TTS systems. Frequent-domain GAN vocoders like Vocos and APNet2 have recently seen rapid advancements, outperforming time-domain models in inference speed while achieving comparable audio quality. However, these frequency-domain vocoders suffer from large parameter sizes, thus introducing extra memory burden. Inspired by PriorGrad and SpecGrad, we employ pseudo-inverse to estimate the amplitude spectrum as the initialization roughly. This simple initialization significantly mitigates the parameter demand for vocoder. Based on APNet2 and our streamlined Amplitude prediction branch, we propose our FreeV, compared with its counterpart APNet2, our FreeV achieves 1.8 times inference speed improvement with nearly half parameters. Meanwhile, our FreeV outperforms APNet2 in resynthesis quality, marking a step forward in pursuing real-time, high-fidelity speech synthesis. Code and checkpoints is available at: https://github.com/BakerBunker/FreeV

To build a French national electronic injury surveillance system based on emergency room visits, we aim to develop a coding system to classify their causes from clinical notes in free-text. Supervised learning techniques have shown good results in this area but require a large amount of expert annotated dataset which is time consuming and costly to obtain. We hypothesize that the Natural Language Processing Transformer model incorporating a generative self-supervised pre-training step can significantly reduce the required number of annotated samples for supervised fine-tuning. In this preliminary study, we test our hypothesis in the simplified problem of predicting whether a visit is the consequence of a traumatic event or not from free-text clinical notes. Using fully re-trained GPT-2 models (without OpenAI pre-trained weights), we assess the gain of applying a self-supervised pre-training phase with unlabeled notes prior to the supervised learning task. Results show that the number of data required to achieve a ginve level of performance (AUC>0.95) was reduced by a factor of 10 when applying pre-training. Namely, for 16 times more data, the fully-supervised model achieved an improvement <1% in AUC. To conclude, it is possible to adapt a multi-purpose neural language model such as the GPT-2 to create a powerful tool for classification of free-text notes with only a small number of labeled samples.

Pre-trained language models (PLMs), such as BERT and GPT, have revolutionized the field of NLP, not only in the general domain but also in the biomedical domain. Most prior efforts in building biomedical PLMs have resorted simply to domain adaptation and focused mainly on English. In this work we introduce eHealth, a Chinese biomedical PLM built from scratch with a new pre-training framework. This new framework pre-trains eHealth as a discriminator through both token- and sequence-level discrimination. The former is to detect input tokens corrupted by a generator and recover their original identities from plausible candidates, while the latter is to further distinguish corruptions of a same original sequence from those of others. As such, eHealth can learn language semantics at both token and sequence levels. Extensive experiments on 11 Chinese biomedical language understanding tasks of various forms verify the effectiveness and superiority of our approach. We release the pre-trained model at https://github.com/PaddlePaddle/Research/tree/master/KG/eHealth and will also release the code later.

Pre-training has been investigated to improve the efficiency and performance of training neural operators in data-scarce settings. However, it is largely in its infancy due to the inherent complexity and diversity, such as long trajectories, multiple scales and varying dimensions of partial differential equations (PDEs) data. In this paper, we present a new auto-regressive denoising pre-training strategy, which allows for more stable and efficient pre-training on PDE data and generalizes to various downstream tasks. Moreover, by designing a flexible and scalable model architecture based on Fourier attention, we can easily scale up the model for large-scale pre-training. We train our PDE foundation model with up to 0.5B parameters on 10+ PDE datasets with more than 100k trajectories. Extensive experiments show that we achieve SOTA on these benchmarks and validate the strong generalizability of our model to significantly enhance performance on diverse downstream PDE tasks like 3D data. Code is available at https://github.com/thu-ml/DPOT.

Recognizing overlapping speech from multiple speakers in conversational scenarios is one of the most challenging problem for automatic speech recognition (ASR). Serialized output training (SOT) is a classic method to address multi-talker ASR, with the idea of concatenating transcriptions from multiple speakers according to the emission times of their speech for training. However, SOT-style transcriptions, derived from concatenating multiple related utterances in a conversation, depend significantly on modeling long contexts. Therefore, compared to traditional methods that primarily emphasize encoder performance in attention-based encoder-decoder (AED) architectures, a novel approach utilizing large language models (LLMs) that leverages the capabilities of pre-trained decoders may be better suited for such complex and challenging scenarios. In this paper, we propose an LLM-based SOT approach for multi-talker ASR, leveraging pre-trained speech encoder and LLM, fine-tuning them on multi-talker dataset using appropriate strategies. Experimental results demonstrate that our approach surpasses traditional AED-based methods on the simulated dataset LibriMix and achieves state-of-the-art performance on the evaluation set of the real-world dataset AMI, outperforming the AED model trained with 1000 times more supervised data in previous works.

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

Neural speech codecs have recently emerged as a focal point in the fields of speech compression and generation. Despite this progress, achieving high-quality speech reconstruction under low-bitrate scenarios remains a significant challenge. In this paper, we propose PSCodec, a series of neural speech codecs based on prompt encoders, comprising PSCodec-Base, PSCodec-DRL-ICT, and PSCodec-CasAN, which are capable of delivering high-performance speech reconstruction with low bandwidths. Specifically, we first introduce PSCodec-Base, which leverages a pretrained speaker verification model-based prompt encoder (VPP-Enc) and a learnable Mel-spectrogram-based prompt encoder (MelP-Enc) to effectively disentangle and integrate voiceprint and Mel-related features in utterances. To further enhance feature utilization efficiency, we propose PSCodec-DRL-ICT, incorporating a structural similarity (SSIM) based disentangled representation loss (DRL) and an incremental continuous training (ICT) strategy. While PSCodec-DRL-ICT demonstrates impressive performance, its reliance on extensive hyperparameter tuning and multi-stage training makes it somewhat labor-intensive. To circumvent these limitations, we propose PSCodec-CasAN, utilizing an advanced cascaded attention network (CasAN) to enhance representational capacity of the entire system. Extensive experiments show that our proposed PSCodec-Base, PSCodec-DRL-ICT, and PSCodec-CasAN all significantly outperform several state-of-the-art neural codecs, exhibiting substantial improvements in both speech reconstruction quality and speaker similarity under low-bitrate conditions.

Accurate segmentation is essential for echocardiography-based assessment of cardiovascular diseases (CVDs). However, the variability among sonographers and the inherent challenges of ultrasound images hinder precise segmentation. By leveraging the joint representation of image and text modalities, Vision-Language Segmentation Models (VLSMs) can incorporate rich contextual information, potentially aiding in accurate and explainable segmentation. However, the lack of readily available data in echocardiography hampers the training of VLSMs. In this study, we explore using synthetic datasets from Semantic Diffusion Models (SDMs) to enhance VLSMs for echocardiography segmentation. We evaluate results for two popular VLSMs (CLIPSeg and CRIS) using seven different kinds of language prompts derived from several attributes, automatically extracted from echocardiography images, segmentation masks, and their metadata. Our results show improved metrics and faster convergence when pretraining VLSMs on SDM-generated synthetic images before finetuning on real images. The code, configs, and prompts are available at https://github.com/naamiinepal/synthetic-boost.

This study aims to explore the implementation of Natural Language Processing (NLP) and machine learning (ML) techniques to automate the coding of medical letters with visualised explainability and light-weighted local computer settings. Currently in clinical settings, coding is a manual process that involves assigning codes to each condition, procedure, and medication in a patient's paperwork (e.g., 56265001 heart disease using SNOMED CT code). There are preliminary research on automatic coding in this field using state-of-the-art ML models; however, due to the complexity and size of the models, the real-world deployment is not achieved. To further facilitate the possibility of automatic coding practice, we explore some solutions in a local computer setting; in addition, we explore the function of explainability for transparency of AI models. We used the publicly available MIMIC-III database and the HAN/HLAN network models for ICD code prediction purposes. We also experimented with the mapping between ICD and SNOMED CT knowledge bases. In our experiments, the models provided useful information for 97.98\% of codes. The result of this investigation can shed some light on implementing automatic clinical coding in practice, such as in hospital settings, on the local computers used by clinicians , project page https://github.com/Glenj01/Medical-Coding.

In this paper, we show that a simple self-supervised pre-trained audio model can achieve comparable inference efficiency to more complicated pre-trained models with speech transformer encoders. These speech transformers rely on mixing convolutional modules with self-attention modules. They achieve state-of-the-art performance on ASR with top efficiency. We first show that employing these speech transformers as an encoder significantly improves the efficiency of pre-trained audio models as well. However, our study shows that we can achieve comparable efficiency with advanced self-attention solely. We demonstrate that this simpler approach is particularly beneficial with a low-bit weight quantization technique of a neural network to improve efficiency. We hypothesize that it prevents propagating the errors between different quantized modules compared to recent speech transformers mixing quantized convolution and the quantized self-attention modules.

Speech produced by human vocal apparatus conveys substantial non-semantic information including the gender of the speaker, voice quality, affective state, abnormalities in the vocal apparatus etc. Such information is attributed to the properties of the voice source signal, which is usually estimated from the speech signal. However, most of the source estimation techniques depend heavily on the goodness of the model assumptions and are prone to noise. A popular alternative is to indirectly obtain the source information through the Electroglottographic (EGG) signal that measures the electrical admittance around the vocal folds using dedicated hardware. In this paper, we address the problem of estimating the EGG signal directly from the speech signal, devoid of any hardware. Sampling from the intractable conditional distribution of the EGG signal given the speech signal is accomplished through optimization of an evidence lower bound. This is constructed via minimization of the KL-divergence between the true and the approximated posteriors of a latent variable learned using a deep neural auto-encoder that serves an informative prior. We demonstrate the efficacy of the method at generating the EGG signal by conducting several experiments on datasets comprising multiple speakers, voice qualities, noise settings and speech pathologies. The proposed method is evaluated on many benchmark metrics and is found to agree with the gold standard while proving better than the state-of-the-art algorithms on a few tasks such as epoch extraction.

Transformer-based models have significantly advanced time series forecasting, with patch-based input strategies offering efficiency and improved long-horizon modeling. Yet, existing approaches rely on temporally-agnostic patch construction, where arbitrary starting positions and fixed lengths fracture temporal coherence by splitting natural transitions across boundaries. This naive segmentation often disrupts short-term dependencies and weakens representation learning. In response, we propose EntroPE (Entropy-Guided Dynamic Patch Encoder), a novel, temporally informed framework that dynamically detects transition points via conditional entropy and dynamically places patch boundaries. This preserves temporal structure while retaining the computational benefits of patching. EntroPE consists of two key modules, namely an Entropy-based Dynamic Patcher (EDP) that applies information-theoretic criteria to locate natural temporal shifts and determine patch boundaries, and an Adaptive Patch Encoder (APE) that employs pooling and cross-attention to capture intra-patch dependencies and produce fixed-size latent representations. These embeddings are then processed by a global transformer to model inter-patch dynamics. Experiments across long-term forecasting benchmarks demonstrate that EntroPE improves both accuracy and efficiency, establishing entropy-guided dynamic patching as a promising new paradigm for time series modeling. Code is available at: https://github.com/Sachithx/EntroPE.

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

Deep learning's growing prevalence has driven its widespread use in healthcare, where AI and sensor advancements enhance diagnosis, treatment, and monitoring. In mobile health, AI-powered tools enable early diagnosis and continuous monitoring of conditions like stress. Wearable technologies and multimodal physiological data have made stress detection increasingly viable, but model efficacy depends on data quality, quantity, and modality. This study develops transformer models for stress detection using the WESAD dataset, training on electrocardiograms (ECG), electrodermal activity (EDA), electromyography (EMG), respiration rate (RESP), temperature (TEMP), and 3-axis accelerometer (ACC) signals. The results demonstrate the effectiveness of single-modality transformers in analyzing physiological signals, achieving state-of-the-art performance with accuracy, precision and recall values in the range of 99.73% to 99.95% for stress detection. Furthermore, this study explores cross-modal performance and also explains the same using 2D visualization of the learned embedding space and quantitative analysis based on data variance. Despite the large body of work on stress detection and monitoring, the robustness and generalization of these models across different modalities has not been explored. This research represents one of the initial efforts to interpret embedding spaces for stress detection, providing valuable information on cross-modal performance.

Learning code representations has been the core prerequisite of many software engineering tasks such as code clone detection and code generation. State-of-the-art program representation techniques mainly utilize pre-trained language models (PLMs) such as CodeBERT. A Transformer encoder is firstly pre-trained on a large-scale code corpus to acquire general knowledge about source code. The pre-trained model is then fine-tuned on specific tasks using an amount of labeled data. However, gathering training samples for the downstream tasks can be prohibitively expensive and impractical for domain-specific languages or project-specific tasks. Besides, pre-training and downstream tasks are usually heterogeneous, which makes it difficult to fully explore the knowledge learned during pre-training. In this paper, we propose Zecoler, a zero-shot approach for learning code representations. Zecoler is built upon a pre-trained programming language model. In order to elicit knowledge from the PLMs efficiently, Zecoler casts the downstream tasks to the same form of pre-training objectives by inserting train-able prompts into the original input. These prompts can guide PLMs on how to generate better results. Subsequently, we employ the prompt tuning technique to search for the optimal prompts for PLMs automatically. This enables the representation model to efficiently fit the downstream tasks through fine-tuning on the dataset in source language domain and then reuse the pre-trained knowledge for the target domain in a zero-shot style. We evaluate Zecoler in five code intelligence tasks including code clone detection, code search, method name prediction, code summarization, and code generation. The results show that our approach significantly outperforms baseline models under the zero-shot setting.

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

Foundation models have demonstrated remarkable potential in medical domain. However, their application to complex cardiovascular diagnostics remains underexplored. In this paper, we present Cardiac-CLIP, a multi-modal foundation model designed for 3D cardiac CT images. Cardiac-CLIP is developed through a two-stage pre-training strategy. The first stage employs a 3D masked autoencoder (MAE) to perform self-supervised representation learning from large-scale unlabeled volumetric data, enabling the visual encoder to capture rich anatomical and contextual features. In the second stage, contrastive learning is introduced to align visual and textual representations, facilitating cross-modal understanding. To support the pre-training, we collect 16641 real clinical CT scans, supplemented by 114k publicly available data. Meanwhile, we standardize free-text radiology reports into unified templates and construct the pathology vectors according to diagnostic attributes, based on which the soft-label matrix is generated to supervise the contrastive learning process. On the other hand, to comprehensively evaluate the effectiveness of Cardiac-CLIP, we collect 6,722 real-clinical data from 12 independent institutions, along with the open-source data to construct the evaluation dataset. Specifically, Cardiac-CLIP is comprehensively evaluated across multiple tasks, including cardiovascular abnormality classification, information retrieval and clinical analysis. Experimental results demonstrate that Cardiac-CLIP achieves state-of-the-art performance across various downstream tasks in both internal and external data. Particularly, Cardiac-CLIP exhibits great effectiveness in supporting complex clinical tasks such as the prospective prediction of acute coronary syndrome, which is notoriously difficult in real-world scenarios.

Medical image segmentation is a critical task in clinical workflows, particularly for the detection and delineation of pathological regions. While convolutional architectures like U-Net have become standard for such tasks, their limited receptive field restricts global context modeling. Recent efforts integrating transformers have addressed this, but often result in deep, computationally expensive models unsuitable for real-time use. In this work, we present a novel end-to-end lightweight architecture designed specifically for real-time binary medical image segmentation. Our model combines a Swin Transformer-like encoder with a U-Net-like decoder, connected via skip pathways to preserve spatial detail while capturing contextual information. Unlike existing designs such as Swin Transformer or U-Net, our architecture is significantly shallower and competitively efficient. To improve the encoder's ability to learn meaningful features without relying on large amounts of labeled data, we first train it using Barlow Twins, a self-supervised learning method that helps the model focus on important patterns by reducing unnecessary repetition in the learned features. After this pretraining, we fine-tune the entire model for our specific task. Experiments on benchmark binary segmentation tasks demonstrate that our model achieves competitive accuracy with substantially reduced parameter count and faster inference, positioning it as a practical alternative for deployment in real-time and resource-limited clinical environments. The code for our method is available at Github repository: https://github.com/mkianih/Barlow-Swin.

In this paper, we propose an efficient and accurate streaming speech recognition model based on the FastConformer architecture. We adapted the FastConformer architecture for streaming applications through: (1) constraining both the look-ahead and past contexts in the encoder, and (2) introducing an activation caching mechanism to enable the non-autoregressive encoder to operate autoregressively during inference. The proposed model is thoughtfully designed in a way to eliminate the accuracy disparity between the train and inference time which is common for many streaming models. Furthermore, our proposed encoder works with various decoder configurations including Connectionist Temporal Classification (CTC) and RNN-Transducer (RNNT) decoders. Additionally, we introduced a hybrid CTC/RNNT architecture which utilizes a shared encoder with both a CTC and RNNT decoder to boost the accuracy and save computation. We evaluate the proposed model on LibriSpeech dataset and a multi-domain large scale dataset and demonstrate that it can achieve better accuracy with lower latency and inference time compared to a conventional buffered streaming model baseline. We also showed that training a model with multiple latencies can achieve better accuracy than single latency models while it enables us to support multiple latencies with a single model. Our experiments also showed the hybrid architecture would not only speedup the convergence of the CTC decoder but also improves the accuracy of streaming models compared to single decoder models.

Modern object detectors have taken the advantages of backbone networks pre-trained on large scale datasets. Except for the backbone networks, however, other components such as the detector head and the feature pyramid network (FPN) remain trained from scratch, which hinders fully tapping the potential of representation models. In this study, we propose to integrally migrate pre-trained transformer encoder-decoders (imTED) to a detector, constructing a feature extraction path which is ``fully pre-trained" so that detectors' generalization capacity is maximized. The essential differences between imTED with the baseline detector are twofold: (1) migrating the pre-trained transformer decoder to the detector head while removing the randomly initialized FPN from the feature extraction path; and (2) defining a multi-scale feature modulator (MFM) to enhance scale adaptability. Such designs not only reduce randomly initialized parameters significantly but also unify detector training with representation learning intendedly. Experiments on the MS COCO object detection dataset show that imTED consistently outperforms its counterparts by sim2.4 AP. Without bells and whistles, imTED improves the state-of-the-art of few-shot object detection by up to 7.6 AP. Code is available at https://github.com/LiewFeng/imTED.