Daily Papers

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

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.

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.

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

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.

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.

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.

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.

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

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

The electrocardiogram (ECG) 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.

With the rapid advances in high-throughput sequencing technologies, the focus of survival analysis has shifted from examining clinical indicators to incorporating genomic profiles with pathological images. However, existing methods either directly adopt a straightforward fusion of pathological features and genomic profiles for survival prediction, or take genomic profiles as guidance to integrate the features of pathological images. The former would overlook intrinsic cross-modal correlations. The latter would discard pathological information irrelevant to gene expression. To address these issues, we present a Cross-Modal Translation and Alignment (CMTA) framework to explore the intrinsic cross-modal correlations and transfer potential complementary information. Specifically, we construct two parallel encoder-decoder structures for multi-modal data to integrate intra-modal information and generate cross-modal representation. Taking the generated cross-modal representation to enhance and recalibrate intra-modal representation can significantly improve its discrimination for comprehensive survival analysis. To explore the intrinsic crossmodal correlations, we further design a cross-modal attention module as the information bridge between different modalities to perform cross-modal interactions and transfer complementary information. Our extensive experiments on five public TCGA datasets demonstrate that our proposed framework outperforms the state-of-the-art methods.

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.

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.

The objective of Radiology Report Generation (RRG) is to automatically generate coherent textual analyses of diseases based on radiological images, thereby alleviating the workload of radiologists. Current AI-based methods for RRG primarily focus on modifications to the encoder-decoder model architecture. To advance these approaches, this paper introduces an Organ-Regional Information Driven (ORID) framework which can effectively integrate multi-modal information and reduce the influence of noise from unrelated organs. Specifically, based on the LLaVA-Med, we first construct an RRG-related instruction dataset to improve organ-regional diagnosis description ability and get the LLaVA-Med-RRG. After that, we propose an organ-based cross-modal fusion module to effectively combine the information from the organ-regional diagnosis description and radiology image. To further reduce the influence of noise from unrelated organs on the radiology report generation, we introduce an organ importance coefficient analysis module, which leverages Graph Neural Network (GNN) to examine the interconnections of the cross-modal information of each organ region. Extensive experiments an1d comparisons with state-of-the-art methods across various evaluation metrics demonstrate the superior performance of our proposed method.

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

Recent advances in learning multi-modal representation have witnessed the success in biomedical domains. While established techniques enable handling multi-modal information, the challenges are posed when extended to various clinical modalities and practical modalitymissing setting due to the inherent modality gaps. To tackle these, we propose an innovative Modality-prompted Heterogeneous Graph for Omnimodal Learning (GTP-4o), which embeds the numerous disparate clinical modalities into a unified representation, completes the deficient embedding of missing modality and reformulates the cross-modal learning with a graph-based aggregation. Specially, we establish a heterogeneous graph embedding to explicitly capture the diverse semantic properties on both the modality-specific features (nodes) and the cross-modal relations (edges). Then, we design a modality-prompted completion that enables completing the inadequate graph representation of missing modality through a graph prompting mechanism, which generates hallucination graphic topologies to steer the missing embedding towards the intact representation. Through the completed graph, we meticulously develop a knowledge-guided hierarchical cross-modal aggregation consisting of a global meta-path neighbouring to uncover the potential heterogeneous neighbors along the pathways driven by domain knowledge, and a local multi-relation aggregation module for the comprehensive cross-modal interaction across various heterogeneous relations. We assess the efficacy of our methodology on rigorous benchmarking experiments against prior state-of-the-arts. In a nutshell, GTP-4o presents an initial foray into the intriguing realm of embedding, relating and perceiving the heterogeneous patterns from various clinical modalities holistically via a graph theory. Project page: https://gtp-4-o.github.io/.

Accurate medical classification requires a large number of multi-modal data, and in many cases, different feature types. Previous studies have shown promising results when using multi-modal data, outperforming single-modality models when classifying diseases such as Alzheimer's Disease (AD). However, those models are usually not flexible enough to handle missing modalities. Currently, the most common workaround is discarding samples with missing modalities which leads to considerable data under-utilization. Adding to the fact that labeled medical images are already scarce, the performance of data-driven methods like deep learning can be severely hampered. Therefore, a multi-modal method that can handle missing data in various clinical settings is highly desirable. In this paper, we present Multi-Modal Mixing Transformer (3MAT), a disease classification transformer that not only leverages multi-modal data but also handles missing data scenarios. In this work, we test 3MT for AD and Cognitively normal (CN) classification and mild cognitive impairment (MCI) conversion prediction to progressive MCI (pMCI) or stable MCI (sMCI) using clinical and neuroimaging data. The model uses a novel Cascaded Modality Transformer architecture with cross-attention to incorporate multi-modal information for more informed predictions. We propose a novel modality dropout mechanism to ensure an unprecedented level of modality independence and robustness to handle missing data scenarios. The result is a versatile network that enables the mixing of arbitrary numbers of modalities with different feature types and also ensures full data utilization missing data scenarios. The model is trained and evaluated on the ADNI dataset with the SOTRA performance and further evaluated with the AIBL dataset with missing data.

This paper presents a novel multimodal framework to distinguish between different symptom classes of subjects in the schizophrenia spectrum and healthy controls using audio, video, and text modalities. We implemented Convolution Neural Network and Long Short Term Memory based unimodal models and experimented on various multimodal fusion approaches to come up with the proposed framework. We utilized a minimal Gated multimodal unit (mGMU) to obtain a bi-modal intermediate fusion of the features extracted from the input modalities before finally fusing the outputs of the bimodal fusions to perform subject-wise classifications. The use of mGMU units in the multimodal framework improved the performance in both weighted f1-score and weighted AUC-ROC scores.

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.

Time series classification (TSC) on multivariate time series is a critical problem. We propose a novel multi-view approach integrating frequency-domain and time-domain features to provide complementary contexts for TSC. Our method fuses continuous wavelet transform spectral features with temporal convolutional or multilayer perceptron features. We leverage the Mamba state space model for efficient and scalable sequence modeling. We also introduce a novel tango scanning scheme to better model sequence relationships. Experiments on 10 standard benchmark datasets demonstrate our approach achieves an average 6.45% accuracy improvement over state-of-the-art TSC models.

Alzheimer's Disease (AD) is the most common form of dementia and often difficult to diagnose due to the multifactorial etiology of dementia. Recent works on neuroimaging-based computer-aided diagnosis with deep neural networks (DNNs) showed that fusing structural magnetic resonance images (sMRI) and fluorodeoxyglucose positron emission tomography (FDG-PET) leads to improved accuracy in a study population of healthy controls and subjects with AD. However, this result conflicts with the established clinical knowledge that FDG-PET better captures AD-specific pathologies than sMRI. Therefore, we propose a framework for the systematic evaluation of multi-modal DNNs and critically re-evaluate single- and multi-modal DNNs based on FDG-PET and sMRI for binary healthy vs. AD, and three-way healthy/mild cognitive impairment/AD classification. Our experiments demonstrate that a single-modality network using FDG-PET performs better than MRI (accuracy 0.91 vs 0.87) and does not show improvement when combined. This conforms with the established clinical knowledge on AD biomarkers, but raises questions about the true benefit of multi-modal DNNs. We argue that future work on multi-modal fusion should systematically assess the contribution of individual modalities following our proposed evaluation framework. Finally, we encourage the community to go beyond healthy vs. AD classification and focus on differential diagnosis of dementia, where fusing multi-modal image information conforms with a clinical need.

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

Health conditions among patients in intensive care units (ICUs) are monitored via electronic health records (EHRs), composed of numerical time series and lengthy clinical note sequences, both taken at irregular time intervals. Dealing with such irregularity in every modality, and integrating irregularity into multimodal representations to improve medical predictions, is a challenging problem. Our method first addresses irregularity in each single modality by (1) modeling irregular time series by dynamically incorporating hand-crafted imputation embeddings into learned interpolation embeddings via a gating mechanism, and (2) casting a series of clinical note representations as multivariate irregular time series and tackling irregularity via a time attention mechanism. We further integrate irregularity in multimodal fusion with an interleaved attention mechanism across temporal steps. To the best of our knowledge, this is the first work to thoroughly model irregularity in multimodalities for improving medical predictions. Our proposed methods for two medical prediction tasks consistently outperforms state-of-the-art (SOTA) baselines in each single modality and multimodal fusion scenarios. Specifically, we observe relative improvements of 6.5\%, 3.6\%, and 4.3\% in F1 for time series, clinical notes, and multimodal fusion, respectively. These results demonstrate the effectiveness of our methods and the importance of considering irregularity in multimodal EHRs.

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.

Sleep is a complex physiological process evaluated through various modalities recording electrical brain, cardiac, and respiratory activities. We curate a large polysomnography dataset from over 14,000 participants comprising over 100,000 hours of multi-modal sleep recordings. Leveraging this extensive dataset, we developed SleepFM, the first multi-modal foundation model for sleep analysis. We show that a novel leave-one-out approach for contrastive learning significantly improves downstream task performance compared to representations from standard pairwise contrastive learning. A logistic regression model trained on SleepFM's learned embeddings outperforms an end-to-end trained convolutional neural network (CNN) on sleep stage classification (macro AUROC 0.88 vs 0.72 and macro AUPRC 0.72 vs 0.48) and sleep disordered breathing detection (AUROC 0.85 vs 0.69 and AUPRC 0.77 vs 0.61). Notably, the learned embeddings achieve 48% top-1 average accuracy in retrieving the corresponding recording clips of other modalities from 90,000 candidates. This work demonstrates the value of holistic multi-modal sleep modeling to fully capture the richness of sleep recordings. SleepFM is open source and available at https://github.com/rthapa84/sleepfm-codebase.

The automated generation of imaging reports proves invaluable in alleviating the workload of radiologists. A clinically applicable reports generation algorithm should demonstrate its effectiveness in producing reports that accurately describe radiology findings and attend to patient-specific indications. In this paper, we introduce a novel method, Structural Entities extraction and patient indications Incorporation (SEI) for chest X-ray report generation. Specifically, we employ a structural entities extraction (SEE) approach to eliminate presentation-style vocabulary in reports and improve the quality of factual entity sequences. This reduces the noise in the following cross-modal alignment module by aligning X-ray images with factual entity sequences in reports, thereby enhancing the precision of cross-modal alignment and further aiding the model in gradient-free retrieval of similar historical cases. Subsequently, we propose a cross-modal fusion network to integrate information from X-ray images, similar historical cases, and patient-specific indications. This process allows the text decoder to attend to discriminative features of X-ray images, assimilate historical diagnostic information from similar cases, and understand the examination intention of patients. This, in turn, assists in triggering the text decoder to produce high-quality reports. Experiments conducted on MIMIC-CXR validate the superiority of SEI over state-of-the-art approaches on both natural language generation and clinical efficacy metrics.

Despite the recent progress in speech emotion recognition (SER), state-of-the-art systems are unable to achieve improved performance in cross-language settings. In this paper, we propose a Multimodal Dual Attention Transformer (MDAT) model to improve cross-language SER. Our model utilises pre-trained models for multimodal feature extraction and is equipped with a dual attention mechanism including graph attention and co-attention to capture complex dependencies across different modalities and achieve improved cross-language SER results using minimal target language data. In addition, our model also exploits a transformer encoder layer for high-level feature representation to improve emotion classification accuracy. In this way, MDAT performs refinement of feature representation at various stages and provides emotional salient features to the classification layer. This novel approach also ensures the preservation of modality-specific emotional information while enhancing cross-modality and cross-language interactions. We assess our model's performance on four publicly available SER datasets and establish its superior effectiveness compared to recent approaches and baseline models.

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

Automatic medical report generation (MRG) is of great research value as it has the potential to relieve radiologists from the heavy burden of report writing. Despite recent advancements, accurate MRG remains challenging due to the need for precise clinical understanding and the identification of clinical findings. Moreover, the imbalanced distribution of diseases makes the challenge even more pronounced, as rare diseases are underrepresented in training data, making their diagnostic performance unreliable. To address these challenges, we propose diagnosis-driven prompts for medical report generation (PromptMRG), a novel framework that aims to improve the diagnostic accuracy of MRG with the guidance of diagnosis-aware prompts. Specifically, PromptMRG is based on encoder-decoder architecture with an extra disease classification branch. When generating reports, the diagnostic results from the classification branch are converted into token prompts to explicitly guide the generation process. To further improve the diagnostic accuracy, we design cross-modal feature enhancement, which retrieves similar reports from the database to assist the diagnosis of a query image by leveraging the knowledge from a pre-trained CLIP. Moreover, the disease imbalanced issue is addressed by applying an adaptive logit-adjusted loss to the classification branch based on the individual learning status of each disease, which overcomes the barrier of text decoder's inability to manipulate disease distributions. Experiments on two MRG benchmarks show the effectiveness of the proposed method, where it obtains state-of-the-art clinical efficacy performance on both datasets.

Medical vision-and-language pre-training (Med-VLP) has shown promising improvements on many downstream medical tasks owing to its applicability to extracting generic representations from medical images and texts. Practically, there exist two typical types, i.e., the fusion-encoder type and the dual-encoder type, depending on whether a heavy fusion module is used. The former is superior at multi-modal tasks owing to the sufficient interaction between modalities; the latter is good at uni-modal and cross-modal tasks due to the single-modality encoding ability. To take advantage of these two types, we propose an effective yet straightforward scheme named PTUnifier to unify the two types. We first unify the input format by introducing visual and textual prompts, which serve as a feature bank that stores the most representative images/texts. By doing so, a single model could serve as a foundation model that processes various tasks adopting different input formats (i.e., image-only, text-only, and image-text-pair). Furthermore, we construct a prompt pool (instead of static ones) to improve diversity and scalability. Experimental results show that our approach achieves state-of-the-art results on a broad range of tasks, spanning uni-modal tasks (i.e., image/text classification and text summarization), cross-modal tasks (i.e., image-to-text generation and image-text/text-image retrieval), and multi-modal tasks (i.e., visual question answering), demonstrating the effectiveness of our approach. Note that the adoption of prompts is orthogonal to most existing Med-VLP approaches and could be a beneficial and complementary extension to these approaches.

Image matching for both cross-view and cross-modality plays a critical role in multimodal perception. In practice, the modality gap caused by different imaging systems/styles poses great challenges to the matching task. Existing works try to extract invariant features for specific modalities and train on limited datasets, showing poor generalization. In this paper, we present MINIMA, a unified image matching framework for multiple cross-modal cases. Without pursuing fancy modules, our MINIMA aims to enhance universal performance from the perspective of data scaling up. For such purpose, we propose a simple yet effective data engine that can freely produce a large dataset containing multiple modalities, rich scenarios, and accurate matching labels. Specifically, we scale up the modalities from cheap but rich RGB-only matching data, by means of generative models. Under this setting, the matching labels and rich diversity of the RGB dataset are well inherited by the generated multimodal data. Benefiting from this, we construct MD-syn, a new comprehensive dataset that fills the data gap for general multimodal image matching. With MD-syn, we can directly train any advanced matching pipeline on randomly selected modality pairs to obtain cross-modal ability. Extensive experiments on in-domain and zero-shot matching tasks, including 19 cross-modal cases, demonstrate that our MINIMA can significantly outperform the baselines and even surpass modality-specific methods. The dataset and code are available at https://github.com/LSXI7/MINIMA .

Self-supervised pre-training recently demonstrates success on large-scale multimodal data, and state-of-the-art contrastive learning methods often enforce the feature consistency from cross-modality inputs, such as video/audio or video/text pairs. Despite its convenience to formulate and leverage in practice, such cross-modality alignment (CMA) is only a weak and noisy supervision, since two modalities can be semantically misaligned even they are temporally aligned. For example, even in the commonly adopted instructional videos, a speaker can sometimes refer to something that is not visually present in the current frame; and the semantic misalignment would only be more unpredictable for the raw videos from the internet. We conjecture that might cause conflicts and biases among modalities, and may hence prohibit CMA from scaling up to training with larger and more heterogeneous data. This paper first verifies our conjecture by observing that, even in the latest VATT pre-training using only instructional videos, there exist strong gradient conflicts between different CMA losses within the same video, audio, text triplet, indicating them as the noisy source of supervision. We then propose to harmonize such gradients, via two techniques: (i) cross-modality gradient realignment: modifying different CMA loss gradients for each sample triplet, so that their gradient directions are more aligned; and (ii) gradient-based curriculum learning: leveraging the gradient conflict information on an indicator of sample noisiness, to develop a curriculum learning strategy to prioritize training on less noisy sample triplets. Applying those techniques to pre-training VATT on the HowTo100M dataset, we consistently improve its performance on different downstream tasks. Moreover, we are able to scale VATT pre-training to more complicated non-narrative Youtube8M dataset to further improve the state-of-the-arts.

Quantification of real-time informal feedback delivered by an experienced surgeon to a trainee during surgery is important for skill improvements in surgical training. Such feedback in the live operating room is inherently multimodal, consisting of verbal conversations (e.g., questions and answers) as well as non-verbal elements (e.g., through visual cues like pointing to anatomic elements). In this work, we leverage a clinically-validated five-category classification of surgical feedback: "Anatomic", "Technical", "Procedural", "Praise" and "Visual Aid". We then develop a multi-label machine learning model to classify these five categories of surgical feedback from inputs of text, audio, and video modalities. The ultimate goal of our work is to help automate the annotation of real-time contextual surgical feedback at scale. Our automated classification of surgical feedback achieves AUCs ranging from 71.5 to 77.6 with the fusion improving performance by 3.1%. We also show that high-quality manual transcriptions of feedback audio from experts improve AUCs to between 76.5 and 96.2, which demonstrates a clear path toward future improvements. Empirically, we find that the Staged training strategy, with first pre-training each modality separately and then training them jointly, is more effective than training different modalities altogether. We also present intuitive findings on the importance of modalities for different feedback categories. This work offers an important first look at the feasibility of automated classification of real-world live surgical feedback based on text, audio, and video modalities.

This review paper explores recent advances in deep learning approaches for non-invasive cognitive impairment detection. We examine various non-invasive indicators of cognitive decline, including speech and language, facial, and motoric mobility. The paper provides an overview of relevant datasets, feature-extracting techniques, and deep-learning architectures applied to this domain. We have analyzed the performance of different methods across modalities and observed that speech and language-based methods generally achieved the highest detection performance. Studies combining acoustic and linguistic features tended to outperform those using a single modality. Facial analysis methods showed promise for visual modalities but were less extensively studied. Most papers focused on binary classification (impaired vs. non-impaired), with fewer addressing multi-class or regression tasks. Transfer learning and pre-trained language models emerged as popular and effective techniques, especially for linguistic analysis. Despite significant progress, several challenges remain, including data standardization and accessibility, model explainability, longitudinal analysis limitations, and clinical adaptation. Lastly, we propose future research directions, such as investigating language-agnostic speech analysis methods, developing multi-modal diagnostic systems, and addressing ethical considerations in AI-assisted healthcare. By synthesizing current trends and identifying key obstacles, this review aims to guide further development of deep learning-based cognitive impairment detection systems to improve early diagnosis and ultimately patient outcomes.

Multi-modality image fusion is a technique that combines information from different sensors or modalities, enabling the fused image to retain complementary features from each modality, such as functional highlights and texture details. However, effective training of such fusion models is challenging due to the scarcity of ground truth fusion data. To tackle this issue, we propose the Equivariant Multi-Modality imAge fusion (EMMA) paradigm for end-to-end self-supervised learning. Our approach is rooted in the prior knowledge that natural imaging responses are equivariant to certain transformations. Consequently, we introduce a novel training paradigm that encompasses a fusion module, a pseudo-sensing module, and an equivariant fusion module. These components enable the net training to follow the principles of the natural sensing-imaging process while satisfying the equivariant imaging prior. Extensive experiments confirm that EMMA yields high-quality fusion results for infrared-visible and medical images, concurrently facilitating downstream multi-modal segmentation and detection tasks. The code is available at https://github.com/Zhaozixiang1228/MMIF-EMMA.

Cardiac ultrasound (US) scanning is a commonly used techniques in cardiology to diagnose the health of the heart and its proper functioning. Therefore, it is necessary to consider ways to automate these tasks and assist medical professionals in classifying and assessing cardiac US images. Machine learning (ML) techniques are regarded as a prominent solution due to their success in numerous applications aimed at enhancing the medical field, including addressing the shortage of echography technicians. However, the limited availability of medical data presents a significant barrier to applying ML in cardiology, particularly regarding US images of the heart. This paper addresses this challenge by introducing the first open graded dataset for Cardiac Assessment and ClassificaTion of UltraSound (CACTUS), which is available online. This dataset contains images obtained from scanning a CAE Blue Phantom and representing various heart views and different quality levels, exceeding the conventional cardiac views typically found in the literature. Additionally, the paper introduces a Deep Learning (DL) framework consisting of two main components. The first component classifies cardiac US images based on the heart view using a Convolutional Neural Network (CNN). The second component uses Transfer Learning (TL) to fine-tune the knowledge from the first component and create a model for grading and assessing cardiac images. The framework demonstrates high performance in both classification and grading, achieving up to 99.43% accuracy and as low as 0.3067 error, respectively. To showcase its robustness, the framework is further fine-tuned using new images representing additional cardiac views and compared to several other state-of-the-art architectures. The framework's outcomes and performance in handling real-time scans were also assessed using a questionnaire answered by cardiac experts.

We address a challenging and practical task of labeling questions in speech in real time during telephone calls to emergency medical services in English, which embeds within a broader decision support system for emergency call-takers. We propose a novel multimodal approach to real-time sequence labeling in speech. Our model treats speech and its own textual representation as two separate modalities or views, as it jointly learns from streamed audio and its noisy transcription into text via automatic speech recognition. Our results show significant gains of jointly learning from the two modalities when compared to text or audio only, under adverse noise and limited volume of training data. The results generalize to medical symptoms detection where we observe a similar pattern of improvements with multimodal learning.

Echocardiography is the most widely used cardiac imaging modality, capturing ultrasound video data to assess cardiac structure and function. Artificial intelligence (AI) in echocardiography has the potential to streamline manual tasks and improve reproducibility and precision. However, most echocardiography AI models are single-view, single-task systems that do not synthesize complementary information from multiple views captured during a full exam, and thus lead to limited performance and scope of applications. To address this problem, we introduce EchoPrime, a multi-view, view-informed, video-based vision-language foundation model trained on over 12 million video-report pairs. EchoPrime uses contrastive learning to train a unified embedding model for all standard views in a comprehensive echocardiogram study with representation of both rare and common diseases and diagnoses. EchoPrime then utilizes view-classification and a view-informed anatomic attention model to weight video-specific interpretations that accurately maps the relationship between echocardiographic views and anatomical structures. With retrieval-augmented interpretation, EchoPrime integrates information from all echocardiogram videos in a comprehensive study and performs holistic comprehensive clinical echocardiography interpretation. In datasets from two independent healthcare systems, EchoPrime achieves state-of-the art performance on 23 diverse benchmarks of cardiac form and function, surpassing the performance of both task-specific approaches and prior foundation models. Following rigorous clinical evaluation, EchoPrime can assist physicians in the automated preliminary assessment of comprehensive echocardiography.

Large Multimodal Models (LMMs) have shown remarkable progress in the field of medical Visual Question Answering (Med-VQA), achieving high accuracy on existing benchmarks. However, their reliability under robust evaluation is questionable. This study reveals that state-of-the-art models, when subjected to simple probing evaluation, perform worse than random guessing on medical diagnosis questions. To address this critical evaluation problem, we introduce the Probing Evaluation for Medical Diagnosis (ProbMed) dataset to rigorously assess LMM performance in medical imaging through probing evaluation and procedural diagnosis. Particularly, probing evaluation features pairing original questions with negation questions with hallucinated attributes, while procedural diagnosis requires reasoning across various diagnostic dimensions for each image, including modality recognition, organ identification, clinical findings, abnormalities, and positional grounding. Our evaluation reveals that top-performing models like GPT-4V and Gemini Pro perform worse than random guessing on specialized diagnostic questions, indicating significant limitations in handling fine-grained medical inquiries. Besides, models like LLaVA-Med struggle even with more general questions, and results from CheXagent demonstrate the transferability of expertise across different modalities of the same organ, showing that specialized domain knowledge is still crucial for improving performance. This study underscores the urgent need for more robust evaluation to ensure the reliability of LMMs in critical fields like medical diagnosis, and current LMMs are still far from applicable to those fields.

The COVID-19 pandemic has underscored the need for low-cost, scalable approaches to measuring contactless vital signs, either during initial triage at a healthcare facility or virtual telemedicine visits. Remote photoplethysmography (rPPG) can accurately estimate heart rate (HR) when applied to close-up videos of healthy volunteers in well-lit laboratory settings. However, results from such highly optimized laboratory studies may not be readily translated to healthcare settings. One significant barrier to the practical application of rPPG in health care is the accurate localization of the region of interest (ROI). Clinical or telemedicine visits may involve sub-optimal lighting, movement artifacts, variable camera angle, and subject distance. This paper presents an rPPG ROI selection method based on 3D facial landmarks and patient head yaw angle. We then demonstrate the robustness of this ROI selection method when coupled to the Plane-Orthogonal-to-Skin (POS) rPPG method when applied to videos of patients presenting to an Emergency Department for respiratory complaints. Our results demonstrate the effectiveness of our proposed approach in improving the accuracy and robustness of rPPG in a challenging clinical environment.

Electronic Health Records (EHRs), which contain patients' medical histories in various multi-modal formats, often overlook the potential for joint reasoning across imaging and table modalities underexplored in current EHR Question Answering (QA) systems. In this paper, we introduce EHRXQA, a novel multi-modal question answering dataset combining structured EHRs and chest X-ray images. To develop our dataset, we first construct two uni-modal resources: 1) The MIMIC- CXR-VQA dataset, our newly created medical visual question answering (VQA) benchmark, specifically designed to augment the imaging modality in EHR QA, and 2) EHRSQL (MIMIC-IV), a refashioned version of a previously established table-based EHR QA dataset. By integrating these two uni-modal resources, we successfully construct a multi-modal EHR QA dataset that necessitates both uni-modal and cross-modal reasoning. To address the unique challenges of multi-modal questions within EHRs, we propose a NeuralSQL-based strategy equipped with an external VQA API. This pioneering endeavor enhances engagement with multi-modal EHR sources and we believe that our dataset can catalyze advances in real-world medical scenarios such as clinical decision-making and research. EHRXQA is available at https://github.com/baeseongsu/ehrxqa.

Biomedical data is inherently multimodal, consisting of electronic health records, medical imaging, digital pathology, genome sequencing, wearable sensors, and more. The application of artificial intelligence tools to these multifaceted sensing technologies has the potential to revolutionize the prognosis, diagnosis, and management of human health and disease. However, current approaches to biomedical AI typically only train and evaluate with one or a small set of medical modalities and tasks. This limitation hampers the development of comprehensive tools that can leverage the rich interconnected information across many heterogeneous biomedical sensors. To address this challenge, we present MultiMed, a benchmark designed to evaluate and enable large-scale learning across a wide spectrum of medical modalities and tasks. MultiMed consists of 2.56 million samples across ten medical modalities such as medical reports, pathology, genomics, and protein data, and is structured into eleven challenging tasks, including disease prognosis, protein structure prediction, and medical question answering. Using MultiMed, we conduct comprehensive experiments benchmarking state-of-the-art unimodal, multimodal, and multitask models. Our analysis highlights the advantages of training large-scale medical models across many related modalities and tasks. Moreover, MultiMed enables studies of generalization across related medical concepts, robustness to real-world noisy data and distribution shifts, and novel modality combinations to improve prediction performance. MultiMed will be publicly available and regularly updated and welcomes inputs from the community.

In the diverse field of medical imaging, automatic segmentation has numerous applications and must handle a wide variety of input domains, such as different types of Computed Tomography (CT) scans and Magnetic Resonance (MR) images. This heterogeneity challenges automatic segmentation algorithms to maintain consistent performance across different modalities due to the requirement for spatially aligned and paired images. Typically, segmentation models are trained using a single modality, which limits their ability to generalize to other types of input data without employing transfer learning techniques. Additionally, leveraging complementary information from different modalities to enhance segmentation precision often necessitates substantial modifications to popular encoder-decoder designs, such as introducing multiple branched encoding or decoding paths for each modality. In this work, we propose a simple Multi-Modal Segmentation (MulModSeg) strategy to enhance medical image segmentation across multiple modalities, specifically CT and MR. It incorporates two key designs: a modality-conditioned text embedding framework via a frozen text encoder that adds modality awareness to existing segmentation frameworks without significant structural modifications or computational overhead, and an alternating training procedure that facilitates the integration of essential features from unpaired CT and MR inputs. Through extensive experiments with both Fully Convolutional Network and Transformer-based backbones, MulModSeg consistently outperforms previous methods in segmenting abdominal multi-organ and cardiac substructures for both CT and MR modalities. The code is available in this {https://github.com/ChengyinLee/MulModSeg_2024{link}}.

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.

We propose to improve transformers of a specific modality with irrelevant data from other modalities, e.g., improve an ImageNet model with audio or point cloud datasets. We would like to highlight that the data samples of the target modality are irrelevant to the other modalities, which distinguishes our method from other works utilizing paired (e.g., CLIP) or interleaved data of different modalities. We propose a methodology named Multimodal Pathway - given a target modality and a transformer designed for it, we use an auxiliary transformer trained with data of another modality and construct pathways to connect components of the two models so that data of the target modality can be processed by both models. In this way, we utilize the universal sequence-to-sequence modeling abilities of transformers obtained from two modalities. As a concrete implementation, we use a modality-specific tokenizer and task-specific head as usual but utilize the transformer blocks of the auxiliary model via a proposed method named Cross-Modal Re-parameterization, which exploits the auxiliary weights without any inference costs. On the image, point cloud, video, and audio recognition tasks, we observe significant and consistent performance improvements with irrelevant data from other modalities. The code and models are available at https://github.com/AILab-CVC/M2PT.

Cardiac MRI allows for a comprehensive assessment of myocardial structure, function, and tissue characteristics. Here we describe a foundational vision system for cardiac MRI, capable of representing the breadth of human cardiovascular disease and health. Our deep learning model is trained via self-supervised contrastive learning, by which visual concepts in cine-sequence cardiac MRI scans are learned from the raw text of the accompanying radiology reports. We train and evaluate our model on data from four large academic clinical institutions in the United States. We additionally showcase the performance of our models on the UK BioBank, and two additional publicly available external datasets. We explore emergent zero-shot capabilities of our system, and demonstrate remarkable performance across a range of tasks; including the problem of left ventricular ejection fraction regression, and the diagnosis of 35 different conditions such as cardiac amyloidosis and hypertrophic cardiomyopathy. We show that our deep learning system is capable of not only understanding the staggering complexity of human cardiovascular disease, but can be directed towards clinical problems of interest yielding impressive, clinical grade diagnostic accuracy with a fraction of the training data typically required for such tasks.

Large vision-language models (LVLMs) have demonstrated exceptional performance on complex multimodal tasks. However, they continue to suffer from significant hallucination issues, including object, attribute, and relational hallucinations. To accurately detect these hallucinations, we investigated the variations in cross-modal attention patterns between hallucination and non-hallucination states. Leveraging these distinctions, we developed a lightweight detector capable of identifying hallucinations. Our proposed method, Detecting Hallucinations by Cross-modal Attention Patterns (DHCP), is straightforward and does not require additional LVLM training or extra LVLM inference steps. Experimental results show that DHCP achieves remarkable performance in hallucination detection. By offering novel insights into the identification and analysis of hallucinations in LVLMs, DHCP contributes to advancing the reliability and trustworthiness of these models.

Depression has proven to be a significant public health issue, profoundly affecting the psychological well-being of individuals. If it remains undiagnosed, depression can lead to severe health issues, which can manifest physically and even lead to suicide. Generally, Diagnosing depression or any other mental disorder involves conducting semi-structured interviews alongside supplementary questionnaires, including variants of the Patient Health Questionnaire (PHQ) by Clinicians and mental health professionals. This approach places significant reliance on the experience and judgment of trained physicians, making the diagnosis susceptible to personal biases. Given that the underlying mechanisms causing depression are still being actively researched, physicians often face challenges in diagnosing and treating the condition, particularly in its early stages of clinical presentation. Recently, significant strides have been made in Artificial neural computing to solve problems involving text, image, and speech in various domains. Our analysis has aimed to leverage these state-of-the-art (SOTA) models in our experiments to achieve optimal outcomes leveraging multiple modalities. The experiments were performed on the Extended Distress Analysis Interview Corpus Wizard of Oz dataset (E-DAIC) corpus presented in the Audio/Visual Emotion Challenge (AVEC) 2019 Challenge. The proposed solutions demonstrate better results achieved by Proprietary and Open-source Large Language Models (LLMs), which achieved a Root Mean Square Error (RMSE) score of 3.98 on Textual Modality, beating the AVEC 2019 challenge baseline results and current SOTA regression analysis architectures. Additionally, the proposed solution achieved an accuracy of 71.43% in the classification task. The paper also includes a novel audio-visual multi-modal network that predicts PHQ-8 scores with an RMSE of 6.51.

Scene understanding based on image segmentation is a crucial component of autonomous vehicles. Pixel-wise semantic segmentation of RGB images can be advanced by exploiting complementary features from the supplementary modality (X-modality). However, covering a wide variety of sensors with a modality-agnostic model remains an unresolved problem due to variations in sensor characteristics among different modalities. Unlike previous modality-specific methods, in this work, we propose a unified fusion framework, CMX, for RGB-X semantic segmentation. To generalize well across different modalities, that often include supplements as well as uncertainties, a unified cross-modal interaction is crucial for modality fusion. Specifically, we design a Cross-Modal Feature Rectification Module (CM-FRM) to calibrate bi-modal features by leveraging the features from one modality to rectify the features of the other modality. With rectified feature pairs, we deploy a Feature Fusion Module (FFM) to perform sufficient exchange of long-range contexts before mixing. To verify CMX, for the first time, we unify five modalities complementary to RGB, i.e., depth, thermal, polarization, event, and LiDAR. Extensive experiments show that CMX generalizes well to diverse multi-modal fusion, achieving state-of-the-art performances on five RGB-Depth benchmarks, as well as RGB-Thermal, RGB-Polarization, and RGB-LiDAR datasets. Besides, to investigate the generalizability to dense-sparse data fusion, we establish an RGB-Event semantic segmentation benchmark based on the EventScape dataset, on which CMX sets the new state-of-the-art. The source code of CMX is publicly available at https://github.com/huaaaliu/RGBX_Semantic_Segmentation.

Image matching, which aims to identify corresponding pixel locations between images, is crucial in a wide range of scientific disciplines, aiding in image registration, fusion, and analysis. In recent years, deep learning-based image matching algorithms have dramatically outperformed humans in rapidly and accurately finding large amounts of correspondences. However, when dealing with images captured under different imaging modalities that result in significant appearance changes, the performance of these algorithms often deteriorates due to the scarcity of annotated cross-modal training data. This limitation hinders applications in various fields that rely on multiple image modalities to obtain complementary information. To address this challenge, we propose a large-scale pre-training framework that utilizes synthetic cross-modal training signals, incorporating diverse data from various sources, to train models to recognize and match fundamental structures across images. This capability is transferable to real-world, unseen cross-modality image matching tasks. Our key finding is that the matching model trained with our framework achieves remarkable generalizability across more than eight unseen cross-modality registration tasks using the same network weight, substantially outperforming existing methods, whether designed for generalization or tailored for specific tasks. This advancement significantly enhances the applicability of image matching technologies across various scientific disciplines and paves the way for new applications in multi-modality human and artificial intelligence analysis and beyond.

Speech patterns have been identified as potential diagnostic markers for neuropsychiatric conditions. However, most studies only compare a single clinical group to healthy controls, whereas clinical practice often requires differentiating between multiple potential diagnoses (multiclass settings). To address this, we assembled a dataset of repeated recordings from 420 participants (67 with major depressive disorder, 106 with schizophrenia and 46 with autism, as well as matched controls), and tested the performance of a range of conventional machine learning models and advanced Transformer models on both binary and multiclass classification, based on voice and text features. While binary models performed comparably to previous research (F1 scores between 0.54-0.75 for autism spectrum disorder, ASD; 0.67-0.92 for major depressive disorder, MDD; and 0.71-0.83 for schizophrenia); when differentiating between multiple diagnostic groups performance decreased markedly (F1 scores between 0.35-0.44 for ASD, 0.57-0.75 for MDD, 0.15-0.66 for schizophrenia, and 0.38-0.52 macro F1). Combining voice and text-based models yielded increased performance, suggesting that they capture complementary diagnostic information. Our results indicate that models trained on binary classification may learn to rely on markers of generic differences between clinical and non-clinical populations, or markers of clinical features that overlap across conditions, rather than identifying markers specific to individual conditions. We provide recommendations for future research in the field, suggesting increased focus on developing larger transdiagnostic datasets that include more fine-grained clinical features, and that can support the development of models that better capture the complexity of neuropsychiatric conditions and naturalistic diagnostic assessment.

Purpose: To introduce a deep learning model capable of multi-organ segmentation in MRI scans, offering a solution to the current limitations in MRI analysis due to challenges in resolution, standardized intensity values, and variability in sequences. Materials and Methods: he model was trained on 1,200 manually annotated MRI scans from the UK Biobank, 221 in-house MRI scans and 1228 CT scans, leveraging cross-modality transfer learning from CT segmentation models. A human-in-the-loop annotation workflow was employed to efficiently create high-quality segmentations. The model's performance was evaluated on NAKO and the AMOS22 dataset containing 600 and 60 MRI examinations. Dice Similarity Coefficient (DSC) and Hausdorff Distance (HD) was used to assess segmentation accuracy. The model will be open sourced. Results: The model showcased high accuracy in segmenting well-defined organs, achieving Dice Similarity Coefficient (DSC) scores of 0.97 for the right and left lungs, and 0.95 for the heart. It also demonstrated robustness in organs like the liver (DSC: 0.96) and kidneys (DSC: 0.95 left, 0.95 right), which present more variability. However, segmentation of smaller and complex structures such as the portal and splenic veins (DSC: 0.54) and adrenal glands (DSC: 0.65 left, 0.61 right) revealed the need for further model optimization. Conclusion: The proposed model is a robust, tool for accurate segmentation of 40 anatomical structures in MRI and CT images. By leveraging cross-modality learning and interactive annotation, the model achieves strong performance and generalizability across diverse datasets, making it a valuable resource for researchers and clinicians. It is open source and can be downloaded from https://github.com/hhaentze/MRSegmentator.

Closed-loop brain stimulation refers to capturing neurophysiological measures such as electroencephalography (EEG), quickly identifying neural events of interest, and producing auditory, magnetic or electrical stimulation so as to interact with brain processes precisely. It is a promising new method for fundamental neuroscience and perhaps for clinical applications such as restoring degraded memory function; however, existing tools are expensive, cumbersome, and offer limited experimental flexibility. In this article, we propose the Portiloop, a deep learning-based, portable and low-cost closed-loop stimulation system able to target specific brain oscillations. We first document open-hardware implementations that can be constructed from commercially available components. We also provide a fast, lightweight neural network model and an exploration algorithm that automatically optimizes the model hyperparameters to the desired brain oscillation. Finally, we validate the technology on a challenging test case of real-time sleep spindle detection, with results comparable to off-line expert performance on the Massive Online Data Annotation spindle dataset (MODA; group consensus). Software and plans are available to the community as an open science initiative to encourage further development and advance closed-loop neuroscience research.

Image translation across domains for unpaired datasets has gained interest and great improvement lately. In medical imaging, there are multiple imaging modalities, with very different characteristics. Our goal is to use cross-modality adaptation between CT and MRI whole cardiac scans for semantic segmentation. We present a segmentation network using synthesised cardiac volumes for extremely limited datasets. Our solution is based on a 3D cross-modality generative adversarial network to share information between modalities and generate synthesized data using unpaired datasets. Our network utilizes semantic segmentation to improve generator shape consistency, thus creating more realistic synthesised volumes to be used when re-training the segmentation network. We show that improved segmentation can be achieved on small datasets when using spatial augmentations to improve a generative adversarial network. These augmentations improve the generator capabilities, thus enhancing the performance of the Segmentor. Using only 16 CT and 16 MRI cardiovascular volumes, improved results are shown over other segmentation methods while using the suggested architecture.

Visible-light cameras can capture subtle physiological biomarkers without physical contact with the subject. We present the Multi-Site Physiological Monitoring (MSPM) dataset, which is the first dataset collected to support the study of simultaneous camera-based vital signs estimation from multiple locations on the body. MSPM enables research on remote photoplethysmography (rPPG), respiration rate, and pulse transit time (PTT); it contains ground-truth measurements of pulse oximetry (at multiple body locations) and blood pressure using contacting sensors. We provide thorough experiments demonstrating the suitability of MSPM to support research on rPPG, respiration rate, and PTT. Cross-dataset rPPG experiments reveal that MSPM is a challenging yet high quality dataset, with intra-dataset pulse rate mean absolute error (MAE) below 4 beats per minute (BPM), and cross-dataset pulse rate MAE below 2 BPM in certain cases. Respiration experiments find a MAE of 1.09 breaths per minute by extracting motion features from the chest. PTT experiments find that across the pairs of different body sites, there is high correlation between remote PTT and contact-measured PTT, which facilitates the possibility for future camera-based PTT research.

With the rapid development of artificial intelligence, large language models (LLMs) have shown promising capabilities in mimicking human-level language comprehension and reasoning. This has sparked significant interest in applying LLMs to enhance various aspects of healthcare, ranging from medical education to clinical decision support. However, medicine involves multifaceted data modalities and nuanced reasoning skills, presenting challenges for integrating LLMs. This paper provides a comprehensive review on the applications and implications of LLMs in medicine. It begins by examining the fundamental applications of general-purpose and specialized LLMs, demonstrating their utilities in knowledge retrieval, research support, clinical workflow automation, and diagnostic assistance. Recognizing the inherent multimodality of medicine, the review then focuses on multimodal LLMs, investigating their ability to process diverse data types like medical imaging and EHRs to augment diagnostic accuracy. To address LLMs' limitations regarding personalization and complex clinical reasoning, the paper explores the emerging development of LLM-powered autonomous agents for healthcare. Furthermore, it summarizes the evaluation methodologies for assessing LLMs' reliability and safety in medical contexts. Overall, this review offers an extensive analysis on the transformative potential of LLMs in modern medicine. It also highlights the pivotal need for continuous optimizations and ethical oversight before these models can be effectively integrated into clinical practice. Visit https://github.com/mingze-yuan/Awesome-LLM-Healthcare for an accompanying GitHub repository containing latest papers.

Due to the distinctive characteristics of sensors, each modality exhibits unique physical properties. For this reason, in the context of multi-modal action recognition, it is important to consider not only the overall action content but also the complementary nature of different modalities. In this paper, we propose a novel network, named Modality Mixer (M-Mixer) network, which effectively leverages and incorporates the complementary information across modalities with the temporal context of actions for action recognition. A key component of our proposed M-Mixer is the Multi-modal Contextualization Unit (MCU), a simple yet effective recurrent unit. Our MCU is responsible for temporally encoding a sequence of one modality (e.g., RGB) with action content features of other modalities (e.g., depth and infrared modalities). This process encourages M-Mixer network to exploit global action content and also to supplement complementary information of other modalities. Furthermore, to extract appropriate complementary information regarding to the given modality settings, we introduce a new module, named Complementary Feature Extraction Module (CFEM). CFEM incorporates sepearte learnable query embeddings for each modality, which guide CFEM to extract complementary information and global action content from the other modalities. As a result, our proposed method outperforms state-of-the-art methods on NTU RGB+D 60, NTU RGB+D 120, and NW-UCLA datasets. Moreover, through comprehensive ablation studies, we further validate the effectiveness of our proposed method.

Learning holistic computational representations in physical, chemical or biological systems requires the ability to process information from different distributions and modalities within the same model. Thus, the demand for multimodal machine learning models has sharply risen for modalities that go beyond vision and language, such as sequences, graphs, time series, or tabular data. While there are many available multimodal fusion and alignment approaches, most of them require end-to-end training, scale quadratically with the number of modalities, cannot handle cases of high modality imbalance in the training set, or are highly topology-specific, making them too restrictive for many biomedical learning tasks. This paper presents Multimodal Lego (MM-Lego), a modular and general-purpose fusion and model merging framework to turn any set of encoders into a competitive multimodal model with no or minimal fine-tuning. We achieve this by introducing a wrapper for unimodal encoders that enforces lightweight dimensionality assumptions between modalities and harmonises their representations by learning features in the frequency domain to enable model merging with little signal interference. We show that MM-Lego 1) can be used as a model merging method which achieves competitive performance with end-to-end fusion models without any fine-tuning, 2) can operate on any unimodal encoder, and 3) is a model fusion method that, with minimal fine-tuning, achieves state-of-the-art results on six benchmarked multimodal biomedical tasks.

Echocardiogram video segmentation plays an important role in cardiac disease diagnosis. This paper studies the unsupervised domain adaption (UDA) for echocardiogram video segmentation, where the goal is to generalize the model trained on the source domain to other unlabelled target domains. Existing UDA segmentation methods are not suitable for this task because they do not model local information and the cyclical consistency of heartbeat. In this paper, we introduce a newly collected CardiacUDA dataset and a novel GraphEcho method for cardiac structure segmentation. Our GraphEcho comprises two innovative modules, the Spatial-wise Cross-domain Graph Matching (SCGM) and the Temporal Cycle Consistency (TCC) module, which utilize prior knowledge of echocardiogram videos, i.e., consistent cardiac structure across patients and centers and the heartbeat cyclical consistency, respectively. These two modules can better align global and local features from source and target domains, improving UDA segmentation results. Experimental results showed that our GraphEcho outperforms existing state-of-the-art UDA segmentation methods. Our collected dataset and code will be publicly released upon acceptance. This work will lay a new and solid cornerstone for cardiac structure segmentation from echocardiogram videos. Code and dataset are available at: https://github.com/xmed-lab/GraphEcho

Echocardiography has been a prominent tool for the diagnosis of cardiac disease. However, these diagnoses can be heavily impeded by poor image quality. Acoustic clutter emerges due to multipath reflections imposed by layers of skin, subcutaneous fat, and intercostal muscle between the transducer and heart. As a result, haze and other noise artifacts pose a real challenge to cardiac ultrasound imaging. In many cases, especially with difficult-to-image patients such as patients with obesity, a diagnosis from B-Mode ultrasound imaging is effectively rendered unusable, forcing sonographers to resort to contrast-enhanced ultrasound examinations or refer patients to other imaging modalities. Tissue harmonic imaging has been a popular approach to combat haze, but in severe cases is still heavily impacted by haze. Alternatively, denoising algorithms are typically unable to remove highly structured and correlated noise, such as haze. It remains a challenge to accurately describe the statistical properties of structured haze, and develop an inference method to subsequently remove it. Diffusion models have emerged as powerful generative models and have shown their effectiveness in a variety of inverse problems. In this work, we present a joint posterior sampling framework that combines two separate diffusion models to model the distribution of both clean ultrasound and haze in an unsupervised manner. Furthermore, we demonstrate techniques for effectively training diffusion models on radio-frequency ultrasound data and highlight the advantages over image data. Experiments on both in-vitro and in-vivo cardiac datasets show that the proposed dehazing method effectively removes haze while preserving signals from weakly reflected tissue.

Predicting in-hospital mortality for intensive care unit (ICU) patients is key to final clinical outcomes. AI has shown advantaged accuracy but suffers from the lack of explainability. To address this issue, this paper proposes an eXplainable Multimodal Mortality Predictor (X-MMP) approaching an efficient, explainable AI solution for predicting in-hospital mortality via multimodal ICU data. We employ multimodal learning in our framework, which can receive heterogeneous inputs from clinical data and make decisions. Furthermore, we introduce an explainable method, namely Layer-Wise Propagation to Transformer, as a proper extension of the LRP method to Transformers, producing explanations over multimodal inputs and revealing the salient features attributed to prediction. Moreover, the contribution of each modality to clinical outcomes can be visualized, assisting clinicians in understanding the reasoning behind decision-making. We construct a multimodal dataset based on MIMIC-III and MIMIC-III Waveform Database Matched Subset. Comprehensive experiments on benchmark datasets demonstrate that our proposed framework can achieve reasonable interpretation with competitive prediction accuracy. In particular, our framework can be easily transferred to other clinical tasks, which facilitates the discovery of crucial factors in healthcare research.

Alzheimer's disease (AD) constitutes a complex neurocognitive disease and is the main cause of dementia. Although many studies have been proposed targeting at diagnosing dementia through spontaneous speech, there are still limitations. Existing state-of-the-art approaches, which propose multimodal methods, train separately language and acoustic models, employ majority-vote approaches, and concatenate the representations of the different modalities either at the input level, i.e., early fusion, or during training. Also, some of them employ self-attention layers, which calculate the dependencies between representations without considering the contextual information. In addition, no prior work has taken into consideration the model calibration. To address these limitations, we propose some new methods for detecting AD patients, which capture the intra- and cross-modal interactions. First, we convert the audio files into log-Mel spectrograms, their delta, and delta-delta and create in this way an image per audio file consisting of three channels. Next, we pass each transcript and image through BERT and DeiT models respectively. After that, context-based self-attention layers, self-attention layers with a gate model, and optimal transport domain adaptation methods are employed for capturing the intra- and inter-modal interactions. Finally, we exploit two methods for fusing the self and cross-attended features. For taking into account the model calibration, we apply label smoothing. We use both performance and calibration metrics. Experiments conducted on the ADReSS Challenge dataset indicate the efficacy of our introduced approaches over existing research initiatives with our best performing model reaching Accuracy and F1-score up to 91.25% and 91.06% respectively.

Using deep learning methods to classify EEG signals can accurately identify people's emotions. However, existing studies have rarely considered the application of the information in another domain's representations to feature selection in the time-frequency domain. We propose a classification network of EEG signals based on the cross-domain feature fusion method, which makes the network more focused on the features most related to brain activities and thinking changes by using the multi-domain attention mechanism. In addition, we propose a two-step fusion method and apply these methods to the EEG emotion recognition network. Experimental results show that our proposed network, which combines multiple representations in the time-frequency domain and spatial domain, outperforms previous methods on public datasets and achieves state-of-the-art at present.

Radiology report generation (RRG) is a challenging task, as it requires a thorough understanding of medical images, integration of multiple temporal inputs, and accurate report generation. Effective interpretation of medical images, such as chest X-rays (CXRs), demands sophisticated visual-language reasoning to map visual findings to structured reports. Recent studies have shown that multimodal large language models (MLLMs) can acquire multimodal capabilities by aligning with pre-trained vision encoders. However, current approaches predominantly focus on single-image analysis or utilise rule-based symbolic processing to handle multiple images, thereby overlooking the essential temporal information derived from comparing current images with prior ones. To overcome this critical limitation, we introduce Libra, a temporal-aware MLLM tailored for CXR report generation using temporal images. Libra integrates a radiology-specific image encoder with a MLLM and utilises a novel Temporal Alignment Connector to capture and synthesise temporal information of images across different time points with unprecedented precision. Extensive experiments show that Libra achieves new state-of-the-art performance among the same parameter scale MLLMs for RRG tasks on the MIMIC-CXR. Specifically, Libra improves the RadCliQ metric by 12.9% and makes substantial gains across all lexical metrics compared to previous models.

How does audio describe the world around us? In this work, we propose a method for generating images of visual scenes from diverse in-the-wild sounds. This cross-modal generation task is challenging due to the significant information gap between auditory and visual signals. We address this challenge by designing a model that aligns audio-visual modalities by enriching audio features with visual information and translating them into the visual latent space. These features are then fed into the pre-trained image generator to produce images. To enhance image quality, we use sound source localization to select audio-visual pairs with strong cross-modal correlations. Our method achieves substantially better results on the VEGAS and VGGSound datasets compared to previous work and demonstrates control over the generation process through simple manipulations to the input waveform or latent space. Furthermore, we analyze the geometric properties of the learned embedding space and demonstrate that our learning approach effectively aligns audio-visual signals for cross-modal generation. Based on this analysis, we show that our method is agnostic to specific design choices, showing its generalizability by integrating various model architectures and different types of audio-visual data.

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.

The purpose of emotion recognition in conversation (ERC) is to identify the emotion category of an utterance based on contextual information. Previous ERC methods relied on simple connections for cross-modal fusion and ignored the information differences between modalities, resulting in the model being unable to focus on modality-specific emotional information. At the same time, the shared information between modalities was not processed to generate emotions. Information redundancy problem. To overcome these limitations, we propose a cross-modal fusion emotion prediction network based on vector connections. The network mainly includes two stages: the multi-modal feature fusion stage based on connection vectors and the emotion classification stage based on fused features. Furthermore, we design a supervised inter-class contrastive learning module based on emotion labels. Experimental results confirm the effectiveness of the proposed method, demonstrating excellent performance on the IEMOCAP and MELD datasets.

Clinical diagnosis is critical in medical practice, typically requiring a continuous and evolving process that includes primary diagnosis, differential diagnosis, and final diagnosis. However, most existing clinical diagnostic tasks are single-step processes, which does not align with the complex multi-step diagnostic procedures found in real-world clinical settings. In this paper, we propose a multi-step diagnostic task and annotate a clinical diagnostic dataset (MSDiagnosis). This dataset includes primary diagnosis, differential diagnosis, and final diagnosis questions. Additionally, we propose a novel and effective framework. This framework combines forward inference, backward inference, reflection, and refinement, enabling the LLM to self-evaluate and adjust its diagnostic results. To assess the effectiveness of our proposed method, we design and conduct extensive experiments. The experimental results demonstrate the effectiveness of the proposed method. We also provide a comprehensive experimental analysis and suggest future research directions for this task.

Due to its ability to accurately predict emotional state using multimodal features, audiovisual emotion recognition has recently gained more interest from researchers. This paper proposes two methods to predict emotional attributes from audio and visual data using a multitask learning and a fusion strategy. First, multitask learning is employed by adjusting three parameters for each attribute to improve the recognition rate. Second, a multistage fusion is proposed to combine results from various modalities' final prediction. Our approach used multitask learning, employed at unimodal and early fusion methods, shows improvement over single-task learning with an average CCC score of 0.431 compared to 0.297. A multistage method, employed at the late fusion approach, significantly improved the agreement score between true and predicted values on the development set of data (from [0.537, 0.565, 0.083] to [0.68, 0.656, 0.443]) for arousal, valence, and liking.

This study presents a deep convolutional autoencoder network for filtering reverberation clutter from transthoracic echocardiographic (TTE) image sequences. Given the spatiotemporal nature of this type of clutter, the filtering network employs 3D convolutional layers to suppress it throughout the cardiac cycle. The design of the network incorporates two key features that contribute to the effectiveness of the filter: 1) an attention mechanism for focusing on cluttered regions and leveraging contextual information, and 2) residual learning for preserving fine image structures. To train the network, a diverse set of artifact patterns was simulated and superimposed onto ultra-realistic synthetic TTE sequences from six ultrasound vendors, generating input for the filtering network. The artifact-free sequences served as ground-truth. Performance of the filtering network was evaluated using unseen synthetic and in vivo artifactual sequences. Results from the in vivo dataset confirmed the network's strong generalization capabilities, despite being trained solely on synthetic data and simulated artifacts. The suitability of the filtered sequences for downstream processing was assessed by computing segmental strain curves. A significant reduction in the discrepancy between strain profiles computed from cluttered and clutter-free segments was observed after filtering the cluttered sequences with the proposed network. The trained network processes a TTE sequence in a fraction of a second, enabling real-time clutter filtering and potentially improving the precision of clinically relevant indices derived from TTE sequences. The source code of the proposed method and example video files of the filtering results are available at: https://github.com/MahdiTabassian/Deep-Clutter-Filtering/tree/main{https://github.com/MahdiTabassian/Deep-Clutter-Filtering/tree/main}.

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.

Multimodal large language models (MLLMs) can simultaneously process visual, textual, and auditory data, capturing insights that complement human analysis. However, existing video question-answering (VidQA) benchmarks and datasets often exhibit a bias toward a single modality, despite the goal of requiring advanced reasoning skills that integrate diverse modalities to answer the queries. In this work, we introduce the modality importance score (MIS) to identify such bias. It is designed to assess which modality embeds the necessary information to answer the question. Additionally, we propose an innovative method using state-of-the-art MLLMs to estimate the modality importance, which can serve as a proxy for human judgments of modality perception. With this MIS, we demonstrate the presence of unimodal bias and the scarcity of genuinely multimodal questions in existing datasets. We further validate the modality importance score with multiple ablation studies to evaluate the performance of MLLMs on permuted feature sets. Our results indicate that current models do not effectively integrate information due to modality imbalance in existing datasets. Our proposed MLLM-derived MIS can guide the curation of modality-balanced datasets that advance multimodal learning and enhance MLLMs' capabilities to understand and utilize synergistic relations across modalities.

Achieving realistic, vivid, and human-like synthesized conversational gestures conditioned on multi-modal data is still an unsolved problem due to the lack of available datasets, models and standard evaluation metrics. To address this, we build Body-Expression-Audio-Text dataset, BEAT, which has i) 76 hours, high-quality, multi-modal data captured from 30 speakers talking with eight different emotions and in four different languages, ii) 32 millions frame-level emotion and semantic relevance annotations. Our statistical analysis on BEAT demonstrates the correlation of conversational gestures with facial expressions, emotions, and semantics, in addition to the known correlation with audio, text, and speaker identity. Based on this observation, we propose a baseline model, Cascaded Motion Network (CaMN), which consists of above six modalities modeled in a cascaded architecture for gesture synthesis. To evaluate the semantic relevancy, we introduce a metric, Semantic Relevance Gesture Recall (SRGR). Qualitative and quantitative experiments demonstrate metrics' validness, ground truth data quality, and baseline's state-of-the-art performance. To the best of our knowledge, BEAT is the largest motion capture dataset for investigating human gestures, which may contribute to a number of different research fields, including controllable gesture synthesis, cross-modality analysis, and emotional gesture recognition. The data, code and model are available on https://pantomatrix.github.io/BEAT/.

Recent advancements in large multimodal models (LMMs) have significantly enhanced performance across diverse tasks, with ongoing efforts to further integrate additional modalities such as video and audio. However, most existing LMMs remain vulnerable to hallucinations, the discrepancy between the factual multimodal input and the generated textual output, which has limited their applicability in various real-world scenarios. This paper presents the first systematic investigation of hallucinations in LMMs involving the three most common modalities: language, visual, and audio. Our study reveals two key contributors to hallucinations: overreliance on unimodal priors and spurious inter-modality correlations. To address these challenges, we introduce the benchmark The Curse of Multi-Modalities (CMM), which comprehensively evaluates hallucinations in LMMs, providing a detailed analysis of their underlying issues. Our findings highlight key vulnerabilities, including imbalances in modality integration and biases from training data, underscoring the need for balanced cross-modal learning and enhanced hallucination mitigation strategies. Based on our observations and findings, we suggest potential research directions that could enhance the reliability of LMMs.

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.

The audio-visual event localization task requires identifying concurrent visual and auditory events from unconstrained videos within a network model, locating them, and classifying their category. The efficient extraction and integration of audio and visual modal information have always been challenging in this field. In this paper, we introduce CACE-Net, which differs from most existing methods that solely use audio signals to guide visual information. We propose an audio-visual co-guidance attention mechanism that allows for adaptive bi-directional cross-modal attentional guidance between audio and visual information, thus reducing inconsistencies between modalities. Moreover, we have observed that existing methods have difficulty distinguishing between similar background and event and lack the fine-grained features for event classification. Consequently, we employ background-event contrast enhancement to increase the discrimination of fused feature and fine-tuned pre-trained model to extract more refined and discernible features from complex multimodal inputs. Specifically, we have enhanced the model's ability to discern subtle differences between event and background and improved the accuracy of event classification in our model. Experiments on the AVE dataset demonstrate that CACE-Net sets a new benchmark in the audio-visual event localization task, proving the effectiveness of our proposed methods in handling complex multimodal learning and event localization in unconstrained videos. Code is available at https://github.com/Brain-Cog-Lab/CACE-Net.

The global aging population faces considerable challenges, particularly in communication, due to the prevalence of hearing and speech impairments. To address these, we introduce the AVE speech dataset, a comprehensive multi-modal benchmark for speech recognition tasks. The dataset includes a 100-sentence Mandarin Chinese corpus with audio signals, lip-region video recordings, and six-channel electromyography (EMG) data, collected from 100 participants. Each subject read the entire corpus ten times, with each sentence averaging approximately two seconds in duration, resulting in over 55 hours of multi-modal speech data per modality. Experiments demonstrate that combining these modalities significantly improves recognition performance, particularly in cross-subject and high-noise environments. To our knowledge, this is the first publicly available sentence-level dataset integrating these three modalities for large-scale Mandarin speech recognition. We expect this dataset to drive advancements in both acoustic and non-acoustic speech recognition research, enhancing cross-modal learning and human-machine interaction.

Predicting multiple real-world tasks in a single model often requires a particularly diverse feature space. Multimodal (MM) models aim to extract the synergistic predictive potential of multiple data types to create a shared feature space with aligned semantic meaning across inputs of drastically varying sizes (i.e. images, text, sound). Most current MM architectures fuse these representations in parallel, which not only limits their interpretability but also creates a dependency on modality availability. We present MultiModN, a multimodal, modular network that fuses latent representations in a sequence of any number, combination, or type of modality while providing granular real-time predictive feedback on any number or combination of predictive tasks. MultiModN's composable pipeline is interpretable-by-design, as well as innately multi-task and robust to the fundamental issue of biased missingness. We perform four experiments on several benchmark MM datasets across 10 real-world tasks (predicting medical diagnoses, academic performance, and weather), and show that MultiModN's sequential MM fusion does not compromise performance compared with a baseline of parallel fusion. By simulating the challenging bias of missing not-at-random (MNAR), this work shows that, contrary to MultiModN, parallel fusion baselines erroneously learn MNAR and suffer catastrophic failure when faced with different patterns of MNAR at inference. To the best of our knowledge, this is the first inherently MNAR-resistant approach to MM modeling. In conclusion, MultiModN provides granular insights, robustness, and flexibility without compromising performance.

Accurate segmentation of tumors in PET/CT images is important in computer-aided diagnosis and treatment of cancer. The key issue of such a segmentation problem lies in the effective integration of complementary information from PET and CT images. However, the quality of PET and CT images varies widely in clinical settings, which leads to uncertainty in the modality information extracted by networks. To take the uncertainty into account in multi-modal information fusion, this paper proposes a novel Multi-modal Evidential Fusion Network (MEFN) comprising a Cross-Modal Feature Learning (CFL) module and a Multi-modal Trusted Fusion (MTF) module. The CFL module reduces the domain gap upon modality conversion and highlights common tumor features, thereby alleviating the needs of the segmentation module to handle modality specificity. The MTF module utilizes mutual attention mechanisms and an uncertainty calibrator to fuse modality features based on modality uncertainty and then fuse the segmentation results under the guidance of Dempster-Shafer Theory. Besides, a new uncertainty perceptual loss is introduced to force the model focusing on uncertain features and hence improve its ability to extract trusted modality information. Extensive comparative experiments are conducted on two publicly available PET/CT datasets to evaluate the performance of our proposed method whose results demonstrate that our MEFN significantly outperforms state-of-the-art methods with improvements of 2.15% and 3.23% in DSC scores on the AutoPET dataset and the Hecktor dataset, respectively. More importantly, our model can provide radiologists with credible uncertainty of the segmentation results for their decision in accepting or rejecting the automatic segmentation results, which is particularly important for clinical applications. Our code will be available at https://github.com/QPaws/MEFN.

We train an object detector built from convolutional neural networks to count interference fringes in elliptical antinode regions in frames of high-speed video recordings of transient oscillations in Caribbean steelpan drums illuminated by electronic speckle pattern interferometry (ESPI). The annotations provided by our model aim to contribute to the understanding of time-dependent behavior in such drums by tracking the development of sympathetic vibration modes. The system is trained on a dataset of crowdsourced human-annotated images obtained from the Zooniverse Steelpan Vibrations Project. Due to the small number of human-annotated images and the ambiguity of the annotation task, we also evaluate the model on a large corpus of synthetic images whose properties have been matched to the real images by style transfer using a Generative Adversarial Network. Applying the model to thousands of unlabeled video frames, we measure oscillations consistent with audio recordings of these drum strikes. One unanticipated result is that sympathetic oscillations of higher-octave notes significantly precede the rise in sound intensity of the corresponding second harmonic tones; the mechanism responsible for this remains unidentified. This paper primarily concerns the development of the predictive model; further exploration of the steelpan images and deeper physical insights await its further application.

Multi-modal multi-label emotion recognition (MMER) aims to identify relevant emotions from multiple modalities. The challenge of MMER is how to effectively capture discriminative features for multiple labels from heterogeneous data. Recent studies are mainly devoted to exploring various fusion strategies to integrate multi-modal information into a unified representation for all labels. However, such a learning scheme not only overlooks the specificity of each modality but also fails to capture individual discriminative features for different labels. Moreover, dependencies of labels and modalities cannot be effectively modeled. To address these issues, this paper presents ContrAstive feature Reconstruction and AggregaTion (CARAT) for the MMER task. Specifically, we devise a reconstruction-based fusion mechanism to better model fine-grained modality-to-label dependencies by contrastively learning modal-separated and label-specific features. To further exploit the modality complementarity, we introduce a shuffle-based aggregation strategy to enrich co-occurrence collaboration among labels. Experiments on two benchmark datasets CMU-MOSEI and M3ED demonstrate the effectiveness of CARAT over state-of-the-art methods. Code is available at https://github.com/chengzju/CARAT.

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.

Speech emotion recognition (SER) has received a great deal of attention in recent years in the context of spontaneous conversations. While there have been notable results on datasets like the well known corpus of naturalistic dyadic conversations, IEMOCAP, for both the case of categorical and dimensional emotions, there are few papers which try to predict both paradigms at the same time. Therefore, in this work, we aim to highlight the performance contribution of multi-task learning by proposing a multi-task, multi-modal system that predicts categorical and dimensional emotions. The results emphasise the importance of cross-regularisation between the two types of emotions. Our approach consists of a multi-task, multi-modal architecture that uses parallel feature refinement through self-attention for the feature of each modality. In order to fuse the features, our model introduces a set of learnable bridge tokens that merge the acoustic and linguistic features with the help of cross-attention. Our experiments for categorical emotions on 10-fold validation yield results comparable to the current state-of-the-art. In our configuration, our multi-task approach provides better results compared to learning each paradigm separately. On top of that, our best performing model achieves a high result for valence compared to the previous multi-task experiments.

Accurate breast lesion risk estimation can significantly reduce unnecessary biopsies and help doctors decide optimal treatment plans. Most existing computer-aided systems rely solely on mammogram features to classify breast lesions. While this approach is convenient, it does not fully exploit useful information in clinical reports to achieve the optimal performance. Would clinical features significantly improve breast lesion classification compared to using mammograms alone? How to handle missing clinical information caused by variation in medical practice? What is the best way to combine mammograms and clinical features? There is a compelling need for a systematic study to address these fundamental questions. This paper investigates several multimodal deep networks based on feature concatenation, cross-attention, and co-attention to combine mammograms and categorical clinical variables. We show that the proposed architectures significantly increase the lesion classification performance (average area under ROC curves from 0.89 to 0.94). We also evaluate the model when clinical variables are missing.

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

Accurate localization and segmentation of intervertebral disc (IVD) is crucial for the assessment of spine disease diagnosis. Despite the technological advances in medical imaging, IVD localization and segmentation are still manually performed, which is time-consuming and prone to errors. If, in addition, multi-modal imaging is considered, the burden imposed on disease assessments increases substantially. In this paper, we propose an architecture for IVD localization and segmentation in multi-modal MRI, which extends the well-known UNet. Compared to single images, multi-modal data brings complementary information, contributing to better data representation and discriminative power. Our contributions are three-fold. First, how to effectively integrate and fully leverage multi-modal data remains almost unexplored. In this work, each MRI modality is processed in a different path to better exploit their unique information. Second, inspired by HyperDenseNet, the network is densely-connected both within each path and across different paths, granting the model the freedom to learn where and how the different modalities should be processed and combined. Third, we improved standard U-Net modules by extending inception modules with two dilated convolutions blocks of different scale, which helps handling multi-scale context. We report experiments over the data set of the public MICCAI 2018 Challenge on Automatic Intervertebral Disc Localization and Segmentation, with 13 multi-modal MRI images used for training and 3 for validation. We trained IVD-Net on an NVidia TITAN XP GPU with 16 GBs RAM, using ADAM as optimizer and a learning rate of 10e-5 during 200 epochs. Training took about 5 hours, and segmentation of a whole volume about 2-3 seconds, on average. Several baselines, with different multi-modal fusion strategies, were used to demonstrate the effectiveness of the proposed architecture.

Chronotype compares individuals' circadian phase to others. It contextualizes mental health risk assessments and detection of social jet lag, which can hamper mental health and cognitive performance. Existing ways of determining chronotypes, such as Dim Light Melatonin Onset (DLMO) or the Morningness-Eveningness Questionnaire (MEQ), are limited by being discrete in time and time-intensive to update, meaning they rarely capture real-world variability across time. Chronotyping users based on a daily planner app might augment existing methods to enable assessment continuously and at scale. This paper reports the construction of a supervised binary classifier that attempts to demonstrate the feasibility of this approach. 1,460 registered users from the Owaves app opted in by filling out the MEQ survey between July 14, 2022, and May 1, 2023. 142 met the eligibility criteria. We used multimodal app data from individuals identified as morning and evening types from MEQ data, basing the classifier on app time series data. This included daily timing for 8 main lifestyle activity types: exercise, sleep, social interactions, meal times, relaxation, work, play, and miscellaneous, as defined in the app. The timing of activities showed substantial change across time, as well as heterogeneity by activity type. Our novel chronotyping classifier was able to predict the morningness and eveningness of its users with an ROC AUC of 0.70. Our findings demonstrate the feasibility of chronotype classification from multimodal, real-world app data, while highlighting fundamental challenges to applying discrete and fixed labels to complex, dynamic, multimodal behaviors. Our findings suggest a potential for real-time monitoring of shifts in chronotype specific to different causes (i.e. types of activity), which could feasibly be used to support future, prospective mental health support research.

With the increasing availability of wearable devices, photoplethysmography (PPG) has emerged as a promising non-invasive tool for monitoring human hemodynamics. We propose a deep learning framework to estimate vascular age (AI-vascular age) from PPG signals, incorporating a distribution-aware loss to address biases caused by imbalanced data. The model was developed using data from the UK Biobank (UKB), with 98,672 participants in the development cohort and 113,559 participants (144,683 data pairs) for clinical evaluation. After adjusting for key confounders, individuals with a vascular age gap (AI-vascular age minus calendar age) exceeding 9 years had a significantly higher risk of major adverse cardiovascular and cerebrovascular events (MACCE) (HR = 2.37, p < 0.005) and secondary outcomes, including diabetes (HR = 2.69, p < 0.005), hypertension (HR = 2.88, p < 0.005), coronary heart disease (HR = 2.20, p < 0.005), heart failure (HR = 2.15, p < 0.005), myocardial infarction (HR = 2.51, p < 0.005), stroke (HR = 2.55, p < 0.005), and all-cause mortality (HR = 2.51, p < 0.005). Conversely, participants with a vascular age gap below -9 years exhibited a significantly lower incidence of these outcomes. We further evaluated the longitudinal applicability of AI-vascular age using serial PPG data from the UKB, demonstrating its value in risk stratification by leveraging AI-vascular age at two distinct time points to predict future MACCE incidence. External validation was performed on a MIMIC-III-derived cohort (n = 2,343), where each one-year increase in vascular age gap was significantly associated with elevated in-hospital mortality risk (OR = 1.02, p < 0.005). In conclusion, our study establishes AI-vascular age as a novel, non-invasive digital biomarker for cardiovascular health assessment.

Visible-infrared person re-identification (VI-ReID) is a challenging task due to large cross-modality discrepancies and intra-class variations. Existing methods mainly focus on learning modality-shared representations by embedding different modalities into the same feature space. As a result, the learned feature emphasizes the common patterns across modalities while suppressing modality-specific and identity-aware information that is valuable for Re-ID. To address these issues, we propose a novel Modality Unifying Network (MUN) to explore a robust auxiliary modality for VI-ReID. First, the auxiliary modality is generated by combining the proposed cross-modality learner and intra-modality learner, which can dynamically model the modality-specific and modality-shared representations to alleviate both cross-modality and intra-modality variations. Second, by aligning identity centres across the three modalities, an identity alignment loss function is proposed to discover the discriminative feature representations. Third, a modality alignment loss is introduced to consistently reduce the distribution distance of visible and infrared images by modality prototype modeling. Extensive experiments on multiple public datasets demonstrate that the proposed method surpasses the current state-of-the-art methods by a significant margin.

An accurate and efficient epileptic seizure onset detection can significantly benefit patients. Traditional diagnostic methods, primarily relying on electroencephalograms (EEGs), often result in cumbersome and non-portable solutions, making continuous patient monitoring challenging. The video-based seizure detection system is expected to free patients from the constraints of scalp or implanted EEG devices and enable remote monitoring in residential settings. Previous video-based methods neither enable all-day monitoring nor provide short detection latency due to insufficient resources and ineffective patient action recognition techniques. Additionally, skeleton-based action recognition approaches remain limitations in identifying subtle seizure-related actions. To address these challenges, we propose a novel Video-based Seizure detection model via a skeleton-based spatiotemporal Vision Graph neural network (VSViG) for its efficient, accurate and timely purpose in real-time scenarios. Our experimental results indicate VSViG outperforms previous state-of-the-art action recognition models on our collected patients' video data with higher accuracy (5.9% error), lower FLOPs (0.4G), and smaller model size (1.4M). Furthermore, by integrating a decision-making rule that combines output probabilities and an accumulative function, we achieve a 5.1 s detection latency after EEG onset, a 13.1 s detection advance before clinical onset, and a zero false detection rate. The project homepage is available at: https://github.com/xuyankun/VSViG/

In this work, we build a simple but strong baseline for sounding video generation. Given base diffusion models for audio and video, we integrate them with additional modules into a single model and train it to make the model jointly generate audio and video. To enhance alignment between audio-video pairs, we introduce two novel mechanisms in our model. The first one is timestep adjustment, which provides different timestep information to each base model. It is designed to align how samples are generated along with timesteps across modalities. The second one is a new design of the additional modules, termed Cross-Modal Conditioning as Positional Encoding (CMC-PE). In CMC-PE, cross-modal information is embedded as if it represents temporal position information, and the embeddings are fed into the model like positional encoding. Compared with the popular cross-attention mechanism, CMC-PE provides a better inductive bias for temporal alignment in the generated data. Experimental results validate the effectiveness of the two newly introduced mechanisms and also demonstrate that our method outperforms existing methods.

According to the 2021 World Health Organization (WHO) Classification scheme for gliomas, glioma segmentation is a very important basis for diagnosis and genotype prediction. In general, 3D multimodal brain MRI is an effective diagnostic tool. In the past decade, there has been an increase in the use of machine learning, particularly deep learning, for medical images processing. Thanks to the development of foundation models, models pre-trained with large-scale datasets have achieved better results on a variety of tasks. However, for medical images with small dataset sizes, deep learning methods struggle to achieve better results on real-world image datasets. In this paper, we propose a cross-modality attention adapter based on multimodal fusion to fine-tune the foundation model to accomplish the task of glioma segmentation in multimodal MRI brain images with better results. The effectiveness of the proposed method is validated via our private glioma data set from the First Affiliated Hospital of Zhengzhou University (FHZU) in Zhengzhou, China. Our proposed method is superior to current state-of-the-art methods with a Dice of 88.38% and Hausdorff distance of 10.64, thereby exhibiting a 4% increase in Dice to segment the glioma region for glioma treatment.

This study investigates the integration of diverse patient data sources into multimodal language models for automated chest X-ray (CXR) report generation. Traditionally, CXR report generation relies solely on CXR images and limited radiology data, overlooking valuable information from patient health records, particularly from emergency departments. Utilising the MIMIC-CXR and MIMIC-IV-ED datasets, we incorporate detailed patient information such as aperiodic vital signs, medications, and clinical history to enhance diagnostic accuracy. We introduce a novel approach to transform these heterogeneous data sources into embeddings that prompt a multimodal language model, significantly enhancing the diagnostic accuracy of generated radiology reports. Our comprehensive evaluation demonstrates the benefits of using a broader set of patient data, underscoring the potential for enhanced diagnostic capabilities and better patient outcomes through the integration of multimodal data in CXR report generation.

Detecting out-of-distribution (OOD) samples is important for deploying machine learning models in safety-critical applications such as autonomous driving and robot-assisted surgery. Existing research has mainly focused on unimodal scenarios on image data. However, real-world applications are inherently multimodal, which makes it essential to leverage information from multiple modalities to enhance the efficacy of OOD detection. To establish a foundation for more realistic Multimodal OOD Detection, we introduce the first-of-its-kind benchmark, MultiOOD, characterized by diverse dataset sizes and varying modality combinations. We first evaluate existing unimodal OOD detection algorithms on MultiOOD, observing that the mere inclusion of additional modalities yields substantial improvements. This underscores the importance of utilizing multiple modalities for OOD detection. Based on the observation of Modality Prediction Discrepancy between in-distribution (ID) and OOD data, and its strong correlation with OOD performance, we propose the Agree-to-Disagree (A2D) algorithm to encourage such discrepancy during training. Moreover, we introduce a novel outlier synthesis method, NP-Mix, which explores broader feature spaces by leveraging the information from nearest neighbor classes and complements A2D to strengthen OOD detection performance. Extensive experiments on MultiOOD demonstrate that training with A2D and NP-Mix improves existing OOD detection algorithms by a large margin. Our source code and MultiOOD benchmark are available at https://github.com/donghao51/MultiOOD.

Lack of large expert annotated MR datasets makes training deep learning models difficult. Therefore, a cross-modality (MR-CT) deep learning segmentation approach that augments training data using pseudo MR images produced by transforming expert-segmented CT images was developed. Eighty-One T2-weighted MRI scans from 28 patients with non-small cell lung cancers were analyzed. Cross-modality prior encoding the transformation of CT to pseudo MR images resembling T2w MRI was learned as a generative adversarial deep learning model. This model augmented training data arising from 6 expert-segmented T2w MR patient scans with 377 pseudo MRI from non-small cell lung cancer CT patient scans with obtained from the Cancer Imaging Archive. A two-dimensional Unet implemented with batch normalization was trained to segment the tumors from T2w MRI. This method was benchmarked against (a) standard data augmentation and two state-of-the art cross-modality pseudo MR-based augmentation and (b) two segmentation networks. Segmentation accuracy was computed using Dice similarity coefficient (DSC), Hausdroff distance metrics, and volume ratio. The proposed approach produced the lowest statistical variability in the intensity distribution between pseudo and T2w MR images measured as Kullback-Leibler divergence of 0.069. This method produced the highest segmentation accuracy with a DSC of 0.75 and the lowest Hausdroff distance on the test dataset. This approach produced highly similar estimations of tumor growth as an expert (P = 0.37). A novel deep learning MR segmentation was developed that overcomes the limitation of learning robust models from small datasets by leveraging learned cross-modality priors to augment training. The results show the feasibility of the approach and the corresponding improvement over the state-of-the-art methods.

Human health can be critically affected by cardiovascular diseases, such as hypertension, arrhythmias, and stroke. Heart rate and blood pressure are important biometric information for the monitoring of cardiovascular system and early diagnosis of cardiovascular diseases. Existing methods for estimating the heart rate are based on electrocardiography and photoplethyomography, which require contacting the sensor to the skin surface. Moreover, catheter and cuff-based methods for measuring blood pressure cause inconvenience and have limited applicability. Therefore, in this thesis, we propose a vision-based method for estimating the heart rate and blood pressure. This thesis proposes a 2-stage deep learning framework consisting of a dual remote photoplethysmography network (DRP-Net) and bounded blood pressure network (BBP-Net). In the first stage, DRP-Net infers remote photoplethysmography (rPPG) signals for the acral and facial regions, and these phase-shifted rPPG signals are utilized to estimate the heart rate. In the second stage, BBP-Net integrates temporal features and analyzes phase discrepancy between the acral and facial rPPG signals to estimate SBP and DBP values. To improve the accuracy of estimating the heart rate, we employed a data augmentation method based on a frame interpolation model. Moreover, we designed BBP-Net to infer blood pressure within a predefined range by incorporating a scaled sigmoid function. Our method resulted in estimating the heart rate with the mean absolute error (MAE) of 1.78 BPM, reducing the MAE by 34.31 % compared to the recent method, on the MMSE-HR dataset. The MAE for estimating the systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 10.19 mmHg and 7.09 mmHg. On the V4V dataset, the MAE for the heart rate, SBP, and DBP were 3.83 BPM, 13.64 mmHg, and 9.4 mmHg, respectively.

Early diagnosis of mild cognitive impairment (MCI) and subjective cognitive decline (SCD) utilizing multi-modal magnetic resonance imaging (MRI) is a pivotal area of research. While various regional and connectivity features from functional MRI (fMRI) and diffusion tensor imaging (DTI) have been employed to develop diagnosis models, most studies integrate these features without adequately addressing their alignment and interactions. This limits the potential to fully exploit the synergistic contributions of combined features and modalities. To solve this gap, our study introduces a novel Hierarchical Alignments and Hierarchical Interactions (HA-HI) method for MCI and SCD classification, leveraging the combined strengths of fMRI and DTI. HA-HI efficiently learns significant MCI- or SCD- related regional and connectivity features by aligning various feature types and hierarchically maximizing their interactions. Furthermore, to enhance the interpretability of our approach, we have developed the Synergistic Activation Map (SAM) technique, revealing the critical brain regions and connections that are indicative of MCI/SCD. Comprehensive evaluations on the ADNI dataset and our self-collected data demonstrate that HA-HI outperforms other existing methods in diagnosing MCI and SCD, making it a potentially vital and interpretable tool for early detection. The implementation of this method is publicly accessible at https://github.com/ICI-BCI/Dual-MRI-HA-HI.git.

In biomedical imaging analysis, the dichotomy between 2D and 3D data presents a significant challenge. While 3D volumes offer superior real-world applicability, they are less available for each modality and not easy to train in large scale, whereas 2D samples are abundant but less comprehensive. This paper introduces the Cross-D Conv operation, a novel approach that bridges the dimensional gap by learning the phase shifting in the Fourier domain. Our method enables seamless weight transfer between 2D and 3D convolution operations, effectively facilitating cross-dimensional learning. The proposed architecture leverages the abundance of 2D training data to enhance 3D model performance, offering a practical solution to the multimodal data scarcity challenge in 3D medical model pretraining. Experimental validation on the RadImagenet (2D) and multimodal (3D) sets demonstrates that our approach achieves comparable or superior performance in feature quality assessment comparable to conventional methods. The enhanced convolution operation presents new opportunities for developing efficient classification and segmentation models in medical imaging. This work represents an advancement in cross-dimensional and multi-modal medical image analysis, offering a robust framework for utilizing 2D priors in 3D model pretraining or vice versa while maintaining computational efficiency.

A range of applications of multi-modal music information retrieval is centred around the problem of connecting large collections of sheet music (images) to corresponding audio recordings, that is, identifying pairs of audio and score excerpts that refer to the same musical content. One of the typical and most recent approaches to this task employs cross-modal deep learning architectures to learn joint embedding spaces that link the two distinct modalities - audio and sheet music images. While there has been steady improvement on this front over the past years, a number of open problems still prevent large-scale employment of this methodology. In this article we attempt to provide an insightful examination of the current developments on audio-sheet music retrieval via deep learning methods. We first identify a set of main challenges on the road towards robust and large-scale cross-modal music retrieval in real scenarios. We then highlight the steps we have taken so far to address some of these challenges, documenting step-by-step improvement along several dimensions. We conclude by analysing the remaining challenges and present ideas for solving these, in order to pave the way to a unified and robust methodology for cross-modal music retrieval.

The inherent challenge of multimodal fusion is to precisely capture the cross-modal correlation and flexibly conduct cross-modal interaction. To fully release the value of each modality and mitigate the influence of low-quality multimodal data, dynamic multimodal fusion emerges as a promising learning paradigm. Despite its widespread use, theoretical justifications in this field are still notably lacking. Can we design a provably robust multimodal fusion method? This paper provides theoretical understandings to answer this question under a most popular multimodal fusion framework from the generalization perspective. We proceed to reveal that several uncertainty estimation solutions are naturally available to achieve robust multimodal fusion. Then a novel multimodal fusion framework termed Quality-aware Multimodal Fusion (QMF) is proposed, which can improve the performance in terms of classification accuracy and model robustness. Extensive experimental results on multiple benchmarks can support our findings.

Artificial Intelligence (AI) has demonstrated significant potential in healthcare, particularly in disease diagnosis and treatment planning. Recent progress in Medical Large Vision-Language Models (Med-LVLMs) has opened up new possibilities for interactive diagnostic tools. However, these models often suffer from factual hallucination, which can lead to incorrect diagnoses. Fine-tuning and retrieval-augmented generation (RAG) have emerged as methods to address these issues. However, the amount of high-quality data and distribution shifts between training data and deployment data limit the application of fine-tuning methods. Although RAG is lightweight and effective, existing RAG-based approaches are not sufficiently general to different medical domains and can potentially cause misalignment issues, both between modalities and between the model and the ground truth. In this paper, we propose a versatile multimodal RAG system, MMed-RAG, designed to enhance the factuality of Med-LVLMs. Our approach introduces a domain-aware retrieval mechanism, an adaptive retrieved contexts selection method, and a provable RAG-based preference fine-tuning strategy. These innovations make the RAG process sufficiently general and reliable, significantly improving alignment when introducing retrieved contexts. Experimental results across five medical datasets (involving radiology, ophthalmology, pathology) on medical VQA and report generation demonstrate that MMed-RAG can achieve an average improvement of 43.8% in the factual accuracy of Med-LVLMs. Our data and code are available in https://github.com/richard-peng-xia/MMed-RAG.

Machine learning systems are often deployed in domains that entail data from multiple modalities, for example, phenotypic and genotypic characteristics describe patients in healthcare. Previous works have developed multimodal variational autoencoders (VAEs) that generate several modalities. We consider subjective data, where single datapoints from one modality (such as class labels) describe multiple datapoints from another modality (such as images). We theoretically and empirically demonstrate that multimodal VAEs with a mixture of experts posterior can struggle to capture variability in such surjective data.

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

Intra-operative recognition of surgical phases holds significant potential for enhancing real-time contextual awareness in the operating room. However, we argue that online recognition, while beneficial, primarily lends itself to post-operative video analysis due to its limited direct impact on the actual surgical decisions and actions during ongoing procedures. In contrast, we contend that the prediction and anticipation of surgical phases are inherently more valuable for intra-operative assistance, as they can meaningfully influence a surgeon's immediate and long-term planning by providing foresight into future steps. To address this gap, we propose a dual approach that simultaneously recognises the current surgical phase and predicts upcoming ones, thus offering comprehensive intra-operative assistance and guidance on the expected remaining workflow. Our novel method, Surgical Phase Recognition and Anticipation (SuPRA), leverages past and current information for accurate intra-operative phase recognition while using future segments for phase prediction. This unified approach challenges conventional frameworks that treat these objectives separately. We have validated SuPRA on two reputed datasets, Cholec80 and AutoLaparo21, where it demonstrated state-of-the-art performance with recognition accuracies of 91.8% and 79.3%, respectively. Additionally, we introduce and evaluate our model using new segment-level evaluation metrics, namely Edit and F1 Overlap scores, for a more temporal assessment of segment classification. In conclusion, SuPRA presents a new multi-task approach that paves the way for improved intra-operative assistance through surgical phase recognition and prediction of future events.

As emotions play a central role in human communication, automatic emotion recognition has attracted increasing attention in the last two decades. While multimodal systems enjoy high performances on lab-controlled data, they are still far from providing ecological validity on non-lab-controlled, namely 'in-the-wild' data. This work investigates audiovisual deep learning approaches for emotion recognition in-the-wild problem. We particularly explore the effectiveness of architectures based on fine-tuned Convolutional Neural Networks (CNN) and Public Dimensional Emotion Model (PDEM), for video and audio modality, respectively. We compare alternative temporal modeling and fusion strategies using the embeddings from these multi-stage trained modality-specific Deep Neural Networks (DNN). We report results on the AffWild2 dataset under Affective Behavior Analysis in-the-Wild 2024 (ABAW'24) challenge protocol.

Major Depressive Disorder (MDD) is a pervasive mental health condition that affects 300 million people worldwide. This work presents a novel, BiLSTM-based tri-modal model-level fusion architecture for the binary classification of depression from clinical interview recordings. The proposed architecture incorporates Mel Frequency Cepstral Coefficients, Facial Action Units, and uses a two-shot learning based GPT-4 model to process text data. This is the first work to incorporate large language models into a multi-modal architecture for this task. It achieves impressive results on the DAIC-WOZ AVEC 2016 Challenge cross-validation split and Leave-One-Subject-Out cross-validation split, surpassing all baseline models and multiple state-of-the-art models. In Leave-One-Subject-Out testing, it achieves an accuracy of 91.01%, an F1-Score of 85.95%, a precision of 80%, and a recall of 92.86%.

As multimodal learning finds applications in a wide variety of high-stakes societal tasks, investigating their robustness becomes important. Existing work has focused on understanding the robustness of vision-and-language models to imperceptible variations on benchmark tasks. In this work, we investigate the robustness of multimodal classifiers to cross-modal dilutions - a plausible variation. We develop a model that, given a multimodal (image + text) input, generates additional dilution text that (a) maintains relevance and topical coherence with the image and existing text, and (b) when added to the original text, leads to misclassification of the multimodal input. Via experiments on Crisis Humanitarianism and Sentiment Detection tasks, we find that the performance of task-specific fusion-based multimodal classifiers drops by 23.3% and 22.5%, respectively, in the presence of dilutions generated by our model. Metric-based comparisons with several baselines and human evaluations indicate that our dilutions show higher relevance and topical coherence, while simultaneously being more effective at demonstrating the brittleness of the multimodal classifiers. Our work aims to highlight and encourage further research on the robustness of deep multimodal models to realistic variations, especially in human-facing societal applications. The code and other resources are available at https://claws-lab.github.io/multimodal-robustness/.

Recently, an audio-visual segmentation (AVS) task has been introduced, aiming to group pixels with sounding objects within a given video. This task necessitates a first-ever audio-driven pixel-level understanding of the scene, posing significant challenges. In this paper, we propose an innovative audio-visual transformer framework, termed COMBO, an acronym for COoperation of Multi-order Bilateral relatiOns. For the first time, our framework explores three types of bilateral entanglements within AVS: pixel entanglement, modality entanglement, and temporal entanglement. Regarding pixel entanglement, we employ a Siam-Encoder Module (SEM) that leverages prior knowledge to generate more precise visual features from the foundational model. For modality entanglement, we design a Bilateral-Fusion Module (BFM), enabling COMBO to align corresponding visual and auditory signals bi-directionally. As for temporal entanglement, we introduce an innovative adaptive inter-frame consistency loss according to the inherent rules of temporal. Comprehensive experiments and ablation studies on AVSBench-object (84.7 mIoU on S4, 59.2 mIou on MS3) and AVSBench-semantic (42.1 mIoU on AVSS) datasets demonstrate that COMBO surpasses previous state-of-the-art methods. Code and more results will be publicly available at https://combo-avs.github.io/.

Left ventricular hypertrophy (LVH) results from chronic remodeling caused by a broad range of systemic and cardiovascular disease including hypertension, aortic stenosis, hypertrophic cardiomyopathy, and cardiac amyloidosis. Early detection and characterization of LVH can significantly impact patient care but is limited by under-recognition of hypertrophy, measurement error and variability, and difficulty differentiating etiologies of LVH. To overcome this challenge, we present EchoNet-LVH - a deep learning workflow that automatically quantifies ventricular hypertrophy with precision equal to human experts and predicts etiology of LVH. Trained on 28,201 echocardiogram videos, our model accurately measures intraventricular wall thickness (mean absolute error [MAE] 1.4mm, 95% CI 1.2-1.5mm), left ventricular diameter (MAE 2.4mm, 95% CI 2.2-2.6mm), and posterior wall thickness (MAE 1.2mm, 95% CI 1.1-1.3mm) and classifies cardiac amyloidosis (area under the curve of 0.83) and hypertrophic cardiomyopathy (AUC 0.98) from other etiologies of LVH. In external datasets from independent domestic and international healthcare systems, EchoNet-LVH accurately quantified ventricular parameters (R2 of 0.96 and 0.90 respectively) and detected cardiac amyloidosis (AUC 0.79) and hypertrophic cardiomyopathy (AUC 0.89) on the domestic external validation site. Leveraging measurements across multiple heart beats, our model can more accurately identify subtle changes in LV geometry and its causal etiologies. Compared to human experts, EchoNet-LVH is fully automated, allowing for reproducible, precise measurements, and lays the foundation for precision diagnosis of cardiac hypertrophy. As a resource to promote further innovation, we also make publicly available a large dataset of 23,212 annotated echocardiogram videos.

Understanding of video creativity and content often varies among individuals, with differences in focal points and cognitive levels across different ages, experiences, and genders. There is currently a lack of research in this area, and most existing benchmarks suffer from several drawbacks: 1) a limited number of modalities and answers with restrictive length; 2) the content and scenarios within the videos are excessively monotonous, transmitting allegories and emotions that are overly simplistic. To bridge the gap to real-world applications, we introduce a large-scale Subjective Response Indicators for Advertisement Videos dataset, namely SRI-ADV. Specifically, we collected real changes in Electroencephalographic (EEG) and eye-tracking regions from different demographics while they viewed identical video content. Utilizing this multi-modal dataset, we developed tasks and protocols to analyze and evaluate the extent of cognitive understanding of video content among different users. Along with the dataset, we designed a Hypergraph Multi-modal Large Language Model (HMLLM) to explore the associations among different demographics, video elements, EEG, and eye-tracking indicators. HMLLM could bridge semantic gaps across rich modalities and integrate information beyond different modalities to perform logical reasoning. Extensive experimental evaluations on SRI-ADV and other additional video-based generative performance benchmarks demonstrate the effectiveness of our method. The codes and dataset will be released at https://github.com/suay1113/HMLLM.

This work uniquely identifies and characterizes four prevalent multimodal model architectural patterns in the contemporary multimodal landscape. Systematically categorizing models by architecture type facilitates monitoring of developments in the multimodal domain. Distinct from recent survey papers that present general information on multimodal architectures, this research conducts a comprehensive exploration of architectural details and identifies four specific architectural types. The types are distinguished by their respective methodologies for integrating multimodal inputs into the deep neural network model. The first two types (Type A and B) deeply fuses multimodal inputs within the internal layers of the model, whereas the following two types (Type C and D) facilitate early fusion at the input stage. Type-A employs standard cross-attention, whereas Type-B utilizes custom-designed layers for modality fusion within the internal layers. On the other hand, Type-C utilizes modality-specific encoders, while Type-D leverages tokenizers to process the modalities at the model's input stage. The identified architecture types aid the monitoring of any-to-any multimodal model development. Notably, Type-C and Type-D are currently favored in the construction of any-to-any multimodal models. Type-C, distinguished by its non-tokenizing multimodal model architecture, is emerging as a viable alternative to Type-D, which utilizes input-tokenizing techniques. To assist in model selection, this work highlights the advantages and disadvantages of each architecture type based on data and compute requirements, architecture complexity, scalability, simplification of adding modalities, training objectives, and any-to-any multimodal generation capability.

We introduce Baichuan-Omni-1.5, an omni-modal model that not only has omni-modal understanding capabilities but also provides end-to-end audio generation capabilities. To achieve fluent and high-quality interaction across modalities without compromising the capabilities of any modality, we prioritized optimizing three key aspects. First, we establish a comprehensive data cleaning and synthesis pipeline for multimodal data, obtaining about 500B high-quality data (text, audio, and vision). Second, an audio-tokenizer (Baichuan-Audio-Tokenizer) has been designed to capture both semantic and acoustic information from audio, enabling seamless integration and enhanced compatibility with MLLM. Lastly, we designed a multi-stage training strategy that progressively integrates multimodal alignment and multitask fine-tuning, ensuring effective synergy across all modalities. Baichuan-Omni-1.5 leads contemporary models (including GPT4o-mini and MiniCPM-o 2.6) in terms of comprehensive omni-modal capabilities. Notably, it achieves results comparable to leading models such as Qwen2-VL-72B across various multimodal medical benchmarks.

Surgical workflow recognition has numerous potential medical applications, such as the automatic indexing of surgical video databases and the optimization of real-time operating room scheduling, among others. As a result, phase recognition has been studied in the context of several kinds of surgeries, such as cataract, neurological, and laparoscopic surgeries. In the literature, two types of features are typically used to perform this task: visual features and tool usage signals. However, the visual features used are mostly handcrafted. Furthermore, the tool usage signals are usually collected via a manual annotation process or by using additional equipment. In this paper, we propose a novel method for phase recognition that uses a convolutional neural network (CNN) to automatically learn features from cholecystectomy videos and that relies uniquely on visual information. In previous studies, it has been shown that the tool signals can provide valuable information in performing the phase recognition task. Thus, we present a novel CNN architecture, called EndoNet, that is designed to carry out the phase recognition and tool presence detection tasks in a multi-task manner. To the best of our knowledge, this is the first work proposing to use a CNN for multiple recognition tasks on laparoscopic videos. Extensive experimental comparisons to other methods show that EndoNet yields state-of-the-art results for both tasks.

Multimodal learning has gained attention for its capacity to integrate information from different modalities. However, it is often hindered by the multimodal imbalance problem, where certain modality dominates while others remain underutilized. Although recent studies have proposed various methods to alleviate this problem, they lack comprehensive and fair comparisons. In this paper, we systematically categorize various mainstream multimodal imbalance algorithms into four groups based on the strategies they employ to mitigate imbalance. To facilitate a comprehensive evaluation of these methods, we introduce BalanceBenchmark, a benchmark including multiple widely used multidimensional datasets and evaluation metrics from three perspectives: performance, imbalance degree, and complexity. To ensure fair comparisons, we have developed a modular and extensible toolkit that standardizes the experimental workflow across different methods. Based on the experiments using BalanceBenchmark, we have identified several key insights into the characteristics and advantages of different method groups in terms of performance, balance degree and computational complexity. We expect such analysis could inspire more efficient approaches to address the imbalance problem in the future, as well as foundation models. The code of the toolkit is available at https://github.com/GeWu-Lab/BalanceBenchmark.

Multimodal emotion recognition is an active research topic in artificial intelligence. Its primary objective is to integrate multi-modalities (such as acoustic, visual, and lexical clues) to identify human emotional states. Current works generally assume accurate emotion labels for benchmark datasets and focus on developing more effective architectures. But due to the inherent subjectivity of emotions, existing datasets often lack high annotation consistency, resulting in potentially inaccurate labels. Consequently, models built on these datasets may struggle to meet the demands of practical applications. To address this issue, it is crucial to enhance the reliability of emotion annotations. In this paper, we propose a novel task called ``Explainable Multimodal Emotion Reasoning (EMER)''. In contrast to previous works that primarily focus on predicting emotions, EMER takes a step further by providing explanations for these predictions. The prediction is considered correct as long as the reasoning process behind the predicted emotion is plausible. This paper presents our initial efforts on EMER, where we introduce a benchmark dataset, establish baseline models, and define evaluation metrics. Meanwhile, we observe the necessity of integrating multi-faceted capabilities to deal with EMER. Therefore, we propose the first multimodal large language model (LLM) in affective computing, called AffectGPT. We aim to tackle the long-standing challenge of label ambiguity and chart a path toward more reliable techniques. Furthermore, EMER offers an opportunity to evaluate the audio-video-text understanding capabilities of recent multimodal LLM. To facilitate further research, we make the code and data available at: https://github.com/zeroQiaoba/AffectGPT.

In recent years, the Segmentation Anything Model (SAM) has attracted considerable attention as a foundational model well-known for its robust generalization capabilities across various downstream tasks. However, SAM does not exhibit satisfactory performance in the realm of medical image analysis. In this study, we introduce the first study on adapting SAM on video segmentation, called MediViSTA-SAM, a novel approach designed for medical video segmentation. Given video data, MediViSTA, spatio-temporal adapter captures long and short range temporal attention with cross-frame attention mechanism effectively constraining it to consider the immediately preceding video frame as a reference, while also considering spatial information effectively. Additionally, it incorporates multi-scale fusion by employing a U-shaped encoder and a modified mask decoder to handle objects of varying sizes. To evaluate our approach, extensive experiments were conducted using state-of-the-art (SOTA) methods, assessing its generalization abilities on multi-vendor in-house echocardiography datasets. The results highlight the accuracy and effectiveness of our network in medical video segmentation.

We present OCTCube-M, a 3D OCT-based multi-modal foundation model for jointly analyzing OCT and en face images. OCTCube-M first developed OCTCube, a 3D foundation model pre-trained on 26,685 3D OCT volumes encompassing 1.62 million 2D OCT images. It then exploits a novel multi-modal contrastive learning framework COEP to integrate other retinal imaging modalities, such as fundus autofluorescence and infrared retinal imaging, into OCTCube, efficiently extending it into multi-modal foundation models. OCTCube achieves best performance on predicting 8 retinal diseases, demonstrating strong generalizability on cross-cohort, cross-device and cross-modality prediction. OCTCube can also predict cross-organ nodule malignancy (CT) and low cardiac ejection fraction as well as systemic diseases, such as diabetes and hypertension, revealing its wide applicability beyond retinal diseases. We further develop OCTCube-IR using COEP with 26,685 OCT and IR image pairs. OCTCube-IR can accurately retrieve between OCT and IR images, allowing joint analysis between 3D and 2D retinal imaging modalities. Finally, we trained a tri-modal foundation model OCTCube-EF from 4 million 2D OCT images and 400K en face retinal images. OCTCube-EF attains the best performance on predicting the growth rate of geographic atrophy (GA) across datasets collected from 6 multi-center global trials conducted in 23 countries. This improvement is statistically equivalent to running a clinical trial with more than double the size of the original study. Our analysis based on another retrospective case study reveals OCTCube-EF's ability to avoid false positive Phase-III results according to its accurate treatment effect estimation on the Phase-II results. In sum, OCTCube-M is a 3D multi-modal foundation model framework that integrates OCT and other retinal imaging modalities revealing substantial diagnostic and prognostic benefits.

Time series data are ubiquitous across a wide range of real-world domains. While real-world time series analysis (TSA) requires human experts to integrate numerical series data with multimodal domain-specific knowledge, most existing TSA models rely solely on numerical data, overlooking the significance of information beyond numerical series. This oversight is due to the untapped potential of textual series data and the absence of a comprehensive, high-quality multimodal dataset. To overcome this obstacle, we introduce Time-MMD, the first multi-domain, multimodal time series dataset covering 9 primary data domains. Time-MMD ensures fine-grained modality alignment, eliminates data contamination, and provides high usability. Additionally, we develop MM-TSFlib, the first multimodal time-series forecasting (TSF) library, seamlessly pipelining multimodal TSF evaluations based on Time-MMD for in-depth analyses. Extensive experiments conducted on Time-MMD through MM-TSFlib demonstrate significant performance enhancements by extending unimodal TSF to multimodality, evidenced by over 15% mean squared error reduction in general, and up to 40% in domains with rich textual data. More importantly, our datasets and library revolutionize broader applications, impacts, research topics to advance TSA. The dataset and library are available at https://github.com/AdityaLab/Time-MMD and https://github.com/AdityaLab/MM-TSFlib.

Medical vision-and-language models (MVLMs) have attracted substantial interest due to their capability to offer a natural language interface for interpreting complex medical data. Their applications are versatile and have the potential to improve diagnostic accuracy and decision-making for individual patients while also contributing to enhanced public health monitoring, disease surveillance, and policy-making through more efficient analysis of large data sets. MVLMS integrate natural language processing with medical images to enable a more comprehensive and contextual understanding of medical images alongside their corresponding textual information. Unlike general vision-and-language models trained on diverse, non-specialized datasets, MVLMs are purpose-built for the medical domain, automatically extracting and interpreting critical information from medical images and textual reports to support clinical decision-making. Popular clinical applications of MVLMs include automated medical report generation, medical visual question answering, medical multimodal segmentation, diagnosis and prognosis and medical image-text retrieval. Here, we provide a comprehensive overview of MVLMs and the various medical tasks to which they have been applied. We conduct a detailed analysis of various vision-and-language model architectures, focusing on their distinct strategies for cross-modal integration/exploitation of medical visual and textual features. We also examine the datasets used for these tasks and compare the performance of different models based on standardized evaluation metrics. Furthermore, we highlight potential challenges and summarize future research trends and directions. The full collection of papers and codes is available at: https://github.com/YtongXie/Medical-Vision-and-Language-Tasks-and-Methodologies-A-Survey.

In this paper, we propose Emotionally paired Music and Image Dataset (EMID), a novel dataset designed for the emotional matching of music and images, to facilitate auditory-visual cross-modal tasks such as generation and retrieval. Unlike existing approaches that primarily focus on semantic correlations or roughly divided emotional relations, EMID emphasizes the significance of emotional consistency between music and images using an advanced 13-dimension emotional model. By incorporating emotional alignment into the dataset, it aims to establish pairs that closely align with human perceptual understanding, thereby raising the performance of auditory-visual cross-modal tasks. We also design a supplemental module named EMI-Adapter to optimize existing cross-modal alignment methods. To validate the effectiveness of the EMID, we conduct a psychological experiment, which has demonstrated that considering the emotional relationship between the two modalities effectively improves the accuracy of matching in abstract perspective. This research lays the foundation for future cross-modal research in domains such as psychotherapy and contributes to advancing the understanding and utilization of emotions in cross-modal alignment. The EMID dataset is available at https://github.com/ecnu-aigc/EMID.

As deep learning models gain attraction in medical data, ensuring transparent and trustworthy decision-making is essential. In skin cancer diagnosis, while advancements in lesion detection and classification have improved accuracy, the black-box nature of these methods poses challenges in understanding their decision processes, leading to trust issues among physicians. This study leverages the CLIP (Contrastive Language-Image Pretraining) model, trained on different skin lesion datasets, to capture meaningful relationships between visual features and diagnostic criteria terms. To further enhance transparency, we propose a method called MedGrad E-CLIP, which builds on gradient-based E-CLIP by incorporating a weighted entropy mechanism designed for complex medical imaging like skin lesions. This approach highlights critical image regions linked to specific diagnostic descriptions. The developed integrated pipeline not only classifies skin lesions by matching corresponding descriptions but also adds an essential layer of explainability developed especially for medical data. By visually explaining how different features in an image relates to diagnostic criteria, this approach demonstrates the potential of advanced vision-language models in medical image analysis, ultimately improving transparency, robustness, and trust in AI-driven diagnostic systems.

A digital twin is a virtual replica of a real-world physical phenomena that uses mathematical modeling to characterize and simulate its defining features. By constructing digital twins for disease processes, we can perform in-silico simulations that mimic patients' health conditions and counterfactual outcomes under hypothetical interventions in a virtual setting. This eliminates the need for invasive procedures or uncertain treatment decisions. In this paper, we propose a method to identify digital twin model parameters using only noninvasive patient health data. We approach the digital twin modeling as a composite inverse problem, and observe that its structure resembles pretraining and finetuning in self-supervised learning (SSL). Leveraging this, we introduce a physics-informed SSL algorithm that initially pretrains a neural network on the pretext task of solving the physical model equations. Subsequently, the model is trained to reconstruct low-dimensional health measurements from noninvasive modalities while being constrained by the physical equations learned in pretraining. We apply our method to identify digital twins of cardiac hemodynamics using noninvasive echocardiogram videos, and demonstrate its utility in unsupervised disease detection and in-silico clinical trials.

With the advent of Vision-Language Models (VLMs), medical artificial intelligence (AI) has experienced significant technological progress and paradigm shifts. This survey provides an extensive review of recent advancements in Medical Vision-Language Models (Med-VLMs), which integrate visual and textual data to enhance healthcare outcomes. We discuss the foundational technology behind Med-VLMs, illustrating how general models are adapted for complex medical tasks, and examine their applications in healthcare. The transformative impact of Med-VLMs on clinical practice, education, and patient care is highlighted, alongside challenges such as data scarcity, narrow task generalization, interpretability issues, and ethical concerns like fairness, accountability, and privacy. These limitations are exacerbated by uneven dataset distribution, computational demands, and regulatory hurdles. Rigorous evaluation methods and robust regulatory frameworks are essential for safe integration into healthcare workflows. Future directions include leveraging large-scale, diverse datasets, improving cross-modal generalization, and enhancing interpretability. Innovations like federated learning, lightweight architectures, and Electronic Health Record (EHR) integration are explored as pathways to democratize access and improve clinical relevance. This review aims to provide a comprehensive understanding of Med-VLMs' strengths and limitations, fostering their ethical and balanced adoption in healthcare.

Estimating the shape and motion state of the myocardium is essential in diagnosing cardiovascular diseases.However, cine magnetic resonance (CMR) imaging is dominated by 2D slices, whose large slice spacing challenges inter-slice shape reconstruction and motion acquisition.To address this problem, we propose a 4D reconstruction method that decouples motion and shape, which can predict the inter-/intra- shape and motion estimation from a given sparse point cloud sequence obtained from limited slices. Our framework comprises a neural motion model and an end-diastolic (ED) shape model. The implicit ED shape model can learn a continuous boundary and encourage the motion model to predict without the supervision of ground truth deformation, and the motion model enables canonical input of the shape model by deforming any point from any phase to the ED phase. Additionally, the constructed ED-space enables pre-training of the shape model, thereby guiding the motion model and addressing the issue of data scarcity. We propose the first 4D myocardial dataset as we know and verify our method on the proposed, public, and cross-modal datasets, showing superior reconstruction performance and enabling various clinical applications.

Brain Signals, such as Electroencephalography (EEG), and human languages have been widely explored independently for many downstream tasks, however, the connection between them has not been well explored. In this study, we explore the relationship and dependency between EEG and language. To study at the representation level, we introduced MTAM, a Multimodal Transformer Alignment Model, to observe coordinated representations between the two modalities. We used various relationship alignment-seeking techniques, such as Canonical Correlation Analysis and Wasserstein Distance, as loss functions to transfigure features. On downstream applications, sentiment analysis and relation detection, we achieved new state-of-the-art results on two datasets, ZuCo and K-EmoCon. Our method achieved an F1-score improvement of 1.7% on K-EmoCon and 9.3% on Zuco datasets for sentiment analysis, and 7.4% on ZuCo for relation detection. In addition, we provide interpretations of the performance improvement: (1) feature distribution shows the effectiveness of the alignment module for discovering and encoding the relationship between EEG and language; (2) alignment weights show the influence of different language semantics as well as EEG frequency features; (3) brain topographical maps provide an intuitive demonstration of the connectivity in the brain regions. Our code is available at https://github.com/Jason-Qiu/EEG_Language_Alignment.

Massive multi-modality datasets play a significant role in facilitating the success of large video-language models. However, current video-language datasets primarily provide text descriptions for visual frames, considering audio to be weakly related information. They usually overlook exploring the potential of inherent audio-visual correlation, leading to monotonous annotation within each modality instead of comprehensive and precise descriptions. Such ignorance results in the difficulty of multiple cross-modality studies. To fulfill this gap, we present MMTrail, a large-scale multi-modality video-language dataset incorporating more than 20M trailer clips with visual captions, and 2M high-quality clips with multimodal captions. Trailers preview full-length video works and integrate context, visual frames, and background music. In particular, the trailer has two main advantages: (1) the topics are diverse, and the content characters are of various types, e.g., film, news, and gaming. (2) the corresponding background music is custom-designed, making it more coherent with the visual context. Upon these insights, we propose a systemic captioning framework, achieving various modality annotations with more than 27.1k hours of trailer videos. Here, to ensure the caption retains music perspective while preserving the authority of visual context, we leverage the advanced LLM to merge all annotations adaptively. In this fashion, our MMtrail dataset potentially paves the path for fine-grained large multimodal-language model training. In experiments, we provide evaluation metrics and benchmark results on our dataset, demonstrating the high quality of our annotation and its effectiveness for model training.

Existing Multimodal Large Language Models (MLLMs) are predominantly trained and tested on consistent visual-textual inputs, leaving open the question of whether they can handle inconsistencies in real-world, layout-rich content. To bridge this gap, we propose the Multimodal Inconsistency Reasoning (MMIR) benchmark to assess MLLMs' ability to detect and reason about semantic mismatches in artifacts such as webpages, presentation slides, and posters. MMIR comprises 534 challenging samples, each containing synthetically injected errors across five reasoning-heavy categories: Factual Contradiction, Identity Misattribution, Contextual Mismatch, Quantitative Discrepancy, and Temporal/Spatial Incoherence. We evaluate six state-of-the-art MLLMs, showing that models with dedicated multimodal reasoning capabilities, such as o1, substantially outperform their counterparts while open-source models remain particularly vulnerable to inconsistency errors. Detailed error analyses further show that models excel in detecting inconsistencies confined to a single modality, particularly in text, but struggle with cross-modal conflicts and complex layouts. Probing experiments reveal that single-modality prompting, including Chain-of-Thought (CoT) and Set-of-Mark (SoM) methods, yields marginal gains, revealing a key bottleneck in cross-modal reasoning. Our findings highlight the need for advanced multimodal reasoning and point to future research on multimodal inconsistency.

Test-time adaptation approaches have recently emerged as a practical solution for handling domain shift without access to the source domain data. In this paper, we propose and explore a new multi-modal extension of test-time adaptation for 3D semantic segmentation. We find that directly applying existing methods usually results in performance instability at test time because multi-modal input is not considered jointly. To design a framework that can take full advantage of multi-modality, where each modality provides regularized self-supervisory signals to other modalities, we propose two complementary modules within and across the modalities. First, Intra-modal Pseudolabel Generation (Intra-PG) is introduced to obtain reliable pseudo labels within each modality by aggregating information from two models that are both pre-trained on source data but updated with target data at different paces. Second, Inter-modal Pseudo-label Refinement (Inter-PR) adaptively selects more reliable pseudo labels from different modalities based on a proposed consistency scheme. Experiments demonstrate that our regularized pseudo labels produce stable self-learning signals in numerous multi-modal test-time adaptation scenarios for 3D semantic segmentation. Visit our project website at https://www.nec-labs.com/~mas/MM-TTA.

The widespread use of chest X-rays (CXRs), coupled with a shortage of radiologists, has driven growing interest in automated CXR analysis and AI-assisted reporting. While existing vision-language models (VLMs) show promise in specific tasks such as report generation or abnormality detection, they often lack support for interactive diagnostic capabilities. In this work we present RadVLM, a compact, multitask conversational foundation model designed for CXR interpretation. To this end, we curate a large-scale instruction dataset comprising over 1 million image-instruction pairs containing both single-turn tasks -- such as report generation, abnormality classification, and visual grounding -- and multi-turn, multi-task conversational interactions. After fine-tuning RadVLM on this instruction dataset, we evaluate it across different tasks along with re-implemented baseline VLMs. Our results show that RadVLM achieves state-of-the-art performance in conversational capabilities and visual grounding while remaining competitive in other radiology tasks. Ablation studies further highlight the benefit of joint training across multiple tasks, particularly for scenarios with limited annotated data. Together, these findings highlight the potential of RadVLM as a clinically relevant AI assistant, providing structured CXR interpretation and conversational capabilities to support more effective and accessible diagnostic workflows.

A network-based approach is presented to investigate the cerebrovascular flow patterns during atrial fibrillation (AF) with respect to normal sinus rhythm (NSR). AF, the most common cardiac arrhythmia with faster and irregular beating, has been recently and independently associated with the increased risk of dementia. However, the underlying hemodynamic mechanisms relating the two pathologies remain mainly undetermined so far; thus the contribution of modeling and refined statistical tools is valuable. Pressure and flow rate temporal series in NSR and AF are here evaluated along representative cerebral sites (from carotid arteries to capillary brain circulation), exploiting reliable artificially built signals recently obtained from an in silico approach. The complex network analysis evidences, in a synthetic and original way, a dramatic signal variation towards the distal/capillary cerebral regions during AF, which has no counterpart in NSR conditions. At the large artery level, networks obtained from both AF and NSR hemodynamic signals exhibit elongated and chained features, which are typical of pseudo-periodic series. These aspects are almost completely lost towards the microcirculation during AF, where the networks are topologically more circular and present random-like characteristics. As a consequence, all the physiological phenomena at microcerebral level ruled by periodicity - such as regular perfusion, mean pressure per beat, and average nutrient supply at cellular level - can be strongly compromised, since the AF hemodynamic signals assume irregular behaviour and random-like features. Through a powerful approach which is complementary to the classical statistical tools, the present findings further strengthen the potential link between AF hemodynamic and cognitive decline.

Following the success of Large Language Models (LLMs), expanding their boundaries to new modalities represents a significant paradigm shift in multimodal understanding. Human perception is inherently multimodal, relying not only on text but also on auditory and visual cues for a complete understanding of the world. In recognition of this fact, audio-visual LLMs have recently emerged. Despite promising developments, the lack of dedicated benchmarks poses challenges for understanding and evaluating models. In this work, we show that audio-visual LLMs struggle to discern subtle relationships between audio and visual signals, leading to hallucinations, underscoring the need for reliable benchmarks. To address this, we introduce AVHBench, the first comprehensive benchmark specifically designed to evaluate the perception and comprehension capabilities of audio-visual LLMs. Our benchmark includes tests for assessing hallucinations, as well as the cross-modal matching and reasoning abilities of these models. Our results reveal that most existing audio-visual LLMs struggle with hallucinations caused by cross-interactions between modalities, due to their limited capacity to perceive complex multimodal signals and their relationships. Additionally, we demonstrate that simple training with our AVHBench improves robustness of audio-visual LLMs against hallucinations.

The ability to quickly learn a new task with minimal instruction - known as few-shot learning - is a central aspect of intelligent agents. Classical few-shot benchmarks make use of few-shot samples from a single modality, but such samples may not be sufficient to characterize an entire concept class. In contrast, humans use cross-modal information to learn new concepts efficiently. In this work, we demonstrate that one can indeed build a better {bf visual} dog classifier by {bf read}ing about dogs and {bf listen}ing to them bark. To do so, we exploit the fact that recent multimodal foundation models such as CLIP are inherently cross-modal, mapping different modalities to the same representation space. Specifically, we propose a simple cross-modal adaptation approach that learns from few-shot examples spanning different modalities. By repurposing class names as additional one-shot training samples, we achieve SOTA results with an embarrassingly simple linear classifier for vision-language adaptation. Furthermore, we show that our approach can benefit existing methods such as prefix tuning, adapters, and classifier ensembling. Finally, to explore other modalities beyond vision and language, we construct the first (to our knowledge) audiovisual few-shot benchmark and use cross-modal training to improve the performance of both image and audio classification.

With read-aloud speech synthesis achieving high naturalness scores, there is a growing research interest in synthesising spontaneous speech. However, human spontaneous face-to-face conversation has both spoken and non-verbal aspects (here, co-speech gestures). Only recently has research begun to explore the benefits of jointly synthesising these two modalities in a single system. The previous state of the art used non-probabilistic methods, which fail to capture the variability of human speech and motion, and risk producing oversmoothing artefacts and sub-optimal synthesis quality. We present the first diffusion-based probabilistic model, called Diff-TTSG, that jointly learns to synthesise speech and gestures together. Our method can be trained on small datasets from scratch. Furthermore, we describe a set of careful uni- and multi-modal subjective tests for evaluating integrated speech and gesture synthesis systems, and use them to validate our proposed approach. Please see https://shivammehta25.github.io/Diff-TTSG/ for video examples, data, and code.

The rapid evolution of artificial intelligence, especially in large language models (LLMs), has significantly impacted various domains, including healthcare. In chest X-ray (CXR) analysis, previous studies have employed LLMs, but with limitations: either underutilizing the multi-tasking capabilities of LLMs or lacking clinical accuracy. This paper presents M4CXR, a multi-modal LLM designed to enhance CXR interpretation. The model is trained on a visual instruction-following dataset that integrates various task-specific datasets in a conversational format. As a result, the model supports multiple tasks such as medical report generation (MRG), visual grounding, and visual question answering (VQA). M4CXR achieves state-of-the-art clinical accuracy in MRG by employing a chain-of-thought prompting strategy, in which it identifies findings in CXR images and subsequently generates corresponding reports. The model is adaptable to various MRG scenarios depending on the available inputs, such as single-image, multi-image, and multi-study contexts. In addition to MRG, M4CXR performs visual grounding at a level comparable to specialized models and also demonstrates outstanding performance in VQA. Both quantitative and qualitative assessments reveal M4CXR's versatility in MRG, visual grounding, and VQA, while consistently maintaining clinical accuracy.

Motivated by in-context learning (ICL) capabilities of Large Language models (LLMs), multimodal LLMs with additional visual modality are also exhibited with similar ICL abilities when multiple image-text pairs are provided as demonstrations. However, relatively less work has been done to investigate the principles behind how and why multimodal ICL works. We conduct a systematic and principled evaluation of multimodal ICL for models of different scales on a broad spectrum of new yet critical tasks. Through perturbations over different modality information, we show that modalities matter differently across tasks in multimodal ICL. Considering such modality impact, we further utilize modality-driven demonstration strategies to boost ICL performance. We also identify that demonstration selection is closely related to the models' ability to capture task inductive biases from multimodal ICL. Our principled analysis provides a comprehensive way of understanding the role of demonstrations in multimodal in-context learning, and sheds light on effectively improving multimodal ICL on a wide range of tasks even if those tasks are not seen in or even contradict pretraining data.

While the field of multi-modal learning keeps growing fast, the deficiency of the standard joint training paradigm has become clear through recent studies. They attribute the sub-optimal performance of the jointly trained model to the modality competition phenomenon. Existing works attempt to improve the jointly trained model by modulating the training process. Despite their effectiveness, those methods can only apply to late fusion models. More importantly, the mechanism of the modality competition remains unexplored. In this paper, we first propose an adaptive gradient modulation method that can boost the performance of multi-modal models with various fusion strategies. Extensive experiments show that our method surpasses all existing modulation methods. Furthermore, to have a quantitative understanding of the modality competition and the mechanism behind the effectiveness of our modulation method, we introduce a novel metric to measure the competition strength. This metric is built on the mono-modal concept, a function that is designed to represent the competition-less state of a modality. Through systematic investigation, our results confirm the intuition that the modulation encourages the model to rely on the more informative modality. In addition, we find that the jointly trained model typically has a preferred modality on which the competition is weaker than other modalities. However, this preferred modality need not dominate others. Our code will be available at https://github.com/lihong2303/AGM_ICCV2023.

Knee Osteoarthritis (KOA) is a highly prevalent chronic musculoskeletal condition with no currently available treatment. The manifestation of KOA is heterogeneous and prediction of its progression is challenging. Current literature suggests that the use of multi-modal data and advanced modeling methods, such as the ones based on Deep Learning, has promise in tackling this challenge. To date, however, the evidence on the efficacy of this approach is limited. In this study, we leveraged recent advances in Deep Learning and, using a Transformer approach, developed a unified framework for the multi-modal fusion of knee imaging data. Subsequently, we analyzed its performance across a range of scenarios by investigating multiple progression horizons -- from short-term to long-term. We report our findings using a large cohort (n=2421-3967) derived from the Osteoarthritis Initiative dataset. We show that structural knee MRI allows identifying radiographic KOA progressors on par with multi-modal fusion approaches, achieving an area under the ROC curve (ROC AUC) of 0.70-0.76 and Average Precision (AP) of 0.15-0.54 in 2-8 year horizons. Progression within 1 year was better predicted with a multi-modal method using X-ray, structural, and compositional MR images -- ROC AUC of 0.76(0.04), AP of 0.13(0.04) -- or via clinical data. Our follow-up analysis generally shows that prediction from the imaging data is more accurate for post-traumatic subjects, and we further investigate which subject subgroups may benefit the most. The present study provides novel insights into multi-modal imaging of KOA and brings a unified data-driven framework for studying its progression in an end-to-end manner, providing new tools for the design of more efficient clinical trials. The source code of our framework and the pre-trained models are made publicly available.

Several medical Multimodal Large Languange Models (MLLMs) have been developed to address tasks involving visual images with textual instructions across various medical modalities, achieving impressive results. Most current medical generalist models are region-agnostic, treating the entire image as a holistic representation. However, they struggle to identify which specific regions they are focusing on when generating a sentence. To mimic the behavior of doctors, who typically begin by reviewing the entire image before concentrating on specific regions for a thorough evaluation, we aim to enhance the capability of medical MLLMs in understanding anatomical regions within entire medical scans. To achieve it, we first formulate Region-Centric tasks and construct a large-scale dataset, MedRegInstruct, to incorporate regional information into training. Combining our collected dataset with other medical multimodal corpora for training, we propose a Region-Aware medical MLLM, MedRegA, which is the first bilingual generalist medical AI system to simultaneously handle image-level and region-level medical vision-language tasks across a broad range of modalities. Our MedRegA not only enables three region-centric tasks, but also achieves the best performance for visual question answering, report generation and medical image classification over 8 modalities, showcasing significant versatility. Experiments demonstrate that our model can not only accomplish powerful performance across various medical vision-language tasks in bilingual settings, but also recognize and detect structures in multimodal medical scans, boosting the interpretability and user interactivity of medical MLLMs. Our project page is https://medrega.github.io.

In this paper, we present our solutions for emotion recognition in the sub-challenges of Multimodal Emotion Recognition Challenge (MER2024). To mitigate the modal competition issue between audio and text, we adopt an early fusion strategy based on a large language model, where joint training of audio and text is conducted initially. And the joint Audio-Text modal feature will be late-fused with other unimodal features. In order to solve the problems of data insufficiency and class imbalance, We use multiple turns of multi-model voting for data mining. Moreover, to enhance the quality of audio features, we employ speech source separation to preprocess audios. Our model ranks 2nd in both MER2024-SEMI and MER2024-NOISE, validating our method's effectiveness.

Compared to single view medical image classification, using multiple views can significantly enhance predictive accuracy as it can account for the complementarity of each view while leveraging correlations between views. Existing multi-view approaches typically employ separate convolutional or transformer branches combined with simplistic feature fusion strategies. However, these approaches inadvertently disregard essential cross-view correlations, leading to suboptimal classification performance, and suffer from challenges with limited receptive field (CNNs) or quadratic computational complexity (transformers). Inspired by state space sequence models, we propose XFMamba, a pure Mamba-based cross-fusion architecture to address the challenge of multi-view medical image classification. XFMamba introduces a novel two-stage fusion strategy, facilitating the learning of single-view features and their cross-view disparity. This mechanism captures spatially long-range dependencies in each view while enhancing seamless information transfer between views. Results on three public datasets, MURA, CheXpert and DDSM, illustrate the effectiveness of our approach across diverse multi-view medical image classification tasks, showing that it outperforms existing convolution-based and transformer-based multi-view methods. Code is available at https://github.com/XZheng0427/XFMamba.

Diverse actions give rise to rich audio-visual signals in long videos. Recent works showcase that the two modalities of audio and video exhibit different temporal extents of events and distinct labels. We address the interplay between the two modalities in long videos by explicitly modelling the temporal extents of audio and visual events. We propose the Time Interval Machine (TIM) where a modality-specific time interval poses as a query to a transformer encoder that ingests a long video input. The encoder then attends to the specified interval, as well as the surrounding context in both modalities, in order to recognise the ongoing action. We test TIM on three long audio-visual video datasets: EPIC-KITCHENS, Perception Test, and AVE, reporting state-of-the-art (SOTA) for recognition. On EPIC-KITCHENS, we beat previous SOTA that utilises LLMs and significantly larger pre-training by 2.9% top-1 action recognition accuracy. Additionally, we show that TIM can be adapted for action detection, using dense multi-scale interval queries, outperforming SOTA on EPIC-KITCHENS-100 for most metrics, and showing strong performance on the Perception Test. Our ablations show the critical role of integrating the two modalities and modelling their time intervals in achieving this performance. Code and models at: https://github.com/JacobChalk/TIM

Multimodal foundation models that can holistically process text alongside images, video, audio, and other sensory modalities are increasingly used in a variety of real-world applications. However, it is challenging to characterize and study progress in multimodal foundation models, given the range of possible modeling decisions, tasks, and domains. In this paper, we introduce Holistic Evaluation of Multimodal Models (HEMM) to systematically evaluate the capabilities of multimodal foundation models across a set of 3 dimensions: basic skills, information flow, and real-world use cases. Basic multimodal skills are internal abilities required to solve problems, such as learning interactions across modalities, fine-grained alignment, multi-step reasoning, and the ability to handle external knowledge. Information flow studies how multimodal content changes during a task through querying, translation, editing, and fusion. Use cases span domain-specific challenges introduced in real-world multimedia, affective computing, natural sciences, healthcare, and human-computer interaction applications. Through comprehensive experiments across the 30 tasks in HEMM, we (1) identify key dataset dimensions (e.g., basic skills, information flows, and use cases) that pose challenges to today's models, and (2) distill performance trends regarding how different modeling dimensions (e.g., scale, pre-training data, multimodal alignment, pre-training, and instruction tuning objectives) influence performance. Our conclusions regarding challenging multimodal interactions, use cases, and tasks requiring reasoning and external knowledge, the benefits of data and model scale, and the impacts of instruction tuning yield actionable insights for future work in multimodal foundation models.

We introduce eCLIP, an enhanced version of the CLIP model that integrates expert annotations in the form of radiologist eye-gaze heatmaps. It tackles key challenges in contrastive multi-modal medical imaging analysis, notably data scarcity and the "modality gap" -- a significant disparity between image and text embeddings that diminishes the quality of representations and hampers cross-modal interoperability. eCLIP integrates a heatmap processor and leverages mixup augmentation to efficiently utilize the scarce expert annotations, thus boosting the model's learning effectiveness. eCLIP is designed to be generally applicable to any variant of CLIP without requiring any modifications of the core architecture. Through detailed evaluations across several tasks, including zero-shot inference, linear probing, cross-modal retrieval, and Retrieval Augmented Generation (RAG) of radiology reports using a frozen Large Language Model, eCLIP showcases consistent improvements in embedding quality. The outcomes reveal enhanced alignment and uniformity, affirming eCLIP's capability to harness high-quality annotations for enriched multi-modal analysis in the medical imaging domain.

Clinical machine learning research and AI driven clinical decision support models rely on clinically accurate labels. Manually extracting these labels with the help of clinical specialists is often time-consuming and expensive. This study tests the feasibility of automatic span- and document-level diagnosis extraction from unstructured Dutch echocardiogram reports. We included 115,692 unstructured echocardiogram reports from the UMCU a large university hospital in the Netherlands. A randomly selected subset was manually annotated for the occurrence and severity of eleven commonly described cardiac characteristics. We developed and tested several automatic labelling techniques at both span and document levels, using weighted and macro F1-score, precision, and recall for performance evaluation. We compared the performance of span labelling against document labelling methods, which included both direct document classifiers and indirect document classifiers that rely on span classification results. The SpanCategorizer and MedRoBERTa.nl models outperformed all other span and document classifiers, respectively. The weighted F1-score varied between characteristics, ranging from 0.60 to 0.93 in SpanCategorizer and 0.96 to 0.98 in MedRoBERTa.nl. Direct document classification was superior to indirect document classification using span classifiers. SetFit achieved competitive document classification performance using only 10\% of the training data. Utilizing a reduced label set yielded near-perfect document classification results. We recommend using our published SpanCategorizer and MedRoBERTa.nl models for span- and document-level diagnosis extraction from Dutch echocardiography reports. For settings with limited training data, SetFit may be a promising alternative for document classification.

We introduce OmnixR, an evaluation suite designed to benchmark SoTA Omni-modality Language Models, such as GPT-4o and Gemini. Evaluating OLMs, which integrate multiple modalities such as text, vision, and audio, presents unique challenges. Particularly, the user message might often consist of multiple modalities, such that OLMs have to establish holistic understanding and reasoning across modalities to accomplish the task. Existing benchmarks are limited to single modality or dual-modality tasks, overlooking comprehensive multi-modal assessments of model reasoning. To address this, OmnixR offers two evaluation variants: (1)synthetic subset: a synthetic dataset generated automatically by translating text into multiple modalities--audio, images, video, and hybrids (Omnify). (2)realistic subset: a real-world dataset, manually curated and annotated by experts, for evaluating cross-modal reasoning in natural settings. OmnixR presents a unique evaluation towards assessing OLMs over a diverse mix of modalities, such as a question that involves video, audio, and text, providing a rigorous cross-modal reasoning testbed unlike any existing benchmarks. Our experiments find that all state-of-the-art OLMs struggle with OmnixR questions that require integrating information from multiple modalities to answer. Further analysis highlights differences in reasoning behavior, underscoring the challenges of omni-modal AI alignment.

Objective: Target identification in brain-computer interface (BCI) spellers refers to the electroencephalogram (EEG) classification for predicting the target character that the subject intends to spell. When the visual stimulus of each character is tagged with a distinct frequency, the EEG records steady-state visually evoked potentials (SSVEP) whose spectrum is dominated by the harmonics of the target frequency. In this setting, we address the target identification and propose a novel deep neural network (DNN) architecture. Method: The proposed DNN processes the multi-channel SSVEP with convolutions across the sub-bands of harmonics, channels, time, and classifies at the fully connected layer. We test with two publicly available large scale (the benchmark and BETA) datasets consisting of in total 105 subjects with 40 characters. Our first stage training learns a global model by exploiting the statistical commonalities among all subjects, and the second stage fine tunes to each subject separately by exploiting the individualities. Results: Our DNN achieves impressive information transfer rates (ITRs) on both datasets, 265.23 bits/min and 196.59 bits/min, respectively, with only 0.4 seconds of stimulation. The code is available for reproducibility at https://github.com/osmanberke/Deep-SSVEP-BCI. Conclusion: The presented DNN strongly outperforms the state-of-the-art techniques as our accuracy and ITR rates are the highest ever reported performance results on these datasets. Significance: Due to its unprecedentedly high speller ITRs and flawless applicability to general SSVEP systems, our technique has great potential in various biomedical engineering settings of BCIs such as communication, rehabilitation and control.

The field of Earth Observations (EO) offers a wealth of data from diverse sensors, presenting a great opportunity for advancing self-supervised multimodal learning. However, current multimodal EO datasets and models focus on a single data type, either mono-date images or time series, which limits their expressivity. We introduce OmniSat, a novel architecture that exploits the spatial alignment between multiple EO modalities to learn expressive multimodal representations without labels. To demonstrate the advantages of combining modalities of different natures, we augment two existing datasets with new modalities. As demonstrated on three downstream tasks: forestry, land cover classification, and crop mapping. OmniSat can learn rich representations in an unsupervised manner, leading to improved performance in the semi- and fully-supervised settings, even when only one modality is available for inference. The code and dataset are available at github.com/gastruc/OmniSat.

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