medical device engineers

Abstract: Lightweight representation bridges make pretrained, task-adapted EEG foundation models executable on other biosignal modalities without retraining their backbones. However, selecting a single bridge pathway globally assigns every instance to the same transfer route and ignores complementary errors across routes. We therefore formulate multi-bridge transfer as an instance-level algorithm-selection problem and introduce BridgeRouter, a gain-aware router over a portfolio of frozen cross-modal pathways. A validation-selected Single Best Solver (SBS) serves as a protected default route. During training, task labels are used to compute the reduction in negative log-likelihood provided by each alternative route relative to the SBS, and a lightweight MLP predicts these route-specific gains from a target-modality representation extracted by a frozen encoder. At inference, BridgeRouter observes only the target modality, requires neither EEG, task labels, nor predictions from all candidate routes, and executes exactly one bridge pathway: the route with the largest predicted gain when that gain exceeds a validation-calibrated threshold, and the SBS otherwise. We evaluate seven EEG foundation-model bridge pathways for EMG-based freezing-of-gait detection on FOG and ECG-based sleep classification on ISRUC. Across five seeds, BridgeRouter achieves $81.38\pm1.11\%$ balanced accuracy on FOG, improving over the BIOT SBS by $11.49$ percentage points, and $62.92\pm2.17\%$ on ISRUC, improving over the CBraMod SBS by $3.83$ points. Per-instance bridge oracles reach $99.96\%$ and $78.61\%$, respectively, revealing substantial remaining portfolio headroom. These results show that anchor-relative gain prediction can convert complementary cross-modal bridge behavior into deployable instance-level routing improvements while retaining single-route inference.

Abstract: In micromanipulation, erroneous hand motion limits unaided manipulation accuracy, which can affect task performance and safety in critical applications like microsurgery. Handheld robots (micromanipulators) enable motion accuracy beyond human limits by providing robotic assistance in a low-cost, compact, intuitive form factor. Particularly, active constraints are an effective form of robotic assistance, which aids the operator by restricting the robot's permissible motion based on task-specific requirements or objectives, thereby providing task guidance and enforcing safety. However, existing formulations of active constraints for handheld systems are limited, most notably because of the inability to provide guidance and enforce safety simultaneously. Implementing active constraints with optimization-based methods can address these limitations, but existing implementations are designed for free-standing robots, and neglect that handheld robots actuate relative to the operator's hand with a limited workspace. In this work, we propose an optimization-based active constraint framework for handheld micromanipulation that enables simultaneous guidance and safety enforcement. The formulation was implemented in a handheld robot and demonstrated on a medically relevant artificial task. Results show that the proposed formulation reduced safety violation rate by more than two orders of magnitude relative to baselines, while recovering the threefold accuracy loss from enforcing safety alone.

Abstract: In medical robotics, data-driven soft-tissue shape control requires deforming tissue toward desired morphologies through sequential physical interactions. This challenge is particularly important in microscale manipulation, where localized deformation is difficult to observe, represent, and control, while physics-based models can be computationally expensive and difficult to adapt to realistic environments. Optical coherence tomography (OCT) provides high-resolution volumetric perception of tissue deformation, but target-conditioned control requires effective representations of both observed and desired tissue states. In this work, we introduce an OCT-guided data-driven framework for tissue shape control, learned from user-guided demonstrations and executed with closed-loop OCT feedback. We study full-volume, tissue-masked sparse-volume, and voxelized point-cloud representations, with or without residual conditioning, using deterministic (Explicit) and generative diffusion (Diffusion) policies. Across 12 configurations and 576 phantom rollouts on 3-DoF depth and 6-DoF directional tasks, OCT-derived 3D representations support both Explicit and Diffusion policies, with performance depending on representation and residual conditioning. Residual conditioning reduces directional Shape RMSE from 0.748 to 0.555 mm for full-volume Diffusion, while voxelized point-cloud Explicit with residuals achieves 0.534 mm for depth and 0.443 mm for directional control, with comparable accuracy at intermediate unseen targets and consistent performance across deployments. We further evaluate the framework in 60 ex vivo porcine rollouts, extending to biological tissue with final geometric errors comparable to human demonstrations. These results establish volumetric OCT as current and goal representations for learned closed-loop tissue shape control across deterministic and generative action models.

Abstract: Automated respiratory sound classification (RSC) aims to identify normal and adventitious respiratory sounds, such as crackles and wheezes. Most existing methods formulate RSC as a flat four-class classification problem over norma, crackle, wheeze and both. However, unlike conventional classification tasks with semantically independent and mutually exclusive categories, the commonly used four-class RSC labels have a compositional structure and can be represented by two clinically meaningful sound attributes: crackle presence and wheeze presence. Existing flat classifiers do not explicitly exploit this structure, which may increase the learning burden by treating the four labels as independent targets. Meanwhile, crackles and wheezes exhibit distinct temporal characteristics, with sparse transient crackle events and sustained continuous wheeze patterns, making a single temporal aggregation strategy less suitable for modeling different adventitious sound evidence. To address these limitations, we propose an Acoustic-Aware Asymmetric Framework (AAAF) for RSC. AAAF reformulates four-class recognition as two sound-attribute detection tasks and recovers the final category through logical composition during inference. Built upon a pretrained BEATs encoder, AAAF employs branch-specific multi-layer fusion and asymmetric temporal aggregation to capture localized crackle evidence and sustained wheeze patterns. Auxiliary normal--abnormal supervision and a batch-adaptive dynamic loss are further introduced to improve global discrimination and robustness under imbalanced labels. Experiments on ICBHI and SPRSound demonstrate that AAAF improves overall RSC performance and generalizes across datasets, achieving a state-of-the-art four-class Score of 65.30% on ICBHI.

Abstract: In settings such as online recommendation platforms, medical decision-making with interim summaries, and stochastic control with static plants, the underlying system is often static so that the next state depends only on the most recent action. Moreover, the true system state is high-dimensional and cannot be observed directly, so actions must be selected based on information received through a rate-limited communication link, which constrains the control performance. This leads to a fundamental rate-cost tradeoff$\unicode{x2014}$the minimum communication rate required to achieve a prescribed average control cost. We study this tradeoff for a class of static systems we term static time-invariant control (STIC) systems, namely, control systems in which the next state depends on the history only through the most recent control action via a time-invariant kernel. For general control systems$\unicode{x2014}$not necessarily static or time-invariant$\unicode{x2014}$our prior work characterized this tradeoff through the limit of a sequence of directed-information minimization problems. However, the dimension of these problems grows with the time horizon, making the limiting formulation computationally intractable. In the present paper, we show for STIC systems that this growing-size formulation admits a single-letter characterization. This identifies STIC systems as the control-side counterpart of Noisy Output is the STate (NOST) channels$\unicode{x2014}$one of the few channel models whose feedback capacity admits a single-letter characterization. This yields, to our knowledge, the first constant-size convex characterization of the rate$\unicode{x2013}$cost tradeoff beyond linear quadratic Gaussian (LQG) control.

Abstract: In endovascular interventions, physicians rely on planar DSA and X-ray fluoroscopy to interpret vessel anatomy and device motion, yet converting these images into feedback for autonomous navigation remains difficult. A perception and control method is formulated for two-dimensional image feedback. Vessel masks are converted into a labeled centerline graph, and device-tip estimates are projected onto a planned path to obtain progress, deviation, and direction. A rule-based controller uses these quantities for delivery, branch selection, probing, rollback, and recovery. The method was evaluated on a physical dual-device robotic platform in 65 closed-loop runs using simulator-rendered planar images across three paths. All runs reached at least 0.95 maximum observed guidewire progress; two runs (3.1%) met the prespecified failure rule of three or more autonomous stop events. The results establish route-level performance on the tested platform; clinical image sequences and broader anatomy remain to be evaluated.

Abstract: Nuclear magnetic resonance (NMR) magnetic tracking offers a promising alternative to magnetic resonance imaging (MRI)-based localization for medical robotic guidance. However, scalar field measurements and field-aligned marker moments constrain position and orientation tracking, requiring careful configuration design. We present a unified information-based framework that uses local covariance analysis to evaluate receiver geometry, marker separation, and external source configuration in on/off-board NMR tracking. Numerical evaluation shows that planar-array precision depends jointly on receiver count and geometry, with triangular lattice arrays achieving the lowest best-case position uncertainty among the evaluated layouts for 9--20 receivers. Two spatially separated, field-aligned markers enable device-axis tracking, with predicted angular uncertainty below $2^\circ$ at the evaluated workspace center for suitable marker separations. We further establish point-dipole source--receiver duality, unifying the analysis of on/off-board NMR tracking. These

Abstract: Electroencephalography (EEG) representation learning is challenged by noisy signals, inter-subject variability, and heterogeneous electrode montages in different datasets and recording settings. Recent self-supervised EEG pretraining methods improve transferability by converting heterogeneous recordings into unified token or sequence representations, but channel-aware designs may still encode montage- or dataset-specific regularities. We propose HyBRA, a self-supervised framework based on hyperbolic global-local brain-region aggregation. HyBRA maps heterogeneous channel observations into a fixed regional token space by combining electrode coordinates, region priors, and feature-dependent hyperbolic distances. A channel-evidence injection branch preserves fine-grained discriminative cues during aggregation. The resulting tokens are processed by a Region-Time Transformer and pretrained with masked reconstruction of latent features and region-level signals. HyBRA outperforms the compared methods in average balanced accuracy on six benchmark datasets. Under a controlled six-fold evaluation on OpenBMI-MI, HyBRA matches CSBrain in balanced accuracy, improves AUROC by 1.84 percentage points and AUPRC by 5.23 percentage points, and uses 96.8\% fewer parameters. Matched comparisons on TUAB and TUEV show higher balanced accuracy for hyperbolic matching than for Euclidean distance or cosine similarity.

Abstract: Deep learning is now central to radiology, helping detect changes on X-rays, CTs, and MRIs. However, these systems are highly vulnerable to adversarial attacks - small, crafted perturbations that mislead models while appearing unchanged to humans. Such errors risk missed cancers or false positives. Studies show over 90% attack success on medical scans. Almost 30% of US hospitals use AI in imaging in 2023. Thus, an effective method of detecting such attacks and their directionality is crucial to ensure the credibility and reliability of medical systems based on DNNs. We propose a novel detection framework that leverages subsequent attacks using random noise to identify adversarial perturbations. Our approach uses the analysis of variations in the Sigmoid function to distinguish genuine medical images from adversarially manipulated ones. Specifically, we compare prediction differences between clean and attacked images, as well as between different adversarially altered versions, to improve detection accuracy. We evaluated our method on three popular medical datasets including 'Chest X-Ray Images for Classification', 'Retinal Fundus Multi-disease Image Dataset' and 'Brain Tumor Dataset' under various attack scenarios, including random noise. Our framework achieved up to 99.8% ACC in identifying adversarial directional attacks, significantly outperforming existing defense mechanisms. It consistently identified adversarial samples across varying attack strengths while keeping false positives low, showing strong reliability and potential for clinical use. Furthermore, our proposal highlights its potential for real-world deployment.

Abstract: Brain tumor classification from MRI scans represents a critical challenge in medical imaging, where accuracy directly impacts patient outcomes. This paper introduces GaborFlow, a novel hardware-software co-optimization framework that revolutionizes the design of the Gabor Filter accelerator for generating feature maps to enhance brain tumor detection. Unlike conventional approaches that rely on fixed filter parameters, our method employs trainable Gabor coefficients within a carefully optimized range, integrated with an EfficientNet-B0 backbone CNN architecture. The innovation lies in the synergistic combination of software optimization through Bayesian hyperparameter tuning and hardware efficiency through precision-optimized multipliers. Our GF baseline accelerator achieves remarkable results, with 98.6% classification accuracy, 28.08% power benefits, and 48.83% footprint savings compared to state-of-the-art implementations, demonstrating that medical AI can be both highly accurate and energy-efficient. The hardware design files are made freely available for easy adoption and further usage by the researchers and designers.

Abstract: Secure transmission of electrocardiogram (ECG) signals remains a major challenge in telecardiology. While traditional mathematical watermarking can embed patient metadata directly into ECG signals, it is highly fragile against temporal desynchronization such as circular phase shifts. In contrast, existing deep watermarking approaches for temporal signals, such as audio, typically rely on lossy quantization, which compromises the high-frequency micro-morphological details critical for clinical diagnosis. To bridge this gap, we propose ECGWmark, a fully convolutional and quantization-free deep watermarking framework for medical time-series. ECGWmark operates in a continuous, full-resolution latent space and utilizes a localized frame-level mechanism to improve the robustness to severe desynchronization. Crucially, we introduce a differentiable Physiological Loss guided by a clinical classifier to preserve diagnostic semantics. Experiments on the benchmark MIT-BIH database show that ECGWmark maintains channel-bit extraction accuracy above 90% under the evaluated circular temporal shifts. Furthermore, under a rigorous inter-patient diagnostic evaluation, Class-V sensitivity changes from 71.97% to 76.50%, whereas Macro-F1 changes from 35.25% to 34.71% and Class-S sensitivity from 8.89% to 1.39%; these results indicate mixed class-level effects.

Abstract: Predicting how a patient's vital signs respond to an intervention is a central question in intensive care. World models can do so by learning dynamics as a function of prior actions. However, such models tend to be brittle outside of training data. Clinicians choose drug dosages based on the patient's state, so the association a model learns between dose and outcome runs opposite to the drug's effect, generalizing poorly to out-of-distribution (OOD) dosing practices. Yet, pharmacological information provides the directional effects of different drugs, which are invariant to OOD shifts. To resolve the OOD sensitivity of current ICU world models, we introduce PHYSIO WORLD, which isolates an intervention's effect by evaluating a forward pass twice: once under recorded doses, and once with those doses set to zero. The difference is projected onto pharmacologically admissible effect directions stated by 70 rules over 28 drugs, leaving the magnitude to be learned from data. Across five distribution-shift parameters over cohorts from three intensive-care databases, and against forecasters, counterfactual models, and invariance objectives, PHYSIO WORLD attains the lowest OOD RMSE in every setting, improving on the strongest external baseline by 8-12%, while matching the in-distribution error of its backbone. Reversing the pharmacological directions degrades accuracy below the backbone, and data-mined directions recover almost no gain, indicating the improvement derives from the content of the pharmacological knowledge. The construction may extend to other settings where the sign of an effect is known in advance and its magnitude is confounded by treatment assignment.

Abstract: Brain signal decoding is challenging because neural recordings are noisy and vary across individuals, while labeled data are often limited. Recent attention-based models on the symmetric positive definite (SPD) manifold have nevertheless achieved strong performance using covariance and connectivity representations, yet the contribution of learned token weighting remains unclear. We examine two representative architectures, MAtt (based on log-Euclidean geometry) and GBWAtt (based on generalized Bures--Wasserstein geometry), and find that their learned attention weights remain close to uniform after training. We relate this behavior to bounded similarity parameterizations that, under the original softmax scaling, limit attention-weight contrast. Moreover, replacing learned weights with uniform weights, throughout training and evaluation, has little effect on mean predictive performance while preserving each model's original aggregation geometry. Motivated by these findings, we introduce SPD-MetaFormer, an attention-free architecture built on uniformly weighted Fréchet aggregation under log-Euclidean geometry. Its backbone uses a geodesic residual to update a summary token and a shared spectral feedforward map to transform all tokens, followed by a learned weighted readout. Token states remain SPD-valued until tangent-space classification. Across three EEG benchmarks, SPD-MetaFormer achieves competitive results relative to published Euclidean and manifold baselines. Separate matched reproductions test learned versus uniform weighting within MAtt and GBWAtt. These results suggest that, in the short-sequence and limited-data regimes studied, carefully designed SPD architectures can provide a simpler and effective alternative to adaptive manifold attention.

Abstract: Robotic minimally invasive surgery has revolutionized surgical practice. However, as the surgeons are mechanically separated from the surgical tools, loss of tactile feedback occurs. We present a compact force sensor with three, millimeter scale sensing elements (taxels) that can be affixed to the grasping face of a robotic surgical tool. The sensor features a miniaturized design using Hall effect sensors and magnets embedded in a deformable elastomer contact layer. Sensor calibration is achieved with a 6 degree of freedom (DoF) parallel robot. Each taxel can detect applied normal and shear forces with average RMSE of 2.133 kPa. The calibrated sensor was validated on phantom and ex vivo porcine tissue, demonstrating tactile sensing during retraction as well as slip. This work introduces a small-scale Hall effect based tactile sensor, enabling sensing for force-sensitive robotic surgical applications.

Abstract: Biventricular repair is favored for children with complex double-outlet right ventricle (DORV) to eliminate the long-term morbidity of single ventricle physiology. However, creating a baffle that maintains adequate cross-sectional area while limiting incursion on the tricuspid valve apparatus is challenging in a distorted, arrested heart. Three-dimensional (3D) models have aided baffle design with anatomic visualization but analytic approaches, including computational fluid dynamic (CFD) simulation support, have not yet been incorporated into clinical workflows. We present the preoperative, prospective construction of a DORV repair baffle guided by a semi-automated area-preserving algorithm and CFD analysis.

Abstract: Bluetooth Low Energy (BLE) pairing establishes the cryptographic foundation for secure device communication. However, mainstream man-in-the-middle (MITM)-resistant pairing methods, such as Numeric Comparison and Passkey Entry, require user interfaces that implantable medical devices (IMDs) inherently lack, making Near-Field Communication (NFC)-assisted Out-of-Band (OOB) pairing an attractive alternative. Existing NFC-assisted OOB schemes authenticate a classical BLE key exchange that remains vulnerable to quantum attacks, while the NFC channel itself is susceptible to eavesdropping and active injection under stronger threat models. To address these limitations, we propose a lightweight, plug-and-play NFC-based OOB pairing protocol that performs a post-quantum key encapsulation mechanism (KEM) entirely over the NFC channel, ensuring that no shared secret is transmitted over NFC while reducing long-range radio-frequency (RF) exposure during pairing. The proposed protocol requires no modifications to the BLE stack and inherently resists RF battery-depletion attacks. Evaluation on an IMD-class proof-of-concept testbed demonstrates that post-quantum OOB pairing is practical on resource-constrained devices, reducing projected battery life by less than 0.57\% for Kyber-1024 and 0.56\% for FireSABER under an operational usage model relative to the MITM-vulnerable Just Works method.

Abstract: Electrophysiological source imaging (ESI) aims to estimate cortical source activity from noninvasive electrophysiological measurements such as electroencephalogram (EEG). However, ESI is fundamentally ill-posed because source activity is substantially higher-dimensional than sensor observations, resulting in non-unique solutions. Recent learning-based approaches address this ambiguity by learning data-driven source priors, yet they often struggle to generalize across subject-specific cortical geometries. To address this, we propose CANDLE, a learning-based ESI model that estimates source activity on subject-specific cortical geometries. CANDLE learns a prior over the null space induced by the source-to-sensor mapping derived from T1-weighted MRI, restricting learning to unobservable source components while preserving geometric constraints. To train CANDLE, we develop a whole-brain simulator spanning over 1,100 subject-specific cortical geometries with source configurations derived from over 26,000 statistical brain maps. Trained exclusively on simulated data, CANDLE outperformed prior ESI methods on simulated source activity estimation and generalized to two empirical tasks: (i) intracranial stimulation localization from simultaneously recorded scalp EEG and (ii) epileptogenic zone estimation from presurgical interictal EEG. Our project page is available at https://candle-esi.pages.dev}{https://candle-esi.pages.dev.

Abstract: Wearable and bedside electrocardiogram (ECG) monitors must adapt to patient-specific morphology to maintain arrhythmia detection accuracy across users, yet personalization is typically performed offline and cannot account for individual physiology, electrode placement, or recording drift. On-device adaptation by backpropagation is expensive for microcontroller-class medical devices because it requires an optimizer state, repeated backward passes through convolutional layers, and labeled arrhythmic beats that may not be available at deployment time. This letter proposes prototype-only head adaptation as a compact personalization primitive for TinyML ECG systems. A one-dimensional convolutional neural network (1-D CNN; 1,314 parameters and 72.6k multiply-accumulate operations per beat) is trained offline on the MIT-BIH Arrhythmia Database under an inter-patient protocol, frozen as a feature extractor, and exported to a PSoC 6 microcontroller. Patient-specific adaptation then reduces to computing closed-form class means in a 32-dimensional embedding space, requiring no convolutional backward pass, no iterative optimization, and only one forward pass per support beat. Prototype adaptation improves inter-patient macro-F1 from 0.635/0.639/0.646 to 0.731/0.771/0.797 at 1/5/10-shot, outperforming linear stochastic-gradient-descent (SGD) head fine-tuning at every shot count for the target tiny backbone. On-device replay over 18 one-shot episodes on a PSoC 6 Cortex-M4F matches the host macro-F1 for the prototype head (0.798), with 11.39 ms per beat, 5.2 KB flash, and 22.2 KB SRAM. A restricted variant that updates only the normal-class prototype from passively buffered sinus beats yields a consistent +0.05 macro-F1 gain, reducing the annotation burden during initial

Abstract: Ultrasound visual servoing is essential for autonomous robotic ultrasound, yet 6-DoF probe control from 2D B-mode images remains challenging due to limited and ambiguous out-of-plane motion cues. Existing methods typically rely on anatomical priors or handcrafted visual features, limiting their generalizability across imaging targets. Inspired by trackerless 3D ultrasound reconstruction, we propose Recon2Servo, a visual servoing framework that learns image-to-motion inference directly from B-mode images for 6-DoF probe control. A DINOv3 encoder with low-rank adaptation and a bidirectional relation module estimate the relative probe pose between current and target images to guide iterative closed-loop target-view alignment. The framework combines supervised relative-pose learning, reconstruction-guided closed-loop adaptation, and bounded residual pose correction to improve motion inference during servoing. Evaluations on a public dataset and an in-house dataset collected from 12 healthy volunteers using different ultrasound systems demonstrate its effectiveness in reconstructed-volume servoing. Additional real-robot demonstrations of target-view alignment and dynamic tracking on a human forearm are provided in the supplementary video: https://youtu.be/qwsOdI-GMYk.

Abstract: Robotic ultrasound couples a high-rate contact-force loop with slower, delayed image feedback, so image-guided ultrasound probe rotation can perturb contact force before the resulting image response is observed. We derive a closed-form orientation-rate limit that bounds the modeled rotation-induced estimated-force excursion over a finite horizon while accounting for disturbance rejection by the fast force loop. The limit depends on local contact stiffness, force-loop gains, a conservative rotation-to-force gain bound, the excursion budget, and the prediction horizon. We implement this model in a dual-rate controller with timestamp-based delay reconstruction and joint-torque-based force estimation, and evaluate it on a curved gelatin phantom using paired controller comparisons and component ablations. Relative to unconstrained image guidance, the proposed rate-limited controller reduced first-second root-mean-square (RMS) estimated-force error by 0.40 N while increasing cue-convergence time by 0.94 s. A fixed rate cap near the analytically predicted ceiling produced no resolvable difference in force error and converged 0.32 s faster, indicating that the principal practical value of the model is the rate-design rule rather than online prediction. Delay reconstruction had no resolvable effect at the tested latency. A single-subject popliteal scan demonstrated feasibility, although the image cue was noise-limited on heterogeneous tissue.

Abstract: Millimeter-wave (mmWave) radar enables unobtrusive, contactless electrocardiogram (ECG) reconstruction for cardiac monitoring. Time-frequency spectrograms preserve fine cardiac patterns but often require large backbones to separate ECG-relevant features from respiration, motion, multipath, and subject-dependent interference. We propose Kapture, a parameter-efficient Koopman-governed framework that projects radar hidden states into a low-dimensional observable space and identifies a regularized full linear evolution operator from adjacent observable states. The Koopman-predicted observables refine subsequent hidden states for ECG reconstruction. To suppress predictable interference dynamics, a temporal contrastive objective pulls neighboring states together and separates non-neighbors, while reconstruction supervision preserves task relevance. Using approximately 80 minutes of quasi-static radar-ECG recordings containing realistic noise from body movements and other sources, Kapture consistently improves reconstruction across matched backbone widths, with the largest gains under aggressive compression. The compact configuration approaches the full-width reference accuracy with 68.1% fewer parameters and 91.3% fewer profiler-covered floating-point operations (FLOPs), while the full-width configuration delivers the strongest overall reconstruction performance. Our code will be made publicly available after potential publication.

Abstract: IoMT communication systems should provide origin authentication and ensure integrity protection for the messages produced by patients' devices for transmission to gateways and further processing by other hospital services. With regard to IoMT, this paper discusses tampering, impersonation, and replay attacks on messages provided as medical reports. Long-term security of the communication system is also addressed considering potential quantum attacks. For this purpose, we design a protocol that meets requirements of practical implementation and employs an ISIS like lattice-based construction combined with concepts of the blockchain technology. Patients' devices generate a canonical JSON format medical report containing a timestamp and critical information. Using a nonce, the patients create a cryptographic signature of the message with a challenge generated from hash of a message. The gateway verifies signatures utilizing the public key of a trusted ledger associated with a particular patient and ensures freshness of the transmitted message. To optimize the performance in case when many devices interact with a gateway at once, the gateway performs batch signature validation using vectorized modular linear equations. The trusted ledger uses tamper-resistant REGISTER and TRUST UPDATE entries, maintaining a trust score of each registered patient and updating the value after each ACCEPT/REJECT operation. Our prototype application demonstrates registration procedure of a new patient, signing and verifying medical reports, auditing of the ledger, and performance assessment. Based on our experiments in the prototype, we argue that, when applied to large-scale systems, batch verification is superior to simple signature validation approach.

Abstract: Powered neck exoskeletons are developed to restore head-neck motions for those with neck muscle weakness. Current methods using hand-held input devices to control these robotic systems are unintuitive or non-viable for these populations. Alternatively, the eyes coordinate with the head to accomplish many daily tasks. Therefore, movements of the eyes can be a useful signal to control the neck exoskeletons without needing to use the hands. However, previous control models lack biobehavioral basis as well as means to personalize the control behavior, causing unnatural head-neck movements. This paper presents a novel eye-tracking controller design leveraging the vestibulo-ocular reflex to emulate natural eyehead coordination. Personalization tools were also designed, consisting of sliders to allow users to adjust the parameters of this controller. Here, we present the technical design and validation of this system in human users. Compared to the previous eye-tracking model, the new controller provides natural head motions personalized to the user through more natural velocity profiles and a 24 percent average increase of accurate motion intent detection. This system provides a powerful platform for studying eye-tracking controllers in the context of personalization and preference, and ultimately restoring the lost head-neck mobility in patient populations.

Abstract: Endovascular brain-computer interfaces (BCIs) avoid craniotomy but require precise device delivery through anatomically variable cerebral veins. This work presents the first demonstration of in vitro autonomous robotic navigation for endovascular BCI access in the cerebral venous system. Soft Actor-Critic controllers were trained in silico for two sequential tasks spanning the right internal jugular vein to the superior sagittal sinus, using geometric augmentation of one training anatomy. Navigation was evaluated in a training anatomy and an anatomically unseen hold-out model over 250 in silico episodes and five fluoroscopy-guided in vitro robotic runs per task-anatomy condition, comprising 1,000 simulated episodes and 20 physical runs overall. Task recurrent predictors were also evaluated for online identification of impending navigation failure. In silico success rates for Tasks A and B were 85.6% and 98.4% in the training anatomy and 42.0% and 91.6% in the hold-out anatomy, respectively. Fourteen of 20 physical runs were successful (70% overall), including 80% success for Task B in the hold-out phantom. In silico the predictors detected 99.3-100.0% of failures with false-alarm rates of 0.8-6.7%. During in vitro evaluation, predicted risk increased before failed episodes, but elevated probabilities during some successful runs showed reduced calibration after transfer. These results demonstrate the feasibility of autonomous cerebral venous access and show how online failure prediction could support human oversight, while also identifying anatomical generalization and sim-to-real calibration as priorities before preclinical translation.

Abstract: Federated learning (FL) enables collaborative training of medical image segmentation models without sharing raw patient data, yet existing approaches assume a homogeneous compute budget across institutions, limiting participation of low-resource sites. We propose Fed-ADApt, a depth-adaptive federated framework for UNet-based segmentation that jointly addresses low-compute training and inference. Fed-ADApt integrates multi-depth supervision with hierarchical depth-wise aggregation, allowing each site to train according to its local compute budget while contributing to a global model that supports dynamic depth selection at deployment. We evaluated Fed-ADApt on multi-site 2D retinal fundus disc segmentation and 3D brain tumor segmentation. Across both tasks, federated collaboration substantially improves robustness under domain shift. Fed-ADApt matched the full-resource FedAvg performance in 3D and achieved competitive 2D performance with a 4.7% average Dice reduction, while reducing average inference cost by 19.5% in 3D and 34.5% in 2D and substantially reducing training cost by 98% at the most constrained sites. Importantly, Fed-ADApt enables low-resource institutions that cannot train full-capacity models to participate in federations while maintaining competitive global performance under a favorable accuracy to efficiency trade-off. By considering training and inference compute budgets, Fed-ADApt provides a practical and equitable solution for federated medical image segmentation across heterogeneous clinical and edge-enabled imaging environments.

Abstract: Wearable ultrasound enables continuous deep-tissue monitoring, and a single programmable probe can operate in multiple complementary modes, such as structural A-mode and Doppler flow measurement. However, each operating mode requires dedicated measurement parameters and peripheral states, with no single configuration serving all modes on resource-constrained devices. Time multiplexing of operating modes introduces reconfiguration latency that lowers the effective mode repetition rate. To address this limitation, we present an open-source, transition-aware control stack for low-latency, in-session reconfiguration of the 32-channel TinyProbe wearable platform. Operating modes are described as hardware configurations, and host-side shadow registers track the peripheral states, enabling transition-specific register updates. Transition sequences are executed either by the host (over Wi-Fi 6) or by a firmware loop on the probe MCU. We validate the stack on a pulsatile-flow phantom by interleaving blocks of 25 to 100 pulsed-wave Doppler shots at 1.43 kHz PRF with single 16-channel A-mode acquisitions, changing channel configurations at every transition. Compared to full reconfiguration, the overhead per transition decreases from 30.2 ms to 11.6 ms (host-scheduled) and 3.1 ms (MCU-scheduled). For 75-shot Doppler blocks, the multi-mode repetition rate reaches 16.0 Hz (MCU-scheduled), 90.1% of the theoretical maximum of 17.7 Hz. Concurrent reconstruction of a Doppler spectrogram and a lumen-diameter trace demonstrates the functionality of time-multiplexed flow and structural monitoring.

Abstract: Electroencephalography (EEG) foundation models are often pretrained with a fixed channel vocabulary or a limited set of montages, making transfer difficult when electrode layouts change. We propose CortexBridge, a lightweight adapter that combines EEG features with electrode and atlas coordinates to map arbitrary montages into a shared cortical latent space. Evaluated with three frozen foundation models on five brain-computer interface (BCI) datasets from the Mother of All BCI Benchmarks (MOABB), CortexBridge improves performance in 13 of 15 evaluations. The gains in balanced accuracy average 0.80% for EEGPT, 0.70% for LaBraM, and 3.26% for CBraMod, with a maximum gain of 13.02% on 12-class steady-state visual evoked potential (SSVEP) classification. Visualizations of the learned atlas representations reveal task-dependent spatial patterns, with SSVEP showing a more concentrated representation in the Yeo Visual network than auditory P300. These results establish cortical alignment as a learnable and anatomically grounded routing mechanism from heterogeneous EEG montages to pretrained foundation models.

Abstract: Physiological recordings often contain nonstationary oscillatory components whose number and dynamics vary across signals. Amplitude- and frequency-modulated (AM-FM) representations are well suited to characterizing such dynamics and have shown broad utility in biomedical signal analysis. Recent approaches have incorporated neural networks to learn mode decomposition patterns from data, but component cardinality is often predefined or determined through separate stopping or selection mechanisms. We propose a permutation-invariant neural framework for variable-cardinality AM-FM mode decomposition (PI-AMFM). PI-AMFM combines a multiscale temporal encoder, Mamba backbone, and component-presence estimation, with permutation-invariant Hungarian matching during training. On synthetic AM-FM signals, PI-AMFM achieved lower decomposition, instantaneous-frequency, reconstruction, and mode-count errors than the compared methods while preserving the overall trajectory pattern in a crossing-chirp example. On photoplethysmographic recordings, recovered modes captured cardiac and respiratory dynamics despite training only on synthetic signals. These results support the feasibility of PI-AMFM for variable-cardinality decomposition of nonstationary biomedical signals.

Abstract: Continuum robots are well suited for gentle manipulation because of their inherent compliance and ability to adapt to complex environments. However, their continuously deformable structure makes accurate configuration estimation challenging, particularly when external vision systems are unavailable or obstructed. In this work, we present an embedded pose sensing framework that combines inertial measurement units (IMUs) and active magnetic fields to estimate the robot configuration without relying on external cameras. The angular measurements from the IMU and magnetic-field references are fused to improve local orientation estimation and reduce accumulated orientation error during operation. This pose sensing scheme achieves an update rate of 16.7~Hz, allowing real-time feedback. The proposed system is experimentally validated through closed-loop control, where the estimated robot configuration is used to maintain the end-effector at a desired position while interacting with an object. These results demonstrate the potential of distributed magnetic--inertial sensing for real-time pose estimation and closed-loop control of continuum robots.

Abstract: Deep Support Vector Data Description (Deep SVDD) has become a prominent framework for unsupervised anomaly detection by learning latent representations that compactly characterize normal data around a center. Despite its empirical success, anomaly decisions produced by Deep SVDD are typically made solely based on anomaly scores without rigorous statistical guarantees, thereby limiting their reliability in safety-critical and high-stakes applications where false positives must be strictly controlled. In this paper, we propose PADI (Post-Anomaly Detection Inference), a novel framework that equips a trained and frozen Deep SVDD detector with statistically valid inference by leveraging the Selective Inference framework. Specifically, PADI performs inference conditional on the event that a test instance is identified as anomalous by Deep SVDD, thereby enabling rigorous statistical assessment of anomaly decisions. Based on this formulation, we derive valid selective p-values that quantify the statistical significance of the detected anomaly. Using these p-values, we theoretically establish control of the false positive rate (FPR) at a user-specified significance level $α$ (e.g., $α=0.05$). Furthermore, we extend the proposed framework to Deep Semi-Supervised Anomaly Detection (Deep SAD), providing a principled approach for statistically reliable inference in semi-supervised anomaly detection settings. Extensive experiments on both synthetic and real-world benchmark datasets robustly support the theoretical findings. The results demonstrate that PADI consistently achieves proper FPR control while attaining superior true positive rates compared with existing approaches.

Abstract: Percutaneous iliosacral screw fixation is an important minimally invasive treatment for unstable pelvic fractures. Because the sacroiliac region has complex anatomy and narrow screw corridors, the accuracy and safety of screw placement directly affect surgical outcomes. Accurate and reliable preoperative screw planning is therefore essential to improve surgical success and reduce intraoperative risks. Conventional preoperative planning typically requires surgeons to determine screw trajectories through manual measurements, a labor-intensive process that depends on subjective clinical experience. To address these challenges, we propose a fully automated pipeline for preoperative iliosacral screw planning in patients with pelvic fractures. Using patient-specific three-dimensional anatomy, the pipeline automatically identifies safe screw corridors and generates individualized insertion trajectories to support clinical preoperative planning. We evaluated the proposed pipeline on 200 clinical cases of pelvic fractures. Compared with conventional manual measurements, the safety margin of the safe insertion corridors increased by 2% across the four screw types, the mean planning time decreased by more than 90%, and the clinical acceptance rate reached 95%.

Abstract: Functional Kolmogorov-Arnold Networks (FunKAN) achieve state-of-the-art accuracy on MRI Gibbs artifact removal and anatomical segmentation, but their 11.6 M parameters and 8.7 GFLOPs are too large for edge medical devices. We present FunKANLite, a two-stage, hardware-aware compression of FunKAN for point-of-care use. FunKANLite-TR reduces the spatial prior and replaces the ResBlock offset predictor with a depthwise-separable block. It has 1.9x fewer parameters than FunKAN and no loss in accuracy. We then distill FunKANLite-TR into FunKANLite-ST, which lowers the Hermite basis rank, factorizes the spatial prior into a low-rank form, and halves the filter widths. FunKANLite-ST has 5.6x fewer parameters and 3.7x fewer GFLOPs than FunKAN. It stays within 1.4 percentage points IoU of FunKAN on BUSI, GlaS, and CVC-ClinicDB, and reaches 33.95 dB PSNR on IXI. On an NVIDIA Jetson Orin Nano and a Raspberry Pi 5, FunKANLite-ST reduces energy per inference by up to 68% and raises throughput by 2.9x.

Abstract: Clinicians and neuroscientists have long analyzed intracranial electroencephalography (iEEG) through directly measurable physiological characteristics, which carry much of the information that downstream tasks depend on. Recent iEEG foundation models learn by reconstructing or predicting their inputs, which leaves the retention of these characteristics implicit. They are also evaluated mainly on cognitive decoding and a narrow clinical task, i.e., seizure detection. On a broad, clinically relevant benchmark such as Omni-iEEG, they remain below task-specific models when used frozen. We introduce PHASE, a physiology-guided foundation model that makes these characteristics explicit learning targets, pairing them with masked latent prediction in a temporal stage (PHASE-T) within each channel and a spatiotemporal stage (PHASE-ST) across synchronized channels. PHASE is pretrained on heterogeneous recordings from 222 participants at nine clinical sites. On all five Omni-iEEG clinical tasks, frozen PHASE-T outperforms every evaluated foundation model by up to 31\%, and fine-tuned PHASE-T surpasses the task-specific models, setting a new state of the art. PHASE-T benefits from physiological supervision, outperforming variants trained with latent prediction alone or auxiliary waveform reconstruction on every task in matched ablations. PHASE-T generalizes to unseen institutions, outperforming the compared models with few or no local labels. PHASE-ST further improves seizure-onset-zone identification over PHASE-T and, when frozen, decodes sound volume and pitch on BrainTreebank better than published models. Beyond task performance, PHASE learns to encapsulate the physiological characteristics clinicians recognize, from seizure onset and its propagation to anatomical region identity, even though its pretraining contains no ictal recordings or anatomical labels.

Abstract: Many physiological time series, such as cardiac and brain recordings, exhibit cyclostationarity: their statistics vary periodically with an underlying cycle phase. Corruption from motion, poor contact, and physiological interference obscures morphology needed for diagnosis, making signal restoration essential. Existing diffusion approaches condition on corrupted observations alone and must learn cyclic structure implicitly. We instead propose two inductive biases which encode cyclostationarity: a shift-covariant wavelet representation and dense per-sample phase conditioning inferred from the corrupted input. We further introduce a training-free cyclostationarity index that quantifies phase structure and predicts when phase conditioning will help. Finally, we propose antithetic coupling of reverse trajectories to reduce sampling variance while achieving comparable performance with fivefold fewer network evaluations. Across modalities, our results show that explicitly encoding measurable cyclic structure improves physiological time-series restoration.

Abstract: Foundation models are increasingly adapted to individual users, but an apparent personalization gain can simply reflect a stronger population model. This distinction matters for brain-computer interfaces, where every new user must be calibrated. We evaluated personal adaptation of three frozen EEG foundation models (CBraMod, REVE and LaBraM) in 235 held-out subjects from three motor-imagery datasets, comparing each subject's adapter with the population model and with adapters fitted to other subjects. Using all first-half session labels, personal adapters improved mean balanced accuracy over the population model by 1.5-5.4 percentage points and outperformed exchanged adapters by 2.3-7.3 points in all nine model-dataset combinations. The size of this benefit depended on population training: with four times the original budget, median gains remained positive (1.0-2.0 points) but were smaller for every model, and no population model reached a confirmed plateau. Acquiring the benefit cheaply was unreliable: few-label calibration was consistently non-negative on only one dataset, and in CBraMod neither unlabeled context nor meta-learned initialization outperformed matched controls. Personalization should therefore be evaluated against both a population reference and exchanged parameters, across population-training budgets.

Abstract: Safe robot-assisted ultrasound imaging requires a reliable controller able to detect and localize probe--tissue interaction. In this paper, we present a B-mode ultrasound image-based contact perception method and a contact-aware impedance controller for robotic ultrasound imaging. The proposed method detects acoustic contact independently of force measurements, enabling contact-conditioned force/torque taring to reduce residual wrench bias. During contact, the method continuously estimates the effective contact location along the curved probe surface and uses it to update the controller interaction frame, enabling visual servoing of the physical probe--tissue contact point during imaging. Experiments on an agar phantom demonstrated a contact-localization RMSE of $\mathbf{1.46 \pm 0.14}$~mm over probe roll angles from $\mathbf{-15^\circ}$ to $\mathbf{15^\circ}$. During static rolling, the proposed controller maintained task-space tracking accuracy comparable to a conventional fixed-frame impedance controller while reducing the maximum compressive interaction force from $\mathbf{31.56}$~N to $\mathbf{20.09}$~N, corresponding to a $\mathbf{36.3\%}$ reduction. These results demonstrate the potential of ultrasound images as direct contact feedback for safe and accurate robot-assisted ultrasound imaging.

Abstract: Rapid advances in humanoid robotics have motivated growing interest in the application of humanoids for healthcare and clinical tasks. However, it remains unclear how close contemporary humanoids are to meeting the kinematic demands of robot-assisted laparoscopic surgery. In this work, we address the question of optimal robot positioning through a quantitative analysis of workspace and robot setup configurations. We present a capability-map-based robot setup framework that optimizes humanoid base placement and tool mounting orientation to maximize bimanual humanoid reachability while accounting for tool-tip kinematics and remote-center-of-motion (RCM) constraints. We evaluate three humanoid platforms spanning different body dimensions and kinematic redundancy on workspace reachability for three representative general surgery procedures: cholecystectomy, inguinal hernia repair, and sleeve gastrectomy. The proposed joint optimization of base placement and tool mounting consistently outperforms base-only optimization and heuristic baselines. For cholecystectomy and inguinal hernia repair, which are characterized by relatively small and minimally overlapping workspaces, humanoid reachability approached 90%. For the larger, overlapping multi-port arm workspace of sleeve gastrectomy, humanoids yield substantially lower coverage. These results quantify the near-term promise of humanoids for selected laparoscopic procedures and clarify key limitations that must be addressed for broader deployment.

Abstract: Brain-computer interfaces (BCIs) have emerged as transformative technologies that enable direct communication between the brain and external devices. Among various BCI paradigms, EEG-based motor imagery (MI) has gained prominence due to its simplicity, non-invasiveness, and potential to restore motor function and facilitate rehabilitation for patients with motor impairments. This paper presents a comprehensive review of the most practical processing algorithms developed over the past decade for decoding brain sensorimotor cortex signals. Specifically, this paper discusses the integration of artificial intelligence (AI)-based algorithms, particularly machine learning and deep learning techniques, and their contributions to improving the performance and efficiency of MI-BCI systems in detail. Furthermore, the paper reviews state-of-the-art hardware platforms and emerging converging technologies, including system-on-chip (SoC) architectures, application-specific integrated circuits (ASICs), field-programmable gate arrays (FPGAs), wearable devices, the Internet of Things (IoT), and augmented/virtual reality (AR/VR), and discusses their integration with advanced signal processing algorithms to enable next-generation MI-BCI systems. By highlighting current achievements of EEG-based MI-BCI technology and predicting future research directions that could further enhance real-time capabilities, this paper aims to provide valuable insights for researchers and practitioners, fostering innovation in high-performance EEG-based MI-BCI systems.

Abstract: Deep Differentiable Logic Gate Networks (LGNs) and Lookup Table Networks (LUTNs) offer a promising approach for very low power inference due to their use of simple binary logic operations instead of arithmetic. In this work, we generalize the logic gates of LGNs to more than two input pins, naturally arriving at networks consisting of $N$-input LUTs. To obtain a differentiable expression for training the $N$-LUT entries, we adopt the Boolean equation of a $2^N$:1 multiplexer (MUX) and optimize its input parameters during training. We investigate the applicability of LGNs and LUTNs to inter-patient ECG arrhythmia classification using the MIT-BIH data set. The proposed models achieve up to 94.41\% accuracy and a $jκ$ index of 0.683 on a four-class task, showing a competitive performance compared to existing CNN-, SVM- and SNN-based methods. Our LGNs and LUTNs only require an estimated 2.89k to 6.17k FLOPs, including preprocessing and readout, which is three to six orders of magnitude less than state-of-the-art methods. We verified our design, which consists of the preprocessing pipeline and a 6-LUTN classifier, by implementing it on a Xilinx Zynq-7000 ZedBoard. The complete system consumes a dynamic energy of 8.25 $μ$J/inference, of which only 0.46 nJ is utilized by the LUTN classifier. These results show that both LGNs and LUTNs can be employed as lightweight hardware-based classifiers for inter-patient ECG arrhythmia classification.

Abstract: Ultrasound (US) acquisition depends on the operator's ability to interpret anatomy and anticipate how the view will change with probe motion. Many robotic US navigation methods select actions without explicitly predicting these anatomical changes. We propose SonoGraph-WM, an action- and goal-conditioned world model for anticipatory probe navigation. The model represents anatomy as scene graphs (SGs), capturing visible structures, their geometry, and spatial relationships without synthesizing US images. Given a history of SGs and probe poses, a unified Transformer jointly predicts future SGs and poses. A receding-horizon planner recursively imagines candidate trajectories, selects the shortest predicted path reaching a goal graph, and follows it over a short execution horizon before replanning from new observations. To reduce reliance on tracked and anatomically annotated US sequences, we generate aligned SG--pose training data from computed tomography (CT) label maps along surface-constrained probe trajectories. On four held-out CT cases, spatial relation F1 remains above 93% over 20 prediction steps, and closed-loop navigation achieves 77.50% and 75.00% success for the gallbladder and pancreas, respectively, using annotation-derived SGs. In robot--phantom navigation experiments with label-map-derived SGs, the planner reached the target view in 73.7% of trials. These findings support CT-supervised anatomical world modeling for probe planning and highlight the importance of frequent observation updates for reliable navigation. Project Page: https://noseefood.github.io/us-sonograph-wm/

Abstract: The utility of flexible continuum mechanisms for dexterous navigation is often impaired by their low stiffness, making them ineffective at manipulation in high-force scenarios. To address this challenge, we propose a novel continuum mechanism that achieves both flexible and rigid behavior by antagonistic extension and contraction of a rod-driven continuum helical structure. The helical design combines variable-length capacity with force locking for workspace and stiffness enhancement. In this article, we present the detailed design of the proposed mechanism and characterize its performance through experiments that quantify bending and stiffness. The results demonstrate 180 degree bending range of motion with an average distal positioning error of <10%. Further tests demonstrate that force locking directly improves axial stiffness and thus indirectly increases bending stiffness anisotropically, with maximum bending stiffness along load paths with a large axial component. Tensioning the driving rods provides additional stiffness tunability in the force-locked state, where increasing rod tension proportionally increases bending stiffness with a dimensionless gain of 0.56.

Abstract: Performing complex medical procedures with continuum robots requires careful selection of their geometric design parameters. The robot should have high dexterity in the specific anatomical environment of its procedure. This work presents a design optimization method that considers both dexterity and anatomy. We introduce the Reachable Volumetric Dexterous Solid Angle (RVDSA) metric as our objective, which measures the ability of a robot's end effector to reach the points in a goal volume from different directions via collision-free paths from a start configuration. We present a computationally efficient motion planner to compute this objective function for a given robotic design, and we use an asymptotically optimal simulated annealing optimizer to compute an optimized design. We applied our new method to optimize the design of a bimanual dexterous sheaths robot for performing procedures on cancerous polyps in colon anatomies, achieving a 78% higher RVDSA on average than optimizing for 3D voxel coverage alone.

Abstract: Optimizing fMRI scan duration and spatial resolution is critical for experimental design, yet traditional correlation-based approaches cannot quantify uncertainty or disentangle scanner measurement noise from true neural variability across subjects. Without principled uncertainty bounds, researchers cannot know whether a protocol is long enough to reliably estimate connectivity, or whether between-subject differences reflect biological variation or noise. We present a Bayesian framework modeling BOLD dynamics as coupled Ornstein-Uhlenbeck processes, using Sequential Neural Posterior Estimation to obtain connectivity posteriors while accounting for frequency-independent measurement noise across the BOLD spectrum. Applied to N = 28 healthy controls (55 scans) at 7T using a functional network atlas (65 DMN regions), the framework quantifies uncertainty across its sources: scanner noise, subject variability, and acquisition length. Spatial analysis identifies a mean of 46 voxels per ROI, roughly half of typical region sizes, as sufficient to achieve 90% of asymptotic precision. At the single-subject level, 7T reaches its within-session precision plateau in approximately 7 minutes versus 10 minutes for 3T, a 40% reduction in required scan time, providing the first direct, model-based quantification of the scan-time advantage conferred by higher field strength. At the population level, 3T requires roughly 37 times more per-subject scan time than 7T for the pooled curves to converge, confirming a consistent advantage of higher field strength at every timescale. Together these findings provide concrete, scanner-specific guidance for protocol optimization, with direct implications for reducing acquisition costs and improving the reliability of connectivity-based clinical biomarkers. We provide code enabling researchers to derive these bounds from their own data.

Abstract: Ultrasound imaging increasingly targets portable, point-of-care, and wearable settings where constraints on power, bandwidth, and hardware complexity often necessitate sparse data acquisition in spatiotemporal scanning. However, image reconstruction using the sparse data can introduce insufficient phase information in coherent beamforming process, resulting in grating-lobe artifacts that degrade imaging contrast resolution. We present a physics-guided, data-driven framework for sparse-to-dense radio-frequency (RF) reconstruction that aligns training with downstream image formation. Our approach trains an end-to-end interpolation network using a hybrid supervision scheme that combines an RF-domain and a beamforming-domain loss with exponential moving average (EMA) to stabilize the multi-objective training. To improve generalization under variable acquisition layouts, we also introduce a random-skip masking strategy that varies sparsity patterns during training so a single model can handle diverse decimation factors and irregular channel configurations. We evaluate the framework on a held-out test set using the mean structural similarity index measure (SSIM) between reconstructed and ground-truth beamformed images. Across decimation factors $\times 2$ to $\times 13$, the best-performing configuration maintains mean SSIM around 0.95. Overall, the results show consistent gains in RF reconstruction and post-beamforming image quality across diverse acquisition conditions. This approach enables robust, high-quality ultrasound imaging at resource-constrained settings by allowing more sparse scanning in spatiotemporal domain.

Abstract: Electrocardiography (ECG) contains subject-specific morphology that supports biometric recognition, yet image-based performance depends on how the waveform is rendered. We introduce representative-morphology heatmaps, a deterministic ECG-to-image representation adapted from ECGXtractor. Within each block of ten aligned beats, the five beats closest to the block mean are averaged into a 400 by L matrix and rendered either as a conventional trace or as a dense cardiac-time-by-lead heatmap. Since both representations contain identical physiological samples, their comparison isolates the effect of rendering. We evaluate verification and closed-set identification on PTB, ECG-ID, and MIMIC-IV-ECG-DEMO. Five compact models, including ZACH-ViT, are trained from scratch, while six ImageNet-pretrained CNN and transformer backbones assess model scale and visual transfer. Heatmaps improve both FNMR operating points and both identification ranks in all 15 compact model-dataset comparisons, while EER improves in 14. Across the matched experiments, EER decreases by 9.59 percentage points and Rank-1 increases by 24.69 points on average. ConvNeXt-Tiny reaches 2.43% EER on PTB and 5.79% on ECG-ID, whereas DeiT-Base reaches 14.92% on MIMIC-DEMO. ImageNet initialization clearly benefits the two multilead datasets but has a mixed effect on ECG-ID, and performance does not increase monotonically with model size. The best heatmap systems approach the strongest signal-domain EER on PTB and ECG-ID, while DeiT-Base provides the strongest evaluated performance on MIMIC-DEMO. Lead-channel ablation further shows that useful channel combinations depend on the cohort and biometric task. Overall, representative-morphology heatmaps provide an effective image representation for ECG verification and identification.

Abstract: PPG-to-vital-sign reconstruction turns a wrist-worn photoplethysmogram into clinical waveforms such as the ECG. Long-horizon multivariate time-series forecasting underpins planning in energy, weather, and traffic. Both generate a target sequence from a condition sequence, and current models hard-code where each target position reads it, as a same-position copy or seasonal recurrence, so neither transfers between tasks. We propose ROOSTER, one conditioning module that handles vital-sign reconstruction and time-series forecasting alike by learning this correspondence. Its core is a periodic-comb bias over the target-condition offset whose center, period, and sharpness are learned per head, so one module settles on the identity alignment or a seasonal lag and reports which it found. On vital-sign reconstruction from PPG, ROOSTER outperformed the published baselines on four heart-rate and respiratory-rate benchmarks. On multivariate time-series forecasting, it achieved the best horizon-averaged MSE on four benchmarks and outperformed the forecasting model it extends on 20 of 24 dataset-horizon settings under matched three-seed training. An ablation study indicated that the relative bias, not content matching, carried the alignment.

Abstract: Surgical robots require highly dexterous and compact robotic systems capable of operating effectively within confined anatomical spaces. However, due to limited access provided by a single incision, the miniaturization and maneuverability of these robots still need to be improved. In this paper, we propose the design and modeling of a single-port three-arm robotic tool containing one major cannula (7.14 mm outer diameter (OD)) and three steerable minor cannulas (1.93 mm OD). By integrating the proposed 12 degrees-of-freedom (DoFs) steerable robotic tool with a 7-DoF robotic arm, this robotic system can potentially achieve multi-arm manipulation capability. We present the design of the steerable robotic tool consisting of tendon-driven joints controlled by a compact actuation system, derive the kinematic model, and validate both the static and kinematic models through experiments. The performance is evaluated with the root mean square error (RMSE) and mean absolute error (MAE) computed between the experimental data and the kinematic model.

Abstract: Scattered light is common in biomedical images, yet its removal remains challenging. The difficulty arises from three aspects: first, aligned scattered-light-free biomedical ground truth is often unavailable; second, scattering is coupled with weak illumination and sensor-induced noise; and third, many learning-based restoration models are computationally expensive for embedded devices in Internet of Medical Things (IoMT) scenarios. To address these issues, this paper proposes PP-Net, a hybrid physical-prior neural network for biomedical scattered light removal. The proposed method consists of three components: DFN-Net suppresses sensor-induced noise, ASAP estimates the scattering map and recovers a physics-based prior map, and GF-Net refines the prior map by fusing it with the denoised observation. To reduce the dependence on paired biomedical ground truth, a progressive synthetic training and cross-domain transfer strategy is developed. Experiments show that the physical-prior branch improves the peak signal-to-noise ratio (PSNR) by up to 1.26 dB on paired synthetic benchmarks. Under joint noise-and-scattering degradation, PP-Net improves PSNR by more than 10.8 dB and the structural similarity index measure (SSIM) by more than 0.62 compared with representative baseline methods. On real W2S biomedical images, the proposed method reduces the average Natural Image Quality Evaluator (NIQE) score by 43.3\%. Edge deployment with RKNN conversion and INT8 quantization achieves an average inference latency of approximately 200 ms per $512\times512$ image over 360 test images. These results demonstrate that PP-Net provides an effective and deployable solution for microscopic imaging, endoscopic inspection, and edge-assisted biomedical analysis in IoMT scenarios.

Abstract: Tendon-driven continuum manipulators are widely used in medical applications, where accurate tip-position estimation is essential for precise navigation and instrument positioning. However, patient anatomy and procedural setup impose task-dependent unknown shaft configurations, while friction, slack, and compliance introduce hysteresis, making tip estimation challenging. This paper presents a motor-history-conditioned gated recurrent unit (GRU) residual estimator for three-dimensional catheter tip estimation without direct shaft-configuration sensing. First, an initial multidirectional sweep strategy is applied to calibrate a geometric catheter model backbone, and encode the motor-angle and drive-torque response into a shaft-configuration context vector. During subsequent motion, the context conditions a GRU that predicts a task-space residual correcting this backbone, relying on motor measurements alone. The context remains fixed for the current shaft configuration, while the recurrent state captures the evolving actuation history. Across four disposable intra-cardiac echocardiography catheters and 16 bent shaft configurations, the method achieves 3.3mm open-loop tip RMSE, a 59% reduction relative to the constant-curvature baseline.

Abstract: Cosserat rod models for soft robots usually construct sectional stiffness by summing material properties over a common cross-section. This assumption becomes inaccurate for trimmed helicoid arms, where load-bearing helix domains are separated and connected only through sparse fused crossings. This paper formulates a separated-section constitutive law that evaluates each helix domain in its local frame and pulls its constitutive response back to the backbone, yielding an effective backbone stiffness. Sparse-fusion mechanics captures the additional compliance caused by relative motion between neighboring domains and determines channel-wise reduction profiles $η_c(s/L)$ for bending, torsion, and extension. The resulting effective sectional stiffness is strongly anisotropic: bending and extension are reduced by about one order of magnitude, whereas torsion remains close to the effective backbone stiffness. The resulting sectional law is embedded in a geometrically exact dynamic Cosserat model with GVS discretization and routed-tendon actuation. Across 103 measured configurations, the three datasets give pooled normalized position errors of \SI{7.7}{\percent}, \SI{6.7}{\percent}, and \SI{7.8}{\percent}, while each full-arm solve requires approximately \SI{0.3}{s} on one CPU core (Intel Xeon, Cascade Lake, \SI{2.8}{GHz}), enabling rapid model-based planning, state and load estimation, and morphology--control co-design for architected soft robots.

Abstract: Electroencephalography (EEG) provides non-invasive monitoring of brain activity and is widely used in emotion recognition, motor imagery and sleep staging. Although within-subject decoding has achieved considerable progress, cross-subject generalization remains a central challenge in practical applications. EEG decoders are typically trained with Adam/AdamW under a fixed second-moment decay coefficient, even though cross-subject learning involves low signal-to-noise ratios, subject variability, and gradient nonstationarity. A fixed coefficient implicitly assumes that gradient statistics are homogeneous across layers and time, which can limit model's adaptability to cross-subject EEG signals and degrade generalization. To address these issues, we propose AFOR, a tensor-wise adaptive optimizer that converts the fixed second-moment decay coefficient into a dynamic coefficient estimated online from local gradient state. AFOR combines a Residual-Alignment Signal Scorer (RASS) and an Adaptive Forgetting Controller (AFC). RASS summarizes local gradient residuals and directional agreement into a signal-quality score, and AFC maps this score through self-referential normalization to a bounded per-step decay coefficient, with cumulative-product initialization correction maintaining consistency under time-varying decay. Under a strict cross-subject protocol on three EEG benchmarks that cover three representative fields, AFOR achieves the best average performance among the compared optimizers, improving the mean test accuracy over Adam by 3.00%, 2.07%, and 4.38%, respectively.

Abstract: Pretrained EEG foundation models are increasingly proposed as general-purpose encoders for brain-computer interfaces, yet recent benchmarks disagree about when their representations transfer to downstream tasks. We audit LaBraM and CBraMod on motor imagery under a validation-locked protocol in which preprocessing, architecture, optimization, freeze depth, checkpoint, temperature, and method selection are determined using training-session data only. On four-class BCI Competition IV-2a, every supervised comparator evaluated here outperforms every foundation-model configuration, including validation-selected fine-tuning. We then examine a key confound: foundation models and task-specific decoders are normally evaluated using different input pipelines. Retraining three supervised architectures on the broadband arrays consumed by the foundation models produces matched-input accuracy differences of opposite sign across architectures: broadband input improves ATCNet by 0.078 accuracy while reducing EEG Conformer accuracy by 0.088. None of the three individual matched-input terms is significant after multiple-comparison correction at n = 9, so we treat the sign variation descriptively rather than as a formal architecture-by-pipeline interaction. These observed sign differences suggest that a single comparator may not provide an architecture-invariant decomposition of a pretrained-versus-supervised performance gap. The four-class deficit also does not reproduce uniformly across motor-imagery datasets: on two-class BNCI2014-004 we cannot detect the same separation between fine-tuned CBraMod and the supervised comparators. Finally, validation-fitted temperature scaling returns foundation-model calibration error to the supervised range despite substantially lower four-class accuracy.

Abstract: Counterfactual simulation with a clinical world model means fixing a patient's history, changing the treatment, and reading off the predicted response. Doing so requires deciding what counts as one intervention. In clinical settings, interventions are documented as bundles: a co-occurrence audit of 945,707 patient-hours from MIMIC-IV shows groups of components, such as every parameter of a dialysis circuit, that never appear apart, so an edit that changes one component on its own describes an hour that never occurs in the data. We hypothesize that the granularity at which an intervention is edited changes how a world model responds, and test this with Clin-JEPA, a latent world model of patient trajectories conditioned on hourly treatment text. At 1,019 documented onsets of invasive ventilation, we keep the patient's history and other treatments fixed and compare editing one ventilator setting with editing the complete configuration recorded for a real patient with the most similar recent trajectory. The complete bundle moves the predicted next state further than any single setting, consistently across all five settings, and the difference remains after accounting for how much each edit changes the model's input. Intervention granularity therefore materially affects the response of a clinical world model: single-component edits may understate treatment sensitivity, and bundle-aware editing may offer a better-supported basis for counterfactual treatment simulation.

Abstract: Background and Objective: Colonoscopy recording practice preserves text reports and still photographs, while the spatial information already present in the recorded video - where the scope traveled, where a lesion was observed, and whether the same lesion was seen again - is discarded when the procedure ends. This study determines whether a lesion-centered spatial record can be assembled and validated without full-colon 3D reconstruction. Methods: A four-layer hierarchical pipeline was assembled - (1) a global topological map, (2) lesion-level spatio-temporal tracks, (3) on-demand local 3D reconstruction, and (4) persistent lesion identity across repeated observations - and ran end to end on four public videos (two C3VDv2 sequences with ground-truth depth and two full REAL-Colon procedures; 40,245 frames). All components are published, individually validated methods; the contribution is their lesion-centered assembly, linking rules, and evaluation. Results: Revisits, impossible under forward-only mapping by construction, were detected by entry-map Bayesian localization: 5,614 and 4,043 revisit events (56 and 68 distinct nodes) in the two full procedures. Lesion-identity merging at the adopted threshold 0.5 maintained ground-truth purity 1.0 while auto-merging 20 of 231 candidate pairs. The endoscopy-specific geometry engine outperformed a general-purpose foundation model on all metrics (overall absolute relative error (AbsRel) 0.2276 vs. 0.3523). Conclusions: The results are partial but establish a concrete near-term path: revisit detection, lesion identity, and local 3D each returned quantitative, reproducible output without waiting for complete geometric reconstruction; validating the record on clinical data is the next step.

Abstract: Video Capsule Endoscopy (VCE) is a non-invasive medical examination that allows for the observation of the small intestine, which is otherwise difficult to access. A fundamental challenge persists in the form of their limited size in order to still be swallowable. The resulting restricted battery capacity, however, contradicts with the power-intensive nature of image capture and transmission. Therefore, we propose CapsuleMotion, a patient-specific dynamic capsule behavior that utilizes the available energy in a goal-oriented manner to increase the likelihood of a complete screening of the gastrointestinal tract. By investigating and combining metrics from the on-device image compression, CapsuleMotion predicts the motion between two successive frames. The camera's frame rate will be modified in accordance with the predicted magnitude of motion. Furthermore, prior to entering the small intestine, the capsule operates in a low power mode with a significantly reduced frame rate. In this mode, the LocalizationNet is employed to determine the current organ, provided that motion was predicted. The proposed framework is evaluated on the Rhode Island VCE dataset and deployed on an ultra-low power single-core RISC-V demonstrator with an integrated hardware accelerator. CapsuleMotion demonstrated the capability to reduce electric energy consumption by up to 20.66% in comparison with conventional capsules that lack a dynamic frame rate. Additionally, the accuracy of detecting the entry point of the small intestine has been improved.

Abstract: The multimode fiber is among the thinnest imaging conduits available, carrying hundreds to thousands of spatial modes through a cross-section comparable to a human hair, but its endoscopic capabilities are currently limited by the sensitivity of the transmission matrix to the fiber's deformed state. Proximal-only recovery of the fiber's transmission matrix is an appealing approach for enabling general use multimode fiber endoscopy, and within the last decade, machine learning techniques have been applied to both single-ended and double-ended transmission matrix recovery tasks. We present a new approach to this interdisciplinary problem and show that neural networks can generalize to recover transmission matrices of an arbitrarily deformed graded-index multimode fiber from proximal measurements alone.

Abstract: Schizophrenia is a serious psychiatric disorder that affects millions of people worldwide, and its diagnosis remains primarily dependent on clinical assessment. Electroencephalography (EEG) provides a non-invasive approach to investigate brain activity and has shown potential to support automated Schizophrenia detection. However, existing EEG-based classification studies often suffer from limitations including small datasets, inconsistent preprocessing strategies, and evaluation protocols that may not adequately prevent subject-related data leakage. In this study, we propose an EEG-based Schizophrenia classification framework that transforms preprocessed EEG recordings into time-frequency representations using the Short-Time Fourier Transform. The generated spectrogram images are classified using both conventional Machine Learning algorithms, including Support Vector Machines, Random Forests, and XGBoost, and Deep Learning models, including convolutional architectures and CNN-Transformer hybrids. To ensure reliable evaluation, all data partitions are performed at the subject level. Experimental results demonstrate that the proposed approach achieves competitive classification performance, with the CNN-Transformer (CT-SZ) model achieving an AUC-ROC of 88.41% and the CNN + Squeeze and Excitation + Transformer (CST-SZ) achieving an AUC-ROC of 92.88% on the independent test set.

Abstract: Three-dimensional ultrasound (US) is a safe, radiation-free complementary modality to CT and X-rays for longitudinal monitoring, yet its segmentation-derived partial point clouds are extremely artifact-laden. Consequently, it is challenging to recover a clean and complete anatomical structure from such US point clouds. In this paper, we present UBone3D, a novel framework based on physics-rectified conditional flow matching (CFM) that performs point cloud completion directly from partial US observations. UBone3D models deterministic physics artifacts (e.g., surface thickening, streaking, dropouts) via a simulated physics proxy, and introduces test-time physics rectification to steer the shape completion. At inference, the completion is jointly steered by two decoupled forces: (1) anatomical plausibility enforced by a CT-trained generative shape prior, BoneFM, and (2) physics consistency enforced by USimNet in the ultrasound formation space. Extensive experiments on simulated and in-vivo data demonstrate significant improvements in reconstruction accuracy and anatomical fidelity over existing baselines.

Abstract: Morphology of the sub-basal nerve plexus (SNP) reflects peripheral nerve health, and corneal confocal microscopy (CCM) provides an important means for in vivo, real-time, non-invasive observation of the SNP. However, mainstream CCM devices offer a limited field of view per frame, whereas the SNP is spatially non-uniform; discrete image sampling is therefore sensitive to sampling location and frame selection, which limits the reproducibility and clinical adoption of CCM as a quantitative assessment tool. Wide-field stitching can reconstruct larger SNP mosaics by integrating sequentially acquired CCM images, but existing methods largely rely on offline post-processing, additional hardware, or specific acquisition protocols, and lack open-source real-time solutions for conventional CCM video streams. This paper presents CRISP (Corneal confocal microscopy Real-time Image Stitching Pipeline), an open-source real-time SNP wide-field stitching framework for conventional CCM examination video streams. CRISP excludes defocused and discontinuous segments via focus-aware gating, propagates poses through local pairwise registration, and maintains non-redundant spatial coverage with a sparse anchor map; when local temporal continuity is interrupted, the system completes relocalization and subgraph merging through global appearance retrieval followed by geometric verification. The framework prioritizes low-latency coverage feedback during examination while outputting accepted frames, poses, and anchor information to initialize offline fine stitching. To our knowledge, CRISP is the first open-source real-time SNP wide-field stitching framework released for conventional CCM video streams. By lowering the barrier to adoption and reproduction of wide-field stitching, CRISP may help move SNP wide-field imaging from a research tool into routine clinical examination workflows.

Abstract: As medical wearables become integrated into daily chronic disease care, effectively interpreting longitudinal monitoring data is essential for patients and clinicians to understand health trends, detect safety-critical events, and make informed decisions. While large language models (LLMs) show promise for transforming this streaming physiological data into personalized health insights, evaluating their reasoning capability and analytical rigor in diverse monitoring tasks remains a fundamental challenge. Existing medical wearable question answering (QA) benchmarks primarily assess short-horizon classification or statistical summaries, largely ignoring the long-term patterns, therapeutic and behavioural contexts, and potential system failures inherent in real-world deployments. To address this, we introduce HealthLoopQA, a comprehensive diagnostic benchmark for evaluating LLM reasoning over continuous diabetes monitoring data. Grounded in a novel taxonomy of eleven atomic reasoning abilities, HealthLoopQA comprises 127 tasks and over 1,500 QA instances spanning process mining, anomaly detection, and prediction over 30-day horizons. To systematically evaluate safety awareness, we complement real-world datasets with a fault-injected simulation testbed modeling diverse device malfunctions and cyber-physical attacks to generate physiologically plausible hazard scenarios. Evaluating state-of-the-art LLMs across prompting and agentic frameworks reveals severe limitations in complex temporal pattern mining. Furthermore, we identify a broader phenomenon of In-context Laziness under long-context prompting, highlighting critical open challenges in deploying LLMs for rigorous long-horizon medical reasoning.