medical device integrators

Abstract: Pneumonia changes across respiration, inflammation, and organ function, while the measurements that describe it arrive at different times and are often incomplete. We introduce PULMOWORLD, a world model for longitudinal pneumonia dynamics that connects asynchronous state estimation, recursive simulation, and evidence-constrained planning. History-aware filtering separates state propagation from observation-driven correction, so a measurement updates the shared belief only when it is observed. That belief supports recursive forecasts of clinical values and modality representations, and summaries of future prognosis. Cap-MBRL searches imagined continuations inside an authorized action set and replaces a frozen fallback only when a candidate meets the risk budget and a predicted-cost margin. On the pneumonia cohort MASS, recursive forecasts are competitive with task-trained sequence models, and simulated future states retain prognostic information. Trained separately on public MIMIC-IV-CXR chest radiographs and clinical trajectories, this model improves prognostic discrimination over latest-value fusion in development and is competitive on long-horizon error on the locked pneumonia panel. In five known-mechanism MASS-Syn environments, Cap-MBRL lowers selection regret relative to direct fallback execution.

Abstract: Efficient and robust tracking of surgical robotic instruments is important for robot-assisted minimally invasive surgery, yet remains challenging due to the complexity of surgical scenes and the unconventional geometry of surgical instruments. Keypoint-based approaches are efficient, but their performance depends on reliable feature detection. Improving these detectors with real-world supervision is difficult because accurate real-world annotations are costly to obtain at scale. To address this limitation, we introduce a tracker-guided self-training framework that adapts a model pretrained on synthetic images to unlabeled real-world videos. Given measured robot joint states, an uncertainty-aware EKF recursively corrects the instrument pose and the observable joint angles by comparing projected model features with detected keypoints, shaft boundaries, and mask-derived cues. An RTS smoother subsequently refines the resulting trajectory, which is projected into pseudo-labels for fine-tuning the feature detector without laborious pose annotations. Experiments on real-world videos demonstrate consistent improvements from self-training across all evaluated keypoint metrics, and the resulting model outperforms prior approaches in both accuracy and runtime. The code and data will be released upon publication.

Abstract: The Model Context Protocol (MCP) provides a common interface through which AI applications discover and use external resources and tools. It allows language-model agents to ground their reasoning in current system state and interact with heterogeneous services. In medical environments, however, exposing device state and action affordances requires deterministic constraints on possible effects. We present an IEEE 11073 Service-Oriented Device Connectivity (SDC)-to-MCP gateway that exposes metrics, alarms, context references, and semantic metadata as read-only resources, while representing selected action affordances as policy-validated dry-run tools. The term safety-bounded denotes a narrow no-execution property: agent-facing requests dispatch no SDC device operation. A Python prototype supports simulated fault and lifecycle experiments, a software-reference protocol path spanning independent Java and Python implementations, deterministic baselines, representation ablations, and multi-model agent evaluation. The results show semantically explicit resource exposure, visible rejection of invalid or outdated state, and preservation of the no-execution boundary across resource, proposal, and authorization paths. Explicit semantic metadata improved conformity to required metric identifiers in structured alarm outputs relative to a generic representation, while retained structured-output failures reveal a distinction between plausible narrative answers and task-compliant machine-readable results.

Abstract: Radiology AI systems increasingly inform clinical decisions such as triage, follow-up imaging, and treatment planning. For these decisions to be made safely, model outputs must be well calibrated, meaning predicted probabilities accurately reflect true risk. Many standard techniques for improving calibration, such as MC Dropout and Deep Ensembles, require access to model parameters or retraining. However, proprietary clinical AI systems operate as black boxes, preventing access to the model's internals. To that end, we propose a model-agnostic framework for improving calibration of black-box models using clinically grounded test-time augmentation (TTA). Our framework applies geometric and physics-inspired 3D CT perturbations and learns probability-level aggregation strategies without access to model internals or the original training data. Across pulmonary embolism and intracranial hemorrhage detection tasks, DualTTA achieved the strongest overall calibration among TTA methods, reducing the Expected Calibration Error by 54% (0.239 -> 0.109) and 43% (0.051 -> 0.029), respectively, while requiring only input-output access. Additionally, DualTTA outperformed uncertainty estimation techniques that require access to model internals, such as Temperature Scaling, MC Dropout, and Deep Ensembles, in most calibration metrics. These results demonstrate that learned TTA aggregation can improve the calibration of clinical AI systems, providing a practical approach for improving the reliability of black-box medical AI.

Abstract: This paper presents SurgicalRoomAgent, a voice-interactive multi-agent system for smart operating rooms based on large language models (LLMs). The system achieves natural language understanding, device control, intraoperative recording, and surgical report generation through a layered architecture comprising a voice interaction pipeline (wake, ASR, turn detection, agent reasoning, TTS) and an agent core (skill registry, task planner, device manager). Three key technologies are investigated: (1) KV Cache prefix warming for low-latency inference, reducing recomputation overhead from approximately 500 ms to tens of milliseconds via byte-level Longest Common Prefix reuse; (2) streaming partial JSON parsing with early parallel task execution, reducing end-to-end latency by approximately 30%; and (3) progressive skill prompt disclosure, which dynamically filters system prompts based on user role, connected devices, and surgical phase to maximize information density within limited context windows. The system is implemented using the Qwen3-27B model with llama.cpp/sglang inference engines. Experimental analysis demonstrates effective operation within a 16,384-token context limit and multi-device parallel control response times meeting OR real-time requirements.